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Sample records for access appointment system

  1. Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?

    Science.gov (United States)

    Frost, Lucy; Jenkins, Louis S; Emmink, Benjamin

    2017-03-30

    Access to health services is one of the Batho Pele ('people first') values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000 outpatient visits monthly, with non-attendance rates of up to 40%. The aim of this research was to gain a greater understanding of the reasons behind non-attendance of outpatient department clinics to allow locally driven, targeted interventions. This was a descriptive study. We attempted to phone all patients who missed appointments over a 1-month period (n = 574). Only 20% were contactable with one person declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had incorrect numbers, 2% had died and 42% did not respond to three attempts. The main reasons for non-attendance included unaware of appointment date (16%), out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport (6%). Only 9% chose to miss their appointment. The other 24% had various reasons. Improved patient awareness of appointments, adjustments in referral systems and enabling appointment cancellation if indicated would directly improve over two-thirds of reasons for non-attendance. Understanding the underlying causes will help appointment planning, reduce wasted costs and have a significant impact on patient care.

  2. Pengaruh Appointment Registration System terhadap Waktu Tunggu dan Kepuasan Pasien

    Directory of Open Access Journals (Sweden)

    Yuli Susanti

    2015-02-01

    Full Text Available Abstrak Peningkatan derajat kesehatan dapat dicapai melalui kemudahan akses terhadap fasilitas kesehatan. Peningkatan peserta pada program Jaminan Kesehatan Nasional (JKN mengakibatkan antrian panjang di sarana pelayanan kesehatan. Penelitian ini bertujuan untuk menganalisis pengaruh metode appointment registration system (ARS terhadap waktu tunggu dan kepuasan pasien. Metode penelitian yang digunakan adalah survei dengan sampel 380 orang dan observasi pada bulan Desember 2014 di RS Al-Islam Bandung. Analisis menggunakan structural equation modeling (SEM dan production operation management-quantitative methods (POMQM. Hasil penelitian diperoleh kondisi pelaksanaan ARS (60,7%, waktu tunggu (59,1%, dan kepuasan pasien (67,3% termasuk dalam kategori cukup. Terdapat pengaruh positif dan signifikan ARS terhadap waktu tunggu (51,84%, pengaruh positif dan signifikan waktu tunggu terhadap kepuasan pasien (25%, dan total pengaruh ARS terhadap kepuasan pasien (16,79%. ARS dapat menurunkan waktu tunggu secara efektif tetapi tidak semua metode ARS dapat menurunkan waktu tunggu. Simpulan, pasien RS Al-Islam Bandung merasa cukup puas terhadap pendaftaran appointment dan waktu tunggu. Kata kunci: Appointment registration system, kepuasan pasien, waktu tunggu   The Influence of Outpatient Appointment Registration System to Waiting Time and Patient Satisfications Abstract Health improvement can be achieved through accessibility to health services. An increased participants in the Health Insurance Program (HIP resulted in a long queue in the hospital. This research aim was to analize influence of appointment registration system (ARS to waiting time and patient satisfaction. Research method using patient satisfaction survey in 380 subjects and observation on December 2014 at Al-Islam Bandung Hospital. The result was analyzed using structural equation modeling (SEM and production operation management-quantitative methods (POMQM. The results showed that the

  3. Enhanced Leads and Appointment System

    Data.gov (United States)

    Social Security Administration — The data asset contains information on current or upcoming appointments, individuals who will be attending the appointment, potential intent to file a claim (lead),...

  4. Qualitative Study of Foster Caregivers’ Views on Adherence to Pediatric Appointments

    Science.gov (United States)

    Schneiderman, Janet U.; Kennedy, Andrea K.; Sayegh, Caitlin S.

    2016-01-01

    clinic environment that encourages adherence to health care appointments. This environment is an organized clinic with easy access including parking, engaged pediatric health providers, ability to reschedule appointments when necessary, and an individualized and consistent appointment reminder system. PMID:27291938

  5. An Effective Outpatient Appointment System for General Leonard Wood Army Community Hospital

    Science.gov (United States)

    1990-07-13

    collection, donated many hours. She asked patients about the appointment system and personally observed clinic personnel. Additionally, as a consumer ...appointment system which must satisfy both the demands 0of external ( patients ) and internal (physicians) customers . At the o0 C 0 same time, the...its health care environment. A variable that can effect patient flow is centralization or decentralization of the registration and appointment system

  6. Measuring Chemotherapy Appointment Duration and Variation Using Real-Time Location Systems.

    Science.gov (United States)

    Barysauskas, Constance M; Hudgins, Gina; Gill, Katie Kupferberg; Camuso, Kristen M; Bagley, Janet; Rozanski, Sheila; Kadish, Sarah

    Clinical schedules drive resource utilization, cost, and patient wait time. Accurate appointment duration allocation ensures appropriate staffing ratios to daily caseloads and maximizes scarce resources. Dana-Farber Cancer Institute (DFCI) infusion appointment duration is adjusted by regimen using a consensus method of experts including pharmacists, nurses, and administrators. Using real-time location system (RTLS), we examined the accuracy of observed appointment duration compared with the scheduled duration. Appointment duration was calculated using RTLS at DFCI between August 1, 2013, and September 30, 2013. Duration was defined as the total time a patient occupied an infusion chair. The top 10 administered infusion regimens were investigated (n = 805). Median observed appointment durations were statistically different than the scheduled durations. Appointment durations were shorter than scheduled 98% (C), 95% (I), and 75% (F) of the time and longer than scheduled 77% (A) and 76% (G) of the time. Fifty-six percent of the longer than scheduled (A) appointments were at least 30 minute longer. RTLS provides reliable and unbiased data to improve schedule accuracy. Replacing consensus with system-based data may improve clinic flow, relieve staff stress, and increase patient satisfaction. Further investigation is warranted to elucidate factors that impact variation in appointment duration.

  7. Appointment scheduling on computer.

    Science.gov (United States)

    Mercando, A D

    1997-07-01

    The program is well-written, intuitive, and easy to use once initial data, such as the available appointment slots, has been entered. While the effort may not seem worthwhile initially, the ability to access an office appointment book from several locations simultaneously and the reporting capabilities of the software make MEDSched a useful addition to any busy office practice or clinic. Please send your comments and suggestions to me at adm4@columbia.edu.

  8. Nonattendance to medical specialists’ appointments and its relation to regional environmental and socioeconomic indicators in the Chilean public health system

    Directory of Open Access Journals (Sweden)

    Elizabeth Angélica Salinas Rebolledo

    2014-10-01

    Full Text Available INTRODUCTION Medical care provided by medical specialists is one of the scarcest resources in the public system. It is costly and difficult to access for the general population. Availability and accessibility of specialized care is related to economic, social and cultural aspects that vary among geographical areas. An aggravating factor for this situation is patients’ failure to appear on the date of their appointment, which is defined as the nonattendance of patients to medical specialist appointments without notice. OBJECTIVES To measure and analyze the phenomenon of nonattendance of patients to medical appointments with specialists in the public healthcare system of Chile and its relationship with environmental and socioeconomic regional indicators. METHODS Ecological design study, using medical care records in the public system and environmental and socioeconomic regional indicators potentially related to the absence of patients, between the years 2005-2010. Poisson regression models with random components were used for assessing associations. RESULTS There is 16.5% of nonattendance of patients, with a range between regions from 8.8 to 20.2%. Nonattendance is higher in the specialties of dermatology, geriatrics and nutrition (20.0%, in children (3.1% more than in adults, in areas with highest indigenous population (RR=1.3, in areas with low diversity of specialties (RR=1.1 and in the months of February, July, November and December (RR>1.1. CONCLUSIONS In Chile, socioeconomic factors and the management of healthcare resources have greater influence on the nonattendance of patients to medical specialists’ appointments than environmental factors; therefore, this phenomenon may be avoidable.

  9. Appointment length, psychiatrists' communication behaviors, and medication management appointment adherence.

    Science.gov (United States)

    Cruz, Mario; Roter, Debra L; Cruz, Robyn F; Wieland, Melissa; Larson, Susan; Cooper, Lisa A; Pincus, Harold Alan

    2013-09-01

    The authors explored the relationship between critical elements of medication management appointments (appointment length, patient-centered talk, and positive nonverbal affect among providers) and patient appointment adherence. The authors used an exploratory, cross-sectional design employing quantitative analysis of 83 unique audio recordings of split treatment medication management appointments for 46 African-American and 37 white patients with 24 psychiatrists at four ambulatory mental health clinics. All patients had a diagnosis of depression. Data collected included demographic information; Patient Health Questionnaire-9 scores for depression severity; psychiatrist verbal and nonverbal communication behaviors during medication management appointments, identified by the Roter Interaction Analysis System during analysis of audio recordings; and appointment adherence. Bivariate analyses were employed to identify covariates that might influence appointment adherence. Generalized estimating equations (GEEs) were employed to assess the relationship between appointment length, psychiatrist patient-centered talk, and positive voice tone ratings and patient appointment adherence, while adjusting for covariates and the clustering of observations within psychiatrists. Wald chi square analyses were used to test whether all or some variables significantly influenced appointment adherence. GEE revealed a significant relationship between positive voice tone ratings and appointment adherence (p=.03). Chi square analyses confirmed the hypothesis of a positive and significant relationship between appointment adherence and positive voice tone ratings (p=.03) but not longer visit length and more patient-centered communication. The nonverbal conveyance of positive affect was associated with greater adherence to medication management appointments by depressed patients. These findings potentially have important implications for communication skills training and adherence research.

  10. A web-based appointment system to reduce waiting for outpatients: a retrospective study.

    Science.gov (United States)

    Cao, Wenjun; Wan, Yi; Tu, Haibo; Shang, Fujun; Liu, Danhong; Tan, Zhijun; Sun, Caihong; Ye, Qing; Xu, Yongyong

    2011-11-22

    Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (Pweb-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

  11. Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population

    Science.gov (United States)

    Sewell, Justin L.; Kushel, Margot B.; Inadomi, John M.; Yee, Hal F.

    2009-01-01

    Goals We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Background Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. Study We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, California. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. 1,833 patients were referred and scheduled for an appointment between 05/2005 and 08/2006. Prisoners were excluded. All patients had a primary care provider. Results 683 patients (37.3%) missed their appointment; 1,150 (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment (adjusted odds ratio 0.42 [0.28,0.63] for Spanish, 0.56 [0.38,0.82] for Asian language, p gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access. PMID:19169147

  12. Disruption management for truck appointment system at a container terminal

    DEFF Research Database (Denmark)

    Li, N.; Chen, Gang; Jin, Z.

    2016-01-01

    -appointed arrivals at a container terminal that is running an appointment system. Second, we propose some response strategies to cope with different levels of disruptions, and evaluate their resilience ability with two Key Performance Indicators (KPIs): total waiting time of on-time trucks and total idling emissions...... of all trucks, in order to balance the service quality to punctual arrivals and green performance of the whole system. Third, we conduct a sensitivity analysis using a discrete event simulation to understand the performance of the proposed strategies. Considering both KPIs, the best strategy in most......-crane moving distance, especially when the first KPI is given lower weight than the second one....

  13. 10 CFR 1045.33 - Appointment of restricted data management official.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Appointment of restricted data management official. 1045... DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.33 Appointment of restricted data management official. (a) Each agency with access to RD or FRD shall...

  14. Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda.

    Science.gov (United States)

    Kalyango, Joan Nakayaga; Hall, Maurice; Karamagi, Charles

    2014-01-01

    Proper management of chronic diseases is important for prevention of disease complications and yet some patients miss appointments for medical review thereby missing the opportunity for proper monitoring of their disease conditions. There is limited information on missed appointments among chronic disease patients in resource limited settings. This study aimed to determine the prevalence of missed appointments for medical review and associated factors among chronic disease patients in an urban area of Uganda. Patients or caregivers of children with chronic diseases were identified as they bought medicines from a community pharmacy. They were visited at home to access their medical documents and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients. The prevalence of missed appointments was 42% (95%CI = 35-49%). The factors associated with missed appointments were: monthly income ≤30US Dollars (OR = 2.56, CI = 1.25-5.26), affording less than half of prescribed drugs (OR = 3.92, CI = 1.64-9.40), not experiencing adverse events (OR = 2.66, CI = 1.26-5.61), not sure if treatment helps (OR = 2.84, CI = 1.047.77), not having a medicines administration schedule (OR = 6.77, CI = 2.11-21.68), and increasing number of drugs (OR = 0.72, CI = 0.53-0.98). Patients missed appointments mainly due to: financial and health system barriers, conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services.

  15. Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles.

    Science.gov (United States)

    McLean, Sionnadh Mairi; Booth, Andrew; Gee, Melanie; Salway, Sarah; Cobb, Mark; Bhanbhro, Sadiq; Nancarrow, Susan A

    2016-01-01

    Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. "Reminder plus", which provides additional information beyond the reminder function may be more effective than simple reminders (ie, date, time, place) at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their health care appointment. The choice of reminder system should be tailored to the individual service

  16. Improving Health Care Accessibility: Strategies and Recommendations.

    Science.gov (United States)

    Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Access time refers to the interval between requesting and actual outpatient appointment. It reflects healthcare accessibility and has a great influence on patient treatment and satisfaction. King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia studied the accessibility to outpatient services in order to develop useful strategies and recommendations for improvement. Utilized, unutilized and no-show appointments were analyzed. It is crucial to manage no-shows and short notice appointment cancellations by preparing a waiting list for those patients who can be called in to an appointment on the same day using an open access policy. An overlapping appointment scheduling model can be useful to minimize patient waiting time and doctor idle time in addition to the sensible use of appointment overbooking that can significantly improve productivity.

  17. Modeling Patient No-Show History and Predicting Future Outpatient Appointment Behavior in the Veterans Health Administration.

    Science.gov (United States)

    Goffman, Rachel M; Harris, Shannon L; May, Jerrold H; Milicevic, Aleksandra S; Monte, Robert J; Myaskovsky, Larissa; Rodriguez, Keri L; Tjader, Youxu C; Vargas, Dominic L

    2017-05-01

    Missed appointments reduce the efficiency of the health care system and negatively impact access to care for all patients. Identifying patients at risk for missing an appointment could help health care systems and providers better target interventions to reduce patient no-shows. Our aim was to develop and test a predictive model that identifies patients that have a high probability of missing their outpatient appointments. Demographic information, appointment characteristics, and attendance history were drawn from the existing data sets from four Veterans Affairs health care facilities within six separate service areas. Past attendance behavior was modeled using an empirical Markov model based on up to 10 previous appointments. Using logistic regression, we developed 24 unique predictive models. We implemented the models and tested an intervention strategy using live reminder calls placed 24, 48, and 72 hours ahead of time. The pilot study targeted 1,754 high-risk patients, whose probability of missing an appointment was predicted to be at least 0.2. Our results indicate that three variables were consistently related to a patient's no-show probability in all 24 models: past attendance behavior, the age of the appointment, and having multiple appointments scheduled on that day. After the intervention was implemented, the no-show rate in the pilot group was reduced from the expected value of 35% to 12.16% (p value < 0.0001). The predictive model accurately identified patients who were more likely to miss their appointments. Applying the model in practice enables clinics to apply more intensive intervention measures to high-risk patients. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  18. Scheduling rules to achieve lead-time targets in outpatient appointment systems

    OpenAIRE

    Sivakumar, Appa Iyer; Nguyen, Thu Ba Thi; Graves, Stephen C

    2015-01-01

    This paper considers how to schedule appointments for outpatients, for a clinic that is subject to appointment lead-time targets for both new and returning patients. We develop heuristic rules, which are the exact and relaxed appointment scheduling rules, to schedule each new patient appointment (only) in light of uncertainty about future arrivals. The scheduling rules entail two decisions. First, the rules need to determine whether or not a patient's request can be accepted; then, if the req...

  19. Managing patient demand: a qualitative study of appointment making in general practice.

    Science.gov (United States)

    Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

    2001-04-01

    Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

  20. 48 CFR 245.7001 - Selection, appointment, and termination.

    Science.gov (United States)

    2010-10-01

    ... REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Appointment of Property... officers, the appointment authority shall consider experience, training, education, business acumen, judgment, character, and ethics. ...

  1. Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles

    Directory of Open Access Journals (Sweden)

    McLean SM

    2016-04-01

    Full Text Available Sionnadh Mairi McLean,1 Andrew Booth,2 Melanie Gee,3 Sarah Salway,2 Mark Cobb,4 Sadiq Bhanbhro,3 Susan A Nancarrow5 1Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK; 2School of Health and Related Research, University of Sheffield, Sheffield, UK; 3Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK; 4Therapeutics & Palliative Care, Sheffield Teaching Hospitals, Sheffield, UK; 5School of Health and Human Science, Southern Cross University, East Lismore, NSW, Australia Abstract: Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and

  2. Shared medical appointments: improving access, outcomes, and satisfaction for patients with chronic cardiac diseases.

    Science.gov (United States)

    Bartley, Kelly Bauer; Haney, Rebecca

    2010-01-01

    Improving access to care, health outcomes, and patient satisfaction are primary objectives for healthcare practices. This article outlines benefits, concerns, and possible challenges of shared medical appointments (SMAs) for patients and providers. The SMA model was designed to support providers' demanding schedules by allowing patients with the same chronic condition to be seen in a group setting. By concentrating on patient education and disease management, interactive meetings provide an opportunity for patients to share both successes and struggles with others experiencing similar challenges. Studies demonstrated that SMAs improved patient access, enhanced outcomes, and promoted patient satisfaction. This article describes the potential benefits of SMAs for patients with chronic heart disease, which consumes a large number of healthcare dollars related to hospital admissions, acute exacerbations, and symptom management. Education for self-management of chronic disease can become repetitive and time consuming. The SMA model introduces a fresh and unique style of healthcare visits, allowing providers to devote more time and attention to patients and improve productivity. The SMA model provides an outstanding method for nurse practitioners to demonstrate their role as a primary care provider, by leading patients in group discussions and evaluating their current health status. Patient selection, preparation, and facilitation of an SMA are discussed to demonstrate the complementary nature of an SMA approach in a healthcare practice.

  3. The impact of case mix on timely access to appointments in a primary care group practice.

    Science.gov (United States)

    Ozen, Asli; Balasubramanian, Hari

    2013-06-01

    At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the impact of the size and case-mix on the ability of a multi-provider practice to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician practice as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a practice: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test practices created using patient level data from the primary care practice at Mayo Clinic, Rochester, Minnesota. An important advantage of our approach is that it can be implemented in an Excel Spreadsheet and used for aggregate level planning and panel management decisions.

  4. Developing a measure of patient access to primary care: the access response index (AROS).

    NARCIS (Netherlands)

    Elwyn, G.; Jones, W.; Rhydderch, S.M.; Edwards, P.

    2003-01-01

    Access to appointments in primary care is not routinely measured, and there is no one standardized method for doing so. Any measurement tool has to take account of the dynamic status of appointment availability and the definitional problems of appointment types. The aim of this study was to develop

  5. Predicting appointment breaking.

    Science.gov (United States)

    Bean, A G; Talaga, J

    1995-01-01

    The goal of physician referral services is to schedule appointments, but if too many patients fail to show up, the value of the service will be compromised. The authors found that appointment breaking can be predicted by the number of days to the scheduled appointment, the doctor's specialty, and the patient's age and gender. They also offer specific suggestions for modifying the marketing mix to reduce the incidence of no-shows.

  6. Improving access for patients – a practice manager questionnaire

    Directory of Open Access Journals (Sweden)

    Brown James S

    2006-06-01

    Full Text Available Abstract Background The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. Methods A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. Results There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256 had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006, urban practices (p Conclusion The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study.

  7. Appointment Template Redesign in a Women's Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency.

    Science.gov (United States)

    Huang, Y; Verduzco, S

    2015-01-01

    Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. This study was conducted in a Women's Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate.

  8. Audiologist-patient communication profiles in hearing rehabilitation appointments.

    Science.gov (United States)

    Meyer, Carly; Barr, Caitlin; Khan, Asaduzzaman; Hickson, Louise

    2017-08-01

    To profile the communication between audiologists and patients in initial appointments on a biomedical-psychosocial continuum; and explore the associations between these profiles and 1) characteristics of the appointment and 2) patients' decisions to pursue hearing aids. Sixty-three initial hearing assessment appointments were filmed and audiologist-patient communication was coded using the Roter Interaction Analysis System. A hierarchical cluster analysis was conducted to profile audiologist-patient communication, after which regression modelling and Chi-squared analyses were conducted. Two distinct audiologist-patient communication profiles were identified during both the history taking phase (46=biopsychosocial profile, 15=psychosocial profile) and diagnosis and management planning phase (45=expanded biomedical profile, 11=narrowly biomedical profile). Longer appointments were significantly more likely to be associated with an expanded biomedical interaction during the diagnosis and management planning phase. No significant associations were found between audiologist-patient communication profile and patients' decisions to pursue hearing aids. Initial audiology consultations appear to remain clinician-centred. Three quarters of appointments began with a biopsychosocial interaction; however, 80% ended with an expanded biomedical interaction. Findings suggest that audiologists could consider modifying their communication in initial appointments to more holistically address the needs of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Appointment breaking: causes and solutions.

    Science.gov (United States)

    Bean, A G; Talaga, J

    1992-12-01

    From a review of research on health care appointment breaking, the authors find that patient demographic characteristics, psychosocial problems, previous appointment keeping, health beliefs, and situational factors predict no-show behavior. Suggestions are offered for designing the marketing mix to increase patient appointment keeping. Methods for mitigating the negative effects of no-shows on health care providers are described.

  10. 38 CFR 13.55 - Veterans Service Center Manager to select and appoint or recommend for appointment the person or...

    Science.gov (United States)

    2010-07-01

    ... Manager to select and appoint or recommend for appointment the person or legal entity to receive....55 Veterans Service Center Manager to select and appoint or recommend for appointment the person or.... The Veterans Service Center Manager is authorized to select and appoint (or in the case of a court...

  11. Approximate dynamic programming approaches for appointment scheduling with patient preferences.

    Science.gov (United States)

    Li, Xin; Wang, Jin; Fung, Richard Y K

    2018-04-01

    During the appointment booking process in out-patient departments, the level of patient satisfaction can be affected by whether or not their preferences can be met, including the choice of physicians and preferred time slot. In addition, because the appointments are sequential, considering future possible requests is also necessary for a successful appointment system. This paper proposes a Markov decision process model for optimizing the scheduling of sequential appointments with patient preferences. In contrast to existing models, the evaluation of a booking decision in this model focuses on the extent to which preferences are satisfied. Characteristics of the model are analysed to develop a system for formulating booking policies. Based on these characteristics, two types of approximate dynamic programming algorithms are developed to avoid the curse of dimensionality. Experimental results suggest directions for further fine-tuning of the model, as well as improving the efficiency of the two proposed algorithms. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Significant Factors Related to Failed Pediatric Dental General Anesthesia Appointments at a Hospital-based Residency Program.

    Science.gov (United States)

    Emhardt, John R; Yepes, Juan F; Vinson, LaQuia A; Jones, James E; Emhardt, John D; Kozlowski, Diana C; Eckert, George J; Maupome, Gerardo

    2017-05-15

    The purposes of this study were to: (1) evaluate the relationship between appointment failure and the factors of age, gender, race, insurance type, day of week, scheduled time of surgery, distance traveled, and weather; (2) investigate reasons for failure; and (3) explore the relationships between the factors and reasons for failure. Electronic medical records were accessed to obtain data for patients scheduled for dental care under general anesthesia from May 2012 to May 2015. Factors were analyzed for relation to appointment failure. Data from 3,513 appointments for 2,874 children were analyzed. Bivariate associations showed statistically significant (Pgeneral anesthesia face specific barriers to care.

  13. Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals

    NARCIS (Netherlands)

    Kortbeek, Nikky; Zonderland, Maartje E.; Braaksma, Aleida; Vliegen, Ingrid M. H.; Boucherie, Richard J.; Litvak, Nelly; Hans, Erwin W.

    2014-01-01

    We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the

  14. Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals

    NARCIS (Netherlands)

    Kortbeek, Nikky; Zonderland, Maartje Elisabeth; Boucherie, Richardus J.; Litvak, Nelli; Hans, Elias W.

    2011-01-01

    We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the

  15. On appointment of Courts presidents - some open questions

    Directory of Open Access Journals (Sweden)

    Mijo Galiot

    2014-01-01

    Full Text Available In their paper, the authors analyse the legal position of the judiciary within the framework of the separation of powers in the Republic of Croatia, as well as the procedure of the election of the members and president, and the scope and manner of operation of the State Judiciary Council on a principal level. The authors especially deal with and analyse the 2010 constitutional changes and the State Judiciary Council Act from 2010 (SJCA, which introduced significant novelties in the appointment of presidents of courts in the normative and institutional sense as well as in practical applications. Separately, an integral historical overview is given of the appointment of presidents of courts from the gaining of Croatian independency until the SJCA became effective, as well as a comparative overview of the manner of appointment of presidents of courts in elected, related European legal systems. Moreover, the authors break down and analyse the procedures of the appointment of presidents of courts with a special reference to each phase. Here, special emphasis is given to the candidate valuation manner and criteria and the legal protection of candidates after the decision on appointment, both in the normative sense and in practice, all this accompanied by authors’ suggestions de lege ferenda.

  16. "Nudge" and the epidemic of missed appointments.

    Science.gov (United States)

    Aggarwal, Ajay; Davies, Joanna; Sullivan, Richard

    2016-06-20

    Purpose - Missed appointments constitute a significant problem in the UK National Health Service (NHS) and this remains an area where improvements could yield substantial efficiency savings. The purpose of this paper is to suggest that nudge policies based on behavioural theories may help target interventions to improve patient motivation to attend appointments. Design/methodology/approach - The authors propose two policies to reduce missed appointments. The first attempts to empower patients through making the appointment system more individualised to them and utilising their intrinsic feelings of social responsibility. The second policy utilises a financial commitment given by the patient at the time of booking. The different mechanisms of influencing patient behaviour are based on two different views of what motivates individuals' actions. The first policy is based on individuals being "knights". They are altruistic and have well-intentioned values. The second policy option is constructed on the premise that an individual is governed by self-interest, and they are in fact "knaves". Findings - A policy, which avoids the use of financial penalties is likely to be more culturally acceptable within the NHS. It could also prevent the phenomenon of "crowding out" whereby the desire to act dutifully gets displaced by the motivation to avoid incurring a monetary fine. Originality/value - Testing both strategies would provide insight into patient attitudes towards health care and society. This would help optimise behavioural strategies which may influence not only appointment attendances but also have wider implications for encouraging rational health care consumption.

  17. 5 CFR 9901.511 - Appointing authorities.

    Science.gov (United States)

    2010-01-01

    ... 9901.511 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT OF DEFENSE-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF DEFENSE NATIONAL SECURITY... these authorities will be given career, career conditional, term or temporary appointments in the...

  18. 5 CFR 316.402 - Procedures for making temporary appointments.

    Science.gov (United States)

    2010-01-01

    ... appointments. Such appointments are not VRA appointments and do not lead to conversion to career-conditional appointment; (3) Career-conditional appointment under § 315.601, 315.604, 315.605, 315.606, 315.607, 315.608... the General Accounting Office; (6) Appointment under 28 U.S.C. 602 for current and former employees of...

  19. Getting patients in the door: medical appointment reminder preferences.

    Science.gov (United States)

    Crutchfield, Trisha M; Kistler, Christine E

    2017-01-01

    Between 23% and 34% of outpatient appointments are missed annually. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive health care services. Missed appointments result in unnecessary costs and organizational inefficiencies. Appointment reminders may help reduce missed appointments; particular types may be more effective than other types. We used a survey with a discrete choice experiment (DCE) to learn why individuals miss appointments and to assess appointment reminder preferences. We enrolled a national sample of adults from an online survey panel to complete demographic and appointment habit questions as well as a 16-task DCE designed in Sawtooth Software's Discover tool. We assessed preferences for four reminder attributes - initial reminder type, arrival of initial reminder, reminder content, and number of reminders. We derived utilities and importance scores. We surveyed 251 adults nationally, with a mean age of 43 (range 18-83) years: 51% female, 84% White, and 8% African American. Twenty-three percent of individuals missed one or more appointments in the past 12 months. Two primary reasons given for missing an appointment include transportation problems (28%) and forgetfulness (26%). Participants indicated the initial reminder type (21%) was the most important attribute, followed by the number of reminders (10%). Overall, individuals indicated a preference for a single reminder, arriving via email, phone call, or text message, delivered less than 2 weeks prior to an appointment. Preferences for reminder content were less clear. The number of missed appointments and reasons for missing appointments are consistent with prior research. Patient-centered appointment reminders may improve appointment attendance by addressing some of the reasons individuals report missing appointments and by meeting patients' needs. Future research is necessary to determine if preferred reminders used in practice

  20. Improving the patient booking service to reduce the number of missed appointments at East London NHS Foundation Trust Community Musculoskeletal Physiotherapy Service.

    Science.gov (United States)

    Tan, Elizabeth; Shah, Amar; De Souza, Warren; Harrison, Mark; Chettur, Chris; Onathukattil, Maimoona; Smart, Michelle; Mata, Marlon; Chitewe, Auzewell; Binley, Emma

    2017-01-01

    The East London National Health Service Foundation Trust (ELFT) Community Musculoskeletal (MSK) Physiotherapy Service had reported a high rate of non-attendance at scheduled appointments. This was leading to delayed access to treatment for patients and a reduced capacity for service users, as well as a waste of clinical resources. The aim of this quality improvement project was therefore to reduce the percentage of missed appointments within this department. This study was undertaken by the ELFT community MSK service, with support from the ELFT Quality Improvement team. To begin with, patient complaints were explored; these indicated that the main reason for missing appointments was due to issues with the patient booking service. Baseline data were initially collected for both new referrals and follow-up patients. The proposed changes were then introduced, which included text message reminders, first via a manual platform and then via an automated system. Ongoing data were recorded to note the effectiveness of these changes. Following the intervention, non-attendance of newly referred patients reduced by 43.35% (23.76%-13.46%) after both cycles. Non-attendance of follow-up patients reduced by 44.14% (23.74%-13.26%) after the second cycle alone. By listening to the opinions of service users, it was possible to improve the patient booking system and the flexibility of appointments. This resulted in a reduction in the percentage of appointments missed. These changes will continue to be monitored within this department to ensure sustainability but there is also now potential for similar interventions to be trialled in other health service departments.

  1. Impact of Delayed Time to Advanced Imaging on Missed Appointments Across Different Demographic and Socioeconomic Factors.

    Science.gov (United States)

    Daye, Dania; Carrodeguas, Emmanuel; Glover, McKinley; Guerrier, Claude Emmanuel; Harvey, H Benjamin; Flores, Efrén J

    2018-05-01

    The aim of this study was to investigate the impact of wait days (WDs) on missed outpatient MRI appointments across different demographic and socioeconomic factors. An institutional review board-approved retrospective study was conducted among adult patients scheduled for outpatient MRI during a 12-month period. Scheduling data and demographic information were obtained. Imaging missed appointments were defined as missed scheduled imaging encounters. WDs were defined as the number of days from study order to appointment. Multivariate logistic regression was applied to assess the contribution of race and socioeconomic factors to missed appointments. Linear regression was performed to assess the relationship between missed appointment rates and WDs stratified by race, income, and patient insurance groups with analysis of covariance statistics. A total of 42,727 patients met the inclusion criteria. Mean WDs were 7.95 days. Multivariate regression showed increased odds ratio for missed appointments for patients with increased WDs (7-21 days: odds ratio [OR], 1.39; >21 days: OR, 1.77), African American patients (OR, 1.71), Hispanic patients (OR, 1.30), patients with noncommercial insurance (OR, 2.00-2.55), and those with imaging performed at the main hospital campus (OR, 1.51). Missed appointment rate linearly increased with WDs, with analysis of covariance revealing underrepresented minorities and Medicaid insurance as significant effect modifiers. Increased WDs for advanced imaging significantly increases the likelihood of missed appointments. This effect is most pronounced among underrepresented minorities and patients with lower socioeconomic status. Efforts to reduce WDs may improve equity in access to and utilization of advanced diagnostic imaging for all patients. Copyright © 2018. Published by Elsevier Inc.

  2. One-appointment endodontic therapy: biological considerations.

    Science.gov (United States)

    Lin, Louis M; Lin, Jarshen; Rosenberg, Paul A

    2007-11-01

    The authors conducted a literature review to present the best available biological evidence concerning one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. Because of recent advances in technology, such as rotary engines and nickel-titanium instruments, some practitioners are performing one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. The authors reviewed the literature, which revealed only a small number of randomized, controlled clinical trials that have been conducted on one-appointment versus multiple-appointment endodontic therapy. As the apical canal preparation is enlarged, a greater percentage of bacteria is eradicated from infected root canals. In addition, sufficiently large apical root canal enlargement facilitates the delivery of antimicrobial irrigant to the apical portion of the canal. However, an association between positive or negative preobturation root canal culture results and the outcome of endodontic treatment has not been well-established. The best available evidence, based on a systematic literature review, indicates that one-appointment endodontic therapy may be feasible in selected cases of apical periodontitis in asymptomatic teeth. However, additional randomized, controlled clinical trials are required.

  3. 25 CFR 11.610 - Appointment of guardians.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Appointment of guardians. 11.610 Section 11.610 Indians... ORDER CODE Domestic Relations § 11.610 Appointment of guardians. The court shall have the jurisdiction to appoint or remove legal guardians for minors and for persons who are incapable of managing their...

  4. Patients’ Perspective on the Value of Medication Management Appointments

    Directory of Open Access Journals (Sweden)

    Mario Cruz

    2015-05-01

    Full Text Available Objectives: There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients’ views and opinions about the value of psychiatric medication management appointments. Methods: Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients’ views and opinions about the value of attending medication management appointments. Analysis: An iterative thematic analysis was performed. Findings: Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Conclusions: Patients’ perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

  5. Missed or Delayed Medical Care Appointments by Older Users of Nonemergency Medical Transportation

    Science.gov (United States)

    MacLeod, Kara E.; Ragland, David R.; Prohaska, Thomas R.; Smith, Matthew Lee; Irmiter, Cheryl; Satariano, William A.

    2015-01-01

    Purpose of the Study: This study identified factors associated with canceling nonemergency medical transportation appointments among older adult Medicaid patients. Design and Methods: Data from 125,913 trips for 2,913 Delaware clients were examined. Mediation analyses, as well as, multivariate logistic regressions were conducted. Results: Over half of canceled trips were attributed to client reasons (e.g., no show, refusal). Client characteristics (e.g., race, sex, functional status) were associated with cancelations; however, these differed based on the cancelation reason. Regularly scheduled trips were less likely to be canceled. Implications: The evolving American health care system may increase service availability. Additional policies can improve service accessibility and overcome utilization barriers. PMID:24558264

  6. Terminal Appointment System Design by Non-stationary M(t)/Ek/c(t) Queueing Model and Genetic Algorithm

    DEFF Research Database (Denmark)

    Chen, Gang; Govindan, Kannan; Yang, Zhong-Zhen

    2013-01-01

    Long truck queue is a common problem at big marine container terminals, where the resources and equipment are usually scheduled to serve ships prior to trucks. To reduce truck queues, some container terminals adopt terminal appointment system (TAS) to manage truck arrivals. This paper addresses two...

  7. Predicting appointment misses in hospitals using data analytics

    Science.gov (United States)

    Karpagam, Sylvia; Ma, Nang Laik

    2017-01-01

    Background There is growing attention over the last few years about non-attendance in hospitals and its clinical and economic consequences. There have been several studies documenting the various aspects of non-attendance in hospitals. Project Predicting Appoint Misses (PAM) was started with the intention of being able to predict the type of patients that would not come for appointments after making bookings. Methods Historic hospital appointment data merged with “distance from hospital” variable was used to run Logistic Regression, Support Vector Machine and Recursive Partitioning to decide the contributing variables to missed appointments. Results Variables that are “class”, “time”, “demographics” related have an effect on the target variable, however, prediction models may not perform effectively due to very subtle influence on the target variable. Previously assumed major contributors like “age”, “distance” did not have a major effect on the target variable. Conclusions With the given data it will be very difficult to make any moderate/strong prediction of the Appointment misses. That being said with the help of the cut off we are able to capture all of the “appointment misses” in addition to also capturing the actualized appointments. PMID:28567409

  8. 48 CFR 1401.603-3 - Appointment.

    Science.gov (United States)

    2010-10-01

    ... Responsibilities 1401.603-3 Appointment. Purchase card holders may be appointed in writing or in accordance with the bureau/office procedures within the constraints of DOI Integrated Charge Card Program Policy Manual located at http://www.doi.gov/pam/chargecard. Additional guidance is available in the GSA Smart...

  9. Appointment, qualifications and responsibilities of ventilation officers

    International Nuclear Information System (INIS)

    1981-01-01

    The Code provides for the appointment of a ventilation officer when required by the appropriate authority. This guideline offers comment on the appointment, qualifications, training and responsibilities of that person

  10. Factors influencing non-attendance of clinic appointments in ...

    African Journals Online (AJOL)

    without an appointment, with an average of eight patients per day missing their appointment. The low rate of compliance with clinic appointments was of concern for the physicians at both the diabetes clinics. Prior to the current study, the reasons for non-attendance had not been examined. Materials and methods. A sample ...

  11. Improving outpatient access and patient experiences in academic ambulatory care.

    Science.gov (United States)

    O'Neill, Sarah; Calderon, Sherry; Casella, Joanne; Wood, Elizabeth; Carvelli-Sheehan, Jayne; Zeidel, Mark L

    2012-02-01

    Effective scheduling of and ready access to doctor appointments affect ambulatory patient care quality, but these are often sacrificed by patients seeking care from physicians at academic medical centers. At one center, Beth Israel Deaconess Medical Center, the authors developed interventions to improve the scheduling of appointments and to reduce the access time between telephone call and first offered appointment. Improvements to scheduling included no redirection to voicemail, prompt telephone pickup, courteous service, complete registration, and effective scheduling. Reduced access time meant being offered an appointment with a physician in the appropriate specialty within three working days of the telephone call. Scheduling and access were assessed using monthly "mystery shopper" calls. Mystery shoppers collected data using standardized forms, rated the quality of service, and transcribed their interactions with schedulers. Monthly results were tabulated and discussed with clinical leaders; leaders and frontline staff then developed solutions to detected problems. Eighteen months after the beginning of the intervention (in June 2007), which is ongoing, schedulers had gone from using 60% of their registration skills to over 90%, customer service scores had risen from 2.6 to 4.9 (on a 5-point scale), and average access time had fallen from 12 days to 6 days. The program costs $50,000 per year and has been associated with a 35% increase in ambulatory volume across three years. The authors conclude that academic medical centers can markedly improve the scheduling process and access to care and that these improvements may result in increased ambulatory care volume.

  12. Transportation barriers to accessing health care for urban children.

    Science.gov (United States)

    Yang, Serena; Zarr, Robert L; Kass-Hout, Taha A; Kourosh, Atoosa; Kelly, Nancy R

    2006-11-01

    The Texas Children's Hospital Residents' Primary Care Group Clinic provides primary care to urban low-income children. The objective of this cross-sectional study was to investigate the impact of transportation problems on a family's ability to keep an appointment. One hundred eighty-three caregivers of children with an appointment were interviewed. Caregivers who kept their appointment were compared with those who did not with respect to demographic and transportation-related characteristics. Logistic regression modeling predicted caregivers with the following characteristics were more likely not to keep an appointment: not using a car to the last kept appointment, not keeping an appointment in the past due to transportation problems, having more than two people in the household, and not keeping an appointment in the past due to reasons other than transportation problems. Future research should focus on developing interventions to help low-income urban families overcome non-financial access barriers, including transportation problems.

  13. CNPC Appoints Chief Experts for Important Technological Projects

    Institute of Scientific and Technical Information of China (English)

    Zhao Jianzhong

    2006-01-01

    @@ On June 27th, China National Petroleum Corporation (CNPC) held a public recruitment to appoint chief experts in Beijing for its important technological projects, which is the first time for CNPC to appoint chief managers by the means of competitive recruitment. This recruitment covers four projects, such as drilling, logging, geophysical survey and ground engineering with 15 projects. Of those,there are 8 drilling projects, which make up 50 percent of all the important technological projects for public recruitment. CNPC expects to further boost the chief expert responsibility system and promote the research and development (R&D) of technological project on the basis of the public recruitment. The company completes the recruitment following the procedure of making announcement, conducting competitive recruitment and giving publicity. On July 25th, the appointment ceremony was held by CNPC and 15 experts were awarded the certificates. CNPC is entering a new stage for the implementation of the technology and talent strategy for the 11th Five-Year Plan. What's more, a new management mode is taking shape for the technological project and for the construction of technological personnel pool.

  14. Between the Cup and the Lip: Missed Dental Appointments.

    Science.gov (United States)

    Tandon, Sandeep; Duhan, Reena; Sharma, Meenakshi; Vasudeva, Suraj

    2016-05-01

    Missed appointments are an issue which have been very commonly noticed but overlooked in Indian dental society. Almost every dentist, general or specialized, private or public, has faced this problem in routine practice but very less research has been conducted on this issue in Asian countries. The aim of this study was to determine the frequency and distribution of missed dental appointments among children and the reasons behind the non-attendance in department of paediatric and preventive dentistry. Patients under 15 years of age who reported during the period March through August 2014 were included in this study. Attendance data and demographical data for patients was obtained from patient records and the hospital database. The type of treatment patients were to receive was gathered from the appointment diaries of staff, postgraduate students and undergraduates. A structured questionnaire regarding the most frequent reasons given by patients for not attending the scheduled appointment was also prepared. The data were analysed using descriptive analysis. Of the total 2294 patients 886 patients failed to come on their scheduled appointment. Percentage of patients who missed their appointments was 38.6%. A 38.2% of them required primary teeth pulp therapy. No significant differences was found between genders regarding the prevalence of missed dental appointments. Only 40% dentist witnessed that the most common reason for their patients to miss dental appointment was "no leave from school". Illness was the second frequent excuse heard by dentists (5/20= 25%) from their patients and attendants. Missed dental appointment was found to be a common issue in paediatric age group. Counseling and motivation is required to be done at first dental visit to reduce the chances of missed appointment.

  15. Investor Response to Appointment of Female CEOs and CFOs

    NARCIS (Netherlands)

    Scholtens, Lambertus; Brinkhuis, Eline

    2018-01-01

    We study the impact of appointing women to top executive positions from an investor perspective. We analyze whether shareholders value announcement of appointment of women to top positions differently than they do appointment of men. This study uses an international sample of 100 announcements of

  16. Behavioral changes during dental appointments in children having tooth extractions

    Directory of Open Access Journals (Sweden)

    Mariana Gonzalez Cademartori

    2017-01-01

    Full Text Available Background: Tooth extractions are associated with anxiety-related situations that can cause behavioral problems in pediatric dental clinics. Aim: We aimed to describe the behavior of children during tooth extraction appointments, compare it to their behavior in preceding and subsequent dental appointments, and assess the behavioral differences according to gender, age, type of dentition, and reason for extraction. Settings and Design: This was a retrospective study based on information obtained from records of children between 6 and 13 years of age who were cared for at the Dentistry School in Pelotas, Brazil. Materials and Methods: Child behavior was assessed during the dental appointment that preceded the tooth extraction, during the tooth extraction appointment, and in the subsequent dental appointment using the Venham Behavior Rating Scale. Statistical Analysis: Results were analyzed using the Pearson Chi-square and McNemar tests. Results: Eighty-nine children were included. Cooperative behavior prevailed in all the dental appointments. The prevalence of “mild/intense protest” was higher in the tooth extraction appointments than in the previous or subsequent dental appointments (P < 0.001. No significant differences in behavior were detected between the type of dentition (primary or permanent teeth, reason for extraction or gender. Conclusion: In this sample of children treated at a dental school, the occurrence of uncooperative behavior was higher during the tooth extraction appointments than in the preceding and subsequent dental appointments.

  17. Students' Motivation to Access Academic Advising Services

    Science.gov (United States)

    Henning, Marcus A.

    2009-01-01

    The interrelationships between motivation for choosing a program of study, intention to access academic advisors, academic difficulty, and actual appointments with academic advisors were based on student self-reports of motivation and intentions. In addition, academic achievement measures and data on student access to academic advisors were…

  18. Assessment of the Correlation between Appointment Scheduling and Patient Satisfaction in a Pediatric Dental Setup

    Directory of Open Access Journals (Sweden)

    Amar N. Katre

    2014-01-01

    Full Text Available Introduction. The practice of modern pediatric dentistry requires delivery of quality care in combination with adherence to excellent business as well as time management principles. A definite appointment schedule should be presented to the parents on the first or second appointment. More importantly, the prescribed schedule should be followed to the best of the professional abilities of the pediatric dentist. Aims. The aim of the study was to assess the co-relation between appointment scheduling and patient satisfaction in a pediatric dental setup with the objective of understanding the parameters related to appointment scheduling to increase patient satisfaction. Method. A total of 40 patients, who visited the Department of Pediatric and Preventive Dentistry, YMT Dental College & Hospital, for dental treatment were selected on a random basis. A questionnaire with a set of 6 questions with a rating scale of 1–5 to assess the patient satisfaction related to appointment scheduling was prepared. Results. A significant number of the patients were happy with the existing appointment scheduling system barring a few exceptions.

  19. Papike appointed Director of IOM

    Science.gov (United States)

    James Papike was appointed director of the Institute of Meteoritics in the Department of Geology and Presidential Professor at the University of New Mexico, Albuquerque, on July 1, 1990. Papike succeeded Klaus Keil, who moved to the University of Hawaii to direct the Planetary Geoscience Division at the Hawaii Institute of Geosciences.The newly constituted IOM will emphasize planetary volcanic processes through the study of achondritic meteorites, the Moon, and Earth, and the origin of primitive solar system materials and planetary formation through the study of chondritic meteorites.

  20. Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review.

    Science.gov (United States)

    Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

    2016-05-17

    The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. A realist review. MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which will require dedicated primary care resources. Published by the BMJ Publishing Group Limited. For

  1. 25 CFR 11.706 - Appointment and duties of appraiser.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of appraiser. 11.706 Section 11... OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.706 Appointment and duties of appraiser. (a) Upon ordering an estate to be probated, the court shall appoint a disinterested and competent person as an...

  2. Council Appointed Mayors in Spain: Effects on Local Democracy

    Directory of Open Access Journals (Sweden)

    María Jesús García García

    2017-03-01

    Full Text Available This paper deals with the influence of having council appointed mayors on local governments. Five elements of local government systems are considered: the electoral system and its influence on the political composition of the local government; the local government structure and the distribution of functions and powers between mayor and council; the role of political parties; scrutiny of the executive and accountability; and citizen participation. This analysis highlights the effect that a council appointed mayor system has in terms of accountability and legitimacy, transparency and efficiency. KEYWORDS Local government systems, directly elected mayors, local governance, council appointed mayors, Local Government Structure; Political Parties; Citizen Participation; Accountability. El presente artículo toma en consideración los efectos que el sistema de elección del Alcalde tiene sobre la democracia local, basándose en la consideración cinco aspectos: el sistema electoral y su influencia en la composición política de las administraciones locales; la estructura de la administración local y la distribución de funciones entre los alcaldes y el pleno municipal; el papel de los partidos políticos; los mecanismos de control del ejecutivo local y la participación ciudadana. El estudio subraya especialmente la incidencia que el sistema de elección del alcalde por los concejales tiene en relación con los principios de responsabilidad, legitimidad, transparencia y eficiencia de la gestión local. PALABRAS CLAVE Gobierno local, elección directa de los alcaldes, elección indirecta de los alcaldes, estructura del gobierno local, partidos políticos, participación ciudadana, responsabilidad política.

  3. Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study.

    Science.gov (United States)

    Horvath, Monica; Levy, Janet; L'Engle, Pete; Carlson, Boyd; Ahmad, Asif; Ferranti, Jeffrey

    2011-05-26

    Internet portal technologies that provide access to portions of electronic health records have the potential to revolutionize patients' involvement in their care. However, relatively few descriptions of the demographic characteristics of portal enrollees or of the effects of portal technology on quality outcomes exist. This study examined data from patients who attended one of seven Duke Medicine clinics and who were offered the option of enrolling in and using the Duke Medicine HealthView portal (HVP). The HVP allows patients to manage details of their appointment scheduling and provides automated email appointment reminders in addition to the telephone and mail reminders that all patients receive. Our objective was to test whether portal enrollment with an email reminder functionality is significantly related to decreases in rates of appointment "no-shows," which are known to impair clinic operational efficiency. Appointment activity during a 1-year period was examined for all patients attending one of seven Duke Medicine clinics. Patients were categorized as portal enrollees or as nonusers either by their status at time of appointment or at the end of the 1-year period. Demographic characteristics and no-show rates among these groups were compared. A binomial logistic regression model was constructed to measure the adjusted impact of HVP enrollment on no-show rates, given confounding factors. To demonstrate the effect of HVP use over time, monthly no-show rates were calculated for patient appointment keeping and contrasted between preportal and postportal deployment periods. Across seven clinics, 58,942 patients, 15.7% (9239/58,942) of whom were portal enrollees, scheduled 198,199 appointments with an overall no-show rate of 9.9% (19,668/198,199). We found that HVP enrollees were significantly more likely to be female, white, and privately insured compared with nonusers. Bivariate no-show rate differences between portal enrollment groups varied widely according

  4. 39 CFR 5.1 - Establishment and appointment.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Establishment and appointment. 5.1 Section 5.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE COMMITTEES (ARTICLE V) § 5.1 Establishment and appointment. From time to time the Board may establish by resolution...

  5. Endodontic inter-appointment flare-ups: An example of chaos?

    Directory of Open Access Journals (Sweden)

    Poorya Jalali

    2015-01-01

    Full Text Available Introduction: Pain and/or swelling after instrumentation of a root canal constitute a significant complication during endodontic treatment. Despite a large number of articles discussing the causative factors behind endodontic flare-ups, the exact mechanism is still not understood. The Hypothesis: The seemingly irrational behavior of endodontic inter-appointment flare-ups may be due to sensitive dependence on initial conditions. A model based on Lorenz′ chaos theory is presented as a possible explanation for the sudden emergence and unpredictability of flare-ups. Evaluation of the Hypothesis: All studies agree on some common traits regarding inter-appointment flare-ups: Careful instrumentation can still cause flare-up; the host inflammatory response behaves as a complex nonlinear network; and also the poly-etiologic nature of this phenomenon all illustrate the sensitive dependence on initial conditions of the system. Integrating more variables (e.g., different species of bacteria into this already complex system will make it increasingly chaotic reflecting its unpredictable behavior.

  6. Reduction of missed appointments at an urban primary care clinic: a randomised controlled study

    Directory of Open Access Journals (Sweden)

    Calmy Alexandra

    2010-10-01

    Full Text Available Abstract Background Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. Methods We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile reminder; 2. If no phone response: a Short Message Service (SMS reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. Results 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122 in the control group and 7.8% (n = 82 in the intervention group (p 1year (OR 2.2; CI: 1.15-4.2, substance abuse (2.09, CI 1.21-3.61, and being an asylum seeker (OR 2.73: CI 1.22-6.09. Conclusion A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders.

  7. Access to surgical assistance: challenges and perspectives

    Directory of Open Access Journals (Sweden)

    Maria Fernanda do Prado Tostes

    2016-01-01

    Full Text Available Objective to characterize the access to surgical assistance in Brazil. Method documentary study, with a quantitative approach, developed from information of the Caixa Preta da Saúde [Health Black Box] database, of the Brazilian Medical Association. Results in the one-year period 3773 cases related to health care in Brazil were recorded. There were 458 (12.3% records on surgical assistance. Of these, most, 339 (74.1%, involved the lack of access in all regions of Brazil. The main access constraint was the prolonged waiting time for surgery. Other constraints were the excessive waiting for medical appointment with experts, doing examinations and cancellation of surgeries. Conclusion the access to surgical assistance, by users of the Brazilian health system, is not widely guaranteed, reinforcing the need for integrated governmental actions, organization of the health care network, management of health care and human resources to overcome the challenges imposed to achieve the Universal Access to Health and Universal Health Coverage.

  8. The Impact of Health Care Appointment Non-Adherence on Graft Outcomes in Kidney Transplantation.

    Science.gov (United States)

    Taber, David J; Fleming, James N; Fominaya, Cory E; Gebregziabher, Mulugeta; Hunt, Kelly J; Srinivas, Titte R; Baliga, Prabhakar K; McGillicuddy, John W; Egede, Leonard E

    2017-01-01

    Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival. The number of transplants that were included in the analysis was 4,646 (3,656 with complete records); 14.6% of patients had an appointment no show rate of ≥12% (non-adherence). Appointment and medication non-adherence were highly correlated and both were significant independent predictors of outcomes. Those with appointment non-adherence had 1.5 times the risk of acute rejection (22.0 vs. 14.7%, p adherence; those with appointment and medication non-adherence were at very high risk of graft loss (aHR 4.18, 95% CI 3.39-5.15, p adherence (aHR 1.39, 95% CI 0.97-2.01, p = 0.0766) or only medication non-adherence (aHR 2.44, 95% CI 2.11-2.81, p adherence to health care appointments is a significant and independent risk factor for graft loss. © 2016 S. Karger AG, Basel.

  9. Appointment attendance at a remote rural dental training facility in Australia.

    Science.gov (United States)

    Lalloo, Ratilal; McDonald, Jenny M

    2013-08-02

    Non-attended appointments have impacts on the operations of dental clinics. These impacts vary from lost productivity, loss of income and loss of clinical teaching hours. Appointment data were analysed to assess the percentage of completed, failed to attend (FTA) and cancelled appointments at an Australian remote rural student dental clinic training facility. The demographic and time characteristics of FTA and cancelled appointments were analysed using simple and multivariate multinomial regression analysis, to inform interventions that may be necessary. Over the 2-year study period a total of 3,042 appointments were made. The percentage of FTA was 21.3% (N = 648) and cancelled appointments 13.7% (N = 418). The odds of an FTA were in excess of 4 times higher in patients aged 19-25 years (OR = 4.1; 95% CI = 2.3-7.3) and 26-35 years (OR = 4.4; 95% CI = 2.5-7.9) compared to patients 65 years and older. The odds of an FTA was 2.3 (95% CI = 1.8-3.1) times higher in public patients compared to private patients. The odds of a cancellation was 1.7 (95% CI = 1.1-2.6) times higher on a Friday compared to a Monday and 1.8 (95% CI = 1.1-2.9) times higher on the last appointment of the day compared to the first appointment. For cancelled appointments, 71.3% were cancelled on the day of the appointment and 16.6% on the day before. Non-attended appointments (FTA or cancelled) were common at this remote rural dental clinic training facility. Efforts to reduce these need to be implemented; including telephonic reminders, educating the community on the importance of attending their appointments, block booking school children and double booking or arranging alternative activities for the students at times when non-attendance is common.

  10. 26 CFR 25.2514-1 - Transfers under power of appointment.

    Science.gov (United States)

    2010-04-01

    ... power of appointment. (a) Introductory. (1) Section 2514 treats the exercise of a general power of... section also treats as a transfer of property the exercise or complete release of a general power of... power of appointment is not treated as a general power of appointment merely by reason of the fact that...

  11. Hans Blix appointed Director General

    International Nuclear Information System (INIS)

    1981-01-01

    On 1 December 1981, Dr Hans Blix took office as Director General of the International Atomic Energy Agency in succession to Dr Sigvard Eklund who has headed the IAEA since 1961. The Agency's Board of Governors nominated Dr Blix by acclamation on 26 September. His appointment was unanimously approved by the final session of the 25th regular session of the General Conference of the IAEA the same day. The President of the Conference, Ambassador Manaspas Xuto, administered the oath of office to Dr Blix at the final plenary meeting that day. Hans Blix was born in 1928 in Uppsala He studied at the University of Uppsala, at Columbia University, where he was also a research graduate and at Cambridge, where he received his Ph D In 1959 he became Doctor of Laws at the Stockholm University and in 1960 was appointed associate professor in international law. From 1963 to 1976 Dr Blix was Head of Department at the Ministry for Foreign Affairs and served as Legal Adviser on International Law. In 1976 he became Undersecretary of State at the Ministry for Foreign Affairs in charge of international development co-operation He was appointed Minister for Foreign Affairs in October 1978 In September 1979 he was again appointed Undersecretary of State at the Ministry for Foreign Affairs in charge of international development co-operation. Since 1961 he has been a member of Sweden's delegation to the United Nations General Assembly, and from 1962 to 1978 a member of the Swedish delegation to the Conference on Disarmament in Geneva. He has written several books on subjects associated with international and constitutional law and was leader of the Liberal Campaign Committee in favour of retention of the Swedish nuclear energy program in the referendum in 1980

  12. Mobile phone messaging reminders for attendance at healthcare appointments.

    Science.gov (United States)

    Car, Josip; Gurol-Urganci, Ipek; de Jongh, Thyra; Vodopivec-Jamsek, Vlasta; Atun, Rifat

    2012-07-11

    Missed appointments are a major cause of inefficiency in healthcare delivery, with substantial monetary costs for the health system, leading to delays in diagnosis and appropriate treatment. Patients' forgetfulness is one of the main reasons for missed appointments, and reminders may help alleviate this problem. Modes of communicating reminders for appointments to patients include face-to-face communication, postal messages, calls to landlines or mobile phones, and mobile phone messaging. Mobile phone messaging applications such as Short Message Service (SMS) and Multimedia Message Service (MMS) could provide an important, inexpensive delivery medium for reminders for healthcare appointments. To assess the effects of mobile phone messaging reminders for attendance at healthcare appointments. Secondary objectives include assessment of patients' and healthcare providers' evaluation of the intervention; costs; and possible risks and harms associated with the intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009). We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, or interrupted time series (ITS) studies with at least three time points before and after the intervention. We included studies assessing mobile phone messaging as reminders for healthcare appointments. We only included studies in which it was possible to assess effects of mobile phone messaging independent of other technologies or interventions.   Two review authors independently assessed all

  13. Email for the coordination of healthcare appointments and attendance reminders.

    Science.gov (United States)

    Atherton, Helen; Sawmynaden, Prescilla; Meyer, Barbara; Car, Josip

    2012-08-15

    Email is a popular and commonly-used method of communication, but its use in health care is not routine. Where email communication has been utilised in health care, its purposes have included the coordination of healthcare appointments and attendance reminders, but the effects of using email in this way are not known. This review considers the use of email for the coordination of healthcare appointments and reminders for attendance; particularly scheduling, rescheduling and cancelling healthcare appointments, and providing prompts/reminders for attendance at appointments. To assess the effects of using email for the coordination of healthcare appointments and attendance reminders, compared to other forms of coordinating appointments and reminders, on outcomes for health professionals, patients and carers, and health services, including harms. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010),and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies of interventions that use email for scheduling health appointments, for reminders for a scheduled health appointment or for ongoing coordination of health appointments and that took the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two review authors independently assessed the titles and abstracts of retrieved

  14. 38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

    Science.gov (United States)

    2010-07-01

    ... and satisfactory reasons are advanced for breaking the appointment and circumstances were such that... unnecessarily breaking appointments. 17.100 Section 17.100 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking...

  15. 25 CFR 140.1 - Sole power to appoint.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Sole power to appoint. 140.1 Section 140.1 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES LICENSED INDIAN TRADERS § 140.1 Sole power to appoint. The Commissioner of Indian Affairs shall have the sole power and authority to...

  16. Mobile phone messaging reminders for attendance at healthcare appointments.

    Science.gov (United States)

    Gurol-Urganci, Ipek; de Jongh, Thyra; Vodopivec-Jamsek, Vlasta; Atun, Rifat; Car, Josip

    2013-12-05

    This review is an update of the original Cochrane review published in July 2012. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs for the health system, leading to delays in diagnosis and appropriate treatment. Patients' forgetfulness is one of the main reasons for missed appointments. Patient reminders may help reduce missed appointments. Modes of communicating reminders for appointments to patients include face-to-face communication, postal messages, calls to landlines or mobile phones, and mobile phone messaging. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), could provide an important, inexpensive delivery medium for reminders for healthcare appointments. To update our review assessing the effects of mobile phone messaging reminders for attendance at healthcare appointments. Secondary objectives include assessment of costs; health outcomes; patients' and healthcare providers' evaluation of the intervention and perceptions of safety; and possible harms and adverse effects associated with the intervention. Original searches were run in June 2009. For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2012, Issue 8), MEDLINE (OvidSP) (January 1993 to August 2012), EMBASE (OvidSP) (January 1993 to August 2012), PsycINFO (OvidSP) (January 1993 to August 2012) and CINAHL (EbscoHOST) (January 1993 to August 2012). We also reviewed grey literature (including trial registers) and reference lists of articles. Randomised controlled trials (RCTs) assessing mobile phone messaging as reminders for healthcare appointments. We only included studies in which it was possible to assess effects of mobile phone messaging independent of other technologies or interventions.   Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third

  17. An investigation into why patients do not attend for out-patient radiology appointments

    International Nuclear Information System (INIS)

    Lyon, Rebecca; Reeves, Pauline J.

    2006-01-01

    Introduction: Patients who do not attend (DNA) for out-patient hospital appointments cause delays in the diagnosis and subsequent treatment of their own, and other patient's, illnesses, with potentially hazardous consequences. This also impacts upon waiting lists. Failure to attend is viewed as a specific type of non-compliance and social cognition theories have been applied to previous studies in an attempt to uncover the reasons why patients choose not to keep their appointments. Methods: A case-control study was conducted throughout the X-ray departments of a District General type of NHS Trust, using telephone interview questionnaires based on the Health Belief Model, in an attempt to identify any significant differences between attenders and non-attenders, so that likely non-attenders could be targeted. Results: Principal reasons for non-attendance were that the patient forgot or that they did not receive their appointment. The results differed from previous research, in that specific health beliefs were not the primary reasons for non-attendance. Departments that gave patients the opportunity to arrange their appointments for a mutually convenient time had exceptionally low DNA rates, as did those which had rigorous confirmation systems in place

  18. Automated detection of follow-up appointments using text mining of discharge records.

    Science.gov (United States)

    Ruud, Kari L; Johnson, Matthew G; Liesinger, Juliette T; Grafft, Carrie A; Naessens, James M

    2010-06-01

    To determine whether text mining can accurately detect specific follow-up appointment criteria in free-text hospital discharge records. Cross-sectional study. Mayo Clinic Rochester hospitals. Inpatients discharged from general medicine services in 2006 (n = 6481). Textual hospital dismissal summaries were manually reviewed to determine whether the records contained specific follow-up appointment arrangement elements: date, time and either physician or location for an appointment. The data set was evaluated for the same criteria using SAS Text Miner software. The two assessments were compared to determine the accuracy of text mining for detecting records containing follow-up appointment arrangements. Agreement of text-mined appointment findings with gold standard (manual abstraction) including sensitivity, specificity, positive predictive and negative predictive values (PPV and NPV). About 55.2% (3576) of discharge records contained all criteria for follow-up appointment arrangements according to the manual review, 3.2% (113) of which were missed through text mining. Text mining incorrectly identified 3.7% (107) follow-up appointments that were not considered valid through manual review. Therefore, the text mining analysis concurred with the manual review in 96.6% of the appointment findings. Overall sensitivity and specificity were 96.8 and 96.3%, respectively; and PPV and NPV were 97.0 and 96.1%, respectively. of individual appointment criteria resulted in accuracy rates of 93.5% for date, 97.4% for time, 97.5% for physician and 82.9% for location. Text mining of unstructured hospital dismissal summaries can accurately detect documentation of follow-up appointment arrangement elements, thus saving considerable resources for performance assessment and quality-related research.

  19. Multi-agent Pareto appointment exchanging in hospital patient scheduling

    NARCIS (Netherlands)

    I.B. Vermeulen (Ivan); S.M. Bohte (Sander); D.J.A. Somefun (Koye); J.A. La Poutré (Han)

    2007-01-01

    htmlabstractWe present a dynamic and distributed approach to the hospital patient scheduling problem, in which patients can have multiple appointments that have to be scheduled to different resources. To efficiently solve this problem we develop a multi-agent Pareto-improvement appointment

  20. Multi-agent Pareto appointment exchanging in hospital patient scheduling

    NARCIS (Netherlands)

    Vermeulen, I.B.; Bohté, S.M.; Somefun, D.J.A.; Poutré, La J.A.

    2007-01-01

    We present a dynamic and distributed approach to the hospital patient scheduling problem, in which patients can have multiple appointments that have to be scheduled to different resources. To efficiently solve this problem we develop a multi-agent Pareto-improvement appointment exchanging algorithm:

  1. 25 CFR 11.704 - Appointment and duties of executor or administrator.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of executor or administrator. 11... executor or administrator. (a) Upon ordering the estate to be probated, the court shall appoint an... be the executor of the estate shall be so appointed, provided such person is willing to serve in such...

  2. 45 CFR 211.5 - Action under State law; appointment of guardian.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Action under State law; appointment of guardian... Action under State law; appointment of guardian. Whenever an eligible person is incapable of giving his... appointment of a legal guardian, to ensure the proper planning for and provision of such care and treatment. ...

  3. 76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

    Science.gov (United States)

    2011-01-14

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 10-2320] Video Programming and Emergency Access Advisory... appointment of members of the Video Programming and Emergency Access Advisory Committee (``Committee'' or... change of the Committee's popular name to the Video Programming Accessibility Advisory Committee (``VPAAC...

  4. Chemotherapy appointment scheduling under uncertainty using mean-risk stochastic integer programming.

    Science.gov (United States)

    Alvarado, Michelle; Ntaimo, Lewis

    2018-03-01

    Oncology clinics are often burdened with scheduling large volumes of cancer patients for chemotherapy treatments under limited resources such as the number of nurses and chairs. These cancer patients require a series of appointments over several weeks or months and the timing of these appointments is critical to the treatment's effectiveness. Additionally, the appointment duration, the acuity levels of each appointment, and the availability of clinic nurses are uncertain. The timing constraints, stochastic parameters, rising treatment costs, and increased demand of outpatient oncology clinic services motivate the need for efficient appointment schedules and clinic operations. In this paper, we develop three mean-risk stochastic integer programming (SIP) models, referred to as SIP-CHEMO, for the problem of scheduling individual chemotherapy patient appointments and resources. These mean-risk models are presented and an algorithm is devised to improve computational speed. Computational results were conducted using a simulation model and results indicate that the risk-averse SIP-CHEMO model with the expected excess mean-risk measure can decrease patient waiting times and nurse overtime when compared to deterministic scheduling algorithms by 42 % and 27 %, respectively.

  5. Single-centre experience with Renal PatientView, a web-based system that provides patients with access to their laboratory results.

    Science.gov (United States)

    Woywodt, Alexander; Vythelingum, Kervina; Rayner, Scott; Anderton, John; Ahmed, Aimun

    2014-10-01

    Renal PatientView (RPV) is a novel, web-based system in the UK that provides patients with access to their laboratory results, in conjunction with patient information. To study how renal patients within our centre access and use RPV. We sent out questionnaires in December 2011 to all 651 RPV users under our care. We collected information on aspects such as the frequency and timing of RPV usage, the parameters viewed by users, and the impact of RPV on their care. A total of 295 (45 %) questionnaires were returned. The predominant users of RPV were transplant patients (42 %) followed by pre-dialysis chronic kidney disease patients (37 %). Forty-two percent of RPV users accessed their results after their clinic appointments, 38 % prior to visiting the clinic. The majority of patients (76 %) had used the system to discuss treatment with their renal physician, while 20 % of patients gave permission to other members of their family to use RPV to monitor results on their behalf. Most users (78 %) reported accessing RPV on average 1-5 times/month. Most patients used RPV to monitor their kidney function, 81 % to check creatinine levels, 57 % to check potassium results. Ninety-two percent of patients found RPV easy to use and 93 % felt that overall the system helps them in taking care of their condition; 53 % of patients reported high satisfaction with RPV. Our results provide interesting insight into use of a system that gives patients web-based access to laboratory results. The fact that 20 % of patients delegate access to relatives also warrants further study. We propose that online access to laboratory results should be offered to all renal patients, although clinicians need to be mindful of the 'digital divide', i.e. part of the population that is not amenable to IT-based strategies for patient empowerment.

  6. Bilevel Fuzzy Chance Constrained Hospital Outpatient Appointment Scheduling Model

    Directory of Open Access Journals (Sweden)

    Xiaoyang Zhou

    2016-01-01

    Full Text Available Hospital outpatient departments operate by selling fixed period appointments for different treatments. The challenge being faced is to improve profit by determining the mix of full time and part time doctors and allocating appointments (which involves scheduling a combination of doctors, patients, and treatments to a time period in a department optimally. In this paper, a bilevel fuzzy chance constrained model is developed to solve the hospital outpatient appointment scheduling problem based on revenue management. In the model, the hospital, the leader in the hierarchy, decides the mix of the hired full time and part time doctors to maximize the total profit; each department, the follower in the hierarchy, makes the decision of the appointment scheduling to maximize its own profit while simultaneously minimizing surplus capacity. Doctor wage and demand are considered as fuzzy variables to better describe the real-life situation. Then we use chance operator to handle the model with fuzzy parameters and equivalently transform the appointment scheduling model into a crisp model. Moreover, interactive algorithm based on satisfaction is employed to convert the bilevel programming into a single level programming, in order to make it solvable. Finally, the numerical experiments were executed to demonstrate the efficiency and effectiveness of the proposed approaches.

  7. New appointment at the IAEA

    International Nuclear Information System (INIS)

    2000-01-01

    The document gives short information on the biography of Professor Dr. Werner Burkart from Germany who was appointed (as of July 2000) as Deputy Director General, Head of the Department of Nuclear Sciences and Applications, IAEA

  8. Access control system operation

    International Nuclear Information System (INIS)

    Barnes, L.D.

    1981-06-01

    An automated method for the control and monitoring of personnel movement throughout the site was developed under contract to the Department of Energy by Allied-General Nuclear Services (AGNS) at the Barnwell Nuclear Fuel Plant (BNFP). These automated features provide strict enforcement of personnel access policy without routine patrol officer involvement. Identification methods include identification by employee ID number, identification by voice verification and identification by physical security officer verification. The ability to grant each level of access authority is distributed over the organization to prevent any single individual at any level in the organization from being capable of issuing an authorization for entry into sensitive areas. Each access event is recorded. As access events occur, the inventory of both the entered and the exited control area is updated so that a current inventory is always available for display. The system has been operated since 1979 in a development mode and many revisions have been implemented in hardware and software as areas were added to the system. Recent changes have involved the installation of backup systems and other features required to achieve a high reliability. The access control system and recent operating experience are described

  9. 7 CFR 1260.145 - Appointment.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE BEEF PROMOTION AND RESEARCH Beef Promotion and Research Order Cattlemen's Beef Promotion and Research Board § 1260.145 Appointment. (a) From...

  10. 7 CFR 1221.103 - Appointment.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum Promotion, Research, and Information Board § 1221.103 Appointment. From the nominations made pursuant to § 1221.101, the Secretary...

  11. 5 CFR 330.1106 - Appointment.

    Science.gov (United States)

    2010-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Federal Employment Priority Consideration Program for Displaced Employees of the... under Public Law 105-274. For employees appointed before October 21, 1998, the conversion will be...

  12. 7 CFR 1280.204 - Appointment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Appointment. 1280.204 Section 1280.204 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... INFORMATION ORDER Lamb Promotion, Research, and Information Order Lamb Promotion, Research, and Information...

  13. Fake passports and appointed communities: Nation and transnationalism in the Danish asylum system

    DEFF Research Database (Denmark)

    Whyte, Zachary

    2003-01-01

    Nationality underwrites a great deal of the Danish asylum process, and of the refugee regime as a whole. The housing and care of asylum seekers, handled by the Danish Red Cross, is based on classifications by nationality. Bending a phrase from Benedict Anderson, these might be called "appointed...... communities". While the Danish asylum system in principle performs individual determination procedures for asylum seekers, granting refugee status on a case-by-case basis, in practice those identified as Iraqi or Afghani have had a very high acceptance rate. However, it is clearly the case that not all asylum...... seekers have citizenship of the countries they claim to come from, or indeed feel they come from the countries of which they have citizenship. In this context, we must enquire about the mechanics of determining nationality and about how asylum seekers themselves relate to national identities. I argue...

  14. Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study.

    Science.gov (United States)

    Sivanesan, Eellan; Lubarsky, David A; Ranasinghe, Chaturani T; Sarantopoulos, Constantine D; Epstein, Richard H

    2017-09-01

    To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%. Retrospective, observational study using electronic health records. Chronic pain clinic of an academic anesthesia department. All patients scheduled for evaluation or follow-up appointments in the chronic pain clinic between April 1, 2014, and December 31, 2015. Open-access scheduling was instituted in April 2015 with appointments offered on a date of the patient's choosing ≥1 business day after calling, with no limit on the daily number of new patients. Mean cancellation rates for new patients were compared between the 12-month baseline period prior to and for 7months after the change, following an intervening 2-month washout period. The method of batch means (by month) and the 2-sided Student t-test were used; Pnew patient mean cancellation rate decreased from a baseline of 35.7% by 4.2% (95% confidence interval [CI] 1.4% to 6.9%; P=0.005); however, this failed to reach the 50% reduction target of 17.8%. Appointment lag time decreased by 4.7days (95% CI 2.3 to 7.0days, Pnew patient group. More new patients were seen within 1week compared to baseline (50.6% versus 19.1%; Pnew patient visits per month increased from 158.5 to 225.0 (P=0.0004). The cancellation rate and appointment lag times did not decrease for established patient visits, as expected because open-access scheduling was not implemented for this group. Access to care for new chronic pain patients improved with modified open-access scheduling. However, their mean cancellation rate only decreased from 35.7% to 31.5%, making this a marginally effective strategy to reduce cancellations. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Practical principles in appointment scheduling

    NARCIS (Netherlands)

    Kuiper, A.; Mandjes, M.

    2015-01-01

    Appointment schedules aim at achieving a proper balance between the conflicting interests of the service provider and her clients: a primary objective of the service provider is to fully utilize her available time, whereas clients want to avoid excessive waiting times. Setting up schedules that

  16. Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

    Directory of Open Access Journals (Sweden)

    McCann Terence V

    2012-08-01

    Full Text Available Abstract Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from

  17. Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study.

    Science.gov (United States)

    McCann, Terence V; Lubman, Dan I

    2012-08-01

    Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding

  18. Scheduling patient appointments via multilevel template: a case study in chemotherapy

    OpenAIRE

    Condotta, A; Shakhlevich, NV

    2014-01-01

    This paper studies a multi-criteria optimization problem which appears in the context of booking chemotherapy appointments. The main feature of the model under study is the requirement to book for each patient multiple appointments which should follow a pre-specified multi-day pattern. Each appointment involves several nurse activities which should also follow a pre-specified intra-day pattern. The main objectives are to minimize patients’ waiting times and peaks of nurses’ workload for an ou...

  19. ARCAS (ACACIA Regional Climate-data Access System) -- a Web Access System for Climate Model Data Access, Visualization and Comparison

    Science.gov (United States)

    Hakkarinen, C.; Brown, D.; Callahan, J.; hankin, S.; de Koningh, M.; Middleton-Link, D.; Wigley, T.

    2001-05-01

    A Web-based access system to climate model output data sets for intercomparison and analysis has been produced, using the NOAA-PMEL developed Live Access Server software as host server and Ferret as the data serving and visualization engine. Called ARCAS ("ACACIA Regional Climate-data Access System"), and publicly accessible at http://dataserver.ucar.edu/arcas, the site currently serves climate model outputs from runs of the NCAR Climate System Model for the 21st century, for Business as Usual and Stabilization of Greenhouse Gas Emission scenarios. Users can select, download, and graphically display single variables or comparisons of two variables from either or both of the CSM model runs, averaged for monthly, seasonal, or annual time resolutions. The time length of the averaging period, and the geographical domain for download and display, are fully selectable by the user. A variety of arithmetic operations on the data variables can be computed "on-the-fly", as defined by the user. Expansions of the user-selectable options for defining analysis options, and for accessing other DOD-compatible ("Distributed Ocean Data System-compatible") data sets, residing at locations other than the NCAR hardware server on which ARCAS operates, are planned for this year. These expansions are designed to allow users quick and easy-to-operate web-based access to the largest possible selection of climate model output data sets available throughout the world.

  20. Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Jimmy C.; Dorfman, Adam L. [C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, University of Michigan Congenital Heart Center, Ann Arbor, MI (United States); C.S. Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Lowery, Ray; Yu, Sunkyung [C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, University of Michigan Congenital Heart Center, Ann Arbor, MI (United States); Ghadimi Mahani, Maryam [C.S. Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)

    2017-07-15

    Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities. To characterize the rate of missed appointments and identify modifiable predictors. This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan. 1, 2014, through Dec. 31, 2015. We identified missed appointments (no-shows or same-day cancellations) from the electronic medical record. We obtained demographic and clinical factors from the medical record and assessed socioeconomic factors by U.S. Census block data by patient ZIP code. Statistically significant variables (P<0.05) were included into a multivariable analysis. Of 795 outpatients (median age 18.5 years, interquartile range 13.4-27.1 years) referred for congenital cardiac MR, a total of 91 patients (11.4%) missed appointments; 28 (3.5%) missed multiple appointments. Reason for missed appointment could be identified in only 38 patients (42%), but of these, 28 (74%) were preventable or could have been identified prior to the appointment. In multivariable analysis, independent predictors of missed appointments were referral by a non-cardiologist (adjusted odds ratio [AOR] 5.8, P=0.0002), referral for research (AOR 3.6, P=0.01), having public insurance (AOR 2.1, P=0.004), and having scheduled cardiac MR from November to April (AOR 1.8, P=0.01). Demographic factors can identify patients at higher risk for missing appointments. These data may inform initiatives to limit missed appointments, such as targeted education of referring providers and patients. Further data are needed to evaluate the efficacy of potential interventions. (orig.)

  1. Effect of second timed appointments for non-attenders of breast cancer screening in England: a randomised controlled trial.

    Science.gov (United States)

    Allgood, Prue C; Maroni, Roberta; Hudson, Sue; Offman, Judith; Turnbull, Anne E; Peacock, Lesley; Steel, Jim; Kirby, Geraldine; Ingram, Christine E; Somers, Julie; Fuller, Clare; Threlfall, Anthony G; Gabe, Rhian; Maxwell, Anthony J; Patnick, Julietta; Duffy, Stephen W

    2017-07-01

    significantly higher in the intervention group (2861 [22%] of 12 807) than in the control group (1632 [12%] of 13 247); relative risk of participation 1·81 (95% CI 1·70-1·93; p<0·0001). These findings show that a policy of second appointments with fixed date and time for non-attenders of breast screening is effective in improving participation. This strategy can be easily implemented by the screening sites and, if combined with simple interventions, could further increase participation and ensure an upward shift in the participation trend nationally. Whether the policy should vary by time since last attended screen will have to be considered. National Health Service Cancer Screening Programmes and Department of Health Policy Research Programme. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  2. Directors General appointed

    CERN Multimedia

    1975-01-01

    At a special session on 21 March, presided over by P. Levaux, the Council of the European Organization for Nuclear Research appointed J . B. Adams and L . Van Hove as Directors General of the Organization for a period of five years beginning 1 January 1976. Dr. Adams will be responsible for the administration of CERN, for the operation of the equipment and services and for the construction of buildings and major equipment. Professor Van Hove will be responsible for the research activities of the Organization.

  3. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    Science.gov (United States)

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  4. 26 CFR 20.2041-1 - Powers of appointment; in general.

    Science.gov (United States)

    2010-04-01

    ... Powers of appointment; in general. (a) Introduction. A decedent's gross estate includes under section... beneficiary of a trust to assent to a periodic accounting, thereby relieving the trustee from further... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Powers of appointment; in general. 20.2041-1...

  5. The LHC access system LACS and LASS

    CERN Document Server

    Ninin, P

    2005-01-01

    The LHC complex is divided into a number of zones with different levels of access controls.Inside the interlocked areas, the personnel protection is ensured by the LHC Access System.The system is made of two parts:the LHC Access Safety System and the LHC Access Control System. During machine operation,the LHC Access Safety System ensures the collective protection of the personnel against the radiation hazards arising from the operation of the accelerator by interlocking the LHC key safety elements. When the beams are off, the LHC Access Control System regulates the access to the accelerator and its many subsystems.It allows a remote, local or automatic operation of the access control equipment which verifies and identifies all users entering the controlled areas.The global architecture of the LHC Access System is now designed and is being validated to ensure that it meets the safety requirements for operation of the LHC.A pilot installation will be tested in the summer 2005 to validate the concept with the us...

  6. [Inequalities in access to and utilization of dental care in Brazil: an analysis of the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL 2009)].

    Science.gov (United States)

    Peres, Marco A; Iser, Betine Pinto Moehlecke; Boing, Antonio Fernando; Yokota, Renata Tiene de Carvalho; Malta, Deborah Carvalho; Peres, Karen Glazer

    2012-01-01

    This study aimed to evaluate access to and utilization of various types of dental services by individuals 18 years or older in Brazil's State capitals. We gathered data from the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL) in 2009 (n = 54,367). More than half of the target population reported the need for dental treatment in the previous year; of these, 15.2% lacked access to dental services when needed. The private sector provided 61.1% of all dental appointments. The share of services provided by the Unified National Health System (SUS) ranged from 6.2% in the Federal District to 35.2% in Boa Vista, in the North. Multivariate Poisson regression models showed higher prevalence of dental treatment needs among women, middle-aged adults, and individuals with more schooling. Lack of access to dental care was more frequent among women, young adults, less educated individuals, and among lightener-skinned blacks. Our findings highlight sharp inequalities in the use of and access to dental services in the Brazilian State capitals.

  7. Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients.

    Science.gov (United States)

    Pundhir, Pooja; North, Carol S; Fatunde, Oluwatomilade; Jain, Mamta K

    2016-02-01

    Appointment-keeping behavior is an important requisite for HCV linkage and treatment initiation. In this study we examine what impact hepatitis C (HCV) knowledge and attitudes has on appointment-keeping behavior among a cohort of HCV and HCV/HIV patients. Knowledge scores and attitude scales, obtained from a cross-sectional survey, were correlated with proportion of appointments kept 1 year prior to taking the survey. Independent risk factors for missing appointments were examined by multiple regression analysis. 292 HCV patients completed the survey, and 149 (51%) were co-infected with HIV. HCV patients kept 67.5 ± 17.4% of their total appointments and a similar proportion (67 ± 38.2) of Liver Clinic appointments, but they attended a higher proportion (73 ± 24.4) of Primary Care Clinic appointments. However, certain health beliefs, psychiatric illness, and HIV co-infection were independently associated with lower levels of appointment-keeping behavior. HCV knowledge was not associated with appointment-keeping behavior. Health beliefs, psychiatric illness, and HIV co-infection are associated with missing appointments, but no link between knowledge and appointment keeping behavior is apparent. In order to increase engagement into HCV care, HCV care coordination programs need to focus on addressing health beliefs and providing resources to those at highest risk for missing appointments.

  8. The Interaction of Publications and Appointments: New Evidence on Academic Economists in Germany

    Science.gov (United States)

    Beckmann, Klaus; Schneider, Andrea

    2013-01-01

    Using a new panel data set comprising publication and appointment data for 889 German academic economists over a quarter of a century, we confirm the familiar hypothesis that publications are important for professorial appointments, but find only a small negative effect of appointments on subsequent research productivity, in particular if one…

  9. Access control and personal identification systems

    CERN Document Server

    Bowers, Dan M

    1988-01-01

    Access Control and Personal Identification Systems provides an education in the field of access control and personal identification systems, which is essential in selecting the appropriate equipment, dealing intelligently with vendors in purchases of the equipment, and integrating the equipment into a total effective system. Access control devices and systems comprise an important part of almost every security system, but are seldom the sole source of security. In order for the goals of the total system to be met, the other portions of the security system must also be well planned and executed

  10. Glance Information System for ATLAS Management

    International Nuclear Information System (INIS)

    Grael, F F; Maidantchik, C; Évora, L H R A; Karam, K; Moraes, L O F; Cirilli, M; Nessi, M; Pommès, K

    2011-01-01

    ATLAS Experiment is an international collaboration where more than 37 countries, 172 institutes and laboratories, 2900 physicists, engineers, and computer scientists plus 700 students participate. The management of this teamwork involves several aspects such as institute contribution, employment records, members' appointment, authors' list, preparation and publication of papers and speakers nomination. Previously, most of the information was accessible by a limited group and developers had to face problems such as different terminology, diverse data modeling, heterogeneous databases and unlike users needs. Moreover, the systems were not designed to handle new requirements. The maintenance has to be an easy task due to the long lifetime experiment and professionals turnover. The Glance system, a generic mechanism for accessing any database, acts as an intermediate layer isolating the user from the particularities of each database. It retrieves, inserts and updates the database independently of its technology and modeling. Relying on Glance, a group of systems were built to support the ATLAS management and operation aspects: ATLAS Membership, ATLAS Appointments, ATLAS Speakers, ATLAS Analysis Follow-Up, ATLAS Conference Notes, ATLAS Thesis, ATLAS Traceability and DSS Alarms Viewer. This paper presents the overview of the Glance information framework and describes the privilege mechanism developed to grant different level of access for each member and system.

  11. Glance Information System for ATLAS Management

    Science.gov (United States)

    Grael, F. F.; Maidantchik, C.; Évora, L. H. R. A.; Karam, K.; Moraes, L. O. F.; Cirilli, M.; Nessi, M.; Pommès, K.; ATLAS Collaboration

    2011-12-01

    ATLAS Experiment is an international collaboration where more than 37 countries, 172 institutes and laboratories, 2900 physicists, engineers, and computer scientists plus 700 students participate. The management of this teamwork involves several aspects such as institute contribution, employment records, members' appointment, authors' list, preparation and publication of papers and speakers nomination. Previously, most of the information was accessible by a limited group and developers had to face problems such as different terminology, diverse data modeling, heterogeneous databases and unlike users needs. Moreover, the systems were not designed to handle new requirements. The maintenance has to be an easy task due to the long lifetime experiment and professionals turnover. The Glance system, a generic mechanism for accessing any database, acts as an intermediate layer isolating the user from the particularities of each database. It retrieves, inserts and updates the database independently of its technology and modeling. Relying on Glance, a group of systems were built to support the ATLAS management and operation aspects: ATLAS Membership, ATLAS Appointments, ATLAS Speakers, ATLAS Analysis Follow-Up, ATLAS Conference Notes, ATLAS Thesis, ATLAS Traceability and DSS Alarms Viewer. This paper presents the overview of the Glance information framework and describes the privilege mechanism developed to grant different level of access for each member and system.

  12. OGIS Access System

    Data.gov (United States)

    National Archives and Records Administration — The OGIS Access System (OAS) provides case management, stakeholder collaboration, and public communications activities including a web presence via a web portal.

  13. When access is an issue: exploring barriers to predictive testing for Huntington disease in British Columbia, Canada.

    Science.gov (United States)

    Hawkins, Alice K; Creighton, Susan; Hayden, Michael R

    2013-02-01

    Predictive testing (PT) for Huntington disease (HD) requires several in-person appointments. This requirement may be a barrier to testing so that at risk individuals do not realize the potential benefits of PT. To understand the obstacles to PT in terms of the accessibility of services, as well as exploring mechanisms by which this issue may be addressed, we conducted an interview study of individuals at risk for HD throughout British Columbia, Canada. Results reveal that the accessibility of PT can be a barrier for two major reasons: distance and the inflexibility of the testing process. Distance is a structural barrier, and relates to the time and travel required to access PT, the financial and other opportunity costs associated with taking time away from work and family to attend appointments and the stress of navigating urban centers. The inflexibility of the testing process barrier relates to the emotional and psychological accessibility of PT. The results of the interview study reveal that there are access barriers to PT that deter individuals from receiving the support, information and counseling they require. What makes accessibility of PT services important is not just that it may result in differences in quality of life and care, but because these differences may be addressed with creative and adaptable solutions in the delivery of genetic services. The study findings underscore the need for us to rethink and personalize the way we deliver such services to improve access issues to prevent inequities in the health care system.

  14. Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice.

    Science.gov (United States)

    MacKichan, Fiona; Brangan, Emer; Wye, Lesley; Checkland, Kath; Lasserson, Daniel; Huntley, Alyson; Morris, Richard; Tammes, Peter; Salisbury, Chris; Purdy, Sarah

    2017-05-04

    To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). Ethnographic case study combining non-participant observation, informal and formal interviewing. Six general practitioner (GP) practices located in three commissioning organisations in England. Reception areas at each practice were observed over the course of a working week (73 hours in total). Practice documents were collected and clinical and non-clinical staff were interviewed (n=19). Patients with recent ED use, or a carer if aged 16 and under, were interviewed (n=29). Past experience of accessing GP care recursively informed patient decisions about where to seek urgent care, and difficulties with access were implicit in patient accounts of ED use. GP practices had complicated, changeable systems for appointments. This made navigating appointment booking difficult for patients and reception staff, and engendered a mistrust of the system. Increasingly, the telephone was the instrument of demand management, but there were unintended consequences for access. Some patient groups, such as those with English as an additional language, were particularly disadvantaged, and the varying patient and staff semantic of words like 'urgent' and 'emergency' was exacerbated during telephone interactions. Poor integration between in-hours and out-of-hours care and patient perceptions of the quality of care accessible at their GP practice also informed ED use. This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around 'inappropriate' patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups. © Article author(s) (or

  15. Access to care for children with emotional/behavioral difficulties.

    Science.gov (United States)

    Henning-Smith, Carrie; Alang, Sirry

    2016-06-01

    Emotional/behavioral difficulties (EBDs) are increasingly diagnosed in children, constituting some of the most common chronic childhood conditions. Left untreated, EBDs pose long-term individual and population-level consequences. There is a growing evidence of disparities in EBD prevalence by various demographic characteristics. This article builds on this research by examining disparities in access to medical care for children with EBD. From 2008 to 2011, using data from the US National Health Interview Survey (N = 31,631) on sample children aged 4-17, we investigate (1) whether having EBD affects access to care (modeled as delayed care due to cost and difficulty making an appointment) and (2) the role demographic characteristics, health insurance coverage, and frequency of service use play in access to care for children with EBD. Results indicate that children with EBD experience issues in accessing care at more than twice the rate of children without EBD, even though they are less likely to be uninsured than their counterparts without EBD. In multivariable models, children with EBD are still more likely to experience delayed care due to cost and difficulty making a timely appointment, even after adjusting for frequency of health service use, insurance coverage, and demographic characteristics. © The Author(s) 2015.

  16. Effectiveness of mobile-phone short message service (SMS reminders for ophthalmology outpatient appointments: Observational study

    Directory of Open Access Journals (Sweden)

    Car Josip

    2008-05-01

    Full Text Available Abstract Background Non-attendance for hospital outpatient appointments is a significant problem in many countries. It causes suboptimal use of clinical and administrative staff and financial losses, as well as longer waiting times. The use of Short Message Service (SMS appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease non-attendance and so improve the efficiency of outpatient healthcare delivery. Methods An SMS text message was sent to patients with scheduled appointments between April and September 2006 in a hospital ophthalmology department in London, reminding them of their appointments. This group acted as the intervention group. Controls were patients with scheduled ophthalmology appointments who did not receive an SMS or any alternative reminder. Results During the period of the study, 11.2% (50/447 of patients who received an SMS appointment reminder were non-attenders, compared to 18.1% (1720/9512 who did not receive an SMS reminder. Non-attendance rates were 38% lower in patients who received an SMS reminder than in patients who did not receive a reminder (RR of non-attendance = 0.62; 95% CI = 0.48 – 0.80. Conclusion The use of SMS reminders for ophthalmology outpatient appointments was associated with a reduction of 38% in the likelihood of patients not attending their appointments, compared to no appointment reminder. The use of SMS reminders may also be more cost-effective than traditional appointment reminders and require less labour. These findings should be confirmed with a more rigorous study design before a wider roll-out.

  17. Self-management model in the scheduling of successive appointments in rheumatology.

    Science.gov (United States)

    Castro Corredor, David; Cuadra Díaz, José Luis; Mateos Rodríguez, Javier José; Anino Fernández, Joaquín; Mínguez Sánchez, María Dolores; de Lara Simón, Isabel María; Tébar, María Ángeles; Añó, Encarnación; Sanz, María Dolores; Ballester, María Nieves

    2018-01-08

    The rheumatology service of Ciudad Real Hospital, located in an autonomous community of that same name that is nearly in the center of Spain, implemented a self-management model of successive appointments more than 10 years ago. Since then, the physicians of the department schedule follow-up visits for their patients depending on the disease, its course and ancillary tests. The purpose of this study is to evaluate and compare the self-management model for successive appointments in the rheumatology service of Ciudad Real Hospital versus the model of external appointment management implemented in 8 of the hospital's 15 medical services. A comparative and multivariate analysis was performed to identify variables with statistically significant differences, in terms of activity and/or performance indicators and quality perceived by users. The comparison involved the self-management model for successive appointments employed in the rheumatology service of Ciudad Real Hospital and the model for external appointment management used in 8 hospital medical services between January 1 and May 31, 2016. In a database with more than 100,000 records of appointments involving the set of services included in the study, the mean waiting time and the numbers of non-appearances and rescheduling of follow-up visits in the rheumatology department were significantly lower than in the other services. The number of individuals treated in outpatient rheumatology services was 7,768, and a total of 280 patients were surveyed (response rate 63.21%). They showed great overall satisfaction, and the incidence rate of claims was low. Our results show that the self-management model of scheduling appointments has better results in terms of activity indicators and in quality perceived by users, despite the intense activity. Thus, this study could be fundamental for decision making in the management of health care organizations. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de

  18. 41 CFR 302-2.4 - What is my effective transfer or appointment date?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is my effective transfer or appointment date? 302-2.4 Section 302-2.4 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES INTRODUCTION 2-EMPLOYEES ELIGIBILITY REQUIREMENTS General...

  19. Missed medical appointment among hypertensive and diabetic ...

    African Journals Online (AJOL)

    Keywords: Missed medical appointments, Hypertensive, Diabetic outpatients, Medication adherence, ... 12 weeks, at 95 % confidence level and 5 % error margin, 300 hypertensive ... monthly income and health insurance status of respondents ...

  20. Automated Computer Access Request System

    Science.gov (United States)

    Snook, Bryan E.

    2010-01-01

    The Automated Computer Access Request (AutoCAR) system is a Web-based account provisioning application that replaces the time-consuming paper-based computer-access request process at Johnson Space Center (JSC). Auto- CAR combines rules-based and role-based functionality in one application to provide a centralized system that is easily and widely accessible. The system features a work-flow engine that facilitates request routing, a user registration directory containing contact information and user metadata, an access request submission and tracking process, and a system administrator account management component. This provides full, end-to-end disposition approval chain accountability from the moment a request is submitted. By blending both rules-based and rolebased functionality, AutoCAR has the flexibility to route requests based on a user s nationality, JSC affiliation status, and other export-control requirements, while ensuring a user s request is addressed by either a primary or backup approver. All user accounts that are tracked in AutoCAR are recorded and mapped to the native operating system schema on the target platform where user accounts reside. This allows for future extensibility for supporting creation, deletion, and account management directly on the target platforms by way of AutoCAR. The system s directory-based lookup and day-today change analysis of directory information determines personnel moves, deletions, and additions, and automatically notifies a user via e-mail to revalidate his/her account access as a result of such changes. AutoCAR is a Microsoft classic active server page (ASP) application hosted on a Microsoft Internet Information Server (IIS).

  1. Improving patient access to an interventional US clinic.

    Science.gov (United States)

    Steele, Joseph R; Clarke, Ryan K; Terrell, John A; Brightmon, Tonya R

    2014-01-01

    A continuous quality improvement project was conducted to increase patient access to a neurointerventional ultrasonography (US) clinic. The clinic was experiencing major scheduling delays because of an increasing patient volume. A multidisciplinary team was formed that included schedulers, medical assistants, nurses, technologists, and physicians. The team created an Ishikawa diagram of the possible causes of the long wait time to the next available appointment and developed a flowchart of the steps involved in scheduling and completing a diagnostic US examination and biopsy. The team then implemented a staged intervention that included adjustments to staffing and room use (stage 1); new procedures for scheduling same-day add-on appointments (stage 2); and a lead technician rotation to optimize patient flow, staffing, and workflow (stage 3). Six months after initiation of the intervention, the mean time to the next available appointment had decreased from 25 days at baseline to 1 day, and the number of available daily appointments had increased from 38 to 55. These improvements resulted from a coordinated provider effort and had a net present value of more than $275,000. This project demonstrates that structural changes in staffing, workflow, and room use can substantially reduce scheduling delays for critical imaging procedures. © RSNA, 2014.

  2. Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

    Science.gov (United States)

    Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

    2017-10-01

    Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

  3. New appointments at the IAEA

    International Nuclear Information System (INIS)

    1999-01-01

    The document shortly presents the following new appointments: the Deputy Director General, Head of the Department of Safeguards (effective as of 1 May 1999), the Director of the Division of Nuclear Fuel Cycle and Waste Technology in the Department of Nuclear Energy, and the Director of the Division of Conference and Document Services in the Department of Administration (effective as of 1 April 1999)

  4. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    Science.gov (United States)

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-01-01

    BACKGROUND: Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. AIM: To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. DESIGN OF STUDY: A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. SETTING: Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. METHOD: Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. RESULTS: The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. CONCLUSION: A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children. PMID:12528583

  5. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    Science.gov (United States)

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-12-01

    Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children.

  6. Equal Opportunity? Gender Gaps in CEO Appointments and Executive Pay

    OpenAIRE

    Keloharju, Matti; Knüpfer, Samuli; Tåg, Joacim

    2016-01-01

    This paper uses exceptionally rich data on Swedish corporate executives and their personal characteristics to study gender gaps in CEO appointments and pay. Both gaps are sizeable: 18% for CEO appointments and 27% for pay. At most one-eight of the gaps can be attributed to observable gender differences in executives' and their firms' characteristics. Further tests suggest that unobservable gender differences in characteristics are unlikely to account for the remaining gaps. Instead, our resul...

  7. Access control system for ISABELLE

    International Nuclear Information System (INIS)

    Potter, K.; Littenberg, L.

    1977-01-01

    An access system based on the one now in operation at the CERN ISR is recommended. Access doors would presumably be located at the entrances to the utility tunnels connecting the support buildings with the ring. Persons requesting access would insert an identity card into a scanner to activate the system. The request would be autologged, the keybank adjacent to the door would be unlocked and ISABELLE operations would be notified. The operator would then select the door, activating a TV-audio link. The person requesting entry would draw a key from the bank, show it and his film badge to the operator who would enable the door release

  8. Easy Access: Auditing the System Network

    Science.gov (United States)

    Wiech, Dean

    2013-01-01

    In today's electronic learning environment, access to appropriate systems and data is of the utmost importance to students, faculty, and staff. Without proper access to the school's internal systems, teachers could be prevented from logging on to an online learning system and students might be unable to submit course work to an online…

  9. Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study.

    Science.gov (United States)

    Ford, John A; Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P; Steel, Nick

    2018-01-01

    We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Older people's experience can be understood within the context of a patient perceived set of unwritten rules or social contract-an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals' described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service.

  10. A multisite audit to assess how women with complex social factors access and engage with maternity services.

    Science.gov (United States)

    Rayment-Jones, Hannah; Butler, Eleanor; Miller, Chelsie; Nay, Christine; O'Dowd, Jennifer

    2017-09-01

    to audit women with socially complex lives' documented access to and engagement with antenatal care provided by three inner city, UK maternity services in relation to birth and neonatal outcomes, and referral processes. women living socially complex lives, including young mothers, recently arrived immigrants, non-English speaking, and those experiencing domestic violence, poor mental health, drug and alcohol abuse, and poverty experience high rates of morbidity, mortality and poor birth outcomes. This is associated with late access to and poor engagement with antenatal care. data was collected from three separate NHS trusts data management systems for a total of 182 women living socially complex lives, between January and December 2015. Data was presented by individual trust and compared to standards derived from NICE guidelines, local trust policy and national statistic using Excel and SPSS Version 22. Tests of correlation were carried out to minimise risks of confounding factors in characteristic differences. non-English speaking women were much less likely to have accessed care within the recommended timeframes, with over 70% of the sample not booked for maternity care by 12 weeks gestation. On average 89% primiparous women across all samples had less than the recommended number of antenatal appointments. No sample met the audit criteria in terms of number of antenatal appointments attended. Data held on the perinatal data management systems for a number of outcomes and processes was largely incomplete and appeared unreliable. this data forms a baseline against which to assess the impact of future service developments aimed at improving access and engagement with services for women living with complex social factors. The audit identified issues with the completeness and reliability of data on the perinatal data management system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. [Principles of nutrition in patients with newly appointed stoma].

    Science.gov (United States)

    Pachocka, Lucyna Małgorzata; Urbanik, Anna

    2016-01-01

    The treatment of intestinal stoma is often a difficult experience for patients and results in numerous problems in the physical, psychological and social aspects. Therefore, post-operative care of the patient with the newly appointed stoma should be taken by therapeutic team consisting of doctors, nurses, physiotherapists, dieticians, psychologists and social workers. Appropriate nutritional education of patients aims to improve their quality of life and to prevent from unpleasant ailments formed after the operation. The specific type of stoma may decide about certain dietary recommendations. The presented work provides a practical dietary recommendations for patients with newly appointed stoma.

  12. Maintenance Appointments in Railway Rolling Stock Rescheduling

    NARCIS (Netherlands)

    J.C. Wagenaar (Joris); L.G. Kroon (Leo); M.E. Schmidt (Marie)

    2016-01-01

    textabstractThis paper addresses the Rolling Stock Rescheduling Problem (RSRP), while taking maintenance appointments into account. After a disruption, the rolling stock of the disrupted passenger trains has to be rescheduled in order to restore a feasible rolling stock circulation. Usually, a

  13. 77 FR 62490 - Performance Review Board Appointments

    Science.gov (United States)

    2012-10-15

    ... Board Appointments AGENCY: Office of Human Resource Management, Departmental Management. ACTION: Notice..., Director, Office of Human Resources Management, telephone: (202) 690-2994, email: [email protected] has a total of seven PRBs: The Secretary's PRB; Career Agency Head's PRB; Departmental Management and...

  14. Maternity patients' access to their electronic medical records: use and perspectives of a patient portal.

    Science.gov (United States)

    Megan Forster, Megan; Dennison, Kerrie; Callen, Joanne; Andrew, Andrew; Westbrook, Johanna I

    Patients have been able to access clinical information from their paper-based health records for a number of years. With the advent of Electronic Medical Records (EMRs) access to this information can now be achieved online using a secure electronic patient portal. The purpose of this study was to investigate maternity patients' use and perceptions of a patient portal developed at the Mater Mothers' Hospital in Brisbane, Australia. A web-based patient portal, one of the first developed and deployed in Australia, was introduced on 26 June 2012. The portal was designed for maternity patients booked at Mater Mothers' Hospital, as an alternative to the paper-based Pregnancy Health Record. Through the portal, maternity patients are able to complete their hospital registration form online and obtain current health information about their pregnancy (via their EMR), as well as access a variety of support tools to use during their pregnancy such as tailored public health advice. A retrospective cross-sectional study design was employed. Usage statistics were extracted from the system for a one year period (1 July 2012 to 30 June 2013). Patients' perceptions of the portal were obtained using an online survey, accessible by maternity patients for two weeks in February 2013 (n=80). Descriptive statistics were employed to analyse the data. Between July 2012 and June 2013, 10,892 maternity patients were offered a patient portal account and access to their EMR. Of those 6,518 created one (60%; 6,518/10,892) and 3,104 went on to request access to their EMR (48%; 3,104/6,518). Of these, 1,751 had their access application granted by 30 June 2013. The majority of maternity patients submitted registration forms online via the patient portal (56.7%). Patients could view their EMR multiple times: there were 671 views of the EMR, 2,781 views of appointment schedules and 135 birth preferences submitted via the EMR. Eighty survey responses were received from EMR account holders, (response

  15. 5 CFR 317.501 - Recruitment and selection for initial SES career appointment be achieved from the brightest and...

    Science.gov (United States)

    2010-01-01

    .... OPM may review proposed career appointments to ensure that they comply with all merit staffing... career appointment be achieved from the brightest and most diverse pool possible. 317.501 Section 317.501... EXECUTIVE SERVICE Career Appointments § 317.501 Recruitment and selection for initial SES career appointment...

  16. LANSCE personnel access control system (PACS)

    International Nuclear Information System (INIS)

    Sturrock, J.C.; Gallegos, F.R.; Hall, M.J.

    1997-01-01

    The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) provides personnel protection from prompt radiation due to accelerated beam. The Personnel Access Control System (PACS) is a component of the RSS that is designed to prevent personnel access to areas where prompt radiation is a hazard. PACS was designed to replace several older personnel safety systems (PSS) with a single modem unified design. Lessons learned from the operation over the last 20 years were incorporated into a redundant sensor, single-point failure safe, fault tolerant, and tamper-resistant system that prevents access to the beam areas by controlling the access keys and beam stoppers. PACS uses a layered philosophy to the physical and electronic design. The most critical assemblies are battery backed up, relay logic circuits; less critical devices use Programmable Logic Controllers (PLCs) for timing functions and communications. Outside reviewers have reviewed the operational safety of the design. The design philosophy, lessons learned, hardware design, software design, operation, and limitations of the device are described

  17. Internet-accessible real-time weather information system

    Digital Repository Service at National Institute of Oceanography (India)

    Desai, R.G.P.; Joseph, A.; Desa, E.; Mehra, P.; Desa, E.; Gouveia, A.D.

    An internet-accessible real-time weather information system has been developed. This system provides real-time accessibility to weather information from a multitude of spatially distributed weather stations. The Internet connectivity also offers...

  18. Practical quantum appointment scheduling

    Science.gov (United States)

    Touchette, Dave; Lovitz, Benjamin; Lütkenhaus, Norbert

    2018-04-01

    We propose a protocol based on coherent states and linear optics operations for solving the appointment-scheduling problem. Our main protocol leaks strictly less information about each party's input than the optimal classical protocol, even when considering experimental errors. Along with the ability to generate constant-amplitude coherent states over two modes, this protocol requires the ability to transfer these modes back-and-forth between the two parties multiple times with very low losses. The implementation requirements are thus still challenging. Along the way, we develop tools to study quantum information cost of interactive protocols in the finite regime.

  19. 76 FR 78225 - Notice of Appointment of Members to the National Agricultural Research, Extension, Education, and...

    Science.gov (United States)

    2011-12-16

    ... (Appointment--3 years); Category H. ``National Food Science Organization, Dr. Mark R. McLellan, Member... specific category related to agriculture. The Board was first appointed in September 1996 and at the time... member is appointed by the Secretary of Agriculture to a specific category on the Board, including...

  20. Mentorship for newly appointed physicians: a strategy for enhancing patient safety?

    Science.gov (United States)

    Harrison, Reema; McClean, Serwaa; Lawton, Rebecca; Wright, John; Kay, Clive

    2014-09-01

    Mentorship is an increasingly popular innovation from business and industry that is being applied in health-care contexts. This paper explores the concept of mentorship for newly appointed physicians in their first substantive senior post, and specifically its utilization to enhance patient safety. Semi-structured face to face and telephone interviews with Medical Directors (n = 5), Deputy Medical Directors (n = 4), and Clinical Directors (n = 6) from 9 acute NHS Trusts in the Yorkshire and Humber region in the north of England. A focused thematic analysis was used. A number of beneficial outcomes were associated with mentorship for newly appointed physicians including greater personal and professional support, organizational commitment, and general well-being. Providing newly appointed senior physicians with support through mentorship was considered to enhance the safety of patient care. Mentorship may prevent or reduce active failures, be used to identify threats in the local working environment, and in the longer term, address latent threats to safety within the organization by encouraging a healthier safety culture. Offering mentorship to all newly appointed physicians in their first substantive post in health care may be a useful strategy to support the development of their clinical, professional, and personal skills in this transitional period that may also enhance the safety of patient care.

  1. Access Control Management for SCADA Systems

    Science.gov (United States)

    Hong, Seng-Phil; Ahn, Gail-Joon; Xu, Wenjuan

    The information technology revolution has transformed all aspects of our society including critical infrastructures and led a significant shift from their old and disparate business models based on proprietary and legacy environments to more open and consolidated ones. Supervisory Control and Data Acquisition (SCADA) systems have been widely used not only for industrial processes but also for some experimental facilities. Due to the nature of open environments, managing SCADA systems should meet various security requirements since system administrators need to deal with a large number of entities and functions involved in critical infrastructures. In this paper, we identify necessary access control requirements in SCADA systems and articulate access control policies for the simulated SCADA systems. We also attempt to analyze and realize those requirements and policies in the context of role-based access control that is suitable for simplifying administrative tasks in large scale enterprises.

  2. EXTENSION EDUCATION SYMPOSIUM: Getting the most out of your extension appointment and still having a life.

    Science.gov (United States)

    Powers, W; Cockett, N; Lardy, G

    2017-04-01

    Managing the demands of an academic appointment in extension can be a challenging task. Demands from constituent groups, expectations of supervisors, and rigors of promotion and tenure processes can create pressures that young faculty did not expect. Throw in spousal and family duties and you have created a situation that many will find hard to navigate. However, there are ways to cope and, even better news, there are ways to excel in meeting the demands of an academic appointment and enjoying life. Because many new extension faculty members do not have prior experience in extension, best practices in documenting programs and extension scholarship over the pretenure period are provided in this paper. Appointments that include both research and extension are quite common at many land grant universities. The advantages of joint appointments are numerous and include the fact that more and more grant agencies are seeking integrated research, teaching, and/or extension projects. However, the time demands of joint appointments can be challenging. Joint appointments can be designed to help faculty members conduct important translational research and have it be applied in a production setting. By seeking commonalities in research and extension efforts, joint appointments can be very synergistic. Development of highly successful programs requires planning on the front end with an emphasis on an in-depth needs assessment to determine stakeholder needs for both research and extension. Impact assessment should be part of this planning effort. Performing as a successful extension faculty member while maintaining relationships outside of work is challenging and requires deliberate effort on the part of employees and supervisors to realize there is more to life than work. Some authors have referred to this as work-life balance, but it may be more helpful to think of it as work-life effectiveness. To do this, one needs to 1) define what success looks like, 2) set boundaries and

  3. Men's Educational Group Appointments in Rural Nicaragua.

    Science.gov (United States)

    Campbell, Bruce B; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

    2017-03-01

    Men's preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men's educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men's hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men's educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua.

  4. Court Appointed Volunteers for Abused and Neglected Children.

    Science.gov (United States)

    Justin, Renate G.

    2002-02-01

    A court appointed special advocate (CASA) volunteer is a trained citizen who is appointed by a judge to represent the best interests of an abused and neglected child in court. An independent voice, the volunteer gathers information and reports to the court. The CASA volunteer works in close cooperation with other professionals, physicians, lawyers, social workers, and teachers to find the most suitable permanent placement for a victimized child, whether it be a foster home, parental home, or adoptive home. Another function for CASA volunteers is to be supportive to the child during a time of uncertainty in his or her life and to help the youngster adjust to new and changing situations; the CASA volunteer may be the only consistent adult presence during this difficult period of transition.

  5. Prevalence and Correlates of Missed First Appointments among ...

    African Journals Online (AJOL)

    In Nigeria, where mental health services are poorly organized, missed appointments and its resultant consequences may be burdensome. Aim: This ... However, having received previous treatment for a psychiatric illness (P = 0.02) and having ...

  6. Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study

    Science.gov (United States)

    Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P.; Steel, Nick

    2018-01-01

    Objective We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Methods Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Findings Older people’s experience can be understood within the context of a patient perceived set of unwritten rules or social contract–an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals’ described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Conclusion Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service. PMID:29509811

  7. Computer access security code system

    Science.gov (United States)

    Collins, Earl R., Jr. (Inventor)

    1990-01-01

    A security code system for controlling access to computer and computer-controlled entry situations comprises a plurality of subsets of alpha-numeric characters disposed in random order in matrices of at least two dimensions forming theoretical rectangles, cubes, etc., such that when access is desired, at least one pair of previously unused character subsets not found in the same row or column of the matrix is chosen at random and transmitted by the computer. The proper response to gain access is transmittal of subsets which complete the rectangle, and/or a parallelepiped whose opposite corners were defined by first groups of code. Once used, subsets are not used again to absolutely defeat unauthorized access by eavesdropping, and the like.

  8. Tom Brown appointed Dean of Students

    OpenAIRE

    Williams, Meghan

    2007-01-01

    James Thomas "Tom" Brown, former senior associate dean of the Dean of Students office, has been appointed as the Dean of Students. The Dean of Students office is responsible for the coordination of student advocacy, new student orientation and parent programs, and responding to student emergencies in collaboration with Judicial Affairs, Residence Life, Cook Counseling Center, Schiffert Health Center, and other departments and agencies.

  9. Research of user access control for networked manufacturing system

    Institute of Scientific and Technical Information of China (English)

    ZHENG Xiao-lin; LEI Yu; CHEN De-ren

    2006-01-01

    An integrated user access control method was proposed to address the issues of security and management in networked manufacturing systems (NMS).Based on the analysis of the security issues in networked manufacturing system,an integrated user access control method composed of role-based access control (RBAC),task-based access control (TBAC),relationship-driven access control (RDAC)and coalition-based access control (CBAC) was proposed,including the hierarchical user relationship model,the reference model and the process model.The elements and their relationships were defined,and the expressions of constraints authorization were given.The extensible access control markup language (XACML) was used to implement this method.This method was used in the networked manufacturing system in the Shaoxing spinning region of China.The results show that the integrated user access control method can reduce the costs of system security maintenance and management.

  10. Assessment of the Correlation between Appointment Scheduling and Patient Satisfaction in a Pediatric Dental Setup

    OpenAIRE

    Katre, Amar N.

    2014-01-01

    Introduction. The practice of modern pediatric dentistry requires delivery of quality care in combination with adherence to excellent business as well as time management principles. A definite appointment schedule should be presented to the parents on the first or second appointment. More importantly, the prescribed schedule should be followed to the best of the professional abilities of the pediatric dentist. Aims. The aim of the study was to assess the co-relation between appointment schedu...

  11. Prevalence and Correlates of Missed First Appointments among ...

    African Journals Online (AJOL)

    quality of care, results in poor treatment outcomes and drains financial resources. In Nigeria, where mental .... and physical aggression. Each subscale has four .... missed first appointments observed in this study falls within the range of 17 and ...

  12. Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records

    Directory of Open Access Journals (Sweden)

    Lawlor Debbie A

    2005-11-01

    Full Text Available Abstract Background Missed appointments are a common occurrence in primary care in the UK, yet little is known about the reasons for them, or the consequences of missing an appointment. This paper aims to determine the reasons for missed appointments and whether patients who miss an appointment subsequently consult their general practitioner (GP. Secondary aims are to compare psychological morbidity, and the previous appointments with GPs between subjects and a comparison group. Methods Postal questionnaire survey and prospective medical notes review of adult patients missing an appointment and the comparison group who attended appointments over a three week period in seven general practices in West Yorkshire. Results Of the 386 who missed appointments 122 (32% responded. Of the 386 in the comparison group 223 (58% responded, resulting in 23 case-control matched pairs with complete data collection. Over 40% of individuals who missed an appointment and participated said that they forgot the appointment and a quarter said that they tried very hard to cancel the appointment or that it was at an inconvenient time. A fifth reported family commitments or being too ill to attend. Over 90% of the patients who missed an appointment subsequently consulted within three months and of these nearly 60% consulted for the stated problem that was going to be presented in the missed consultation. The odds of missing an appointment decreased with increasing age and were greater among those who had missed at least one appointment in the previous 12 months. However, estimates for comparisons between those who missed appointments and the comparison group were imprecise due to the low response rate. Conclusion Patients who miss appointments tend to cite practice factors and their own forgetfulness as the main reasons for doing so, and most attend within three months of a missed appointment. This study highlights a number of implications for future research. More work

  13. Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator.

    Science.gov (United States)

    Chen, Shih-Chih; Jong, Din; Lai, Min-Tsai

    2014-09-01

    Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

  14. A TIMELY APPOINTMENT – SAMA'S NEW CEO

    African Journals Online (AJOL)

    Nicky

    Her middle name might mean 'the one who came before her time', but Dr. Aquina Motlakapele Thulare, 42, the new CEO of the South African Medical. Association, is determined to see doctors better paid and properly valued during her tenure. Ratified by the full board last month, her historic appointment follows the.

  15. Computer Security Systems Enable Access.

    Science.gov (United States)

    Riggen, Gary

    1989-01-01

    A good security system enables access and protects information from damage or tampering, but the most important aspects of a security system aren't technical. A security procedures manual addresses the human element of computer security. (MLW)

  16. An Attribute Based Access Control Framework for Healthcare System

    Science.gov (United States)

    Afshar, Majid; Samet, Saeed; Hu, Ting

    2018-01-01

    Nowadays, access control is an indispensable part of the Personal Health Record and supplies for its confidentiality by enforcing policies and rules to ensure that only authorized users gain access to requested resources in the system. In other words, the access control means protecting patient privacy in healthcare systems. Attribute-Based Access Control (ABAC) is a new access control model that can be used instead of other traditional types of access control such as Discretionary Access Control, Mandatory Access Control, and Role-Based Access Control. During last five years ABAC has shown some applications in both recent academic fields and industry purposes. ABAC by using user’s attributes and resources, makes a decision according to an access request. In this paper, we propose an ABAC framework for healthcare system. We use the engine of ABAC for rendering and enforcing healthcare policies. Moreover, we handle emergency situations in this framework.

  17. [HIV infection and syphilis prevalence among men who have sex with men receiving voluntary counseling and testing appointed through a web-based registering system and related factors].

    Science.gov (United States)

    Wu, Qiongmiao; Cheng, Weibin; Zhong, Fei; Xu, Huifang; Liu, Qi; Lin, Peng

    2015-05-01

    To understand the human immunodeficiency virus (HIV) infection status and syphilis prevalence among men who have sex with men (MSM) receiving voluntary counseling and testing appointed through a web-based registering system and related factors. The MSM receiving web appointed HIV counseling and testing from 2011 to 2012 in Guangzhou were recruited and a questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior. Binary and multivariate logistic regression model were used to identify the factors associated with HIV infection or syphilis prevalence. A total of 4,904 MSM were enrolled in the study, the average age of the MSM was (28.77±7.24) years, and 70.3% of them had high education level; the unmarried MSM accounted for 72.7%. The HIV infection rate and syphilis prevalence were 8.7% and 4.4% respectively. The co-infection rate of HIV and Treponema pallidum was 1.2% (59/4 904). About one in three MSM did not use condom at latest homosexual behavior, 43.5% did not use condoms at each homosexual behavior in the past three months. Lower education level, occupation (worker or farmer), non-consistent condom use at each sex with men in the past three months, receiving HIV test or not and Treponema pallidum infection were associated with HIV infection. Age≥40 years, lower education level, multi male sex partners in the past three months and HIV infection were associated with Treponema pallidum infection. MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate, but had low previous HIV testing rate. It is necessary to strengthen the promotion of HIV test through web based appointment and conduct target behavior intervention in older MSM with lower education level.

  18. Toward a strategy of patient-centered access to primary care.

    Science.gov (United States)

    Berry, Leonard L; Beckham, Dan; Dettman, Amy; Mead, Robert

    2014-10-01

    Patient-centered access (PCA) to primary care services is rapidly becoming an imperative for efficiently delivering high-quality health care to patients. To enhance their PCA-related efforts, some medical practices and health systems have begun to use various tactics, including team-based care, satellite clinics, same-day and group appointments, greater use of physician assistants and nurse practitioners, and remote access to health services. However, few organizations are addressing the PCA imperative comprehensively by integrating these various tactics to develop an overall PCA management strategy. Successful integration means taking into account the changing competitive and reimbursement landscape in primary care, conducting an evidence-based assessment of the barriers and benefits of PCA implementation, and attending to the particular needs of the institution engaged in this important effort. This article provides a blueprint for creating a multifaceted but coordinated PCA strategy-one aimed squarely at making patient access a centerpiece of how health care is delivered. The case of a Wisconsin-based health system is used as an illustrative example of how other institutions might begin to conceive their fledgling PCA strategies without proposing it as a one-size-fits-all model. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. 78 FR 75948 - Senior Executive Service; Appointment of Members to the Performance Review Board

    Science.gov (United States)

    2013-12-13

    ... Resources Center--Sydney T. Rose Executive Secretary--Director, Executive Resources--Kim L.H. Green... H. Moore, Deputy Assistant Secretary for Operations and Analysis--appointment expires on 09/30/16..., New York--appointment expires on 09/30/16 OLMS Stephen J. Willertz, Director, Office of Enforcement...

  20. A new access scheme in OFDMA systems

    Institute of Scientific and Technical Information of China (English)

    GU Xue-lin; YAN Wei; TIAN Hui; ZHANG Ping

    2006-01-01

    This article presents a dynamic random access scheme for orthogonal frequency division multiple access (OFDMA) systems. The key features of the proposed scheme are:it is a combination of both the distributed and the centralized schemes, it can accommodate several delay sensitivity classes,and it can adjust the number of random access channels in a media access control (MAC) frame and the access probability according to the outcome of Mobile Terminals access attempts in previous MAC frames. For floating populated packet-based networks, the proposed scheme possibly leads to high average user satisfaction.

  1. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

    Science.gov (United States)

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-06-01

    The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more

  2. Information-flow-based Access Control for Virtualized Systems

    Directory of Open Access Journals (Sweden)

    Dmitriy Aleksandrovich Postoev

    2014-12-01

    Full Text Available The article is devoted to the method of information-flow-based access control, adopted for virtualized systems. General structure of access control system for virtual infrastructure is proposed.

  3. 76 FR 38348 - Notice of Appointment of Committee Members to the Advisory Committee on Biotechnology and 21st...

    Science.gov (United States)

    2011-06-30

    ... Service Notice of Appointment of Committee Members to the Advisory Committee on Biotechnology and 21st.... ACTION: Notice of Appointment of Committee Members to the Advisory Committee on Biotechnology and 21st... the appointment of members to the Advisory Committee on Biotechnology and 21st Century Agriculture...

  4. Treatment dropout and missed appointments among adults with attention-deficit/hyperactivity disorder: associations with patient- and disorder-related factors.

    Science.gov (United States)

    Soendergaard, Helle M; Thomsen, Per H; Pedersen, Pernille; Pedersen, Erik; Poulsen, Agnethe E; Nielsen, Jette M; Winther, Lars; Henriksen, Anne; Rungoe, Berit; Soegaard, Hans J

    2016-02-01

    educational and occupational systems and highest rates of skipping class during mandatory schooling is equally associated with current behavior of treatment dropout and missed appointments as are sociodemographic and clinical factors. ClinicalTrials.gov identifier: NCT02226445. © Copyright 2015 Physicians Postgraduate Press, Inc.

  5. Men’s Educational Group Appointments in Rural Nicaragua

    Science.gov (United States)

    Campbell, Bruce B.; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

    2016-01-01

    Men’s preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men’s educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men’s hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men’s educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua. PMID:27885146

  6. Council appoints CERN’s next Director General

    CERN Multimedia

    Maximilien Brice

    2007-01-01

    On 14 December 2007, CERN Council appointed Professor Rolf-Dieter Heuer to succeed Dr Robert Aymar as CERN Director General. Professor Heuer will serve a five-year term, taking office on 1 January 2009. From Left to right: Dr Robert Aymar, current CERN Director General, Professor Torsten Åkesson, President of CERN Council, and Professor Rolf-Dieter Heuer, CERN's next Director General.

  7. 77 FR 21109 - Senior Executive Service; Appointment of Members to the Performance Review Board

    Science.gov (United States)

    2012-04-09

    ... DEPARTMENT OF LABOR Office of the Secretary Senior Executive Service; Appointment of Members to the Performance Review Board Title 5 U.S.C. 4314(c)(4) provides that Notice of the Appointment of an individual to serve as a member of the Performance Review Board of the Senior Executive Service shall be...

  8. Nuclear information access system

    International Nuclear Information System (INIS)

    Ham, C. H.; Yang, M. H.; Yoon, S. W.

    1998-01-01

    The energy supply in the countries, which have abundant energy resources, may not be affected by accepting the assertion of anti-nuclear and environment groups. Anti-nuclear movements in the countries which have little energy resources may cause serious problem in securing energy supply. Especially, it is distinct in Korea because she heavily depends on nuclear energy in electricity supply(nuclear share in total electricity supply is about 40%).The cause of social trouble surrounding nuclear energy is being involved with various circumstances. However, it is very important that we are not aware of the importance of information access and prepared for such a situation from the early stage of nuclear energy's development. In those matter, this paper analyzes the contents of nuclear information access system in France and Japan which have dynamic nuclear development program and presents the direction of the nuclear access regime through comparing Korean status and referring to progresses of the regime

  9. 78 FR 24749 - Health Information Technology Policy Committee Appointment

    Science.gov (United States)

    2013-04-26

    ... GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Appointment AGENCY... Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee to make recommendations on the implementation of a nationwide health information technology...

  10. Patient experience of access to primary care: identification of predictors in a national patient survey.

    Science.gov (United States)

    Kontopantelis, Evangelos; Roland, Martin; Reeves, David

    2010-08-28

    The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger

  11. Patient experience of access to primary care: identification of predictors in a national patient survey

    Directory of Open Access Journals (Sweden)

    Kontopantelis Evangelos

    2010-08-01

    Full Text Available Abstract Background The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. Methods 8,307 English general practices were included in the survey (of 8,403 identified. 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. Results After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. Conclusions This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given

  12. Access to abortion: what women want from abortion services.

    Science.gov (United States)

    Wiebe, Ellen R; Sandhu, Supna

    2008-04-01

    Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Women presenting for abortion over a two-month period at two free-standing abortion clinics, one publicly funded and the other private, were invited to participate in the study. Phase I of the study involved administration of a questionnaire seeking information about demographics, perceived barriers to access to abortion, and what the women wanted from abortion services. Phase II involved semi-structured interviews of a convenience sample of women to record their responses to questions about access. Responses from Phase I questionnaires were compared between the two clinics, and qualitative analysis was performed on the interview responses. Of 423 eligible women, 402 completed questionnaires, and of 45 women approached, 39 completed interviews satisfactorily. Women received information about abortion services from their physicians (60.0%), the Internet (14.8%), a telephone directory (7.8%), friends or family (5.3%), or other sources (12.3%). Many had negative experiences in gaining access. The most important issue regarding access was the long wait time; the second most important issue was difficulty in making appointments. In the private clinic, 85% of the women said they were willing to pay for shorter wait times, compared with 43.5% in the public clinic. Physicians who failed to refer patients for abortion or provide information about obtaining an abortion caused distress and impeded access for a significant minority of women requesting an abortion. Management of abortion services should be prioritized to reflect what women want: particularly decreased wait times for abortion and greater ease and convenience in booking appointments

  13. Role Based Access Control system in the ATLAS experiment

    International Nuclear Information System (INIS)

    Valsan, M L; Dumitru, I; Darlea, G L; Bujor, F; Dobson, M; Miotto, G Lehmann; Schlenker, S; Avolio, G; Scannicchio, D A; Filimonov, V; Khomoutnikov, V; Zaytsev, A S; Korol, A A; Bogdantchikov, A; Caramarcu, C; Ballestrero, S; Twomey, M

    2011-01-01

    The complexity of the ATLAS experiment motivated the deployment of an integrated Access Control System in order to guarantee safe and optimal access for a large number of users to the various software and hardware resources. Such an integrated system was foreseen since the design of the infrastructure and is now central to the operations model. In order to cope with the ever growing needs of restricting access to all resources used within the experiment, the Roles Based Access Control (RBAC) previously developed has been extended and improved. The paper starts with a short presentation of the RBAC design, implementation and the changes made to the system to allow the management and usage of roles to control access to the vast and diverse set of resources. The RBAC implementation uses a directory service based on Lightweight Directory Access Protocol to store the users (∼3000), roles (∼320), groups (∼80) and access policies. The information is kept in sync with various other databases and directory services: human resources, central CERN IT, CERN Active Directory and the Access Control Database used by DCS. The paper concludes with a detailed description of the integration across all areas of the system.

  14. A missed primary care appointment correlates with a subsequent emergency department visit among children with asthma.

    Science.gov (United States)

    McGovern, Colleen Marie; Redmond, Margaret; Arcoleo, Kimberly; Stukus, David R

    2017-11-01

    Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits. Longitudinal, retrospective review at a children's hospital was conducted for children with diagnosed asthma (ICD-9 493.xx), ages 2-18 years, scheduled for a PC visit between January 1, 2010, and June 30, 2012 (N = 3895). Records were cross-referenced with all asthma-related ED visits from January 1, 2010 to December 31, 2012. Logistic regression with maximum likelihood estimation was conducted. None of the children who completed a PC appointment experienced an ED visit in the subsequent 6 months whereas 2.7% of those with missed PC appointments had an ED visit (χ 2 = 64.28, p asthma as one mechanism for preventing ED visits was demonstrated. Interventions targeting missed visits could decrease asthma-related morbidity, preventable ED visits, and healthcare costs.

  15. [Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

    2016-01-01

    This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

  16. Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic.

    Science.gov (United States)

    Drewek, Rupali; Mirea, Lucia; Adelson, P David

    High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.

  17. Role Based Access Control system in the ATLAS experiment

    CERN Document Server

    Valsan, M L; The ATLAS collaboration; Lehmann Miotto, G; Scannicchio, D A; Schlenker, S; Filimonov, V; Khomoutnikov, V; Dumitru, I; Zaytsev, A S; Korol, A A; Bogdantchikov, A; Caramarcu, C; Ballestrero, S; Darlea, G L; Twomey, M; Bujor, F; Avolio, G

    2011-01-01

    The complexity of the ATLAS experiment motivated the deployment of an integrated Access Control System in order to guarantee safe and optimal access for a large number of users to the various software and hardware resources. Such an integrated system was foreseen since the design of the infrastructure and is now central to the operations model. In order to cope with the ever growing needs of restricting access to all resources used within the experiment, the Roles Based Access Control (RBAC) previously developed has been extended and improved. The paper starts with a short presentation of the RBAC design, implementation and the changes made to the system to allow the management and usage of roles to control access to the vast and diverse set of resources. The paper continues with a detailed description of the integration across all areas of the system: local Linux and Windows nodes in the ATLAS Control Network (ATCN), the Linux application gateways offering remote access inside ATCN, the Windows Terminal Serv...

  18. Role Based Access Control System in the ATLAS Experiment

    CERN Document Server

    Valsan, M L; The ATLAS collaboration; Lehmann Miotto, G; Scannicchio, D A; Schlenker, S; Filimonov, V; Khomoutnikov, V; Dumitru, I; Zaytsev, A S; Korol, A A; Bogdantchikov, A; Avolio, G; Caramarcu, C; Ballestrero, S; Darlea, G L; Twomey, M; Bujor, F

    2010-01-01

    The complexity of the ATLAS experiment motivated the deployment of an integrated Access Control System in order to guarantee safe and optimal access for a large number of users to the various software and hardware resources. Such an integrated system was foreseen since the design of the infrastructure and is now central to the operations model. In order to cope with the ever growing needs of restricting access to all resources used within the experiment, the Roles Based Access Control (RBAC) previously developed has been extended and improved. The paper starts with a short presentation of the RBAC design, implementation and the changes made to the system to allow the management and usage of roles to control access to the vast and diverse set of resources. The paper continues with a detailed description of the integration across all areas of the system: local Linux and Windows nodes in the ATLAS Control Network (ATCN), the Linux application gateways offering remote access inside ATCN, the Windows Terminal Serv...

  19. Teachers' Attitudes toward the Appointment of Women as School Leaders: The Case of the Arab Education System in Israel

    Science.gov (United States)

    Arar, Khalid; Abramovitz, Ruth

    2013-01-01

    The trend towards gender equality in principalship appointments continues to interest researchers, especially when it appears in traditional societies that maintain patriarchal, anti-feminist attitudes and values. Arab society in Israel is undergoing transition from traditionalism to modernism. Arab women hold the majority of Arab school teaching…

  20. 22 CFR 11.30 - Senior Foreign Service officer career candidate and limited non-career appointments.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Senior Foreign Service officer career candidate... PERSONNEL APPOINTMENT OF FOREIGN SERVICE OFFICERS § 11.30 Senior Foreign Service officer career candidate and limited non-career appointments. (a) General considerations. (1) Career officers at the Senior...

  1. The Development Needs of Newly Appointed Senior School Leaders in the Western Cape South Africa: A Case Study

    Directory of Open Access Journals (Sweden)

    Nelius Jansen van Vuuren

    2017-12-01

    Full Text Available The essential role that senior school leaders play in school leadership teams to ensure effective strategic leadership in schools has been the subject of intense discussion for many years. Crucial to this debate is the establishment of professional learning and leadership approaches for newly appointed senior school leaders. Recommendations for policy and practice highlight the importance of appropriate, multifaceted, developmental support initiatives for newly appointed school leaders. In many countries, including South Africa, a teaching qualification and, in most cases, extensive teaching experience is the only requirement for being appointed as a senior school leader in a school. This tends to suggest that no further professional development is required for newly appointed school leaders, the problem addressed in this paper. This paper reports on the main findings of the perceived development needs of newly appointed senior school leaders in the Western Cape, South Africa, and suggests that school leaders occupy a unique and specialist role in education, which requires relevant and specific preparation to support effective leadership. The respondents of this study report a lack of contextualised training and support before and after their appointment in their new roles creating unique development needs. This paper, therefore, employs a mixed-method approach to gather data to understand the perceived needs of twenty newly appointed senior school leaders in the Western Cape, South Africa.

  2. A Study of an Appointment Scheduling System for Outpatients at the United States Air Force Academy Hospital.

    Science.gov (United States)

    1988-07-30

    8a. NAME OF FUNDING/SPONSORING 8b. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (If applicable) 8c. ADDRESS (City, State...Services are provided in General Dentistry, Oral Surgery, Periodontics, Prosthodontics, Endodontics , and Orthodontics (MHR 1987, 4-5). The hospital also...appointment D. Shields 4 clerks using a rotary wheel file. Schedules were forwarded to outpatien records to pull the patient record prior to the clinic

  3. A Study to Determine the Optimal Patient Appointment System for the Fitzsimons Army Medical Center Outpatient Clinic

    Science.gov (United States)

    1988-06-01

    Patient attitudes of health care services are complex and multidimensional (Powers, 394). Consumers expect to be treated courteously and promptly and...34, 891). When satisfied with health services, many patients will perceive the facility as efficient and worth the money spent. Satisfied customers will... health care facilities expect prompt appointments (Cupit, 140). It is for this reason, that in this era of consumerism , patient waiting time has emerged

  4. The unilateral appointment of co-arbitrators

    DEFF Research Database (Denmark)

    Tufte-Kristensen, Johan

    2016-01-01

    on some important aspects of the procedure but leaves certain aspects and arguments unconsidered. The article approaches the appointment procedure from a neutral position. It identifies and considers the relevant rules, practices, and arguments in order to discuss the procedure’s implications...... of experienced arbitration practitioners have advocated against the procedure for some of the reasons above, whereas other experienced arbitration practitioners have defended the procedure because of its practical advantages and underlying rationales. Each of the previous contributions to the debate sheds light...

  5. Analysis of Access Control Policies in Operating Systems

    Science.gov (United States)

    Chen, Hong

    2009-01-01

    Operating systems rely heavily on access control mechanisms to achieve security goals and defend against remote and local attacks. The complexities of modern access control mechanisms and the scale of policy configurations are often overwhelming to system administrators and software developers. Therefore, mis-configurations are common, and the…

  6. Performance estimates for personnel access control systems

    International Nuclear Information System (INIS)

    Bradley, R.G.

    1980-10-01

    Current performance estimates for personnel access control systems use estimates of Type I and Type II verification errors. A system performance equation which addresses normal operation, the insider, and outside adversary attack is developed. Examination of this equation reveals the inadequacy of classical Type I and II error evaluations which require detailed knowledge of the adversary threat scenario for each specific installation. Consequently, new performance measures which are consistent with the performance equation and independent of the threat are developed as an aid in selecting personnel access control systems

  7. Methods of appointment and qualifications of club doctors and physiotherapists in English professional football: some problems and issues.

    Science.gov (United States)

    Waddington, I; Roderick, M; Naik, R

    2001-02-01

    To examine the methods of appointment, experience, and qualifications of club doctors and physiotherapists in professional football. Semistructured tape recorded interviews with 12 club doctors, 10 club physiotherapists, and 27 current and former players. A questionnaire was also sent to 90 club doctors; 58 were returned. In almost all clubs, methods of appointment of doctors are informal and reflect poor employment practice: posts are rarely advertised and many doctors are appointed on the basis of personal contacts and without interview. Few club doctors had prior experience or qualifications in sports medicine and very few have a written job description. The club doctor is often not consulted about the appointment of the physiotherapist; physiotherapists are usually appointed informally, often without interview, and often by the manager without involving anyone who is qualified in medicine or physiotherapy. Half of all clubs do not have a qualified (chartered) physiotherapist; such unqualified physiotherapists are in a weak position to resist threats to their clinical autonomy, particularly those arising from managers' attempts to influence clinical decisions. Almost all aspects of the appointment of club doctors and physiotherapists need careful re-examination.

  8. Access control within military C4ISR systems

    Science.gov (United States)

    Maschino, Mike

    2003-07-01

    Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance (C4ISR) tactical battlefield systems must provide the right information and resources to the right individuals at the right time. At the same time, the C4ISR system must enforce access controls to prevent the wrong individuals from obtaining sensitive information, or consuming scarce resources. Because lives, missions and property depend upon them, these access control mechanisms must be effective, reliable, efficient and flexible. The mechanisms employed must suit the nature of the items that are to be protected, as well as the varieties of access policies that must be enforced, and the types of access that will be made to these items. Some access control technologies are inherently centralized, while others are suitable for distributed implementation. The C4ISR architect must select from among the available technologies a combination of mechanisms that eases the burden of policy administration, but is inherently survivable, accurate, resource efficient, and which provides low latency. This paper explores various alternative access enforcement mechanisms, and assesses their effectiveness in managing policy-driven access control within the battlespace.

  9. Use of Six Sigma Methodology to Reduce Appointment Lead-Time in Obstetrics Outpatient Department.

    Science.gov (United States)

    Ortiz Barrios, Miguel A; Felizzola Jiménez, Heriberto

    2016-10-01

    This paper focuses on the issue of longer appointment lead-time in the obstetrics outpatient department of a maternal-child hospital in Colombia. Because of extended appointment lead-time, women with high-risk pregnancy could develop severe complications in their health status and put their babies at risk. This problem was detected through a project selection process explained in this article and to solve it, Six Sigma methodology has been used. First, the process was defined through a SIPOC diagram to identify its input and output variables. Second, six sigma performance indicators were calculated to establish the process baseline. Then, a fishbone diagram was used to determine the possible causes of the problem. These causes were validated with the aid of correlation analysis and other statistical tools. Later, improvement strategies were designed to reduce appointment lead-time in this department. Project results evidenced that average appointment lead-time reduced from 6,89 days to 4,08 days and the deviation standard dropped from 1,57 days to 1,24 days. In this way, the hospital will serve pregnant women faster, which represents a risk reduction of perinatal and maternal mortality.

  10. Philip II’s Quest. The Appointment of Governors-General during the Dutch Revolt (1559-1598

    Directory of Open Access Journals (Sweden)

    V. Soen

    2011-01-01

    Full Text Available Philip II’s Quest: The Appointment of Governors-General during the Dutch Revolt (1559-1598Recent historiographical studies have presented the Habsburg appointment of governors-general during the Dutch Revolt as the outcome of factional infighting at the Spanish Court. While this so-called ‘faction model’ has yielded new insights, it also raises a number of problems. Firstly, in the new model, the role of the dynasty is unduly relegated to the background – even though Philip II’s appointment decisions were mainly driven by dynastic considerations. Secondly, the power struggle at the Spanish Court was not only a conflict between court factions, but also between noble houses vying for prestige and trying to secure positions for their offspring. Thirdly, there is an excessive focus on the Spanish Court, while the feuds between noble houses in the Low Countries also played a role in the interim appointments made during the Revolt. Finally, Philip II always looked for the most suitable candidate in terms of administration and warfare during the Dutch Revolt, in accordance with the constraints of the composite Spanish monarchy. Only the combination of these four (frequently contradictory motives reveals how Philip II’s appointment of governors can be seen as a quest for the right man or woman in the right place.

  11. How much does a diabetes out-patient appointment actually cost? An argument for PLICS.

    Science.gov (United States)

    Grant, Paul

    2015-01-01

    The national tariff system for clinical processes and procedures aims to put a discrete unit cost on clinical activity. Calculating such costs can be subject to a great deal of local variation and interpretation. Given the rising costs of diabetes the purpose of this paper is to ask the question what does a diabetes outpatient appointment in the UK NHS actually cost? This is important in a time of financial austerity and healthcare rationing because it can be difficult to decipher the attribution of costs within the acute hospital setting. Exploring this question, the author considers the present cost model and analyse in terms of the language of unit model cost; the basic tariff system and how it works in diabetes and looking at internal cost information the author attempts to unbundle the cost to provide a more accurate value for the cost object. One major finding is that costs and overheads are divided arbitrarily as opposed to being distributed on the basis of measured relative consumption. Alternative costing methods are appraised to demonstrate that a patient level episodic costing approach such as patient level information and costing system (PLICS) which incorporates aspects of activity-based costing (ABC) would be far more appropriate. Using time driven ABC (TDABC), a new patient appointment costs £162 for 30 minutes and a follow-up appointment costs £81 for 15 minutes. PLICS has the added benefit of greater financial and clinical transparency and this goes some way towards the holy grail of greater engagement with the doctors delivering clinical care. It would appear that there are different purposes of different costing systems. One can argue that a costing system is there to both contain costs and divide overheads and demonstrate activity. Depending on how data are interpreted costing information can be an agent of enlightenment and behavioural modification for healthcare professionals to show them their direct and indirect costs, their capacity and

  12. Location based mobile app for doctor's appointment inSaudi Arabia ...

    African Journals Online (AJOL)

    Journal of Fundamental and Applied Sciences ... Reducing waiting times and surgeon idle time improves the quality of service and efficiency ... to develop an appointment management application for mobile devices using the Android platform.

  13. Safety testing for LHC access system

    CERN Document Server

    Valentini, F; Ninin, P; Scibile, S

    2008-01-01

    In the domain of Safety Real-Time Systems the problem of testing represents always a big effort in terms of time, costs and efficiency to guarantee an adequate coverage degree. Exhaustive tests may, in fact, not be practicable for large and distributed systems. This paper describes the testing process followed during the validation of the CERN's LHC Access System [1], responsible for monitoring and preventing physical risks for the personnel accessing the underground areas. In the paper we also present a novel strategy for the testing problem, intended to drastically reduce the time for the test patterns generation and execution. In particular, we propose a methodology for blackbox testing that relies on the application of Model Checking techniques. Model Checking is a formal method from computer science, commonly adopted to prove correctness of system’s models through an automatic system’s state space exploration against some property formulas.

  14. Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

    Directory of Open Access Journals (Sweden)

    Freda Mold

    2015-12-01

    Full Text Available Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1 Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2 Whether online access to records improves patient safety and health outcomes; (3 Whether record access increases disparities across social classes and between genders; and (4 Improving efficiency. The challenges for practice are: (1 How to incorporate online access into clinical workflow; (2 The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

  15. 25 CFR 291.10 - What is the role of the mediator appointed by the Secretary?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is the role of the mediator appointed by the... ENTERPRISES CLASS III GAMING PROCEDURES § 291.10 What is the role of the mediator appointed by the Secretary? (a) The mediator must ask the Indian tribe and the State to submit their last best proposal for Class...

  16. Effect Through Broadcasting System Access Point For Video Transmission

    Directory of Open Access Journals (Sweden)

    Leni Marlina

    2015-08-01

    Full Text Available Most universities are already implementing wired and wireless network that is used to access integrated information systems and the Internet. At present it is important to do research on the influence of the broadcasting system through the access point for video transmitter learning in the university area. At every university computer network through the access point must also use the cable in its implementation. These networks require cables that will connect and transmit data from one computer to another computer. While wireless networks of computers connected through radio waves. This research will be a test or assessment of how the influence of the network using the WLAN access point for video broadcasting means learning from the server to the client. Instructional video broadcasting from the server to the client via the access point will be used for video broadcasting means of learning. This study aims to understand how to build a wireless network by using an access point. It also builds a computer server as instructional videos supporting software that can be used for video server that will be emitted by broadcasting via the access point and establish a system of transmitting video from the server to the client via the access point.

  17. 78 FR 14071 - Notice of Appointment of Members to the National Agricultural Research, Extension, Education, and...

    Science.gov (United States)

    2013-03-04

    ...,'' Charles Boyer, Dean, Jordan College of Agriculture and Technology, California State University-Fresno... DEPARTMENT OF AGRICULTURE Office of the Secretary Notice of Appointment of Members to the National... Act, 5 U.S.C. App 2, the United States Department of Agriculture announces the appointments made by...

  18. Access safety systems - New concepts from the LHC experience

    International Nuclear Information System (INIS)

    Ladzinski, T.; Delamare, C.; Luca, S. di; Hakulinen, T.; Hammouti, L.; Havart, F.; Juget, J.F.; Ninin, P.; Nunes, R.; Riesco, T.; Sanchez-Corral Mena, E.; Valentini, F.

    2012-01-01

    The LHC Access Safety System has introduced a number of new concepts into the domain of personnel protection at CERN. These can be grouped into several categories: organisational, architectural and concerning the end-user experience. By anchoring the project on the solid foundations of the IEC 61508/61511 methodology, the CERN team and its contractors managed to design, develop, test and commission on time a SIL3 safety system. The system uses a successful combination of the latest Siemens redundant safety programmable logic controllers with a traditional relay logic hard wired loop. The external envelope barriers used in the LHC include personnel and material access devices, which are interlocked door-booths introducing increased automation of individual access control, thus removing the strain from the operators. These devices ensure the inviolability of the controlled zones by users not holding the required credentials. To this end they are equipped with personnel presence detectors and the access control includes a state of the art bio-metry check. Building on the LHC experience, new projects targeting the refurbishment of the existing access safety infrastructure in the injector chain have started. This paper summarises the new concepts introduced in the LHC access control and safety systems, discusses the return of experience and outlines the main guiding principles for the renewal stage of the personnel protection systems in the LHC injector chain in a homogeneous manner. (authors)

  19. Task-role-based Access Control Model in Smart Health-care System

    Directory of Open Access Journals (Sweden)

    Wang Peng

    2015-01-01

    Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

  20. Why Patients Miss Follow-Up Appointments: A Prospective Control ...

    African Journals Online (AJOL)

    Reasons include: transport (19 responses), ill-health (6) and financial constraints (5). State transport was unavailable to almost twothirds of the responders who cited transport as a problem. Conclusions: The 17% missed appointment rate is largely due to transport constraints. The commonest time for patients to miss ...

  1. Task Delegation Based Access Control Models for Workflow Systems

    Science.gov (United States)

    Gaaloul, Khaled; Charoy, François

    e-Government organisations are facilitated and conducted using workflow management systems. Role-based access control (RBAC) is recognised as an efficient access control model for large organisations. The application of RBAC in workflow systems cannot, however, grant permissions to users dynamically while business processes are being executed. We currently observe a move away from predefined strict workflow modelling towards approaches supporting flexibility on the organisational level. One specific approach is that of task delegation. Task delegation is a mechanism that supports organisational flexibility, and ensures delegation of authority in access control systems. In this paper, we propose a Task-oriented Access Control (TAC) model based on RBAC to address these requirements. We aim to reason about task from organisational perspectives and resources perspectives to analyse and specify authorisation constraints. Moreover, we present a fine grained access control protocol to support delegation based on the TAC model.

  2. Scientific profile and professional responsibility of Court-appointed Medical Technical Consultants in Italy: time for a specific educational curriculum?

    Science.gov (United States)

    Conti, Andrea Alberto

    2014-08-20

    Court-appointed Technical Consultants (CTCs) are fundamental figures in the Italian judicial system. CTCs are experts appointed by judges in order to supplement their activities by ascertaining, collecting and analyzing facts concerning the specific subject of a lawsuit. These experts formulate opinions, gather motivations and perform checks to provide clear, objective and irrefutable answers to the questions posed by judges. With direct reference to the medical field, while police doctors (specialists in forensic medicine) follow an academic, dedicated, well-structured educational curriculum, the University specialty school in Forensic Medicine, other medical CTCs, though not infrequently luminaries with one or many medical specialties and professional acknowledgments, may have no specific legal-medicine and juridical expertise, precisely because a similar expertise is not formally required of them. In the light of these considerations, in Italy some professionals of the legal world, and of the health context too, have proposed for medical CTCs targeted educational pathways, which would provide these experts with formal specific qualifications. In synthesis and in conclusion, a full knowledge and a rigorous respect of the rules of legal proceedings emerge as increasingly important characteristics for current and future Court-appointed Technical Consultants, together with a specific educational curriculum.

  3. Integrated Identity and Access Management System for Tertiary ...

    African Journals Online (AJOL)

    Nigerian Journal of Technology ... identity management and access control and the unavailability of actionable information on pattern of ... This Tertiary Identity and Access Management System (T-IAMS) is a fingerprint biometric database that ...

  4. 5 CFR 315.603 - Appointment based on former incumbency of a position brought into the competitive service.

    Science.gov (United States)

    2010-01-01

    ... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or Career-Conditional Appointment Under Special Authorities § 315.603 Appointment based on former... type of case from this requirement. (b) Review of disapproved recommendations. Agencies shall establish...

  5. Task-role-based Access Control Model in Smart Health-care System

    OpenAIRE

    Wang Peng; Jiang Lingyun

    2015-01-01

    As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for...

  6. Joint Optimization of Preventive Maintenance and Spare Parts Inventory with Appointment Policy

    Directory of Open Access Journals (Sweden)

    Jing Cai

    2017-01-01

    Full Text Available Under the background of the wide application of condition-based maintenance (CBM in maintenance practice, the joint optimization of maintenance and spare parts inventory is becoming a hot research to take full advantage of CBM and reduce the operational cost. In order to avoid both the high inventory level and the shortage of spare parts, an appointment policy of spare parts is first proposed based on the prediction of remaining useful lifetime, and then a corresponding joint optimization model of preventive maintenance and spare parts inventory is established. Due to the complexity of the model, the combination method of genetic algorithm and Monte Carlo is presented to get the optimal maximum inventory level, safety inventory level, potential failure threshold, and appointment threshold to minimize the cost rate. Finally, the proposed model is studied through a case study and compared with both the separate optimization and the joint optimization without appointment policy, and the results show that the proposed model is more effective. In addition, the sensitivity analysis shows that the proposed model is consistent with the actual situation of maintenance practices and inventory management.

  7. Predictors of Missed Research Appointments in a Randomized Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Stéphanie J.E. Becker

    2014-09-01

     Younger patients with no college education, who believe their health can be controlled, are more likely to miss a research appointment when enrolled in a randomized placebo injection-controlled trial. 

  8. Stock Market Reaction to CEO Appointment – Preliminary Results

    Directory of Open Access Journals (Sweden)

    Katarzyna Byrka-Kita

    2017-06-01

    Full Text Available Purpose: The aim of this paper is to examine shareholders’ reaction to the decision of the supervisory board to appoint a CEO in companies listed on the Warsaw Stock Exchange. Methodology: An event study and the mean-adjusted model were applied. The abnormal returns were measured as the CAAR in the entire (-60, + 60 window and selected sub-windows. Findings: The obtained values of abnormal returns indicate the shareholder’s negative reaction. Throughout the observation window, they oscillate slightly below zero, and in the window (0, +20 they are negative at -1.566%. Irrespective of the observation window, negative abnormal returns were obtained for over half of the observation (52–57%. Therefore, preliminary results indicate the predominance of the information effect over the real one. The decrease in market value as a result of the event may result from an increase in investors’ uncertainty as to the effects of changes in strategy and skills of the new CEO. Originality: The research is a unique one. To date, no one has carried out research into shareholders’ reaction to a CEO appointment in either the Polish or Central and Eastern European capital markets. They primarily bring the value of cognition of shareholders’ behaviour in the analysed event, which is reflected in share prices. They extend the literature on the signalization instruments, i.e. the activities that boards can undertake due to the new information transmitted to the capital market participants and stakeholders. The market reaction to a CEO appointment will without a doubt interest investors; the institutions responsible for supervision (which in the case of Poland is the Financial Oversight Commission and the legislator in charge of regulations that prevent insider trading while promoting corporate disclosure transparency.

  9. Predictors of full-time faculty appointment among MD–PhD program graduates: a national cohort study

    Directory of Open Access Journals (Sweden)

    Dorothy A. Andriole

    2016-05-01

    Full Text Available Purpose: The authors sought to identify variables associated with MD–PhD program graduates’ academic medicine careers. Methods: We analyzed data for a national cohort of MD–PhD program graduates from 2000 to 2005, using multivariable logistic regression to identify independent predictors of full-time academic medicine faculty appointment through 2013. Results: Of 1,860 MD–PhD program graduates in 2000–2005, we included 1,846 (99.2% who had completed residency training before 2014. Of these 1,846 graduates, 968 (52.4% held full-time faculty appointments. Graduates who attended schools with Medical Scientist Training Program (MSTP funding (vs. no MSTP funding; adjusted odds ratio [aOR], 1.41; 95% confidence interval [CI], 1.14–1.74 and participated in ≥1 year of research during residency (vs. no documented research year; aOR, 1.85; 95% CI, 1.50–2.28 were more likely to have held full-time faculty appointments. Asian/Pacific Islander (aOR, 0.74; 95% CI, 0.60–0.93 and under-represented minority (URM; aOR, 0.68; 95% CI, 0.48–0.98 graduates (each vs. white graduates, graduates who reported total debt of ≥$100,000 (vs. no debt at graduation (aOR, 0.58; 95% CI, 0.39–0.88, and graduates in surgical practice (aOR, 0.64; 95% CI, 0.48–0.84 and other practice (aOR, 0.66, 95% CI, 0.54–0.81 specialties (each vs. ‘medicine, pediatrics, pathology, or neurology’ were less likely to have held full-time faculty appointments. Gender was not independently associated with likelihood of full-time faculty appointment. Conclusions: Over half of all MD–PhD program graduates in our study had full-time faculty appointments. Our findings regarding variables independently associated with full-time faculty appointments can inform the design of strategies to promote academic medicine career choice among MD–PhD program graduates. Further research is warranted to identify other factors amenable to intervention, in addition to those included in

  10. H1DS: A new web-based data access system

    Energy Technology Data Exchange (ETDEWEB)

    Pretty, D.G., E-mail: david.pretty@anu.edu.au; Blackwell, B.D.

    2014-05-15

    Highlights: • We present H1DS, a new RESTful web service for accessing fusion data. • We examine the scalability and extensibility of H1DS. • We present a fast and user friendly web browser client for the H1DS web service. • A summary relational database is presented as an application of the H1DS API. - Abstract: A new data access system, H1DS, has been developed and deployed for the H-1 Heliac at the Australian Plasma Fusion Research Facility. The data system provides access to fusion data via a RESTful web service. With the URL acting as the API to the data system, H1DS provides a scalable and extensible framework which is intuitive to new users, and allows access from any internet connected device. The H1DS framework, originally designed to work with MDSplus, has a modular design which can be extended to provide access to alternative data storage systems.

  11. H1DS: A new web-based data access system

    International Nuclear Information System (INIS)

    Pretty, D.G.; Blackwell, B.D.

    2014-01-01

    Highlights: • We present H1DS, a new RESTful web service for accessing fusion data. • We examine the scalability and extensibility of H1DS. • We present a fast and user friendly web browser client for the H1DS web service. • A summary relational database is presented as an application of the H1DS API. - Abstract: A new data access system, H1DS, has been developed and deployed for the H-1 Heliac at the Australian Plasma Fusion Research Facility. The data system provides access to fusion data via a RESTful web service. With the URL acting as the API to the data system, H1DS provides a scalable and extensible framework which is intuitive to new users, and allows access from any internet connected device. The H1DS framework, originally designed to work with MDSplus, has a modular design which can be extended to provide access to alternative data storage systems

  12. 22 CFR 11.20 - Foreign Service specialist career candidate appointments.

    Science.gov (United States)

    2010-04-01

    ..., background investigation, and final review process required of career candidates, but normally they will not... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service specialist career candidate... SERVICE OFFICERS § 11.20 Foreign Service specialist career candidate appointments. (a) General...

  13. 76 FR 10945 - San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver

    Science.gov (United States)

    2011-02-28

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver Notice is hereby given that, pursuant to the authority... appointed the Federal Deposit Insurance Corporation as sole Receiver for San Luis Trust Bank, FSB, San Luis...

  14. 76 FR 73521 - Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law

    Science.gov (United States)

    2011-11-29

    ... 3206-AM06 Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law... statutory bar on employment in an Executive agency of an individual who was required to register with the... as follows: Subpart G--Statutory Bar to Appointment of Persons Who Fail To Register Under the...

  15. Hardships of end-of-life care with court-appointed guardians.

    Science.gov (United States)

    Hastings, Kylie B

    2014-02-01

    In the United States, the court-appointed guardians do not have the ability to make decisions regarding end-of-life (EOL) care for their clients. Additionally, the process of initiating EOL care measures can be slow and cumbersome, despite an existing process of getting approval for such care. This process has the potential to prolong suffering and delay imperative decisions. This article reviews the hardships that patients, court-appointed guardians, and health care staff endure while moving through the oppressive process of obtaining EOL care orders through the court. This article also proposes ways of tuning up the laws, regulations, and communications to make it easier and faster to obtain orders regarding EOL care to preserve the dignity of our patients and loved ones. "A guardianship is a legal relationship created when a person or institution named in a will or assigned by the court to take care of minor children or incompetent adults."

  16. Human engineering considerations in designing a computerized controlled access security system

    International Nuclear Information System (INIS)

    Moore, J.W.; Banks, W.W.

    1988-01-01

    This paper describes a human engineering effort in the design of a major security system upgrade at Lawrence Livermore National Laboratory. This upgrade was to be accomplished by replacing obsolete and difficult-to-man (i.e., multiple operator task actions required) security equipment and systems with a new, automated, computer-based access control system. The initial task was to assist the electronic and mechanical engineering staff in designing a computerized security access system too functionally and ergonomically accommodate 100% of the Laboratory user population. The new computerized access system was intended to control entry into sensitive exclusion areas by requiring personnel to use an entry booth-based system and/or a remote access control panel system. The primary user interface with the system was through a control panel containing a magnetic card reader, function buttons, LCD display, and push-button keypad

  17. Key criteria in appointment of arbitrators in international arbitration

    Directory of Open Access Journals (Sweden)

    Bazil Oglindă

    2015-12-01

    Full Text Available Maybe in all situations the most important factor is the decision making person. In arbitration this person is the arbitrator. Knowing how to choose your arbitrator is the first step in knowing how to win your case. There are some important criteria that needs to be taken into account when appointing an arbitrator, like the independence and impartiality of the arbitrator, the experience in similar cases, knowledge of the system of law applicable to the contract and other backgrounds.Another important aspect is the number of arbitrators and the advantages and disadvantages of having one, three or more arbitrators. All those issues are very important when drafting the arbitration agreement and in matters of complex contracts it is of high importance to have legal advisors that will help you draft an agreement that will minimize risks and favor efficient arbitral proceedings.

  18. Approaches taken by South African advertisers to select and appoint ...

    African Journals Online (AJOL)

    Pitch and industry guidelines play an important role in awarding advertising agency contracts, but agencies must take into account that not all advertisers will adhere to these guidelines. The exploratory research study on which this article reports provides insight into the appointment process and selection criteria applied ...

  19. 41 CFR 102-3.130 - What policies apply to the appointment, and compensation or reimbursement of advisory committee...

    Science.gov (United States)

    2010-07-01

    ... committee staff person who is not a current Federal employee serving under an assignment must be appointed... the appointment, and compensation or reimbursement of advisory committee members, staff, and experts... compensation or reimbursement of advisory committee members, staff, and experts and consultants? In developing...

  20. 31 CFR 370.5 - How can I appoint a financial institution to receive payments on my behalf?

    Science.gov (United States)

    2010-07-01

    ... Entries § 370.5 How can I appoint a financial institution to receive payments on my behalf? You must name a financial institution to receive payments through credit entries using the ACH method. You also... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How can I appoint a financial...

  1. A utility perspective on radiation worker access control systems

    International Nuclear Information System (INIS)

    Watson, B.A.; Goff, T.E.

    1984-01-01

    Based on an evaluation of the current commercial Radiation Worker Access Control Software Systems, Baltimore Gas and Electric Company has elected to design and develop a site specific access control and accountability system for the Calvert Cliffs Nuclear Power Plant. The vendor provided systems allow for radiation worker access control based on training and external exposure records and authorizations. These systems do not afford internal exposure control until after bioassay measurements or maximum permissible concentration-hours are tabulated. The vendor provided systems allow for data trending for ALARA purposes, but each software package must be modified to meet site specific requirements. Unlike the commercial systems, the Calvert Cliffs Radiological Controls and Accountability System (RCAS) will provide radiation worker exposure control, both internal and external. The RCAS is designed to fulfill the requirements by integrating the existing Radiation Safety, Dosemetry, and Training data bases with a comprehensive radiological surveillance program. Prior to each worker's entry into the Radiological Control Area; his training and qualifications, radiation exposure history and authorization, will be compared with administrative controls, such as radiation work permits, and respiratory protection requirements and the radiological conditions in the work area. The RCAS, a computer based applied health physics access control system is described as it is presently configured for development. The mechanisms for enhancing worker internal and external exposure controls are discussed. Proposed data application to both the Calvert Cliffs ALARA and outage planning programs is included

  2. The ARAC client system: network-based access to ARAC

    International Nuclear Information System (INIS)

    Leach, M J; Sumikawa, D; Webster, C

    1999-01-01

    The ARAC Client System allows users (such as emergency managers and first responders) with commonly available desktop and laptop computers to utilize the central ARAC system over the Internet or any other communications link using Internet protocols. Providing cost-effective fast access to the central ARAC system greatly expands the availability of the ARAC capability. The ARAC Client system consists of (1) local client applications running on the remote user's computer, and (2) ''site servers'' that provide secure access to selected central ARAC system capabilities and run on a scalable number of dedicated workstations residing at the central facility. The remote client applications allow users to describe a real or potential them-bio event, electronically sends this information to the central ARAC system which performs model calculations, and quickly receive and visualize the resulting graphical products. The site servers will support simultaneous access to ARAC capabilities by multiple users. The ARAC Client system is based on object-oriented client/server and distributed computing technologies using CORBA and Java, and consists of a large number of interacting components

  3. 26 CFR 25.2523(e)-1 - Marital deduction; life estate with power of appointment in donee spouse.

    Science.gov (United States)

    2010-04-01

    ... satisfied and S is treated as having a general power to appoint 100/250 of the entire interest in the 250... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Marital deduction; life estate with power of... Deductions § 25.2523(e)-1 Marital deduction; life estate with power of appointment in donee spouse. (a) In...

  4. Access to primary health care services for Indigenous peoples: A framework synthesis.

    Science.gov (United States)

    Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

    2016-09-30

    Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

  5. Servant as leader: Critical requirements for the appointment and training of retirement fund trustees

    Directory of Open Access Journals (Sweden)

    L.M. Magda Hewitt

    2017-09-01

    Full Text Available Orientation: The South African retirement fund industry ranks among the 15 largest retirement fund industries internationally, with some 8 million members and assets under management of close to R2 trillion. However, to be successful, retirement funds need good governance. Research purpose: To explore the most critical servant leadership qualities required that can serve as profile in the selection, appointment and training of retirement fund trustees (RFTs to serve on boards of trustees of retirement funds in the South African context. Motivation for the study: The South African National Treasury’s retirement reform proposal clearly articulates government’s concern for the poor governance of retirement fund assets by appointed boards of trustees and the broader implications on social and economic security in retirement. It promotes the regulation of standards relating to the minimum qualifications and expertise needed to be appointed to serve on a board of trustees (BoTs. Although the measures proposed by government to improve fund governance and the role of the RFTs are sound in principle, it does not inform the character, leadership qualities or leadership competence desired for RFTs, thus leaving the management of funds in the hands of people who must make investment decisions when they themselves are not fully committed. Research design, approach and method: The research question was addressed through an extensive literature review and a qualitative methodology using a semi-structured interview; fieldwork that included personal observations; and notes with six active, high-profile, respected, purposefully selected RFTs. An interpretive approach was adopted to provide elaborative interpretations of phenomena without having to rely on numerical measurement. Main findings: A strong similitude exists between servant leader qualities, as found in the literature, and those qualities identified and required to be appointed as a RFT. Literature

  6. The effectiveness of SMS Reminders and the impact of patient characteristics on missed appointments in a public dental outpatient clinic

    OpenAIRE

    Emilia Bellucci; Lasitha Dharmasena; Lemai Nguyen; Hanny Calache

    2017-01-01

    This paper reports on the Failure To Attend (FTA) rate of appointments as well as patients following the implementation of SMS reminders in a public dental outpatient service.  Given the ineffectiveness of the intervention and a highly representative patient’s profile, this paper identifies the demographic characteristics of patients who miss all of their appointments.  Data on appointment attendance, patient demographics and dental service type was collected over a time period of 46 consecut...

  7. Channel Access Algorithm Design for Automatic Identification System

    Institute of Scientific and Technical Information of China (English)

    Oh Sang-heon; Kim Seung-pum; Hwang Dong-hwan; Park Chan-sik; Lee Sang-jeong

    2003-01-01

    The Automatic Identification System (AIS) is a maritime equipment to allow an efficient exchange of the navigational data between ships and between ships and shore stations. It utilizes a channel access algorithm which can quickly resolve conflicts without any intervention from control stations. In this paper, a design of channel access algorithm for the AIS is presented. The input/output relationship of each access algorithm module is defined by drawing the state transition diagram, dataflow diagram and flowchart based on the technical standard, ITU-R M.1371. In order to verify the designed channel access algorithm, the simulator was developed using the C/C++ programming language. The results show that the proposed channel access algorithm can properly allocate transmission slots and meet the operational performance requirements specified by the technical standard.

  8. Development of an access control system for the LHD experimental hall

    International Nuclear Information System (INIS)

    Kawano, T.; Inoue, N.; Sakuma, Y.; Uda, T.; Yamanishi, H.; Miyake, H.; Tanahashi, S.; Motozima, O.

    2000-01-01

    An access control system for the LHD (Large Helical Device) experimental hall had been constructed and its practical operation started in March 1998. Continuously, the system has been improved. The present system keeps watch on involved entrance and exit for the use of persons at four entrances by using five turnstile gates while watching on eight shielding doors at eight positions (four entrances, three carriage entrances and a hall overview) and a stairway connecting the LHD main hall with the LHD basement. Besides, for the security of safety operation of the LHD, fifteen kinds of interlock signals are exchanged between the access control system and the LHD control system. Seven of the interlock signals are properly sent as the occasional demands from the access control system to the LHD control system, in which three staple signals are B Personnel Access to Controlled Area, D Shielding Door Closed, and E No Entrance. It is important that any plasma experiments of the LHD are not permitted while the signal B being sent or D being not sent. The signal E is sent to inform the LHD control system that the turnstile gates are locked. All the plasma experiments should not be done unless the lock procedure of the turnstile is confirmed. When the turnstile gates are locked, any persons cannot enter into the LHD controlled area, but are permissible to exit only. Six of the interlock signals are used to send the information of the working at that time in the LHD controlled area to the access control system. When one signal of the operation mode is sent to the access control system from the LHD, the access control system sets the turnstile gate in situation corresponding to the operation mode, A Equipment Operation, B Vacuum Pumping, C Coil Cooling, D Coil Excitation, and E Plasma Experiment. If the access control system receives, for example, the signal B, this system sets the turnstile gate in the condition of control such that only persons assigned to the work of vacuum

  9. Database design for Physical Access Control System for nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sathishkumar, T., E-mail: satishkumart@igcar.gov.in; Rao, G. Prabhakara, E-mail: prg@igcar.gov.in; Arumugam, P., E-mail: aarmu@igcar.gov.in

    2016-08-15

    Highlights: • Database design needs to be optimized and highly efficient for real time operation. • It requires a many-to-many mapping between Employee table and Doors table. • This mapping typically contain thousands of records and redundant data. • Proposed novel database design reduces the redundancy and provides abstraction. • This design is incorporated with the access control system developed in-house. - Abstract: A (Radio Frequency IDentification) RFID cum Biometric based two level Access Control System (ACS) was designed and developed for providing access to vital areas of nuclear facilities. The system has got both hardware [Access controller] and software components [server application, the database and the web client software]. The database design proposed, enables grouping of the employees based on the hierarchy of the organization and the grouping of the doors based on Access Zones (AZ). This design also illustrates the mapping between the Employee Groups (EG) and AZ. By following this approach in database design, a higher level view can be presented to the system administrator abstracting the inner details of the individual entities and doors. This paper describes the novel approach carried out in designing the database of the ACS.

  10. Database design for Physical Access Control System for nuclear facilities

    International Nuclear Information System (INIS)

    Sathishkumar, T.; Rao, G. Prabhakara; Arumugam, P.

    2016-01-01

    Highlights: • Database design needs to be optimized and highly efficient for real time operation. • It requires a many-to-many mapping between Employee table and Doors table. • This mapping typically contain thousands of records and redundant data. • Proposed novel database design reduces the redundancy and provides abstraction. • This design is incorporated with the access control system developed in-house. - Abstract: A (Radio Frequency IDentification) RFID cum Biometric based two level Access Control System (ACS) was designed and developed for providing access to vital areas of nuclear facilities. The system has got both hardware [Access controller] and software components [server application, the database and the web client software]. The database design proposed, enables grouping of the employees based on the hierarchy of the organization and the grouping of the doors based on Access Zones (AZ). This design also illustrates the mapping between the Employee Groups (EG) and AZ. By following this approach in database design, a higher level view can be presented to the system administrator abstracting the inner details of the individual entities and doors. This paper describes the novel approach carried out in designing the database of the ACS.

  11. 40 CFR 264.34 - Access to communications or alarm system.

    Science.gov (United States)

    2010-07-01

    ... FACILITIES Preparedness and Prevention § 264.34 Access to communications or alarm system. (a) Whenever... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Access to communications or alarm system. 264.34 Section 264.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

  12. Need an Information Security in Access Control System?

    Directory of Open Access Journals (Sweden)

    V. R. Petrov

    2011-12-01

    Full Text Available The purpose of this paper is the general problems of information security in access control system. The field of using is the in project of reconstruction Physical protection system.

  13. RFID Based Security Access Control System with GSM Technology

    OpenAIRE

    Peter Adole; Joseph M. Môm; Gabriel A. Igwue

    2016-01-01

    The security challenges being encountered in many places today require electronic means of controlling access to secured premises in addition to the available security personnel. Various technologies were used in different forms to solve these challenges. The Radio Frequency Identification (RFID) Based Access Control Security system with GSM technology presented in this work helps to prevent unauthorized access to controlled environments (secured premises). This is achieved mainly...

  14. A Fine-Grained Data Access Control System in Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    Boniface K. Alese

    2015-12-01

    Full Text Available The evolving realities of Wireless Sensor Network (WSN deployed to various terrain of life require serving multiple applications. As large amount of sensed data are distributed and stored in individual sensors nodes, the illegal access to these sensitive data can be devastating. Consequently, data insecurity becomes a big concern. This study, therefore, proposes a fine-grained access control system which only requires the right set of users to access a particular data, based on their access privileges in the sensor networks. It is designed using Priccess Protocol with Access policy formulation adopting the principle of Bell Lapadula model as well as Attribute-Based Encryption (ABE to control access to sensor data. The functionality of the proposed system is simulated using Netbeans. The performance analysis of the proposed system using execution time and size of the key show that the higher the key size, the harder it becomes for the attacker to hack the system. Additionally, the time taken for the proposed work is lesser which makes the work faster than the existing work. Consequently, a well secure interactive web-based application that could facilitates the field officers access to stored data in safe and secure manner is developed.

  15. [Requests for emergency appointments with dermatologists in private practice in France: the ETude Urgences en DErmatologie libérale (ET.U.DE) study].

    Science.gov (United States)

    Penso-Assathiany, D; Bourdon-Lanoy, E; Derancourt, C; Roujeau, J-C; Bastuji-Garin, S

    2007-01-01

    work. The score showed good specificity but poor sensitivity and discriminative value. These results suggest that requests for emergency appointments are more frequent than previously suspected (14% of all requests). Physicians considered that emergency appointments within 48 hours were justified for one third of patients. The reasons for consultation and the resulting diagnoses were similar to those seen in emergency hospital consultations. The criteria on which the need for emergency consultation was based were not for the most part dermatologic. The scoring system we established was not sensitive enough to allow reliable pre-selection of patients requiring emergency consultation by telephone.

  16. Supreme Court Appointment Process: Roles of the President, Judiciary Committee, and Senate

    National Research Council Canada - National Science Library

    Rutkus, Denis S

    2007-01-01

    .... Under the Constitution, Justices on the Supreme Court receive lifetime appointments. Such job security in the government has been conferred solely on judges and, by constitutional design, helps insure the Court's independence from the President...

  17. CDC STATE System Tobacco Legislation - Youth Access

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation—Youth Access. The STATE...

  18. Towards ubiquitous access of computer-assisted surgery systems.

    Science.gov (United States)

    Liu, Hui; Lufei, Hanping; Shi, Weishong; Chaudhary, Vipin

    2006-01-01

    Traditional stand-alone computer-assisted surgery (CAS) systems impede the ubiquitous and simultaneous access by multiple users. With advances in computing and networking technologies, ubiquitous access to CAS systems becomes possible and promising. Based on our preliminary work, CASMIL, a stand-alone CAS server developed at Wayne State University, we propose a novel mobile CAS system, UbiCAS, which allows surgeons to retrieve, review and interpret multimodal medical images, and to perform some critical neurosurgical procedures on heterogeneous devices from anywhere at anytime. Furthermore, various optimization techniques, including caching, prefetching, pseudo-streaming-model, and compression, are used to guarantee the QoS of the UbiCAS system. UbiCAS enables doctors at remote locations to actively participate remote surgeries, share patient information in real time before, during, and after the surgery.

  19. Free-space optical code-division multiple-access system design

    Science.gov (United States)

    Jeromin, Lori L.; Kaufmann, John E.; Bucher, Edward A.

    1993-08-01

    This paper describes an optical direct-detection multiple access communications system for free-space satellite networks utilizing code-division multiple-access (CDMA) and forward error correction (FEC) coding. System performance is characterized by how many simultaneous users operating at data rate R can be accommodated in a signaling bandwidth W. The performance of two CDMA schemes, optical orthogonal codes (OOC) with FEC and orthogonal convolutional codes (OCC), is calculated and compared to information-theoretic capacity bounds. The calculations include the effects of background and detector noise as well as nonzero transmitter extinction ratio and power imbalance among users. A system design for 10 kbps multiple-access communications between low-earth orbit satellites is given. With near- term receiver technology and representative system losses, a 15 W peak-power transmitter provides 10-6 BER performance with seven interfering users and full moon background in the receiver FOV. The receiver employs an array of discrete wide-area avalanche photodiodes (APD) for wide field of view coverage. Issues of user acquisition and synchronization, implementation technology, and system scalability are also discussed.

  20. ACCESS TO A COMPUTER SYSTEM. BETWEEN LEGAL PROVISIONS AND TECHNICAL REALITY

    Directory of Open Access Journals (Sweden)

    Maxim DOBRINOIU

    2016-05-01

    Full Text Available Nowadays, on a rise of cybersecurity incidents and a very complex IT&C environment, the national legal systems must adapt in order to properly address the new and modern forms of criminality in cyberspace. The illegal access to a computer system remains one of the most important cyber-related crimes due to its popularity but also from the perspective as being a door opened to computer data and sometimes a vehicle for other tech crimes. In the same time, the information society services slightly changed the IT paradigm and represent the new interface between users and systems. Is true that services rely on computer systems, but accessing services goes now beyond the simple accessing computer systems as commonly understood by most of the legislations. The article intends to explain other sides of the access related to computer systems and services, with the purpose to advance possible legal solutions to certain case scenarios.

  1. Patient Telephone Appointment System for High Volume Primary Care Sites

    National Research Council Canada - National Science Library

    Worthington, Francine

    2000-01-01

    ... efficient, timely, convenient, and appropriate access to care. This study follows a Continuous Improvement philosophy of customer satisfaction, quality process improvement, and benchmarking, also known as "idealized process redesign...

  2. 75 FR 8731 - Proposed Appointment to the National Indian Gaming Commission

    Science.gov (United States)

    2010-02-25

    ... National Indian Gaming Commission ACTION: Notice. SUMMARY: The Indian Gaming Regulatory Act provides for a three-person National Indian Gaming Commission. One member, the chairman, is appointed by the President... as an associate member of the National Indian Gaming Commission for a term of 3 years. DATES...

  3. 12 CFR 509.101 - Appointment of Office of Financial Institution Adjudication.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appointment of Office of Financial Institution... Office of Financial Institution Adjudication. Unless otherwise directed by the Office, all hearings under... direction of the Office of Financial Institution Adjudication, 1700 G Street NW., Washington, DC 20552. ...

  4. The entire network topology display system of terminal communication access network

    OpenAIRE

    An Yi

    2016-01-01

    Now order terminal communication access network is network technology in Shanxi Province is diversiform, device type complex, lack of unified technical standard, the terminal communication access network management system of construction constitutes a great obstacle. Need to build a “unified communication interface and communication standard, unified communications network management” of the terminal communication access network cut in the integrated network management system, for the termina...

  5. The COROT ground-based archive and access system

    Science.gov (United States)

    Solano, E.; González-Riestra, R.; Catala, C.; Baglin, A.

    2002-01-01

    A prototype of the COROT ground-based archive and access system is presented here. The system has been developed at LAEFF and it is based on the experience gained at Laboratorio de Astrofisica Espacial y Fisica Fundamental (LAEFF) with the INES (IUE Newly Extracted System) Archive.

  6. [Judicial and medical/legal aspects of the responsibility of workers appointed to carry out first aid].

    Science.gov (United States)

    Caprioli, L C; Ciavarella, M; Sacco, A

    2005-01-01

    One of the innovations introduced by law 626/94 [the Italian law on occupational health and safety of workers] is the obligation of the employer to designate workers responsible for first aid. To identify and discuss the duties, the role and the medical and legal responsibility of workers appointed to carry out first aid measures. Analysis of legislation and current practice concerning medical and legal responsibility in first aid procedures. The worker appointed to carry out first aid measures is, by virtue of his appointment, obliged to take action. Therefore, he could commit an illegitimate act both by "acting" and by "omitting" to carry out a duty that is his responsibility. In the first case the worker could be accused of committing an unpremeditated criminal offence when his actions involve negligence, imprudence, inexperience or violation of regulations concerning his duties. A "serious criminal offence" is committed when the most elementary rules of diligence, prudence and skill are violated; the offence is "slight" when negligence, imprudence or inexperience are involved in particularly complex situations. The reference parameter for inexperience is not a first aid volunteer, nor a member of the public, but a worker designated to carry out first aid possessing "average" attitudes, training and ability. Briefly, a guilty error by the appointed worker consists of the following: i) the professional conduct of the operator was clearly wrong, serious and unjustifiable; ii) the operator clearly omitted doing his/her duty; iii) the consequence of the error is physical personal damage. The observations made clearly illustrate the delicacy of the tasks of the worker appointed to carry out first aid measures. Essential elements for minimizing wrong and/or negligent conduct are appropriate choice of the designated workers and their adequate training.

  7. CDC STATE System Tobacco Legislation - Youth Access

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2016. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation—Youth Access. The STATE...

  8. Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments.

    Science.gov (United States)

    Sanchez, Iris

    2011-01-01

    The purpose of this study was to implement diabetes self-management education in primary care using the Chronic Care Model and shared medical appointments (SMA) to provide evidence-based interventions to improve process and measure outcomes. A quality improvement project using the Plan-Do-Check-Act cycle was implemented in a primary care setting in South Texas to provide diabetes self-management education for adults. Biological measures were evaluated in 70 patients at initiation of the project and thereafter based on current practice guidelines. The results of the project were consistent with the literature regarding the benefits, sustainability, and viability of SMA. As compared with that in studies presented in the literature, the patient population who participated in SMA had similar outcomes regarding improvement in A1C, self-management skills, and satisfaction. SMA are an innovative system redesign concept with the potential to provide comprehensive and coordinated care for patients with multiple and chronic health conditions while still being an efficient, effective, financially viable, and sustainable program. As the incidence and prevalence of diabetes increase, innovative models of care can meet the growing demand for access and utilization of diabetes self-management education programs. Programs focusing on chronic conditions to improve outcomes can be replicated by health care providers in primary care settings. SMA can increase revenue and productivity, improve disease management, and increase provider and patient satisfaction.

  9. 78 FR 18363 - Proposed Appointment to the National Indian Gaming Commission

    Science.gov (United States)

    2013-03-26

    ... Gaming Commission AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: Before appointing a member to the National Indian Gaming Commission, the Secretary must provide public notice and allow a... member of the National Indian Gaming Commission for a term of 3 years. DATES: Comments must be received...

  10. MAST's Integrated Data Access Management system: IDAM

    International Nuclear Information System (INIS)

    Muir, D.G.; Appel, L.; Conway, N.J.; Kirk, A.; Martin, R.; Meyer, H.; Storrs, J.; Taylor, D.; Thomas-Davies, N.; Waterhouse, J.

    2008-01-01

    A new Integrated Data Access Management system, IDAM, has been created to address specific data management issues of the MAST spherical Tokamak. For example, this system enables access to numerous file formats, both legacy and modern (IDA, Ufile, netCDF, HDF5, MDSPlus, PPF, JPF). It adds data quality values at the signal level, and automatically corrects for problems in data: in timings, calibrations, and labelling. It also builds new signals from signal components. The IDAM data server uses a hybrid XML-relational database to record how data are accessed, whether locally or remotely, and how alias and generic signal names are mapped to true names. Also, XML documents are used to encode the details of data corrections, as well as definitions of composite signals and error models. The simple, user friendly, API and accessor function library, written in C on Linux, is available for applications in C, C++, IDL and Fortran-90/95/2003 with good performance: a MAST plasma current trace (28 kbytes of data), requested using a generic name and with data corrections applied, is delivered over a 100 Mbit/s network in ∼13 ms

  11. The reason for appointing more women to top positions

    OpenAIRE

    Hansson, Martina; Kalantari, Leila

    2015-01-01

    Objective: Our main objective is to identify why the executive management positions of most companies in Europe are not moderately genders diverse. Within this objective we study the pattern of gender representation and diversity in a specific company (named Company A) and investigate theoretically why more women should be appointed to the top positions. Research and practical implications: This thesis contributes to a better understanding of the reason behind not having moderately gender div...

  12. New Editors Appointed for Water Resources Research

    Science.gov (United States)

    2009-03-01

    Praveen Kumar (University of Illinois at Urbana-Champaign), the newly appointed editor in chief of Water Resources Research (WRR), heads the new team of editors for the journal. The other editors are Tom Torgersen (University of Connecticut, Groton), who continues his editorship; Tissa Illangasekare (Colorado School of Mines, Golden); Graham Sander (Loughborough University, Loughborough, UK); and John Selker (Oregon State University, Corvallis). Hoshin Gupta (University of Arizona, Tucson) will join WRR at the end of 2009. The new editors will begin receiving submissions immediately. The incoming editorial board thanks outgoing editors Marc Parlange, Brian Berkowitz, Amilcare Porporato, and Scott Tyler, all of whom will assist during the transition.

  13. Some remarks regarding the procedure of the appointment of the secretary general of the United Nations

    OpenAIRE

    Novaković Marko

    2016-01-01

    Appointing Secretary-General is a process that has always been enshrined in secrecy. In 2016, due to reforms in the appointment process instigated by the president of the Security Council Mogens Lykketoft, more inclusion and transparency have been achieved, with the non-state actors being much more involved in the process. In the procedure itself, first five straw polls suggested that Antonio Guterres will be the new Secretary-General and this proved to be truth. Will this more transparent sy...

  14. Extension Education Symposium: Getting the Most Out of Your Extension Appointment and Still Having a Life

    OpenAIRE

    Powers, W.; Cockett, Noelle E.; Lardy, Gregory P.

    2017-01-01

    Managing the demands of an academic appointment in extension can be a challenging task. Demands from constituent groups, expectations of supervisors, and rigors of promotion and tenure processes can create pressures that young faculty did not expect. Throw in spousal and family duties and you have created a situation that many will find hard to navigate. However, there are ways to cope and, even better news, there are ways to excel in meeting the demands of an academic appointment and enjoyin...

  15. Open Access to General Practice Was Associated with Burnout among General Practitioners

    DEFF Research Database (Denmark)

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without....... In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach...... Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters...

  16. Managing HIV-infected children in a low-resource, public clinic: a comparison of nurse vs. clinical officer practices in ART refill, calculation of adherence and subsequent appointments.

    Science.gov (United States)

    Weigel, Ralf; Feldacker, Caryl; Tweya, Hannock; Gondwe, Chimwemwe; Chiwoko, Jane; Gumulira, Joe; Kalulu, Mike; Phiri, Sam

    2012-01-01

    In Malawi, as in other sub-Saharan African countries, nurses manage patients of all ages on antiretroviral treatment(ART). Nurse management of children is rarely studied.We compare ART prescribing between nurses and clinical officers during routine clinic visits at an urban, public clinic to inform policy in paediatric ART management. Caregivers of children on first-line ART provided information about visit dates, pill counts, ART dosage and formulation to a nurse and, subsequently, to a clinical officer. Nurses and clinical officers independently calculated adherence, dosage based on body weight, and set next appointment date. Clinical officers, but not nurses, accessed an electronic data system that made the calculations for them based on information from prior visits, actual and expected pill consumption, and standard drug supplies. Nurses calculated with pen and paper. For numerical variables, Bland-Altman graphs plot differences of each nurse clinical officer pair against the mean, show the 95% limits of agreement (LoA), and also show the mean difference across all reviews. Kappa statistics assess agreement for categorical variables. A total of 704 matched nurse clinical officer reviews of 367 children attending the ART clinics between March and July 2010 were analyzed. Eight nurses and 18 clinical officers were involved; two nurses and five clinical officers managed 100 visits or more. Overall, there was a good agreement between the two cadres. Differences between nurses and clinical officers were within narrow LoA and mean differences showed little deviation from zero, indicating little skewing towards one cadre. LoA of adherence and morning and evening ART dosages varied from -24% to 24%, -0.4 to 0.4 and -0.41 to 0.40 tablets,respectively, with mean differences (95% CI) of 0.003 (-0.9, 0.91), -0.005 (-0.02, 0.01) and -0.009 (-0.02, 0.01). Next appointment calculations differed more between cadres with LoA from -40 to 42 days [mean difference: 0.96 days (95

  17. Application of the transtheoretical model of behaviour change for identifying older clients' readiness for hearing rehabilitation during history-taking in audiology appointments.

    Science.gov (United States)

    Ekberg, Katie; Grenness, Caitlin; Hickson, Louise

    2016-07-01

    The transtheoretical model (TTM) of behaviour change focuses on clients' readiness for adopting new health behaviours. This study explores how clients' readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients' readiness has consequences for the rehabilitation decisions they make within the initial appointment. Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment. The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments. Clients' readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined). The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients' needs, attitudes, desires, and psychological readiness for action in order to optimize clients' hearing outcomes.

  18. Glance Information System for ATLAS Management

    CERN Document Server

    De Oliveira Fernandes Moraes, L; The ATLAS collaboration; Ramos De Azevedo Evora, LH; Karam, K; Fink Grael, F; Pommes, K; Nessi, M; Cirilli, M

    2011-01-01

    ATLAS Experiment is an international collaboration where more than 37 countries, 172 institutes and laboratories, 2900 physicists, engineers, and computer scientists plus 700 students participate. The management of this teamwork involves several aspects such as institute contribution, employment records, members' appointment, authors' list, preparation and publication of papers and speakers nomination. Previously, most of the information was accessible by a limited group of people and the system used was not designed to handle new requirements easily. Moreover, developers had to face problems such as different terminology, diverse data modeling, heterogeneous databases and unlike users needs. Besides that, the maintenance has to be an easy task considering the long lifetime experiment and professionals turnover. The Glance system, a generic mechanism for accessing any database, acts as an intermediate layer isolating the user from the particularities of each database. It retrieves, inserts and updates the dat...

  19. Editorial - Open Access and accessing openness

    Directory of Open Access Journals (Sweden)

    Yngve Nordkvelle

    2008-12-01

    Full Text Available Seminar.net enters it’s fourth year, and has reached a state of maturity in a number of meanings: it receives manuscripts from all continents, the articles are read from 134 countries, of which India represents the highest number of readers, a number of articles have been read by more than 10 000 interested persons, and the frequency of issues is now three per year, and will reach four by next year. Interested parties now approach us in order to learn about our policies and practices.It takes time to become established and influential in the sense that articles are cited and referred to in prestigious publications. Still, the most prestigious publications are on paper. Many countries now embark on a policy that rewards researchers that publish in international journals, preferably in English. National languages are rendered less significant. In the UK, the research assessment exercise (RAE, and several other countries with a publication or citation based reward system in research, tend to favour quantitative dimensions at the expense of the quality of the publication. International publishing houses are huge profit-making companies that over years have increased their profit rates, charging increasingly economically pressured higher education institution with high subscription rates. With the advent of electronic publishing their position is severely challenged. It has been noted that the most significant publication of the last couple of decades was an electronic publication: Tim Berners Lee published the protocol for the World Wide Web in 1990. It was never refereed, nor was controlled by appointed gatekeepers of the “establishment”. The number of Open Access publications is rising every day, and the number of e-journals for academic publishing is reaching higher and higher numbers. In a recent case The Faculty of Arts and Sciences at Harvard University decided, that Harvard employees must publish all their material simultaneously on the

  20. Distributed Access View Integrated Database (DAVID) system

    Science.gov (United States)

    Jacobs, Barry E.

    1991-01-01

    The Distributed Access View Integrated Database (DAVID) System, which was adopted by the Astrophysics Division for their Astrophysics Data System, is a solution to the system heterogeneity problem. The heterogeneous components of the Astrophysics problem is outlined. The Library and Library Consortium levels of the DAVID approach are described. The 'books' and 'kits' level is discussed. The Universal Object Typer Management System level is described. The relation of the DAVID project with the Small Business Innovative Research (SBIR) program is explained.

  1. Optimizing data access in the LAMPF control system

    International Nuclear Information System (INIS)

    Schaller, S.C.; Corley, J.K.; Rose, P.A.

    1985-01-01

    The LAMPF control system data access software offers considerable power and flexibility to application programs through symbolic device naming and an emphasis on hardware independence. This paper discusses optimizations aimed at improving the performance of the data access software while retaining these capabilities. The only aspects of the optimizations visible to the application programs are ''vector devices'' and ''aggregate devices.'' A vector device accesses a set of hardware related data items through a single device name. Aggregate devices allow run-time optimization of references to groups of unrelated devices. Optimizations not visible on the application level include careful handling of: network message traffic; the sharing of global resources; and storage allocation

  2. Sports Direct to appoint full-time nurse after inquiry into employment practices.

    Science.gov (United States)

    2016-09-14

    Retailer Sports Direct is to appoint a full-time nurse at its vast warehouse in response to concerns about health and safety. The firm was the subject of a House of Commons business, innovation and skills select committee inquiry into its employment practices.

  3. Factors related to missing and rescheduling pharmaceutical care appointments by aged outpatients in a Brazilian public health setting

    Directory of Open Access Journals (Sweden)

    Thiago Vinícius Nadaleto Didone

    2015-12-01

    Full Text Available Objectives: To uncover reasons why patients missed pharmaceutical care (PC appointments, identify predictive factors to miss at least one appointment and to reschedule after a miss, and compare the rescheduling behavior of patients receiving different types of PC. Methods: All elderly patients who had at least one scheduled appointment in the PC service of a health setting of São Paulo city, Brazil, from January to December/2011 were included. Chi-square analysis compared categorical data between groups; multivariate logistic regression models predicted attendance and rescheduling behavior. Results: We identified 421 patients, being 221 (52.5% non-attenders. Forgetting the appointment was the most common patient-related reason (56.3%. Illiteracy was a risk factor to be a non-attender [OR(95%CI=2.27(1.17:4.40, p=0.015]. Patients having previous knowledge of the pharmacist presented more chance to rescheduled an appointment after the first miss compared to those who had not [OR(95%CI=3.57(1.90:6.71, p<0.001]. Further, non-attenders who had knowledge of the pharmacist and received Medication Review with Follow-up rescheduled more than the ones receiving other types of PC (p=0.035. Conclusion: Illiteracy predicted non-attendance in PC to aged outpatients and forgetfulness was the main reason for that. The previous acquaintance of the pharmacist and the provision of pharmaceotherapeutic follow-up explained the rescheduling behavior, which indicates the establishment of a patient-centered patient-pharmacist relationship plays a pivotal role in the continuity of the PC.

  4. Homeless people's access to primary care physiotherapy services: an exploratory, mixed-method investigation using a follow-up qualitative extension to core quantitative research.

    Science.gov (United States)

    Dawes, Jo; Deaton, Stuart; Greenwood, Nan

    2017-06-30

    The purpose of this study was to appraise referrals of homeless patients to physiotherapy services and explore perceptions of barriers to access. This exploratory mixed-method study used a follow-up qualitative extension to core quantitative research design. Over 9 months, quantitative data were gathered from the healthcare records of homeless patients referred to physiotherapy by a general practitioner (GP) practice, including the number of referrals and demographic data of all homeless patients referred. Corresponding physiotherapy records of those people referred to physiotherapy were searched for the outcome of their care. Qualitative semi-structured telephone interviews, based on the quantitative findings, were carried out with staff involved with patient care from the referring GP practice and were used to expand insight into the quantitative findings. Two primary care sites provided data for this study: a GP practice dedicated exclusively to homeless people and the physiotherapy department receiving their referrals. Quantitative data from the healthcare records of 34 homeless patient referrals to physiotherapy were collected and analysed. In addition, five staff involved in patient care were interviewed. 34 referrals of homeless people were made to physiotherapy in a 9-month period. It was possible to match 25 of these to records from the physiotherapy department. Nine (36%) patients did not attend their first appointment; seven (28%) attended an initial appointment, but did not attend a subsequent appointment and were discharged from the service; five (20%) completed treatment and four patients (16%) had ongoing treatment. Semi-structured interviews revealed potential barriers preventing homeless people from accessing physiotherapy services, the complex factors being faced by those making referrals and possible ways to improve physiotherapy access. Homeless people with musculoskeletal problems may fail to access physiotherapy treatment, but opportunities

  5. Access control system for two person rule at Rokkasho Reprocessing Plant

    International Nuclear Information System (INIS)

    Yanagisawa, Sawako; Ino, Munekazu; Yamada, Noriyuki; Oota, Hiroto; Iwasaki, Mitsuaki; Kodani, Yoshiki; Iwamoto, Tomonori

    2014-01-01

    Following the amendment and enforcement of Regulation of Reprocessing Activity on March 29th 2012, two person rule has become compulsory for the specific rooms to counter and prevent the sabotage or theft of nuclear materials by the insiders at reprocessing plant in Japan. The rooms will include those which contains cooling systems for decay heat removal from spent fuels and so on, scavenging systems to prevent the hydrogen accumulation, and those which contains nuclear material. To ensure the two person rule at Rokkasho Reprocessing Plant, JNFL has recently, after comprehensive study, introduced efficient and effective access control system for the rooms mentioned above. The system is composed of bio-attestation devices, surveillance cameras and electronic locks to establish access control system. This report outlines the access control system for two person rule and introduces the operation. (author)

  6. mHealth Clinic Appointment PC Tablet: Implementation, Challenges and Solutions

    Science.gov (United States)

    Smith, Carol E.; Spaulding, Ryan; Piamjariyakul, Ubolrat; Werkowitch, Marilyn; Yadrich, Donna Macan; Hooper, Dedrick; Moore, Tyson; Gilroy, Richard

    2015-01-01

    Background Patients requiring daily intravenous (IV) home parenteral nutrition (HPN) would benefit from in-home professional observation to improve self-care, to assess, detect and prevent serious complications. Aims The study aims are to assess the viability and utility of conducting mobile healthcare (mHealth) videoconference assessments with patients managing lifelong daily 12-hour IV nutrition infusions in their homes. The challenges and solutions to implementing mobile personal computer (PC) tablet based clinic appointments are described. Methods A wireless Apple iPad Mini™ mobile touch-screen tablet computer with 5 mega-pixel camera was loaned to patients. Each tablet had Polycom RealPresence software and a fourth generation (4G) mobile telecommunications data plan. These supported audio-visual mobile videoconferencing encrypted connections between health professionals in their offices and HPN patients and their family members in their homes. Patients’ and professionals’ evaluations of their mHealth clinic experiences are collected. Results Patients (mean age = 41.9, SD = 2.8 years) had been prescribed 12-hour home parenteral nutrition (HPN) infusions daily due short bowel disorders. Patients had been on HPN from 1 to 10 years (M=4, SD=3.6). Evaluation of clinic appointments revealed that 100% of the patients (n=45) and the professionals (n=6) indicated that they can clearly hear and easily see one another. The mHealth audio-visual interactions were highly rated by patients and family members. Professionals highly rated their ability to obtain a medical history and visual inspection of patients. Several challenges were identified and recommendations for resolutions are described. Discussion All patients and professionals highly rated the iPad mHealth clinic appointments for convenience and ease of communicating between homes and offices. An important challenge for all mHealth visits is the clinical professional’s ability to make clinically accurate

  7. Efficient medium access control protocol for geostationary satellite systems

    Institute of Scientific and Technical Information of China (English)

    王丽娜; 顾学迈

    2004-01-01

    This paper proposes an efficient medium access control (MAC) protocol based on multifrequency-time division multiple access (MF-TDMA) for geostationary satellite systems deploying multiple spot-beams and onboard processing,which uses a method of random reservation access with movable boundaries to dynamically request the transmission slots and can transmit different types of traffic. The simulation results have shown that our designed MAC protocol can achieve a high bandwidth utilization, while providing the required quality of service (QoS) for each class of service.

  8. Navy Controls for Invoice, Receipt, Acceptance, and Property Transfer System Need Improvement

    Science.gov (United States)

    2016-02-25

    appointment. Defense Finance and Accounting Ser vice personnel who maintain the official DD Form 577 database for DoD stated that the DD Forms 577 for these...agreements bet ween iR APT and the various entitlement systems and a memorandum of understanding bet ween Nav y and the Defense Finance and Accounting ...Pacific, SWRMC, NAVFAC SW, DLA; and Defense Finance and Accounting Ser v ice to identif y policies and procedures in place over the access

  9. Direct and indirect patient costs of dermatology clinic visits and their impact on access to care and provider preference.

    Science.gov (United States)

    Rothstein, Brooke E; Gonzalez, Jessica; Cunningham, Kiera; Saraiya, Ami; Dornelles, Adriana C; Nguyen, Bichchau M

    2017-12-01

    The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients. Patients' lost time and earnings comprise the opportunity cost of obtaining care. A monetary value for this opportunity cost can be calculated by multiplying a patient's hourly wage by the number of hours that the patient dedicated to attending the dermatology appointment. Using a single institution survey, this study quantified the direct and indirect patient costs, including opportunity costs and time burden, associated with dermatology clinic visits to better appreciate the impact of these factors on health care access and dermatologic provider preference.

  10. 5 CFR 315.705 - Employees serving under transitional or veterans recruitment appointments.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Employees serving under transitional or veterans recruitment appointments. 315.705 Section 315.705 Administrative Personnel OFFICE OF PERSONNEL...-Conditional Employment From Other Types of Employment § 315.705 Employees serving under transitional or...

  11. A novel IPTV program multiplex access system to EPON

    Science.gov (United States)

    Xu, Xian; Liu, Deming; He, Wei; Lu, Xi

    2007-11-01

    With the rapid development of high speed networks, such as Ethernet Passive Optical Network (EPON), traffic patterns in access networks have evolved from traditional text-oriented service to the mixed text-, voice- and video- based services, leading to so called "Triple Play". For supporting IPTV service in EPON access network infrastructure, in this article we propose a novel IPTV program multiplex access system to EPON, which enables multiple IPTV program source servers to seamlessly access to IPTV service access port of optical line terminal (OLT) in EPON. There are two multiplex schemes, namely static multiplex scheme and dynamic multiplex scheme, in implementing the program multiplexing. Static multiplex scheme is to multiplex all the IPTV programs and forward them to the OLT, regardless of the need of end-users. While dynamic multiplex scheme can dynamically multiplex and forward IPTV programs according to what the end-users actually demand and those watched by no end-user would not be multiplexed. By comparing these two schemes, a reduced traffic of EPON can be achieved by using dynamic multiplex scheme, especially when most end-users are watching the same few IPTV programs. Both schemes are implemented in our system, with their hardware and software designs described.

  12. Facilitators of prenatal care access in rural Appalachia.

    Science.gov (United States)

    Phillippi, Julia C; Myers, Carole R; Schorn, Mavis N

    2014-12-01

    There are many providers and models of prenatal care, some more effective than others. However, quantitative research alone cannot determine the reasons beneficial models of care improve health outcomes. Perspectives of women receiving care from effective clinics can provide valuable insight. We surveyed 29 women receiving care at a rural, Appalachian birth center in the United States with low rates of preterm birth. Semi-structured interviews and demographic questionnaires were analyzed using conventional qualitative content analysis of manifest content. Insurance was the most common facilitator of prenatal access. Beneficial characteristics of the provider and clinic included: personalized care, unrushed visits, varied appointment times, short waits, and choice in the type and location of care. There is a connection between compassionate and personalized care and positive birth outcomes. Women were willing to overcome barriers to access care that met their needs. To facilitate access to prenatal care and decrease health disparities, healthcare planners, and policy makers need to ensure all women can afford to access prenatal care and allow women a choice in their care provider. Clinic administrators should create a welcoming clinic environment with minimal wait time. Unrushed, woman-centered prenatal visits can increase access to and motivation for care and are easily integrated into prenatal care with minimal cost. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. Evaluating accessibility to Bangkok Metro Systems using multi-dimensional criteria across user groups

    Directory of Open Access Journals (Sweden)

    Duangporn Prasertsubpakij

    2012-07-01

    Full Text Available Metro systems act as fast and efficient transport systems for many modern metropolises; however, enhancing higher usage of such systems often conflicts with providing suitable accessibility options. The traditional approach of metro accessibility studies seems to be an ineffective measure to gage sustainable access in which the equal rights of all users are taken into account. Bangkok Metropolitan Region (BMR transportation has increasingly relied on the role of two mass rapid transport systems publicly called “BTS Skytrain” and “MRT Subway”, due to limited availability of land and massive road congestion; however, access to such transit arguably treats some vulnerable groups, especially women, the elderly and disabled people unfairly. This study constructs a multi-dimensional assessment of accessibility considerations to scrutinize how user groups access metro services based on BMR empirical case. 600 individual passengers at various stations were asked to rate the questionnaire that simultaneously considers accessibility aspects of spatial, feeder connectivity, temporal, comfort/safety, psychosocial and other dimensions. It was interestingly found by user disaggregated accessibility model that the lower the accessibility perceptions—related uncomfortable and unsafe environment conditions, the greater the equitable access to services, as illustrated by MRT — Hua Lumphong and MRT — Petchaburi stations. The study suggests that, to balance the access priorities of groups on services, policy actions should emphasize acceptably safe access for individuals, cost efficient feeder services connecting the metro lines, socioeconomic influences and time allocation. Insightful discussions on integrated approach balancing different dimensions of accessibility and recommendations would contribute to accessibility-based knowledge and potential propensity to use the public transits towards transport sustainability.

  14. 77 FR 63872 - Senior Executive Service; Appointment of Members to the Performance Review Board

    Science.gov (United States)

    2012-10-17

    ... Resources--Kim L.H. Green. Rotating Membership ASP Kathleen E. Franks, Director, Office of Regulatory and... OLMS Stephen J. Willertz, Director, Office of Enforcement and International Union Audits--appointment...

  15. Accessibility and preferred use of online Web applications among WIC participants with Internet access.

    Science.gov (United States)

    Bensley, Robert J; Hovis, Amanda; Horton, Karissa D; Loyo, Jennifer J; Bensley, Kara M; Phillips, Diane; Desmangles, Claudia

    2014-01-01

    This study examined the current technology use of clients in the western Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) region and the preferences these current clients have for using new technologies to interact with WIC. Cross-sectional convenience sample for online survey of WIC clients over 2 months in 2011. A weighted sample of 8,144 participants showed that the majority of WIC clients have access to the Internet using a computer or mobile phone. E-mail, texting, and Facebook were technologies most often used for communication. Significant differences (P video chat. Technologies should be considered for addressing WIC clients' needs, including use of text messaging and smartphone apps for appointments, education, and other WIC services; online scheduling and nutrition education; and a stronger Facebook presence for connecting with WIC clients and breastfeeding support. Published by Elsevier Inc.

  16. 20 CFR 408.1101 - Can you appoint someone to represent you?

    Science.gov (United States)

    2010-04-01

    ... WORLD WAR II VETERANS Representation of Parties § 408.1101 Can you appoint someone to represent you? (a... clause in paragraph (b), the second sentences in paragraphs (b)(1) and (b)(2), and paragraph (c)(2) do... this part, the rules on representation of parties in §§ 416.1500-416.1505, 416.1507-416.1515 and 416...

  17. 75 FR 44853 - Woodlands Bank, Bluffton, SC; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-07-29

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Woodlands Bank, Bluffton, SC; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Woodlands Bank, Bluffton, South Carolina (OTS No. 08464), as of...

  18. 75 FR 45012 - Turnberry Bank, Aventura, FL; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-07-30

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Turnberry Bank, Aventura, FL; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Turnberry Bank, Aventura, Florida (OTS No. 08087), on July 16...

  19. Development of Patient Status-Based Dynamic Access System for Medical Information Systems

    Directory of Open Access Journals (Sweden)

    Chang Won Jeong

    2015-06-01

    Full Text Available Recently, the hospital information system environment using IT communication technology and utilization of medical information has been increasing. In the medical field, the medical information system only supports the transfer of patient information to medical staff through an electronic health record, without information about patient status. Hence, it needs a method of real-time monitoring for the patient. Also, in this environment, a secure method in approaching healthcare through various smart devices is required. Therefore, in this paper, in order to classify the status of the patients, we propose a dynamic approach of the medical information system in a hospital information environment using the dynamic access control method. Also, we applied the symmetric method of AES (Advanced Encryption Standard. This was the best encryption algorithm for sending and receiving biological information. We can define usefulness as the dynamic access application service based on the final result of the proposed system. The proposed system is expected to provide a new solution for a convenient medical information system.

  20. Improving patient access to prevent sight loss: ophthalmic electronic referrals and communication (Scotland).

    Science.gov (United States)

    Khan, A A; Mustafa, M Z; Sanders, R

    2015-02-01

    With the number of people with sight loss predicted to double to four million people in the UK by the year 2050, preventable visual loss is a significant public health issue. Sight loss is associated with an increased risk of falls, accidents and depression and evidence suggests that 50% of sight loss can be avoided. Timely diagnosis is central to the prevention of sight loss. Access to care can be a limiting factor in preventable cases. By improving referrals and access to hospital eye services it is possible to treat and minimise the number of patients with preventable sight loss and the impact this has on wider society. In 2005, NHS Fife took part in a flagship pilot funded by the Scottish government e-health department to evaluate the feasibility, safety, clinical effectiveness, and cost of electronic referral with images of patients directly from community optometrists to Hospital Eye Service (HES). The pilot study showed that electronic referral was feasible, fast, safe, and obviated the need for outpatient appointments in 128 (37%) patients with a high patient satisfaction. The results of the pilot study were presented and in May 2007, the electronic referral system was rolled out regionally in southeast Scotland. Referrals were accepted at a single site with vetting by a trained team and appointments were allocated within 48 hours. Following the implementation of electronic referral, waiting times were reduced from a median of 14 to 4 weeks. Significantly fewer new patients were seen (7462 vs 8714 [p electronic communication between community optometry practices and hospital eye departments. Five electronic forms were specifically designed for cataract, glaucoma, macula, paediatric and general ophthalmic disease. A Virtual Private Network was created which enabled optometrists to connect to the Scottish clinical information gateway system and send referrals to hospital and receive referral status feedback. Numerous hurdles have been encountered and overcome

  1. Accessing files in an Internet: The Jade file system

    Science.gov (United States)

    Peterson, Larry L.; Rao, Herman C.

    1991-01-01

    Jade is a new distribution file system that provides a uniform way to name and access files in an internet environment. It makes two important contributions. First, Jade is a logical system that integrates a heterogeneous collection of existing file systems, where heterogeneous means that the underlying file systems support different file access protocols. Jade is designed under the restriction that the underlying file system may not be modified. Second, rather than providing a global name space, Jade permits each user to define a private name space. These private name spaces support two novel features: they allow multiple file systems to be mounted under one directory, and they allow one logical name space to mount other logical name spaces. A prototype of the Jade File System was implemented on Sun Workstations running Unix. It consists of interfaces to the Unix file system, the Sun Network File System, the Andrew File System, and FTP. This paper motivates Jade's design, highlights several aspects of its implementation, and illustrates applications that can take advantage of its features.

  2. Accessing files in an internet - The Jade file system

    Science.gov (United States)

    Rao, Herman C.; Peterson, Larry L.

    1993-01-01

    Jade is a new distribution file system that provides a uniform way to name and access files in an internet environment. It makes two important contributions. First, Jade is a logical system that integrates a heterogeneous collection of existing file systems, where heterogeneous means that the underlying file systems support different file access protocols. Jade is designed under the restriction that the underlying file system may not be modified. Second, rather than providing a global name space, Jade permits each user to define a private name space. These private name spaces support two novel features: they allow multiple file systems to be mounted under one directory, and they allow one logical name space to mount other logical name spaces. A prototype of the Jade File System was implemented on Sun Workstations running Unix. It consists of interfaces to the Unix file system, the Sun Network File System, the Andrew File System, and FTP. This paper motivates Jade's design, highlights several aspects of its implementation, and illustrates applications that can take advantage of its features.

  3. The first antenatal appointment: An exploratory study of the experiences of women with a diagnosis of mental illness.

    Science.gov (United States)

    Phillips, Louise; Thomas, Dona

    2015-08-01

    to explore and gain insight into the expectations and experiences of women with a pre-existing diagnosis of mental illness, of their first booking appointment; to make recommendations for practice development and collaborative partnership working between healthcare professionals. a qualitative design using semi structured interviews and thematic analysis of the data. QSR NVivo 10 software is used to organise the data into themes. the interviews took place either at the women׳s homes, or within the antenatal service with the consent of the woman and relevant practitioners. twelve participants were selected from one antenatal clinic and one perinatal mental health service. the themes identified within the data included the lack of information prior to the initial midwife booking appointment; the perception of too much information at the initial booking appointment and women not being clear about their mental health needs at this time; a general positivity about disclosing mental illness diagnoses; overall positive thoughts about midwives although some midwives appeared less knowledgeable about bipolar disorder, and perceptions about a lack of joined up working between antenatal and perinatal mental health services. it is recommended that GPs receive adequate training in order to equip them with the skills needed to discuss sensitive issues around perinatal mental illness and the impact on pregnancy and childbirth. Women require more information about their booking appointment, and it would be beneficial for their emotional and physical health needs to be assessed at each follow-up antenatal appointment. Midwives need to be facilitated to receive up-to-date knowledge of antenatal and postnatal mental illness and treatments, and the referral process to perinatal mental health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Optimizing man-machine performance of a personnel access restriction security system

    International Nuclear Information System (INIS)

    Banks, W.W.; Moore, J.W.

    1988-01-01

    This paper describes a human engineering design and analysis effort for a major security system upgrade at a DOE facility. This upgrade was accomplished by replacing an obsolete and poorly human engineered security screening both the with a new, user oriented, semiautomated, computer-based access control system. Human factors engineers assisted the designer staff in specifying a security access interface to physically and cognitively accommodate all employees which included handicapped individuals in wheel chairs, and several employees who were severely disabled, both visually and aurally. The new access system was intended to control entry into sensitive exclusion areas by requiring personnel to enter a security screening booth and interact with card reader devices and a-simple-to-operate access control panel system. Extensive man-machine testing with prototype mock-ups was conducted to assess human engineered design features and to illuminate potentially confusing or difficult-to-operated hardware placement, layout, and operation sequencing. These evaluations, along with the prototype mock-ups, provided input which resulted in a prototype which was easy to enter, operate, and understand by end users. This prototype later served as the design basis for the final systems design

  5. 28 CFR 25.6 - Accessing records in the system.

    Science.gov (United States)

    2010-07-01

    ... National Instant Criminal Background Check System § 25.6 Accessing records in the system. (a) FFLs may... through the NCIC communication network. Upon receiving a request for a background check from an FFL, a POC...

  6. Key issues of multiple access technique for LEO satellite communication systems

    Institute of Scientific and Technical Information of China (English)

    温萍萍; 顾学迈

    2004-01-01

    The large carrier frequency shift caused by the high-speed movement of satellite (Doppler effects) and the propagation delay on the up-down link are very critical issues in an LEO satellite communication system, which affects both the selection and the implementation of a suitable access method. A Doppler based multiple access technique is used here to control the flow and an MPRMA-HS protocol is proposed for the application in LEO satellite communication systems. The extended simulation trials prove that the proposed scheme seems to be a very promising access method.

  7. CDC STATE System E-Cigarette Legislation - Youth Access

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. E-Cigarette Legislation—Youth Access....

  8. A system for success: BMC Systems Biology, a new open access journal.

    Science.gov (United States)

    Hodgkinson, Matt J; Webb, Penelope A

    2007-09-04

    BMC Systems Biology is the first open access journal spanning the growing field of systems biology from molecules up to ecosystems. The journal has launched as more and more institutes are founded that are similarly dedicated to this new approach. BMC Systems Biology builds on the ongoing success of the BMC series, providing a venue for all sound research in the systems-level analysis of biology.

  9. A Protective Mechanism for the Access Control System in the Virtual Domain

    Institute of Scientific and Technical Information of China (English)

    Jinan Shen; Deqing Zou; Hai Jin; Kai Yang; Bin Yuan; Weiming Li

    2016-01-01

    In traditional framework,mandatory access control (MAC) system and malicious software are run in kernel mode.Malicious software can stop MAC systems to be started and make it do invalid.This problem cannot be solved under the traditional framework if the operating system (OS) is comprised since malwares are running in ring0 level.In this paper,we propose a novel way to use hypervisors to protect kernel integrity and the access control system in commodity operating systems.We separate the access control system into three parts:policy management (PM),security server (SS) and policy enforcement (PE).Policy management and the security server reside in the security domain to protect them against malware and the isolation feather of the hypervisor can protect them from attacks.We add an access vector cache (AVC) between SS and PE in the guest OS,in order to speed up communication between the guest OS and the security domain.The policy enforcement module is retained in the guest OS for performance.The security of AVC and PE can be ensured by using a memory protection mechanism.The goal of protecting the OS kemel is to ensure the security of the execution path.We implement the system by a modified Xen hypervisor.The result shows that we can secure the security of the access control system in the guest OS with no overhead compared with modules in the latter.Our system offers a centralized security policy for virtual domains in virtual machine environments.

  10. Database application research in real-time data access of accelerator control system

    International Nuclear Information System (INIS)

    Chen Guanghua; Chen Jianfeng; Wan Tianmin

    2012-01-01

    The control system of Shanghai Synchrotron Radiation Facility (SSRF) is a large-scale distributed real-time control system, It involves many types and large amounts of real-time data access during the operating. Database system has wide application prospects in the large-scale accelerator control system. It is the future development direction of the accelerator control system, to replace the differently dedicated data structures with the mature standardized database system. This article discusses the application feasibility of database system in accelerators based on the database interface technology, real-time data access testing, and system optimization research and to establish the foundation of the wide scale application of database system in the SSRF accelerator control system. Based on the database interface technology, real-time data access testing and system optimization research, this article will introduce the application feasibility of database system in accelerators, and lay the foundation of database system application in the SSRF accelerator control system. (authors)

  11. 75 FR 74748 - Senior Executive Service; Appointment of Members to the Performance Review Board

    Science.gov (United States)

    2010-12-01

    ... Commissioner, Office of Employment and Unemployment Statistics--appointment expires on 09/30/2013 EBSA Sharon S... 9/30/12 OLMS Stephen J. Willertz, Director, Office of Enforcement and International Union Audits...

  12. 19 CFR 141.14 - Deceased or insolvent consignees and court-appointed administrators.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Deceased or insolvent consignees and court-appointed administrators. 141.14 Section 141.14 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION... administrators. The executor or administrator of the estate of a deceased consignee, the receiver or other legal...

  13. How do socio-economic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?

    DEFF Research Database (Denmark)

    Hindhede, Anette L; Bonde, Ane; Schipperijn, Jasper

    2016-01-01

    Aim: The aim was to explore to which extent a Danish prevention centre catered for marginalised groups within the catchment area. We examined if the district’s socio-economic vulnerability status and distance from the citizens’ residential sector to the centre influenced referrals of citizens...... to the centre, citizens’ attendance at initial appointment and completion of planned activities at the centre. Background: Disparities in access to health care services is one among many aspects of inequality in health. The determinants within populations (e.g. socio-economic status, ethnicity and education...... was estimated based on the citizens’ educational level, ethnicity, income, and unemployment rate and a socio-economic vulnerability score (SE-score) was calculated. Logistic regression was used to describe the probability that a person was referred to the centre, attended the initial appointment and completed...

  14. Considering User's Access Pattern in Multimedia File Systems

    Science.gov (United States)

    Cho, KyoungWoon; Ryu, YeonSeung; Won, Youjip; Koh, Kern

    2002-12-01

    Legacy buffer cache management schemes for multimedia server are grounded at the assumption that the application sequentially accesses the multimedia file. However, user access pattern may not be sequential in some circumstances, for example, in distance learning application, where the user may exploit the VCR-like function(rewind and play) of the system and accesses the particular segments of video repeatedly in the middle of sequential playback. Such a looping reference can cause a significant performance degradation of interval-based caching algorithms. And thus an appropriate buffer cache management scheme is required in order to deliver desirable performance even under the workload that exhibits looping reference behavior. We propose Adaptive Buffer cache Management(ABM) scheme which intelligently adapts to the file access characteristics. For each opened file, ABM applies either the LRU replacement or the interval-based caching depending on the Looping Reference Indicator, which indicates that how strong temporally localized access pattern is. According to our experiment, ABM exhibits better buffer cache miss ratio than interval-based caching or LRU, especially when the workload exhibits not only sequential but also looping reference property.

  15. 40 CFR 265.34 - Access to communications or alarm system.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Access to communications or alarm system. 265.34 Section 265.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID..., STORAGE, AND DISPOSAL FACILITIES Preparedness and Prevention § 265.34 Access to communications or alarm...

  16. System Hardening Architecture for Safer Access to Critical Business ...

    African Journals Online (AJOL)

    System Hardening Architecture for Safer Access to Critical Business Data. ... and the threat is growing faster than the potential victims can deal with. ... in this architecture are applied to the host, application, operating system, user, and the ...

  17. A qualitative study of the impact of the implementation of advanced access in primary healthcare on the working lives of general practice staff

    Directory of Open Access Journals (Sweden)

    Offredy Maxine

    2005-09-01

    Full Text Available Abstract Background The North American model of 'advanced access' has been emulated by the National Primary Care Collaborative in the UK as a way of improving patients' access in primary care. The aim of this study was to explore the impact of the implementation of advanced access on the working lives of general practice staff. Methods A qualitative study design, using semi-structured interviews, was conducted with 18 general practice staff: 6 GPs, 6 practice managers and 6 receptionists. Two neighbouring boroughs in southeast England were used as the study sites. NUD*IST computer software assisted in data management to identify concepts, categories and themes of the data. A framework approach was used to analyse the data. Results Whilst practice managers and receptionists saw advanced access as having a positive effect on their working lives, the responses of general practitioners (GPs were more ambivalent. Receptionists reported improvements in their working lives with a change in their role from gatekeepers for appointments to providing access to appointments, fewer confrontations with patients, and greater job satisfaction. Practice managers perceived reductions in work stress from fewer patient complaints, better use of time, and greater flexibility for contingency planning. GPs recognised benefits in terms of improved consultations, but had concerns about the impact on workload and continuity of care. Conclusion AA has improved working conditions for receptionists, converting their perceived role from gatekeeper to access facilitator, and for practice managers as patients were more satisfied. GP responses were more ambivalent, as they experienced both positive and negative effects.

  18. Improving feedback from outpatient medical appointments attended by escorted psychiatric patients in the North London Forensic Service.

    Science.gov (United States)

    McCurdy, Kathleen; Croxford, Anna

    2015-01-01

    It is well established that patients with mental illness are known to have a high level of morbidity and mortality compared to the general population. This is particularly prominent in long-stay psychiatric patients, such as those in secure settings. The Royal College of Psychiatrists recommends that psychiatrists should promote the physical health of their patients and liaise with other specialties. However, there is evidence that communication between psychiatry and other specialties is poor. A survey was carried out at the North London Forensic Service in June 2014. This looked at the views of clinical staff about the frequency and quality of feedback obtained when inpatients attend outpatient hospital appointments at local general hospitals. This survey highlighted the general perception among staff that feedback is poor, with 68.43% of respondents saying that they were "very unsatisfied" or "unsatisfied" with the level and quality of feedback. Clinical staff felt that many patients who attended hospital outpatient appointments, even when escorted by staff, returned with little or no feedback. This was confirmed by a baseline audit across 3 wards showing that details of the appointment (date, time, hospital, and specialty) were only documented in 54.5% of cases and the content of the appointment documented in even fewer cases. A form was designed by junior doctors that provided a simple framework of 6 questions to be answered at the outpatient clinic about the problem, diagnosis, and further actions needed. This was introduced and its impact assessed with a 3-month and 6-month audit of electronic notes, as well as a follow-up survey after 6 months. The audit showed significant improvement in the quality of feedback about the appointment at both the 3-month and 6-month point. The follow-up survey showed that 70% of respondents were aware of the form and 100% of those who were aware of the form had used it at least once and found it helpful. The general

  19. CDC STATE System E-Cigarette Legislation - Youth Access

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2017. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. E-Cigarette Legislation—Youth Access....

  20. General Controls Over the Electronic Document Access System

    National Research Council Canada - National Science Library

    2000-01-01

    ...) system as part of the DoD Paper-Free Contracting Initiative. EDA contributes to the initiative by digitizing paper documents and offering web-based read-only access to official contracting, finance and accounting documents...

  1. Automated biometric access control system for two-man-rule enforcement

    International Nuclear Information System (INIS)

    Holmes, J.P.; Maxwell, R.L.; Henderson, R.W.

    1991-01-01

    This paper describes a limited access control system for nuclear facilities which makes use of the eye retinal identity verifier to control the passage of personnel into and out of one or a group of security controlled working areas. This access control system requires no keys, cards or credentials. The user simply enters his Personal Identification Number (PIN) and takes an eye reading to request passage. The PIN does not have to be kept secret. The system then relies on biometric identity verification of the user, along with other system information, to make the decision of whether or not to unlock the door. It also enforces multiple zones control with personnel tracking and the two-man-rule

  2. RFID-Based Monitoring And Access Control System For Parliamentary Campus

    Directory of Open Access Journals (Sweden)

    Sai Thu Rein Htun

    2015-08-01

    Full Text Available This paper is to implement monitoring and access control system based on RFID and Zigbee technology which can be used at Parliamentary Campus. Nowadays RFID technology is widely used for access control system because it is cheap waterproof and easy to use as well as it contains unique EPC electronic protect code .In addition Zigbee wireless module is cost-effective and can be reliable for security. Sothis system consists of RFID tag RFID reader Arduino Uno and Zigbee. This system can also be used for industrial amp commercial and security HVAC closures. This paper describes the results of point-to-point connection and point-to-multipoint connection using Zigbee and RFID technology.

  3. Are pregnant women receiving support for smoking dependence when attending routine antenatal appointments?

    LENUS (Irish Health Repository)

    Cully, G

    2010-09-01

    Early and consistent intervention with pregnant smokers can reduce the incidence of adverse pregnancy outcomes associated with smoking during pregnancy. A survey of 470 pregnant women was conducted to establish the care they received in relation to smoking whilst attending routine public antenatal appointments. The overall prevalence of smoking was 23.5%. Age, level of education and nationality were associated with smoking status with younger, less educated Irish women being most likely to smoke. Women attending for their first visit were much more likely to be asked about their smoking status 71 (85.5) versus 68 (17.8) and advised to quit if they were smokers 11 (73.3) versus 11 (15.7). None of the women were offered specific assistance to help them stop smoking or had a follow-up appointment arranged specifically to do with smoking. 167 women (35.6) were exposed to passive smoking in their own homes.

  4. Fast Access Data Acquisition System (FADAS)

    International Nuclear Information System (INIS)

    Katsman, Vladimir

    1998-01-01

    Our goal in this program is to develop Fast Access Data Acquisition System (FADAS) by combining the flexibility of Multilink's GaAs and InP electronics and electro-optics with an extremely high data rate for the efficient handling and transfer of collider experimental data. This novel solution is based on Multilink's and Los Alamos National Laboratory's (LANL) unique components and technologies for extremely fast data transfer, storage, and processing

  5. Treatment Availability Influences Physicians' Portrayal of Robotic Surgery During Clinical Appointments.

    Science.gov (United States)

    Scherr, Karen A; Fagerlin, Angela; Wei, John T; Williamson, Lillie D; Ubel, Peter A

    2017-01-01

    In order to empower patients as decision makers, physicians must educate them about their treatment options in a factual, nonbiased manner. We propose that site-specific availability of treatment options may be a novel source of bias, whereby physicians describe treatments more positively when they are available. We performed a content analysis of physicians' descriptions of robotic prostatectomy within 252 appointments at four Veterans Affairs medical centers where robotic surgery was either available or unavailable. We coded how physicians portrayed robotic versus open prostatectomy across specific clinical categories and in the appointment overall. We found that physicians were more likely to describe robotic prostatectomy as superior when it was available [F(1, 42) = 8.65, p = .005]. We also provide initial qualitative evidence that physicians may be shaping their descriptions of robotic prostatectomy in an effort to manage patients' emotions and demand for the robotic technology. To our knowledge, this is the first study to provide empirical evidence that treatment availability influences how physicians describe the advantages and disadvantages of treatment alternatives to patients during clinical encounters, which has important practical implications for patient empowerment and patient satisfaction.

  6. Exploring Audiologists' Language and Hearing Aid Uptake in Initial Rehabilitation Appointments.

    Science.gov (United States)

    Sciacca, Anna; Meyer, Carly; Ekberg, Katie; Barr, Caitlin; Hickson, Louise

    2017-06-13

    The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon. A binomial, multivariate logistic regression analysis was conducted to investigate the associations between these language measures and hearing aid uptake. The logistic regression model revealed that the Flesch-Kincaid reading grade level of audiologists' language was significantly associated with hearing aid uptake. Patients were less likely to obtain hearing aids when audiologists' language was at a higher reading grade level. No associations were found between audiologists' use of jargon and hearing aid uptake. Audiologists' use of complex language may present a barrier for patients to understand hearing rehabilitation recommendations. Reduced understanding may limit patient participation in the decision-making process and result in patients being less willing to trial hearing aids. Clear, concise language is recommended to facilitate shared decision making.

  7. Access Safety Systems – New Concepts from the LHC Experience

    CERN Document Server

    Ladzinski, T; di Luca, S; Hakulinen, T; Hammouti, L; Riesco, T; Nunes, R; Ninin, P; Juget, J-F; Havart, F; Valentini, F; Sanchez-Corral Mena, E

    2011-01-01

    The LHC Access Safety System has introduced a number of new concepts into the domain of personnel protection at CERN. These can be grouped into several categories: organisational, architectural and concerning the end-user experience. By anchoring the project on the solid foundations of the IEC 61508/61511 methodology, the CERN team and its contractors managed to design, develop, test and commission on time a SIL3 safety system. The system uses a successful combination of the latest Siemens redundant safety programmable logic controllers with a traditional relay logic hardwired loop. The external envelope barriers used in the LHC include personnel and material access devices, which are interlocked door-booths introducing increased automation of individual access control, thus removing the strain from the operators. These devices ensure the inviolability of the controlled zones by users not holding the required credentials. To this end they are equipped with personnel presence detectors and th...

  8. Upper bound for energy efficiency in multi-cell fibre-wireless access systems

    NARCIS (Netherlands)

    Koonen, A.M.J.; Popov, M.; Wessing, H.

    2013-01-01

    Bringing radio access points closer to the end-users improves radio energy efficiency. However, taking into account both the radio and the optical parts of a fibre-wireless access system, the overall system energy efficiency has an upper bound determined by the relation between the energy

  9. Upper bound for energy efficiency in multi-cell fibre-wireless access systems

    DEFF Research Database (Denmark)

    Koonen, A.M.J.; Popov, M.; Wessing, Henrik

    2013-01-01

    Bringing radio access points closer to the end-users improves radio energy efficiency. However, taking into account both the radio and the optical parts of a fibre-wireless access system, the overall system energy efficiency has an upper bound determined by the relation between the energy...

  10. 28 CFR 16.74 - Exemption of National Security Division Systems-limited access.

    Science.gov (United States)

    2010-07-01

    ... National Security Division Systems—limited access. (a) The following system of records is exempted from... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of National Security Division Systems-limited access. 16.74 Section 16.74 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR...

  11. 17 CFR 249.250 - Form F-X, for appointment of agent for service of process by issuers registering securities on...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form F-X, for appointment of agent for service of process by issuers registering securities on Form F-8, F-9, F-10 or F-80 (§ 239.38... F-X, for appointment of agent for service of process by issuers registering securities on Form F-8...

  12. Cardea: Dynamic Access Control in Distributed Systems

    Science.gov (United States)

    Lepro, Rebekah

    2004-01-01

    Modern authorization systems span domains of administration, rely on many different authentication sources, and manage complex attributes as part of the authorization process. This . paper presents Cardea, a distributed system that facilitates dynamic access control, as a valuable piece of an inter-operable authorization framework. First, the authorization model employed in Cardea and its functionality goals are examined. Next, critical features of the system architecture and its handling of the authorization process are then examined. Then the S A M L and XACML standards, as incorporated into the system, are analyzed. Finally, the future directions of this project are outlined and connection points with general components of an authorization system are highlighted.

  13. 76 FR 28130 - Coastal Bank, Cocoa Beach, Florida; Notice of Appointment of Receiver

    Science.gov (United States)

    2011-05-13

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Coastal Bank, Cocoa Beach, Florida; Notice of Appointment of Receiver Notice is hereby given that, pursuant to the authority contained in... Federal Deposit Insurance Corporation as sole Receiver for Coastal Bank, Cocoa Beach, Florida, (OTS No...

  14. 76 FR 35086 - Atlantic Bank & Trust, Charleston, SC; Notice of Appointment of Receiver

    Science.gov (United States)

    2011-06-15

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Atlantic Bank & Trust, Charleston, SC... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Atlantic Bank & Trust, Charleston, South...

  15. Six-monthly appointment spacing for clinical visits as a model for retention in HIV Care in Conakry-Guinea: a cohort study.

    Science.gov (United States)

    Bekolo, Cavin Epie; Diallo, Abdourahimi; Philips, Mit; Yuma, Joseph-Desire; Di Stefano, Letizia; Drèze, Stéphanie; Mouton, Jerome; Koita, Youssouf; Tiomtore, Ousseni W

    2017-12-13

    The outbreak of the Ebola virus disease (EVD) in 2014 led to massive dropouts in HIV care in Guinea. Meanwhile, Médecins Sans Frontières (MSF) was implementing a six-monthly appointment spacing approach adapted locally as Rendez-vous de Six Mois (R6M) with an objective to improve retention in care. We sought to evaluate this innovative model of ART delivery in circumstances where access to healthcare is restricted. A retrospective cohort study in 2014 of the outcome of a group of stable patients (viral load ≤1000 copies/μl) enrolled voluntarily in R6M compared with a group of stable patients continuing standard one to three monthly visits in Conakry. Log-rank test and Cox proportional hazards model were used to compare rates of attrition (deaths and defaulters) from care between the two groups. A linear regression analysis was used to describe the trend or pattern in the number of clinical visits over time. Included were 1957 adults of 15 years old and above of whom 1166 (59.6%) were enrolled in the R6M group and 791 (40.4%) in the standard care group. The proportion remaining in care at 18 months and beyond was 90% in the R6M group; significantly higher than the 75% observed in the control group (p Conakry despite restricted access to healthcare caused by the devastating EVD on the health system in Guinea. R6M could be rolled out as the model of care for stable patients where and when feasible as a strategy likely to improve retention in HIV care.

  16. Attendance at Mental Health Appointments by Women Who Were Referred During Pregnancy or the Postpartum Period.

    Science.gov (United States)

    Albaugh, Avril S; Friedman, Susan Hatters; Yang, Sarah Nagle; Rosenthal, Miriam

    2018-01-01

    To describe characteristics of women referred to mental health care during pregnancy or the year after giving birth and to identify characteristics associated with attendance at mental health intake visits. Retrospective record review of referral documentation. Women's health practices and perinatal mental health clinics in urban areas. The sample included 647 women during pregnancy or the year after giving birth who were referred for mental health treatment. We reviewed the referral data sent from women's health care providers to perinatal mental health clinics to determine if mental health visits occurred. Fifty percent of the 647 women who accepted perinatal mental health referrals had intake appointments. Women were more likely to participate in an intake appointment if in-home services were offered (p women who accepted referrals to mental health services, only half attended intake appointments. For this group of pregnant women and those in the first year after birth, in-home mental health visits were most likely to result in care engagement, which has important implications for service delivery. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  17. A System to Generate SignWriting for Video Tracks Enhancing Accessibility of Deaf People

    Directory of Open Access Journals (Sweden)

    Elena Verdú

    2017-12-01

    Full Text Available Video content has increased much on the Internet during last years. In spite of the efforts of different organizations and governments to increase the accessibility of websites, most multimedia content on the Internet is not accessible. This paper describes a system that contributes to make multimedia content more accessible on the Web, by automatically translating subtitles in oral language to SignWriting, a way of writing Sign Language. This system extends the functionality of a general web platform that can provide accessible web content for different needs. This platform has a core component that automatically converts any web page to a web page compliant with level AA of WAI guidelines. Around this core component, different adapters complete the conversion according to the needs of specific users. One adapter is the Deaf People Accessibility Adapter, which provides accessible web content for the Deaf, based on SignWritting. Functionality of this adapter has been extended with the video subtitle translator system. A first prototype of this system has been tested through different methods including usability and accessibility tests and results show that this tool can enhance the accessibility of video content available on the Web for Deaf people.

  18. 22 CFR 11.5 - Certification for appointment to class 7 or 8.

    Science.gov (United States)

    2010-04-01

    ... abroad (to a maximum of 2 years of such civilian service), or Peace Corps volunteer service, will be... examination in a foreign language, but the appointment will be subject to the condition that the newly..., adequate proficiency in a foreign language is achieved. (22 U.S.C. 1221 et seq.) [37 FR 19356, Sept. 20...

  19. Access to Mobile Communication Technology and Willingness to Participate in Automated Telemedicine Calls Among Chronically Ill Patients in Honduras

    Science.gov (United States)

    Mendoza-Avelares, Milton O.; Milton, Evan C.; Lange, Ilta; Fajardo, Roosevelt

    2010-01-01

    Abstract Objectives: Patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support. Materials and Methods: 624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management. Results: Participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p 80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures. Conclusions: Even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries. PMID:21062234

  20. The effectiveness of SMS Reminders and the impact of patient characteristics on missed appointments in a public dental outpatient clinic

    Directory of Open Access Journals (Sweden)

    Emilia Bellucci

    2017-03-01

    Full Text Available This paper reports on the Failure To Attend (FTA rate of appointments as well as patients following the implementation of SMS reminders in a public dental outpatient service.  Given the ineffectiveness of the intervention and a highly representative patient’s profile, this paper identifies the demographic characteristics of patients who miss all of their appointments.  Data on appointment attendance, patient demographics and dental service type was collected over a time period of 46 consecutive months.  Using descriptive and inferential statistics (chi-square, two sample tests and Marascuilo procedure we found the SMS intervention was ineffective in reducing the FTA rates. Further, patients associated with high rates of non-attendance exhibited one or more of the following characteristics: male; age 26 – 44; non-concession card holders; a person of Indigenous, local, Asian or African descent, and of refugee status, persons living in low socio-economic areas; and appointments in General Care and Student Clinics. Whilst the literature overwhelmingly attributes SMS reminders to improving the attendance rate of patients in outpatient clinics, our contradictory findings suggest a more targeted approach in settings whose patients exhibit strong characteristics associated with non-attendance.

  1. Prospective evaluation of an internet-linked handheld computer critical care knowledge access system.

    Science.gov (United States)

    Lapinsky, Stephen E; Wax, Randy; Showalter, Randy; Martinez-Motta, J Carlos; Hallett, David; Mehta, Sangeeta; Burry, Lisa; Stewart, Thomas E

    2004-12-01

    Critical care physicians may benefit from immediate access to medical reference material. We evaluated the feasibility and potential benefits of a handheld computer based knowledge access system linking a central academic intensive care unit (ICU) to multiple community-based ICUs. Four community hospital ICUs with 17 physicians participated in this prospective interventional study. Following training in the use of an internet-linked, updateable handheld computer knowledge access system, the physicians used the handheld devices in their clinical environment for a 12-month intervention period. Feasibility of the system was evaluated by tracking use of the handheld computer and by conducting surveys and focus group discussions. Before and after the intervention period, participants underwent simulated patient care scenarios designed to evaluate the information sources they accessed, as well as the speed and quality of their decision making. Participants generated admission orders during each scenario, which were scored by blinded evaluators. Ten physicians (59%) used the system regularly, predominantly for nonmedical applications (median 32.8/month, interquartile range [IQR] 28.3-126.8), with medical software accessed less often (median 9/month, IQR 3.7-13.7). Eight out of 13 physicians (62%) who completed the final scenarios chose to use the handheld computer for information access. The median time to access information on the handheld handheld computer was 19 s (IQR 15-40 s). This group exhibited a significant improvement in admission order score as compared with those who used other resources (P = 0.018). Benefits and barriers to use of this technology were identified. An updateable handheld computer system is feasible as a means of point-of-care access to medical reference material and may improve clinical decision making. However, during the study, acceptance of the system was variable. Improved training and new technology may overcome some of the barriers we

  2. Applying Toyota Production System principles to a psychiatric hospital: making transfers safer and more timely.

    Science.gov (United States)

    Young, John Q; Wachter, Robert M

    2009-09-01

    Health care organizations have increasingly embraced industrial methods, such as the Toyota Production System (TPS), to improve quality, safety, timeliness, and efficiency. However, the use of such methods in psychiatric hospitals has been limited. A psychiatric hospital applied TPS principles to patient transfers to the outpatient medication management clinics (MMCs) from all other inpatient and outpatient services within the hospital's system. Sources of error and delay were identified, and a new process was designed to improve timely access (measured by elapsed time from request for transfer to scheduling of an appointment and to the actual visit) and patient safety by decreasing communication errors (measured by number of failed transfers). Complexity was substantially reduced, with one streamlined pathway replacing five distinct and more complicated pathways. To assess sustainability, the postintervention period was divided into Period 1 (first 12 months) and Period 2 (next 24 months). Time required to process the transfer and schedule the first appointment was reduced by 74.1% in Period 1 (p < .001) and by an additional 52.7% in Period 2 (p < .0001) for an overall reduction of 87% (p < .0001). Similarly, time to the actual appointment was reduced 31.2% in Period 1 (p < .0001), but was stable in Period 2 (p = .48). The number of transfers per month successfully processed and scheduled increased 95% in the postintervention period compared with the pre-implementation period (p = .015). Finally, data for failed transfers were only available for the postintervention period, and the rate decreased 89% in Period 2 compared with Period 1 (p = .017). The application of TPS principles enhanced access and safety through marked and sustained improvements in the transfer process's timeliness and reliability. Almost all transfer processes have now been standardized.

  3. Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

    2016-01-01

    unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia......Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely......, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than...

  4. An Information System to Access Status Information of the LHCb Online

    International Nuclear Information System (INIS)

    Frank, M; Gaspar, C

    2012-01-01

    The LHCb collaboration consists of roughly 700 physicists from 52 institutes and universities. Most of the collaborating physicists - including subdetector experts - are not permanently based at CERN. This paper describes the architecture used to publish data internal to the LHCb experiment control- and data acquisition system to the World Wide Web. Collaborators can access the online (sub-) system status and the system performance directly from the institute abroad, from home or from a smart phone without the need of direct access to the online computing infrastructure.

  5. On the Protection of Personal Data in the Access Control System

    Directory of Open Access Journals (Sweden)

    A. P. Durakovskiy

    2012-03-01

    Full Text Available The aim is to prove the qualification system of access control systems (ACS as an information system for personal data (ISPDn. Applications: systems of physical protection of facilities.

  6. 76 FR 5432 - United Western Bank Denver, Colorado; Notice of Appointment of Receiver

    Science.gov (United States)

    2011-01-31

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision United Western Bank Denver, Colorado... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for United Western Bank, Denver, Colorado, (OTS No...

  7. 78 FR 12219 - Excepted Service-Appointment of Persons With Intellectual Disabilities, Severe Physical...

    Science.gov (United States)

    2013-02-22

    ...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... appointment of people with mental retardation, severe physical disabilities, and psychiatric disabilities. As... a particular work environment. Persons with disabilities today, however, often have work...

  8. Neglected Issues Relating to African Health Systems: An Incentive ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Several issues that affect access to and quality of health care for the poor and ... Conferences will be held at local, district and national levels to share the results of the ... Minister Bibeau announces appointments of IDRC's President and new ...

  9. A System for Web-based Access to the HSOS Database

    Science.gov (United States)

    Lin, G.

    Huairou Solar Observing Station's (HSOS) magnetogram and dopplergram are world-class instruments. Access to their data has opened to the world. Web-based access to the data will provide a powerful, convenient tool for data searching and solar physics. It is necessary that our data be provided to users via the Web when it is opened to the world. In this presentation, the author describes general design and programming construction of the system. The system will be generated by PHP and MySQL. The author also introduces basic feature of PHP and MySQL.

  10. 17 CFR 269.5 - Form F-X, for appointment of agent for service of process by issuers registering securities on...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form F-X, for appointment of agent for service of process by issuers registering securities on Form F-8, F-9, F-10 or F-80 (§§ 239... INDENTURE ACT OF 1939 § 269.5 Form F-X, for appointment of agent for service of process by issuers...

  11. An Efficient Role and Object Based Access Control Model Implemented in a PDM System

    Institute of Scientific and Technical Information of China (English)

    HUANG Xiaowen; TAN Jian; HUANG Xiangguo

    2006-01-01

    An effective and reliable access control is crucial to a PDM system. This article has discussed the commonly used access control models, analyzed their advantages and disadvantages, and proposed a new Role and Object based access control model that suits the particular needs of a PDM system. The new model has been implemented in a commercial PDM system, which has demonstrated enhanced flexibility and convenience.

  12. Cognitive radio networks medium access control for coexistence of wireless systems

    CERN Document Server

    Bian, Kaigui; Gao, Bo

    2014-01-01

    This book gives a comprehensive overview of the medium access control (MAC) principles in cognitive radio networks, with a specific focus on how such MAC principles enable different wireless systems to coexist in the same spectrum band and carry out spectrum sharing.  From algorithm design to the latest developments in the standards and spectrum policy, readers will benefit from leading-edge knowledge of how cognitive radio systems coexist and share spectrum resources.  Coverage includes cognitive radio rendezvous, spectrum sharing, channel allocation, coexistence in TV white space, and coexistence of heterogeneous wireless systems.   • Provides a comprehensive reference on medium access control (MAC)-related problems in the design of cognitive radio systems and networks; • Includes detailed analysis of various coexistence problems related to medium access control in cognitive radio networks; • Reveals novel techniques for addressing the challenges of coexistence protocol design at a higher level ...

  13. The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.

    Science.gov (United States)

    Mold, Freda; Ellis, Beverley; de Lusignan, Simon; Sheikh, Aziz; Wyatt, Jeremy C; Cavill, Mary; Michalakidis, Georgios; Barker, Fiona; Majeed, Azeem; Quinn, Tom; Koczan, Phil; Avanitis, Theo; Gronlund, Toto Anne; Franco, Christina; McCarthy, Mary; Renton, Zoë; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Jones, Simon; Rafi, Imran

    2012-01-01

    Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.

  14. 75 FR 33389 - TierOne Bank Lincoln, Nebraska; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-06-11

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision TierOne Bank Lincoln, Nebraska; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for TierOne Bank, Lincoln, Nebraska, (OTS No. 03309), on June 4, 2010...

  15. 48 CFR 1815.207-71 - Appointing non-Government evaluators as special Government employees.

    Science.gov (United States)

    2010-10-01

    ...; (2) Unsolicited proposals; and (3) SBIR and STTR proposals. [63 FR 9954, Feb. 27, 1998, as amended at... BY NEGOTIATION Solicitation and Receipt of Proposals and Information 1815.207-71 Appointing non... employee shall be made by: (1) The NASA Headquarters personnel office when the release of proposal...

  16. Access to justice in the Convention on Rights system

    NARCIS (Netherlands)

    Gerards, J.H.; Glas, L.R.

    2017-01-01

    The numerous reforms to the Convention system of the past two decades have unquestionably had an effect on applicants’ means to access justice in the system. It is, however, open to question how these changes should be evaluated: with reference to the individual right to petition, or with reference

  17. A model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.

    Science.gov (United States)

    Seekoe, Eunice

    2014-04-24

    South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997). The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa.  To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.  A qualitative and theory-generating design was used (following empirical findings regarding needs analysis) in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied.  The structure of the model is multidimensional and complex in nature (macro, mesoand micro) based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation.  The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.

  18. A CRISE DO MEIO AMBIENTE ENTRE AS VÁRIAS AGENDAS CONTEMPORÂNEAS / THE CRISIS OF ENVIROMENT BETWEEN DIFERENT APPOINTMENTS CONTEMPORARY

    OpenAIRE

    Boaz Antonio de Vasconcelos Lopes

    2009-01-01

    In this paper are showing the main appointments for the management of natural resources while uncovering the internal contradictions of the whole process of socio-environmental. was chosen an approach which identifies the following categories of analysis: vision, procedure, instrument, key players and space. then, with the referrals are characterized as follows appointments of environmental management: theory of pigou, coase's thesis, thesis of the integrated management of natural resources a...

  19. Open Access to General Practice Was Associated with Burnout among General Practitioners.

    Science.gov (United States)

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1-8.8, P = 0.035)). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice.

  20. Assessment of Deafblind Access to Manual Language Systems (ADAMLS)

    Science.gov (United States)

    Blaha, Robbie; Carlson, Brad

    2007-01-01

    This document presents the Assessment of Deafblind Access to Manual Language Systems (ADAMLS), a resource for educational teams who are responsible for developing appropriate adaptations and strategies for children who are deafblind who are candidates for learning manual language systems. The assessment tool should be used for all children with a…

  1. Access to essential medicines in Pakistan: policy and health systems research concerns.

    Directory of Open Access Journals (Sweden)

    Shehla Zaidi

    Full Text Available INTRODUCTION: Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i gaps related to access to essential medicine in Pakistan; and ii prioritization of emerging policy and research concerns. METHODS: An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. FINDINGS: A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. CONCLUSION: Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.

  2. Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.

    Science.gov (United States)

    Jung, Hye-Young; Gichoya, Judy Wawira; Vest, Joshua R

    2017-02-01

    An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals. The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014. The primary outcome was an indicator of access of an imaging study instead of access of a text-only report. Multilevel mixed-effects regression models were used to estimate the association between provider and session characteristics and access of images compared with text-only reports. Compared with primary care physicians, specialists had an 18% higher probability of accessing actual images instead of text-only reports (β = 0.18; P < .001). Compared with primary care practice settings, the probability of accessing images was 4% higher for specialty care practices (P < .05) and 8% lower for emergency departments (P < .05). Radiologists, orthopedists, and neurologists accounted for 79% of all the sessions with actual images accessed. Orthopedists, radiologists, surgeons, and pulmonary disease specialists accessed imaging more often than text-based reports only. Consideration for differences in the need to access images compared with text-only reports based on the type of provider and setting of care are needed to maximize the benefits of image sharing for patient care. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

    Science.gov (United States)

    Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

    2018-05-01

    The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Development of a wireless protection against imitation system for identification and control of vehicle access

    Directory of Open Access Journals (Sweden)

    Aleksei A. Gavrishev

    2018-03-01

    Full Text Available This article deals with wireless systems for identification and control of vehicle access to protected objects. Known systems are considered. As a result, it has been established that one of the most promising approaches to identifying and controlling vehicle access to protected objects is the use of systems based on the "friend or foe" principle. Among these systems, there are "one-directional" and "bedirectional" identification and access control systems. "Bidirectional" systems are more preferable for questions of identification and access control. However, at present, these systems should have a reduced probability of recognizing the structure of the request and response signals because the potential attacker can easily perform unauthorized access to the radio channel of the system. On this basis, developed a wireless system identification and control vehicle access to protected objects based on the principle of "friend or foe", featuring increased protection from unauthorized access and jamming through the use of rewritable drives chaotic sequences. In addition, it’s proposed to use to identify the vehicle's RFID tag containing additional information about it. Are some specifications of the developed system (the possible frequency range of the request-response signals, the communication range, data rate, the size of the transmitted data, guidelines for choosing RFID. Also, with the help of fuzzy logic, was made the security assessment from unauthorized access request-response signals based on the system of "friend or foe", which are transferred via radio channel, developed systems and analogues. The security assessment of the developed system shows an adequate degree of protection against complex threats (view, spoofing, interception and jamming of traffic in comparison with known systems of this class. Among the main advantages of the developed system it’s necessary to mention increased security from unauthorized access and jamming

  5. Problems and Concerns Regarding Access Control System Construction in Radiation Facilities Based on the NIFS Experience

    International Nuclear Information System (INIS)

    Kawano, T.; Inoue, N.; Sakuma, Y.; Motojima, O.

    2001-01-01

    Full text: In 1998, access control system for the large helical device (LHD) experimental hall was constructed and put into operation at the National Institute for Fusion Science (NIFS) in Toki, Japan. Since then, the system has been continuously improved. It now controls access into the LHD controlled area through four entrances. The system has five turnstile gates and enables control of access at the four entrances. The system is always checking whether the shielding doors are open or closed at eight positions. The details pertaining to the construction of the system were reported at IRPA-10 held in Hiroshima, Japan, in 2000. Based on our construction experience of the NIFS access control system, we will discuss problems related to software and operational design of the system. We will also discuss some concerns regarding the use of the system in radiation facilities. The problems we will present concern, among other thing, individual registration, time control, turnstile control, interlock signal control, data aggregation and transactions, automatic and manual control, and emergency procedures. For example, in relation to the time control and turnstile control functions, we will discuss the gate-opening time interval for an access event, the timing of access data recording, date changing, turn bar control, double access, and access error handling. (author)

  6. Data Access System for Hydrology

    Science.gov (United States)

    Whitenack, T.; Zaslavsky, I.; Valentine, D.; Djokic, D.

    2007-12-01

    As part of the CUAHSI HIS (Consortium of Universities for the Advancement of Hydrologic Science, Inc., Hydrologic Information System), the CUAHSI HIS team has developed Data Access System for Hydrology or DASH. DASH is based on commercial off the shelf technology, which has been developed in conjunction with a commercial partner, ESRI. DASH is a web-based user interface, developed in ASP.NET developed using ESRI ArcGIS Server 9.2 that represents a mapping, querying and data retrieval interface over observation and GIS databases, and web services. This is the front end application for the CUAHSI Hydrologic Information System Server. The HIS Server is a software stack that organizes observation databases, geographic data layers, data importing and management tools, and online user interfaces such as the DASH application, into a flexible multi- tier application for serving both national-level and locally-maintained observation data. The user interface of the DASH web application allows online users to query observation networks by location and attributes, selecting stations in a user-specified area where a particular variable was measured during a given time interval. Once one or more stations and variables are selected, the user can retrieve and download the observation data for further off-line analysis. The DASH application is highly configurable. The mapping interface can be configured to display map services from multiple sources in multiple formats, including ArcGIS Server, ArcIMS, and WMS. The observation network data is configured in an XML file where you specify the network's web service location and its corresponding map layer. Upon initial deployment, two national level observation networks (USGS NWIS daily values and USGS NWIS Instantaneous values) are already pre-configured. There is also an optional login page which can be used to restrict access as well as providing a alternative to immediate downloads. For large request, users would be notified via

  7. 77 FR 40341 - Proposed Information Collection; Comment Request; Application for Appointment in the NOAA...

    Science.gov (United States)

    2012-07-09

    ... Collection; Comment Request; Application for Appointment in the NOAA Commissioned Officer Corps AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice. SUMMARY: The Department... and instructions should be directed to Eric Johnson, (301) 713-7727 or [email protected]noaa.gov...

  8. New Editors Appointed for Sections of Journal of Geophysical Research

    Science.gov (United States)

    2009-04-01

    New editors have been appointed for the Atmospheres, Biogeosciences, and Oceans sections of the Journal of Geophysical Research (JGR). Joost de Gouw (NOAA, Boulder, Colo.) and Renyi Zhang (Texas A&M, College Station) are filling the vacancies of retiring Atmospheres section editors John Austin and Jose Fuentes. De Gouw and Zhang join the continuing editors Steven Ghan and Yinon Rudich. Sara Pryor (Indiana University, Bloomington) is joining the Atmospheres section editorial board as an associate editor now; she will transition to editor in January 2010.

  9. NASA Access Mechanism - Graphical user interface information retrieval system

    Science.gov (United States)

    Hunter, Judy F.; Generous, Curtis; Duncan, Denise

    1993-01-01

    Access to online information sources of aerospace, scientific, and engineering data, a mission focus for NASA's Scientific and Technical Information Program, has always been limited by factors such as telecommunications, query language syntax, lack of standardization in the information, and the lack of adequate tools to assist in searching. Today, the NASA STI Program's NASA Access Mechanism (NAM) prototype offers a solution to these problems by providing the user with a set of tools that provide a graphical interface to remote, heterogeneous, and distributed information in a manner adaptable to both casual and expert users. Additionally, the NAM provides access to many Internet-based services such as Electronic Mail, the Wide Area Information Servers system, Peer Locating tools, and electronic bulletin boards.

  10. NASA access mechanism: Graphical user interface information retrieval system

    Science.gov (United States)

    Hunter, Judy; Generous, Curtis; Duncan, Denise

    1993-01-01

    Access to online information sources of aerospace, scientific, and engineering data, a mission focus for NASA's Scientific and Technical Information Program, has always been limited to factors such as telecommunications, query language syntax, lack of standardization in the information, and the lack of adequate tools to assist in searching. Today, the NASA STI Program's NASA Access Mechanism (NAM) prototype offers a solution to these problems by providing the user with a set of tools that provide a graphical interface to remote, heterogeneous, and distributed information in a manner adaptable to both casual and expert users. Additionally, the NAM provides access to many Internet-based services such as Electronic Mail, the Wide Area Information Servers system, Peer Locating tools, and electronic bulletin boards.

  11. The Reform of Management System of Accountants in China

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The common existing problems of the false processing of accounting information in China and the solution--the appointment system of accountants are analyzed in this paper, it is proposed that the reform of management systems of accountants--the appointment system of accountants should be applied temporally in particular conditions.

  12. Systemic barriers accessing HIV treatment among people who inject drugs in Russia: a qualitative study.

    Science.gov (United States)

    Sarang, Anya; Rhodes, Tim; Sheon, Nicolas

    2013-10-01

    Achieving 'universal access' to antiretroviral HIV treatment (ART) in lower income and transitional settings is a global target. Yet, access to ART is shaped by local social condition and is by no means universal. Qualitative studies are ideally suited to describing how access to ART is socially situated. We explored systemic barriers to accessing ART among people who inject drugs (PWID) in a Russian city (Ekaterinburg) with a large burden of HIV treatment demand. We undertook 42 in-depth qualitative interviews with people living with HIV with current or recent experience of injecting drug use. Accounts were analysed thematically, and supplemented here with an illustrative case study. Three core themes were identified: 'labyrinthine bureaucracy' governing access to ART; a 'system Catch 22' created by an expectation that access to ART was conditional upon treated drug use in a setting of limited drug treatment opportunity; and 'system verticalization', where a lack of integration across HIV, tuberculosis (TB) and drug treatment compromised access to ART. Taken together, we find that systemic factors play a key role in shaping access to ART with the potential adverse effects of reproducing treatment initiation delay and disengagement from treatment. We argue that meso-level systemic factors affecting access to ART for PWID interact with wider macro-level structural forces, including those related to drug treatment policy and the social marginalization of PWID. We note the urgent need for systemic and structural changes to improve access to ART for PWID in this setting, including to simplify bureaucratic procedures, foster integrated HIV, TB and drug treatment services, and advocate for drug treatment policy reform.

  13. Administrative circular No. 2 (Rev. 5) – Recruitment, appointment and possible developments regarding the contractual position of staff members

    CERN Document Server

    HR Department

    2011-01-01

    Administrative Circular No. 2 (Rev. 5) entitled "Recruitment, appointment and possible developments regarding the contractual position of staff members", approved by the Director-General following discussion in the Standing Concertation Committee meeting on 1 September 2011, is available on the intranet site of the Human Resources Department: https://cern.ch/hr-docs/admincirc/admincirc.asp It cancels and replaces Administrative Circular No. 2 (Rev. 4) entitled "Recruitment, appointment and possible developments regarding the contractual position of staff members" of September 2009. Department Head Office

  14. Resource Allocation and Outpatient Appointment Scheduling Using Simulation Optimization

    Directory of Open Access Journals (Sweden)

    Carrie Ka Yuk Lin

    2017-01-01

    Full Text Available This paper studies the real-life problems of outpatient clinics having the multiple objectives of minimizing resource overtime, patient waiting time, and waiting area congestion. In the clinic, there are several patient classes, each of which follows different treatment procedure flow paths through a multiphase and multiserver queuing system with scarce staff and limited space. We incorporate the stochastic factors for the probabilities of the patients being diverted into different flow paths, patient punctuality, arrival times, procedure duration, and the number of accompanied visitors. We present a novel two-stage simulation-based heuristic algorithm to assess various tactical and operational decisions for optimizing the multiple objectives. In stage I, we search for a resource allocation plan, and in stage II, we determine a block appointment schedule by patient class and a service discipline for the daily operational level. We also explore the effects of the separate strategies and their integration to identify the best possible combination. The computational experiments are designed on the basis of data from a study of an ophthalmology clinic in a public hospital. Results show that our approach significantly mitigates the undesirable outcomes by integrating the strategies and increasing the resource flexibility at the bottleneck procedures without adding resources.

  15. Interactive water monitoring system accessible by cordless telephone

    Science.gov (United States)

    Volpicelli, Richard; Andeweg, Pierre; Hagar, William G.

    1985-12-01

    A battery-operated, microcomputer-controlled monitoring device linked with a cordless telephone has been developed for remote measurements. This environmental sensor is self-contained and collects and processes data according to the information sent to its on-board computer system. An RCA model 1805 microprocessor forms the basic controller with a program encoded in memory for data acquisition and analysis. Signals from analog sensing devices used to monitor the environment are converted into digital signals and stored in random access memory of the microcomputer. This remote sensing system is linked to the laboratory by means of a cordless telephone whose base unit is connected to regular telephone lines. This offshore sensing system is simply accessed by a phone call originating from a computer terminal in the laboratory. Data acquisition is initiated upon request: Information continues to be processed and stored until the computer is reprogrammed by another phone call request. Information obtained may be recalled by a phone call after the desired environmental measurements are finished or while they are in progress. Data sampling parameters may be reset at any time, including in the middle of a measurement cycle. The range of the system is limited only by existing telephone grid systems and by the transmission characteristics of the cordless phone used as a communications link. This use of a cordless telephone, coupled with the on-board computer system, may be applied to other field studies requiring data transfer between an on-site analytical system and the laboratory.

  16. Performance Analysis of DPSK-OCDMA System for Optical Access Network

    Science.gov (United States)

    Islam, Monirul; Ahmed, N.; Aljunid, S. A.; Ali, Sharafat; Sayeed, S.; Sabri, Naseer

    2016-03-01

    In this research, the performance of optical code division multiple access (OCDMA) using differential phase shift keying (DPSK) has been compared with OCDMA On-Off Keying (OOK). This comparison took place in terms of bit error rate (BER) and receiver power where two bit rates (155 Mbps and 622 Mbps) have been used for this analysis. Using of OptiSystem 7.0 simulation, comparing eye diagram and optical spectrum alongside with BER and Rx power. It is found that OCDMA-DPSK performs better in comparison to OCDMA-OOK. The performance analysis also provides parameter for designing and development of an OCDMA system for optical access network using DPSK.

  17. A model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa

    Directory of Open Access Journals (Sweden)

    Eunice Seekoe

    2014-02-01

    Full Text Available Background: South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997. The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa. Objectives: To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa. Method: A qualitative and theory-generating design was used (following empirical findings regarding needs analysis in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied. Results: The structure of the model is multidimensional and complex in nature (macro, mesoand micro based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation. Conclusion: The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.

  18. Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy

    Directory of Open Access Journals (Sweden)

    Goh Khean-Lee

    2011-07-01

    Full Text Available Abstract Background Risk factors for poor bowel preparation are recognized to be independent of the type of bowel preparation method used. Patient and administrative factors influencing bowel preparation are known to vary in different healthcare systems. Methods A prospective, cross-sectional study of patients undergoing colonoscopy in an Asian tertiary centre was conducted to identify risk factors associated with poor bowel preparation, and to evaluate the impact of poor bowel preparation on technical performance and patient comfort. Results Data on 501 patients (mean age 60.1 ± 14.0 years old, 51.2% males, 60.9% with secondary education or higher was available for analysis. Poor bowel preparation was present in 151 patients (30.1%. Lower education level (OR = 2.35, 95% CI = 1.54 - 3.60, colonoscopy appointment waiting time beyond 16 weeks (OR = 1.86, 95% CI = 1.04 - 3.37 and non-adherence to bowel preparation instructions (OR = 4.76, 95% CI = 3.00 - 7.55 were identified as independent risk factors for poor bowel preparation. Poor bowel preparation was associated with a lower cecal intubation rate (78.1% versus 98.3%, p Conclusions Education levels and appointment waiting times, in addition to non-adherence to bowel preparation instructions, increase the risk of poor bowel preparation in adult patients undergoing colonoscopy. The latter has a significant impact on colonoscopy performance and patient comfort.

  19. 75 FR 45011 - Olde Cypress Community Bank, Clewiston, FL; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-07-30

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Olde Cypress Community Bank, Clewiston, FL... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Olde Cypress Community Bank, Clewiston, Florida...

  20. 75 FR 65404 - Security Savings Bank, FSB; Olathe, KS; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-10-22

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Security Savings Bank, FSB; Olathe, KS... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision (OTS) has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Security Savings Bank, FSB, Olathe...

  1. 75 FR 41927 - Ideal Federal Savings Bank, Baltimore, Maryland; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-07-19

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Ideal Federal Savings Bank, Baltimore... contained in section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Ideal Federal Savings Bank...

  2. 12 CFR 1777.28 - Appointment of conservator for a significantly undercapitalized or critically undercapitalized...

    Science.gov (United States)

    2010-01-01

    ... appointment of a conservator would have serious adverse effects on economic conditions of national financial markets or on the financial stability of the housing finance market; and (ii) The public interest would be... FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS...

  3. Effect of calcium hydroxide and triple antibiotic paste as intracanal medicaments on the incidence of inter-appointment flare-up in diabetic patients: An in vivo study

    Science.gov (United States)

    Pai, Swathi; Vivekananda Pai, A. R.; Thomas, Manuel S.; Bhat, Vishal

    2014-01-01

    Aim: To evaluate and compare the effect of antibacterial intracanal medicaments on inter-appointment flare-up in diabetic patients. Materials and Methods: Fifty diabetic patients requiring root canal treatment were assigned into groups I, II, and III. In group I, no intracanal medicament was placed. In groups II and III, calcium hydroxide and triple antibiotic pastes were placed as intracanal medicaments, respectively. Patients were instructed to record their pain on days 1, 2, 3, 7, and 14. Inter-appointment flare-up was evaluated using verbal rating scale (VRS). Results: Overall incidence of inter-appointment flare-up among diabetic patients was found to be 16%. In group I, 50% of the patients and in group II, 15% of the patients developed inter-appointment flare-up. However, no patients in group III developed inter-appointment flare-up. The comparison of these results was found to be statistically significant (P = 0.002; χ2 = 12.426). However, with respect to intergroup comparison, only the difference between groups I and III was found to be statistically significant (P = 0.002; χ2 = 12.00). Conclusions: Calcium hydroxide and triple antibiotic paste are effective for managing inter-appointment flare-ups in diabetic patients. Triple antibiotic paste is more effective than calcium hydroxide in preventing the occurrence of flare-up in diabetic patients. PMID:24944440

  4. Psychiatrist-patient verbal and nonverbal communications during split-treatment appointments.

    Science.gov (United States)

    Cruz, Mario; Roter, Debra; Cruz, Robyn Flaum; Wieland, Melissa; Cooper, Lisa A; Larson, Susan; Pincus, Harold Alan

    2011-11-01

    This study characterized psychiatrist and patient communication behaviors and affective voice tones during pharmacotherapy appointments with depressed patients at four community-based mental health clinics where psychiatrists provided medication management and other mental health professionals provided therapy ("split treatment"). Audiorecordings of 84 unique pairs of psychiatrists and patients with a depressive disorder were analyzed with the Roter Interaction Analysis System, which identifies 41 discrete speech categories that can be grouped into composites representing broad conceptual communication domains. Cluster analysis identified psychiatrist communication patterns. T test and chi square analyses compared the clusters for verbal dominance, affective voice tone, and characteristics of psychiatrist and patients. On average, 53% of psychiatrist talk was devoted to partnering and relationship building, and 67% of patient talk was about biomedical subjects, such as depression symptoms, and psychosocial information giving. Psychiatrist communication patterns were characterized by two clusters, a biomedical-centered cluster that emphasized biomedical questions (η²=.22, df=82, prelationship building while maintaining a focus on symptoms or psychosocial issues. However, patient behaviors did not reflect a similar level of partnering. Future studies should identify psychiatrist communication behaviors that activate collaborative patient communications or improve treatment outcomes.

  5. A system for success: BMC Systems Biology, a new open access journal

    OpenAIRE

    Webb Penelope A; Hodgkinson Matt J

    2007-01-01

    Abstract BMC Systems Biology is the first open access journal spanning the growing field of systems biology from molecules up to ecosystems. The journal has launched as more and more institutes are founded that are similarly dedicated to this new approach. BMC Systems Biology builds on the ongoing success of the BMC series, providing a venue for all sound research in the systems-level analysis of biology.

  6. The provision and impact of online patient access to their electronic health records (EHR and transactional services on the quality and safety of health care: systematic review protocol

    Directory of Open Access Journals (Sweden)

    Freda Mold

    2013-09-01

    Full Text Available Background Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR. International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.Objective To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.Method Two reviewers independently searched 11 international databases during the period 1999–2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion .A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis.Prospero (International Prospective Register of Systematic Reviews registration number: crd42012003091.

  7. Email based remote access and surveillance system for smart home infrastructure

    Directory of Open Access Journals (Sweden)

    Pooshkar Rajiv

    2016-09-01

    Full Text Available With the rapid rise of Internet of Things in public domain, people expect fast, reliable and on-demand home security via the Internet. However, existing remote home surveillance systems place a very rigid constraint on authentication and require customized hardware and software. In this paper we have proposed an ingenious and reliable internet based, home access system for smart homes that can be easily deployed on generic hardware. The proposed architecture uses popular email service providers to notify and update the user about the home access. It sends an email to the owner with the attached picture of the person who is at the door. It also incorporates a protected mechanism to give access of the door to a remote user by responding to that email. It essentially means that we can view and give access to the person at our door via sending and receiving an email. Furthermore, an image processing based mechanism has also been incorporated to provide access without email, to few selected personnel who are trusted by the owner. It works by capturing and comparing the visitor's image with the stored images in the database. Perceptual hashing or fingerprint matching algorithm is used for comparison purposes. Similarity percentage based on hamming distance was evaluated, and the similarity threshold for providing access was set. The simulations were performed in rigorous environment. The efficiency of the hashing algorithm was found to be 97% at the similarity threshold of 95%. The results validate that the average latency is only 155 ms with low standard deviation. The CPU utilization remained quite low with a minimum value of 10 MHz and a maximum value of 30 MHz when the payload size of the sent mail was increased to 1500 kB. Thus, the proposed system can be used for developing a larger low power infrastructure.

  8. The upgrade of the J-TEXT experimental data access and management system

    International Nuclear Information System (INIS)

    Yang, C.; Zhang, M.; Zheng, W.; Liu, R.; Zhuang, G.

    2014-01-01

    Highlights: • The J-TEXT DAMS is developed based on B/S model, which makes it conveniently access the system. • The JWeb-Scope adopts segment strategy to read data that improve the speed of reading data. • DAMS have integrated the management and JWeb-Scope and make an easy way for visitors to access the experiment data. • The JWeb-Scope can be visited all over the world, plot experiment data and zoom in or out smoothly. - Abstract: The experimental data of J-TEXT tokamak are stored in the MDSplus database. The old J-TEXT data access system is based on the tools provided by MDSplus. Since the number of signals is huge, the data retrieval for an experiment is difficult. To solve this problem, the J-TEXT experimental data access and management system (DAMS) based on MDSplus has been developed. The DAMS left the old MDSplus system unchanged providing new tools, which can help users to handle all signals as well as to retrieve signals they need thanks to the user information requirements. The DAMS also offers users a way to create their jScope configuration files which can be downloaded to the local computer. In addition, the DAMS provides a JWeb-Scope tool to visualize the signal in a browser. JWeb-Scope adopts segment strategy to read massive data efficiently. Users can plot one or more signals on their own choice and zoom-in, zoom-out smoothly. The whole system is based on B/S model, so that the users only need of the browsers to access the DAMS. The DAMS has been tested and it has a better user experience. It will be integrated into the J-TEXT remote participation system later

  9. Providing Access to Library Automation Systems for Students with Disabilities.

    Science.gov (United States)

    California Community Colleges, Sacramento. High-Tech Center for the Disabled.

    This document provides information on the integration of assistive computer technologies and library automation systems at California Community Colleges in order to ensure access for students with disabilities. Topics covered include planning, upgrading, purchasing, implementing and using these technologies with library systems. As information…

  10. Knowledge of disease and access to a specialist reported by Spanish patients with ulcerative colitis. UC-LIFE survey.

    Science.gov (United States)

    Argüelles-Arias, Federico; Carpio, Daniel; Calvet, Xavier; Romero, Cristina; Cea-Calvo, Luis; Juliá, Berta; López-Sanromán, Antonio

    2017-06-01

    Education of patients with ulcerative colitis (UC) about their disease and access to a specialist are important to improve health outcomes. Our objective was to determine, by collecting information directly from the patients, their information sources and knowledge of the disease, and the options for access to the gastroenterologist. The information was collected using a printed survey handed out by 39 gastroenterologists to 15 consecutive adult patients with UC. Patients answered anonymously from their home. The responses were stratified by hospital size (> 900; 500-900; < 500 beds). A total of 585 patients received the survey and 436 responded (74.5%; mean age of 46 years [13.5], 53% men). The main information source was the specialist physician (89.2%). Between 32% and 80% of patients had areas of improvement regarding knowledge of their disease. Knowledge of the disease was better in patients from small hospitals (< 500 beds). The frequency of routine visits was also higher in small hospitals. In case of a flare-up, 60% stated they were able to contact their doctor by phone and 37%, that they could get an appointment on the same day. The percentage stating that they had to ask for an appointment and wait until their physician was available was lower in small hospitals. There are areas of improvement with regard to knowledge of their disease in patients with UC followed in hospital clinics. Patients followed in small hospitals seem to know their disease better, are followed more frequently in the clinic, and have better access in case of a flare-up.

  11. What systems participants know about access and service entry and why managers should listen.

    Science.gov (United States)

    Duncombe, Rohena

    2017-08-01

    Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners

  12. Average opportunity-based accessibility of public transit systems to grocery stores in small urban areas

    Directory of Open Access Journals (Sweden)

    Nimish Dharmadhikari

    2015-12-01

    Full Text Available This research studies the accessibility of grocery stores to university students using the public transportation system, drawing from a case study of Fargo, North Dakota. Taking into consideration the combined travel time components of walking, riding, and waiting, this study measures two types of accessibilities: accessibility to reach a particular place and accessibility to reach the bus stop to ride the public transit system. These two accessibilities are interdependent and cannot perform without each other. A new method to calculate the average accessibility measure for the transit routes is proposed. A step-wise case study analysis indicates that one route provides accessibility to a grocery store in eight minutes. This also suggests that the North Dakota State University area has moderate accessibility to grocery stores.

  13. Quantifying Appointments, Treatment Time, Impressions, and Diagnostic Data of Cases Staffed by General Dentists and Prosthodontists in a Dental School Clinic.

    Science.gov (United States)

    Imbery, Terence A; Greenfield, Kristy; Diaz, Nicholas; Janus, Charles; Best, Al M

    2016-10-01

    The aim of this retrospective study was to quantify differences between general dentists and prosthodontists regarding appointments, treatment time, impressions, and preoperative diagnostic data in teaching predoctoral clinical fixed prosthodontics. Electronic dental records (n=356) of patients treated at one dental school in academic year 2012 were randomly selected for review to obtain the following data: faculty and student demographics, number of appointments and treatment time from preparation to cementation, number of impressions made, completion of oral disease control treatment (ODCT), and presence of preoperative periapical radiographs and diagnostic casts. The results showed that ODCT was completed in 78%, preoperative radiographs were present in 76%, and diagnostic casts made in 53% of the cases reviewed. There was no statistically significant difference in number of appointments, treatment time, or number of final impressions when students were staffed by general dentists or prosthodontists. When students were supervised by multiple faculty members, there was generally an increase in treatment time and number of appointments and final impressions. Although this study found no statistically significant differences between general dentists and prosthodontists regarding the criteria evaluated, the results suggest that faculty development and calibration are needed to ensure ODCT is completed and preoperative radiographs are present prior to initiating fixed prosthodontic procedures.

  14. 5 CFR 330.504 - Special restrictions after appointment under Part-time Direct Hire Program.

    Science.gov (United States)

    2010-01-01

    ... under Part-time Direct Hire Program. 330.504 Section 330.504 Administrative Personnel OFFICE OF... To Protect Competitive Principles § 330.504 Special restrictions after appointment under Part-time Direct Hire Program. (a) A person hired under the Part-time Direct Hire Program may not be changed to...

  15. Design and Implementation of a Library and Information Science Open Access Journal Union Catalogue System

    Directory of Open Access Journals (Sweden)

    Sinn-Cheng Lin

    2017-03-01

    Full Text Available Open access is a mode of academic communication that has been on the rise in recent years, but open access academic resources are widely dispersed across the internet, making it occasionally inconvenient in terms of its use. This research is focused on library and information science, using the OAIS reference model as the system framework, two open access platform, DOAJ and E-LIS as the data sources, and through system implementation develop a “library and information science open access journal union catalogue” system. Using the OAI-PMH protocol as the data interoperability standard, and LAMP as the development environment, four major functionalities: injest, archiving, management and access of information were designed, developed, and integrated into system build. Actual testing and verification showed this system is able to successfully collect data from DOAJ and E-LIS open journal resources related to library and information science. The system is now active and functional, and can be used by researchers in the library and science information field.

  16. A semi-automated vascular access system for preclinical models

    International Nuclear Information System (INIS)

    Berry-Pusey, B N; David, J; Taschereau, R; Silverman, R W; Williams, D; Ladno, W; Stout, D; Chatziioannou, A; Chang, Y C; Prince, S W; Chu, K; Tsao, T C

    2013-01-01

    Murine models are used extensively in biological and translational research. For many of these studies it is necessary to access the vasculature for the injection of biologically active agents. Among the possible methods for accessing the mouse vasculature, tail vein injections are a routine but critical step for many experimental protocols. To perform successful tail vein injections, a high skill set and experience is required, leaving most scientists ill-suited to perform this task. This can lead to a high variability between injections, which can impact experimental results. To allow more scientists to perform tail vein injections and to decrease the variability between injections, a vascular access system (VAS) that semi-automatically inserts a needle into the tail vein of a mouse was developed. The VAS uses near infrared light, image processing techniques, computer controlled motors, and a pressure feedback system to insert the needle and to validate its proper placement within the vein. The VAS was tested by injecting a commonly used radiolabeled probe (FDG) into the tail veins of five mice. These mice were then imaged using micro-positron emission tomography to measure the percentage of the injected probe remaining in the tail. These studies showed that, on average, the VAS leaves 3.4% of the injected probe in the tail. With these preliminary results, the VAS system demonstrates the potential for improving the accuracy of tail vein injections in mice. (paper)

  17. The optimal access system for future far-offshore wind farms

    Energy Technology Data Exchange (ETDEWEB)

    Obdam, T.S.; Rademakers, L.W.M.M.; Savenije, L.B. [ECN Wind Energy, Petten (Netherlands)

    2013-12-15

    Operation and maintenance (O and M) of offshore wind turbines is one of the main cost drivers of offshore wind energy. One of the aspects critical for an efficient and cost-effective O and M strategy is the selection of the access system which is used to transfer technicians and, optionally, small spare parts. Currently, most offshore wind farms are located close to shore, and their size is relatively small. For these farms the typical access system consists of catamaran-like workboats, which are used to transfer both technicians and small spare parts. As wind farms move further offshore this O and M concept might no longer be cost-effective. Currently, different alternative O and M concepts are being considered for the future far-offshore sites. In this paper an extensive and holistic comparison of different O and M concepts including different access system solutions is presented. This analysis has been performed using the OMCECalculator, ECN's software for advanced O and M cost modelling. Different sites have been considered, which are typical for the future offshore wind farms that will be commissioned during the next five years. The results of the performed analyses indicate that when moving further offshore harbour-based O and M strategies are no longer economical, even when helicopters are added to the mix. Looking at farm-based O and M concepts a supply vessel with a compensated access gangway offers great potential. However, the calculations also indicate that its ability to transfer small spare parts, in addition to technicians, is crucial.

  18. Asynchronous Free-Space Optical CDMA Communications System for Last-mile Access Network

    DEFF Research Database (Denmark)

    Jurado-Navas, Antonio; Raddo, Thiago R.; Sanches, Anderson L.

    2016-01-01

    We propose a new hybrid asynchronous OCDMA-FSO communications system for access network solutions. New ABER expressions are derived under gamma-gamma scintillation channels, where all users can surprisingly achieve error-free transmissions when FEC is employed.......We propose a new hybrid asynchronous OCDMA-FSO communications system for access network solutions. New ABER expressions are derived under gamma-gamma scintillation channels, where all users can surprisingly achieve error-free transmissions when FEC is employed....

  19. Michel Spiro is appointed director of the IN2P3 and the Department of Nuclear and Particle Physics of the CNRS

    CERN Multimedia

    2003-01-01

    "Michel Spiro was appointed director of the IN2P3, by order of the Minister of Youth, National Education and Research and the Minister of Research and New Technologies on February 17, 2003. He was also appointed director of the Department of Nuclear and Particle Physics of the CNRS by decision of the CNRS Director General on February 21, 2003" (1/2 page).

  20. Distributed magnetic field positioning system using code division multiple access

    Science.gov (United States)

    Prigge, Eric A. (Inventor)

    2003-01-01

    An apparatus and methods for a magnetic field positioning system use a fundamentally different, and advantageous, signal structure and multiple access method, known as Code Division Multiple Access (CDMA). This signal architecture, when combined with processing methods, leads to advantages over the existing technologies, especially when applied to a system with a large number of magnetic field generators (beacons). Beacons at known positions generate coded magnetic fields, and a magnetic sensor measures a sum field and decomposes it into component fields to determine the sensor position and orientation. The apparatus and methods can have a large `building-sized` coverage area. The system allows for numerous beacons to be distributed throughout an area at a number of different locations. A method to estimate position and attitude, with no prior knowledge, uses dipole fields produced by these beacons in different locations.

  1. The design and implementation of access control management system in IHEP network

    International Nuclear Information System (INIS)

    Wang Yanming; An Dehai; Qi Fazhi

    2010-01-01

    In campus network environment of Institute of High Energy Physics, because of the number of Network devices and computers are large scale, ensuring the access validity of network devices and user's computer, and aiming at effective control the exceptional network communication are technological means to achieve network normal running. The access control system of Campus network of institute of High Energy Physics using MySQL database in the behind, and using CGI PHP HTML language to develop the front interface. The System achieves user information management, user computer access control, cutting down the exceptional network communication and alarm function. Increasing the management effective of network, to ensure campus network safety and reliable running. (authors)

  2. 75 FR 17463 - Key West Bank, Key West, Florida; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-04-06

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Key West Bank, Key West, Florida; Notice... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Key West Bank, Key West, Florida, (OTS No...

  3. 75 FR 4909 - Charter Bank: Santa Fe, New Mexico; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-01-29

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Charter Bank: Santa Fe, New Mexico; Notice... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Charter Bank, Santa Fe, New Mexico, (OTS No...

  4. Towards Payment Systems for all: accessible POS

    Directory of Open Access Journals (Sweden)

    Begoña Pino

    2014-10-01

    Full Text Available The project presented here is a first step towards building a more accessible world through Payment Systems and a successful implementation of a User Centred Design. By means of a beep-system, a Point of Sale (POS payment device informs the user of those transaction steps that require his/her attention at the moment of payment, such as when: the card has been successfully read, the Personal Identification Number (PIN must be entered, the transaction has been successfully processed and the transaction has not been completed due to an error. The proposed solution increases the personal autonomy and security of blind people when paying at a merchant.

  5. From System Expansion to System Contraction: Access to Higher Education in Poland

    Science.gov (United States)

    Kwiek, Marek

    2013-01-01

    Access to higher education in Poland is changing due to the demography of smaller cohorts of potential students. Following a demand-driven educational expansion after the collapse of communism in 1989, the higher education system is now contracting. Such expansion/contraction and growth/decline in European higher education has rarely been…

  6. DOE's nation-wide system for access control can solve problems for the federal government

    International Nuclear Information System (INIS)

    Callahan, S.; Tomes, D.; Davis, G.; Johnson, D.; Strait, S.

    1996-07-01

    The U.S. Department of Energy's (DOE's) ongoing efforts to improve its physical and personnel security systems while reducing its costs, provide a model for federal government visitor processing. Through the careful use of standardized badges, computer databases, and networks of automated access control systems, the DOE is increasing the security associated with travel throughout the DOE complex, and at the same time, eliminating paperwork, special badging, and visitor delays. The DOE is also improving badge accountability, personnel identification assurance, and access authorization timeliness and accuracy. Like the federal government, the DOE has dozens of geographically dispersed locations run by many different contractors operating a wide range of security systems. The DOE has overcome these obstacles by providing data format standards, a complex-wide virtual network for security, the adoption of a standard high security system, and an open-systems-compatible link for any automated access control system. If the location's level of security requires it, positive visitor identification is accomplished by personal identification number (PIN) and/or by biometrics. At sites with automated access control systems, this positive identification is integrated into the portals

  7. A CRISE DO MEIO AMBIENTE ENTRE AS VÁRIAS AGENDAS CONTEMPORÂNEAS / THE CRISIS OF ENVIROMENT BETWEEN DIFERENT APPOINTMENTS CONTEMPORARY

    Directory of Open Access Journals (Sweden)

    Boaz Antonio de Vasconcelos Lopes

    2009-12-01

    Full Text Available In this paper are showing the main appointments for the management of natural resources while uncovering the internal contradictions of the whole process of socio-environmental. was chosen an approach which identifies the following categories of analysis: vision, procedure, instrument, key players and space. then, with the referrals are characterized as follows appointments of environmental management: theory of pigou, coase's thesis, thesis of the integrated management of natural resources and the radical critique of the model of production and current consumption.

  8. A mobile console for local access to accelerator control systems.

    CERN Multimedia

    1981-01-01

    Microprocessors were installed as auxiliary crate controllers (ACCs) in the CAMAC interface of control systems for various accelerators. The same ACC was also at the hearth of a stand-alone system in the form of a mobile console. This was also used for local access to the control systems for tests and development work (Annual Report 1981, p. 80, Fig. 10).

  9. A System to Generate SignWriting for Video Tracks Enhancing Accessibility of Deaf People

    OpenAIRE

    Elena Verdú; Cristina Pelayo G-Bustelo; Ángeles Martínez Sánchez; Rubén Gonzalez-Crespo

    2017-01-01

    Video content has increased much on the Internet during last years. In spite of the efforts of different organizations and governments to increase the accessibility of websites, most multimedia content on the Internet is not accessible. This paper describes a system that contributes to make multimedia content more accessible on the Web, by automatically translating subtitles in oral language to Sign Writing, a way of writing Sign Language. This system extends the functionality of a general we...

  10. Privacy and Access Control for IHE-Based Systems

    Science.gov (United States)

    Katt, Basel; Breu, Ruth; Hafner, Micahel; Schabetsberger, Thomas; Mair, Richard; Wozak, Florian

    Electronic Health Record (EHR) is the heart element of any e-health system, which aims at improving the quality and efficiency of healthcare through the use of information and communication technologies. The sensitivity of the data contained in the health record poses a great challenge to security. In this paper we propose a security architecture for EHR systems that are conform with IHE profiles. In this architecture we are tackling the problems of access control and privacy. Furthermore, a prototypical implementation of the proposed model is presented.

  11. Bus Access Optimisation for FlexRay-based Distributed Embedded Systems

    DEFF Research Database (Denmark)

    Pop, Traian; Pop, Paul; Eles, Petru

    2007-01-01

    -real time communication in a deterministic manner. In this paper, we propose techniques for optimising the FlexRay bus access mechanism of a distributed system, so that the hard real-time deadlines are met for all the tasks and messages in the system. We have evaluated the proposed techniques using...

  12. 75 FR 82146 - Appalachian Community Bank, FSB, McCaysville, GA, Notice of Appointment of Receiver

    Science.gov (United States)

    2010-12-29

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Appalachian Community Bank, FSB... contained in section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Appalachian Community Bank, FSB...

  13. Training experience and views of recently appointed consultants in geriatric medicine.

    Science.gov (United States)

    Sandler, M

    1992-01-01

    A postal survey of 71 recently appointed consultant geriatricians was undertaken in spring 1991. Several respondents were concerned about the adequacy of training in domiciliary visiting and continuing care, and about the time allocated for research and study. A high proportion felt they had been poorly prepared for the administrative and organisational components of their consultant post, and 75% of respondents advocated training in managerial skills for senior registrars. These findings are relevant to the planning of future training for senior registrars in geriatric medicine.

  14. A novel technique to extract events from access control system and locate persons

    International Nuclear Information System (INIS)

    Vincent, M.; Vaidyanathan, Mythili; Patidar, Suresh Chandra; Prabhakara Rao, G.

    2011-01-01

    Indira Gandhi Centre for Atomic Research houses many laboratories which handle radioactive materials and classified materials. Protection and accounting of men and material and critical facilities are important aspect of nuclear security. Access Control System (ACS) is used to enhance the protective measures against elevated threat environment. Access control system hardware consists of hand geometry readers, RFID readers, Controllers, Electromagnetic door locks, Turnstiles, fiber cable laying and termination etc. Access Control System controls and monitors the people accessing the secured facilities. Access Control System generates events on: 1. Showing of RFID card, 2. Rotation of turnstile, 3. Download of valid card numbers, 4. Generation of alarms etc. Access control system turnstiles are located in main entrance of a facility, entrance of inside laboratory and door locks are fixed on secured facilities. Events are stored in SQL server database. From the events stored in database a novel technique is developed to extract events and list the persons in a particular facility, list all entry/exit events on one day, list the first in and last out entries. This paper discusses the complex multi level group by queries and software developed to extract events from database, locate persons and generate reports. Software is developed as a web application in ASP.Net and query is written in SQL. User can select the doors, type of events and generate reports. Reports are generated using the master data stored about employees RFID cards and events data stored in tables. Four types of reports are generated 1. Plant Emergency Report, 2. Locate User Report, 3. Entry - Exit Report, 4. First in Last out Report. To generate plant emergency report for whole plant only events generated in outer gates have to be considered. To generate plant emergency report for inside laboratory, events generated in entrance gates have to be ignored. (author)

  15. Impact of Checklist Use on Wellness and Post-Elective Surgery Appointments in a Veterinary Teaching Hospital.

    Science.gov (United States)

    Ruch-Gallie, Rebecca; Weir, Heather; Kogan, Lori R

    Cognitive functioning is often compromised with increasing levels of stress and fatigue, both of which are often experienced by veterinarians. Many high-stress fields have implemented checklists to reduce human error. The use of these checklists has been shown to improve the quality of medical care, including adherence to evidence-based best practices and improvement of patient safety. Although it has been recognized that veterinary medicine would likely demonstrate similar benefits, there have been no published studies to date evaluating the use of checklists for improving quality of care in veterinary medicine. The purpose of the current study was to evaluate the impact of checklists during wellness and post-elective surgery appointments conducted by fourth-year veterinary students within their Community Practice rotation at a US veterinary teaching hospital. Students were randomly assigned to one of two groups: those who were specifically asked to use the provided checklists during appointments, and those who were not asked to use the checklists but had them available. Two individuals blinded to the study reviewed the tapes of all appointments in each study group to determine the amount and type of medical information offered by veterinary students. Students who were specifically asked to use the checklists provided significantly more information to owners, with the exception of keeping the incision clean. Results indicate the use of checklists helps students provide more complete information to their clients, thereby potentially enhancing animal care.

  16. Design of pulse waveform for waveform division multiple access UWB wireless communication system.

    Science.gov (United States)

    Yin, Zhendong; Wang, Zhirui; Liu, Xiaohui; Wu, Zhilu

    2014-01-01

    A new multiple access scheme, Waveform Division Multiple Access (WDMA) based on the orthogonal wavelet function, is presented. After studying the correlation properties of different categories of single wavelet functions, the one with the best correlation property will be chosen as the foundation for combined waveform. In the communication system, each user is assigned to different combined orthogonal waveform. Demonstrated by simulation, combined waveform is more suitable than single wavelet function to be a communication medium in WDMA system. Due to the excellent orthogonality, the bit error rate (BER) of multiuser with combined waveforms is so close to that of single user in a synchronous system. That is to say, the multiple access interference (MAI) is almost eliminated. Furthermore, even in an asynchronous system without multiuser detection after matched filters, the result is still pretty ideal and satisfactory by using the third combination mode that will be mentioned in the study.

  17. Embedded systems for supporting computer accessibility.

    Science.gov (United States)

    Mulfari, Davide; Celesti, Antonio; Fazio, Maria; Villari, Massimo; Puliafito, Antonio

    2015-01-01

    Nowadays, customized AT software solutions allow their users to interact with various kinds of computer systems. Such tools are generally available on personal devices (e.g., smartphones, laptops and so on) commonly used by a person with a disability. In this paper, we investigate a way of using the aforementioned AT equipments in order to access many different devices without assistive preferences. The solution takes advantage of open source hardware and its core component consists of an affordable Linux embedded system: it grabs data coming from the assistive software, which runs on the user's personal device, then, after processing, it generates native keyboard and mouse HID commands for the target computing device controlled by the end user. This process supports any operating system available on the target machine and it requires no specialized software installation; therefore the user with a disability can rely on a single assistive tool to control a wide range of computing platforms, including conventional computers and many kinds of mobile devices, which receive input commands through the USB HID protocol.

  18. A Comprehensive System for Monitoring Urban Accessibility in Smart Cities.

    Science.gov (United States)

    Mora, Higinio; Gilart-Iglesias, Virgilio; Pérez-Del Hoyo, Raquel; Andújar-Montoya, María Dolores

    2017-08-09

    The present work discusses the possibilities offered by the evolution of Information and Communication Technologies with the aim of designing a system to dynamically obtain knowledge of accessibility issues in urban environments. This system is facilitated by technology to analyse the urban user experience and movement accessibility, which enabling accurate identification of urban barriers and monitoring its effectiveness over time. Therefore, the main purpose of the system is to meet the real needs and requirements of people with movement disabilities. The information obtained can be provided as a support service for decision-making to be used by city government, institutions, researchers, professionals and other individuals of society in general to improve the liveability and quality of the lives of citizens. The proposed system is a means of social awareness that makes the most vulnerable groups of citizens visible by involving them as active participants. To perform and implement the system, the latest communication and positioning technologies for smart sensing have been used, as well as the cloud computing paradigm. Finally, to validate the proposal, a case study has been presented using the university environment as a pre-deployment step in urban environments.

  19. Open-Access, Low-Magnetic-Field MRI System for Lung Research

    Science.gov (United States)

    Mair, Ross W.; Rosen, Matthew S.; Tsai, Leo L.; Walsworth, Ronald L.; Hrovat, Mirko I.; Patz, Samuel; Ruset, Iullian C.; Hersman, F. William

    2009-01-01

    An open-access magnetic resonance imaging (MRI) system is being developed for use in research on orientational/gravitational effects on lung physiology and function. The open-access geometry enables study of human subjects in diverse orientations. This system operates at a magnetic flux density, considerably smaller than the flux densities of typical other MRI systems, that can be generated by resistive electromagnet coils (instead of the more-expensive superconducting coils of the other systems). The human subject inhales air containing He-3 or Xe-129 atoms, the nuclear spins of which have been polarized by use of a laser beam to obtain a magnetic resonance that enables high-resolution gas space imaging at the low applied magnetic field. The system includes a bi-planar, constant-current, four-coil electromagnet assembly and associated electronic circuitry to apply a static magnetic field of 6.5 mT throughout the lung volume; planar coils and associated circuitry to apply a pulsed magnetic-field-gradient for each spatial dimension; a single, detachable radio-frequency coil and associated circuitry for inducing and detecting MRI signals; a table for supporting a horizontal subject; and electromagnetic shielding surrounding the electromagnet coils.

  20. 75 FR 45011 - MainStreet Savings Bank, FSB, Hastings, MI; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-07-30

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision MainStreet Savings Bank, FSB, Hastings, MI... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for MainStreet Savings Bank, Hastings, Michigan...

  1. 75 FR 47899 - Bayside Savings Bank, Port St. Joe, FL; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-08-09

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Bayside Savings Bank, Port St. Joe, FL... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Bayside Savings Bank, Port St. Joe, Florida...

  2. 5 CFR 230.402 - Agency authority to make emergency-indefinite appointments in a national emergency.

    Science.gov (United States)

    2010-01-01

    ...) Definition. A national emergency must meet all of the following conditions: (i) It was declared by the... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Agency authority to make emergency-indefinite appointments in a national emergency. 230.402 Section 230.402 Administrative Personnel OFFICE OF...

  3. Knowledge of disease and access to a specialist reported by Spanish patients with ulcerative colitis: UC-LIFE survey

    Directory of Open Access Journals (Sweden)

    Federico Argüelles-Arias

    Full Text Available Background and aim: Education of patients with ulcerative colitis (UC about their disease and access to a specialist are important to improve health outcomes. Our objective was to determine, by collecting information directly from the patients, their information sources and knowledge of the disease, and the options for access to the gastroenterologist. Methods: The information was collected using a printed survey handed out by 39 gastroenterologists to 15 consecutive adult patients with UC. Patients answered anonymously from their home. The responses were stratified by hospital size (> 900; 500-900; < 500 beds. Results: A total of 585 patients received the survey and 436 responded (74.5%; mean age of 46 years [13.5], 53% men. The main information source was the specialist physician (89.2%. Between 32% and 80% of patients had areas of improvement regarding knowledge of their disease. Knowledge of the disease was better in patients from small hospitals (< 500 beds. The frequency of routine visits was also higher in small hospitals. In case of a flare-up, 60% stated they were able to contact their doctor by phone and 37%, that they could get an appointment on the same day. The percentage stating that they had to ask for an appointment and wait until their physician was available was lower in small hospitals. Conclusions: There are areas of improvement with regard to knowledge of their disease in patients with UC followed in hospital clinics. Patients followed in small hospitals seem to know their disease better, are followed more frequently in the clinic, and have better access in case of a flare-up.

  4. The integrity of persons elected, appointed or exercising public functions

    Directory of Open Access Journals (Sweden)

    Agathi Nano

    2017-07-01

    On 17 December 2015, Members of the Albanian Parliament adopt by consensus the constitutional amendments and legislative framework which are necessary to introduce in our country a clear mechanism for the exclusion of criminal offenders from public offices. In this paper we examine regulatory issues relating to the legal framework necessary to guarantee the integrity of public officials, the verification and ascertainment of the prohibition of exercising public functions and the implementation of the prohibitive measures provided for by law no. 138/2015 “On guaranteeing the integrity of the persons elected and/or appointed to, or exercising public functions”, the so called “decriminalisation” law.

  5. 31 CFR 363.27 - What do I need to know about accounts for minors who have not had a legal guardian appointed by a...

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What do I need to know about accounts for minors who have not had a legal guardian appointed by a court? 363.27 Section 363.27 Money and... minors who have not had a legal guardian appointed by a court? (a) We do not permit a minor to purchase...

  6. Primary care patients' expectations regarding medical appointments and their experiences during a visit: does age matter?

    Directory of Open Access Journals (Sweden)

    Jaworski M

    2017-07-01

    Full Text Available Mariusz Jaworski,1 Marta Rzadkiewicz,1 Miroslawa Adamus,1 Joanna Chylinska,1 Magdalena Lazarewicz,1 Gørill Haugan,2 Monica Lillefjell,3 Geir Arild Espnes,2 Dorota Wlodarczyk1 1Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland; 2Department of Public Health and Nursing, 3Department of Neuromedicine and Movement Science, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway Introduction: There is evidence that meeting patients’ expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit.Patients and methods: The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients.Results: We observed differences related to age in patients’ expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients’ appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and

  7. Does the public deserve free access to climate system science?

    Science.gov (United States)

    Grigorov, Ivo

    2010-05-01

    Some time ago it was the lack of public access to medical research data that really stirred the issue and gave inertia for legislation and a new publishing model that puts tax payer-funded medical research in the hands of those who fund it. In today's age global climate change has become the biggest socio-economic challenge, and the same argument resonates: climate affects us all and the publicly-funded science quantifying it should be freely accessible to all stakeholders beyond academic research. Over the last few years the ‘Open Access' movement to remove as much as possible subscription, and other on-campus barriers to academic research has rapidly gathered pace, but despite significant progress, the climate system sciences are not among the leaders in providing full access to their publications and data. Beyond the ethical argument, there are proven and tangible benefits for the next generation of climate researchers to adapt the way their output is published. Through the means provided by ‘open access', both data and ideas can gain more visibility, use and citations for the authors, but also result in a more rapid exchange of knowledge and ideas, and ultimately progress towards a sought solution. The presentation will aim to stimulate discussion and seek progress on the following questions: Should free access to climate research (& data) be mandatory? What are the career benefits of using ‘open access' for young scientists? What means and methods should, or could, be incorporated into current European graduate training programmes in climate research, and possible ways forward?

  8. 20 CFR 422.515 - Forms used for withdrawal, reconsideration and other appeals, and appointment of representative.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Forms used for withdrawal, reconsideration... SOCIAL SECURITY ADMINISTRATION ORGANIZATION AND PROCEDURES Applications and Related Forms § 422.515 Forms used for withdrawal, reconsideration and other appeals, and appointment of representative. The...

  9. 78 FR 43963 - Twenty-Third Meeting: RTCA Special Committee 224, Airport Security Access Control Systems

    Science.gov (United States)

    2013-07-22

    ... Committee 224, Airport Security Access Control Systems AGENCY: Federal Aviation Administration (FAA), U.S. Department of Transportation (DOT). ACTION: Meeting Notice of RTCA Special Committee 224, Airport Security... meeting of the RTCA Special Committee 224, Airport Security Access Control Systems. DATES: The meeting...

  10. 75 FR 9646 - La Jolla Bank, FSB, La Jolla, CA; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-03-03

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision La Jolla Bank, FSB, La Jolla, CA; Notice... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision (OTS) has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for La Jolla Bank, FSB, La Jolla...

  11. A Rewritable, Random-Access DNA-Based Storage System.

    Science.gov (United States)

    Yazdi, S M Hossein Tabatabaei; Yuan, Yongbo; Ma, Jian; Zhao, Huimin; Milenkovic, Olgica

    2015-09-18

    We describe the first DNA-based storage architecture that enables random access to data blocks and rewriting of information stored at arbitrary locations within the blocks. The newly developed architecture overcomes drawbacks of existing read-only methods that require decoding the whole file in order to read one data fragment. Our system is based on new constrained coding techniques and accompanying DNA editing methods that ensure data reliability, specificity and sensitivity of access, and at the same time provide exceptionally high data storage capacity. As a proof of concept, we encoded parts of the Wikipedia pages of six universities in the USA, and selected and edited parts of the text written in DNA corresponding to three of these schools. The results suggest that DNA is a versatile media suitable for both ultrahigh density archival and rewritable storage applications.

  12. Digital Dentistry — Digital Impression and CAD/CAM System Applications

    Directory of Open Access Journals (Sweden)

    Gabor Alin-Gabriel

    2017-03-01

    Full Text Available Digital imprint and computer-aided design/computer-aided manufacture (CAD/CAM systems offer several benefits compared to traditional techniques. The use of a CAD/CAM system to scan preparations and generate restorations in-office, removes a second appointment for the patient. The existence of precision benefits in using complete systems and chairside scanning systems, has been proven. CAD/CAM restorations have a good longevity and meet the accepted clinical parameters. New digital impression methods are presently accessible, and before long, the long-awaited goal of sparing patients of one the most unpleasant practices in clinical dentistry, acquiring dental impressions, will be exchanged by intraoral digital scanning. CAD/CAM systems existing nowadays, can feed data through accurate digital scans created from plaster models, straight to manufacturing systems that can shape ceramic or resin restorations with no requirement of a physical copy of the prepared, adjacent, and antagonist teeth.

  13. Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

    Science.gov (United States)

    Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

    2014-01-01

    To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  14. Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

    Science.gov (United States)

    Hussey, Peter S.; Ringel, Jeanne S.; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W.; Lovejoy, Susan L.; Martsolf, Grant R.; Rudin, Robert S.; Schultz, Dana; Sloss, Elizabeth M.; Watkins, Katherine E.; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R.; Burns, Rachel M.; Chen, Emily K.; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H.; Friedberg, Mark W.; Gidengil, Courtney A.; Ginsburg, Paul B.; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y.; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J.; MacCarthy, Sarah; Maksabedian, Ervant J.; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N.; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E.; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M.; Uscher-Pines, Lori; Vaiana, Mary E.; Vesely, Joseph V.; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth. PMID:28083424

  15. Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positive Tanzanian women (Connected2Care)

    DEFF Research Database (Denmark)

    Linde, Ditte S; Andersen, Marianne S; Mwaiselage, Julius D

    2017-01-01

    group (standard care). In a period of 10 months, the intervention group will receive 15 one-directional health educative text messages and SMS reminders for their appointment. The total sample size will be 700 with 350 women in each study arm. Primary outcome is attendance rate for follow-up. Secondary...... on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for high-risk (HR) Human...

  16. The assessment of exploitation process of power for access control system

    Science.gov (United States)

    Wiśnios, Michał; Paś, Jacek

    2017-10-01

    The safety of public utility facilities is a function not only of effectiveness of the electronic safety systems, used for protection of property and persons, but it also depends on the proper functioning of their power supply systems. The authors of the research paper analysed the power supply systems, which are used in buildings for the access control system that is integrated with the closed-circuit TV. The Access Control System is a set of electronic, electromechanical and electrical devices and the computer software controlling the operation of the above-mentioned elements, which is aimed at identification of people, vehicles allowed to cross the boundary of the reserved area, to prevent from crossing the reserved area and to generate the alarm signal informing about the attempt of crossing by an unauthorised entity. The industrial electricity with appropriate technical parameters is a basis of proper functioning of safety systems. Only the electricity supply to the systems is not equivalent to the operation continuity provision. In practice, redundant power supply systems are used. In the carried out reliability analysis of the power supply system, various power circuits of the system were taken into account. The reliability and operation requirements for this type of system were also included.

  17. Seed quality of common bean accessions under organic and conventional farming systems

    Directory of Open Access Journals (Sweden)

    Diego Medeiros Gindri

    2017-06-01

    Full Text Available Agrobiodiversity is essential for a sustainable food production, and the knowledge of the potential characteristics of landrace seeds may prompt farmers to adopt the habit of seed conservation for this species. This study aimed at categorizing landrace and commercial common bean (Phaseolus vulgaris L. accessions, according to the physiological quality (viability and vigor of seeds produced in the field, during two growing seasons, under organic and conventional farming systems. Germination percentage, field emergence, electrical conductivity, accelerated aging, cold test and seedling length were assessed. The landrace bean accessions exhibit diversity in the physiological seed quality, in terms of their viability and vigor. No differences were observed between the farming systems, in relation to the physiological quality of the seeds produced. The categorization of landrace common bean accessions allows to identify those with superior physiological seed quality.

  18. TPMG Northern California appointments and advice call center.

    Science.gov (United States)

    Conolly, Patricia; Levine, Leslie; Amaral, Debra J; Fireman, Bruce H; Driscoll, Tom

    2005-08-01

    Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of healthcare services to KP members efficiently and cost effectively. Since 1995, when The Permanente Medical Group (TPMG) began to consolidate primary care phone services into three physical call centers, the TPMG Appointments and Advice Call Center (AACC) has become the "front office" for primary care services across approximately 89% of Northern California. The AACC provides primary care phone service for approximately 3 million Kaiser Foundation Health Plan members in Northern California and responds to approximately 1 million calls per month across the three AACC sites. A database records each caller's identity as well as the day, time, and duration of each call; reason for calling; services provided to callers as a result of calls; and clinical outcomes of calls. We here summarize this information for the period 2000 through 2003.

  19. Computer access and Internet use by urban and suburban emergency department customers.

    Science.gov (United States)

    Bond, Michael C; Klemt, Ryan; Merlis, Jennifer; Kopinski, Judith E; Hirshon, Jon Mark

    2012-07-01

    Patients are increasingly using the Internet (43% in 2000 vs. 70% in 2006) to obtain health information, but is there a difference in the ability of urban and suburban emergency department (ED) customers to access the Internet? To assess computer and Internet resources available to and used by people waiting to be seen in an urban ED and a suburban ED. Individuals waiting in the ED were asked survey questions covering demographics, type of insurance, access to a primary care provider, reason for their ED visit, computer access, and ability to access the Internet for health-related matters. There were 304 individuals who participated, 185 in the urban ED and 119 in the suburban ED. Urban subjects were more likely than suburban to be women, black, have low household income, and were less likely to have insurance. The groups were similar in regard to average age, education, and having a primary care physician. Suburban respondents were more likely to own a computer, but the majority in both groups had access to computers and the Internet. Their frequency of accessing the Internet was similar, as were their reasons for using it. Individuals from the urban ED were less willing to schedule appointments via the Internet but more willing to contact their health care provider via e-mail. The groups were equally willing to use the Internet to fill prescriptions and view laboratory results. Urban and suburban ED customers had similar access to the Internet. Both groups were willing to use the Internet to access personal health information. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Evaluasi Pemanfaatan Wireless Internet Protocol Access System di Kota Malang

    Directory of Open Access Journals (Sweden)

    Ahmad Budi Setiawan

    2012-03-01

    Full Text Available WIPAS (Wireless Internet Protocol Accsess System adalah salah satu teknologi pita lebar (broadband yang terbaru. Teknologi tersebut dikembangkan berdasarkan model point-to-multipoint access system pada jaringan nirkabel tetap atau Fixed Wireless Access (FWA dengan memanfaatkan pita frekuensi 26-GHz. Dengan besarnya pita frekuensi yang digunakan, teknologi WIPAS dapat menampung kapasitas akses untuk lalu lintas jaringan yang sangat besar. Dalam penelitian ini akan dikaji dan dievaluasi efektifitas penggunaan teknologi WIPAS melalui kasus pemanfaatan teknologi WIPAS untuk pemberdayaan komunitas di kota Malang. Dalam penelitian ini juga akan dideskripsikan pemanfaatan teknologi WIPAS untuk melihat manfaat penggunaan teknologi tersebut. Penelitian ini dilakukan dengan metode kualitatif dengan melakukan evaluasi terhadap infrastruktur yang telah dibangun untuk melihat efektifitas pemanfaatan WIPAS. Hasil penelitian ini adalah sebuah kajian evaluatif tentang pemanfaatan WIPAS di kota Malang dan rekomendasi untuk implementasi lebih lanjut.

  1. An end-to-end secure patient information access card system.

    Science.gov (United States)

    Alkhateeb, A; Singer, H; Yakami, M; Takahashi, T

    2000-03-01

    The rapid development of the Internet and the increasing interest in Internet-based solutions has promoted the idea of creating Internet-based health information applications. This will force a change in the role of IC cards in healthcare card systems from a data carrier to an access key medium. At the Medical Informatics Department of Kyoto University Hospital we are developing a smart card patient information project where patient databases are accessed via the Internet. Strong end-to-end data encryption is performed via Secure Socket Layers, transparent to transmit patient information. The smart card is playing the crucial role of access key to the database: user authentication is performed internally without ever revealing the actual key. For easy acceptance by healthcare professionals, the user interface is integrated as a plug-in for two familiar Web browsers, Netscape Navigator and MS Internet Explorer.

  2. Presidential Management Fellows (PMF) Talent Acquisition System, PMF-TAS (ACCESS CONTROLLED)

    Data.gov (United States)

    Office of Personnel Management — Application and Assessment system for Presidential Management Fellows (PMF) and PMF Science, Technology, Engineering, and Math (STEM) programs. This sytem is access...

  3. 28 CFR 16.72 - Exemption of Office of the Associate Attorney General System-limited access.

    Science.gov (United States)

    2010-07-01

    ... Attorney General System-limited access. 16.72 Section 16.72 Judicial Administration DEPARTMENT OF JUSTICE....72 Exemption of Office of the Associate Attorney General System—limited access. (a) The following...) General Files System of the Office of the Associate Attorney General (JUSTICE/AAG-001). These exemptions...

  4. Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans.

    Science.gov (United States)

    Haeder, Simon F; Weimer, David L; Mukamel, Dana B

    2016-07-01

    The adequacy of provider networks for plans sold through insurance Marketplaces established under the Affordable Care Act has received much scrutiny recently. Various studies have established that networks are generally narrow. To learn more about network adequacy and access to care, we investigated two questions. First, no matter the nominal size of a network, can patients gain access to primary care services from providers of their choice in a timely manner? Second, how does access compare to plans sold outside insurance Marketplaces? We conducted a "secret shopper" survey of 743 primary care providers from five of California's nineteen insurance Marketplace pricing regions in the summer of 2015. Our findings indicate that obtaining access to primary care providers was generally equally challenging both inside and outside insurance Marketplaces. In less than 30 percent of cases were consumers able to schedule an appointment with an initially selected physician provider. Information about provider networks was often inaccurate. Problems accessing services for patients with acute conditions were particularly troubling. Effectively addressing issues of network adequacy requires more accurate provider information. Project HOPE—The People-to-People Health Foundation, Inc.

  5. TECHNOLOGY FOR ADMINISTERING OF THE ACCESS TO INFORMATION RESOURCES IN MANAGEMENT SYSTEM ON THE AVIATION ENTERPRISE

    Directory of Open Access Journals (Sweden)

    Andrey V. Degtyarev

    2015-01-01

    Full Text Available The task of administering software-information complex occurs duringthe development of application systems for managing business-processes and is connected with the organization of access forusers to information resources in conditions of multi-user information systems for management. For solution of this problem proposed theapproach, which is based on a hierarchical system of access rightsto information resources on the levels: tool, object and procedural.Keywords: software-information complex, information resources,administering, permissions, separation of powers, access model.

  6. Access to Justice in the European Convention on Human Rights System

    NARCIS (Netherlands)

    Glas, L.R.; Gerards, J.H.

    2017-01-01

    The numerous reforms to the Convention system of the past two decades have unquestionably had an effect on applicants’ means to access justice in the system. It is, however, open to question how these changes should be evaluated: with reference to the individual right to petition, or with reference

  7. Propagation Characteristics in an Underground Shopping Area for 5GHz-band Wireless Access Systems

    Science.gov (United States)

    Itokawa, Kiyohiko; Kita, Naoki; Sato, Akio; Matsue, Hideaki; Mori, Daisuke; Watanabe, Hironobu

    5-GHz band wireless access systems, such as the RLAN (Radio Local Area Network) system of IEEE802.11a, HiperLAN/2, HiSWANa and AWA, are developed and provide transmission rates over 20 Mbps for indoor use. Those 5-GHz access systems are expected to extend service areas from the office to the so-called “hot-spot" in public areas. Underground shopping malls are one of the anticipated service areas for such a nomadic wireless access service. Broadband propagation characteristics are required for radio zone design in an underground mall environment despite previous results obtained by narrow band measurements. This paper presents results of an experimental study on the propagation characteristics for broadband wireless access systems in an underground mall environment. First, broadband propagation path loss is measured and formulated considering human body shadowing. A ray trace simulation is used to clarify the basic propagation mechanism in such a closed environment. Next, a distance dependency of the delay spread during a crowded time period, rush hour, is found to be at most 65 nsec, which is under the permitted maximum value of the present 5-GHz systems. Finally, above propagation characteristics support the result of transmission test carried out by using AWA equipment.

  8. On board processing for future satellite communications systems: Comparison of FDM, TDM and hybrid accessing schemes

    Science.gov (United States)

    Berk, G.; Jean, P. N.; Rotholz, E.

    1982-01-01

    Several satellite uplink and downlink accessing schemes for customer premises service are compared. Four conceptual system designs are presented: satellite-routed frequency division multiple access (FDMA), satellite-switched time division multiple access (TDMA), processor-routed TDMA, and frequency-routed TDMA, operating in the 30/20 GHz band. The designs are compared on the basis of estimated satellite weight, system capacity, power consumption, and cost. The systems are analyzed for fixed multibeam coverage of the continental United States. Analysis shows that the system capacity is limited by the available satellite resources and by the terminal size and cost.

  9. Systemic lupus erythematosus observations of travel burden: A qualitative inquiry.

    Science.gov (United States)

    Williams, Edith M; Ortiz, Kasim; Flournoy-Floyd, Minnjuan; Bruner, Larisa; Kamen, Diane

    2015-09-01

    Explorations of travel impediments among patients suffering from rheumatic diseases have been very limited. Research has consistently indicated a shortage of rheumatologists, resulting in patients potentially having to travel long distances for care. The purpose of our study was to explore how systemic lupus erythematosus (SLE) patients experience travel issues differentially by race and socio-economic status. We conducted semi-structured interviews and a brief demographic survey with 10 patients diagnosed with SLE. Interview transcripts were coded and analyzed using NVivo Analysis Software to facilitate the reporting of recurrent themes and supporting quotations, and an initial codebook was independently developed by two researchers on the study team and then verified together. Patients described three major areas of concern with respect to travel burden in accessing their rheumatologists: reliance on caregivers; meeting financial priorities; and pain and physical limitations. Our data suggest general traveling challenges interfering with medical appointment compliance for several participants and the importance of socio-economic issues when considering travel issues. This study highlights an important area with implications for adherence to medical appointments and participation in research among patients with SLE. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  10. Information system architecture to support transparent access to distributed, heterogeneous data sources

    International Nuclear Information System (INIS)

    Brown, J.C.

    1994-08-01

    Quality situation assessment and decision making require access to multiple sources of data and information. Insufficient accessibility to data exists for many large corporations and Government agencies. By utilizing current advances in computer technology, today's situation analyst's have a wealth of information at their disposal. There are many potential solutions to the information accessibility problem using today's technology. The United States Department of Energy (US-DOE) faced this problem when dealing with one class of problem in the US. The result of their efforts has been the creation of the Tank Waste Information Network System -- TWINS. The TWINS solution combines many technologies to address problems in several areas such as User Interfaces, Transparent Access to Multiple Data Sources, and Integrated Data Access. Data related to the complex is currently distributed throughout several US-DOE installations. Over time, each installation has adopted their own set of standards as related to information management. Heterogeneous hardware and software platforms exist both across the complex and within a single installation. Standards for information management vary between US-DOE mission areas within installations. These factors contribute to the complexity of accessing information in a manner that enhances the performance and decision making process of the analysts. This paper presents one approach taken by the DOE to resolve the problem of distributed, heterogeneous, multi-media information management for the HLW Tank complex. The information system architecture developed for the DOE by the TWINS effort is one that is adaptable to other problem domains and uses

  11. GP preferences for information systems: conjoint analysis of speed, reliability, access and users.

    Science.gov (United States)

    Wyatt, Jeremy C; Batley, Richard P; Keen, Justin

    2010-10-01

    To elicit the preferences and trade-offs of UK general practitioners about key features of health information systems, to help inform the design of such systems in future. A stated choice study to uncover implicit preferences based on a binary choice between scenarios presented in random order. were all 303 general practice members of the UK Internet service provider, Medix who were approached by email to participate. The main outcome measure was the number of seconds delay in system response that general practitioners were willing to trade off for each key system feature: the reliability of the system, the sites from which the system could be accessed and which staff are able to view patient data. Doctors valued speed of response most in information systems but would be prepared to wait 28 seconds to access a system in exchange for improved reliability from 95% to 99%, a further 2 seconds for an improvement to 99.9% and 27 seconds for access to data from anywhere including their own home compared with one place in a single health care premises. However, they would require a system that was 14 seconds faster to compensate for allowing social care as well as National Health Service staff to read patient data. These results provide important new evidence about which system characteristics doctors value highly, and hence which characteristics designers need to focus on when large scale health information systems are planned. © 2010 Blackwell Publishing Ltd.

  12. 28 CFR 16.83 - Exemption of the Executive Office for Immigration Review System-limited access.

    Science.gov (United States)

    2010-07-01

    ... Immigration Review System-limited access. 16.83 Section 16.83 Judicial Administration DEPARTMENT OF JUSTICE....83 Exemption of the Executive Office for Immigration Review System—limited access. (a) The following system of records is exempt from 5 U.S.C. 552a(d): (1) The Executive Office for Immigration Review's...

  13. Multiple Access Interference Reduction Using Received Response Code Sequence for DS-CDMA UWB System

    Science.gov (United States)

    Toh, Keat Beng; Tachikawa, Shin'ichi

    This paper proposes a combination of novel Received Response (RR) sequence at the transmitter and a Matched Filter-RAKE (MF-RAKE) combining scheme receiver system for the Direct Sequence-Code Division Multiple Access Ultra Wideband (DS-CDMA UWB) multipath channel model. This paper also demonstrates the effectiveness of the RR sequence in Multiple Access Interference (MAI) reduction for the DS-CDMA UWB system. It suggests that by using conventional binary code sequence such as the M sequence or the Gold sequence, there is a possibility of generating extra MAI in the UWB system. Therefore, it is quite difficult to collect the energy efficiently although the RAKE reception method is applied at the receiver. The main purpose of the proposed system is to overcome the performance degradation for UWB transmission due to the occurrence of MAI during multiple accessing in the DS-CDMA UWB system. The proposed system improves the system performance by improving the RAKE reception performance using the RR sequence which can reduce the MAI effect significantly. Simulation results verify that significant improvement can be obtained by the proposed system in the UWB multipath channel models.

  14. Shared and individual medical appointments for children and adolescents with type 1 diabetes: differences in topics discussed?

    NARCIS (Netherlands)

    Rijswijk, C.; Zantinge, E.; Seesing, F.; Raats, I.; Dulmen, S. van

    2010-01-01

    OBJECTIVE: The purpose of this study was to examine differences in the type of topics discussed during shared medical appointments (SMAs) and traditional individual outpatient visits for children and adolescents with type 1 diabetes. In addition, differences between the conversational contributions

  15. Experiences and reflections of patients with motor neuron disease on breaking the news in a two-tiered appointment: a qualitative study.

    Science.gov (United States)

    Seeber, Antje A; Pols, A Jeannette; Hijdra, Albert; Grupstra, Hepke F; Willems, Dick L; de Visser, Marianne

    2016-02-02

    Breaking bad news should be fine-tuned to the individual patient, contain intelligible information, include emotional support and offer a tailor-made treatment plan. To achieve this goal in motor neuron disease (MND), neurologists of the amyotrophic lateral sclerosis (ALS) centre Amsterdam deliver the message on 2 separate visits within 14 days. To evaluate how patients with MND react to and view disclosure of the diagnosis, in this 2-tiered approach. Non-participating observations and in-depth interviews with patients were conducted in 1 tertiary ALS referral centre. Qualitative analysis consisted of inductive analysis of observation reports and verbatim typed out interviews. 10 2-tiered appointments were observed and 21 Dutch patients with MND interviewed. They experienced the straightforward message to be suffering from a fatal disease as devastating, yet unavoidable. The prospect of a short-term second appointment offered structure for the period immediately following the diagnosis. The time between appointments provided the opportunity for a first reorientation on their changed perspective on their life. The second appointment allowed for detailed discussions about various aspects of MND and a tailor-made treatment plan. The 2-tiered approach fits well with the way in which Dutch patients with MND process the disclosure of their diagnosis, gather information and handle the changed perspective on their life. It may serve as a model for other life-limiting diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Digital Autonomous Terminal Access Communication (DATAC) system

    Science.gov (United States)

    Novacki, Stanley M., III

    1987-01-01

    In order to accommodate the increasing number of computerized subsystems aboard today's more fuel efficient aircraft, the Boeing Co. has developed the DATAC (Digital Autonomous Terminal Access Control) bus to minimize the need for point-to-point wiring to interconnect these various systems, thereby reducing total aircraft weight and maintaining an economical flight configuration. The DATAC bus is essentially a local area network providing interconnections for any of the flight management and control systems aboard the aircraft. The task of developing a Bus Monitor Unit was broken down into four subtasks: (1) providing a hardware interface between the DATAC bus and the Z8000-based microcomputer system to be used as the bus monitor; (2) establishing a communication link between the Z8000 system and a CP/M-based computer system; (3) generation of data reduction and display software to output data to the console device; and (4) development of a DATAC Terminal Simulator to facilitate testing of the hardware and software which transfer data between the DATAC's bus and the operator's console in a near real time environment. These tasks are briefly discussed.

  17. 75 FR 21391 - First Federal Bank of North Florida; Palatka, FL; Notice of Appointment of Receiver

    Science.gov (United States)

    2010-04-23

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision First Federal Bank of North Florida... contained in section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for First Federal Bank of North Florida...

  18. ACCESS Sub-system Performance

    Science.gov (United States)

    Kaiser, Mary Elizabeth; Morris, Matthew J.; Aldoroty, Lauren Nicole; Godon, David; Pelton, Russell; McCandliss, Stephan R.; Kurucz, Robert L.; Kruk, Jeffrey W.; Rauscher, Bernard J.; Kimble, Randy A.; Wright, Edward L.; Benford, Dominic J.; Gardner, Jonathan P.; Feldman, Paul D.; Moos, H. Warren; Riess, Adam G.; Bohlin, Ralph; Deustua, Susana E.; Dixon, William Van Dyke; Sahnow, David J.; Lampton, Michael; Perlmutter, Saul

    2016-01-01

    ACCESS: Absolute Color Calibration Experiment for Standard Stars is a series of rocket-borne sub-orbital missions and ground-based experiments designed to leverage significant technological advances in detectors, instruments, and the precision of the fundamental laboratory standards used to calibrate these instruments to enable improvements in the precision of the astrophysical flux scale through the transfer of laboratory absolute detector standards from the National Institute of Standards and Technology (NIST) to a network of stellar standards with a calibration accuracy of 1% and a spectral resolving power of 500 across the 0.35 to 1.7 micron bandpass.A cross wavelength calibration of the astrophysical flux scale to this level of precision over this broad a bandpass is relevant for the data used to probe fundamental astrophysical problems such as the SNeIa photometry based measurements used to constrain dark energy theories.We will describe the strategy for achieving this level of precision, the payload and calibration configuration, present sub-system test data, and the status and preliminary performance of the integration and test of the spectrograph and telescope. NASA APRA sounding rocket grant NNX14AH48G supports this work.

  19. Access to general practice for Pacific peoples: a place for cultural competency.

    Science.gov (United States)

    Ludeke, Melissa; Puni, Ronald; Cook, Lynley; Pasene, Maria; Abel, Gillian; Sopoaga, Faafetai

    2012-06-01

    Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. Pacific participants were recruited through Pacific networks known to Pegasus Health and via 'snowball' sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants' views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacific peoples: language and communication; rushed consultations; appointment availability; reception; and Pacific presence. The findings indicate that all personnel within the primary care setting have the ability to directly engage in the improvement of the health status of Pacific peoples in New Zealand by developing cultural competency and incorporating flexibility and diversity into the care and service they provide.

  20. [Analysis of the patients who missed their appointments at the neurology clinic of the Marina Alta].

    Science.gov (United States)

    Morera-Guitart, J; Mas-Server, M A; Más-Sesé, G

    To analyze the frequency, reasons and characteristics of patients who missed their appointments (NP) at the Neurology Clinic (CEN). To compare the characteristics of the NP with the patients who did not miss their appointment. Suggest measures to reduce avoidable causes of NP. During the period 1/10/99 to 30/4/2000 the cases of NP were prospectively recorded and compared with a sample of patients who attended the CEN during the same period. We analyze the data on age, sex, distance of home from CEN, diagnosis, type of consultation and date of last consultation. The NP were contacted by phone and asked why they had not gone for their appointments. The reasons given were then classified as avoidable or unavoidable. Of the 1,842 consultations scheduled, 19% were NP. When the NP and the patients who did attend were compared we found statistically significant differences regarding the distance home/CEN. According to the diagnosis, the NP had more 'symptoms/signs' and other MIA, whilst those who attended the clinic had more 'neuropathies' and 'awaiting diagnosis'. The commonest avoidable reasons (55.8%) for NP were forgetting, administrative error and communication failure, and for unavoidable reasons (44.2%) physical disability, other priorities and improvement. There is a large proportion of NP in the CEN of the Marina Alta. The distance from home to CEN (over 25 km) was the main factor affecting the rate of NP. Since 56% of the NP were due to avoidable causes, strategies could be designed to reduce this percentage. In the NP group, the main causes were forgetting, administrative errors and communication failure.

  1. Design mobile satellite system architecture as an integral part of the cellular access digital network

    Science.gov (United States)

    Chien, E. S. K.; Marinho, J. A.; Russell, J. E., Sr.

    1988-01-01

    The Cellular Access Digital Network (CADN) is the access vehicle through which cellular technology is brought into the mainstream of the evolving integrated telecommunications network. Beyond the integrated end-to-end digital access and per call network services provisioning of the Integrated Services Digital Network (ISDN), the CADN engenders the added capability of mobility freedom via wireless access. One key element of the CADN network architecture is the standard user to network interface that is independent of RF transmission technology. Since the Mobile Satellite System (MSS) is envisioned to not only complement but also enhance the capabilities of the terrestrial cellular telecommunications network, compatibility and interoperability between terrestrial cellular and mobile satellite systems are vitally important to provide an integrated moving telecommunications network of the future. From a network standpoint, there exist very strong commonalities between the terrestrial cellular system and the mobile satellite system. Therefore, the MSS architecture should be designed as an integral part of the CADN. This paper describes the concept of the CADN, the functional architecture of the MSS, and the user-network interface signaling protocols.

  2. Impact of optical hard limiter on the performance of an optical overlapped-code division multiple access system

    Science.gov (United States)

    Inaty, Elie; Raad, Robert; Tablieh, Nicole

    2011-08-01

    Throughout this paper, a closed form expression of the multiple access interference (MAI) limited bit error rate (BER) is provided for the multiwavelength optical code-division multiple-access system when the system is working above the nominal transmission rate limit imposed by the passive encoding-decoding operation. This system is known in literature as the optical overlapped code division multiple access (OV-CDMA) system. A unified analytical framework is presented emphasizing the impact of optical hard limiter (OHL) on the BER performance of such a system. Results show that the performance of the OV-CDMA system may be highly improved when using OHL preprocessing at the receiver side.

  3. Broadband and scalable mobile satellite communication system for future access networks

    Science.gov (United States)

    Ohata, Kohei; Kobayashi, Kiyoshi; Nakahira, Katsuya; Ueba, Masazumi

    2005-07-01

    Due to the recent market trends, NTT has begun research into next generation satellite communication systems, such as broadband and scalable mobile communication systems. One service application objective is to provide broadband Internet access for transportation systems, temporal broadband access networks and telemetries to remote areas. While these are niche markets the total amount of capacity should be significant. We set a 1-Gb/s total transmission capacity as our goal. Our key concern is the system cost, which means that the system should be unified system with diversified services and not tailored for each application. As satellites account for a large portion of the total system cost, we set the target satellite size as a small, one-ton class dry mass with a 2-kW class payload power. In addition to the payload power and weight, the mobile satellite's frequency band is extremely limited. Therefore, we need to develop innovative technologies that will reduce the weight and maximize spectrum and power efficiency. Another challenge is the need for the system to handle up to 50 dB and a wide data rate range of other applications. This paper describes the key communication system technologies; the frequency reuse strategy, multiplexing scheme, resource allocation scheme, and QoS management algorithm to ensure excellent spectrum efficiency and support a variety of services and quality requirements in the mobile environment.

  4. Peripheral Insertion of a Central Venous Access Device Under Fluoroscopic Guidance Using a Peripherally Accessed System (PAS) Port in the Forearm

    International Nuclear Information System (INIS)

    Hata, Yasuhiro; Morita, Sojiro; Morita, Yoshitaka; Awatani, Toshihide; Takasaki, Motohiro; Horimi, Tadashi; Ozawa, Zen

    1998-01-01

    Purpose: We describe the technique, efficacy, and complications of fluoroscopy-guided implantation of a central venous access device using a peripherally accessed system (PAS) port via the forearm. Methods: Beginning in July 1994, 105 central venous access devices were implanted in 104 patients for the long-term infusion of antibiotics or antineoplasmic agents, blood products, or parenteral nutrition. The devices was inserted under fluoroscopic guidance with real-time venography from a peripheral route. Results: All ports were successfully implanted. There were no procedure-related complications. No thrombosis or local infection was observed; however, in six patients catheter-related phlebitis occurred. Conclusion: Fluoroscopy-guided implantation of a central venous access device using a PAS port via the forearm is safe and efficacious, and injection of contrast medium through a peripheral IV catheter before introduction of the catheter helps to avoid catheter-related phlebitis

  5. MessageSpace: a messaging system for health research

    Science.gov (United States)

    Escobar, Rodrigo D.; Akopian, David; Parra-Medina, Deborah; Esparza, Laura

    2013-03-01

    Mobile Health (mHealth) has emerged as a promising direction for delivery of healthcare services via mobile communication devices such as cell phones. Examples include texting-based interventions for chronic disease monitoring, diabetes management, control of hypertension, smoking cessation, monitoring medication adherence, appointment keeping and medical test result delivery; as well as improving patient-provider communication, health information communication, data collection and access to health records. While existing messaging systems very well support bulk messaging and some polling applications, they are not designed for data collection and processing of health research oriented studies. For that reason known studies based on text-messaging campaigns have been constrained in participant numbers. In order to empower healthcare promotion and education research, this paper presents a system dedicated for healthcare research. It is designed for convenient communication with various study groups, feedback collection and automated processing.

  6. Peer Assessment and Compliance Review (PACR) Innovative Strategies Report. California Court Appointed Special Advocates (CASA) Programs

    Science.gov (United States)

    Macro, Bronwen; Huang, Lee Ann

    2005-01-01

    This report focuses on the innovative strategies study component of the Peer Assessment and Compliance Review (PACR) project. California (Court Appointed Special Advocates) CASA programs have developed many innovative strategies to serve children in their communities. At each of the programs visited during the PACR project, the team identified at…

  7. 78 FR 65290 - Request for Applicants for the Appointment to the United States-India CEO Forum

    Science.gov (United States)

    2013-10-31

    ... Appointment to the United States- India CEO Forum AGENCY: Global Markets, International Trade Administration... President (or have a comparable level of responsibility) of a U.S.-owned or controlled company that is... doing business in both India and the United States. Each candidate also must be a U.S. citizen or...

  8. Code division multiple-access techniques in optical fiber networks. II - Systems performance analysis

    Science.gov (United States)

    Salehi, Jawad A.; Brackett, Charles A.

    1989-08-01

    A technique based on optical orthogonal codes was presented by Salehi (1989) to establish a fiber-optic code-division multiple-access (FO-CDMA) communications system. The results are used to derive the bit error rate of the proposed FO-CDMA system as a function of data rate, code length, code weight, number of users, and receiver threshold. The performance characteristics for a variety of system parameters are discussed. A means of reducing the effective multiple-access interference signal by placing an optical hard-limiter at the front end of the desired optical correlator is presented. Performance calculations are shown for the FO-CDMA with an ideal optical hard-limiter, and it is shown that using a optical hard-limiter would, in general, improve system performance.

  9. Generation-based memory synchronization in a multiprocessor system with weakly consistent memory accesses

    Energy Technology Data Exchange (ETDEWEB)

    Ohmacht, Martin

    2017-08-15

    In a multiprocessor system, a central memory synchronization module coordinates memory synchronization requests responsive to memory access requests in flight, a generation counter, and a reclaim pointer. The central module communicates via point-to-point communication. The module includes a global OR reduce tree for each memory access requesting device, for detecting memory access requests in flight. An interface unit is implemented associated with each processor requesting synchronization. The interface unit includes multiple generation completion detectors. The generation count and reclaim pointer do not pass one another.

  10. Generation-based memory synchronization in a multiprocessor system with weakly consistent memory accesses

    Science.gov (United States)

    Ohmacht, Martin

    2014-09-09

    In a multiprocessor system, a central memory synchronization module coordinates memory synchronization requests responsive to memory access requests in flight, a generation counter, and a reclaim pointer. The central module communicates via point-to-point communication. The module includes a global OR reduce tree for each memory access requesting device, for detecting memory access requests in flight. An interface unit is implemented associated with each processor requesting synchronization. The interface unit includes multiple generation completion detectors. The generation count and reclaim pointer do not pass one another.

  11. Access Denied! Contrasting Data Access in the United States and Ireland

    Directory of Open Access Journals (Sweden)

    Grogan Samuel

    2016-07-01

    Full Text Available The ability of an Internet user to access data collected about himself as a result of his online activity is a key privacy safeguard. Online, data access has been overshadowed by other protections such as notice and choice. This paper describes attitudes about data access. 873 US and Irish Internet users participated in a survey designed to examine views on data access to information held by online companies and data brokers. We observed low levels of awareness of access mechanisms along with a high desire for access in both participant groups. We tested three proposed access systems in keeping with industry programs and regulatory proposals. User response was positive. We conclude that access remains an important privacy protection that is inadequately manifested in practice. Our study provides insight for lawmakers and policymakers, as well as computer scientists who implement these systems.

  12. A Novel Medium Access Control for Ad hoc Networks Based on OFDM System

    Institute of Scientific and Technical Information of China (English)

    YU Yi-fan; YIN Chang-chuan; YUE Guang-xin

    2005-01-01

    Recently, hosts of Medium Access Control (MAC) protocols for Ad hoc radio networks have been proposed to solve the hidden terminal problem and exposed terminal problem. However most of them take into no account the interactions between physical (PHY) system and MAC protocol. Therefore, the current MAC protocols are either inefficient in the networks with mobile nodes and fading channel or difficult in hardware implementation. In this paper, we present a novel media access control for Ad hoc networks that integrates a media access control protocol termed as Dual Busy Tone Multiple Access (DBTMA) into Orthogonal Frequency Division Multiplexing (OFDM) system proposed in IEEE 802.11a standard. The analysis presented in the paper indicates that the proposed MAC scheme achieves performance improvement over IEEE 802.11 protocol about 25%~80% especially in the environment with high mobility and deep fading. The complexity of the proposed scheme is also lower than other implementation of similar busy tone solution. Furthermore, it is compatible with IEEE 802.11a networks.

  13. Health Information System Role-Based Access Control Current Security Trends and Challenges.

    Science.gov (United States)

    de Carvalho Junior, Marcelo Antonio; Bandiera-Paiva, Paulo

    2018-01-01

    This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. We have selected articles related to our investigation theme "RBAC trends and limitations" in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: "Role-Based Access Control" OR "RBAC" AND "Health information System" OR "EHR" AND "Trends" OR "Challenges" OR "Security" OR "Authorization" OR "Attacks" OR "Permission Assignment" OR "Permission Relation" OR "Permission Mapping" OR "Constraint". We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.

  14. An Intelligent System Proposal for Improving the Safety and Accessibility of Public Transit by Highway

    Directory of Open Access Journals (Sweden)

    Carmelo R. García

    2015-08-01

    Full Text Available The development of public transit systems that are accessible and safe for everyone, including people with special needs, is an objective that is justified from the civic and economic points of view. Unfortunately, public transit services are conceived for people who do not have reduced physical or cognitive abilities. In this paper, we present an intelligent public transit system by highway with the goal of facilitating access and improving the safety of public transit for persons with special needs. The system is deployed using components that are commonly available in transport infrastructure, e.g., sensors, mobile communications systems, and positioning systems. In addition, the system can operate in non-urban transport contexts, e.g., isolated rural areas, where the availability of basic infrastructure, such as electricity and communications infrastructures, is not always guaranteed. To construct the system, the principles and techniques of Ubiquitous Computing and Ambient Intelligence have been employed. To illustrate the utility of the system, two cases of services rendered by the system are described: the first case involves a surveillance system to guarantee accessibility at bus stops; the second case involves a route assistant for blind people.

  15. The new biometric access control system resembles a big electronic eye. It will be used to control access to the LHC from 2007 onwards.

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    The new LHC access control systems will soon be using the latest technology: optical recognition based on iris image data. In order to gain access to the tunnel it will be your eye, not your credentials that you'll be required to show! As of September, the entrance point at Point 8 should be the first to be fitted out with iris recognition equipment. The other access shafts will then gradually be equipped one by one.

  16. Is the Japanese Distribution System Becoming More Accessible to Foreign Firms?

    OpenAIRE

    Ralf bebenroth; Nir Kshetri; Reinhard Hunerberg

    2009-01-01

    Complexities in the Japanese distribution system are well-publicized. An emerging body of literature has documented recent changes in the Japanese distribution system. In this paper, it is examined whether foreign firms' accessibility to the Japanese distribution system has changed in a favorable direction in recent years. Furthermore, as foreign firms vary widely in terms of institutional barriers and complexity they face in the Japanese market, the authors also investigate the determinants ...

  17. National Geothermal Data System: an Exemplar of Open Access to Data

    Science.gov (United States)

    Allison, M. L.; Richard, S. M.; Blackman, H.; Anderson, A.

    2013-12-01

    The National Geothermal Data System's (NGDS - www.geothermaldata.org) formal launch in 2014 will provide open access to millions of datasets, sharing technical geothermal-relevant data across the geosciences to propel geothermal development and production. With information from all of the Department of Energy's sponsored development and research projects and geologic data from all 50 states, this free, interactive tool is opening new exploration opportunities and shortening project development by making data easily discoverable and accessible. We continue to populate our prototype functional data system with multiple data nodes and nationwide data online and available to the public. Data from state geological surveys and partners includes more than 5 million records online, including 1.48 million well headers (oil and gas, water, geothermal), 732,000 well logs, and 314,000 borehole temperatures and is growing rapidly. There are over 250 Web services and another 138 WMS (Web Map Services) registered in the system as of August, 2013. Companion projects run by Boise State University, Southern Methodist University, and USGS are adding millions of additional data records. The National Renewable Energy Laboratory is managing the Geothermal Data Repository which will serve as a system node and clearinghouse for data from hundreds of DOE-funded geothermal projects. NGDS is built on the US Geoscience Information Network data integration framework, which is a joint undertaking of the USGS and the Association of American State Geologists (AASG). NGDS is fully compliant with the White House Executive Order of May 2013, requiring all federal agencies to make their data holdings publicly accessible online in open source, interoperable formats with common core and extensible metadata. The National Geothermal Data System is being designed, built, deployed, and populated primarily with grants from the US Department of Energy, Geothermal Technologies Office. To keep this operational

  18. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail...... and Metro system resulting from the construction of a new terminal Metro station connecting southern townships to Copenhagen city centre. The results show that public transport based job accessibility has a positive and permanent effect on individual earnings. The increase in earnings is associated...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  19. Remotely Sensed Land Imagery and Access Systems: USGS Updates

    Science.gov (United States)

    Lamb, R.; Pieschke, R.; Lemig, K.

    2017-12-01

    The U.S. Geological Survey (USGS) Earth Resources Observation and Science (EROS) Center has implemented a number of updates to its suite of remotely sensed products and distribution systems. These changes will greatly expand the availability, accessibility, and usability of the image products from USGS. As of late 2017, several new datasets are available for public download at no charge from USGS/EROS Center. These products include Multispectral Instrument (MSI) Level-1C data from the Sentinel-2B satellite, which was launched in March 2017. Along with Sentinel-2A, the Sentinel-2B images are now being distributed through USGS systems as part of a collaborative effort with the European Space Agency (ESA). The Sentinel-2 imagery is highly complementary to multispectral data collected by the USGS Landsat 7 and 8 satellites. With these two missions operating together, the potential local revisit rate can be reduced to 2-4 days. Another product addition is Resourcesat-2 data acquired over the United States by the Indian Space Research Organisation (ISRO). The Resourcesat-2 products from USGS consist of Advanced Wide Field Sensor (AWiFS) and Linear Imaging Self-Scanning Sensor Three (LISS-3) images acquired August 2016 to present. In an effort to maximize future Landsat data interoperability, including time series analysis of the 45+ year archive, the reprocessing of Collection 1 for all historical Landsat Level 1 products is nearly complete. The USGS is now working on operational release of higher-level science products to support analysis of the Landsat archive at the pixel level. Major upgrades were also completed in 2017 for several USGS data discovery and access systems, including the LandsatLook Viewer (https://landsatlook.usgs.gov/) and GloVis Tool (https://glovis.usgs.gov/). Other options are now being developed to further enhance data access and overall user experience. These future options will be discussed and community feedback will be encouraged.

  20. Shared random access memory resource for multiprocessor real-time systems

    International Nuclear Information System (INIS)

    Dimmler, D.G.; Hardy, W.H. II

    1977-01-01

    A shared random-access memory resource is described which is used within real-time data acquisition and control systems with multiprocessor and multibus organizations. Hardware and software aspects are discussed in a specific example where interconnections are done via a UNIBUS. The general applicability of the approach is also discussed

  1. A remark on accessibility

    International Nuclear Information System (INIS)

    Wu, Xinxing; Wang, Jianjun

    2016-01-01

    Highlights: • Obtain some characteristics of accessibility and Kato’s chaos. • Answer negatively a question in [Li R, Wang H, Zhao Y. Kato’s chaos in duopoly games. Chaos Solit Fract 2016;84:69–72]. • A dynamical system is indecomposable if and only if it is weakly transitive. - Abstract: This note obtains some characteristics of accessibility and Kato’s chaos. Applying these results, an accessible dynamical system whose product system is not accessible is constructed, giving a negative answer to a question in [Li R, Wang H, Zhao Y. Kato’s chaos in duopoly games. Chaos Solit Fract 2016;84:69–72]. Besides, it is proved that every transitive interval self-map is accessible.

  2. Access Request Trustworthiness in Weighted Access Control Framework

    Institute of Scientific and Technical Information of China (English)

    WANG Lun-wei; LIAO Xiang-ke; WANG Huai-min

    2005-01-01

    Weighted factor is given to access control policies to express the importance of policy and its effect on access control decision. According to this weighted access control framework, a trustworthiness model for access request is also given. In this model, we give the measure of trustworthiness factor to access request, by using some idea of uncertainty reasoning of expert system, present and prove the parallel propagation formula of request trustworthiness factor among multiple policies, and get the final trustworthiness factor to decide whether authorizing. In this model, authorization decision is given according to the calculation of request trustworthiness factor, which is more understandable, more suitable for real requirement and more powerful for security enhancement than traditional methods. Meanwhile the finer access control granularity is another advantage.

  3. Multiple Coaxial Catheter System for Reliable Access in Interventional Stroke Therapy

    International Nuclear Information System (INIS)

    Kulcsar, Zsolt; Yilmaz, Hasan; Bonvin, Christophe; Lovblad, Karl O.; Ruefenacht, Daniel A.

    2010-01-01

    In some patients with acute cerebral vessel occlusion, navigating mechanical thrombectomy systems is difficult due to tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries. Our purpose was to describe a multiple coaxial catheter system used for mechanical revascularization that helps navigation and manipulations in tortuous vessels. A triple or quadruple coaxial catheter system was built in 28 consecutive cases presenting with acute ischemic stroke. All cases were treated by mechanical thrombectomy with the Penumbra System. In cases of unsuccessful thrombo-aspiration, additional thrombolysis or angioplasty with stent placement was used for improving recanalization. The catheter system consisted of an outermost 8-Fr and an intermediate 6-Fr guiding catheter, containing the inner Penumbra reperfusion catheters. The largest, 4.1-Fr, reperfusion catheter was navigated over a Prowler Select Plus microcatheter. The catheter system provided access to reach the cerebral lesions and provided stability for the mechanically demanding manipulations of thromboaspiration and stent navigation in all cases. Apart from their mechanical role, the specific parts of the system could also provide access to different types of interventions, like carotid stenting through the 8-Fr guiding catheter and intracranial stenting and thrombolysis through the Prowler Select Plus microcatheter. In this series, there were no complications related to the catheter system. In conclusion, building up a triple or quadruple coaxial system proved to be safe and efficient in our experience for the mechanical thrombectomy treatment of acute ischemic stroke.

  4. Diversity begets diversity? The effects of board composition on the appointment and success of women CEOs.

    Science.gov (United States)

    Cook, Alison; Glass, Christy

    2015-09-01

    Previous research on the effects of leadership diversity on firm outcomes has produced inconsistent and inconclusive findings. While some scholars argue that diversity increases organizational equity and enhances performance, others argue that diversity increases conflict, reduces cooperation and harms performance. This study tests the impact of a variety of compositional factors on firm outcomes. Specifically, we analyze whether and how board composition affects the advancement and mobility of women CEOs and firm performance. Our analysis relies on a unique data set of all Chief Executive Officers (CEOs) and Board of Directors (BODs) in Fortune 500 companies over a ten-year period. We find a marginally significant positive relationship between board diversity and the likelihood of a woman being appointed CEO. We further find that board diversity significantly and positively influences the post-promotion success of women CEOs. Our findings suggest that board composition is critical for the appointment and success of women CEOs, and increasing board diversity should be central to any organizational diversity efforts. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.

    Science.gov (United States)

    Panattoni, Laura; Stone, Ashley; Chung, Sukyung; Tai-Seale, Ming

    2015-03-01

    The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. The study included family medicine (n = 104) and internal medicine (n = 101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n = 12,688). Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third next-available appointment. Physician FTE was directly associated with better continuity of care received (0.172% per FTE, p part-time PCPs in practice redesign efforts and initiatives to meet the demand for primary care services.

  6. Interoperable Access to Near Real Time Ocean Observations with the Observing System Monitoring Center

    Science.gov (United States)

    O'Brien, K.; Hankin, S.; Mendelssohn, R.; Simons, R.; Smith, B.; Kern, K. J.

    2013-12-01

    The Observing System Monitoring Center (OSMC), a project funded by the National Oceanic and Atmospheric Administration's Climate Observations Division (COD), exists to join the discrete 'networks' of In Situ ocean observing platforms -- ships, surface floats, profiling floats, tide gauges, etc. - into a single, integrated system. The OSMC is addressing this goal through capabilities in three areas focusing on the needs of specific user groups: 1) it provides real time monitoring of the integrated observing system assets to assist management in optimizing the cost-effectiveness of the system for the assessment of climate variables; 2) it makes the stream of real time data coming from the observing system available to scientific end users into an easy-to-use form; and 3) in the future, it will unify the delayed-mode data from platform-focused data assembly centers into a standards- based distributed system that is readily accessible to interested users from the science and education communities. In this presentation, we will be focusing on the efforts of the OSMC to provide interoperable access to the near real time data stream that is available via the Global Telecommunications System (GTS). This is a very rich data source, and includes data from nearly all of the oceanographic platforms that are actively observing. We will discuss how the data is being served out using a number of widely used 'web services' (including OPeNDAP and SOS) and downloadable file formats (KML, csv, xls, netCDF), so that it can be accessed in web browsers and popular desktop analysis tools. We will also be discussing our use of the Environmental Research Division's Data Access Program (ERDDAP), available from NOAA/NMFS, which has allowed us to achieve our goals of serving the near real time data. From an interoperability perspective, it's important to note that access to the this stream of data is not just for humans, but also for machine-to-machine requests. We'll also delve into how we

  7. ATLAS, an integrated structural analysis and design system. Volume 4: Random access file catalog

    Science.gov (United States)

    Gray, F. P., Jr. (Editor)

    1979-01-01

    A complete catalog is presented for the random access files used by the ATLAS integrated structural analysis and design system. ATLAS consists of several technical computation modules which output data matrices to corresponding random access file. A description of the matrices written on these files is contained herein.

  8. An Investigation into Patient Non-Attendance and Use of a Short-Message Reminder System at a University Dental Clinic.

    Science.gov (United States)

    Storrs, Mark J; Ramov, Helen M; Lalloo, Ratilal

    2016-01-01

    Non-attended appointments in health care facilities create inefficiencies and loss of clinical productivity: clinical teaching hours are reduced, impacting students' ability to meet the competencies necessary for professional registration. The aim of this study was to assess demographic and time-related factors for patient non-attendance at a dental school clinic in Australia. Appointment data were extracted from the patient management system for the years 2011 and 2012. Data included the status of appointment (attended, cancelled, or failed to attend [FTA]) and an array of demographic and time-related factors. Multinomial logistic regression was conducted to assess relationships between these factors and appointment status. Attendance rates were also compared by year following implementation of a short message service (SMS) reminder at the beginning of 2012. The results showed that, of 58,622 appointments booked with students during 2011 and 2012, 68% of patients attended, 23% cancelled, and 9% were FTA. The percentage of non-attended (cancelled or FTA) appointments differed by demographic and time-related factors. Females were 7% less likely to be FTA, those aged 16-24 years were five times more likely to be FTA, and early morning appointments were 18% less likely to be cancelled and FTA. With the SMS reminder system, the odds of a cancellation were 15% higher, but FTAs were 14% lower (both were statistically significant differences). This study found that failing to attend an appointment was significantly related to a number of factors. Clinical scheduling and reminder systems may need to take these factors into account to decrease the number of teaching hours lost due to patients' missing their appointments.

  9. First Experiences Using XACML for Access Control in Distributed Systems

    Science.gov (United States)

    Lorch, Marcus; Proctor, Seth; Lepro, Rebekah; Kafura, Dennis; Shah, Sumit

    2003-01-01

    Authorization systems today are increasingly complex. They span domains of administration, rely on many different authentication sources, and manage permissions that can be as complex as the system itself. Worse still, while there are many standards that define authentication mechanisms, the standards that address authorization are less well defined and tend to work only within homogeneous systems. This paper presents XACML, a standard access control language, as one component of a distributed and inter-operable authorization framework. Several emerging systems which incorporate XACML are discussed. These discussions illustrate how authorization can be deployed in distributed, decentralized systems. Finally, some new and future topics are presented to show where this work is heading and how it will help connect the general components of an authorization system.

  10. Security Guidelines for the Development of Accessible Web Applications through the implementation of intelligent systems

    Directory of Open Access Journals (Sweden)

    Luis Joyanes Aguilar

    2009-12-01

    Full Text Available Due to the significant increase in threats, attacks and vulnerabilities that affect the Web in recent years has resulted the development and implementation of pools and methods to ensure security measures in the privacy, confidentiality and data integrity of users and businesses. Under certain circumstances, despite the implementation of these tools do not always get the flow of information which is passed in a secure manner. Many of these security tools and methods cannot be accessed by people who have disabilities or assistive technologies which enable people to access the Web efficiently. Among these security tools that are not accessible are the virtual keyboard, the CAPTCHA and other technologies that help to some extent to ensure safety on the Internet and are used in certain measures to combat malicious code and attacks that have been increased in recent times on the Web. Through the implementation of intelligent systems can detect, recover and receive information on the characteristics and properties of the different tools and hardware devices or software with which the user is accessing a web application and through analysis and interpretation of these intelligent systems can infer and automatically adjust the characteristics necessary to have these tools to be accessible by anyone regardless of disability or navigation context. This paper defines a set of guidelines and specific features that should have the security tools and methods to ensure the Web accessibility through the implementation of intelligent systems.

  11. National Geothermal Data System: Open Access to Geoscience Data, Maps, and Documents

    Science.gov (United States)

    Caudill, C. M.; Richard, S. M.; Musil, L.; Sonnenschein, A.; Good, J.

    2014-12-01

    The U.S. National Geothermal Data System (NGDS) provides free open access to millions of geoscience data records, publications, maps, and reports via distributed web services to propel geothermal research, development, and production. NGDS is built on the US Geoscience Information Network (USGIN) data integration framework, which is a joint undertaking of the USGS and the Association of American State Geologists (AASG), and is compliant with international standards and protocols. NGDS currently serves geoscience information from 60+ data providers in all 50 states. Free and open source software is used in this federated system where data owners maintain control of their data. This interactive online system makes geoscience data easily discoverable, accessible, and interoperable at no cost to users. The dynamic project site http://geothermaldata.org serves as the information source and gateway to the system, allowing data and applications discovery and availability of the system's data feed. It also provides access to NGDS specifications and the free and open source code base (on GitHub), a map-centric and library style search interface, other software applications utilizing NGDS services, NGDS tutorials (via YouTube and USGIN site), and user-created tools and scripts. The user-friendly map-centric web-based application has been created to support finding, visualizing, mapping, and acquisition of data based on topic, location, time, provider, or key words. Geographic datasets visualized through the map interface also allow users to inspect the details of individual GIS data points (e.g. wells, geologic units, etc.). In addition, the interface provides the information necessary for users to access the GIS data from third party software applications such as GoogleEarth, UDig, and ArcGIS. A redistributable, free and open source software package called GINstack (USGIN software stack) was also created to give data providers a simple way to release data using

  12. Administrative Circular No. 2 (Rev. 7) - Recruitment, appointment and possible developments regarding the contractual position of staff members

    CERN Multimedia

    2015-01-01

    Administrative Circular No. 2 (Rev. 7), entitled "Recruitment, appointment and possible developments regarding the contractual position of staff members", approved by the Director-General following discussion at the Standing Concertation Committee meeting held on 17 February 2015 is available via the following link: AC No. 2 (Rev.7).   This revised circular cancels and replaces Administrative Circular No. 2 (Rev. 6), entitled "Recruitment, appointment and possible developments regarding the contractual position of staff members" and dated January 2015. The circular was revised in order to implement the amendment to Article R II 1.17 of the Staff Regulations, which introduces the possibility of extending limited-duration (LD) contracts up to a maximum total duration of eight years from the previous duration of five years. The award of indefinite contracts will continue to be subject to the outcome of a competitive process. Department Head Of...

  13. Administrative Circular No. 30 (Rev. 3) - “Financial benefits on taking up appointment and on termination of contract”

    CERN Multimedia

    2013-01-01

    Administrative Circular No. 30 (Rev. 3) entitled “Financial benefits on taking up appointment and on termination of contract”, approved by the Director-General following discussion at the Standing Concertation Committee meeting of 27 June 2013 and entering into force on 1 August 2013, is available on the intranet site of the Human Resources Department (see here).   Administrative Circular No. 30 (Rev. 3) is applicable to all members of the personnel. It cancels and replaces Administrative Circular No. 30 (Rev. 2/Corr.) entitled "Financial benefits on taking up appointment and on termination of contract” of September 2009. This circular was revised in order to implement the modifications introduced into the Staff Rules and Regulations in January 2013 relating to the introduction of the status of Associate Member States and new categories of associated members of the personnel. In particular, the notion of “Member State” in Annexe II (&a...

  14. ICSW2AN : An Inter-vehicle Communication System Using Mobile Access Point over Wireless Wide Area Networks

    Science.gov (United States)

    Byun, Tae-Young

    This paper presents a prototype of inter-vehicle communication system using mobile access point that internetworks wired or wireless LAN and wireless WAN anywhere. Implemented mobile access point can be equipped with various wireless WAN interfaces such as WCDMA and HSDPA. Mobile access point in the IP mechanism has to process connection setup procedure to one wireless WAN. To show the applicability of the mobile access point to inter-vehicle communication, a simplified V2I2V-based car communication system called ICSW2AN is implemented to evaluate major performance metrics by road test. In addition, results of road test for traffic information service are investigated in view of RTT, latency and server processing time. The experimental result indicates that V2I2V-based car communication system sufficiently can provide time-tolerant traffic information to moving vehicles while more than two mobile devices in restricted spaces such as car, train and ship access wireless Internet simultaneously.

  15. Demystifying Open Access

    International Nuclear Information System (INIS)

    Mele, Salvatore

    2007-01-01

    The tenets of Open Access are to grant anyone, anywhere and anytime free access to the results of scientific research. HEP spearheaded the Open Access dissemination of scientific results with the mass mailing of preprints in the pre-WWW era and with the launch of the arXiv preprint system at the dawn of the '90s. The HEP community is now ready for a further push to Open Access while retaining all the advantages of the peer-review system and, at the same time, bring the spiralling cost of journal subscriptions under control. I will present a possible plan for the conversion to Open Access of HEP peer-reviewed journals, through a consortium of HEP funding agencies, laboratories and libraries: SCOAP3 (Sponsoring Consortium for Open Access Publishing in Particle Physics). SCOAP3 will engage with scientific publishers towards building a sustainable model for Open Access publishing, which is as transparent as possible for HEP authors. The current system in which journals income comes from subscription fees is replaced with a scheme where SCOAP3 compensates publishers for the costs incurred to organise the peer-review service and give Open Access to the final version of articles. SCOAP3 will be funded by all countries active in HEP under a 'fair share' scenario, according to their production of HEP articles. In this talk I will present a short overview of the history of Open Access in HEP, the details of the SCOAP3 model and the outlook for its implementation.

  16. Predictors of appendiceal perforation in an equal access system.

    Science.gov (United States)

    Walker, Avery; Hatch, Quinton; Drake, Thurston; Nelson, Daniel W; Fitzpatrick, Emilie; Bingham, Jason; Black, George; Maykel, Justin A; Steele, Scott R

    2014-07-01

    Discrepancies in socioeconomic factors have been associated with higher rates of perforated appendicitis. As an equal-access health care system theoretically removes these barriers, we aimed to determine if remaining differences in demographics, education, and pay result in disparate outcomes in the rate of perforated appendicitis. All patients undergoing appendectomy for acute appendicitis (November 2004-October 2009) at a tertiary care equal access institution were categorized by demographics and perioperative data. Rank of the sponsor was used as a surrogate for economic status. A multivariate logistic regression model was performed to determine patient and clinical characteristics associated with perforated appendicitis. A total of 680 patients (mean age 30±16 y; 37% female) were included. The majority were Caucasian (56.4% [n=384]; African Americans 5.6% [n=38]; Asians 1.9% [n=13]; and other 48.9% [n=245]) and enlisted (87.2%). Overall, 6.4% presented with perforation, with rates of 6.6%, 5.8%, and 6.7% (P=0.96) for officers, enlisted soldiers, and contractors, respectively. There was no difference in perforation when stratified by junior or senior status for either officers or enlisted (9.3% junior versus 4.40% senior officers, P=0.273; 6.60% junior versus 5.50% senior enlisted, P=0.369). On multivariate analysis, parameters such as leukocytosis and temperature, as well as race and rank were not associated with perforation (P=0.7). Only age had a correlation, with individuals aged 66-75 y having higher perforation rates (odds ratio, 1.04; 95% confidence interval, 1.02-1.05; P<0.001). In an equal-access health care system, older age, not socioeconomic factors, correlated with increased appendiceal perforation rates. Published by Elsevier Inc.

  17. “Future Directions”: m-government computer systems accessed via cloud computing – advantages and possible implementations

    OpenAIRE

    Daniela LIŢAN

    2015-01-01

    In recent years, the activities of companies and Public Administration had been automated and adapted to the current information system. Therefore, in this paper, I will present and exemplify the benefits of m-government computer systems development and implementation (which can be accessed from mobile devices and which are specific to the workflow of Public Administrations) starting from the “experience” of e-government systems implementation in the context of their access and usage through ...

  18. Access systems strategy in the accelerator complex and experimental areas

    International Nuclear Information System (INIS)

    Nunes, R.; Ninin, P.; Sanchez-Corral, E.; Ladzinski, T.

    2012-01-01

    This paper reviews the main features of the new PS Personnel Protection System (PSPSS) as well as the main milestones for its deployment during the Long Shutdown of 2013-2014. Access conditions in the PS, SPS and LHC complexes during this period shall be described as well as the upgrades and improvements that are under preparation. (authors)

  19. Obtaining a follow-up appointment before discharge protects against readmission for patients with acute coronary syndrome and heart failure: A quality improvement project.

    Science.gov (United States)

    Baky, Vidagay; Moran, Dane; Warwick, Tessa; George, Alice; Williams, Tammy; McWilliams, Eric; Marine, Joseph E

    2018-04-15

    Cardiac patients have a high risk of readmission following hospital discharge. The aim of our project was to examine the factors associated with increased readmission rate, with a view to eventually decrease the rate of readmission for patients admitted to the hospital due to acute coronary syndrome (ACS) or heart failure. Patients admitted to the cardiac step-down unit at a single private hospital from 2015 to 2016 were included in our study. Interventions that were employed included: (1) improved pre-discharge follow-up appointment scheduling, (2) medication education by a pharmacist, and (3) timely discharge planning. Our primary outcome of interest was all-cause rate of hospital readmission within 30days. We conducted a multivariate analysis to determine the factors that were predictive of readmission rate. 578 patients were included in the study and 402 were diagnosed with ACS (69.9%). The rate of readmission was 14.2% for patients with heart failure, compared to 7.5% for patients with ACS. Following the bundle of interventions, patients were significantly more likely to receive an appointment (45.6% vs. 75.4%, pReadmission rate was comparable following the intervention (8.6% vs. 9.7%), but patients that received an appointment had 0.374 times lower odds of being readmitted (p=0.004). While our package of interventions did not lead to a significant decline in our readmission rate, patients who received a follow-up appointment prior to discharge were strongly protected against readmission. Copyright © 2017. Published by Elsevier B.V.

  20. Defense Hotline Allegations Concerning the Biometric Identification System for Access Omnibus Contract

    National Research Council Canada - National Science Library

    2008-01-01

    .... According to the Strategic Services Sourcing (S3) performance work statement the purpose of the BISA is to provide a biometric base access control system that can operate in a hostile environment...

  1. Guide on Project Web Access of SFR R and D and Technology Monitoring System

    International Nuclear Information System (INIS)

    Lee, Dong Uk; Won, Byung Chool; Lee, Yong Bum; Kim, Young In; Hahn, Do Hee

    2008-09-01

    The SFR R and D and technology monitoring system based on the MS enterprise project management is developed for systematic effective management of 'Development of Basic Key Technologies for Gen IV SFR' project which was performed under the Mid- and Long-term Nuclear R and D Program sponsored by the Ministry of Education, Science and Technology. This system is a tool for project management based on web access. Therefore this manual is a detailed guide for Project Web Access(PWA). Section 1 describes the common guide for using of system functions such as project server 2007 client connection setting, additional outlook function setting etc. The section 2 describes the guide for system administrator. It is described the guide for project management in section 3, 4

  2. Performance enhancement of optical code-division multiple-access systems using transposed modified Walsh code

    Science.gov (United States)

    Sikder, Somali; Ghosh, Shila

    2018-02-01

    This paper presents the construction of unipolar transposed modified Walsh code (TMWC) and analysis of its performance in optical code-division multiple-access (OCDMA) systems. Specifically, the signal-to-noise ratio, bit error rate (BER), cardinality, and spectral efficiency were investigated. The theoretical analysis demonstrated that the wavelength-hopping time-spreading system using TMWC was robust against multiple-access interference and more spectrally efficient than systems using other existing OCDMA codes. In particular, the spectral efficiency was calculated to be 1.0370 when TMWC of weight 3 was employed. The BER and eye pattern for the designed TMWC were also successfully obtained using OptiSystem simulation software. The results indicate that the proposed code design is promising for enhancing network capacity.

  3. Guide on Project Web Access of SFR R and D and Technology Monitoring System

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Uk; Won, Byung Chool; Lee, Yong Bum; Kim, Young In; Hahn, Do Hee

    2008-09-15

    The SFR R and D and technology monitoring system based on the MS enterprise project management is developed for systematic effective management of 'Development of Basic Key Technologies for Gen IV SFR' project which was performed under the Mid- and Long-term Nuclear R and D Program sponsored by the Ministry of Education, Science and Technology. This system is a tool for project management based on web access. Therefore this manual is a detailed guide for Project Web Access(PWA). Section 1 describes the common guide for using of system functions such as project server 2007 client connection setting, additional outlook function setting etc. The section 2 describes the guide for system administrator. It is described the guide for project management in section 3, 4.

  4. Scheduling with Bus Access Optimization for Distributed Embedded Systems

    DEFF Research Database (Denmark)

    Eles, Petru; Doboli, Alex; Pop, Paul

    2000-01-01

    of control. Our goal is to derive a worst case delay by which the system completes execution, such that this delay is as small as possible; to generate a logically and temporally deterministic schedule; and to optimize parameters of the communication protocol such that this delay is guaranteed. We have......In this paper, we concentrate on aspects related to the synthesis of distributed embedded systems consisting of programmable processors and application-specific hardware components. The approach is based on an abstract graph representation that captures, at process level, both dataflow and the flow......, generates an efficient bus access scheme as well as the schedule tables for activation of processes and communications....

  5. Introduction to the Personal Access Satellite System Study

    Science.gov (United States)

    Sue, Miles K.

    1990-01-01

    A recent study by the National Telecommunications and Information Administration (NTIA) has concluded that the 21st century will be the age of information in which the telecommunication infrastructure will be vital to the social and economic well being of society. To meet the challenge of the coming age, JPL has been performing studies on a personal access satellite system (PASS) for the 21st century. The PASS study can be traced back to a study in which the technical feasibility and potential applications of a high frequency, low data rate satellite system were identified using small fixed terminals. Herein, the PASS concept is described along with the strawman design. Then the key challenges are identified along with possible solutions. Finally, the plan for the future is summarized from the key results.

  6. Development of Remote Monitoring and a Control System Based on PLC and WebAccess for Learning Mechatronics

    Directory of Open Access Journals (Sweden)

    Wen-Jye Shyr

    2013-02-01

    Full Text Available This study develops a novel method for learning mechatronics using remote monitoring and control, based on a programmable logic controller (PLC and WebAccess. A mechatronics module, a Web-CAM and a PLC were integrated with WebAccess software to organize a remote laboratory. The proposed system enables users to access the Internet for remote monitoring and control of the mechatronics module via a web browser, thereby enhancing work flexibility by enabling personnel to control mechatronics equipment from a remote location. Mechatronics control and long-distance monitoring were realized by establishing communication between the PLC and WebAccess. Analytical results indicate that the proposed system is feasible. The suitability of this system is demonstrated in the department of industrial education and technology at National Changhua University of Education, Taiwan. Preliminary evaluation of the system was encouraging and has shown that it has achieved success in helping students understand concepts and master remote monitoring and control techniques.

  7. Juan Antonio Rubio appointed as Director-General of CIEMAT

    CERN Multimedia

    2004-01-01

    Juan Antonio Rubio, Head of CERN's ETT unit (Education and Technology Transfer) has been appointed by the Spanish Ministry of Education and Science as the Director General of the Research Centre for Energy, Environment and Technology, CIEMAT. Dr Rubio's career began at the Spanish Nuclear Energy Commission where he held the posts of Investigator, Head of the High Energy Group and Head of Nuclear Physics and High Energy Division. Later, he was named Director of the Department of Basic Investigation and Scientific Director of the CIEMAT. In 1987 he joined CERN as Scientific Adviser to the Director General and Group Leader of the Scientific Assessment Group. Up to now, Dr Rubio has been the Head of the ETT unit, as well as Coordinator for Latin America and Commissioner for the 50th Anniversary of the Organization. He was born on 4 June 1944 in Madrid, and holds a Doctorate in Physical Sciences from the Universidad Complutense de Madrid.

  8. Welcome to Systems — A New Interdisciplinary Open Access Journal for Systems Science and Engineering

    Directory of Open Access Journals (Sweden)

    Thomas Huynh

    2012-04-01

    Full Text Available Natural and human-made systems abound around us. Our solar system, the human body, the food chain, and ecosystems are some examples of natural systems. Some human-made systems are transportation systems, weapon systems, computer systems, software systems, satellite communications systems, ships, missile defense systems, health care systems, the internet, financial systems, and regional economies. Understanding of natural systems is essential to the survival of the human species, which is intertwined with the survival of other species on earth. Having the knowledge and ability to build human-made systems is critical to the employment of systems that effectively serve the needs of their users. To gain such understanding and to acquire such knowledge and ability, it is necessary that cutting-edge research in systems science, systems engineering, and systems-related fields continue. This open access journal aims to achieve quick and global dissemination of results of such research. [...

  9. Development of Decision-Making Automated System for Optimal Placement of Physical Access Control System’s Elements

    Science.gov (United States)

    Danilova, Olga; Semenova, Zinaida

    2018-04-01

    The objective of this study is a detailed analysis of physical protection systems development for information resources. The optimization theory and decision-making mathematical apparatus is used to formulate correctly and create an algorithm of selection procedure for security systems optimal configuration considering the location of the secured object’s access point and zones. The result of this study is a software implementation scheme of decision-making system for optimal placement of the physical access control system’s elements.

  10. Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock: luer lock cap vs. luer access split septum system (Q-Syte).

    Science.gov (United States)

    Pohl, Fabian; Hartmann, Werner; Holzmann, Thomas; Gensicke, Sandra; Kölbl, Oliver; Hautmann, Matthias G

    2014-01-25

    Many cancer patients receive a central venous catheter or port system prior to therapy to assure correct drug administration. Even appropriate hygienic intervention maintenance carries the risk of contaminating the middle port (C-port) of a three-way cock (TWC), a risk that increases with the number of medical interventions. Because of the complexity of the cleaning procedure with disconnection and reconnection of the standard luer lock cap (referred as "intervention"), we compared luer lock caps with a "closed access system" consisting of a luer access split septum system with regard to process optimization (work simplification, process time), efficiency (costs) and hygiene (patient safety). For determination of process optimization the workflow of an intervention according to the usual practice and risks was depicted in a process diagram. For determining the actual process costs, we analyzed use of material and time parameters per intervention and used the process parameters for programming the process into a simulation run (n = 1000) to determine the process costs as well as their differences (ACTUAL vs. NOMINAL) within the framework of a discrete event simulation.Additionally cultures were carried out at the TWC C-ports to evaluate possible contamination. With the closed access system, the mean working time of 5.5 minutes could be reduced to 2.97 minutes. The results for average process costs (labour and material costs per use) were 3.92 € for luer lock caps and 2.55 € for the closed access system. The hypothesis test (2-sample t-test, CI 0.95, p-valuerisks (related to material, surroundings, staff handling) could be reduced by 65.38%. In the present research, the closed access system with a divided split septum was superior to conventional luer lock caps. The advantage of the closed access system lies in the simplified handling for staff, which results in a reduced risk of patient infection due to improved clinical hygiene.

  11. Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2010-01-01

    Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.

  12. Study and development of a document file system with selective access

    International Nuclear Information System (INIS)

    Mathieu, Jean-Claude

    1974-01-01

    The objective of this research thesis was to design and to develop a set of software aimed at an efficient management of a document file system by using methods of selective access to information. Thus, the three main aspects of file processing (creation, modification, reorganisation) have been addressed. The author first presents the main problems related to the development of a comprehensive automatic documentation system, and their conventional solutions. Some future aspects, notably dealing with the development of peripheral computer technology, are also evoked. He presents the characteristics of INIS bibliographic records provided by the IAEA which have been used to create the files. In the second part, he briefly describes the file system general organisation. This system is based on the use of two main files: an inverse file which contains for each descriptor a list of of numbers of files indexed by this descriptor, and a dictionary of descriptor or input file which gives access to the inverse file. The organisation of these both files is then describes in a detailed way. Other related or associated files are created, and the overall architecture and mechanisms integrated into the file data input software are described, as well as various processing applied to these different files. Performance and possible development are finally discussed

  13. U-Access: a web-based system for routing pedestrians of differing abilities

    Science.gov (United States)

    Sobek, Adam D.; Miller, Harvey J.

    2006-09-01

    For most people, traveling through urban and built environments is straightforward. However, for people with physical disabilities, even a short trip can be difficult and perhaps impossible. This paper provides the design and implementation of a web-based system for the routing and prescriptive analysis of pedestrians with different physical abilities within built environments. U-Access, as a routing tool, provides pedestrians with the shortest feasible route with respect to one of three differing ability levels, namely, peripatetic (unaided mobility), aided mobility (mobility with the help of a cane, walker or crutches) and wheelchair users. U-Access is also an analytical tool that can help identify obstacles in built environments that create routing discrepancies among pedestrians with different physical abilities. This paper discusses the system design, including database, algorithm and interface specifications, and technologies for efficiently delivering results through the World Wide Web (WWW). This paper also provides an illustrative example of a routing problem and an analytical evaluation of the existing infrastructure which identifies the obstacles that pose the greatest discrepancies between physical ability levels. U-Access was evaluated by wheelchair users and route experts from the Center for Disability Services at The University of Utah, USA.

  14. The equipment access software for a distributed UNIX-based accelerator control system

    International Nuclear Information System (INIS)

    Trofimov, Nikolai; Zelepoukine, Serguei; Zharkov, Eugeny; Charrue, Pierre; Gareyte, Claire; Poirier, Herve

    1994-01-01

    This paper presents a generic equipment access software package for a distributed control system using computers with UNIX or UNIX-like operating systems. The package consists of three main components, an application Equipment Access Library, Message Handler and Equipment Data Base. An application task, which may run in any computer in the network, sends requests to access equipment through Equipment Library calls. The basic request is in the form Equipment-Action-Data and is routed via a remote procedure call to the computer to which the given equipment is connected. In this computer the request is received by the Message Handler. According to the type of the equipment connection, the Message Handler either passes the request to the specific process software in the same computer or forwards it to a lower level network of equipment controllers using MIL1553B, GPIB, RS232 or BITBUS communication. The answer is then returned to the calling application. Descriptive information required for request routing and processing is stored in the real-time Equipment Data Base. The package has been written to be portable and is currently available on DEC Ultrix, LynxOS, HPUX, XENIX, OS-9 and Apollo domain. ((orig.))

  15. Shared Medical Appointments marginally enhance interaction between patients: an observational study on children and adolescents with type 1 diabetes.

    NARCIS (Netherlands)

    Noordman, J.; Dulmen, S. van

    2013-01-01

    Objective: To examine informational and emotional patient–provider and patient–patient communication sequences (i.e. cues and subsequent responses) during Shared Medical Appointments (SMAs) for children and adolescents with type 1 Diabetes Mellitus (T1DM) and their parents. Methods: 57

  16. An API-based search system for one click access to information

    NARCIS (Netherlands)

    Ionita, Dan; Tax, Niek; Hiemstra, Djoerd

    This paper proposes a prototype One Click access system, based on previous work in the field and the related 1CLICK-2@NTCIR10 task. The proposed solution integrates methods from into a three tier algorithm: query categorization, information extraction and output generation and offers suggestions on

  17. Completeness and overlap in open access systems: Search engines, aggregate institutional repositories and physics-related open sources.

    Science.gov (United States)

    Tsay, Ming-Yueh; Wu, Tai-Luan; Tseng, Ling-Li

    2017-01-01

    This study examines the completeness and overlap of coverage in physics of six open access scholarly communication systems, including two search engines (Google Scholar and Microsoft Academic), two aggregate institutional repositories (OAIster and OpenDOAR), and two physics-related open sources (arXiv.org and Astrophysics Data System). The 2001-2013 Nobel Laureates in Physics served as the sample. Bibliographic records of their publications were retrieved and downloaded from each system, and a computer program was developed to perform the analytical tasks of sorting, comparison, elimination, aggregation and statistical calculations. Quantitative analyses and cross-referencing were performed to determine the completeness and overlap of the system coverage of the six open access systems. The results may enable scholars to select an appropriate open access system as an efficient scholarly communication channel, and academic institutions may build institutional repositories or independently create citation index systems in the future. Suggestions on indicators and tools for academic assessment are presented based on the comprehensiveness assessment of each system.

  18. Android Access Control Extension

    Directory of Open Access Journals (Sweden)

    Anton Baláž

    2015-12-01

    Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.

  19. Effects of shared medical appointments on quality of life and cost-effectiveness for patients with a chronic neuromuscular disease. Study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van der Wilt Gert-Jan

    2011-08-01

    Full Text Available Abstract Background Shared medical appointments are a series of one-to-one doctor-patient contacts, in presence of a group of 6-10 fellow patients. This group visits substitute the annual control visits of patients with the neurologist. The same items attended to in a one-to- one appointment are addressed. The possible advantages of a shared medical appointment could be an added value to the present management of neuromuscular patients. The currently problem-focused one-to-one out-patient visits often leave little time for the patient's psychosocial needs, patient education, and patient empowerment. Methods/design A randomized, prospective controlled study (RCT with a follow up of 6 months will be conducted to evaluate the clinical and cost-effectiveness of shared medical appointments compared to usual care for 300 neuromuscular patients and their partners at the Radboud University Nijmegen Medical Center. Every included patient will be randomly allocated to one of the two study arms. This study has been reviewed and approved by the medical ethics committee of the region Arnhem-Nijmegen, the Netherlands. The primary outcome measure is quality of life as measured by the EQ-5D, SF-36 and the Individualized neuromuscular Quality of Life Questionnaire. The primary analysis will be an intention-to-treat analysis on the area under the curve of the quality of life scores. A linear mixed model will be used with random factor group and fixed factors treatment, baseline score and type of neuromuscular disease. For the economic evaluation an incremental cost-effectiveness analysis will be conducted from a societal perspective, relating differences in costs to difference in health outcome. Results are expected in 2012. Discussion This study will be the first randomized controlled trial which evaluates the effect of shared medical appointments versus usual care for neuromuscular patients. This will enable to determine if there is additional value of shared

  20. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    LENUS (Irish Health Repository)

    Prabhu, Neeta T

    2010-03-01

    The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.