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Sample records for basic service set

  1. Basic set theory

    CERN Document Server

    Levy, Azriel

    2002-01-01

    An advanced-level treatment of the basics of set theory, this text offers students a firm foundation, stopping just short of the areas employing model-theoretic methods. Geared toward upper-level undergraduate and graduate students, it consists of two parts: the first covers pure set theory, including the basic motions, order and well-foundedness, cardinal numbers, the ordinals, and the axiom of choice and some of it consequences; the second deals with applications and advanced topics such as point set topology, real spaces, Boolean algebras, and infinite combinatorics and large cardinals. An

  2. Get the Basics Right: A Description of the Key Priorities for Establishing a Neonatal Service in a Resource-Limited Setting in Cambodia.

    Science.gov (United States)

    Fox-Lewis, Shivani; Genasci Smith, Wyatt; Lor, Vary; McKellar, Gregor; Phal, Chea; Fox-Lewis, Andrew; Turner, Paul; Neou, Leakhena; Turner, Claudia

    2018-05-28

    Worldwide, reduction in under-five mortality has not sufficiently included neonates, who represent 45% of deaths in children of age under five years. The least progress has been observed in resource-limited settings. This mixed methods study conducted at a Cambodian non-governmental paediatric hospital described the key priorities of the ongoing neonatal service. Routinely collected data from the hospital and microbiology databases included the number of admissions, discharges and deaths and the number of cases of bacteraemias (2011-2016). Semi-structured interviews with the management staff explored the essential features of the service. There were 2127 neonatal admissions and 247 deaths. The incidence of facility-based neonatal mortality decreased by 81%. Bacteraemic healthcare-associated infections decreased by 68%. A dedicated area for neonatal care was perceived as crucial, allowing better infection control and delivery of staff training. In this hospital, the neonatal service prioritized basic measures, particularly, having a dedicated neonatal area. Facility-based mortality and bacteraemic healthcare-associated infections decreased.

  3. Submatrices of character tables and basic sets

    DEFF Research Database (Denmark)

    Bessenrodt, Christine; Olsson, Jørn Børling

    2012-01-01

    In this investigation of character tables of nite groups we study basic sets and associated representation theoretic data for complementary sets of conjugacy lasses. For the symmetric groups we nd unexpected properties of characters on restricted sets of conjugacy classes, like beautiful...... combinatorial determinant formulae for submatrices of the character table and Cartan matrices with respect to basic sets; we observe that similar phenomena occur for the transition matrices between power sum symmetric functions to bounded partitions and the k-Schur functions dened by Lapointe and Morse...

  4. International spinal cord injury musculoskeletal basic data set

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Burns, A S; Curt, A

    2012-01-01

    To develop an International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set as part of the International SCI Data Sets to facilitate consistent collection and reporting of basic musculoskeletal findings in the SCI population.Setting:International.......To develop an International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set as part of the International SCI Data Sets to facilitate consistent collection and reporting of basic musculoskeletal findings in the SCI population.Setting:International....

  5. International spinal cord injury pulmonary function basic data set

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Krassioukov, A; Alexander, M S

    2012-01-01

    To develop the International Spinal Cord Injury (SCI) Pulmonary Function Basic Data Set within the framework of the International SCI Data Sets in order to facilitate consistent collection and reporting of basic bronchopulmonary findings in the SCI population.......To develop the International Spinal Cord Injury (SCI) Pulmonary Function Basic Data Set within the framework of the International SCI Data Sets in order to facilitate consistent collection and reporting of basic bronchopulmonary findings in the SCI population....

  6. International spinal cord injury cardiovascular function basic data set

    DEFF Research Database (Denmark)

    Krassioukov, A; Alexander, M S; Karlsson, Anders Hans

    2010-01-01

    To create an International Spinal Cord Injury (SCI) Cardiovascular Function Basic Data Set within the framework of the International SCI Data Sets.......To create an International Spinal Cord Injury (SCI) Cardiovascular Function Basic Data Set within the framework of the International SCI Data Sets....

  7. International Spinal Cord Injury Male Sexual Function Basic Data Set

    DEFF Research Database (Denmark)

    Alexander, M S; Biering-Sørensen, F; Elliott, S

    2011-01-01

    To create the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set within the International SCI Data Sets.......To create the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set within the International SCI Data Sets....

  8. International Spinal Cord Injury Upper Extremity Basic Data Set

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Bryden, A; Curt, A

    2014-01-01

    OBJECTIVE: To develop an International Spinal Cord Injury (SCI) Upper Extremity Basic Data Set as part of the International SCI Data Sets, which facilitates consistent collection and reporting of basic upper extremity findings in the SCI population. SETTING: International. METHODS: A first draft...

  9. A Survey of Basic Facilities and Service Provision for the Successful Inclusion of the Students with Hearing Impairment in Inklusive Education Setting in Cross River, Akwa IBOM & Rivers State of Nigeria

    Directory of Open Access Journals (Sweden)

    James Abua Ewa

    2014-12-01

    Full Text Available Obviously, since the challenges of life change with time, education should aim at bringing up children with hearing impairment to face these changes and make necessary adjustment in their lives for successful living. Hence education programs and service provisions should therefore be dynamic. To realise these important functions, programs and services designed for the students with hearing impairment in an inclusive education setting should not be on exemption, since the society itself is dynamic in many respects, its fundamental needs equally change with time which hitherto makes societal objective changes also, owing to advancement in scientific inventions, innovation in trends and practices of inclusive education. Bearing this in mind, this paper sought to ascertain the level of provision and availability of basic facilities and services necessary for the successful inclusion of students with hearing impairment. The survey focused on the availability and use of assistive technology devices by the hearing impaired students, recruitment and training of teaching and supportive staff, communication strategies adapted by the teachers, medical and socials services .Data were collected using a Likert-like questionnaire from the sampled secondary schools in the states under investigation. The researcher analysed the data using the Pearson Product Moment Correlation co-efficient. The results revealed that much is yet to be put in place in the states under study for the successful inclusion of students with hearing impairment into inclusive education setting.

  10. Service Station Attendant. Performance Objectives. Basic Course.

    Science.gov (United States)

    Davis, John

    Several intermediate performance objectives and corresponding criterion measures are listed for each of 24 terminal objectives for a basic secondary level service station attendant course. The materials were developed for a two-semester course (2 and 3 hours daily). The specialized classroom and shop experiences are designed to enable the student…

  11. International urinary tract imaging basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Craggs, M; Kennelly, M

    2008-01-01

    OBJECTIVE: To create an International Urinary Tract Imaging Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. SETTING: An international working group. METHODS: The draft of the Data Set was developed by a working group comprising members appointed...... of comparable minimal data. RESULTS: The variables included in the International Urinary Tract Imaging Basic SCI Data Set are the results obtained using the following investigations: intravenous pyelography or computer tomography urogram or ultrasound, X-ray, renography, clearance, cystogram, voiding cystogram...

  12. Basic requirements of nuclear medicine services

    International Nuclear Information System (INIS)

    Belcher, E.H.

    1992-01-01

    Technological progress in nuclear medicine continues, not always to the immediate advantage of the developing world. The capital expense, operational demands and maintenance requirements of ever more complex equipment, the consequent need for highly trained staff, the necessity to assure regular supplies of costly radioactive materials, all present problems to which compromise or alternative solutions must often be sought. This chapter constitutes an attempt to define the basic requirements for thr practice of nuclear medicine with respect to staff, equipment, accommodation, supplies and supporting services with particular reference to the needs of institutions in developing countries

  13. Basic requirements of nuclear medicine services

    Energy Technology Data Exchange (ETDEWEB)

    Belcher, E H

    1993-12-31

    Technological progress in nuclear medicine continues, not always to the immediate advantage of the developing world. The capital expense, operational demands and maintenance requirements of ever more complex equipment, the consequent need for highly trained staff, the necessity to assure regular supplies of costly radioactive materials, all present problems to which compromise or alternative solutions must often be sought. This chapter constitutes an attempt to define the basic requirements for thr practice of nuclear medicine with respect to staff, equipment, accommodation, supplies and supporting services with particular reference to the needs of institutions in developing countries

  14. International Spinal Cord Injury Urinary Tract Infection Basic Data Set

    DEFF Research Database (Denmark)

    Goetz, L L; Cardenas, D D; Kennelly, M

    2013-01-01

    To develop an International Spinal Cord Injury (SCI) Urinary Tract Infection (UTI) Basic Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on UTIs in daily practice or research.......To develop an International Spinal Cord Injury (SCI) Urinary Tract Infection (UTI) Basic Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on UTIs in daily practice or research....

  15. Improving traffic signal management and operations : a basic service model.

    Science.gov (United States)

    2009-12-01

    This report provides a guide for achieving a basic service model for traffic signal management and : operations. The basic service model is based on simply stated and defensible operational objectives : that consider the staffing level, expertise and...

  16. 77 FR 67290 - Basic Service Tier Encryption Compatibility Between Cable Systems and Consumer Electronics Equipment

    Science.gov (United States)

    2012-11-09

    ...-126] Basic Service Tier Encryption Compatibility Between Cable Systems and Consumer Electronics... between consumer electronics equipment (such as digital television sets) and newly encrypted cable service... Act''), Congress sought to make sure that consumer electronics equipment could receive cable...

  17. The International Spinal Cord Injury Pain Basic Data Set

    DEFF Research Database (Denmark)

    Widerstrom-Noga, E.; Bryce, T.; Cardenas, D.D.

    2008-01-01

    Objective:To develop a basic pain data set (International Spinal Cord Injury Basic Pain Data Set, ISCIPDS:B) within the framework of the International spinal cord injury (SCI) data sets that would facilitate consistent collection and reporting of pain in the SCI population.Setting:International.......Methods:The ISCIPDS:B was developed by a working group consisting of individuals with published evidence of expertise in SCI-related pain regarding taxonomy, psychophysics, psychology, epidemiology and assessment, and one representative of the Executive Committee of the International SCI Standards and Data Sets...... on suggestions from members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA and APS Boards, and the Neuropathic Pain Special Interest Group of the IASP, individual reviewers and societies and the ISCoS Council.Results:The final ISCIPDS:B contains...

  18. Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

    Science.gov (United States)

    Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

    2014-04-01

    broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.

  19. International urodynamic basic spinal cord injury data set.

    Science.gov (United States)

    Biering-Sørensen, F; Craggs, M; Kennelly, M; Schick, E; Wyndaele, J-J

    2008-07-01

    To create the International Urodynamic Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. International working group. The draft of the data set was developed by a working group consisting of members appointed by the Neurourology Committee of the International Continence Society, the European Association of Urology, the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the Executive Committee of the International SCI Standards and Data Sets. The final version of the data set was developed after review and comments by members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA Board, relevant and interested (international) organizations and societies (around 40) and persons and the ISCoS Council. Endorsement of the data set by relevant organizations and societies will be obtained. To make the data set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. Variables included in the International Urodynamic Basic SCI Data Set are date of data collection, bladder sensation during filling cystometry, detrusor function, compliance during filing cystometry, function during voiding, detrusor leak point pressure, maximum detrusor pressure, cystometric bladder capacity and post-void residual volume.

  20. International urodynamic basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Craggs, M.; Kennelly, M.; Schick, E.

    2008-01-01

    of the data set was developed after review and comments by members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA Board, relevant and interested (international) organizations and societies (around 40) and persons and the ISCoS Council......: Variables included in the International Urodynamic Basic SCI Data Set are date of data collection, bladder sensation during filling cystometry, detrusor function, compliance during filing cystometry, function during voiding, detrusor leak point pressure, maximum detrusor pressure, cystometric bladder...

  1. International spinal cord injury pulmonary function basic data set.

    Science.gov (United States)

    Biering-Sørensen, F; Krassioukov, A; Alexander, M S; Donovan, W; Karlsson, A-K; Mueller, G; Perkash, I; Sheel, A William; Wecht, J; Schilero, G J

    2012-06-01

    To develop the International Spinal Cord Injury (SCI) Pulmonary Function Basic Data Set within the framework of the International SCI Data Sets in order to facilitate consistent collection and reporting of basic bronchopulmonary findings in the SCI population. International. The SCI Pulmonary Function Data Set was developed by an international working group. The initial data set document was revised on the basis of suggestions from members of the Executive Committee of the International SCI Standards and Data Sets, the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, American Spinal Injury Association (ASIA) Board, other interested organizations and societies and individual reviewers. In addition, the data set was posted for 2 months on ISCoS and ASIA websites for comments. The final International SCI Pulmonary Function Data Set contains questions on the pulmonary conditions diagnosed before spinal cord lesion,if available, to be obtained only once; smoking history; pulmonary complications and conditions after the spinal cord lesion, which may be collected at any time. These data include information on pneumonia, asthma, chronic obstructive pulmonary disease and sleep apnea. Current utilization of ventilator assistance including mechanical ventilation, diaphragmatic pacing, phrenic nerve stimulation and Bi-level positive airway pressure can be reported, as well as results from pulmonary function testing includes: forced vital capacity, forced expiratory volume in one second and peak expiratory flow. The complete instructions for data collection and the data sheet itself are freely available on the website of ISCoS (http://www.iscos.org.uk).

  2. International urinary tract imaging basic spinal cord injury data set.

    Science.gov (United States)

    Biering-Sørensen, F; Craggs, M; Kennelly, M; Schick, E; Wyndaele, J-J

    2009-05-01

    To create an International Urinary Tract Imaging Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. An international working group. The draft of the Data Set was developed by a working group comprising members appointed by the Neurourology Committee of the International Continence Society, the European Association of Urology, the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the Executive Committee of the International SCI Standards and Data Sets. The final version of the Data Set was developed after review and comments by members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA Board, relevant and interested international organizations and societies (around 40), individual persons with specific expertise and the ISCoS Council. Endorsement of the Data Sets by relevant organizations and societies will be obtained. To make the Data Set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. The variables included in the International Urinary Tract Imaging Basic SCI Data Set are the results obtained using the following investigations: intravenous pyelography or computer tomography urogram or ultrasound, X-ray, renography, clearance, cystogram, voiding cystogram or micturition cystourogram or videourodynamics. The complete instructions for data collection and the data sheet itself are freely available on the websites of both ISCoS (http://www.iscos.org.uk) and ASIA (http://www.asia-spinalinjury.org).

  3. International bowel function basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A

    2008-01-01

    S Scientific Committee and the ASIA Board. Relevant and interested scientific and professional (international) organizations and societies (approximately 40) were also invited to review the data set and it was posted on the ISCoS and ASIA websites for 3 months to allow comments and suggestions. The ISCo......STUDY DESIGN: International expert working group. OBJECTIVE: To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research....... SETTING: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: A draft prepared by the working group was reviewed by Executive Committee of the International SCI Standards and Data Sets, and later by ISCo...

  4. International spinal cord injury cardiovascular function basic data set.

    Science.gov (United States)

    Krassioukov, A; Alexander, M S; Karlsson, A-K; Donovan, W; Mathias, C J; Biering-Sørensen, F

    2010-08-01

    To create an International Spinal Cord Injury (SCI) Cardiovascular Function Basic Data Set within the framework of the International SCI Data Sets. An international working group. The draft of the data set was developed by a working group comprising members appointed by the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the executive committee of the International SCI Standards and Data Sets. The final version of the data set was developed after review by members of the executive committee of the International SCI Standards and Data Sets, the ISCoS scientific committee, ASIA board, relevant and interested international organizations and societies, individual persons with specific interest and the ISCoS Council. To make the data set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. The variables included in the International SCI Cardiovascular Function Basic Data Set include the following items: date of data collection, cardiovascular history before the spinal cord lesion, events related to cardiovascular function after the spinal cord lesion, cardiovascular function after the spinal cord lesion, medications affecting cardiovascular function on the day of examination; and objective measures of cardiovascular functions, including time of examination, position of examination, pulse and blood pressure. The complete instructions for data collection and the data sheet itself are freely available on the websites of both ISCoS (http://www.iscos.org.uk) and ASIA (http://www.asia-spinalinjury.org).

  5. Poor access to basic services | IDRC - International Development ...

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

    2015-10-28

    Oct 28, 2015 ... Poor access to basic services can foster competition and fuel conflict between groups. ... Make clean water, sanitation, electricity, and other services accessible ... Poverty, inequality, and violence in urban India: Towards more ...

  6. The international spinal cord injury pain basic data set.

    Science.gov (United States)

    Widerström-Noga, E; Biering-Sørensen, F; Bryce, T; Cardenas, D D; Finnerup, N B; Jensen, M P; Richards, J S; Siddall, P J

    2008-12-01

    To develop a basic pain data set (International Spinal Cord Injury Basic Pain Data Set, ISCIPDS:B) within the framework of the International spinal cord injury (SCI) data sets that would facilitate consistent collection and reporting of pain in the SCI population. International. The ISCIPDS:B was developed by a working group consisting of individuals with published evidence of expertise in SCI-related pain regarding taxonomy, psychophysics, psychology, epidemiology and assessment, and one representative of the Executive Committee of the International SCI Standards and Data Sets. The members were appointed by four major organizations with an interest in SCI-related pain (International Spinal Cord Society, ISCoS; American Spinal Injury Association, ASIA; American Pain Society, APS and International Association for the Study of Pain, IASP). The initial ISCIPDS:B was revised based on suggestions from members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA and APS Boards, and the Neuropathic Pain Special Interest Group of the IASP, individual reviewers and societies and the ISCoS Council. The final ISCIPDS:B contains core questions about clinically relevant information concerning SCI-related pain that can be collected by health-care professionals with expertise in SCI in various clinical settings. The questions concern pain severity, physical and emotional function and include a pain-intensity rating, a pain classification and questions related to the temporal pattern of pain for each specific pain problem. The impact of pain on physical, social and emotional function, and sleep is evaluated for each pain.

  7. Improving Access to Justice and Basic Services in the Informal ...

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

    Cartels often control basic services in these informal settlements, charging ... It will generate practical knowledge on how formal and informal land tenure, ... Researchers will also assess how these tools and planning processes can be used to ...

  8. Mobile and Portable Dental Services Catering to the Basic Oral ...

    African Journals Online (AJOL)

    the urban slum dwellers are denied of even the basic dental services though there is ... in the absence of national oral health policy and organized school dental ... we propose a model to cater to the basic oral health needs of an extensive ...

  9. 42 CFR 417.104 - Payment for basic health services.

    Science.gov (United States)

    2010-10-01

    ...) Nominal differentials in rates may be established to reflect differences in marketing costs and the... of the total cost of providing any single service to its enrollees, nor in the aggregate more than 20 percent of the total cost of providing all basic health services. (ii) To insure that copayments are not a...

  10. Pre-Service Teachers' Mental Models of Basic Astronomy Concepts

    Science.gov (United States)

    Arslan, A. Saglam; Durikan, U.

    2016-01-01

    The aim of the present study is to determine pre-service teachers' mental models related to basic astronomy concepts. The study was conducted using a survey method with 293 pre-service teachers from 4 different departments; physics education, science education, primary teacher education and early childhood education. An achievement test with…

  11. Pre-service teachers' mathematical knowledge for teaching basic ...

    African Journals Online (AJOL)

    This study measured pre-service teachers' mathematical knowledge for teaching (MKT) basic school mathematics. MKT multiple-choice test was administered to 100 pre-service teachers from two colleges of education (located at Mampong in the Ashanti Region of Ghana) to assess their mathematical knowledge for ...

  12. Basic Services for All in an Urbanizing World: GOLD III

    Directory of Open Access Journals (Sweden)

    Claire Frost

    2014-07-01

    Full Text Available Basic Services for All in an Urbanizing World is the third instalment in United Cities and Local Government’s (UCLG flagship series of global reports on local democracy and decentralisation (GOLD III. In the context of rapid urbanisation, climate change and economic uncertainty the report is an impressive attempt to analyse local government’s role in the provision of basic services, the challenges they are facing, and make recommendations to improve local government’s ability to ensure access for all. Published in 2014, the report is well positioned to feed into the current debate on what will follow the UN Millennium Development Goals, and examines the role of local government in the provision of basic services across the world regions.

  13. Industrial Perspectives of Work Place Basics and Training Delivery Services.

    Science.gov (United States)

    Logan, Joyce; Byers, Charles

    1991-01-01

    Kentucky employers (249 of 800 surveyed) identified adaptability, teamwork, communication, and problem solving as entry-level and advancement skills. Over 50 percent did no preemployment testing. Responses indicated areas needing change: training focused on workplace basics, accessible training delivery, and preemployment assessment services. (SK)

  14. Blueprint for Incorporating Service Learning: A Basic, Developmental, K-12 Service Learning Typology

    Science.gov (United States)

    Terry, Alice W.; Bohnenberger, Jann E.

    2004-01-01

    Citing the need for a basic, K-12 developmental framework for service learning, this article describes such a model. This model, an inclusive typology of service learning, distinguishes three levels of service learning: Community Service, Community Exploration, and Community Action. The authors correlate this typology to Piaget's cognitive…

  15. International Spinal Cord Injury Female Sexual and Reproductive Function Basic Data Set

    DEFF Research Database (Denmark)

    Alexander, M S; Biering-Sørensen, F; Elliott, S

    2011-01-01

    To create the International Spinal Cord Injury (SCI) Female Sexual and Reproductive Function Basic Data Set within the International SCI Data Sets.......To create the International Spinal Cord Injury (SCI) Female Sexual and Reproductive Function Basic Data Set within the International SCI Data Sets....

  16. International spinal cord injury skin and thermoregulation function basic data set

    DEFF Research Database (Denmark)

    Karlsson, Annette; Krassioukov, A; Alexander, M S

    2012-01-01

    To create an international spinal cord injury (SCI) skin and thermoregulation basic data set within the framework of the International SCI Data Sets.......To create an international spinal cord injury (SCI) skin and thermoregulation basic data set within the framework of the International SCI Data Sets....

  17. Setting the bar: Standards for ecosystem services.

    Science.gov (United States)

    Polasky, Stephen; Tallis, Heather; Reyers, Belinda

    2015-06-16

    Progress in ecosystem service science has been rapid, and there is now a healthy appetite among key public and private sector decision makers for this science. However, changing policy and management is a long-term project, one that raises a number of specific practical challenges. One impediment to broad adoption of ecosystem service information is the lack of standards that define terminology, acceptable data and methods, and reporting requirements. Ecosystem service standards should be tailored to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most headway toward rapid uptake of ecosystem service science by working directly with these organizations. Progress has been made in aligning with existing organizations in areas such as product certification and sustainability reporting, but a major challenge remains in mainstreaming ecosystem service information into core public and private use contexts, such as agricultural and energy subsidy design, national income accounts, and corporate accounts.

  18. Setting the bar: Standards for ecosystem services

    Science.gov (United States)

    Polasky, Stephen; Tallis, Heather; Reyers, Belinda

    2015-01-01

    Progress in ecosystem service science has been rapid, and there is now a healthy appetite among key public and private sector decision makers for this science. However, changing policy and management is a long-term project, one that raises a number of specific practical challenges. One impediment to broad adoption of ecosystem service information is the lack of standards that define terminology, acceptable data and methods, and reporting requirements. Ecosystem service standards should be tailored to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most headway toward rapid uptake of ecosystem service science by working directly with these organizations. Progress has been made in aligning with existing organizations in areas such as product certification and sustainability reporting, but a major challenge remains in mainstreaming ecosystem service information into core public and private use contexts, such as agricultural and energy subsidy design, national income accounts, and corporate accounts. PMID:26082540

  19. Fuzzy Sets Applications in Civil Engineering Basic Areas

    Directory of Open Access Journals (Sweden)

    Latif Onur UĞUR

    2016-01-01

    Full Text Available Civil engineering is a professional engineering discipline that deals with the design, construction, and maintenance of the physical and naturally built environment, including works like roads, bridges, canals, dams, and buildings. This paper presents some Fuzzy Logic (FL applications in civil engeering discipline and shows the potential of facilities of FL in this area. The potential role of fuzzy sets in analysing system and human uncertainty is investigated in the paper. The main finding of this inquiry is FL applications used in different areas of civil engeering discipline with success. Once developed, the fuzzy logic models can be used for further monitoring activities, as a management tool.

  20. The international spinal cord injury endocrine and metabolic function basic data set

    DEFF Research Database (Denmark)

    Bauman, W A; Biering-Sørensen, Fin; Krassioukov, A

    2011-01-01

    To develop the International Spinal Cord Injury (SCI) Endocrine and Metabolic Function Basic Data Set within the framework of the International SCI Data Sets that would facilitate consistent collection and reporting of basic endocrine and metabolic findings in the SCI population....

  1. Infection prevention and control in outpatient settings in China-structure, resources, and basic practices.

    Science.gov (United States)

    Qiao, Fu; Huang, Wenzhi; Zong, Zhiyong; Yin, Weijia

    2018-01-25

    More than 7 billion visits are made by patients to ambulatory services every year in mainland China. Healthcare-associated infections are becoming a new source of illness for outpatients. Little is known about infection prevention, control structure, resources available, and basic practices in outpatient settings. In 2014, we conducted a multisite survey. Five provinces were invited to participate based on geographic dispersion. Self-assessment questionnaires regarding the structure, infrastructure, apparatus and materials, and basic activities of infection prevention and control were issued to 25 hospitals and 5 community health centers in each province. A weight was assigned to each question according to its importance. Overall, 146 of 150 facilities (97.3%) participated in this study. The average survey score was 77.6 (95% confidence interval 75.7-79.5) and varied significantly between the different gross domestic product areas (P infection prevention and control was practiced consistently, although there were lapses in some areas. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Service Dogs in the Perioperative Setting.

    Science.gov (United States)

    Levey, Janet A; Chappy, Sharon L

    2017-04-01

    Service dogs are critical for the independence of individuals with disabilities because they assist with daily living activities and help these individuals navigate society. Perioperative nurses need a working knowledge of disability laws pertaining to service dogs to provide patient-centered care for individuals using service dogs. This article provides information on the Americans With Disabilities Act regulations regarding service dogs, makes recommendations for the care of patients with service dogs across the perioperative continuum, and offers policy directives to ensure that safe, high-quality care is delivered to patients using service dogs. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  3. Assessing the physical service setting: a look at emergency departments.

    Science.gov (United States)

    Steinke, Claudia

    2015-01-01

    To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

  4. Good validity of the international spinal cord injury quality of life basic data set

    NARCIS (Netherlands)

    Post, M. W. M.; Adriaansen, J. J. E.; Charlifue, S.; Biering-Sorensen, F.; van Asbeck, F. W. A.

    Study design: Cross-sectional validation study. Objectives: To examine the construct and concurrent validity of the International Spinal Cord Injury (SCI) Quality of Life (QoL) Basic Data Set. Setting: Dutch community. Participants: People 28-65 years of age, who obtained their SCI between 18 and 35

  5. Reliability of the International Spinal Cord Injury Musculoskeletal Basic Data Set

    DEFF Research Database (Denmark)

    Baunsgaard, C B; Chhabra, H S; Harvey, L A

    2016-01-01

    STUDY DESIGN: Psychometric study. OBJECTIVES: To determine the intra- and inter-rater reliability and content validity of the International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set (ISCIMSBDS). SETTING: Four centers with one in each of the countries in Australia, England, India and...

  6. Relevance of the international spinal cord injury basic data sets to youth

    DEFF Research Database (Denmark)

    Carroll, A; Vogel, L C; Zebracki, K

    2017-01-01

    STUDY DESIGN: Mixed methods, using the Modified Delphi Technique and Expert Panel Review. OBJECTIVE: To evaluate the utility and relevance of the International Spinal Cord Injury (SCI) Core and Basic Data Sets for children and youth with SCI. SETTING: International. METHODS: Via 20 electronic...

  7. Good validity of the international spinal cord injury quality of life basic data set

    DEFF Research Database (Denmark)

    Post, M W M; Adriaansen, J J E; Charlifue, S

    2016-01-01

    STUDY DESIGN: Cross-sectional validation study. OBJECTIVES: To examine the construct and concurrent validity of the International Spinal Cord Injury (SCI) Quality of Life (QoL) Basic Data Set. SETTING: Dutch community. PARTICIPANTS: People 28-65 years of age, who obtained their SCI between 18...... and 35 years of age, were at least 10 years post SCI and were wheelchair users in daily life.Measure(s):The International SCI QoL Basic Data Set consists of three single items on satisfaction with life as a whole, physical health and psychological health (0=complete dissatisfaction; 10=complete...... and psychological health (0.70). CONCLUSIONS: This first validity study of the International SCI QoL Basic Data Set shows that it appears valid for persons with SCI....

  8. Municipal service delivery SET for success

    CSIR Research Space (South Africa)

    Naidoo, S

    2015-10-01

    Full Text Available The application of scientific, engineering and technological solutions by the CSIR to support local government environmental management and service delivery has the potential for significant impact. A case study illustrates the application...

  9. Setting the bar: Standards for ecosystem services

    CSIR Research Space (South Africa)

    Polasky, S

    2015-06-01

    Full Text Available to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most...

  10. Gender Integration in Basic Training: The Services Are Using a Variety of Approaches

    National Research Council Canada - National Science Library

    1997-01-01

    ...) the extent to which the services have gender integrated basic training and (2) the performance of men and women in gender integrated basic training compared with that of men and women whose training is segregated...

  11. Customer loyalty in a service setting

    NARCIS (Netherlands)

    Bloemer, J.M.M.; Ruyter, de J.C.; Wetzels, M.G.M.

    1998-01-01

    In this paper the antecedents and consequences of perceived service quality in a retail context are examined both from the employee and the customer perspective. We investigate the impact of role stress (role ambiguity and role conflict), on organizational commitment and commitment to quality.

  12. 47 CFR 69.119 - Basic service element expedited approval process.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Basic service element expedited approval process. 69.119 Section 69.119 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Computation of Charges § 69.119 Basic service element...

  13. Development of the International Spinal Cord Injury Activities and Participation Basic Data Set

    DEFF Research Database (Denmark)

    Post, M W; Charlifue, S; Biering-Sørensen, F

    2016-01-01

    on a three-point scale for each item completes the total of 24 A&P variables. CONCLUSION: Collection of the International SCI A&P Basic Data Set variables in all future research on SCI outcomes is advised to facilitate comparison of results across published studies from around the world. Additional......STUDY DESIGN: Consensus decision-making process. OBJECTIVES: The objective of this study was to develop an International Spinal Cord Injury (SCI) Activities and Participation (A&P) Basic Data Set. SETTING: International working group. METHODS: A committee of experts was established to select...... and define A&P data elements to be included in this data set. A draft data set was developed and posted on the International Spinal Cord Society (ISCoS) and American Spinal Injury Association websites and was also disseminated among appropriate organizations for review. Suggested revisions were considered...

  14. International lower urinary tract function basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Craggs, M.; Kennelly, M.; Schick, E.

    2008-01-01

    OBJECTIVE: To create the International Lower Urinary Tract Function Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. SETTING: International working group. METHODS: The draft of the Data Set was developed by a working group consisting of the members......:Variables included in the International Lower Urinary Tract Function Basic SCI Data Set are as follows: date of data collection, urinary tract impairment unrelated to spinal cord lesion, awareness of the need to empty the bladder, bladder emptying, average number of voluntary bladder emptyings per day during...... the last week, incontinence within the last 3 months, collecting appliances for urinary incontinence, any drugs for the urinary tract within the last year, surgical procedures on the urinary tract and any change in urinary symptoms within the last year. Complete instruction for data collection, data sheet...

  15. Basic priority rating model 2.0: current applications for priority setting in health promotion practice.

    Science.gov (United States)

    Neiger, Brad L; Thackeray, Rosemary; Fagen, Michael C

    2011-03-01

    Priority setting is an important component of systematic planning in health promotion and also factors into the development of a comprehensive evaluation plan. The basic priority rating (BPR) model was introduced more than 50 years ago and includes criteria that should be considered in any priority setting approach (i.e., use of predetermined criteria, standardized comparisons, and a rubric that controls bias). Although the BPR model has provided basic direction in priority setting, it does not represent the broad array of data currently available to decision makers. Elements in the model also give more weight to the impact of communicable diseases compared with chronic diseases. For these reasons, several modifications are recommended to improve the BPR model and to better assist health promotion practitioners in the priority setting process. The authors also suggest a new name, BPR 2.0, to represent this revised model.

  16. International lower urinary tract function basic spinal cord injury data set.

    Science.gov (United States)

    Biering-Sørensen, F; Craggs, M; Kennelly, M; Schick, E; Wyndaele, J-J

    2008-05-01

    To create the International Lower Urinary Tract Function Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. International working group. The draft of the Data Set was developed by a working group consisting of the members appointed by the International Continence Society, the European Association of Urology, the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the Executive Committee of the International SCI Standards and Data Sets. The final version of the Data Set was developed after review and comments by the members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA Board, relevant and interested (international) organizations and societies (around 40) and persons, and the ISCoS Council. Endorsement of the Data Set by relevant organizations and societies will be obtained. To make the Data Set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. Variables included in the International Lower Urinary Tract Function Basic SCI Data Set are as follows: date of data collection, urinary tract impairment unrelated to spinal cord lesion, awareness of the need to empty the bladder, bladder emptying, average number of voluntary bladder emptyings per day during the last week, incontinence within the last 3 months, collecting appliances for urinary incontinence, any drugs for the urinary tract within the last year, surgical procedures on the urinary tract and any change in urinary symptoms within the last year. Complete instruction for data collection, data sheet and training cases available at the website of ISCoS (www.iscos.org.uk) and ASIA (www.asia-spinalinjury.org).

  17. Basic Laparoscopic Skills Assessment Study: Validation and Standard Setting among Canadian Urology Trainees.

    Science.gov (United States)

    Lee, Jason Y; Andonian, Sero; Pace, Kenneth T; Grober, Ethan

    2017-06-01

    As urology training programs move to a competency based medical education model, iterative assessments with objective standards will be required. To develop a valid set of technical skills standards we initiated a national skills assessment study focusing initially on laparoscopic skills. Between February 2014 and March 2016 the basic laparoscopic skill of Canadian urology trainees and attending urologists was assessed using 4 standardized tasks from the AUA (American Urological Association) BLUS (Basic Laparoscopic Urological Surgery) curriculum, including peg transfer, pattern cutting, suturing and knot tying, and vascular clip applying. All performances were video recorded and assessed using 3 methods, including time and error based scoring, expert global rating scores and C-SATS (Crowd-Sourced Assessments of Technical Skill Global Rating Scale), a novel, crowd sourced assessment platform. Different methods of standard setting were used to develop pass-fail cut points. Six attending urologists and 99 trainees completed testing. Reported laparoscopic experience and training level correlated with performance (p standard setting methods to define pass-fail cut points for all 4 AUA BLUS tasks. The 4 AUA BLUS tasks demonstrated good construct validity evidence for use in assessing basic laparoscopic skill. Performance scores using the novel C-SATS platform correlated well with traditional time-consuming methods of assessment. Various standard setting methods were used to develop pass-fail cut points for educators to use when making formative and summative assessments of basic laparoscopic skill. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Web service based system for generating input data sets

    International Nuclear Information System (INIS)

    Kralev, Velin; Kraleva, Radoslava

    2011-01-01

    This article deals with a three-layer architectural model of a distributed information system based on Web services, which will be used for automatic generation of sets of input data. The information system will be constructed of a client layer, a service layer and of a data layer. The web services as a tool of developing distributed software systems will be presented briefly. A web service and the implementation of its web methods will be described. A way to use the developed web methods in real application will be proposed. Keywords: web services

  19. International spinal cord injury bowel function basic data set (Version 2.0)

    DEFF Research Database (Denmark)

    Krogh, K; Emmanuel, A; Perrouin-Verbe, B

    2017-01-01

    : Working group appointed by the American Spinal injury association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: The draft prepared by the working group was reviewed by the International SCI Data Set Committee and later by members of the ISCoS Executive and Scientific Committees......STUDY DESIGN: International expert working group. OBJECTIVES: To revise the International Spinal Cord Injury (SCI) Bowel Function Basic Data Set as a standardized format for the collecting and reporting of a minimal amount of information on bowel function in clinical practice and research. SETTING...... and the ASIA board. The revised data set was posted on the ASIA and ISCoS websites for 1 month to allow further comments and suggestions. Changes resulting from a Delphi process among experts in children with SCI were included. Members of ISCoS Executive and Scientific Committees and the ASIA board made...

  20. International spinal cord injury skin and thermoregulation function basic data set.

    Science.gov (United States)

    Karlsson, A K; Krassioukov, A; Alexander, M S; Donovan, W; Biering-Sørensen, F

    2012-07-01

    To create an international spinal cord injury (SCI) skin and thermoregulation basic data set within the framework of the International SCI Data Sets. An international working group. The draft of the data set was developed by a working group comprising members appointed by the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the Executive Committee of the International SCI Standards and Data Sets. The final version of the data set was developed after review and comments by members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA Board, relevant and interested international organizations and societies, individual persons with specific interest and the ISCoS Council. To make the data set uniform, each variable and each response category within each variable have been specifically defined to promote the collection and reporting of comparable minimal data. Variables included in the present data set are: date of data collection, thermoregulation history after SCI, including hyperthermia or hypothermia (noninfectious or infectious), as well as the history of hyperhidrosis or hypohidrosis above or below level of lesion. Body temperature and the time of measurement are included. Details regarding the presence of any pressure ulcer and stage, location and size of the ulcer(s), date of appearance of the ulcer(s) and whether surgical treatment has been performed are included. The history of any pressure ulcer during the last 12 months is also noted.

  1. Awaken to the World of Food Service; Commercial Cooking and Baking--Basic: 9193.01.

    Science.gov (United States)

    Dade County Public Schools, Miami, FL.

    This course outline has been prepared as a guide for the tenth grade student in commercial cooking and baking or food management, production, and services. It provides basic experiences in the field of commercial food service, the hotel and restaurant industry and types of food service establishments. The course consists of 90 clock hours, covered…

  2. 76 FR 66666 - Basic Service Tier Encryption Compatibility Between Cable Systems and Consumer Electronics Equipment

    Science.gov (United States)

    2011-10-27

    ... 11-153] Basic Service Tier Encryption Compatibility Between Cable Systems and Consumer Electronics... substantially affect compatibility between cable service and consumer electronics equipment for most subscribers... problems between cable service and consumer electronics equipment were limiting and/or precluding the...

  3. The international spinal cord injury endocrine and metabolic function basic data set.

    Science.gov (United States)

    Bauman, W A; Biering-Sørensen, F; Krassioukov, A

    2011-10-01

    To develop the International Spinal Cord Injury (SCI) Endocrine and Metabolic Function Basic Data Set within the framework of the International SCI Data Sets that would facilitate consistent collection and reporting of basic endocrine and metabolic findings in the SCI population. International. The International SCI Endocrine and Metabolic Function Data Set was developed by a working group. The initial data set document was revised on the basis of suggestions from members of the Executive Committee of the International SCI Standards and Data Sets, the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, American Spinal Injury Association (ASIA) Board, other interested organizations and societies, and individual reviewers. In addition, the data set was posted for 2 months on ISCoS and ASIA websites for comments. The final International SCI Endocrine and Metabolic Function Data Set contains questions on the endocrine and metabolic conditions diagnosed before and after spinal cord lesion. If available, information collected before injury is to be obtained only once, whereas information after injury may be collected at any time. These data include information on diabetes mellitus, lipid disorders, osteoporosis, thyroid disease, adrenal disease, gonadal disease and pituitary disease. The question of gonadal status includes stage of sexual development and that for females also includes menopausal status. Data will be collected for body mass index and for the fasting serum lipid profile. The complete instructions for data collection and the data sheet itself are freely available on the websites of ISCoS (http://www.iscos.org.uk) and ASIA (http://www.asia-spinalinjury.org).

  4. Spatial accessibility to basic public health services in South Sudan

    Directory of Open Access Journals (Sweden)

    Peter M. Macharia

    2017-05-01

    Full Text Available At independence in 2011, South Sudan’s health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.

  5. The International Spinal Cord Injury Pain Basic Data Set (version 2.0)

    DEFF Research Database (Denmark)

    Widerström-Noga, E; Biering-Sørensen, F; Bryce, T N

    2014-01-01

    OBJECTIVES: To revise the International Spinal Cord Injury Pain Basic Data Set (ISCIPBDS) based on new developments in the field and on suggestions from the spinal cord injury (SCI) and pain clinical and research community. SETTING: International. METHODS: The ISCIPBDS working group evaluated...... suggestions regarding the utility of the ISCIPBDS and made modifications in response to these and to significant developments in the field. The revised ISCIPBDS (version 2.0) was reviewed by members of the Executive Committee of the International SCI Standards and Data Sets, the International Spinal Cord...... Society (ISCoS) Executive and Scientific Committees, the American Spinal Injury Association and American Pain Society Boards and the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain, individual reviewers and societies and the ISCoS Council. RESULTS...

  6. BASIC

    DEFF Research Database (Denmark)

    Hansen, Pelle Guldborg; Schmidt, Karsten

    2017-01-01

    De sidste 10 år har vi været vidner til opkomsten af et nyt evidensbaseret policy paradigme, Behavioural Public Policy (BPP), der søger at integrere teoretiske og metodiske indsigter fra adfærdsvidenskaberne i offentlig politikudvikling. Arbejdet med BPP har dog båret præg af, at være usystematisk...... BPP. Tilgangen består dels af den overordnede proces-model BASIC og dels af et iboende framework, ABCD, der er en model for systematisk adfærdsanalyse, udvikling, test og implementering af adfærdsrettede løsningskoncepter. Den samlede model gør det muligt for forskere såvel som offentligt ansatte...

  7. Basic Functional Capabilities for a Military Message Processing Service

    Science.gov (United States)

    1974-09-01

    Rey, California 90291 I1. CONTROLLING OFFICE NAME AND ADORESS 2. MREPORT OWNtL Advanced Research Projects Agency September 1974 1400 Wilson Blvd. Is...WOROD (Conionwo m trevre aide If tneeoooy arm idmentify by egekA INber) automated message processing, command and control , writer-to-reader service...Characterizations During Preparation 31 Post-Preparation Phases 38 Transmission 38 Delivery 39 Reception 41 Archival 44 Administrativo Functions 44

  8. Managed land settlement process: "Thought piece" on basic services

    CSIR Research Space (South Africa)

    Wall, K

    2009-12-01

    Full Text Available – the higher the residential densities, the more likely it is that a public transport operation will find it financially viable to provide a service that will reach physically closer to each individual household. And of course reduction in unit costs... levels, and before investments are made. Returning for a moment to site-specific characteristics. These are of fundamental importance, rendering some sites unsuitable for residential development, or relatively expensive for residential development...

  9. An Investigation of Mathematical Knowledge Related to Mathematics Teachers' Basic Concepts in Sets Unit

    Directory of Open Access Journals (Sweden)

    Nurullah YAZICI

    2017-05-01

    Full Text Available This research was conducted in order to examine the subject matter of Mathematics teachers in the context of "Mathematical Knowledge For Teaching" (MKT model of "Basic Concepts in Sets" which is the first topic of the 9th class "Sets". The study group, which is one of the qualitative research methods, used the case study design, constitutes 5 mathematics teachers who work in different education levels (primary and secondary education in the academic year of 2015-2016. Open-ended questions and semi-structured interview form developed by the researcher were used for data collection. A descriptive analysis technique was used to analyze the data obtained through interviews. While analyzing the data, teacher and student textbooks, which were prepared by the Ministry of National Education for the purpose of teaching in 2015-2016 academic year, were taken as a reference. According to the research findings, it was determined that the teachers had deficiencies in the subject field of "Basic Concepts in the Sets" and had superficial knowledge rather than in depth knowledge.

  10. 47 CFR 76.930 - Initiation of review of basic cable service and equipment rates.

    Science.gov (United States)

    2010-10-01

    ... rates for the basic service tier and associated equipment with a franchising authority within 30 days of receiving written notification from the franchising authority that the franchising authority has been...

  11. Goal setting with mothers in child development services.

    Science.gov (United States)

    Forsingdal, S; St John, W; Miller, V; Harvey, A; Wearne, P

    2014-07-01

    The aim of this grounded theory study was to explore mothers' perspectives of the processes of collaborative goal setting in multidisciplinary child development services involving follow-up home therapy. Semi-structured interviews were conducted in South East Queensland, Australia with 14 mothers of children aged 3-6 years who were accessing multidisciplinary child development services. Interviews were focussed around the process of goal setting. A grounded theory of Maternal Roles in Goal Setting (The M-RIGS Model) was developed from analysis of data. Mothers assumed Dependent, Active Participator and Collaborator roles when engaging with the therapist in goal-setting processes. These roles were characterized by the mother's level of dependence on the therapist and insight into their child's needs and therapy processes. Goal Factors, Parent Factors and Therapist Factors influenced and added complexity to the goal-setting process. The M-RIGS Model highlights that mothers take on a range of roles in the goal-setting process. Although family-centred practice encourages negotiation and collaborative goal setting, parents may not always be ready to take on highly collaborative roles. Better understanding of parent roles, goal-setting processes and influencing factors will inform better engagement with families accessing multidisciplinary child development services. © 2013 John Wiley & Sons Ltd.

  12. An assessment of adherence to basic ecological principles by payments for ecosystem service projects.

    Science.gov (United States)

    Prager, C M; Varga, A; Olmsted, P; Ingram, J C; Cattau, M; Freund, C; Wynn-Grant, R; Naeem, S

    2016-08-01

    Programs and projects employing payments for ecosystem service (PES) interventions achieve their objectives by linking buyers and sellers of ecosystem services. Although PES projects are popular conservation and development interventions, little is known about their adherence to basic ecological principles. We conducted a quantitative assessment of the degree to which a global set of PES projects adhered to four ecological principles that are basic scientific considerations for any project focused on ecosystem management: collection of baseline data, identification of threats to an ecosystem service, monitoring, and attention to ecosystem dynamics or the formation of an adaptive management plan. We evaluated 118 PES projects in three markets-biodiversity, carbon, and water-compiled using websites of major conservation organizations; ecology, economic, and climate-change databases; and three scholarly databases (ISI Web of Knowledge, Web of Science, and Google Scholar). To assess adherence to ecological principles, we constructed two scientific indices (one additive [ASI] and one multiplicative [MSI]) based on our four ecological criteria and analyzed index scores by relevant project characteristics (e.g., sector, buyer, seller). Carbon-sector projects had higher ASI values (P < 0.05) than water-sector projects and marginally higher ASI scores (P < 0.1) than biodiversity-sector projects, demonstrating their greater adherence to ecological principles. Projects financed by public-private partnerships had significantly higher ASI values than projects financed by governments (P < 0.05) and marginally higher ASI values than those funded by private entities (P < 0.1). We did not detect differences in adherence to ecological principles based on the inclusion of cobenefits, the spatial extent of a project, or the size of a project's budget. These findings suggest, at this critical phase in the rapid growth of PES projects, that fundamental ecological principles should be

  13. Governance of basic services provision in sub-Saharan Africa and the need to shift gear

    NARCIS (Netherlands)

    N. Awortwi (Nicholas); A.H.J. Helmsing (Bert)

    2007-01-01

    textabstractDuring 1970 to mid 1980s, governments’ policies on basic services in sub-Saharan Africa (SSA) had an almost exclusive focus on directly provided, publicly-funded. This approach coupled with disintegration of the economic structures resulted in steep decline in people’s access to basic

  14. Basic characteristics of hospital stroke services in Eastern Hungary

    International Nuclear Information System (INIS)

    Mihalka, Laszlo; Fekete, Istvan; Csepany, Tuende; Csiba, Laszlo; Bereczki, Daniel

    1999-01-01

    Stroke mortality is extremely high in Central-Eastern European countries. We report basic characteristics of a stroke unit in Eastern Hungary, including age and sex distribution; the proportion of transient ischemic attacks (TIA), ischemic and hemorrhagic strokes; case fatality; application of diagnostic methods; and length of stay for all patients treated with acute cerebrovascular disease over a 12-month period. Records of all patients with acute cerebrovascular disease (n = 522) discharged in 1995 from a stroke unit with a well defined catchment area of 220,000 inhabitants in Eastern Hungary were retrospectively analyzed. Case fatality was 18.6% for all patients and 21.1% after excluding cases with TIA. Computer tomography, duplex carotid ultrasound, cerebrospinal fluid examination and electroencephalography were performed in 79%, 77%, 7% and 2% of the patients, respectively. The database of the university hospital with the same catchment area was electronically searched for patients who were discharged with the diagnosis of stroke from the three departments of internal medicine. Stroke mortality data of the catchment area based on death certificates was obtained from the Central Statistical Bureau. Two hundred twenty-eight stroke deaths were reported in the catchment area in 1995. In the same period 97 stroke deaths occurred at the stroke unit and 76 at the departments of internal medicine. If we aim to treat all patients with acute stroke at the stroke unit, with the present stroke incidence and duration of hospital stay the current capacity of the stroke unit (1 bed per 10.000 inhabitants) should be doubled

  15. Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi.

    Science.gov (United States)

    Lindgren, T G; Deutsch, K; Schell, E; Bvumbwe, A; Hart, K B; Laviwa, J; Rankin, S H

    2011-01-01

    The majority of Malawians are impoverished and primarily dependant on subsistence farming, with 85% of the population living in a rural area. The country is highly affected by HIV and under-resourced rural health centers struggle to meet the government's goal of expanding HIV testing, antiretroviral treatment, and other basic services. This report describes the work of two four-wheel drive mobile clinics launched in 2008 to fill an identified service gap in the remote areas of Mulanje District, Malawi. The program was developed by an international non-governmental organization, Global AIDS Interfaith Alliance (GAIA), and the Mulanje District Health Office, with funding from the Elizabeth Taylor HIV/AIDS Foundation. The clinics provide: (1) rapid HIV testing and treatment referral; (2) diagnosis and treatment of malaria; (3) sputum collection for TB screening; (4) diagnosis and treatment of sexually transmitted and opportunistic infections; and (5) pre-natal care. The clinic vehicles provide medical supplies and personnel (a clinical officer, nurse, and nurse aide) to set up clinics in community buildings such as churches or schools. In such a project, the implementation process and schedule can be affected by medication, supply chain and infrastructural issues, as well as governmental and non-governmental requirements. Timelines should be sufficiently flexible to accommodate unexpected delays. Once established, service scheduling should be flexible and responsive; for instance, malaria treatment rather than HIV testing was most urgently needed in the season when these services were launched. Assessing the impact of healthcare delivery in Malawi is challenging. Although mobile clinic and the government Health Management Information System (HMIS) data were matched, inconsistent variables and gaps in data made direct comparisons difficult. Data collection was compromised by the competing demand of high patient volume; however, rather than reducing the burden on

  16. Reliability and validity of the International Spinal Cord Injury Basic Pain Data Set items as self-report measures

    DEFF Research Database (Denmark)

    Jensen, M P; Widerström-Noga, E; Richards, J S

    2010-01-01

    To evaluate the psychometric properties of a subset of International Spinal Cord Injury Basic Pain Data Set (ISCIBPDS) items that could be used as self-report measures in surveys, longitudinal studies and clinical trials....

  17. AEC sets basic policy line on treatment and disposal of radioactive waste

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    The AEC's new policy line for the treatment and disposal of radioactive wastes is explained with three tables added. The first table was prepared by MITI's Nuclear Fuel Advisory Committee regarding the projections on the amounts of radioactive wastes to be discharged from nuclear power plants, fuel fabrication plants and reprocessing plants, and the other two tables were made by the AEC committee on technical development of radioactive waste management, the one proposed the developmental steps necessary for establishing waste management technologies, and the other showed the related research and development items with target time schedule. The proper treatment and disposal of radioactive waste S are the problems that have to be resolved prior to the full development and utilization of nuclear energy. The Atomic Energy Commission set up a committee on July 29, 1975, to discuss the technologies on the management of radioactive wastes. The principle essential to the radioactive waste management was set, and it is desirable that this principle is put into practice with the cooperation and understanding of the people and all parties concerned. The countermeasures proposed will be subject to review yet as the technology makes further progress and they are as follows: on the high level radioactive waste management and the low-and intermediate-level radioactive waste management, the basic idea, targets and measures are given, and the methods for promoting experimental ocean dumping of low level radioactive wastes are proposed. (Iwakiri, K.)

  18. Information-seeking behavior of basic science researchers: implications for library services.

    Science.gov (United States)

    Haines, Laura L; Light, Jeanene; O'Malley, Donna; Delwiche, Frances A

    2010-01-01

    This study examined the information-seeking behaviors of basic science researchers to inform the development of customized library services. A qualitative study using semi-structured interviews was conducted on a sample of basic science researchers employed at a university medical school. The basic science researchers used a variety of information resources ranging from popular Internet search engines to highly technical databases. They generally relied on basic keyword searching, using the simplest interface of a database or search engine. They were highly collegial, interacting primarily with coworkers in their laboratories and colleagues employed at other institutions. They made little use of traditional library services and instead performed many traditional library functions internally. Although the basic science researchers expressed a positive attitude toward the library, they did not view its resources or services as integral to their work. To maximize their use by researchers, library resources must be accessible via departmental websites. Use of library services may be increased by cultivating relationships with key departmental administrative personnel. Despite their self-sufficiency, subjects expressed a desire for centralized information about ongoing research on campus and shared resources, suggesting a role for the library in creating and managing an institutional repository.

  19. Emotion Regulation through Movement: Unique Sets of Movement Characteristics are Associated with and Enhance Basic Emotions.

    Science.gov (United States)

    Shafir, Tal; Tsachor, Rachelle P; Welch, Kathleen B

    2015-01-01

    We have recently demonstrated that motor execution, observation, and imagery of movements expressing certain emotions can enhance corresponding affective states and therefore could be used for emotion regulation. But which specific movement(s) should one use in order to enhance each emotion? This study aimed to identify, using Laban Movement Analysis (LMA), the Laban motor elements (motor characteristics) that characterize movements whose execution enhances each of the basic emotions: anger, fear, happiness, and sadness. LMA provides a system of symbols describing its motor elements, which gives a written instruction (motif) for the execution of a movement or movement-sequence over time. Six senior LMA experts analyzed a validated set of video clips showing whole body dynamic expressions of anger, fear, happiness and sadness, and identified the motor elements that were common to (appeared in) all clips expressing the same emotion. For each emotion, we created motifs of different combinations of the motor elements common to all clips of the same emotion. Eighty subjects from around the world read and moved those motifs, to identify the emotion evoked when moving each motif and to rate the intensity of the evoked emotion. All subjects together moved and rated 1241 motifs, which were produced from 29 different motor elements. Using logistic regression, we found a set of motor elements associated with each emotion which, when moved, predicted the feeling of that emotion. Each emotion was predicted by a unique set of motor elements and each motor element predicted only one emotion. Knowledge of which specific motor elements enhance specific emotions can enable emotional self-regulation through adding some desired motor qualities to one's personal everyday movements (rather than mimicking others' specific movements) and through decreasing motor behaviors which include elements that enhance negative emotions.

  20. Emotion regulation through movement: Unique sets of movement characteristics are associated with and enhance basic emotions

    Directory of Open Access Journals (Sweden)

    Tal eShafir

    2016-01-01

    Full Text Available We have recently demonstrated that motor execution, observation and imagery of movements expressing certain emotions can enhance corresponding affective states and therefore could be used for emotion regulation. But which specific movement(s should one use in order to enhance each emotion? This study aimed to identify, using Laban Movement Analysis (LMA, the Laban motor elements (motor characteristics that characterize movements whose execution enhances each of the basic emotions: anger, fear happiness, and sadness. LMA provides a system of symbols describing its motor elements, which gives a written instruction (motif for the execution of a movement or movement-sequence over time. Six senior LMA experts analyzed a validated set of video clips showing whole body dynamic expressions of anger, fear, happiness and sadness, and identified the motor elements that were common to (appeared in all clips expressing the same emotion. For each emotion, we created motifs of different combinations of the motor elements common to all clips of the same emotion. Eighty subjects from around the world read and moved those motifs, to identify the emotion evoked when moving each motif and to rate the intensity of the evoked emotion. All subjects together moved and rated 1241 motifs, which were produced from 29 different motor elements. Using logistic regression, we found a set of motor elements associated with each emotion which, when moved, predicted the feeling of that emotion. Each emotion was predicted by a unique set of motor elements and each motor element predicted only one emotion. Knowledge of which specific motor elements enhance specific emotions can enable emotional self-regulation through adding some desired motor qualities to one’s personal everyday movements (rather than mimicking others’ specific movements and through decreasing motor behaviors which include elements that enhance negative emotions.

  1. Setting Up Workplace Basic Skills Training. Guidelines for Practitioners. An ALBSU Special Development Project.

    Science.gov (United States)

    Rees, Libby

    This guide provides information on basic skills needs and programs in the workplace and issues affecting basic skills provision from a British perspective. Section 1 aims to provide a context for workplace basic skills provision. Sections 2-7 provide practical suggestions and advice on the following topics: (1) marketing; (2) contacting employers;…

  2. Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek

    2017-07-01

    The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  3. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Science.gov (United States)

    2010-04-01

    ... include: (a) A customer-centered case management approach; (b) The provision of workforce investment... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING...

  4. Mobile and portable dental services catering to the basic oral health ...

    African Journals Online (AJOL)

    Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model. ... Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the ...

  5. A Study on an appropriate operating system of environmental basic facility service industry

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Hyun Joo [Korea Environment Institute, Seoul (Korea)

    1998-12-01

    The environmental basic facility service industry is designed to have a structural reorganization of general operating system and the efficient and effective participation of private industry and regulation of industry in connection with the general system. 35 refs., 9 figs., 20 tabs.

  6. Geographical information System - Tool for the administration of the services of basic sanitation and drinkable water

    International Nuclear Information System (INIS)

    Villegas A, Claudia; Figueroa V, Claudia; Betancur V, Teresita

    2000-01-01

    The utility a Geographic Information System (GIS), is to develop urbane zone in this case, in the Jardin Municipality many elements and tools are supporting the management of service of potable water and basic sanitation, which constitute components of Territorial Ordering Plane (TOP)

  7. FACTORS INFLUENCING CUSTOMERS’ BEHAVIOUR TOWARDS TRUSTED SERVICE PROVIDERS: AN INVESTIGATION OF FOUR SERVICE SETTINGS

    Directory of Open Access Journals (Sweden)

    Gurau Calin

    2013-07-01

    20 minutes, and the respondents being randomly selected from the waiting areas of five UK supermarkets. The collected data has been analysed with the SPSS software, using the Chi Square and Pearson’s two-tailed correlation tests. The results indicate a complex relationship between various categories of factors and the level of customer loyalty, which varies in relation to specific service settings. The findings have been integrated into a synthetic model, developed for four different types of services.

  8. Legislative and policy frameworks for basic services: A South African comparative study

    Directory of Open Access Journals (Sweden)

    Hlako Choma

    2015-12-01

    Full Text Available It is common course that equitable access to water and sanitation must be accordingly and primarily regarded as criteria for the realization of other several human rights, such as the right to life, dignity, health, food, adequate standard of living and education. Access to safe drinking water and sanitation is essential to the enjoyment of safety and environment that is not hazardous to human health. The lack of water and sanitation does not only hinder access to other available rights, but also magnifies the vulnerability of women, girls and people with disabilities. Water and sanitation services are of outmost important to the health and wellbeing of all people. South Africa is operating under one of the most outstanding legislative and policy frameworks for basic services in the world, including the Constitutional right of access to sufficient water and right to basic sanitation.

  9. Religious institutions and the politics of access to basic services in displacement contexts

    DEFF Research Database (Denmark)

    Lauterbach, Karen

    This paper provides a study of religious institutions as service providers in contexts of crises and displacement. Religious institutions, as well as other non-state institutions, provide access to a vast range of resources and services (such as food, housing, clothes, counseling, money, and access...... to networks). In contexts of displacement access to basic services is formally regulated by one’s status (e.g. as refugee or national citizen) and by physical location (e.g. in settlements/camps or urban areas). The paper discusses what role religious institutions play when access to services provided...... by the state or the international humanitarian system is limited or non-existent and what kind of relations of exchange that is at stake. Empirically the project deals with Congolese churches in Kampala, Uganda of which many pastors and members have refugee status. The paper analyses the range and categories...

  10. Relevance of the international spinal cord injury basic data sets to youth: an Inter-Professional review with recommendations.

    Science.gov (United States)

    Carroll, A; Vogel, L C; Zebracki, K; Noonan, V K; Biering-Sørensen, F; Mulcahey, M J

    2017-09-01

    Mixed methods, using the Modified Delphi Technique and Expert Panel Review. To evaluate the utility and relevance of the International Spinal Cord Injury (SCI) Core and Basic Data Sets for children and youth with SCI. International. Via 20 electronic surveys, an interprofessional sample of healthcare professionals with pediatric SCI experience participated in an iterative critical review of the International SCI Data Sets, and submitted suggestions for modifications for use with four pediatric age groups. A panel of 5 experts scrutinized the utility of all data sets, correlated any modifications with the developing National Institute of Neurological Disorders and Stroke (NINDS) pediatric SCI Common Data Elements (CDE) and distributed final recommendations for modifications required to the adult data sets to the International SCI Data Set Committee and the associated Working Groups. Two International SCI Data Sets were considered relevant and appropriate for use with children without any changes. Three were considered not appropriate or applicable for use with children, regardless of age. Recommendations were made for five data sets to enhance their relevance and applicability to children across the age groups, and recommendations for seven data sets were specific to infants and younger children. The results of this critical review are significant in that substantive recommendations to align the International SCI Core and Basic Data Sets to pediatric practice were made. This project was funded by the Rick Hansen Institute Grant# 2015-27.

  11. The Basic Challenge in EU Countries Promotion Strategy in Exporting Commercial Services

    Directory of Open Access Journals (Sweden)

    Octavian-Liviu Olaru

    2012-05-01

    Full Text Available The global financial and economic crisis which started in 2007 had a considerable impact onthe international exchange of goods and services and on the intensity of global financial flows andbusiness activity. Starting with 2010, the EU-27 economy returned to its previous trend of progressivelymore integration with the international economy in terms of its level of credits and debits relative togross domestic product (GDP, having experienced a reversal in 2009. The average value of EU-27 tradeflows of goods corresponded to 11.6 % of GDP in 2010, up from 9.8 % the previous year. The level oftrade integration of services rose to 4.0 % of GDP in 2010, up from 3.9 % in 2008 and 3.8 % in 2009.The basic challenge in EU countries promotion strategy in exporting a commercial service is to convincea foreigner to try a service that does not exist yet. The foreigners have to believe that the service will beof good quality and will meet their needs. Usually the foreigner forms that belief based onrecommendations, referrals, or somehow seeing the service provider in action. There are also severalroles that trade promotion activities can play in building that belief or credibility. A national TPO needsto find or reinforce some special quality that its country has so that when potential customers hear abouta service supplier from this country, their first response is, “Oh yes, I’ve heard good things aboutservices from your country.”

  12. Development of a participatory Management approach of the Committee for Basic Education School under the Nongbualamphu Primary Educational Service Area Office 2

    Directory of Open Access Journals (Sweden)

    Jirayu Prommajak

    2016-10-01

    Full Text Available This study aimed: 1 study the present state and adverse conditions of administration with the participation of the basic education in schools. 2 Development of a participatory Management approach of the Committee for Basic Education school under the Nongbualamphu Primary Educational Service Area Office 2. Split data into 2 phases. Phase 1: The sample used for this research consisted of 128 members of the committee on basic education in school under the Nongbualamphu Primary Educational Service Area Office 2. Selected by using stratified random sampling. Instruments used included a set of rating scale questionnaires. Phase 2: Data from the interviews using a structured questionnaire and focus group discussion. The basic statistics used for analyzing the collected data were percentage, means and standard deviation. The results of this study were as follows: 1. On the present state administration with the participation of the basic education commission in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall participation in management is moderate. Considering the individual aspects, found that the academic administration overall participation in management and budget management were moderate. The personnel management and general and administrative overall participation in management at a high level. 2. Adverse conditions of administration with the participation of the school board for basic education in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall in a high level. Considering the individual aspects, found that the school board in basic education is desirable to participate in the management of all aspects. 3. Development of a participatory management approach of the committee for basic education school under the Nongbualamphu Primary Educational Service Area Office 2 is a developmental process management principles PDCA, 5 steps. Step 1: Creating a common understanding Step

  13. Geochemistry and tectonic setting of basic dykes in the Boroujerd area (Sanandaj- Sirjan Zone

    Directory of Open Access Journals (Sweden)

    Zahra Tahmasbi

    2017-03-01

    Full Text Available Basic dykes, trending NE-SW and cross cutting the middle Jurassic granodioritic rocksexposed in the Boroujerd area. They are dark green and fine to medium–grained rocksand are characterized by ophitic to subophitic texture. These rocks are dominated bymajor minerals including amphibole and plagioclase as well as minor biotite, apatite,sphene and prehnite. Amphibole is calcic, with magnesia-hornblende to actinolitehornblendecomposition. T = 600-700ºC and P = 3.5-5.2 kbar were calculated forcrystallization of these minerals. The composition of plagioclases ranges from albite tooligoclase. The basic dykes studied are undeformed and the youngest magmatic activityin the area.. The collision of Arabian and Central Iranian plates, gave rise to the pressurein the Central Iranian plate, which expanded the extension fractures in the direction ofthe plate movement. As a result, the dykes in discussion formed in direction of platemovement. Thus, development of basic dykes in the Northeast-Southwest direction withrespect to the convergence zone is justified. The basic dykes, on the discriminationtectonic diagrams, are classified as alkaline series and plotted on within plateenvironment field, which originated from partial melting of an enriched mantle source.

  14. [Blood transfusion in emergency settings: French military health service experience].

    Science.gov (United States)

    Sailliol, A; Ausset, S; Peytel, E

    2010-12-01

    Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  15. Performance Measurement Implementation Of Minimum Service Standards For Basic Education Based On The Balanced Scorecard

    Directory of Open Access Journals (Sweden)

    Budiman Rusli

    2015-08-01

    Full Text Available Policies Minimum Service Standards for Basic Education has rolled out since 2002 by the minister in accordance with the Decree No. 129a U 2004 About Minimum Service Standards Education is continually updated and lastly Regulation of the Minister of Education and Culture No. 23 of 2013. All of the district government town should achieve the target of achieving 100 per cent in each of the indicators listed in the minimum service standards for the end of 2014. achievement pad on each indicator is just one measure of the performance of the local government department of education. Unfortunately from the announced target for 27 indicators that exist almost all regions including local governments do not reach Tangerang Regency. It is necessary for measuring the performance of local authorities particularly the education department. One performance measure modern enough that measurements can be done that The Balance Scorecard BSc. In the Balanced Scorecard is a management tool contemporare complete measure company performance not only of the financial perspective but also non-financial performance such as Customer Perspective Internal Business Processes and Learning and Growth. This approach is actually ideally suited for multinational companies because this approach requires very expensive but can be used to measure the profit performance of the company in addition to the combination of a long-term strategic and short-strategic. Balanced Scorecard it can also be done in measuring the performance of public sector services as well by modifying a few things so it can be used to measure the performance of the public sector including the Performance Measurement Minimum Service Standards for Basic Education.

  16. Basic Structure of Some Classes of Neutrosophic Crisp Nearly Open Sets & Possible Application to GIS Topology

    Directory of Open Access Journals (Sweden)

    A. A. Salama

    2015-01-01

    Full Text Available Since the world is full of indeterminacy, the neutrosophics found their place into contemporary research. The fundamental concepts of neutrosophic set, introduced by Smarandache and Salama et al. In Geographical information systems (GIS there is a need to model spatial regions with indeterminate boundary and under indeterminacy. In this paper the structure of some classes of neutrosophic crisp nearly open sets are investigated and some applications are given. Finally we generalize the crisp topological and intuitioistic studies to the notion of neutrosophic crisp set. Possible applications to GIS topological rules are touched upon.

  17. The relative importance of service dimensions in a healthcare setting.

    Science.gov (United States)

    Ramsaran-Fowdar, Rooma Roshnee

    2008-01-01

    The paper aims to focus on an augmented SERVQUAL instrument that was used to measure private patients' service expectations and perceptions. A questionnaire was administered to 750 and 34 per cent responded. A new service quality instrument called PRIVHEALTHQUAL emerged from the study, based on factor and reliability analysis. The "reliability and fair and equitable treatment" factor was found to be the most important healthcare service quality dimension. Adds to the existing body of research on service quality and demonstrates that SERVQUAL is not a generic service quality measure for all industries.

  18. Servicing HEP experiments with a complete set of ready integreated and configured common software components

    International Nuclear Information System (INIS)

    Roiser, Stefan; Gaspar, Ana; Perrin, Yves; Kruzelecki, Karol

    2010-01-01

    The LCG Applications Area at CERN provides basic software components for the LHC experiments such as ROOT, POOL, COOL which are developed in house and also a set of 'external' software packages (70) which are needed in addition such as Python, Boost, Qt, CLHEP, etc. These packages target many different areas of HEP computing such as data persistency, math, simulation, grid computing, databases, graphics, etc. Other packages provide tools for documentation, debugging, scripting languages and compilers. All these packages are provided in a consistent manner on different compilers, architectures and operating systems. The Software Process and Infrastructure project (SPI) [1] is responsible for the continous testing, coordination, release and deployment of these software packages. The main driving force for the actions carried out by SPI are the needs of the LHC experiments, but also other HEP experiments could profit from the set of consistent libraries provided and receive a stable and well tested foundation to build their experiment software frameworks. This presentation will first provide a brief description of the tools and services provided for the coordination, testing, release, deployment and presentation of LCG/AA software packages and then focus on a second set of tools provided for outside LHC experiments to deploy a stable set of HEP related software packages both as binary distribution or from source.

  19. Servicing HEP experiments with a complete set of ready integreated and configured common software components

    Energy Technology Data Exchange (ETDEWEB)

    Roiser, Stefan; Gaspar, Ana; Perrin, Yves [CERN, CH-1211 Geneva 23, PH Department, SFT Group (Switzerland); Kruzelecki, Karol, E-mail: stefan.roiser@cern.c, E-mail: ana.gaspar@cern.c, E-mail: yves.perrin@cern.c, E-mail: karol.kruzelecki@cern.c [CERN, CH-1211 Geneva 23, PH Department, LBC Group (Switzerland)

    2010-04-01

    The LCG Applications Area at CERN provides basic software components for the LHC experiments such as ROOT, POOL, COOL which are developed in house and also a set of 'external' software packages (70) which are needed in addition such as Python, Boost, Qt, CLHEP, etc. These packages target many different areas of HEP computing such as data persistency, math, simulation, grid computing, databases, graphics, etc. Other packages provide tools for documentation, debugging, scripting languages and compilers. All these packages are provided in a consistent manner on different compilers, architectures and operating systems. The Software Process and Infrastructure project (SPI) [1] is responsible for the continous testing, coordination, release and deployment of these software packages. The main driving force for the actions carried out by SPI are the needs of the LHC experiments, but also other HEP experiments could profit from the set of consistent libraries provided and receive a stable and well tested foundation to build their experiment software frameworks. This presentation will first provide a brief description of the tools and services provided for the coordination, testing, release, deployment and presentation of LCG/AA software packages and then focus on a second set of tools provided for outside LHC experiments to deploy a stable set of HEP related software packages both as binary distribution or from source.

  20. The Jump Set under Geometric Regularization. Part 1: Basic Technique and First-Order Denoising

    KAUST Repository

    Valkonen, Tuomo

    2015-01-01

    -894] have shown the containment Hm-1 (Ju \\Jf) = 0 of the jump set Ju of u in that of f. Their proof unfortunately depends heavily on the co-area formula, as do many results in this area, and as such is not directly extensible to higher

  1. Stackel spaces of an electrovacuum with isotropic complete sets. Formulation of problem and basic relations

    International Nuclear Information System (INIS)

    Bagrov, V.G.; Evseevich, A.A.; Obukhov, V.V.; Osetrin, K.E.

    1987-01-01

    The authors consider the problem of the classification of the Stackel spaces of the electrovacuum with isotropic complete sets. The metrics of the spaces are represented in a form that is convenient for their investigation. We obtain necessary relations for the construction of the field equations

  2. Regulation and price setting of pilotage services in Brazil

    OpenAIRE

    Marcos M O Pinto; David J K Goldberg; Bruno Stupello; Christopher W Haley

    2010-01-01

    The Ministry of Ports (SEP) was created in 2007 to improve the efficiency of Brazilian maritime ports and boost international trade. One of the most important and challenging issues that SEP has been dealing with is the pilotage service provision. Although recognized as of good quality, the service is considered to be too expensive and unregulated. This article's objective is to demonstrate that the Brazilian monopolistic and unregulated model is not suitable for a public utility service such...

  3. Contract and Game Theory: Basic Concepts for Settings with Finite Horizons

    OpenAIRE

    Joel Watson

    2013-01-01

    This paper examines a general model of contract in multi-period settings with both external and self-enforcement. In the model, players alternately engage in contract negotiation and take individual actions. A notion of contractual equilibrium, which combines a bargaining solution and individual incentive constraints, is proposed and analyzed. The modeling framework helps identify the relation between the manner in which players negotiate and the outcome of the long-term contractual relations...

  4. Quality of basic life support education and automated external defibrillator setting in schools in Ishikawa, Japan.

    Science.gov (United States)

    Takamura, Akiteru; Ito, Sayori; Maruyama, Kaori; Ryo, Yusuke; Saito, Manami; Fujimura, Shuhei; Ishiura, Yuna; Hori, Ariyuki

    2017-03-01

    Automated external defibrillators (AED) have been installed in schools in Japan since 2004, and the government strongly recommends teaching basic life support (BLS). We therefore examined the quality of BLS education and AED installation in schools. We conducted a prefecture-wide questionnaire survey of all primary and junior high schools in 2016, to assess BLS education and AED installation against the recommendations of the Japan Circulation Society. The results were analyzed using descriptive statistics and chi-squared test. In total, 195 schools out of 315 (62%) responded, of which 38% have introduced BLS education for children. BLS training was held in a smaller proportion of primary schools (18%) than junior high schools (86%). More than 90% of primary school staff had undergone BLS training in the previous 2 years. The most common locations of AED were the gymnasium (32%) followed by entrance hall (28%), staffroom (25%), and infirmary (12%). The reasons given for location were that it was obvious (34%), convenient for staff (32%), could be used out of hours (17%), and the most likely location for a heart attack (15%). Approximately 18% of schools reported that it takes >5 min to reach the AED from the furthest point. BLS training, AED location, and understanding of both are not sufficient to save children's lives efficiently. Authorities should make recommendations about the correct number of AED, and their location, and provide more information to improve the quality of BLS training in schools. © 2016 Japan Pediatric Society.

  5. Study of steam condensation at sub-atmospheric pressure: setting a basic research using MELCOR code

    Science.gov (United States)

    Manfredini, A.; Mazzini, M.

    2017-11-01

    One of the most serious accidents that can occur in the experimental nuclear fusion reactor ITER is the break of one of the headers of the refrigeration system of the first wall of the Tokamak. This results in water-steam mixture discharge in vacuum vessel (VV), with consequent pressurization of this container. To prevent the pressure in the VV exceeds 150 KPa absolute, a system discharges the steam inside a suppression pool, at an absolute pressure of 4.2 kPa. The computer codes used to analyze such incident (eg. RELAP 5 or MELCOR) are not validated experimentally for such conditions. Therefore, we planned a basic research, in order to have experimental data useful to validate the heat transfer correlations used in these codes. After a thorough literature search on this topic, ACTA, in collaboration with the staff of ITER, defined the experimental matrix and performed the design of the experimental apparatus. For the thermal-hydraulic design of the experiments, we executed a series of calculations by MELCOR. This code, however, was used in an unconventional mode, with the development of models suited respectively to low and high steam flow-rate tests. The article concludes with a discussion of the placement of experimental data within the map featuring the phenomenon characteristics, showing the importance of the new knowledge acquired, particularly in the case of chugging.

  6. Best practices for basic and advanced skills in health care service recovery: a case study of a re-admitted patient.

    Science.gov (United States)

    Hayden, Anna C; Pichert, James W; Fawcett, Jodi; Moore, Ilene N; Hickson, Gerald B

    2010-07-01

    Service recovery refers to an organizations entire process for facilitating resolution of dissatisfactions, whether or not visible to patients and families. Patients are an important resource for reporting miscommunications, provider inattention, rudeness, or delays, especially if they perceive a connection to misdiagnosis or failed treatment. Health systems that encourage patients to be "the eyes and ears" of individual and team performance capitalize on a rich source of data for quality improvement and risk prevention. Effective service recovery requires organizations (1) to learn about negative perceptions and experiences and (2) to create an infrastructure that supports staff's ability to respond. Service recovery requires the exercise of both basic and advanced skills. We term certain skills as advanced because of the significant variation in their use or endorsement among 30 health care organizations in the United States. On the basis of our work with the 30 organizations, a mnemonic, HEARD, incorporates best practices for basic service recovery processes: Hearing the person's concern; Empathizing with the person raising the issue; Acknowledging, expressing appreciation to the person for sharing, and Apologizing when warranted; Responding to the problem, setting time lines and expectations for follow-up; and Documenting or Delegating the documentation to the appropriate person. Impartiality, chain of command, setting boundaries, and Documentation represent four advanced service recovery skills critical for addressing challenging situations. Using best practices in service recovery enables the organization to do its best to make right what patients and family members experience as wrong.

  7. Nomenclature and basic concepts in automation in the clinical laboratory setting: a practical glossary.

    Science.gov (United States)

    Evangelopoulos, Angelos A; Dalamaga, Maria; Panoutsopoulos, Konstantinos; Dima, Kleanthi

    2013-01-01

    In the early 80s, the word automation was used in the clinical laboratory setting referring only to analyzers. But in late 80s and afterwards, automation found its way into all aspects of the diagnostic process, embracing not only the analytical but also the pre- and post-analytical phase. While laboratories in the eastern world, mainly Japan, paved the way for laboratory automation, US and European laboratories soon realized the benefits and were quick to follow. Clearly, automation and robotics will be a key survival tool in a very competitive and cost-concious healthcare market. What sets automation technology apart from so many other efficiency solutions are the dramatic savings that it brings to the clinical laboratory. Further standardization will assure the success of this revolutionary new technology. One of the main difficulties laboratory managers and personnel must deal with when studying solutions to reengineer a laboratory is familiarizing themselves with the multidisciplinary and technical terminology of this new and exciting field. The present review/glossary aims at giving an overview of the most frequently used terms within the scope of laboratory automation and to put laboratory automation on a sounder linguistic basis.

  8. The Jump Set under Geometric Regularization. Part 1: Basic Technique and First-Order Denoising

    KAUST Repository

    Valkonen, Tuomo

    2015-01-01

    © 2015 Society for Industrial and Applied Mathematics. Let u ∈ BV(Ω) solve the total variation (TV) denoising problem with L2-squared fidelity and data f. Caselles, Chambolle, and Novaga [Multiscale Model. Simul., 6 (2008), pp. 879-894] have shown the containment Hm-1 (Ju \\\\Jf) = 0 of the jump set Ju of u in that of f. Their proof unfortunately depends heavily on the co-area formula, as do many results in this area, and as such is not directly extensible to higher-order, curvature-based, and other advanced geometric regularizers, such as total generalized variation and Euler\\'s elastica. These have received increased attention in recent times due to their better practical regularization properties compared to conventional TV or wavelets. We prove analogous jump set containment properties for a general class of regularizers. We do this with novel Lipschitz transformation techniques and do not require the co-area formula. In the present Part 1 we demonstrate the general technique on first-order regularizers, while in Part 2 we will extend it to higher-order regularizers. In particular, we concentrate in this part on TV and, as a novelty, Huber-regularized TV. We also demonstrate that the technique would apply to nonconvex TV models as well as the Perona-Malik anisotropic diffusion, if these approaches were well-posed to begin with.

  9. Identifying mental health services in clinical genetic settings.

    Science.gov (United States)

    Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D

    2009-10-01

    The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.

  10. Contract and Game Theory: Basic Concepts for Settings with Finite Horizons

    Directory of Open Access Journals (Sweden)

    Joel Watson

    2013-08-01

    Full Text Available This paper examines a general model of contract in multi-period settings with both external and self-enforcement. In the model, players alternately engage in contract negotiation and take individual actions. A notion of contractual equilibrium, which combines a bargaining solution and individual incentive constraints, is proposed and analyzed. The modeling framework helps identify the relation between the manner in which players negotiate and the outcome of the long-term contractual relationship. In particular, the model shows the importance of accounting for the self-enforced component of contract in the negotiation process. Examples and guidance for applications are provided, along with existence results and a result on a monotone relation between “activeness of contracting” and contractual equilibrium values.

  11. Version 1.1 of the international spinal cord injury skin and thermoregulation function basic data set.

    Science.gov (United States)

    Biering-Sørensen, F; Alexander, M S; van Asbeck, F W A; Donovan, W; Krassioukov, A; Post, M W M

    2017-06-01

    To describe the changes made to the international spinal cord injury (SCI) skin and thermoregulation function basic data set in version 1.1. International. An international working group reviewed suggested changes to the international SCI skin and thermoregulation function basic data set version 1.0. These changes were discussed and the agreed changes were made. Subsequently, the recommended adjustments were circulated for review to the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, the American Spinal Injury Association (ASIA) Board, around 40 national and international societies, and to interested individuals who had signed up wishing to have the opportunity to review. In addition, the suggested changes were displayed at the ISCoS and ASIA websites for at least a month for possible comments. The recommendation 'largest diameter, including undermining' is changed to: 'Largest undermining', and a description of how to measure this is inserted. The 'smallest opening diameter' is changed to: 'Width' as the maximum dimension perpendicular to the length axis. In the literature, there is a tendency to replace 'grades' or 'stages' with 'categories'; therefore, the word 'category' is used instead of 'grade' or 'stage'. Impracticable measurements have been adjusted and new terminology adopted. All are to be found on ISCoS website: http://www.iscos.org.uk/international-sci-skin-and-thermoregulation-function-data-sets.

  12. Setting up and Running a Sharing Service: an Organisational Perspective

    Directory of Open Access Journals (Sweden)

    Naemi Luckner

    2015-05-01

    Full Text Available Enabled by web and mobile technologies, there has been an explosion of interest in the sharing economy and peer-to-peer exchange, with much high profile attention given to monetised exchanges such as in AirBnB and Uber. However there are also many other sharing initiatives, such as time banking, that focus on smaller, more local communities and do not involve monetisation of exchanges. While there is a growing body of literature elaborating participation and motivation in sharing services as well as analysing organisers’ roles, little is discussed about the work involved in the day-to-day organisation and management of such services. In this paper we report on an interview study with ten participants discussing five different sharing systems from three different countries. A qualitative thematic analysis of the data points to significant on-going effort reported by all to establish, maintain and grow a service, not only focussing on its practical aspects but also on growing a community and building trust. How they engaged in this practical work though was not so much shaped by the service model (time banking, LETS and so on but on a complex relationship between their funding model, the service goal and whether it was a top-down or bottom-up initiative. These findings have implications for the design of technical platforms to support services, not just in elaborating a range of possible tasks to be supported but also in where and how it needs to be tailorable to certain needs, how adaptive it is to different service models and how it facilitates monitoring and reporting duties for organisers.

  13. Delivering high-quality family planning services in crisis-affected settings I: program implementation.

    Science.gov (United States)

    Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh

    2015-02-04

    In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization

  14. 47 CFR 76.944 - Commission review of franchising authority decisions on rates for the basic service tier and...

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Commission review of franchising authority... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.944 Commission review of franchising authority... forum for appeals of decisions by franchising authorities on rates for the basic service tier or...

  15. The Views of Science Pre-Service Teachers about the Usage of Basic Information Technologies (BIT) in Education and Instruction

    Science.gov (United States)

    Çetin, Oguz

    2016-01-01

    In this study aiming to present a description based on science pre-service teachers' views related to use of Basic Information Technologies (BIT) in education and training, an interview is carried out with 21 pre-service science teachers who study in different classes in Faculty of Education, Nigde University. For this aim, improved interview form…

  16. Setting up recovery clinics and promoting service user involvement.

    Science.gov (United States)

    John, Thomas

    2017-06-22

    Service user involvement in mental health has gained considerable momentum. Evidence from the literature suggests that it remains largely theoretical rather than being put into practice. The current nature of acute inpatient mental health units creates various challenges for nurses to put this concept into practice. Recovery clinics were introduced to bridge this gap and to promote service user involvement practice within the current care delivery model at Kent and Medway NHS and Social Care Partnership Trust. It has shaped new ways of working for nurses with a person-centred approach as its philosophy. Service users and nurses were involved in implementing a needs-led and bottom-up initiative using Kotter's change model. Initial results suggest that it has been successful in meeting its objectives evidenced through increased meaningful interactions and involvement in care by service users and carers. The clinics have gained wide recognition and have highlighted a need for further research into care delivery models to promote service user involvement in these units.

  17. Mental Health Service Use in Schools and Non-School-Based Outpatient Settings: Comparing Predictors of Service Use.

    Science.gov (United States)

    Langer, David A; Wood, Jeffrey J; Wood, Patricia A; Garland, Ann F; Landsverk, John; Hough, Richard L

    2015-09-01

    Researchers have consistently documented a gap between the large number of US youth meeting criteria for a mental health disorder with significant associated impairment, and the comparatively few youth receiving services. School-based mental health care may address the need-services gap by offering services more equitably to youth in need, irrespective of family economic resources, availability of transportation, and other factors that can impede access to community clinics. However, diagnoses alone do not fully capture the severity of an individual's mental health status and need for services. Studying service use only in relation to diagnoses may restrict our understanding of the degree to which service use is reflective of service need, and inhibit our ability to compare school and non-school-based outpatient settings on their responsiveness to service need. The present study evaluated predictors of mental health service use in school- and community-based settings for youth who had had an active case in one of two public sectors of care, comparing empirically-derived dimensional measurements of youth mental health service need and impairment ratings against non-need variables (e.g., ethnicity, income). Three dimensions of youth mental health service need were identified. Mental health service need and non-need variables each played a significant predictive role. Parent-rated impairment was the strongest need-based predictor of service use across settings. The impact of non-need variables varied by service setting, with parental income having a particularly noticeable effect on school-based services. Across time, preceding service use and impairment each significantly predicted future service use.

  18. Improving Services for Women with Depression in Primary Care Settings

    Science.gov (United States)

    Katon, Wayne J.; Ludman, Evette J.

    2003-01-01

    Women have a higher prevalence of depressive disorders compared to men. The current system of care for women with depressive disorders provides significant financial barriers for patients with lower incomes to access mental health services. Primary care systems are used extensively by women and have the potential to diagnose patients at early…

  19. The effect of urban basic medical insurance on health service utilisation in Shaanxi Province, China: a comparison of two schemes.

    Science.gov (United States)

    Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

    2014-01-01

    Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (pinsured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.

  20. Using Video Games to Support Pre-Service Elementary Teachers Learning of Basic Physics Principles

    Science.gov (United States)

    Anderson, Janice; Barnett, Michael

    2011-08-01

    The purpose of this work is to share our findings in using video gaming technology to facilitate the understanding of basic electromagnetism with pre-service elementary teachers. To this end we explored the impact of using a game called Supercharged! on pre-service teachers' understanding of electromagnetic concepts compared to students who conducted a more traditional inquiry oriented investigation of the same concepts. This study was a part of a larger design experiment examining the pedagogical potential of Supercharged! the control group learned through a series of guided inquiry methods while the experimental group played Supercharged! during the laboratory sections of the science course. There was significant difference F(2,134) = 4.8, p video games can lead to positive learning outcomes, as demonstrated by the increase in test scores from pre- to post-assessment. Additionally, this study also suggests that a complementary approach, in which video games and hands-on activities are integrated, with each activity informing the other, could be a very powerful technique for supporting student scientific understanding. Further, our findings suggest that video game designers should embed meta-cognitive activities such as reflective opportunities into educational video games to provide scaffolds for students and to reinforce that they are engaged in an educational learning experience.

  1. Basic occupational health services (BOHS) in community primary care: the MSF (Dhaka) model.

    Science.gov (United States)

    Muralidhar, Venkiteswaran; Ahasan, Md Faizul; Khan, Ahad Mahmud; Alam, Mohammad Shariful

    2017-03-20

    The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries. The MSF experience begs the need for replication of such services in densely populated urban areas in developing nations like Bangladesh and India, where no specialty occupational health clinics exist in primary care but are desperately needed and where occupational health clinics on factory premises are exclusive to industry workers and are not accessible to communities. 2017 BMJ Publishing Group Ltd.

  2. Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

    Directory of Open Access Journals (Sweden)

    Lijun Guo

    Full Text Available Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001. In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022. The urban comprehensive score also exceeded that of the suburbs (P<0.001. In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this

  3. Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs.

    Science.gov (United States)

    Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C

    2017-07-21

    Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076-16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12-255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and

  4. Complexities of Providing Dental Hygiene Services in Community Care Settings.

    Science.gov (United States)

    Zarkowski, Pamela; Aksu, Mert N

    2016-06-01

    Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.' An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. From basic raw material goods to cultural and environmental services: the Chinese bamboo sophistication path

    Directory of Open Access Journals (Sweden)

    Manuel Ruiz Pérez

    2014-12-01

    Full Text Available Bamboo has deep cultural and economic roots in China, the country with the largest bamboo resources in the world. Over the last three decades bamboo has evolved from a supply of raw material for basic goods into the material base of an increasingly diversified array of products and, more recently, into a potentially important source of cultural and environmental services. Based on a general literature review and the lessons learned from detailed case studies in different regions of China, we explored the changing roles of bamboo, and its effects on local economies and farmers' livelihood strategies. As the country develops and new economic activities continue to appear, bamboo production has shifted from a superior income-generating opportunity that largely benefited the better-off to a less attractive option left for those who have no other choice. The nature of the work has also changed, from families working directly on their bamboo plots to an emphasis on hired labor, with prosperous bamboo owners devoting most of their time to more lucrative activities. A similar process can be observed in bamboo processing in counties where previous industrial structures hinged around raw material harvests, but which have now entered into other secondary and tertiary industry activities. At the same time, bamboo has attracted new opportunities as a source of cultural, aesthetic, and leisure-related activities, as well as some potentially important climatic, watershed, and biodiversity functions. We analyze the complementarity between goods and services provided by bamboo and discuss some research issues and future trends that may help in overcoming these conflicts.

  6. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Elsje Scheffler

    2015-06-01

    Full Text Available Background: Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. Objectives: The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. Methods: A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Results: Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the DistrictHealth System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Conclusion: Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services and demand (user needs and promote universal and equitable access.

  7. Effects of added antibiotics on the basic properties of anti-washout-type fast-setting calcium phosphate cement.

    Science.gov (United States)

    Takechi, M; Miyamoto, Y; Ishikawa, K; Nagayama, M; Kon, M; Asaoka, K; Suzuki, K

    1998-02-01

    The effect of added antibiotics on the basic properties of anti-washout-type fast-setting calcium phosphate cement (aw-FSCPC) was investigated in a preliminary evaluation of aw-FSCPC containing drugs. Flomoxef sodium was employed as the antibiotic and was incorporated into the powder-phase aw-FSCPC at up to 10%. The setting time, consistency, wet diametral tensile strength (DTS) value, and porosity were measured for aw-FSCPC containing various amounts of flomoxef sodium. X-ray diffraction (XRD) analysis was also conducted for the identification of products. To evaluate the drug-release profile, set aw-FSCPC was immersed in saline and the released flomoxef sodium was determined at regular intervals. The spread area of the cement paste as an index of consistency of the cement increased progressively with the addition of flomoxef sodium, and it doubled when the aw-FSCPC contained 8% flomoxef sodium. In contrast, the wet DTS value decreased with increase in flomoxef sodium content. Bulk density measurement and scanning electron microscopic observation revealed that the set mass was more porous with the amount of flomoxef sodium contained in the aw-FSCPC. The XRD analysis revealed that formation of hydroxyapatite (HAP) from aw-FSCPC was reduced even after 24 h, when the aw-FSCPC contained flomoxef sodium at > or = 6%. Therefore, the decrease of wet DTS value was thought to be partly the result of the increased porosity and inhibition of HAP formation in aw-FSCPC containing large amounts of flomoxef sodium. The flomoxef sodium release from aw-FSCPC showed the typical profile observed in a skeleton-type drug delivery system (DDS). The rate of drug release from aw-FSCPC can be controlled by changing the concentration of sodium alginate. Although flomoxef sodium addition has certain disadvantageous effects on the basic properties of aw-FSCPC, we conclude that aw-FSCPC is a good candidate for potential use as a DDS carrier that may be useful in surgical operations.

  8. International spinal cord injury male sexual function and female sexual and reproductive function basic data sets-version 2.0

    DEFF Research Database (Denmark)

    Alexander, Marcalee S; New, Peter W; Biering-Sørensen, Fin

    2017-01-01

    S Scientific and Executive Committees and ASIA board of directors. RESULTS: The data sets were modified to a self-report format. They were reviewed for appropriateness for the pediatric age group and adapted to include a new variable to address the issue of sexual orientation. A clarification of the difference......STUDY DESIGN: Data set review and modification. OBJECTIVE: To describe modifications in the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set Version 2.0 and the International SCI Female Sexual and Reproductive Function Basic Data Set Version 2.0. SETTING: International...... expert work group using on line communication. METHODS: An international team of experts was compiled to review and revise the International SCI Male Sexual Function and Female Sexual and Reproductive Function Basic Data Sets Version 1.0. The group adapted Version 1.0 based upon review of published...

  9. Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

    Science.gov (United States)

    Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

    2018-01-01

    Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470

  10. Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

    Science.gov (United States)

    Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

    2018-01-01

    Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.

  11. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    Science.gov (United States)

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  12. Alcohol-based instant hand sanitizer use in military settings: a prospective cohort study of Army basic trainees.

    Science.gov (United States)

    Mott, Peter J; Sisk, Brian W; Arbogast, James W; Ferrazzano-Yaussy, Cristina; Bondi, Cara A M; Sheehan, James J

    2007-11-01

    We investigated the impact of a customized alcohol-based instant hand sanitizer hand-hygiene regimen in an Army basic training setting. The entire population at the U.S. Army Field Artillery Training Center, Fort Sill, Oklahoma, participated in the 13-week prospective cohort study between January 18, 2005 and April 18, 2005. Two training battalions were randomly assigned to the control group, one to the primary intervention group (customized Purell Instant Hand Sanitizer regimen, education, reinforcement) and one to the secondary intervention group (customized Purell Instant Hand Sanitizer regimen). When compared to the control group, intervention groups experienced 40% less respiratory illness (p < 0.001), 48% less gastrointestinal illness (p < 0.02), 44% less lost training time (p < 0.001), and 31% fewer health care encounters (p < 0.001). These findings suggest that this intervention is capable of significantly reducing illness in this setting and has the potential to help reduce absenteeism in the military workforce as a whole.

  13. 47 CFR 76.923 - Rates for equipment and installation used to receive the basic service tier.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rates for equipment and installation used to... § 76.923 Rates for equipment and installation used to receive the basic service tier. (a) Scope. (1... control units; and (iii) Inside wiring. (2) Subscriber charges for such equipment shall not exceed charges...

  14. Investigation of Pre-Service Teachers' Opinions about Science in Terms of the Basic Elements of the Education Program

    Science.gov (United States)

    Sengul, Ozge Aydin

    2016-01-01

    The purpose of the current study is to investigate the pre-service teachers' opinions about science within the context of the basic elements of the education program, such as objectives, content, learning-teaching process and evaluation. The study was designed as a case study, one of the qualitative research methods. The participants of the study…

  15. EVALUATION OF SERVICE QUALITY OF AIRWAY COMPANIES GIVING DOMESTIC SERVICES IN TURKEY WITH FUZZY SET APPROACH

    Directory of Open Access Journals (Sweden)

    H. Handan DEMIR

    2013-01-01

    Full Text Available Today, service quality has become a major phenomenon with the requirement of meeting consumer demands in the best way brought along with the rising competition between companies. Airway transportation is preferred more and more during the recent years. Many qualitative and quantitative criteria are considered while evaluating service criteria in airway transportation. In this context, evaluation of service quality is a decisionmaking problem with many criteria. The purpose of this study is to evaluate service quality of domestic airway companies in Turkey. In this study; fuzzy TOPSIS method which is one of the most preferred fuzzy MCDM methods, extension of multi criteria decision making methods in fuzzy environments, considering qualitative and quantitative criteria together and giving opportunity to make group decisions in fuzzy environments. As a result, evaluation was made based on service quality criteria for the most preferred airways companies in Turkey and these companies were ranked according to their levels of service quality.

  16. In-Service Preschool Teachers' Thoughts about Technology and Technology Use in Early Educational Settings

    Science.gov (United States)

    Kara, Nuri; Cagiltay, Kursat

    2017-01-01

    The purpose of this study is to understand in-service preschool teachers' thoughts about technology and technology use in early educational settings. Semi-structured interviews were conducted with 18 in-service preschool teachers. These teachers were selected from public and private preschools. Convenient sampling was applied because teachers who…

  17. Measurement framework for product service system performance of generator set distributors

    Science.gov (United States)

    Sofianti, Tanika D.

    2017-11-01

    Selling Generator Set (Genset) in B2B market, distributors assisted manufacturers to sell products. This is caused by the limited resources owned by the manufacturer for adding service elements. These service elements are needed to enhance the competitiveness of the generator sets. Some genset distributors often sell products together with supports to their customers. Industrial distributor develops services to meet the needs of the customer. Generator set distributors support machines and equipment produced by manufacturer. The services delivered by the distributors could enhance value obtained by the customers from the equipment. Services provided to customers in bidding process, ordering process of the equipment from the manufacturer, equipment delivery, installations, and the after sales stage. This paper promotes framework to measure Product Service System (PSS) of Generator Set distributors in delivering their products and services for the customers. The methodology of conducting this research is by adopting the perspective of the providers and customers and by taking into account the tangible and intangible products. This research leads to the idea of improvement of current Product Service System of a Genset distributor. This research needs further studies in more detailed measures and the implementation of measurement tools.

  18. Disaster Relief and Emergency Medical Services Project (DREAMS TM): Clinical and Basic Science Projects

    National Research Council Canada - National Science Library

    Casscells, Ward

    1999-01-01

    DREAMS clinical and basic science projects complement the digital EMS effort by investigating the mechanisms of tissue injury in order to minimize the mortality and mortality of trauma and "natural...

  19. Explaining public service motivation : the role of leadership and basic needs satisfaction. Paper

    NARCIS (Netherlands)

    Vandenabeele, W.V.

    2009-01-01

    Both leadership and public service motivation are important issues in contemporary public administration. By connecting these issues, the aim of this paper is to assess the impact of transformational leadership behavior (promoting public values) on public service motivation development. Two

  20. Assessing the In-Service Needs of Basic School Natural Science ...

    African Journals Online (AJOL)

    ... that no significant associations existed. It was recommended among other things that in-service training courses be used as platforms in upgrading the teachers' knowledge and skills. Additionally, in-service course organizers should first assess the in-service needs of participants before providing the appropriate support ...

  1. The Effects of Graphic Feedback, Goal-Setting, and Manager Praise on Customer Service Behaviors

    Science.gov (United States)

    Loewy, Shannon; Bailey, Jon

    2007-01-01

    The current study used a multiple baseline design to investigate the effects of graphic feedback, goal setting, and manager praise on customer service behaviors in a large retail setting. Direct observation of customer greeting, eye contact, and smiling was used to collect data. After baseline data were collected feedback graphs were posted twice…

  2. Compensating citizens for poor service delivery : Experimental research in public and private settings

    NARCIS (Netherlands)

    Thomassen, Jean Pierre; Leliveld, Marijke C.; Van de Walle, Steven; Ahaus, Kees

    2017-01-01

    After a service failure, citizens expect a recovery strategy that restores perceived justice and places a reasonable value on their loss. Offering monetary compensation is a strategy commonly used in private settings, but less so in public settings. To date, compensation effects have not been

  3. Service Quality: A Main Determinant Factor for Health Information System Success in Low-resource Settings.

    Science.gov (United States)

    Tilahun, Binyam; Fritz, Fleur

    2015-01-01

    With the increasing implementation of different health information systems in developing countries, there is a growing need to measure the main determinants of their success. The results of this evaluation study on the determinants of HIS success in five low resource setting hospitals show that service quality is the main determinant factor for information system success in those kind of settings.

  4. Emergency residential care settings: A model for service assessment and design.

    Science.gov (United States)

    Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

    2018-02-01

    There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Compensating citizens for poor service delivery: experimental research in public and private settings

    OpenAIRE

    Thomassen, JP; Leliveld, MC; Van de Walle, Steven; Ahaus, K

    2017-01-01

    After a service failure, citizens expect a recovery strategy that restores perceived justice and places a reasonable value on their loss. Offering monetary compensation is a strategy commonly used in private settings, but less so in public settings. To date compensation effects have not been researched in public settings. To investigate citizens’ evaluations of perceived justice, negative emotions and post-recovery satisfaction we used a 2 (sector: public, private) by 2 (compensation promised...

  6. [Comparison of the "Trigger" tool with the minimum basic data set for detecting adverse events in general surgery].

    Science.gov (United States)

    Pérez Zapata, A I; Gutiérrez Samaniego, M; Rodríguez Cuéllar, E; Gómez de la Cámara, A; Ruiz López, P

    Surgery is a high risk for the occurrence of adverse events (AE). The main objective of this study is to compare the effectiveness of the Trigger tool with the Hospital National Health System registration of Discharges, the minimum basic data set (MBDS), in detecting adverse events in patients admitted to General Surgery and undergoing surgery. Observational and descriptive retrospective study of patients admitted to general surgery of a tertiary hospital, and undergoing surgery in 2012. The identification of adverse events was made by reviewing the medical records, using an adaptation of "Global Trigger Tool" methodology, as well as the (MBDS) registered on the same patients. Once the AE were identified, they were classified according to damage and to the extent to which these could have been avoided. The area under the curve (ROC) were used to determine the discriminatory power of the tools. The Hanley and Mcneil test was used to compare both tools. AE prevalence was 36.8%. The TT detected 89.9% of all AE, while the MBDS detected 28.48%. The TT provides more information on the nature and characteristics of the AE. The area under the curve was 0.89 for the TT and 0.66 for the MBDS. These differences were statistically significant (P<.001). The Trigger tool detects three times more adverse events than the MBDS registry. The prevalence of adverse events in General Surgery is higher than that estimated in other studies. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Alcohol screening and brief intervention in workplace settings and social services: A comparison of literature

    Directory of Open Access Journals (Sweden)

    Bernd eSchulte

    2014-10-01

    Full Text Available BACKGROUND: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBI in primary health care (PHC suggests a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions take place in this context. METHODS: Update of two systematic reviews on ASBI effectiveness in workplaces, social service and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in nonmedical settings.RESULTS: We found a limited number of randomized controlled trials (RCTs in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest a stepped and carefully tailored approach is likely to be required.DISCUSSION: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance and potential effectiveness of ASBI for different target groups, organisational frameworks and professionals.

  8. 47 CFR 76.945 - Procedures for Commission review of basic service rates.

    Science.gov (United States)

    2010-10-01

    ... schedule with the Commission within 30 days, with a copy to the local franchising authority. (b) Basic... cable operator and the local franchising authority. The cable operator may file an opposition within... franchising authority. (d) Filings proposing a rate not within the rate regulation standards of §§ 76.922 and...

  9. Effects of librarian-provided services in healthcare settings: a systematic review.

    Science.gov (United States)

    Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

    2014-01-01

    To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Service user involvement in mental health system strengthening in a rural African setting: qualitative study

    OpenAIRE

    Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

    2017-01-01

    Background It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Methods Thirty nine semi-structured interviews were carried out with pur...

  11. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Science.gov (United States)

    2010-10-01

    ...; and (8) Preventive health services, which must be made available to members and must include at least... HMO is required only to make a good-faith effort to provide or arrange for the provision of the...

  12. Application of phased arrays in basic and in-service inspection

    International Nuclear Information System (INIS)

    Gebhardt, W.; Schwarz, H.P.; Bonitz, F.; Woll, H.

    1985-01-01

    In the scope of the reactor safety research program of the Federal Ministry of Research and Technology a flexible microcomputer controlled phased array system was developed. Meanwhile, several industrial prototypes for simple and complicated applications are built up. The applicability of phased array systems in NDE for basic and inservice inspections of reactor pressure vessels is investigated. Methods for defect detection, reconstruction and classification are described

  13. A Study on Identifying the Misconceptions of Pre-Service and In-Service Teachers about Basic Astronomy Concepts

    Science.gov (United States)

    Kanli, Uygar

    2014-01-01

    Nowadays, the importance given to astronomy teaching in science and physics education has been gradually increasing. At the same time, teachers play an important role in remediating the misconceptions about astronomy concepts held by students. The present study aims to determine the misconceptions of pre-service physics teachers (n = 117),…

  14. [Functional deterioration of basic daily living activities after an emergency service consultation].

    Science.gov (United States)

    Gutiérrez Rodríguez, J; Varela Suárez, C; Alonso Alvarez, M; Solano Jaurrieta, J J

    2000-05-01

    To determine the incidence of functional decline of elderly patients discharged from an emergency department and to analized functional impairment as a risk of readmission. A prospective cohort aged 75 or older were followed up after discharge from an emergency department between 01-02-95 and 01-04-95. The study protocol included sociodemografics, clinicals, functionals and mentalsoutcomes. We studied the incidence of functional decline in basic activities of daily living, with Barthel Index, and association with the risk of readmission. The sample was composed by 125 elders (mean aged 81.9 +/- 4.6 years and 60.8% were women). The incidence of functional decline in basic activities of daily living at the visit to emergency department was 20.8% and one moth after discharge was 18.4%. Both activities with more functional impairment were bathing, dressing and movility activities. Functional decline was associated with the risk of readmission at emergency department (Odds Ratio = 4.1 [1.4-11.8]) 20% of patients who are discharged of emergency department present a new functional impairment in basics activities of daily living. Functional decline is associated with the risk of readmission one moth after discharged.

  15. 42 CFR 415.170 - Conditions for payment on a fee schedule basis for physician services in a teaching setting.

    Science.gov (United States)

    2010-10-01

    ... physician services in a teaching setting. 415.170 Section 415.170 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.170 Conditions for payment on a fee schedule basis...

  16. Developing a business-practice model for pharmacy services in ambulatory settings.

    Science.gov (United States)

    Harris, Ila M; Baker, Ed; Berry, Tricia M; Halloran, Mary Ann; Lindauer, Kathleen; Ragucci, Kelly R; McGivney, Melissa Somma; Taylor, A Thomas; Haines, Stuart T

    2008-02-01

    A business-practice model is a guide, or toolkit, to assist managers and clinical pharmacy practitioners in the exploration, proposal, development and implementation of new clinical pharmacy services and/or the enhancement of existing services. This document was developed by the American College of Clinical Pharmacy Task Force on Ambulatory Practice to assist clinical pharmacy practitioners and administrators in the development of business-practice models for new and existing clinical pharmacy services in ambulatory settings. This document provides detailed instructions, examples, and resources on conducting a market assessment and a needs assessment, types of clinical services, operations, legal and regulatory issues, marketing and promotion, service development and exit plan, evaluation of service outcomes, and financial considerations in the development of a clinical pharmacy service in the ambulatory environment. Available literature is summarized, and an appendix provides valuable citations and resources. As ambulatory care practices continue to evolve, there will be increased knowledge of how to initiate and expand the services. This document is intended to serve as an essential resource to assist in the growth and development of clinical pharmacy services in the ambulatory environment.

  17. The Development of the Academic Administration Model of Basic Primary Educational Institutions under the Office of Sakon Nakhon Educational Service Area Office 3

    Directory of Open Access Journals (Sweden)

    Kamonlrat Kaenchan

    2017-09-01

    Full Text Available The research aimed to 1 examine the current conditions, problems and academic administration of basic education schools under the office of Sakon Nakhon educational service area office 3, 2 develop the academic administration model of basic educational schools under the office of Sakon Nakhon educational service area office 3. The study was divided into 2 phases. Phase 1: Study the researches and literatures concerning the framework, the current conditions and the problems of academic administration to gain the concept for constructing a set of questionnaire. The questionnaire was then used to collect data from 50 administrators, 83 heads of academic sections and 198 heads of learning areas ; and interviewed the administrators of 5 schools that ranked top-five of the national education test scores (O-NET and were certified by the office of educational standard assurance and quality assessment in the third-round inspection. Phase 2: Construct the model of educational administration of basic education schools under the office of Sakon Nakhon educational service area office 3, held a focus group discussion of which the participants were 2 educational administrators and 5 school directors on the constructed model, evaluated the educational administration models of the schools under the office of Sakon Nakhon educational service area office 3 by 30 school administrators and teachers. The instruments used to collect data were a set of questionnaire, interviewing forms, recording forms and evaluating forms. The data were analyzed by a computer application. The statistics used to analyze the data were percentage, mean and standard deviation. The results were as follows: 1 The current conditions of academic administration of basic education schools under the office of Sakon Nakhon educational service area office 3, overall, were at a high level. The highest mean was the development of the learning process. The problems of academic administration, overall

  18. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Directory of Open Access Journals (Sweden)

    Lene Bjørn Jensen

    2018-05-01

    Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  19. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Science.gov (United States)

    Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

    2018-05-07

    The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  20. TimeSet: A computer program that accesses five atomic time services on two continents

    Science.gov (United States)

    Petrakis, P. L.

    1993-01-01

    TimeSet is a shareware program for accessing digital time services by telephone. At its initial release, it was capable of capturing time signals only from the U.S. Naval Observatory to set a computer's clock. Later the ability to synchronize with the National Institute of Standards and Technology was added. Now, in Version 7.10, TimeSet is able to access three additional telephone time services in Europe - in Sweden, Austria, and Italy - making a total of five official services addressable by the program. A companion program, TimeGen, allows yet another source of telephone time data strings for callers equipped with TimeSet version 7.10. TimeGen synthesizes UTC time data strings in the Naval Observatory's format from an accurately set and maintained DOS computer clock, and transmits them to callers. This allows an unlimited number of 'freelance' time generating stations to be created. Timesetting from TimeGen is made feasible by the advent of Becker's RighTime, a shareware program that learns the drift characteristics of a computer's clock and continuously applies a correction to keep it accurate, and also brings .01 second resolution to the DOS clock. With clock regulation by RighTime and periodic update calls by the TimeGen station to an official time source via TimeSet, TimeGen offers the same degree of accuracy within the resolution of the computer clock as any official atomic time source.

  1. On the new situation to descend a basic level technology library information service work

    International Nuclear Information System (INIS)

    Sun Haiyan

    2010-01-01

    With information technology fast developing. library can give readers modernization service. The results of information technology revolution can be used in library. Information materials can be supplied by acoustic image and researching in internet. In this document, we analysis the characteristics, present situations and developments of grass-roots libraries. Discuss the questions in grass-roots science-technology library in nuclear industry, improving the grass-roots equipments, developing various data library, and how to improve the quality of information service in grass-roots library. (author)

  2. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

    Science.gov (United States)

    Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

    2012-01-01

    Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

  3. Service user involvement in mental health system strengthening in a rural African setting: qualitative study.

    Science.gov (United States)

    Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

    2017-05-18

    It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered

  4. Basic Skills in the Hotel & Food Service Industries. Workforce & Workplace Literacy Series. Revised.

    Science.gov (United States)

    BCEL Brief, 1993

    1993-01-01

    This report contains a list of 21 contacts and 9 references concerned with workplace literacy programs in the hotel and food service industries. Each listing includes addresses and telephone numbers, prices if applicable, and a brief description of the resource or materials. The materials listed are mostly reports of workplace literacy projects in…

  5. Explaining Public Service Motivation : The Role of Leadership and Basic Needs Satisfaction

    NARCIS (Netherlands)

    Vandenabeele, Wouter

    2014-01-01

    Both leadership and public service motivation (PSM) are important issues in contemporary public administration. By connecting these issues, the aim of this article is to assess the impact of one particular type of transformational leadership behavior-promoting public values-on PSM development. Two

  6. Utilization of basic directives radioprotection norm in industrial radiography services CNEN-3.01

    International Nuclear Information System (INIS)

    Dagnino, R.

    1989-01-01

    The characteristics of the introduction of the standart CNEN - 3.01 - Diretrizes Basicas de Radioprotecao in industrial radiography field, mainly referred to service companies are presented. Some suggestions are proposed in order that the accomplishment of these principles does not stop the works which use this inspection technique. (author)

  7. Career Pathways for Related Service Paratherapists Working in Early Intervention and Other Education Settings.

    Science.gov (United States)

    Longhurst, Thomas M.

    1997-01-01

    Discusses issues in personnel training practices for paraprofessionals providing related services in early intervention and education settings. The term paratherapist is used to refer to paraprofessionals working under the supervision of professionals in physical therapy, occupational therapy, and speech-language pathology. Presents a philosophy…

  8. Choice architecture as a means to change eating behaviour in self-service settings

    DEFF Research Database (Denmark)

    Skov, Laurits Rohden; Lourenco, Sofia; Laub Hansen, Gitte

    2013-01-01

    Summary: The primary objective of this review was to investigate the current evidence-base for the use of choice architecture as a means to change eating behaviour in self-service eating settings, hence potentially reduce calorie intake. 12 databases were searched systematically for experimental ...

  9. Using Multiattribute Utility Theory as a Priority-Setting Tool in Human Services Planning.

    Science.gov (United States)

    Camasso, Michael J.; Dick, Janet

    1993-01-01

    The feasibility of applying multiattribute utility theory to the needs assessment and priority-setting activities of human services planning councils was studied in Essex County (New Jersey). Decision-making and information filtering processes are explored in the context of community planning. (SLD)

  10. Level of health care and services in a tertiary health setting in Nigeria

    African Journals Online (AJOL)

    Level of health care and services in a tertiary health setting in Nigeria. ... Background: There is a growing awareness and demand for quality health care across the world; hence the ... Doctors and nurses formed 64.3% of the study population.

  11. The Treatment of Sexual Dysfunction in a University Health Service Setting

    Science.gov (United States)

    Babineau, Raymond; Schwartz, Allan J.

    1977-01-01

    Experience of the authors indicates that solo therapists with adequate background in individual and couple therapy, who also have additional training/experience in sex therapy, can provide treatment for sexual dysfunction to student couples in a health service setting with encouraging results. (MB)

  12. Greek In-Service and Preservice Teachers' Views about Bullying in Early Childhood Settings

    Science.gov (United States)

    Psalti, Anastasia

    2017-01-01

    Despite the plethora of studies regarding bullying worldwide, there are limited studies at the early childhood level. This article presents the results of a pilot study aiming at exploring preservice and in-service early childhood teachers' views on bullying in Greek early childhood settings. A total of 192 early childhood teachers completed a…

  13. Individual Education Plan Goals and Services for Adolescents with Autism: Impact of Age and Educational Setting

    Science.gov (United States)

    Kurth, Jennifer; Mastergeorge, Ann M.

    2010-01-01

    The purpose of this study is to describe the educational programs for adolescents with autism (age 12-16 years) in inclusion and noninclusion settings as reflected in their Individual Education Plan (IEP) goals, services, and curricular adaptations. Students who were included in general education math and language arts instruction had fewer…

  14. Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting.

    Science.gov (United States)

    Cooper, Angela; Abbass, Allan; Town, Joel

    2017-11-29

    Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP) with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 ( d = 0.4). A statistically significant (23%) decrease in family physicians' visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a 'Primary Care Psychological Consultation and Treatment Service'.

  15. Splitting Computation of Answer Set Program and Its Application on E-service

    Directory of Open Access Journals (Sweden)

    Bo Yang

    2011-10-01

    Full Text Available As a primary means for representing and reasoning about knowledge, Answer Set Programming (ASP has been applying in many areas such as planning, decision making, fault diagnosing and increasingly prevalent e-service. Based on the stable model semantics of logic programming, ASP can be used to solve various combinatorial search problems by finding the answer sets of logic programs which declaratively describe the problems. Itrs not an easy task to compute answer sets of a logic program using Gelfond and Lifschitzrs definition directly. In this paper, we show some results on characterization of answer sets of a logic program with constraints, and propose a way to split a program into several non-intersecting parts step by step, thus the computation of answer sets for every subprogram becomes relatively easy. To instantiate our splitting computation theory, an example about personalized product configuration in e-retailing is given to show the effectiveness of our method.

  16. An efficiency analysis of basic service provision in South African local government (2006/7 to 2008/9

    Directory of Open Access Journals (Sweden)

    Gert van der Westhuizen

    2012-12-01

    Full Text Available The South African local government sector has undergone changes in the post-apartheid era as policy makers have sought to improve basic services provided to disadvantaged local communities. While scholars have considered various dimensions of the reform program, little effort has been directed at evaluating the effectiveness and efficiency dimensions of the changes in service provision, with some notable exceptions (van der Westhuizen and Dollery, 2009; Krugell, et al., 2010. This article seeks to contribute to this literature by evaluating the efficiency with which municipalities have provided (Reconstruction and Development Program RDP water, RDP sanitation RDP electricity and RDP refuse removal, using Data Envelopment Analysis techniques (DEA applied to panel data from 2006/2007 to 2008/2009 for 231 local municipalities and 46 district municipalities. Keywords: Data warehousing, Systems thinking, Prescriptive theory, Descriptive theory, Interpretative research. Disciplines: Information technology, systems theory, data warehousing, hermeneutics

  17. Basic principles and guidelines governing services of the police for the protection of nuclear installations

    International Nuclear Information System (INIS)

    Schulte, R.; Kern, R.

    1989-01-01

    Services of the police can be ordered for physical protection of nuclear installations of any kind and of nuclear materials transports in cases where there is danger that those first responsible cannot cope with the situation. The contribution discusses physical protection measures as a licensing requirement, the duties of the police forces within the given scope, the measures that can and may be taken by the police, the establishment of special commissions, as well as the particular provisions for nuclear materials transports. The provisions governing police services for physical protection have led to an efficient and well furnished system in terms of organisation, personnel, and materials, which guarantees protection to a great extent. (orig./HSCH) [de

  18. Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review

    Science.gov (United States)

    Ehiri, John E.; Gunn, Jayleen K.L.; Center, Katherine E.; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E.

    2014-01-01

    Background Training of lay refugees/internally displaced persons (IDPs) and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. Objectives To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Methods PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014) with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Results Ten studies (five cross-sectional, four pre-post, and one post-test only) conducted in Africa (Guinea and Tanzania), Central America (Belize), and Asia (Myanmar) were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Conclusion Although available evidence

  19. Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review

    Directory of Open Access Journals (Sweden)

    John E. Ehiri

    2014-10-01

    Full Text Available Background: Training of lay refugees/internally displaced persons (IDPs and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. Objectives: To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Methods: PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014 with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Results: Ten studies (five cross-sectional, four pre-post, and one post-test only conducted in Africa (Guinea and Tanzania, Central America (Belize, and Asia (Myanmar were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Conclusion: Although

  20. Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review.

    Science.gov (United States)

    Ehiri, John E; Gunn, Jayleen K L; Center, Katherine E; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E

    2014-01-01

    Training of lay refugees/internally displaced persons (IDPs) and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014) with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Ten studies (five cross-sectional, four pre-post, and one post-test only) conducted in Africa (Guinea and Tanzania), Central America (Belize), and Asia (Myanmar) were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Although available evidence suggests a positive impact of training and deployment

  1. High risk pregnancy referrals adequacy in the Basic Health Services of Sobral, Ceará, Brazil

    Directory of Open Access Journals (Sweden)

    José Juvenal Linhares

    2009-03-01

    Full Text Available Objective: To describe the appropriateness of referrals of high-risk pregnancies in the basic healthcare network of Sobral, in Ceará, Brazil. Methods: A descriptive quantitative study. The medical files of 173 pregnant patients referred to the high-risk outpatient clinic of Centro de Especialidades Médicas of Sobral, during the period from July 2006 to April 2007, were analyzed. Variables analyzed were correctness of the referrals, professionals who made them, causes and origins of the referrals, and age bracket of the patients referred. The referrals were divided into “appropriate” and “inappropriate”, according to the classification of risk established by the technical manual of the Ministry of Health. Rresults: Of the 173 cases, 102 (59% were considered appropriate/correct, and 71 (41% referrals were considered inappropriate/incorrect. The referrals were divided according to the professional class of the referring individuals: physicians or nurses. Of the 173 referrals, 49 (28.3% were made by physicians, and 124 (71.7% by nurses. Of the 49 patients referred by physicians, 39 (79.6% were considered correct. Of the 124 referrals made by nurses, 63 (50.8% were considered incorrect, revealing a significant difference between the groups (p < 0.00001. The most common causes of referrals of pregnant patients were hypertensive syndromes (23.6%, physiological modifications of pregnancy (22.6%, prolonged pregnancy (15.1%, and diabetes (12.3%. Cconclusions: There was a low rate of appropriate/correct referrals. There is a need for training in the basic healthcare network for quality prenatal care, with special emphasis on referring nurses.

  2. The Analysis of Basic Public Service Supply Regional Equalization in China’s Provinces——Based on the Theil Index Evaluation

    Science.gov (United States)

    Liao, Zangyi

    2017-12-01

    Accomplishing the regional equalization of basic public service supply among the provinces in China is an important objective that can promote the people’s livelihood construction. In order to measure the problem which is about the non-equalization of basic public service supply, this paper takes these aspects as the first index, such as the infrastructure construction, basic education services, public employment services, public health service and social security service. At the same time, it cooperates with 16 index as the second index to construct the performance evaluation systems, and then use the Theil index to evaluate the performance in provinces that using the panel data from the year 2000 to 2012.

  3. In-Service and Pre-Service Early Childhood Teachers' Views and Intentions about ICT Use in Early Childhood Settings: A Comparative Study

    Science.gov (United States)

    Gialamas, Vasilis; Nikolopoulou, Kleopatra

    2010-01-01

    This paper regards a comparative study which investigates in-service and pre-service Greek early childhood teachers' views and intentions about integrating and using computers in early childhood settings. Views and intentions were investigated via a questionnaire administered to 240 in-service and 428 pre-service early childhood teachers.…

  4. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

    Science.gov (United States)

    Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

    2014-08-01

    Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

  5. Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting

    Directory of Open Access Journals (Sweden)

    Angela Cooper

    2017-11-01

    Full Text Available Medically unexplained symptoms (MUS are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 (d = 0.4. A statistically significant (23% decrease in family physicians’ visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a ‘Primary Care Psychological Consultation and Treatment Service’.

  6. Problems and Guidelines of Strategy Implementation in Basic Educational Institutions under the Supervision of KhonKaen Primary Educational Service Area Office 4

    Directory of Open Access Journals (Sweden)

    Sasiwan Tonkanya

    2016-09-01

    Full Text Available The research aimed to 1 study problems of strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4 ; and 2 propose the guidelines for strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4. The study was carried out in 2 phases. In phase 1, it focused on the study and analysis of the strategic implementation problems and phase 2 studied the best practice schools. The informants for the interview in phase 1 comprised 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools. They were selected by the use of purposive sampling technique. The population in the study of the strategic implementation problems in basic educational institutions in phase 1 consisted of 543 school administrators and teachers who were involved in strategy implementation from 181 schools under Khonkaen Primary Educational Service Area Office 4 in academic year 2014. The study samples were 217 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools under Khonkaen Primary Educational Service Area Office 4. The samples were selected by the use of stratified sampling technique. The informants of the phase 2 study were 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized best practice schools obtained from purposive sampling technique. The research instruments used for data collection consisted of 2 sets of questionnaires. The Set 1 questionnaire was the 5-point Likert scale on the levels of the problems in implementation with item discrimination at 0.60 – 1.00 and reliability of the whole questionnaire at .9359. The questionnaire contained 3 parts with 65 items. The Set 2 questionnaire comprised 2 parts with 10 items regarding

  7. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  8. The effects of China's urban basic medical insurance schemes on the equity of health service utilisation: evidence from Shaanxi Province.

    Science.gov (United States)

    Zhou, Zhongliang; Zhu, Liang; Zhou, Zhiying; Li, Zhengya; Gao, Jianmin; Chen, Gang

    2014-03-09

    In order to alleviate the problem of "Kan Bing Nan, Kan Bing Gui" (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China. Using the data from the fourth National Health Services Survey in Shaanxi Province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents. For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively. The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation.

  9. New and Improved GLDAS Data Sets and Data Services at NASA GES DISC

    Science.gov (United States)

    Rui, Hualan; Beaudoing, Hiroko; Teng, William; Vollmer, Bruce; Rodell, Matthew; Lei, Guang-Dih

    2012-01-01

    The goal of a Land Data Assimilation System (LDAS) is to ingest satellite- and ground-based observational data products, using advanced land surface modeling and data assimilation techniques, in order to generate optimal fields of land surface states and fluxes data and, thereby, facilitate hydrology and climate modeling, research, and forecast. With the motivation of creating more climatologically consistent data sets, NASA GSFC's Hydrological Sciences Laboratory has generated more than 60 years (Jan. 1948-- Dec. 2008) of Global LDAS Version 2 (GLDAS-2) data, by using the Princeton Forcing Data Set and upgraded versions of Land Surface Models (LSMs). GLDAS data and data services are provided at NASA GES DISC Hydrology Data and Information Services Center (HDISC), in collaboration with HSL and LDAS.

  10. User library service expectations in health science vs. other settings: a LibQUAL+ Study.

    Science.gov (United States)

    Thompson, Bruce; Kyrillidou, Martha; Cook, Colleen

    2007-12-01

    To explore how the library service expectations and perceptions of users might differ across health-related libraries as against major research libraries not operating in a medical context; to determine whether users of medical libraries demand better library service quality, because the inability of users to access needed literature promptly may lead to a patient who cannot be properly diagnosed, or a diagnosis that cannot be properly treated. We compared LibQUAL+ total and subscale scores across three groups of US, Canadian and British libraries for this purpose. Anticipated differences in expectations for health as other library settings did not emerge. The expectations and perceptions are similar across different types of health science library settings, hospital and academic, and across other general research libraries.

  11. An update: choice architecture as a means to change eating behaviour in self-service settings

    DEFF Research Database (Denmark)

    Skov, Laurits Rohden; Perez-Cueto, Armando

    2014-01-01

    Objective: The primary objective of this review was to update the current evidence-base for the use of choice architecture as a means to change eating behaviour in self-service eating settings, hence potentially reducing energy intake. Methodology: 12 databases were searched systematically for ex...... in the topic of choice architecture and nudging has increased the scientific output since the last review. There is a clear limitation in the lack of a clear definitions and theoretical foundation....

  12. Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

    Science.gov (United States)

    Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

    2008-01-01

    The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

  13. [Health and social inequality in Europe: changes of the basic conditions for municipal health services].

    Science.gov (United States)

    Huster, E U

    1998-11-01

    Good health is not distributed equally, neither in life conditions--including the individual ability to act--nor according to the supply grid. These interrelations, shown in several empirical investigations, assume more importance in view of the groving tendency to social polarisation in the countries of Europe, different in fact in the single countries, but clear in respect of tendency: social exclusion does not only mean to have less financial resources but also social disadvantages in other realms of living, especially in health. Migration, not only from East to West, but also inside and between the countries of the European Union and inside of Eastern Europe too, is only an especially dear expression that social problems have their origin in international problems and casualities, but become visible in local and regional structures and thus in the responsibility of the municipalities. Globalisation, Europe etc., terms mostly connected with positive connotations, have not only a positive side, but also another one, namely, the re-regionalisation of social problems especially in the municipalities. Normally the municipalities have to counterbalance and to regulate the negative consequences of these European--and moreover international--changes of the structures, although their financial means are declining. The municipal health service is integrated in this contradictory constellation. To prevent irrational social and/or political developments, the reasons and possible strategies of reform policy will have to be discussed carefully.

  14. Version 1.1 of the international spinal cord injury skin and thermoregulation function basic data set

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Alexander, M S; van Asbeck, F W A

    2017-01-01

    ' or 'stages' with 'categories'; therefore, the word 'category' is used instead of 'grade' or 'stage'. CONCLUSIONS: Impracticable measurements have been adjusted and new terminology adopted. All are to be found on ISCoS website: http://www.iscos.org.uk/international-sci-skin-and-thermoregulation-function-data-sets....

  15. Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

    Science.gov (United States)

    Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

    2015-02-01

    Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting.

    Science.gov (United States)

    Agu, Kenneth Anene; Oqua, Dorothy; Agada, Peter; Ohiaeri, Samuel I; Adesina, Afusat; Abdulkareem, Mohammed Habeeb; King, Rosalyn C; Wutoh, Anthony K

    2014-06-01

    The patient's perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Seventeen HIV treatment centres in Nigeria. This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Patient satisfaction with pharmaceutical services. Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26-40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3-26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists' efforts to solve patients' medication related problems was negative. The participants' rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with

  17. Urban settings do not ensure access to services: findings from the immunisation programme in Kampala Uganda.

    Science.gov (United States)

    Babirye, Juliet N; Engebretsen, Ingunn M S; Rutebemberwa, Elizeus; Kiguli, Juliet; Nuwaha, Fred

    2014-03-06

    Previous studies on vaccination coverage in developing countries focus on individual- and community-level barriers to routine vaccination mostly in rural settings. This paper examines health system barriers to childhood immunisation in urban Kampala Uganda. Mixed methods were employed with a survey among child caretakers, 9 focus group discussions (FGDs), and 9 key informant interviews (KIIs). Survey data underwent descriptive statistical analysis. Latent content analysis was used for qualitative data. Of the 821 respondents in the survey, 96% (785/821) were mothers with a mean age of 26 years (95% CI 24-27). Poor geographical access to immunisation facilities was reported in this urban setting by FGDs, KIIs and survey respondents (24%, 95% CI 21-27). This coupled with reports of few health workers providing immunisation services led to long queues and long waiting times at facilities. Consumers reported waiting for 3-6 hours before receipt of services although this was more common at public facilities. Only 33% (95% CI 30-37) of survey respondents were willing to wait for three or more hours before receipt of services. Although private-for-profit facilities were engaged in immunisation service provision their participation was low as only 30% (95% CI 27-34) of the survey respondents utilised these facilities. The low participation could be due to lack of financial support for immunisation activities at these facilities. This in turn could explain the rampant informal charges for services in this setting. Charges ranged from US$ 0.2 to US$4 and these were more commonly reported at private (70%, 95% CI 65-76) than at public (58%, 95% CI 54-63) facilities. There were intermittent availability of vaccines and transport for immunisation services at both private and public facilities. Complex health system barriers to childhood immunisation still exist in this urban setting; emphasizing that even in urban areas with great physical access, there are hard to reach people

  18. Prospects for the sustainability of delivering the Basic Package of Health Services in Afghanistan: a stakeholder analysis.

    Science.gov (United States)

    Haidari, A M; Zaidi, S; Gul, R

    2014-06-09

    This study explored the readiness of stakeholders in Afghanistan for sustaining delivery of the Basic Package of Health Services (BPHS) without external technical and financial assistance. A stakeholder analysis was applied using qualitative methods. Fifteen stakeholders were purposively drawn from the Afghanistan ministries of public health and finance, political representatives, development partners, nonprofit organizations and public health experts. Data were collected through in-depth interviews with the stakeholders and desk review of pertinent documents. We found that sustainability of the BPHS in Afghanistan is questionable as stakeholders are suboptimally organized to come up with effective alternatives. Uneven ownership and divisive positioning are bottlenecks to the evolution of a realistic continuation plan. Those with the most significant influence are lukewarm, while those who are most supportive have the least influence. Sustainability needs to be tackled at the start in designing the BPHS rather than in the wake of eventual donor withdrawal.

  19. Developing a service improvement initiative for people with learning disabilities in hospice settings.

    Science.gov (United States)

    Springall, Fiona

    2018-03-21

    People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  20. Basic investigation of the laminated alginate impression technique: Setting time, permanent deformation, elastic deformation, consistency, and tensile bond strength tests.

    Science.gov (United States)

    Kitamura, Aya; Kawai, Yasuhiko

    2015-01-01

    Laminated alginate impression for edentulous is simple and time efficient compared to border molding technique. The purpose of this study was to examine clinical applicability of the laminated alginate impression, by measuring the effects of different Water/Powder (W/P) and mixing methods, and different bonding methods in the secondary impression of alginate impression. Three W/P: manufacturer-designated mixing water amount (standard), 1.5-fold (1.5×) and 1.75-fold (1.75×) water amount were mixed by manual and automatic mixing methods. Initial and complete setting time, permanent and elastic deformation, and consistency of the secondary impression were investigated (n=10). Additionally, tensile bond strength between the primary and secondary impression were measured in the following surface treatment; air blow only (A), surface baking (B), and alginate impression material bonding agent (ALGI-BOND: AB) (n=12). Initial setting times significantly shortened with automatic mixing for all W/P (p<0.05). The permanent deformation decreased and elastic deformation increased as high W/P, regardless of the mixing method. Elastic deformation significantly reduced in 1.5× and 1.75× with automatic mixing (p<0.05). All of these properties resulted within JIS standards. For all W/P, AB showed a significantly high bonding strength as compared to A and B (p<0.01). The increase of mixing water, 1.5× and 1.75×, resulted within JIS standards in setting time, suggesting its applicability in clinical setting. The use of automatic mixing device decreased elastic strain and shortening of the curing time. For the secondary impression application of adhesives on the primary impression gives secure adhesion. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  1. Individual psychological therapy in an acute inpatient setting: Service user and psychologist perspectives.

    Science.gov (United States)

    Small, Catherine; Pistrang, Nancy; Huddy, Vyv; Williams, Claire

    2018-01-18

    The acute inpatient setting poses potential challenges to delivering one-to-one psychological therapy; however, there is little research on the experiences of both receiving and delivering therapies in this environment. This qualitative study aimed to explore service users' and psychologists' experiences of undertaking individual therapy in acute inpatient units. It focused on the relationship between service users and psychologists, what service users found helpful or unhelpful, and how psychologists attempted to overcome any challenges in delivering therapy. The study used a qualitative, interview-based design. Eight service users and the six psychologists they worked with were recruited from four acute inpatient wards. They participated in individual semi-structured interviews eliciting their perspectives on the therapy. Service users' and psychologists' transcripts were analysed together using Braun and Clarke's (2006, Qualitative Research in Psychology, 3, 77) method of thematic analysis. The accounts highlighted the importance of forming a 'human' relationship - particularly within the context of the inpatient environment - as a basis for therapeutic work. Psychological therapy provided valued opportunities for meaning-making. To overcome the challenges of acute mental health crisis and environmental constraints, psychologists needed to work flexibly and creatively; the therapeutic work also extended to the wider context of the inpatient unit, in efforts to promote a shared understanding of service users' difficulties. Therapeutic relationships between service users and clinicians need to be promoted more broadly within acute inpatient care. Psychological formulation can help both service users and ward staff in understanding crisis and working collaboratively. Practice-based evidence is needed to demonstrate the effectiveness of adapted psychological therapy models. Developing 'human' relationships at all levels of acute inpatient care continues to be an

  2. Justifying a Set of Basic Characteristics of High Temperature Cold Accumulators in Their Designing for the Ground-Based Systems

    Directory of Open Access Journals (Sweden)

    E. S. Khromov

    2015-01-01

    Full Text Available The ground-based systems use a wide variety of heat-emitting equipment. For temperature control of equipment and facilities, the thermal management systems (TMS are included in the ground-based systems. However, in operation, the off-nominal situations with increased heat emission are possible. To avoid overheating of equipment or environment in facilities, where equipment is placed, is possible through completing a set of TMS by high-temperature cold accumulators (CA.When filling CA by thermal accumulating materials (TAM with change in phase at the temperature level exceeding the ambient temperature, CA integration in TMS is simplified and the need to increase the cooling capacity of the sources of its cold is eliminated. Among the known multiple-cycle TAMs with change in phase "melting-solidification" in a set of characteristics, the most promising are crystal hydrates of salts and their systems, as well as paraffin, especially clean. However, advantages and disadvantages of these classes of TAM are different and disable us to develop a generic version of the CA design.The objective of this work is to identify a set of the main characteristics that significantly affect the CA efficiency. To achieve the goal is used a mathematical simulation of heat exchange and phase change processes, using CA with intermediate coolant as an example. Simulation is based on generation and solution of the system of equations of a thermal balance for the coolant circulating through the inner tube of CA container. The system of equations is solved using Excel tools.Varying values of studied characteristics and generalization of results allowed to us define a following set: TAM thermal conductivity, temperature difference in the coolant – TAM system, TAM container dimensions. The results can be applied when developing a CA, as a part of the "TMS-CA heat generation facility" of the ground-based systems with a specified heat absorption capacity at given temperature

  3. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar

    Directory of Open Access Journals (Sweden)

    Sharon Low

    2014-09-01

    Full Text Available Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH reach the vulnerable population in the ethnic health organizations’ (EHOs and community-based organizations’ (CBHOs service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in

  4. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar.

    Science.gov (United States)

    Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin

    2014-01-01

    Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations' (EHOs) and community-based organizations' (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Despite the chronic conflict in Burma/Myanmar, this report provides evidence of the substantive

  5. A cost and technical efficiency analysis of two alternative models for implementing the basic package of health services in Afghanistan.

    Science.gov (United States)

    Blaakman, Aaron Philip; Salehi, Ahmad Shah; Boitard, Romain

    2014-01-01

    Since 2003, the Afghan Ministry of Public Health (MoPH) and international partners have directed a contracting-out model through which non-governmental organisations (NGOs) deliver the Basic Package of Health Services (BPHS) in 31 of the 34 Afghan provinces. The MoPH also managed health service delivery in three provinces under an alternative initiative entitled Strengthening Mechanisms (SM). In 2011, under the authority of the MoPH and Delegation of the European Union to Afghanistan, EPOS Health Management conducted a cost and technical efficiency study of the contracting-out and SM mechanisms in six provinces to examine economic trade-offs in the provision of the BPHS. The study provides analyses of all resource inputs and primary outputs of the BPHS in the six provinces during 2008 and 2009. The authors examined technical efficiency using Data Envelopment Analysis (DEA) at the BPHS facility level. Cost analysis results indicate that the weighted average cost per BPHS outpatient visit totalled $3.41 in the SM provinces and $5.39 in the NGO-led provinces in 2009. Furthermore, the data envelopment analyses (DEAs) indicate that facilities in the three NGO-led provinces scored 0.168 points higher on the DEA scale (0-1) than SM facilities. The authors conclude that an approximate 60% increase in costs yielded a 16.8% increase in technical efficiency in the delivery of the BPHS during 2009 in the six provinces.

  6. The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

    Science.gov (United States)

    Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

    2014-07-01

    The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

  7. Linking public health nursing competencies and service-learning in a global setting.

    Science.gov (United States)

    Brown, Cynthia L

    2017-09-01

    Nurse educators in baccalaureate programs are charged with addressing student competence in public health nursing practice. These educators are also responsible for creating nursing student opportunities for civic engagement and development of critical thinking skills. The IOM report (2010) on the Future of Nursing emphasizes the nurse educator's role in promoting collaborative partnerships that incorporate interdisciplinary and intraprofessional efforts to promote health. The purpose of this article is to describe an innovative approach to address public health nursing competencies and to improve the health and well-being of indigenous populations in a global setting through promotion of collaboration and service- learning principles. As part of a hybrid elective course, baccalaureate nursing students from various nursing tracks participated in a 2 week immersion experience in Belize that included preimmersion preparation. These students were to collaborate among themselves and with Belizean communities to address identified health knowledge deficits and health-related needs for school-aged children and adult populations. Students successfully collaborated in order to meet health-related needs and to engage in health promotion activities in the Toledo district of Belize. They also gained practice in developing public health nursing competencies for entry-level nursing practice. Implementation of service-learning principles provided students with opportunities for civic engagement and self-reflection. Some challenges existed from the students', faculty, and global community's perspectives. Lack of culturally appropriate and country specific health education materials was difficult for students and the community. Faculty encountered challenges in communicating and collaborating with the Belizean partners. Commonalities exist between entry-level public health nursing competencies and service-learning principles. Using service-learning principles in the development of

  8. A managed clinical network for cardiac services: set-up, operation and impact on patient care

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton

    2005-09-01

    Full Text Available Purpose: To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. Methods: This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Results: Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and ‘bed down’. Its primary “modus operand” was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were

  9. A managed clinical network for cardiac services: set-up, operation and impact on patient care.

    Science.gov (United States)

    Stc Hamilton, Karen E; Sullivan, Frank M; Donnan, Peter T; Taylor, Rex; Ikenwilo, Divine; Scott, Anthony; Baker, Chris; Wyke, Sally

    2005-01-01

    To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and 'bed down'. Its primary "modus operand" was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were not statistically significant. There was no difference

  10. Cost accounting models used for price-setting of health services: an international review.

    Science.gov (United States)

    Raulinajtys-Grzybek, Monika

    2014-12-01

    The aim of the article was to present and compare cost accounting models which are used in the area of healthcare for pricing purposes in different countries. Cost information generated by hospitals is further used by regulatory bodies for setting or updating prices of public health services. The article presents a set of examples from different countries of the European Union, Australia and the United States and concentrates on DRG-based payment systems as they primarily use cost information for pricing. Differences between countries concern the methodology used, as well as the data collection process and the scope of the regulations on cost accounting. The article indicates that the accuracy of the calculation is only one of the factors that determine the choice of the cost accounting methodology. Important aspects are also the selection of the reference hospitals, precise and detailed regulations and the existence of complex healthcare information systems in hospitals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Insurer views on reimbursement of preventive services in the dental setting: results from a qualitative study.

    Science.gov (United States)

    Feinstein-Winitzer, Rebecca T; Pollack, Harold A; Parish, Carrigan L; Pereyra, Margaret R; Abel, Stephen N; Metsch, Lisa R

    2014-05-01

    We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.

  12. A REST Service for Triangulation of Point Sets Using Oriented Matroids

    Directory of Open Access Journals (Sweden)

    José Antonio Valero Medina

    2014-05-01

    Full Text Available This paper describes the implementation of a prototype REST service for triangulation of point sets collected by mobile GPS receivers. The first objective of this paper is to test functionalities of an application, which exploits mobile devices’ capabilities to get data associated with their spatial location. A triangulation of a set of points provides a mechanism through which it is possible to produce an accurate representation of spatial data. Such triangulation may be used for representing surfaces by Triangulated Irregular Networks (TINs, and for decomposing complex two-dimensional spatial objects into simpler geometries. The second objective of this paper is to promote the use of oriented matroids for finding alternative solutions to spatial data processing and analysis tasks. This study focused on the particular case of the calculation of triangulations based on oriented matroids. The prototype described in this paper used a wrapper to integrate and expose several tools previously implemented in C++.

  13. The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

    Science.gov (United States)

    Allott, Kelly; Lloyd, Susan

    2009-07-01

    Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

  14. Assessing the potential impacts of a revised set of on-farm nutrient and sediment 'basic' control measures for reducing agricultural diffuse pollution across England.

    Science.gov (United States)

    Collins, A L; Newell Price, J P; Zhang, Y; Gooday, R; Naden, P S; Skirvin, D

    2018-04-15

    The need for improved abatement of agricultural diffuse water pollution represents cause for concern throughout the world. A critical aspect in the design of on-farm intervention programmes concerns the potential technical cost-effectiveness of packages of control measures. The European Union (EU) Water Framework Directive (WFD) calls for Programmes of Measures (PoMs) to protect freshwater environments and these comprise 'basic' (mandatory) and 'supplementary' (incentivised) options. Recent work has used measure review, elicitation of stakeholder attitudes and a process-based modelling framework to identify a new alternative set of 'basic' agricultural sector control measures for nutrient and sediment abatement across England. Following an initial scientific review of 708 measures, 90 were identified for further consideration at an industry workshop and 63 had industry support. Optimisation modelling was undertaken to identify a shortlist of measures using the Demonstration Test Catchments as sentinel agricultural landscapes. Optimisation selected 12 measures relevant to livestock or arable systems. Model simulations of 95% implementation of these 12 candidate 'basic' measures, in addition to business-as-usual, suggested reductions in the national agricultural nitrate load of 2.5%, whilst corresponding reductions in phosphorus and sediment were 11.9% and 5.6%, respectively. The total cost of applying the candidate 'basic' measures across the whole of England was estimated to be £450 million per annum, which is equivalent to £52 per hectare of agricultural land. This work contributed to a public consultation in 2016. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  15. A prospective randomized study to test the transfer of basic psychomotor skills from virtual reality to physical reality in a comparable training setting.

    Science.gov (United States)

    Lehmann, Kai S; Ritz, Joerg P; Maass, Heiko; Cakmak, Hueseyin K; Kuehnapfel, Uwe G; Germer, Christoph T; Bretthauer, Georg; Buhr, Heinz J

    2005-03-01

    To test whether basic skills acquired on a virtual endoscopic surgery simulator are transferable from virtual reality to physical reality in a comparable training setting. For surgical training in laparoscopic surgery, new training methods have to be developed that allow surgeons to first practice in a simulated setting before operating on real patients. A virtual endoscopic surgery trainer (VEST) has been developed within the framework of a joint project. Because of principal limitations of simulation techniques, it is essential to know whether training with this simulator is comparable to conventional training. Devices used were the VEST system and a conventional video trainer (CVT). Two basic training tasks were constructed identically (a) as virtual tasks and (b) as mechanical models for the CVT. Test persons were divided into 2 groups each consisting of 12 novices and 4 experts. Each group carried out a defined training program over the course of 4 consecutive days on the VEST or the CVT, respectively. To test the transfer of skills, the groups switched devices on the 5th day. The main parameter was task completion time. The novices in both groups showed similar learning curves. The mean task completion times decreased significantly over the 4 training days of the study. The task completion times for the control task on Day 5 were significantly lower than on Days 1 and 2. The experts' task completion times were much lower than those of the novices. This study showed that training with a computer simulator, just as with the CVT, resulted in a reproducible training effect. The control task showed that skills learned in virtual reality are transferable to the physical reality of a CVT. The fact that the experts showed little improvement demonstrates that the simulation trains surgeons in basic laparoscopic skills learned in years of practice.

  16. Disability, poverty, and role of the basic livelihood security system on health services utilization among the elderly in South Korea.

    Science.gov (United States)

    Jeon, Boyoung; Noguchi, Haruko; Kwon, Soonman; Ito, Tomoko; Tamiya, Nanako

    2017-04-01

    With rapid aging, many of the elderly suffer from poverty and high healthcare needs. In Korea, there is a means-tested and non-contributory public assistance, the National Basic Livelihood Security System (NBLSS). The purpose of this study is to show older population's condition of disability and poverty, to evaluate the impact of NBLSS on health services utilization, and to examine the differential effect of the NBLSS by disability status among the elderly. This study used the Korea Welfare Panel Study data 2005-2014 with the final sample of 40,365, who were 65 years and older. The participants were divided into people with mild disability, severe disability, and without disability according to the Korean disability registration system. The income-level was defined to the low-income with NBLSS, the low-income without NBLSS, and the middle and high income, using the relative poverty line as a proxy of the low-income. The dependent variables were the number of outpatient visits and inpatient days, experience of home care services, total healthcare expenditure, and financial burden of healthcare expenditure. We performed Generalized Estimating Equations population-averaged model using the ten years of panel data. The result showed that within the same disability status, the low-income without NBLSS group used the least amount of inpatient care, but their financial burden of health expenditure was the highest among the three income groups. The regression model showed that if the elderly with severe disability were in the low-income without NBLSS, they reduced the outpatient and inpatient days; but their financial burden of healthcare became intensified. This study shows that the low-income elderly with disability but without adequate social protection are the most disadvantaged group. Policy is called for to mitigate the difficulties of this vulnerable population. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Supporting UK adaptation: building services for the next set of UK climate projections

    Science.gov (United States)

    Fung, Fai; Lowe, Jason

    2016-04-01

    As part of the Climate Change Act 2008, the UK Government sets out a national adaptation programme to address the risks and opportunities identified in a national climate change risk assessment (CCRA) every five years. The last risk assessment in 2012 was based on the probabilistic projections for the UK published in 2009 (UKCP09). The second risk assessment will also use information from UKCP09 alongside other evidence on climate projections. However, developments in the science of climate projeciton, and evolving user needs (based partly on what has been learnt about the diverse user requirements of the UK adaptation community from the seven years of delivering and managing UKCP09 products, market research and the peer-reviewed literature) suggest now is an appropriate time to update the projections and how they are delivered. A new set of UK climate projections are now being produced to upgrade UKCP09 to reflect the latest developments in climate science, the first phase of which will be delivered in 2018 to support the third CCRA. A major component of the work is the building of a tailored service to support users of the new projections during their development and to involve users in key decisions so that the projections are of most use. We will set out the plan for the new climate projections that seek to address the evolving user need. We will also present a framework which aims to (i) facilitate the dialogue between users, boundary organisations and producers, reflecting their different decision-making roles (ii) produce scientifically robust, user-relevant climate information (iii) provide the building blocks for developing further climate services to support adaptation activities in the UK.

  18. A Power-Efficient Access Point Operation for Infrastructure Basic Service Set in IEEE 802.11 MAC Protocol

    Directory of Open Access Journals (Sweden)

    Hua Ye Ming

    2006-01-01

    Full Text Available Infrastructure-based wireless LAN technology has been widely used in today's personal communication environment. Power efficiency and battery management have been the center of attention in the design of handheld devices with wireless LAN capability. In this paper, a hybrid protocol named improved PCF operation is proposed, which intelligently chooses the access point- (AP- assisted DCF (distributed coordinator function and enhanced PCF (point coordinator function transmission mechanism of IEEE 802.11 protocol in an infrastructure-based wireless LAN environment. Received signal strength indicator (RSSI is used to determine the tradeoff between direct mobile-to-mobile transmission and transmission routed by AP. Based on the estimation, mobile stations can efficiently communicate directly instead of being routed through AP if they are in the vicinity of each other. Furthermore, a smart AP protocol is proposed as extension to the improved PCF operation by utilizing the historical end-to-end delay information to decide the waking up time of mobile stations. Simulation results show that using the proposed protocol, energy consumption of mobile devices can be reduced at the cost of slightly longer end-to-end packet delay compared to traditional IEEE 802.11 PCF protocol. However, in a non-time-critical environment, this option can significantly prolong the operation time of mobile devices.

  19. Evaluation of a Short Message Service diary methodology in a nonclinical, naturalistic setting.

    Science.gov (United States)

    Walsh, Erin I; Brinker, Jay K

    2012-11-01

    Particularly suited to repeated measures in naturalistic settings, Short Message Service (SMS) is garnering increasing attention as a viable method of data collection. The current study explored issues of practical importance for the development of this methodology, including factors impacting on attrition and compliance, and participant perception of SMS. Using a business-card-sized questionnaire key, 98 university students were sent prompt SMS messages nightly for a week. Completion and compliance were very high in all participants who responded to at least one prompt SMS; those who responded at least once (n=63) responded to 83 percent of all seven prompts, with 95 percent of responses containing appropriate alphanumeric answers to all questions. However, a time lag between recruitment and participation was associated with a failure to commence the diary study. Participants reported positive perceptions of SMS privacy and convenience.

  20. Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

    Science.gov (United States)

    Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

    2015-01-01

    We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.

  1. Chemometric evaluation of the combined effect of temperature, pressure, and co-solvent fractions on the chiral separation of basic pharmaceuticals using actual vs set operational conditions.

    Science.gov (United States)

    Forss, Erik; Haupt, Dan; Stålberg, Olle; Enmark, Martin; Samuelsson, Jörgen; Fornstedt, Torgny

    2017-05-26

    The need to determine the actual operational conditions, instead of merely using the set operational conditions, was investigated for in packed supercritical fluid chromatography (SFC) by design of experiments (DoE) using a most important type of compounds, pharmaceutical basics, as models. The actual values of temperature, pressure, and methanol levels were recorded and calculated from external sensors, while the responses in the DoE were the retention factors and selectivity. A Kromasil CelluCoat column was used as the stationary phase, carbon dioxide containing varying methanol contents as the mobile phase, and the six racemates of alprenolol, atenolol, metoprolol, propranolol, clenbuterol, and mianserin were selected as model solutes. For the retention modeling, the most important term was the methanol fraction followed by the temperature and pressure. Significant differences (p<0.05) between most of the coefficients in the retention models were observed when comparing models from set and actual conditions. The selectivity was much less affected by operational changes, and therefore was not severely affected by difference between set and actual conditions. The temperature differences were usually small, maximum ±1.4°C, whereas the pressure differences were larger, typically approximately +10.5bar. The set and actual fractions of methanol also differed, usually by ±0.4 percentage points. A cautious conclusion is that the primary reason for the discrepancy between the models is a mismatch between the set and actual methanol fractions. This mismatch is more serious in retention models at low methanol fractions. The study demonstrates that the actual conditions should almost always be preferred. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Physics Education: Effect of Micro-Teaching Method Supported by Educational Technologies on Pre-Service Science Teachers' Misconceptions on Basic Astronomy Subjects

    Science.gov (United States)

    Gurbuz, Fatih

    2016-01-01

    The purpose of this research study is to explore pre-service science teachers' misconceptions on basic astronomy subjects and to examine the effect of micro teaching method supported by educational technologies on correcting misconceptions. This study is an action research. Semi- structured interviews were used in the study as a data collection…

  3. A Pragmatic Guide to the Setting up of Integrated Hypnotherapy Services in Primary Care and Clinical Settings.

    Science.gov (United States)

    Entwistle, Paul Andrew

    2017-01-01

    Despite the continued debate and lack of a clear consensus about the true nature of the hypnotic phenomenon, hypnosis is increasingly being utilized successfully in many medical, health, and psychological spheres as a research method, motivational tool, and therapeutic modality. Significantly, however, although hypnotherapy is widely advertised, advocated, and employed in the private medical arena for the management and treatment of many physical and emotional disorders, too little appears to be being done to integrate hypnosis into primary care and national health medical services. This article discusses some of the reasons for the apparent reluctance of medical and scientific health professionals to consider incorporating hypnosis into their medical practice, including the practical problems inherent in using hypnosis in a medical context and some possible solutions.

  4. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    Science.gov (United States)

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  5. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    NARCIS (Netherlands)

    M. Chersich (Matthew); S. Luchters (Stanley); I. Ntaganira (Innocent); A. Gerbase (Antonio); Y-R. Lo (Ying-Ru); F. Scorgie (Fiona); R. Steen (Richard)

    2012-01-01

    textabstractIntroduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for

  6. Developing a portfolio of financially sustainable, scalable, basic ...

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

    cmanuel

    2016-05-17

    May 17, 2016 ... investment in service delivery to improve access to justice. ... national development strategies, set up new institutions to track ... Development Research Centre has developed a framework for thinking about how basic legal.

  7. Determination of a basic set of Eigen-functions and of the corresponding norm in the case of the one-velocity integral differential Boltzmann equation in spherical geometry

    International Nuclear Information System (INIS)

    Lafore, P.

    1965-01-01

    The object of the present work is to draw up a basic set of orthogonal eigenfunctions; resolution of the one-velocity integral-differential Boltzmann equation; this in the case of a spherical geometry system. (author) [fr

  8. A review of electronic medical record keeping on mobile medical service trips in austere settings.

    Science.gov (United States)

    Dainton, Christopher; Chu, Charlene H

    2017-02-01

    Electronic medical records (EMRs) may address the need for decision and language support for Western clinicians on mobile medical service trips (MSTs) in low resource settings abroad, while providing improved access to records and data management. However, there has yet to be a review of this emerging technology used by MSTs in low-resource settings. The aim of this study is to describe EMR systems designed specifically for use by mobile MSTs in remote settings, and accordingly, determine new opportunities for this technology to improve quality of healthcare provided by MSTs. A MEDLINE, EMBASE, and Scopus/IEEE search and supplementary Google search were performed for EMR systems specific to mobile MSTs. Information was extracted regarding EMR name, organization, scope of use, platform, open source coding, commercial availability, data integration, and capacity for linguistic and decision support. Missing information was requested by email. After screening of 122 abstracts, two articles remained that discussed deployment of EMR systems in MST settings (iChart, SmartList To Go), and thirteen additional EMR systems were found through the Google search. Of these, three systems (Project Buendia, TEBOW, and University of Central Florida's internally developed EMR) are based on modified versions of Open MRS software, while three are smartphone apps (QuickChart EMR, iChart, NotesFirst). Most of the systems use a local network to manage data, while the remaining systems use opportunistic cloud synchronization. Three (TimmyCare, Basil, and Backpack EMR) contain multilingual user interfaces, and only one (QuickChart EMR) contained MST-specific clinical decision support. There have been limited attempts to tailor EMRs to mobile MSTs. Only Open MRS has a broad user base, and other EMR systems should consider interoperability and data sharing with larger systems as a priority. Several systems include tablet compatibility, or are specifically designed for smartphone, which may be

  9. [The Unified National Health System and the third sector: Characterization of non-hospital facilities providing basic health care services in Belo Horizonte, Minas Gerais, Brazil].

    Science.gov (United States)

    Canabrava, Claudia Marques; Andrade, Eli Iôla Gurgel; Janones, Fúlvio Alves; Alves, Thiago Andrade; Cherchiglia, Mariangela Leal

    2007-01-01

    In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic health care in the country. This article identifies and describes non-hospital nonprofit facilities providing systematically organized basic health care in Belo Horizonte, Minas Gerais, Brazil, in 2004. The research focused on the facilities registered with the National Council on Social Work, using computer-assisted telephone and semi-structured interviews. Identification and description of these organizations showed that the charitable segment of the third sector conducts organized and systematic basic health care services but is not recognized by the Unified National Health System as a potential partner, even though it receives referrals from basic government services. The study showed spatial and temporal overlapping of government and third-sector services in the same target population.

  10. Evaluation of the first fracture liaison service in the Greek healthcare setting.

    Science.gov (United States)

    Makras, Polyzois; Panagoulia, Maria; Mari, Andriana; Rizou, Stavroula; Lyritis, George P

    2017-12-01

    We evaluated the first implementation of FLS in the Greek healthcare setting, at the 251 Hellenic Air Force and VA General Hospital of Athens. Participation rate was moderate (54.5%) and needs improvement; osteoporosis medication was either suggested or reviewed in 74 out of the 116 patients recruited. The purpose of this study was to evaluate the first implementation of a fracture liaison service (FLS) in Greece, at the 251 Hellenic Air Force and VA General Hospital, Athens. Single-center, prospective study from May 1, 2013 to April 30, 2015 (first year-second year follow-up) was conducted. Patients of both genders aged 40-90 years old, with a history of a low trauma fracture and willing to participate, were included after identification by an FLS nurse. Following recruitment, osteoporosis risk factors were assessed, FRAX score was calculated for treatment-naïve patients, bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA), and osteoporosis treatment was suggested where applicable. The rate of participation, the indication of osteoporosis treatment, and the difficulties met were evaluated. Of the eligible 213 patients, 97 (45.5%) were reluctant to participate for personal reasons. From the 116 initially recruited patients (mean age 74.8 ± 12 years), 77 (66.4%) discontinued their participation at some point for various reasons and 39 patients concluded the study. All 116 patients were assessed for osteoporosis risk factors and given a tailor-made exercise and education program, while FRAX score was assessed in all treatment-naïve patients (74 patients, 63.8%). Osteoporosis medication was suggested or reviewed in 74 patients; however, an adherence rate of 100% is only available for the 24 who concluded the study. We report the first implementation of FLS in the Greek healthcare setting. The participation rate is moderate and definitely needs improvement.

  11. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    Science.gov (United States)

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  12. NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

    Science.gov (United States)

    Aleman, Alicia; Olsen, Lola; Ritz, Scott; Morahan, Michael; Cepero, Laurel; Stevens, Tyler

    2011-01-01

    NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov/

  13. The impact of primary service and servicescape on customer satisfaction in a leisure service setting : an empirical investigation among theatregoers

    OpenAIRE

    Jobst, Johanna; Boerner, Sabine

    2015-01-01

    This paper investigates the effects of perceived primary service and perceived servicescape on customer satisfaction in theatres. According to a questionnaire study, among n=2897 theatregoers in 12 German-speaking theatres, factors pertaining to the perceived primary service are most influential on customer satisfaction (in particular, the perceived artistic quality, followed by visitors’ emotional and cognitive response to the performance). Contrariwise, factors pertaining to the perceived s...

  14. Customer service strategy options : a multiple case study in a B2B setting

    NARCIS (Netherlands)

    Wouters, J.P.M.

    2004-01-01

    This study addresses the question whether customer service actually has order winning potential in B2B situations, which customer service strategies are deployed, and what determines customer service relevance. A literature review was followed by a multiple case study, using 12 organizations from

  15. The Use of Classroom Assessment to Explore Problem Solving Skills Based on Pre-Service Teachers’ Cognitive Style Dimension in Basic Physics Course

    Science.gov (United States)

    Rahmawati; Rustaman, Nuryani Y.; Hamidah, Ida; Rusdiana, Dadi

    2017-02-01

    The aim of this study was to explore the use of assessment strategy which can measure problem solving skills of pre-service teachers based on their cognitive style in basic physics course. The sample consisted of 95 persons (male = 15, female = 75). This study used an exploratory research with observation techniques by interview, questionnaire, and test. The results indicated that the lecturer only used paper-pencil test assessment strategy to measure pre-service teachers’ achievement and also used conventional learning strategy. It means that the lecturer did not measure pre-services’ thinking process in learning, like problem solving skills. One of the factors which can influence student problem solving skills is cognitive style as an internal factor. Field Dependent (FD) and Field Independent (FI) are two cognitive styles which were measured with using Group Embedded Figure Test (GEFT) test. The result showed that 82% of pre-service teachers were FD cognitive style and only 18% of pre-service teachers had FI cognitive style. Furthermore, these findings became the fundamental design to develop a problem solving assessment model to measure pre-service teachers’ problem solving skills and process in basic physics course.

  16. Detection of spatial aggregation of cases of cancer from data on patients and health centres contained in the Minimum Basic Data Set

    Directory of Open Access Journals (Sweden)

    Pablo Fernández-Navarro

    2018-05-01

    Full Text Available The feasibility of the Minimum Basic Data Set (MBDS as a tool in cancer research was explored monitoring its incidence through the detection of spatial clusters. Case-control studies based on MBDS and marked point process were carried out with the focus on the residence of patients from the Prince of Asturias University Hospital in Alcalá de Henares (Madrid, Spain. Patients older than 39 years with diagnoses of stomach, colorectal, lung, breast, prostate, bladder and kidney cancer, melanoma and haematological tumours were selected. Geocoding of the residence address of the cases was done by locating them in the continuous population roll provided by the Madrid Statistical Institute and extracting the coordinates. The geocoded control group was a random sample of 10 controls per case matched by frequency of age and sex. To assess case clusters, differences in Ripley K functions between cases and controls were calculated. The spatial location of clusters was explored by investigating spatial intensity and its ratio between cases and controls. Results suggest the existence of an aggregation of cancers with a common risk factor such as tobacco smoking (lung, bladder and kidney cancers. These clusters were located in an urban area with high socioeconomic deprivation. The feasibility of designing and carrying out case-control studies from the MBDS is shown and we conclude that MBDS can be a useful epidemiological tool for cancer surveillance and identification of risk factors through case-control spatial point process studies.

  17. Setting up an IAPT site: the Ealing Mental Health & Well-Being Service.

    Science.gov (United States)

    Ruprah-Shah, Baljeet

    2009-01-01

    IAPT will succeed or fail on the extent to which it enables partnerships. For years I have been working to integrate mental health services in Ealing. Improving Access to Psychological Therapies (IAPT) offers the best chance I have ever known to achieve this, and to make a coordinated impact on the health of the people of Ealing. IAPT is an exciting opportunity for us in Ealing and we have grabbed it with both hands. We are incorporating it into our beliefs, values and passion to produce a service that will reflect our vision for holistic primary care services. A service which is financially sound. A service which does not believe that there is one answer to everyone's mild to moderate mental health problems. A service which recognises that working in silos is detrimental to our patients' health. A service which is constantly striving to improve relationships with our partners. A service which is mindful about the people we see, and the staff who see them.

  18. Introducing Matrix Management within a Children's Services Setting--Personal Reflections

    Science.gov (United States)

    Brooks, Michael; Kakabadse, Nada K.

    2014-01-01

    This article reflects on the introduction of "matrix management" arrangements for an Educational Psychology Service (EPS) within a Children's Service Directorate of a Local Authority (LA). It seeks to demonstrate critical self-awareness, consider relevant literature with a view to bringing insights to processes and outcomes, and offers…

  19. Integrating Information Services in an Academic Setting: The Organizational and Technical Challenge.

    Science.gov (United States)

    Branin, Joseph J.; And Others

    1993-01-01

    Describes a project to integrate the support and delivery of information services to faculty and staff at the University of Minnesota from the planning phase to implementation of a new organizational entity. Topics addressed include technical and organizational integration, control and delivery of services, and networking and organizational fit.…

  20. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

    OpenAIRE

    Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

    2012-01-01

    Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services.

  1. Mapping ecosystem functions and services in Eastern Europe using global-scale data sets

    NARCIS (Netherlands)

    Schulp, C.J.E.; Alkemade, R.; Klein Goldewijk, K.; Petz, K.

    2012-01-01

    To assess future interactions between the environment and human well-being, spatially explicit ecosystem service models are needed. Currently available models mainly focus on provisioning services and do not distinguish changes in the functioning of the ecosystem (Ecosystem Functions – ESFs) and

  2. Stochastic inventory management at a service facility with a set of ...

    African Journals Online (AJOL)

    We consider a continuous review perishable inventory system at a service facility with a finite waiting capacity. The maximum inventory level is fixed and the customers arrive according to a Markov arrival process. The life time of each item and the service time are assumed to have independent exponential distributions.

  3. Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

    Science.gov (United States)

    Niv, Noosha; Bennett, Lauren

    2017-06-01

    Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

  4. The Effects of Task Clarification, Feedback, and Goal Setting on Student Advisors' Office Behaviors and Customer Service

    Science.gov (United States)

    Tittelbach, Danielle; DeAngelis, Maureen; Sturmey, Peter; Alvero, Alicia M.

    2007-01-01

    This study evaluated the effects of feedback, task clarification and goal-setting on office behaviors and customer service of ten undergraduate participants that served as university advisors. A multiple baseline design was implemented across three target behaviors: client greeting, front-desk behaviors, and punctuality. During intervention the…

  5. Development of a comprehensive survey of sexuality issues including a self-report version of the International Spinal Cord Injury sexual function basic data sets.

    Science.gov (United States)

    New, P W; Currie, K E

    2016-08-01

    Questionnaire development, validation and completion. Develop comprehensive survey of sexuality issues including validated self-report versions of the International Spinal Cord Injury male sexual function and female sexual and reproductive function basic data sets (SR-iSCI-sexual function). People with spinal cord damage (SCD) living in the community, Australia from August 2013 to June 2014. An iterative process involving rehabilitation medicine clinicians, a nurse specialising in sexuality issues in SCD and people with SCD who developed a comprehensive survey that included the SR-iSCI-sexual function. Participants recruitment through spinal rehabilitation review clinic and community organisations that support people with SCD. Surveys completed by 154 people. Most were male (n=101, 65.6%). Respondents' median age was 50 years (interquartile range (IQR) 38-58), and they were a median of 10 years (IQR 4-20) after the onset of SCD. Sexual problems unrelated to SCD were reported by 12 (8%) respondents, and 114 (n=75.5%) reported sexual problems because of SCD. Orgasms were much less likely (χ(2)=13.1, P=0.006) to be normal in males (n=5, 5%) compared with females (n=11, 22%). Males had significantly worse (χ(2)=26.0, P=0.001) psychogenic genital functioning (normal n=9, 9%) than females (normal n=13, 26%) and worse (χ(2)=10.8, P=0.013) reflex genital functioning. Normal ejaculation was reported in only three (3%) men. Most (n=26, 52%) women reported reduced or absent menstruation pattern since SCD. The SR-iSCI-sexual function provides a useful tool for researchers and clinicians to collect information regarding patient-reported sexual functioning after SCD and to facilitate comparative studies.

  6. Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy?

    Science.gov (United States)

    Darrah, J; Wiart, L; Magill-Evans, J; Ray, L; Andersen, J

    2012-01-01

    Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite

  7. The World Health Organization's Basic Radiological System (WHO-BRS). How to provide a better service with less cost

    International Nuclear Information System (INIS)

    Gomez Crespo, G.; Hanson, G.P.

    1986-01-01

    This article describes the application of the World Health Organization - Basic Radiological System (WHO-BRS) in Latin America in particular in Colombia. Various aspects of the radiological system are discussed including the X-ray equipment, radiation safety, training, manuals for operating and maintenance of the equipments, supply of spare parts, etc. The difficulties encountered in applying medical radiography in Latin America are pointed out. 6 refs

  8. Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model.

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, Br; Goel, P; Hongal, Sg; Jain, M

    2014-05-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  9. Mobile and Portable Dental Services Catering to the Basic Oral Health Needs of the Underserved Population in Developing Countries: A Proposed Model

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, BR; Goel, P; Hongal, SG; Jain, M

    2014-01-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  10. Innovations with services relating to energy efficiency. Basic information and examples; Innovationen mit Dienstleistungen im Bereich Energieeffizienz. Basisinformationen und Beispiele

    Energy Technology Data Exchange (ETDEWEB)

    Knoll, Michael; Kollnig, Sarah; Oertel, Britta

    2010-07-01

    This study describes how the ''Energy Efficient City'' competition is intended to promote activities towards greater energy efficiency which relate to cities as systems, are innovative, and conceive of and incorporate services as part of the solution. ''Innovation with services'' is not only about the further development of existing services but more particularly about the creation of high-quality services in growth areas which can serve to speed up innovation and create new application potentials for technical developments. They should be based on a holistic view on urban processes of energy use and energy supply and give consideration to all relevant stakeholders. The ''Energy Efficient City'' competition is aimed at systematically linking innovations with services to energy efficiency issues. The implementation of these goals will be facilitated by accompanying research. To this end the present text provides information on how services can be geared to energy efficiency.

  11. Factors affecting utilization of cervical cancer prevention services in low-resource settings

    Directory of Open Access Journals (Sweden)

    Bingham Allison

    2003-01-01

    Full Text Available Strategies for introducing or strengthening cervical cancer prevention programs must focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. This article summarizes the experiences of research projects in Bolivia, Peru, Kenya, South Africa, and Mexico. Factors that affect participation rates in cervical cancer prevention programs are categorized in three sections. The first section describes factors that arise from prevailing sociocultural norms that influence women's views on reproductive health, well being, and notions of illness. The second section discusses factors related to the clinical requirements and the type of service delivery system in which a woman is being asked to participate. The third section discusses factors related to quality of care. Examples of strategies that programs are using to encourage women's participation in cervical cancer prevention services are provided.

  12. Service Failure and Recovery in a Public Setting: A Comparative Study of Target and Observing Customers

    OpenAIRE

    SEYED SHAHIN SHARIFI

    2017-01-01

    Previous research has examined the effect of service failure and recovery on target and the observing customers separately, with an emphasis on evaluations by target customers. It has been assumed that the reactions of those customers observing the recovery efforts would mirror those of target customers, or perhaps be even more favourable, given that they are not directly affected by the service failure. This research challenges this pre-conception. Through a series of experimental studies, t...

  13. Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

    Science.gov (United States)

    Mbah, Henry; Negedu-Momoh, Olubunmi Ruth; Adedokun, Oluwasanmi; Ikani, Patrick Anibbe; Balogun, Oluseyi; Sanwo, Olusola; Ochei, Kingsley; Ekanem, Maurice; Torpey, Kwasi

    2014-01-01

    The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration. A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000). This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

  14. Measuring mental health in the clinical setting: what is important to service users? The Mini-Service user Recovery Evaluation scale (Mini-SeRvE).

    Science.gov (United States)

    Barber, Joanna M; Parsons, Helen; Wilson, Carol A; Cook, Christopher C H

    2017-12-01

    Since 2001, a policy of positive mental health recovery has been promoted in the UK, with service user involvement. This has not been easy to implement in the clinical setting. To develop and validate a brief self-report, service user-designed, outcome measure (Mini-SeRvE), for clinical use, including spiritual and religious issues. From the previously developed Service user Recovery Evaluation scale (SeRvE), 15 questions were selected for Mini-SeRvE which was self-completed by 207 people; 100 service users and, for comparison, 107 staff. Results were analysed using SPSS software (SPSS Inc., Chicago, IL). Mini-SeRvE is reliable, Cronbach's alpha 0.852. Correlation with another recovery scale, Mental Health Recovery Measure, was high, r = 0.819. Three reliable subscales emerged; existential well-being (EWB), mental ill-being (MIB) and religious well-being (RWB). Scores of the EWB and MIB subscales were higher for staff, consistent with higher mental well-being. Religious well-being scores were higher in service users, who also rated religion as more important to them. Mini-SeRvE is a valid measure of service user recovery. The importance of religion/spiritual belief for our users is highlighted, this being reflected in the subject matter of Mini-SeRvE. Mini-SeRvE assessments could show individual priorities, evaluate therapy and aid clinical decision-making.

  15. An Exploration of Factors that Effect the Implementation of Peer Support Services in Community Mental Health Settings.

    Science.gov (United States)

    Mancini, Michael A

    2018-02-01

    This study explored the integration of peer services into community mental health settings through qualitative interviews with peer-providers and non-peer mental health workers. Results show peer job satisfaction was contingent upon role clarity, autonomy, and acceptance by non-peer coworkers. Mental health workers reported the need for organizational support for peer services and guidance about how to utilize peers, negotiate their professional boundaries and accommodate their mental health needs. Effective peer integration requires organizational readiness, staff preparation and clear policies and procedures. Consultation from consumer-based organizations, enhanced professional competencies, and professional development and career advancement opportunities for peers represent important resources.

  16. Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example.

    Science.gov (United States)

    Li, Tongtong; Lei, Trudy; Xie, Zheng; Zhang, Tuohong

    2016-02-04

    To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China. Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.

  17. Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

    Directory of Open Access Journals (Sweden)

    Henry Mbah

    Full Text Available The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration.A quantitative before-and-after study conducted in 122 Family Health International (FHI360 supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and <25% NO integration. Weaknesses were noted and addressed.We analyzed 9 (7.4% primary, 104 (85.2% secondary and 9 (7.4% tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01. Baseline median total integration score was 4 (IQR 3 to 5 compared to 7 (IQR 4 to 9 at 3 months follow-up (p = 0.000. Partial and fully integrated laboratory systems were 64 (52.5% and 0 (0.0% at baseline, compared to 100 (82.0% and 3 (2.4% respectively at 3 months follow-up (p = 0.000.This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

  18. Oh! Web 2.0, Virtual Reference Service 2.0, Tools and Techniques (I): A Basic Approach

    Science.gov (United States)

    Arya, Harsh Bardhan; Mishra, J. K.

    2011-01-01

    This study targets librarians and information professionals who use Web 2.0 tools and applications with a view to providing snapshots on how Web 2.0 technologies are used. It also aims to identify values and impact that such tools have exerted on libraries and their services, as well as to detect various issues associated with the implementation…

  19. Design of Availability-Dependent Distributed Services in Large-Scale Uncooperative Settings

    Science.gov (United States)

    Morales, Ramses Victor

    2009-01-01

    Thesis Statement: "Availability-dependent global predicates can be efficiently and scalably realized for a class of distributed services, in spite of specific selfish and colluding behaviors, using local and decentralized protocols". Several types of large-scale distributed systems spanning the Internet have to deal with availability variations…

  20. Definition of Intervener Services and Interveners in Educational Settings. Technical Report

    Science.gov (United States)

    National Consortium on Deaf-Blindness, 2013

    2013-01-01

    This technical report synthesizes the process and information used by National Consortium on Deaf-Blindness (NCDB) in the development of a consistently applied definition of intervener services. It addresses challenges and questions, provides comparisons between interveners and paraprofessionals, and offers definitions, roles and concepts used by…

  1. Supply sensitive services in Swiss ambulatory care: An analysis of basic health insurance records for 2003-2007

    Directory of Open Access Journals (Sweden)

    Künzi Beat

    2010-11-01

    Full Text Available Abstract Background Swiss ambulatory care is characterized by independent, and primarily practice-based, physicians, receiving fee for service reimbursement. This study analyses supply sensitive services using ambulatory care claims data from mandatory health insurance. A first research question was aimed at the hypothesis that physicians with large patient lists decrease their intensity of services and bill less per patient to health insurance, and vice versa: physicians with smaller patient lists compensate for the lack of patients with additional visits and services. A second research question relates to the fact that several cantons are allowing physicians to directly dispense drugs to patients ('self-dispensation' whereas other cantons restrict such direct sales to emergencies only. This second question was based on the assumption that patterns of rescheduling patients for consultations may differ across channels of dispensing prescription drugs and therefore the hypothesis of different consultation costs in this context was investigated. Methods Complete claims data paid for by mandatory health insurance of all Swiss physicians in own practices were analyzed for the years 2003-2007. Medical specialties were pooled into six main provider types in ambulatory care: primary care, pediatrics, gynecology & obstetrics, psychiatrists, invasive and non-invasive specialists. For each provider type, regression models at the physician level were used to analyze the relationship between the number of patients treated and the total sum of treatment cost reimbursed by mandatory health insurance. Results The results show non-proportional relationships between patient numbers and total sum of treatment cost for all provider types involved implying that treatment costs per patient increase with higher practice size. The related additional costs to the health system are substantial. Regions with self-dispensation had lowest treatment cost for primary care

  2. Performance of the measures of processes of care for adults and service providers in rehabilitation settings.

    Science.gov (United States)

    Bamm, Elena L; Rosenbaum, Peter; Wilkins, Seanne; Stratford, Paul

    2015-01-01

    In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). A validation study. In-patient rehabilitation facilities. MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71-0.88 for health care professionals, 0.82-0.90 for patients, and 0.87-0.94 for family members), as well as moderate to good correlations between domains (0.40-0.78 for health care professionals and 0.52-0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.

  3. Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

    Science.gov (United States)

    Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

    2016-01-01

    To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice

  4. Capability of Public Organizationstructure After Regional Extention in Way Kanan Regency (a Study on Basic Service Organization)

    OpenAIRE

    Lustiadi, Yadi

    2016-01-01

    A primary issue in this study is that Way Kanan, a 13-year-old district, since it was formed from the expansion of the North Lampung Regency, is not strong enough to show the ability to carry out effective public services, even it is still categorized as a remote area.The public organization structure of Way Kanandistrict that is essential element of organizational capability, has not effectively supported the management of existing resources towards the achievement of the main objectives of ...

  5. Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting.

    Science.gov (United States)

    DiPiro, Pamela J; Krajewski, Katherine M; Giardino, Angela A; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

    2017-01-01

    The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

  6. Radiology consultation in the era of precision oncology: A review of consultation models and services in the tertiary setting

    Energy Technology Data Exchange (ETDEWEB)

    DiPiro, Pamela J.; Krajewski, Katherine M.; Giardino, Angela A.; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H. [Dept. of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States)

    2017-01-15

    The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

  7. How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

    Science.gov (United States)

    Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

    2017-01-01

    The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

  8. Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

    Science.gov (United States)

    Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

    2008-09-01

    Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

  9. Interprofessional service-learning in a community setting: findings from a pilot study.

    Science.gov (United States)

    Buff, Scotty M; Jenkins, Kelli; Kern, Donna; Worrall, Cathy; Howell, David; Martin, Kelley; Brown, Debora; White, Andrea; Blue, Amy

    2015-03-01

    Interprofessional education is becoming more popular in higher education and service-learning has been a successful method to facilitate experiences that foster teamwork between professions. This report shares the results from an interprofessional service-learning project (ISLP) targeting students across eight disciplines (physician assistant, medicine, pharmacy, dietetic internship, physical therapy, master in health administration, nursing and biomedical science). The project used an existing resource, the South Carolina Area Health Education Consortium (SC-AHEC), to coordinate student learning across multiple regions and an established health promotion program curriculum for student outreach content. Participating students (n = 149) were evaluated to determine how the activity affected student appreciation and knowledge of their own and other professions, their interaction with other professional students, and student teamwork skills. Students found the most value in learning with students from other professions as part of the activity with lesser value placed on students increasing their knowledge about their profession's role in interprofessional work.

  10. Reflections on product/service-system (PSS) conceptualisation in a course setting

    DEFF Research Database (Denmark)

    Tan, Adrian; McAloone, Timothy Charles; Lauridsen, Erik Hagelskjær

    2009-01-01

    Product/service-system (PSS) approaches have over the past decade received considerable attention as possible sustainable innovation strategies. This paper presents and reflects upon the background, rationale and experiences behind a PSS design methodology applied with engineering students...... in a project course for the past five years. The methodology proposes four complementary dimensions of PSS: value proposition, product life cycle, activity modelling cycle and actor network, that all seem to comprehensively describe the essential conceptual design perspectives. Each of these dimensions...

  11. Medication therapy management and condition care services in a community-based employer setting.

    Science.gov (United States)

    Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

    2010-08-15

    A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical

  12. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

    Science.gov (United States)

    Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

    2018-05-16

    To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  13. Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

    Science.gov (United States)

    van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne

    2017-01-01

    Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699

  14. Integration of prevention of mother-to-child transmission of HIV (PMTCT postpartum services with other HIV care and treatment services within the maternal and child health setting in Zimbabwe, 2012.

    Directory of Open Access Journals (Sweden)

    Katherine Wiegert

    Full Text Available We assessed the integration of PMTCT services during the postpartum period including early infant diagnosis of HIV (EID and adult and pediatric antiretroviral therapy (ART in maternal and child health (MCH facilities in Zimbabwe.From August to December 2012 we conducted a cross-sectional survey of a nationally representative sample of 151 MCH facilities. A questionnaire was used to survey each site about staff training, dried blood spot sample (DBS collection, turnaround time (TAT for test results, PMTCT services, and HIV care and treatment linkages for HIV-infected mothers and children and HIV-exposed infants. Descriptive analyses were used. Of the facilities surveyed, all facilities were trained on DBS collection and 92% responded. Approximately, 99% of responding facilities reported providing DBS collection and a basic HIV-exposed infant service package including EID, extended nevirapine prophylaxis, and use of cotrimoxazole. DBS collection was integrated with immunisations at 83% of facilities, CD4 testing with point-of-care machines was available at 37% of facilities, and ART for both mothers and children was provided at 27% of facilities. More than 80% of facilities reported that DBS test results take >4 weeks to return; TAT did not have a direct association with any specific type of transport, distance to the lab, or intermediate stops for data to travel.Zimbabwe has successfully scaled up and integrated the national EID and PMTCT programs into the existing MCH setting. The long TAT of infant DBS test results and the lack of integrated ART programs in the MCH setting could reduce effectiveness of the national PMTCT and ART programs. Addressing these important gaps will support successful implementation of the 2014 Zimbabwe's PMTCT guidelines under which all HIV-infected pregnant and breastfeeding women will be offered life-long ART and decentralized ART care.

  15. A Systems Approach to Understanding Occupational Therapy Service Negotiations in a Preschool Setting

    Science.gov (United States)

    Silverman, Fern; Kramer, Paula; Ravitch, Sharon

    2011-01-01

    The purpose of this study was to use a systems approach to examine informal communications, meaning those occurring outside of scheduled meetings, among stakeholders in a preschool early intervention program. This investigation expands the discussion of how occupational therapy treatment decisions are made in educational settings by using a…

  16. Learning Visual Basic NET

    CERN Document Server

    Liberty, Jesse

    2009-01-01

    Learning Visual Basic .NET is a complete introduction to VB.NET and object-oriented programming. By using hundreds of examples, this book demonstrates how to develop various kinds of applications--including those that work with databases--and web services. Learning Visual Basic .NET will help you build a solid foundation in .NET.

  17. Clinical and economic outcomes of nurse-led services in the ambulatory care setting: A systematic review.

    Science.gov (United States)

    Chan, Raymond J; Marx, Wolfgang; Bradford, Natalie; Gordon, Louisa; Bonner, Ann; Douglas, Clint; Schmalkuche, Diana; Yates, Patsy

    2018-02-21

    With the increasing burden of chronic and age-related diseases, and the rapidly increasing number of patients receiving ambulatory or outpatient-based care, nurse-led services have been suggested as one solution to manage increasing demand on the health system as they aim to reduce waiting times, resources, and costs while maintaining patient safety and enhancing satisfaction. The aims of this review were to assess the clinical effectiveness, economic outcomes and key implementation characteristics of nurse-led services in the ambulatory care setting. A systematic review was conducted using the standard Cochrane Collaboration methodology and was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE EBSCO, CINAHL EBSCO, and PsycINFO Ovid (from inception to April 2016). Data were extracted and appraisal undertaken. We included randomised controlled trials; quasi-randomised controlled trials; controlled and non-controlled before-and-after studies that compared the effects of nurse-led services in the ambulatory or community care setting with an alternative model of care or standard care. Twenty-five studies of 180,308 participants were included in this review. Of the 16 studies that measured and reported on health-related quality of life outcomes, the majority of studies (n = 13) reported equivocal outcomes; with three studies demonstrating superior outcomes and one demonstrating inferior outcomes in comparison with physician-led and standard care. Nurse-led care demonstrated either equivalent or better outcomes for a number of outcomes including symptom burden, self-management and behavioural outcomes, disease-specific indicators, satisfaction and perception of quality of life, and health service use. Benefits of nurse-led services remain inconclusive in terms of economic outcomes. Nurse

  18. Determinants of Physicians' Technology Acceptance for Mobile Health Services in Healthcare Settings

    Directory of Open Access Journals (Sweden)

    Saeid Ebrahimi

    2018-01-01

    Full Text Available Introduction: World Health Organization reports indicated that the image of health care service delivery has changed by application of mobile health and wireless technologies for supporting and achieving the objectives of the health industry. The present study aimed to determine the level of physicians’ familiarity and investigate the factors affecting the acceptance of mobile health from the viewpoint of physicians working in educational hospitals of Zahedan University of Medical Sciences. Method: A cross-sectional study was carried out in Zahedan University of Medical Sciences in the southeast of Iran in 2016. The statistical population included all physicians working in five University Teaching Hospitals (n=150. In this study, systematic random sampling was used. A validated questionnaire, prepared based on the variables of Technology Acceptance Model 2 and models, was used for data collection. To analyze the data, we used descriptive and analytical statistics (Confirmatory Factor Analysis, linear and multiple regression. Results: Most of the respondents (112, or 74.4% were female and 84 of them (56% were less than 30 years old. All of the physicians (specialist and general physician used Smartphones. The score of perceived usefulness, behavioral intention, perceived enjoyment, subjective norm, perceived ease of use, image, volunteering, and objective usability constructs were higher than the average baseline, representing the acceptance of mobile phone by them. The relationship of all the constructs with each other towards the attitudinal and behavioral objectives of the mobile health services acceptance was significant (P0.05. Conclusion: The results of this study provide useful information to health managers and policymakers so that they can take steps to improve the quality of services using modern technologies. Plans can also be made by considering the factors as behavioral acceptance of mobile health and other effective factors to

  19. Indirect Effects of Field Management on Pollination Service and Seed Set in Hybrid Onion Seed Production.

    Science.gov (United States)

    Gillespie, Sandra; Long, Rachael; Williams, Neal

    2015-12-01

    Pollination in crops, as in native ecosystems, is a stepwise process that can be disrupted at any stage. Healthy pollinator populations are critical for adequate visitation, but pollination still might fail if crop management interferes with the attraction and retention of pollinators. Farmers must balance the direct benefits of applying insecticide and managing irrigation rates against their potential to indirectly interfere with the pollination process. We investigated these issues in hybrid onion seed production, where previous research has shown that high insecticide use reduces pollinator attraction. We conducted field surveys of soil moisture, nectar production, pollinator visitation, pollen-stigma interactions, and seed set at multiple commercial fields across 2 yr. We then examined how management actions, such as irrigation rate (approximated by soil moisture), or insecticide use could affect the pollination process. Onions produced maximum nectar at intermediate soil moisture, and high nectar production attracted more pollinators. Insecticide use weakly affected pollinator visitation, but when applied close to bloom reduced pollen germination and pollen tube growth. Ultimately, neither soil moisture nor insecticide use directly affected seed set, but the high correlation between pollinator visitation and seed set suggests that crop management will ultimately affect yields via indirect effects on the pollination process. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study.

    Science.gov (United States)

    Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

    2015-01-01

    This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported

  1. The effects of China’s urban basic medical insurance schemes on the equity of health service utilisation: evidence from Shaanxi Province

    Science.gov (United States)

    2014-01-01

    Introduction In order to alleviate the problem of “Kan Bing Nan, Kan Bing Gui” (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China. Methods Using the data from the fourth National Health Services Survey in Shaanxi Province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents. Results For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively. Conclusions The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation. PMID:24606592

  2. Linking Emotional Labor, Public Service Motivation, and Job Satisfaction: Social Workers in Health Care Settings.

    Science.gov (United States)

    Roh, Chul-Young; Moon, M Jae; Yang, Seung-Bum; Jung, Kwangho

    2016-01-01

    This study examines the determinants of emotional laborers'--social workers in health care organizations--job satisfaction and their public service motivation in using a structural equation model and provides empirical evidence regarding what contributes to job satisfaction or burnout in these workers. Among several latent variables, this study confirmed that false face significantly decreases the job satisfaction of social worker and is positively associated with burnout. In addition, commitment to public interest increases social workers' job satisfaction significantly. This study has implications for the management of emotional labor. By educating emotional laborers to reappraise situations to increase their job satisfaction and avoid burnout, reappraisal training and education are expected to result in increases in positive emotions and decreases in negative emotions, and to improve employees' performance in their organizations.

  3. ELIXIR pilot action: Marine metagenomics - towards a domain specific set of sustainable services.

    Science.gov (United States)

    Robertsen, Espen Mikal; Denise, Hubert; Mitchell, Alex; Finn, Robert D; Bongo, Lars Ailo; Willassen, Nils Peder

    2017-01-01

    Metagenomics, the study of genetic material recovered directly from environmental samples, has the potential to provide insight into the structure and function of heterogeneous microbial communities.  There has been an increased use of metagenomics to discover and understand the diverse biosynthetic capacities of marine microbes, thereby allowing them to be exploited for industrial, food, and health care products. This ELIXIR pilot action was motivated by the need to establish dedicated data resources and harmonized metagenomics pipelines for the marine domain, in order to enhance the exploration and exploitation of marine genetic resources. In this paper, we summarize some of the results from the ELIXIR pilot action "Marine metagenomics - towards user centric services".

  4. Prospects for international trade in environmental services: An analysis of international carbon emission off-sets

    International Nuclear Information System (INIS)

    Swisher, J.N.

    1991-01-01

    This dissertation presents a case study analysis in which the costs to a US electric utility of reducing its carbon dioxide (CO 2 ) emissions are compared with the costs of carbon-saving forestry projects in Costa Rica and Guatemala. The results show that a large electric utility in the south-central US would find it relatively inexpensive, even profitable given a conducive regulatory treatment, to reduce its CO 2 emissions by a few percent over the next ten years, through direct investment in energy end-use efficiency improvements. In comparison, the costs of the forestry projects studied in Central America range from $1/TC to a worst-case value of about $55/TC, with most project costs between $5 and $13/TC, depending on the type of project, the climate, and the opportunity cost of land. The total amount of CO 2 storage potential is significant, about 100 million tons per country, but not enough to suggest that forestry can offset more than a few percent of global CO 2 emissions from fossil fuel use. These case studies suggest that international trade in the environmental service of reducing global CO 2 accumulation could have significant economic and ecological benefits. A transaction in which a utility pays for forestry projects in exchange for credit against an emission reduction policy is an example of an international carbon emission offset (ICEO). ICEO's could provide a currency for funding carbon-saving services as a way to comply with national policies to reduce CO 2 emissions, as long as compliance is allowed through investments in other countries. This type of North-South transfer is necessary to reconcile economic efficiency and international equity, because of the disparity between the national allocations of responsibility for greenhouse gas emissions and opportunities for emission reductions

  5. A description of assistive technology sources, services and outcomes of use in a number of African settings.

    Science.gov (United States)

    Visagie, Surona; Eide, Arne H; Mannan, Hasheem; Schneider, Marguerite; Swartz, Leslie; Mji, Gubela; Munthali, Alister; Khogali, Mustafa; van Rooy, Gert; Hem, Karl-Gerhard; MacLachlan, Malcolm

    2017-10-01

    Purpose statement: The article explores assistive technology sources, services and outcomes in South Africa, Namibia, Malawi and Sudan. A survey was done in purposively selected sites of the study countries. Cluster sampling followed by random sampling served to identify 400-500 households (HHs) with members with disabilities per country. A HH questionnaire and individual questionnaire was completed. Country level analysis was limited to descriptive statistics. Walking mobility aids was most commonly bought/provided (46.3%), followed by visual aids (42.6%). The most common sources for assistive technology were government health services (37.8%), "other" (29.8%), and private health services (22.9%). Out of the participants, 59.3% received full information in how to use the device. Maintenance was mostly done by users and their families (37.3%). Devices helped a lot in 73.3% of cases and improved quality of life for 67.9% of participants, while 39.1% experienced functional difficulties despite the devices. Although there is variation between the study settings, the main impression is that of fragmented or absent systems of provision of assistive technology. Implications for rehabilitation Provision of assistive technology and services varied between countries, but the overall impression was of poor provision and fragmented services. The limited provision of assistive technology for personal care and handling products is of concern as many of these devices requires little training and ongoing support while they can make big functional differences. Rural respondents experienced more difficulties when using the device and received less information on use and maintenance of the device than their urban counterparts. A lack of government responsibility for assistive device services correlated with a lack of information and/or training of participants and maintenance of devices.

  6. Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings.

    Science.gov (United States)

    Bednar, Erica M; Walsh, Michael T; Baker, Ellen; Muse, Kimberly I; Oakley, Holly D; Krukenberg, Rebekah C; Dresbold, Cara S; Jenkinson, Sandra B; Eppolito, Amanda L; Teed, Kelly B; Klein, Molly H; Morman, Nichole A; Bowdish, Elizabeth C; Russ, Pauline; Wise, Emaline E; Cooper, Julia N; Method, Michael W; Henson, John W; Grainger, Andrew V; Arun, Banu K; Lu, Karen H

    2018-05-16

    An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project's success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.

  7. Hygiene Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Hygiene Basics KidsHealth / For Teens / Hygiene Basics What's in this article? Oily Hair Sweat ... smell, anyway? Read below for information on some hygiene basics — and learn how to deal with greasy ...

  8. First year pre-service science teachers’ experiences of authentic instructional tasks in a PDS setting

    DEFF Research Database (Denmark)

    Pontoppidan, Birgitte; Nielsen, Birgitte Lund

    . The small groups gave the student teachers the opportunity to get on a level with the school students. They also refer to the iterative dimension and the importance of formative assessment. Based on the evaluative criteria it may be concluded that the two examples are successful models for authentic......Professional development schools (PDS) have been a source of inspiration for a new approach at the teacher education in Aarhus (DK). The importance of student teachers’ inquiries in authentic settings is in line with various research-based approaches to educating (science) teachers. The purpose...... for an authentic instructional task, are presented. Ten students were asked to describe their experiences of working with these tasks during repeated interviews. They refer to concrete examples of school students’ activities and/or learning when reflecting on their own learning and to dialogue with school students...

  9. Development of a novel set of criteria to select methodology for designing product service systems

    Directory of Open Access Journals (Sweden)

    Tuananh Tran

    2016-04-01

    Full Text Available This paper proposes eight groups of twenty nine scoring criteria that can help designers and practitioners to compare and select an appropriate methodology for a certain problem in designing product service system (PSS. PSS has been researched for more than a decade and is now becoming more and more popular in academia as well as industry. Despite that fact, the adoption of PSS is still limited for its potential. One of the main reasons is that designing PSS itself is a challenge. Designers and developers face difficulties in choosing appropriate PSS design methodologies for their projects so that they can design effective PSS offerings. By proposing eight groups of twenty nine scoring criteria, this paper enables a “step by step” process to identify the most appropriate design methodology for a company’s PSS problem. An example is also introduced to illustrate the use of the proposed scoring criteria and provide a clear picture of how different design methodologies can be utilized at their best in terms of application.

  10. Customers' Precedence for Service Quality Dimensions in Indian Private Healthcare Setting: A Ridit Approach.

    Science.gov (United States)

    Panda, Rajeev Kumar; Kondasani, Rama Koteswara Rao

    2017-01-01

    Changes in demographic and sociocultural environment, improved health awareness, and information technology have considerably changed the outlook of healthcare sector in India. While both the public and the private healthcare sectors have priority of increasing access while minimizing costs, they try hard to achieve goals without letting the quality suffer. Customers with rising disposable income no longer have faith in the public healthcare system and are willing to migrate to the private healthcare sector, which is more professional, technology savvy, and trustworthy. However, there are enough loopholes in the private healthcare sector that are yet to be plugged. The purpose of this research study was to identify and assess the relative importance of the diverse service quality dimensions and prioritize them to draw meaningful conclusions. Survey responses from 370 customers were analyzed using factor analysis to find underlying relationships between the survey items. This allowed the individual items to be placed into related groups. Independently, a ridit analysis was conducted to determine the relative importance of each item to the survey respondents. Based on the ridit analysis a priority ranking was assigned to each item. An analysis was then undertaken of the degree to which the items grouped into each particular factor tended to have high or low priority rankings. The results of the study may be helpful to the managers of the private healthcare sector to focus their strategies and plan their efforts in line with the findings to gain superior customer satisfaction and retention.

  11. HIV as a chronic disease considerations for service planning in resource-poor settings

    Directory of Open Access Journals (Sweden)

    Reynolds Lucy

    2011-10-01

    Full Text Available Abstract This paper reviews the healthcare issues facing nations which have a substantial caseload of chronic HIV cases. It considers the challenges of extending antiretroviral coverage to an expanding caseload as supplier price rises and international trade agreements come into force to reduce the availability of affordable antiretrovirals just as the economic downturn restricts donor funding. It goes on to review the importance in this context of supporting adherence to drug regimens in order to preserve access to affordable antiretrovirals for those already on treatment, and of removing key barriers such as patient fees and supply interruptions. The demands of those with chronic HIV for health services other than antiretroviral therapy are considered in the light of the fearful or discriminatory attitudes of non-specialist healthcare staff due to HIV-related stigma, which is linked with the weakness of infection control measures in many health facilities. The implications for prevention strategies including those involving criminalisation of HIV transmission or exposure are briefly summarised for the current context, in which the caseload of those whose chronic HIV infection must be controlled with antiretrovirals will continue to rise for the foreseeable future.

  12. Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

    Science.gov (United States)

    Schmid, Wolfgang; Ostermann, Thomas

    2010-10-14

    Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their

  13. Basic technologies of web services framework for research, discovery, and processing the disparate massive Earth observation data from heterogeneous sources

    Science.gov (United States)

    Savorskiy, V.; Lupyan, E.; Balashov, I.; Burtsev, M.; Proshin, A.; Tolpin, V.; Ermakov, D.; Chernushich, A.; Panova, O.; Kuznetsov, O.; Vasilyev, V.

    2014-04-01

    Both development and application of remote sensing involves a considerable expenditure of material and intellectual resources. Therefore, it is important to use high-tech means of distribution of remote sensing data and processing results in order to facilitate access for as much as possible number of researchers. It should be accompanied with creation of capabilities for potentially more thorough and comprehensive, i.e. ultimately deeper, acquisition and complex analysis of information about the state of Earth's natural resources. As well objective need in a higher degree of Earth observation (EO) data assimilation is set by conditions of satellite observations, in which the observed objects are uncontrolled state. Progress in addressing this problem is determined to a large extent by order of the distributed EO information system (IS) functioning. Namely, it is largely dependent on reducing the cost of communication processes (data transfer) between spatially distributed IS nodes and data users. One of the most effective ways to improve the efficiency of data exchange processes is the creation of integrated EO IS optimized for running procedures of distributed data processing. The effective EO IS implementation should be based on specific software architecture.

  14. An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey

    Directory of Open Access Journals (Sweden)

    Yosi Wibowo

    2015-12-01

    Full Text Available Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient’s own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients’ views have been limited to developed countries.Objectives. To investigate, within a developing country setting (Indonesia, current use of pharmacy services by type 2 diabetes patients, and to evaluate their views regarding community pharmacists’ roles, and the characteristics that influence their views.Methods. A questionnaire survey was conducted within 10 purposefully selected community pharmacies in Surabaya, Indonesia. Each pharmacy recruited approximately 20 patients seeking antidiabetic medications. Usage of pharmacy services was identified using binary responses (‘yes’/‘no’ and views on pharmacists’ roles were rated using Likert scales; an open-ended question was used to identify patient perceived priority roles. Logistic regression models were used to determine characteristics associated with patients’ views.Results. A total of 196 pharmacy patients with type 2 diabetes responded (58.3% response rate. Most patients used community pharmacies for dispensing (100% and education on how to use medications (79.6%. There were mixed views towards pharmacists providing services beyond dispensing. The highest priorities identified were from the ‘patient education’ domain: education on medications (i.e., directions for use (64.5%, storage (26.6%, common/important adverse effects (25.5%; and the ‘monitoring’ domain: monitoring medication compliance (37.3%. Patients with higher incomes or who were working were less supportive of these expanded services

  15. Level of Awareness and Basic Knowledge Related to Radiation Protection Based on Academic Qualification and Service Tenure in Malaysian Nuclear Agency

    International Nuclear Information System (INIS)

    Munira Shaikh Nasir

    2015-01-01

    Effective radiation protection program is vital to ensure the safety of workers involved in work related to radiation. This objective of this research was to determine the level of awareness towards radiation protection among the workers at Malaysian Nuclear Agency. Questionnaire forms containing questions related to relevant work experience and knowledge of radiation safety were distributed to a group of identified radiation workers. The hypothesis of this study is that all workers involved have high levels of awareness and basic knowledge as they work in an institution which activities frequently and routinely involve radiation. The result of this research show that the level of awareness and knowledge of the respondents were at a good level, with an average overall score of 87.2% showed a high level of awareness among respondents. Overall, highest academic qualifications did not affect the level of knowledge (p > 0.05). In contrast, service tenure affects their level of knowledge (p < 0.05). (author)

  16. Assessment of patient satisfaction with acute pain management service: Monitoring quality of care in clinical setting

    Directory of Open Access Journals (Sweden)

    Fizzah Farooq

    2016-01-01

    Full Text Available Background and Aims: Assessment of patient satisfaction is an important tool for monitoring the quality of care in hospitals. The aim of this survey was to develop a reliable tool to assess patient satisfaction with acute pain management service (APMS and identify variables affecting this so that care can be improved. Methods: A questionnaire was developed and administered to  patients after being discharged from APMS care by an unbiased person. Data collected from record included patient demographics, surgical procedure, analgesic modality, co-analgesics and dynamic and static pain scores. Questions included pain expected and pain experienced, APMS response time, quality of pain relief with treatment, professionalism of APMS team, overall experience of pain relief and choosing/suggesting same modality for themselves/family/friends again. Five-point Likert scale was used for most of the options. Statistical analysis was done using SPSS 19. Results: Frequency and percentages were computed for qualitative observation and presented on pie chart and histogram. Seventy-one per cent patients expected severe pain while 43% actually experienced it. About 79.4% would choose same analgesia modality in future for self/family/friends. Ninety-nine per cent found APMS staff courteous and professional. About 89% rated their experience of pain management as excellent to very good. Conclusion: The survey of patients′ satisfaction to monitor the quality of care provided by APMS provided positive inputs on its role. This also helps to identify areas requiring improvement in care and as a tool to gauge the quality of care.

  17. Health service changes to address diabetes in pregnancy in a complex setting: perspectives of health professionals.

    Science.gov (United States)

    Kirkham, R; Boyle, J A; Whitbread, C; Dowden, M; Connors, C; Corpus, S; McCarthy, L; Oats, J; McIntyre, H D; Moore, E; O'Dea, K; Brown, A; Maple-Brown, L

    2017-08-03

    Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional's perceptions of models of care and related quality improvement activities since the implementation of the Partnership. Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A 'systems assessment tool' was used to guide six focus groups (49 healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology. Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes. The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population however improvements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.

  18. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services.

    Science.gov (United States)

    Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

    2013-03-04

    Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers' access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers' control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services - including peer interventions, condom promotion and STI screening - would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for

  19. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    Science.gov (United States)

    Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

    2013-01-01

    Introduction Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. Results We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are

  20. IO strategies and data services for petascale data sets from a global cloud resolving model

    International Nuclear Information System (INIS)

    Schuchardt, K L; Palmer, B J; Daily, J A; Elsethagen, T O; Koontz, A S

    2007-01-01

    Global cloud resolving models at resolutions of 4km or less create significant challenges for simulation output, data storage, data management, and post-simulation analysis and visualization. To support efficient model output as well as data analysis, new methods for IO and data organization must be evaluated. The model we are supporting, the Global Cloud Resolving Model being developed at Colorado State University, uses a geodesic grid. The non-monotonic nature of the grid's coordinate variables requires enhancements to existing data processing tools and community standards for describing and manipulating grids. The resolution, size and extent of the data suggest the need for parallel analysis tools and allow for the possibility of new techniques in data mining, filtering and comparison to observations. We describe the challenges posed by various aspects of data generation, management, and analysis, our work exploring IO strategies for the model, and a preliminary architecture, web portal, and tool enhancements which, when complete, will enable broad community access to the data sets in familiar ways to the community

  1. Development and pilot study of an essential set of indicators for general surgery services.

    Science.gov (United States)

    Soria-Aledo, Victor; Angel-Garcia, Daniel; Martinez-Nicolas, Ismael; Rebasa Cladera, Pere; Cabezali Sanchez, Roger; Pereira García, Luis Francisco

    2016-11-01

    At present there is a lack of appropriate quality measures for benchmarking in general surgery units of Spanish National Health System. The aim of this study is to present the selection, development and pilot-testing of an initial set of surgical quality indicators for this purpose. A modified Delphi was performed with experts from the Spanish Surgeons Association in order to prioritize previously selected indicators. Then, a pilot study was carried out in a public hospital encompassing qualitative analysis of feasibility for prioritized indicators and an additional qualitative and quantitative three-rater reliability assessment for medical record-based indicators. Observed inter-rater agreement, prevalence adjusted and bias adjusted kappa and non-adjusted kappa were performed, using a systematic random sample (n=30) for each of these indicators. Twelve out of 13 proposed indicators were feasible: 5 medical record-based indicators and 7 indicators based on administrative databases. From medical record-based indicators, 3 were reliable (observed agreement >95%, adjusted kappa index >0.6 or non-adjusted kappa index >0.6 for composites and its components) and 2 needed further refinement. Currently, medical record-based indicators could be used for comparison purposes, whilst further research must be done for validation and risk-adjustment of outcome indicators from administrative databases. Compliance results in the adequacy of informed consent, diagnosis-to-treatment delay in colorectal cancer, and antibiotic prophylaxis show room for improvement in the pilot-tested hospital. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Copernicus stratospheric ozone service, 2009–2012: validation, system intercomparison and roles of input data sets

    Directory of Open Access Journals (Sweden)

    K. Lefever

    2015-03-01

    Full Text Available This paper evaluates and discusses the quality of the stratospheric ozone analyses delivered in near real time by the MACC (Monitoring Atmospheric Composition and Climate project during the 3-year period between September 2009 and September 2012. Ozone analyses produced by four different chemical data assimilation (CDA systems are examined and compared: the Integrated Forecast System coupled to the Model for OZone And Related chemical Tracers (IFS-MOZART; the Belgian Assimilation System for Chemical ObsErvations (BASCOE; the Synoptic Analysis of Chemical Constituents by Advanced Data Assimilation (SACADA; and the Data Assimilation Model based on Transport Model version 3 (TM3DAM. The assimilated satellite ozone retrievals differed for each system; SACADA and TM3DAM assimilated only total ozone observations, BASCOE assimilated profiles for ozone and some related species, while IFS-MOZART assimilated both types of ozone observations. All analyses deliver total column values that agree well with ground-based observations (biases The northern spring 2011 period is studied in more detail to evaluate the ability of the analyses to represent the exceptional ozone depletion event, which happened above the Arctic in March 2011. Offline sensitivity tests are performed during this month and indicate that the differences between the forward models or the assimilation algorithms are much less important than the characteristics of the assimilated data sets. They also show that IFS-MOZART is able to deliver realistic analyses of ozone both in the troposphere and in the stratosphere, but this requires the assimilation of observations from nadir-looking instruments as well as the assimilation of profiles, which are well resolved vertically and extend into the lowermost stratosphere.

  3. High Levels of Post-Abortion Complication in a Setting Where Abortion Service Is Not Legalized

    Science.gov (United States)

    Melese, Tadele; Habte, Dereje; Tsima, Billy M.; Mogobe, Keitshokile Dintle; Chabaesele, Kesegofetse; Rankgoane, Goabaone; Keakabetse, Tshiamo R.; Masweu, Mabole; Mokotedi, Mosidi; Motana, Mpho; Moreri-Ntshabele, Badani

    2017-01-01

    Background Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications. Methods A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients’ records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed. Result A total of 619 patients’ records were reviewed with a mean (SD) age of 27.12 (5.97) years. The majority of abortions (95.5%) were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%). Offensive vaginal discharge (17.9%), tender uterus (11.3%), septic shock (3.9%) and pelvic peritonitis (2.4%) were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2%) of the cases followed by hypovolemic and septic shock 65 (10.5%). There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively). Conclusion Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for

  4. High Levels of Post-Abortion Complication in a Setting Where Abortion Service Is Not Legalized.

    Directory of Open Access Journals (Sweden)

    Tadele Melese

    Full Text Available Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications.A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients' records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed.A total of 619 patients' records were reviewed with a mean (SD age of 27.12 (5.97 years. The majority of abortions (95.5% were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%. Offensive vaginal discharge (17.9%, tender uterus (11.3%, septic shock (3.9% and pelvic peritonitis (2.4% were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2% of the cases followed by hypovolemic and septic shock 65 (10.5%. There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively.Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for clinical audit on post-abortion care

  5. Preventing and controlling foodborne disease in commercial and institutional food service settings: a systematic review of published intervention studies.

    Science.gov (United States)

    Viator, Catherine; Blitstein, Jonathan; Brophy, Jenna E; Fraser, Angela

    2015-02-01

    This study reviews the current literature on behavioral and environmental food safety interventions conducted in commercial and institutional food service settings. A systematic search of the published literature yielded 268 candidate articles, from which a set of 23 articles reporting intervention outcomes was retained for evaluation. A categorization of measured outcomes is reported; studies addressed multiple outcomes ranging from knowledge, attitudes, and behavior of personal hygiene and food safety to management practices and disease rates and outbreaks. This study also investigates the quality of reported research methods used to evaluate the effectiveness of the interventions, using a nine-point quality index adapted by the authors. The observed scores suggest that there are opportunities to improve the design and reporting of research in the field of foodborne disease prevention as it applies to food safety interventions that target the food service industry. The aim is to aid researchers in this area to design higher quality studies and to produce clearer and more useful reports of their research. In turn, this can help to create a more complete evidence base that can be used to continually improve interventions in this domain.

  6. Beneficial Effects of Two Types of Personal Health Record Services Connected With Electronic Medical Records Within the Hospital Setting.

    Science.gov (United States)

    Lee, Jisan; Kim, James G Boram; Jin, Meiling; Ahn, Kiwhan; Kim, Byungjun; Kim, Sukwha; Kim, Jeongeun

    2017-11-01

    Healthcare consumers must be able to make decisions based on accurate health information. To assist with this, we designed and developed an integrated system connected with electronic medical records in hospitals to ensure delivery of accurate health information. The system-called the Consumer-centered Open Personal Health Record platform-is composed of two services: a portal for users with any disease and a mobile application for users with cleft lip/palate. To assess the benefits of these services, we used a quasi-experimental, pretest-posttest design, assigning participants to the portal (n = 50) and application (n = 52) groups. Both groups showed significantly increased knowledge, both objective (actual knowledge of health information) and subjective (perceived knowledge of health information), after the intervention. Furthermore, while both groups showed higher information needs satisfaction after the intervention, the application group was significantly more satisfied. Knowledge changes were more affected by participant characteristics in the application group. Our results may be due to the application's provision of specific disease information and a personalized treatment plan based on the participant and other users' data. We recommend that services connected with electronic medical records target specific diseases to provide personalized health management to patients in a hospital setting.

  7. Development of a new version of the Liverpool Malaria Model. I. Refining the parameter settings and mathematical formulation of basic processes based on a literature review

    Directory of Open Access Journals (Sweden)

    Jones Anne E

    2011-02-01

    Full Text Available Abstract Background A warm and humid climate triggers several water-associated diseases such as malaria. Climate- or weather-driven malaria models, therefore, allow for a better understanding of malaria transmission dynamics. The Liverpool Malaria Model (LMM is a mathematical-biological model of malaria parasite dynamics using daily temperature and precipitation data. In this study, the parameter settings of the LMM are refined and a new mathematical formulation of key processes related to the growth and size of the vector population are developed. Methods One of the most comprehensive studies to date in terms of gathering entomological and parasitological information from the literature was undertaken for the development of a new version of an existing malaria model. The knowledge was needed to allow the justification of new settings of various model parameters and motivated changes of the mathematical formulation of the LMM. Results The first part of the present study developed an improved set of parameter settings and mathematical formulation of the LMM. Important modules of the original LMM version were enhanced in order to achieve a higher biological and physical accuracy. The oviposition as well as the survival of immature mosquitoes were adjusted to field conditions via the application of a fuzzy distribution model. Key model parameters, including the mature age of mosquitoes, the survival probability of adult mosquitoes, the human blood index, the mosquito-to-human (human-to-mosquito transmission efficiency, the human infectious age, the recovery rate, as well as the gametocyte prevalence, were reassessed by means of entomological and parasitological observations. This paper also revealed that various malaria variables lack information from field studies to be set properly in a malaria modelling approach. Conclusions Due to the multitude of model parameters and the uncertainty involved in the setting of parameters, an extensive

  8. Basic electrotechnology

    CERN Document Server

    Ashen, R A

    2013-01-01

    BASIC Electrotechnology discusses the applications of Beginner's All-purpose Symbolic Instruction Code (BASIC) in engineering, particularly in solving electrotechnology-related problems. The book is comprised of six chapters that cover several topics relevant to BASIC and electrotechnology. Chapter 1 provides an introduction to BASIC, and Chapter 2 talks about the use of complex numbers in a.c. circuit analysis. Chapter 3 covers linear circuit analysis with d.c. and sinusoidal a.c. supplies. The book also discusses the elementary magnetic circuit theory. The theory and performance of two windi

  9. From failure to value: economic valuation for a selected set of products and services from Mediterranean forests

    Energy Technology Data Exchange (ETDEWEB)

    Masiero, M.; Pettenella, D.; Secco, L.

    2016-07-01

    Aim of study: the paper estimates the economic value of a selected range of forest products and services, i.e. roundwood, non-wood forest products (NWFPs), and carbon-related services. Area of study: the research covers 21 Mediterranean countries, distinguished into four sub-regions. Material and methods: data have been gathered from official statistical sources (e.g. FAOSTAT), scientific literature and technical reports. Different estimation approaches based on market-price have been used for different products/services. Main results: the estimated value ranges between €10,512 and €11,158 million (M). Wood products represent more than 85% of the total value. Within them, industrial timber is the most relevant component (65%). Figures for NWFPs are likely to be underestimated because data are available only for some products and countries. When using alternative estimates for pine nuts, pine resin and cork, figures show a €36.8-572 M increase. In geographical terms, the economic value of Mediterranean forests is highly concentrated: North-West Mediterranean countries account for 70%, and nearly 90% is in just four countries (France, Spain, Turkey and Italy). Research highlights: enhancing the offer of Mediterranean forest products and increasing their role in the rural economy could help to reduce the costs of forest protection: a well-structured forest economy ensuring stable flows of incomes can provide a fundamental set of public non-market services and social values to both local people and the whole community. Understanding the true value of natural resources, then, is an essential step for promoting their protection and sustainable use. (Author)

  10. From failure to value: economic valuation for a selected set of products and services from Mediterranean forests

    Directory of Open Access Journals (Sweden)

    Davide Pettenella

    2016-04-01

    Full Text Available Aim of study: the paper estimates the economic value of a selected range of forest products and services, i.e. roundwood, non-wood forest products (NWFPs, and carbon-related services.Area of study: the research covers 21 Mediterranean countries, distinguished into four sub-regions.Material and methods: data have been gathered from official statistical sources (e.g. FAOSTAT, scientific literature and technical reports. Different estimation approaches based on market-price have been used for different products/services.Main results: the estimated value ranges between €10,512 and €11,158 million (M. Wood products represent more than 85% of the total value. Within them, industrial timber is the most relevant component (65%. Figures for NWFPs are likely to be underestimated because data are available only for some products and countries. When using alternative estimates for pine nuts, pine resin and cork, figures show a €36.8-572 M increase. In geographical terms, the economic value of Mediterranean forests is highly concentrated: North-West Mediterranean countries account for 70%, and nearly 90% is in just four countries (France, Spain, Turkey and Italy.Research highlights: enhancing the offer of Mediterranean forest products and increasing their role in the rural economy could help to reduce the costs of forest protection: a well-structured forest economy ensuring stable flows of incomes can provide a fundamental set of public non-market services and social values to both local people and the whole community. Understanding the true value of natural resources, then, is an essential step for promoting their protection and sustainable use.Abbreviations: Bln: billion; CUM: cubic meter; EM: East Mediterranean; FAO: Food and Agriculture Organisation of the United Nations; FRA: Forest Resource Assessment; ha: hectare; M: million; NEM: North-East Mediterranean; NWFP: non-wood forest product; NWM: North-West Mediterranean; SM: South Mediterranean. 

  11. The definition of basic parameters of the set of small-sized equipment for preparation of dry mortar for various applications

    Directory of Open Access Journals (Sweden)

    Emelyanova Inga

    2017-01-01

    Full Text Available Based on the conducted information retrieval and review of the scientific literature, unsolved issues have been identified in the process of preparation of dry construction mixtures in the conditions of a construction site. The constructions of existing technological complexes for the production of dry construction mixtures are considered and their main drawbacks are identified in terms of application in the conditions of the construction site. On the basis of the conducted research, the designs of technological sets of small-sized equipment for the preparation of dry construction mixtures in the construction site are proposed. It is found out that the basis for creating the proposed technological kits are new designs of concrete mixers operating in cascade mode. A technique for calculating the main parameters of technological sets of equipment is proposed, depending on the use of the base machine of the kit.

  12. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    Directory of Open Access Journals (Sweden)

    Ostermann Thomas

    2010-10-01

    Full Text Available Abstract Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8, were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely

  13. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    Science.gov (United States)

    2010-01-01

    Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

  14. Anesthesia Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Anesthesia Basics KidsHealth / For Teens / Anesthesia Basics What's in ... español Conceptos básicos sobre la anestesia What Is Anesthesia? No doubt about it, getting an operation can ...

  15. BASIC Programming.

    Science.gov (United States)

    Jennings, Carol Ann

    Designed for use by both secondary- and postsecondary-level business teachers, this curriculum guide consists of 10 units of instructional materials dealing with Beginners All-Purpose Symbol Instruction Code (BASIC) programing. Topics of the individual lessons are numbering BASIC programs and using the PRINT, END, and REM statements; system…

  16. Using Goal Achievement Training in juvenile justice settings to improve substance use services for youth on community supervision.

    Science.gov (United States)

    Fisher, Jacqueline Horan; Becan, Jennifer E; Harris, Philip W; Nager, Alexis; Baird-Thomas, Connie; Hogue, Aaron; Bartkowski, John P; Wiley, Tisha

    2018-04-30

    The link between substance use and involvement in the juvenile justice system has been well established. Justice-involved youth tend to have higher rates of drug use than their non-offending peers. At the same time, continued use can contribute to an elevated risk of recidivism, which leads to further, and oftentimes more serious, involvement with the juvenile justice system. Because of these high rates of use, the juvenile justice system is well positioned to help identify youth with substance use problems and connect them to treatment. However, research has found that only about 60% of juvenile probation agencies screen all youth for substance involvement, and even fewer provide comprehensive assessment or help youth enroll in substance use treatment. This paper describes an integrated training curriculum that was developed to help juvenile justice agencies improve their continuum of care for youth probationers with substance use problems. Goal Achievement Training (GAT) provides a platform for continuous quality improvement via two sessions delivered onsite to small groups of staff from juvenile justice and behavioral health agencies. In the first session, participants are taught to identify goals and goal steps for addressing identified areas of unmet need (i.e., screening, assessment, and linkage to treatment services). In the second session, participants learn principles and strategies of data-driven decision-making for achieving these goals. This paper highlights GAT as a model for the effective implementation of cost-efficient training strategies designed to increase self-directed quality improvement activities that can be applied to any performance domain within juvenile justice settings. Efforts to monitor implementation fidelity of GAT within the specific context of the juvenile justice settings are highlighted. Challenges to setting the stage for process improvement generally, as well as specific hurdles within juvenile justice settings are discussed

  17. Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the Emergency Medical Services Setting: A Systematic Review

    Science.gov (United States)

    2018-01-11

    Background: This study sought to systematically search the literature to identify reliable and valid survey instruments for fatigue measurement in the Emergency Medical Services (EMS) occupational setting. Methods: A systematic review study design wa...

  18. Streams of events and performance of queuing systems: The basic anatomy of arrival/departure processes, when the focus is set on autocorrelation

    DEFF Research Database (Denmark)

    Nielsen, Erland Hejn

    2004-01-01

    significant nature or (2) aggregate system behaviour is in general very different from just the summing-up (even for finite sets of micro-behavioural patterns) and/or (3) it is simply a wrong assumption that in many cases is chosen by mere convention or plain convenience. It is evident that before choosing...... method or some autocorrelation extended descriptive sampling method, can then easily be applied. The results from the Livny, Melamed and Tsiolis (1993) study as well as the results from this work both indicates that system performance measures as for instance average waiting time or average time...

  19. Effect of the laryngeal tube on the no-flow-time in a simulated two rescuer basic life support setting with inexperienced users.

    Science.gov (United States)

    Schröder, J; Bucher, M; Meyer, O

    2016-09-01

    Intubation with a laryngeal tube (LT) is a recommended alternative to endotracheal intubation during advanced life support (ALS). LT insertion is easy; therefore, it may also be an alternative to bag-mask ventilation (BMV) for untrained personnel performing basic life support (BLS). Data from manikin studies support the influence of LT on no-flow-time (NFT) during ALS. We performed a prospective, randomized manikin study using a two-rescuer model to compare the effects of ventilation using a LT and BMV on NFT during BLS. Participants were trained in BMV and were inexperienced in the use of a LT. There was no significant difference in total NFT with the use of a LT and BMV (LT: mean 83.1 ± 37.3 s; BMV: mean 78.7 ± 24.5 s; p = 0.313), but we found significant differences in the progression of the scenario: in the BLS-scenario, the proportion of time spent performing chest compressions was higher when BMV was used compared to when a LT was used. The quality of chest compressions and the ventilation rate did not differ significantly between the two groups. The mean tidal volume and mean minute volume were significantly larger with the use of a LT compared with the use of BMV. In conclusion, in a two-rescuer BLS scenario, NFT is longer with the use of a LT (without prior training) than with the use of BMV (with prior training). The probable reasons for this result are higher tidal volumes with the use of a LT leading to longer interruptions without chest compressions.

  20. Effect of using a laryngeal tube on the no-flow time in a simulated, single-rescuer, basic life support setting with inexperienced users.

    Science.gov (United States)

    Meyer, O; Bucher, M; Schröder, J

    2016-03-01

    The laryngeal tube (LT) is a recommended alternative to endotracheal intubation during advanced life support (ALS). Its insertion is relatively simple; therefore, it may also serve as an alternative to bag mask ventilation (BMV) for untrained personnel performing basic life support (BLS). Data support the influence of LT on the no-flow time (NFT) compared with BMV during ALS in manikin studies. We performed a manikin study to investigate the effect of using the LT for ventilation instead of BMV on the NFT during BLS in a prospective, randomized, single-rescuer study. All 209 participants were trained in BMV, but were inexperienced in using LT; each participant performed BLS during a 4-min time period. No significant difference in total NFT (LT: mean 81.1 ± 22.7 s; BMV: mean 83.2 ± 13.1 s, p = 0.414) was found; however, significant differences in the later periods of the scenario were identified. While ventilating with the LT, the proportion of chest compressions increased significantly from 67.2 to 73.2%, whereas the proportion of chest compressions increased only marginally when performing BMV. The quality of the chest compressions and the associated ventilation rate did not differ significantly. The mean tidal volume and mean minute volume were significantly lower when performing BMV. The NFT was significantly shorter in the later periods in a single-rescuer, cardiac arrest scenario when using an LT without previous training compared with BMV with previous training. A possible explanation for this result may be the complexity and workload of alternating tasks (e.g., time loss when reclining the head and positioning the mask for each ventilation during BMV).

  1. Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting

    Directory of Open Access Journals (Sweden)

    Nielsen Anne

    2012-05-01

    Full Text Available Abstract Background Ambulance personnel play an essential role in the ‘Chain of Survival’. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island. Methods The Basic Life Support (BLS and Automated External Defibrillator (AED skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given. Results On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2 was used by 80%. A mean compression depth of 40–50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm. The mean compression rate was 123 per min (SD 15/min. The mean tidal volume was 746 ml (SD 221 ml. Only the mean tidal volume deviated significantly from the recommended (p = 0.01. During the rhythm analysis, 65% did not perform any visual or verbal safety check. Conclusion The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.

  2. REFERQUAL: a pilot study of a new service quality assessment instrument in the GP exercise referral scheme setting

    Science.gov (United States)

    Cock, Don; Adams, Iain C; Ibbetson, Adrian B; Baugh, Phil

    2006-01-01

    Background The development of an instrument accurately assessing service quality in the GP Exercise Referral Scheme (ERS) industry could potentially inform scheme organisers of the factors that affect adherence rates leading to the implementation of strategic interventions aimed at reducing client drop-out. Methods A modified version of the SERVQUAL instrument was designed for use in the ERS setting and subsequently piloted amongst 27 ERS clients. Results Test re-test correlations were calculated via Pearson's 'r' or Spearman's 'rho', depending on whether the variables were Normally Distributed, to show a significant (mean r = 0.957, SD = 0.02, p < 0.05; mean rho = 0.934, SD = 0.03, p < 0.05) relationship between all items within the questionnaire. In addition, satisfactory internal consistency was demonstrated via Cronbach's 'α'. Furthermore, clients responded favourably towards the usability, wording and applicability of the instrument's items. Conclusion REFERQUAL is considered to represent promise as a suitable tool for future evaluation of service quality within the ERS community. Future research should further assess the validity and reliability of this instrument through the use of a confirmatory factor analysis to scrutinise the proposed dimensional structure. PMID:16725021

  3. 'Being a conduit' between hospital and home: stakeholders' views and perceptions of a nurse-led Palliative Care Discharge Facilitator Service in an acute hospital setting.

    Science.gov (United States)

    Venkatasalu, Munikumar Ramasamy; Clarke, Amanda; Atkinson, Joanne

    2015-06-01

    To explore and critically examine stakeholders' views and perceptions concerning the nurse-led Palliative Care Discharge Service in an acute hospital setting and to inform sustainability, service development and future service configuration. The drive in policy and practice is to enable individuals to achieve their preferred place of care during their last days of life. However, most people in UK die in acute hospital settings against their wishes. To facilitate individuals' preferred place of care, a large acute hospital in northeast England implemented a pilot project to establish a nurse-led Macmillan Palliative Care Discharge Facilitator Service. A pluralistic evaluation design using qualitative methods was used to seek stakeholders' views and perceptions of this service. In total, 12 participants (five bereaved carers and seven health professionals) participated in the evaluation. Semi-structured interviews were conducted with bereaved carers who used this service for their relatives. A focus group and an individual interview were undertaken with health professionals who had used the service since its inception. Individual interviews were also conducted with the Discharge Facilitator and service manager. Analysis of all data was guided by Framework Analysis. Four key themes emerged relating to the role of the Discharge Facilitator Service: achieving preferred place of care; the Discharge Facilitator as the 'conduit' between hospital and community settings; delays in hospital discharge and stakeholders' perceptions of the way forward for the service. The Discharge Facilitator Service acted as a reliable resource and support for facilitating the fast-tracking of end-of-life patients to their preferred place of care. Future planning for hospital-based palliative care discharge facilitating services need to consider incorporating strategies that include: increased profile of the service, expansion of service provision and the Discharge Facilitator's earlier

  4. Basic hydraulics

    CERN Document Server

    Smith, P D

    1982-01-01

    BASIC Hydraulics aims to help students both to become proficient in the BASIC programming language by actually using the language in an important field of engineering and to use computing as a means of mastering the subject of hydraulics. The book begins with a summary of the technique of computing in BASIC together with comments and listing of the main commands and statements. Subsequent chapters introduce the fundamental concepts and appropriate governing equations. Topics covered include principles of fluid mechanics; flow in pipes, pipe networks and open channels; hydraulic machinery;

  5. Investigating Pre-Service Early Childhood Teachers' Views and Intentions about Integrating and Using Computers in Early Childhood Settings: Compilation of an Instrument

    Science.gov (United States)

    Nikolopoulou, Kleopatra; Gialamas, Vasilis

    2009-01-01

    This paper discusses the compilation of an instrument in order to investigate pre-service early childhood teachers' views and intentions about integrating and using computers in early childhood settings. For the purpose of this study a questionnaire was compiled and administered to 258 pre-service early childhood teachers (PECTs), in Greece. A…

  6. Using AN Essea Earth Systems Science Course in a Web-Enhanced Setting for Pre-Service Middle School Teachers

    Science.gov (United States)

    Slattery, W.

    2003-12-01

    The ESSEA Middle School course was originally designed as an asynchronous on-line tool for teacher professional development. The ESSEA course uses real world events such as deforestation, volcanic eruptions and hurricanes to develop content understandings of Earth systems processes and to model pedagogical best practices appropriate for middle school students. The course is structured as multiple three-week learning cycles. During week one of each cycle, participants are formed into Sphere groups to study the impact of the event under consideration on the atmosphere, biosphere, hydrosphere, or lithosphere. During week two, Event teams are formed to include members from each of the previous week's Sphere groups. Together they develop interactions between the different spheres and the event. During week three, teachers develop classroom applications and post them on-line for other participants to comment upon. On-going assessment suggests that in-service teacher participants of the on-line course are more likely to infuse inquiry-based science instruction into their classroom settings and to teach science as a subject integrating Physical science, Life science, and Earth/Space science in their own classrooms It is imperative to develop such characteristics in pre-service teachers as well. Wright State University's undergraduate Middle School teacher preparation program requires that undergraduates seeking Middle Childhood Licensure by the State of Ohio take a course in Earth Systems science that is aligned with the national and state science education standards. Towards this end the ESSEA course has been adapted for use in a web-enhanced setting. Weeks one and two (Sphere and Event study) of the ESSEA Middle School course are used as an integral component of this Earth Systems science course. In this way content knowledge and pedagogical strategies are modeled just as they are in the fully on-line course. Questions raised on-line are the topic of research or

  7. Sustainability Assessment of Out-of-Home Meals: Potentials and Challenges of Applying the Indicator sets NAHGAST Meal-Basic and NAHGAST Meal-Pro

    Directory of Open Access Journals (Sweden)

    Tobias Engelmann

    2018-02-01

    Full Text Available Nutrition is responsible for about 30% of global natural resource use. In order to limit the negative impact the nutritional sector has on the environment and on society, the consumption and processing of foodstuffs with assumed low negative impact is an important topic in the effort of sustainable development. In professional kitchens, clearly defined indicators assessing the impact of business activities are needed in this effort. The research and development in the NAHGAST project provides groundwork that could be of important assistance in this effort. Two versions of an assessment tool, with indicators of different complexity (NAHGAST Meal-Basic and NAHGAST Meal-Pro, were developed that can be used by kitchen professionals to determine the sustainability performance of their products—the offered meal. An informed selection of indicators, and a discussion of what processes and impacts this indicator relates to in the wider context, are essential and are discussed in this paper. Furthermore, in the selection of indicators for the purpose of our research certain criteria were considered simultaneously: (1 Communicability—What information an indicator can communicate and how comprehensible this information is for different actors; (2 Feasibility and data availability—Whether there is sufficient data for an indicator to be included and whether it is realistic for companies to integrate this indicator in their daily work practice; and (3 Scientific relevance—Whether the indicator is relevant for sustainability efforts on a larger scale and for related discussions in the scientific community. Insights related to these considerations are valuable for future developments in sustainability assessment in out-of-home gastronomy. The tool has been used to evaluate a number of dishes and results are deemed meaningful. However, assessments must not be understood as an accurate measurement but as an approximation of the sustainability of meals. At

  8. Basic Finance

    Science.gov (United States)

    Vittek, J. F.

    1972-01-01

    A discussion of the basic measures of corporate financial strength, and the sources of the information is reported. Considered are: balance sheet, income statement, funds and cash flow, and financial ratios.

  9. Perceptions of registered nurses regarding factors influencing service delivery in expanding programmes in a primary healthcare setting

    Directory of Open Access Journals (Sweden)

    Nnoi. A. Xaba

    2012-11-01

    Full Text Available The aim of this study was to explore and describe the perceptions of registered nurses regarding factors influencing service delivery regarding expansion programmes in a primary healthcare setting, using a qualitative approach. The registered nurses, who have been working in the clinics for more than two years and have been exposed to the expansion programmes there, were purposively sampled. Two focus group interviews were conducted in a neutral place and the data collected by the researcher Nnoi A. Xaba (N.A.X.. Data were analysed by the researcher and an independent co-coder using the Tesch method. Categories, subcategories and themes were identified; those that formed the basis of discussion were disabling factors, enabling factors, client-related factors, service-related factors and solutions to problems. It is recommended that integration of programmes and coordination be done at a provincial level and planned together with the training centres in order to alleviate problems in service delivery. Training on expansion programmes in the form of in-service education should be carried out continually in the region.Die doel van die studie was om die persepsie van geregistreerde verpleegkundiges met betrekking tot die faktore wat dienslewering van die uitbreidingsprogramme in ‘n primêre gesondheid opset beinvloed; te eksploreer en te beskryf. ‘n Kwalitatiewe benadering is gevolg in die iutvoering van die studie. ‘n Doelgerigte steekproef is uitgevoer vanuit geregistreerde verpleegkundiges wat vir langer as twee jaar in die klinieke werksaam was en blootgestel is aan die uitbreiding programme. Twee fokus groep onderhoude is deur die navorser Nnoi A. Xaba (N.A.X. in ‘n neutrale opset uitgevoer. Data is deur die navorser en ʼn onafhanklike kodeerder ontleed volgens Tesch se metode van analise. Kategorieë, sub-kategorieë en temas was geidentifiseer. Die kategorieë fundamenteel tot die bespreking behels: remmende faktore, bydraende faktore

  10. Development NGOs: Basic Facts

    OpenAIRE

    Aldashev, Gani; Navarra, Cecilia

    2017-01-01

    This paper systematizes the results of the empirical literature on development non-governmental organizations (NGOs), drawing both from quantitative and qualitative analyses, and constructs a set of basic facts about these organizations. These basic facts concern the size of the development NGO sector and its evolution, the funding of NGOs, the allocation of NGO aid and projects across beneficiary countries, the relationship of NGOs with beneficiaries, and the phenomenon of globalization of d...

  11. Basic stress analysis

    CERN Document Server

    Iremonger, M J

    1982-01-01

    BASIC Stress Analysis aims to help students to become proficient at BASIC programming by actually using it in an important engineering subject. It also enables the student to use computing as a means of learning stress analysis because writing a program is analogous to teaching-it is necessary to understand the subject matter. The book begins by introducing the BASIC approach and the concept of stress analysis at first- and second-year undergraduate level. Subsequent chapters contain a summary of relevant theory, worked examples containing computer programs, and a set of problems. Topics c

  12. Informatics solutions for bridging the gap between clinical and laboratory services in a low-resource setting

    Directory of Open Access Journals (Sweden)

    Julia Driessen

    2015-06-01

    Full Text Available Background: There has been little formal analysis of laboratory systems in resource-limited settings, despite widespread consensus around the importance of a strong laboratory infrastructure. Objectives: This study details the informational challenges faced by the laboratory at Kamuzu Central Hospital, a tertiary health facility in Malawi; and proposes ways in which informatics can bolster the efficiency and role of low-resource laboratory systems. Methods: We evaluated previously-collected data on three different aspects of laboratory use. A four-week quality audit of laboratory test orders quantified challenges associated with collecting viable specimens for testing. Data on tests run by the laboratory over a one yearperiod described the magnitude of the demand for laboratory services. Descriptive information about the laboratory workflow identified informational process breakdowns in the pre-analytical and post-analytical phases and was paired with a 24-hour sample of laboratory data on results reporting. Results: The laboratory conducted 242 242 tests over a 12-month period. The four-week quality audit identified 54% of samples as untestable. Prohibitive paperwork errors were identified in 16% of samples. Laboratory service workflows indicated a potential process breakdown in sample transport and results reporting resulting from the lack of assignment of these tasks to any specific employee cadre. The study of result reporting time showed a mean of almost six hours, with significant variation. Conclusions: This analysis identified challenges in each phase of laboratory testing. Informatics could improve the management of this information by streamlining test ordering and the communication of test orders to the laboratory and results back to the ordering physician.

  13. Basic electronics

    CERN Document Server

    Holbrook, Harold D

    1971-01-01

    Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t

  14. The Standard Days Method(®): efficacy, satisfaction and demand at regular family planning service delivery settings in Turkey.

    Science.gov (United States)

    Kursun, Zerrin; Cali, Sanda; Sakarya, Sibel

    2014-06-01

    To evaluate the demand, efficacy, and satisfaction concerning the Standard Days Method(®) (SDM; a fertility awareness method) as an option presented among other contraceptive methods at regular service delivery settings. The survey group consisted of 993 women who presented at the primary care units in Umraniye District of Istanbul, Turkey, between 1 October 2006 and 31 March 2008, and started to use a new method. Women were enrolled until reaching a limit of 250 new users for each method, or expiration of the six-month registration period. Participants were followed for up to one year of method use. The characteristics of women who chose the SDM were similar to those of participants who opted for other methods. The most common reasons for selecting it were that it is natural and causes no side effects. Fifty-one percent used the SDM for the full year, compared to 71% who chose an intrauterine device (IUD). Continuation rates were significantly lower for all other methods. During the one-year follow-up period, 12% of SDM-, 7% of pill-, 7% of condom-, 3% of monthly injection-, 1% of quarterly injection-, and 0.5% of IUD users became pregnant. The SDM had relatively high continuation rates and relatively good levels of satisfaction among participants and their husbands. It should be mentioned among the routinely offered contraceptive methods.

  15. Basic concepts

    International Nuclear Information System (INIS)

    Dorner, B.

    1999-01-01

    The basic concepts of neutron scattering as a tool for studying the structure and the dynamics of condensed matter. Theoretical aspects are outlined, the two different cases of coherent and incoherent scattering are presented. The issue of resolution, coherence volume and the role of monochromators are also discussed. (K.A.)

  16. Body Basics

    Science.gov (United States)

    ... learn more about how the body works, what basic human anatomy is, and what happens when parts of ... consult your doctor. © 1995- The Nemours Foundation. All rights reserved. Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.

  17. Basic Thermodynamics

    International Nuclear Information System (INIS)

    Duthil, P

    2014-01-01

    The goal of this paper is to present a general thermodynamic basis that is useable in the context of superconductivity and particle accelerators. The first part recalls the purpose of thermodynamics and summarizes its important concepts. Some applications, from cryogenics to magnetic systems, are covered. In the context of basic thermodynamics, only thermodynamic equilibrium is considered

  18. Basic Thermodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Duthil, P [Orsay, IPN (France)

    2014-07-01

    The goal of this paper is to present a general thermodynamic basis that is useable in the context of superconductivity and particle accelerators. The first part recalls the purpose of thermodynamics and summarizes its important concepts. Some applications, from cryogenics to magnetic systems, are covered. In the context of basic thermodynamics, only thermodynamic equilibrium is considered.

  19. Ethanol Basics

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-01-30

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  20. Wavelet basics

    CERN Document Server

    Chan, Y T

    1995-01-01

    Since the study of wavelets is a relatively new area, much of the research coming from mathematicians, most of the literature uses terminology, concepts and proofs that may, at times, be difficult and intimidating for the engineer. Wavelet Basics has therefore been written as an introductory book for scientists and engineers. The mathematical presentation has been kept simple, the concepts being presented in elaborate detail in a terminology that engineers will find familiar. Difficult ideas are illustrated with examples which will also aid in the development of an intuitive insight. Chapter 1 reviews the basics of signal transformation and discusses the concepts of duals and frames. Chapter 2 introduces the wavelet transform, contrasts it with the short-time Fourier transform and clarifies the names of the different types of wavelet transforms. Chapter 3 links multiresolution analysis, orthonormal wavelets and the design of digital filters. Chapter 4 gives a tour d'horizon of topics of current interest: wave...

  1. Education: The Basics. The Basics

    Science.gov (United States)

    Wood, Kay

    2011-01-01

    Everyone knows that education is important, we are confronted daily by discussion of it in the media and by politicians, but how much do we really know about education? "Education: The Basics" is a lively and engaging introduction to education as an academic subject, taking into account both theory and practice. Covering the schooling system, the…

  2. Urban Services and Child Migration to the Slums of Nairobi

    NARCIS (Netherlands)

    Archambault, C.; Laat, J. de; Zulu, E.M.

    2012-01-01

    An estimated 30–70% of Nairobi’s population lives in informal settlements with very poor access to basic services, yet children are notably absent from the informal settlements. This paper combines qualitative research with three micro data sets and finds that the presence of urban basic services

  3. [Case-Mix of hospital emergencies in the Andalusian Health Service based on the 2012 Minimum Data Set. Spain].

    Science.gov (United States)

    Goicoechea Salazar, Juan Antonio; Nieto García, María Adoración; Laguna Téllez, Antonio; Larrocha Mata, Daniel; Canto Casasola, Vicente David; Murillo Cabezas, Francisco

    2013-01-01

    The implementation of digital health records in emergency departments (ED) in hospitals in the Andalusian Health Service and the development of an automatic encoder for this area have allowed us to establish a Minimum Data Set for Emergencies (MDS-ED). The aim of this article is to describe the case mix of hospital EDs using various dimensions contained in the MDS-ED. 3.235.600 hospital emergency records in 2012 were classified in clinical categories from the ICD-9-CM codes generated by the automatic encoder. Operating rules to obtain response time and length of stay were defined. A descriptive analysis was carried out to obtain demographic and chronological indicators as well as hospitalization, return and death rates and response time and length of stay in the Eds. Women generated 54,26% of all occurrences and their average age (39,98 years) was higher than men's (37,61). Paediatric emergencies accounted for 21,49% of the total. The peak hours were from 10:00 to 13:00 and from 16:00 to 17:00. Patients who did not undergo observation (92,67%) remained in the ED an average of 153 minutes. Injuries and poisoning, respiratory diseases, musculoskeletal diseases and symptoms and signs generated over 50% of all visits. 79.191 cases of chest pain, 28.741 episodes of heart failure and 27.989 episodes of serious infections were identified among the most relevant disorders. The MDS-ED makes it possible to address systematically the analysis of hospital emergencies by identifying the activity developed, the case-mix attended, the response times, the time spent in ED and the quality of the care.

  4. Where do young Irish women want Chlamydia-screening services to be set up? A qualitative study employing Goffman's impression management framework.

    Science.gov (United States)

    Balfe, Myles; Brugha, Ruairi; O' Connell, Emer; McGee, Hannah; O' Donovan, Diarmuid

    2010-01-01

    We conducted interviews with 35 young women recruited from eight community healthcare rural and urban settings across two regions of Ireland. The aim of the study was to explore where these women thought Chlamydia-screening services should be located. Respondents wanted screening services to be located in settings where they would not be witnessed either asking for, or being asked to take, Chlamydia tests. Respondents were worried that their identities would become stigmatized if others were to find out that they had accepted screening. Findings are interpreted through Goffman's stigma and impression management framework. We conclude with public health recommendations.

  5. Service climate in self-managing teams: Mapping the linkage of team member perceptions and service performance outcomes in a business-to-business setting

    NARCIS (Netherlands)

    Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.

    2005-01-01

    Drawing from the organizational behaviour and services marketing literature, we develop a conceptual model of self-managing team (SMT) service climate, taking into account characteristics of the organizational context, the SMT, and the individual employee. In order to assess the impact of SMT

  6. Impacts of extreme heat on emergency medical service calls in King County, Washington, 2007-2012: relative risk and time series analyses of basic and advanced life support.

    Science.gov (United States)

    Calkins, Miriam M; Isaksen, Tania Busch; Stubbs, Benjamin A; Yost, Michael G; Fenske, Richard A

    2016-01-28

    Exposure to excessive heat kills more people than any other weather-related phenomenon, aggravates chronic diseases, and causes direct heat illness. Strong associations between extreme heat and health have been identified through increased mortality and hospitalizations and there is growing evidence demonstrating increased emergency department visits and demand for emergency medical services (EMS). The purpose of this study is to build on an existing regional assessment of mortality and hospitalizations by analyzing EMS demand associated with extreme heat, using calls as a health metric, in King County, Washington (WA), for a 6-year period. Relative-risk and time series analyses were used to characterize the association between heat and EMS calls for May 1 through September 30 of each year for 2007-2012. Two EMS categories, basic life support (BLS) and advanced life support (ALS), were analyzed for the effects of heat on health outcomes and transportation volume, stratified by age. Extreme heat was model-derived as the 95th (29.7 °C) and 99th (36.7 °C) percentile of average county-wide maximum daily humidex for BLS and ALS calls respectively. Relative-risk analyses revealed an 8 % (95 % CI: 6-9 %) increase in BLS calls, and a 14 % (95 % CI: 9-20 %) increase in ALS calls, on a heat day (29.7 and 36.7 °C humidex, respectively) versus a non-heat day for all ages, all causes. Time series analyses found a 6.6 % increase in BLS calls, and a 3.8 % increase in ALS calls, per unit-humidex increase above the optimum threshold, 40.7 and 39.7 °C humidex respectively. Increases in "no" and "any" transportation were found in both relative risk and time series analyses. Analysis by age category identified significant results for all age groups, with the 15-44 and 45-64 year old age groups showing some of the highest and most frequent increases across health conditions. Multiple specific health conditions were associated with increased risk of an EMS call including abdominal

  7. Basic principles

    International Nuclear Information System (INIS)

    Wilson, P.D.

    1996-01-01

    Some basic explanations are given of the principles underlying the nuclear fuel cycle, starting with the physics of atomic and nuclear structure and continuing with nuclear energy and reactors, fuel and waste management and finally a discussion of economics and the future. An important aspect of the fuel cycle concerns the possibility of ''closing the back end'' i.e. reprocessing the waste or unused fuel in order to re-use it in reactors of various kinds. The alternative, the ''oncethrough'' cycle, discards the discharged fuel completely. An interim measure involves the prolonged storage of highly radioactive waste fuel. (UK)

  8. Basic electronics

    CERN Document Server

    Tayal, DC

    2010-01-01

    The second edition of this book incorporates the comments and suggestions of my friends and students who have critically studied the first edition. In this edition the changes and additions have been made and subject matter has been rearranged at some places. The purpose of this text is to provide a comprehensive and up-to-date study of the principles of operation of solid state devices, their basic circuits and application of these circuits to various electronic systems, so that it can serve as a standard text not only for universities and colleges but also for technical institutes. This book

  9. Economic Costs of Patients Attending the Prevention of Mother-to- Child Transmission of HIV/AIDS (PMTCT Services in Ethiopia: Urban-Rural Settings

    Directory of Open Access Journals (Sweden)

    Elias Asfaw Zegeye

    2016-08-01

    Full Text Available Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT. This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence and rural (low-HIV prevalence settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory and direct non-medical (food, transportation and accommodation. The mean direct medical expense per patient per year was Ethiopian birr (ETB 746 (US$ 38 in the urban settings, as compared to ETB 368 (US$ 19 in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327 and ETB 2,154 (US$ 110 per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132 and ETB 2,919 (US$ 148.39 in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.

  10. Economic Feasibility of Wireless Sensor Network-Based Service Provision in a Duopoly Setting with a Monopolist Operator.

    Science.gov (United States)

    Sanchis-Cano, Angel; Romero, Julián; Sacoto-Cabrera, Erwin J; Guijarro, Luis

    2017-11-25

    We analyze the feasibility of providing Wireless Sensor Network-data-based services in an Internet of Things scenario from an economical point of view. The scenario has two competing service providers with their own private sensor networks, a network operator and final users. The scenario is analyzed as two games using game theory. In the first game, sensors decide to subscribe or not to the network operator to upload the collected sensing-data, based on a utility function related to the mean service time and the price charged by the operator. In the second game, users decide to subscribe or not to the sensor-data-based service of the service providers based on a Logit discrete choice model related to the quality of the data collected and the subscription price. The sinks and users subscription stages are analyzed using population games and discrete choice models, while network operator and service providers pricing stages are analyzed using optimization and Nash equilibrium concepts respectively. The model is shown feasible from an economic point of view for all the actors if there are enough interested final users and opens the possibility of developing more efficient models with different types of services.

  11. The impact of incomplete information on the use of marketing research intelligence in international service settings: An experimental study

    NARCIS (Netherlands)

    Birgelen, van M.; Ruyter, de J.C.; Wetzels, M.G.M.

    2000-01-01

    Unfamiliarity with foreign business environments and cultures will result in higher levels of uncertainty, especially for international service organizations. To effectively deal with international uncertainty, it seems crucial to have access to information that is as complete as possible. In

  12. Teaming in Two-Year Postsecondary Settings: An Approach to Providing Effective and Efficient Services for Students with Disabilities.

    Science.gov (United States)

    Bigaj, Stephen J.; Bazinet, Gregory P.

    1993-01-01

    Suggests a team approach for effectively and efficiently providing services for postsecondary students with disabilities. Reviews various teaming concepts and presents a framework for a postsecondary disability problem-solving team. (Author/JOW)

  13. Mobile surgical services in primary care in a rural and remote setting: Experience and evidence from Yala, Cross River State, Nigeria

    Directory of Open Access Journals (Sweden)

    Emmanuel Monjok

    2009-07-01

    Full Text Available Surgical conditions account for 11 to 15% of the global burden of disease. Yet, surgical services are very scarce in the rural areas of Nigeria where approximately 60 to 80% of the population resides. Among other basic contributing factors is the shortage of surgical workforce, since Nigeria’s few surgeons practise in the urban centre of the major cities. One way to respond to this acute shortage of surgeons is the training of generalist medical doctors to undertake surgery in rural areas. The introduction of mobile surgical services in rural populations as part of the existing primary health care activities in the Local Government Areas (districts can reduce surgical morbidity and mortality in Nigeria. This can be done by the generalist physician with training and experience in surgery using local health staff and simple surgical equipment. A number of recommendations are made.

  14. Convenience, quality and choice: Patient and service-provider perspectives for treating primary care complaints in urgent care settings.

    Science.gov (United States)

    Sturgeon, David

    2017-11-01

    To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers. A comparative case study approach was adopted and between October 2014 and May 2015 the researcher was embedded as a participant observer as part of the emergency nurse practitioner team at two, nurse-led, MIUs (site A and B). During this time, 40 patients, 17 service-providers and 1 senior manager were interviewed. Patients and service-providers at both sites identified convenience and quality of care as the principle reasons patients presented for primary healthcare services at MIUs rather than their GP practice. Service-providers were aware that by providing treatment, they established a precedent and a sense of expectation for future care. Patients are acting rationally and predictably in response to healthcare policy promises regarding choice, expectation created by service-providers, and local demographic factors. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Inflation Basics

    Energy Technology Data Exchange (ETDEWEB)

    Green, Dan [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)

    2014-03-01

    inflation since metrical fluctuations, both scalar and tensor, are also produced in inflationary models. Thus, the time appears to be appropriate for a very basic and simple exposition of the inflationary model written from a particle physics perspective. Only the simplest scalar model will be explored because it is easy to understand and contains all the basic elements of the inflationary model.

  16. Inflation Basics

    International Nuclear Information System (INIS)

    Green, Dan

    2014-01-01

    waves imprinted on the CMB. These would be a ''smoking gun'' for inflation since metrical fluctuations, both scalar and tensor, are also produced in inflationary models. Thus, the time appears to be appropriate for a very basic and simple exposition of the inflationary model written from a particle physics perspective. Only the simplest scalar model will be explored because it is easy to understand and contains all the basic elements of the inflationary model.

  17. Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right.

    Science.gov (United States)

    Atilola, Olayinka

    2016-06-01

    The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.

  18. The development of a 'best practice' service for women in a medium-secure psychiatric setting: treatment components and evaluation.

    Science.gov (United States)

    Long, Clive G; Fulton, Barbara; Hollin, Clive R

    2008-01-01

    The inadequacy of inpatient facilities for women with severe psychiatric and co-morbid difficulties has been repeatedly documented. The establishment of effective therapeutic programmes for women in medium psychiatric facilities is also in their infancy, and little research has been undertaken. This article describes the development of a 'best practice' psychological treatment programme for women with a dual diagnosis. Emphasis is placed on the need to develop further intensive gender-specific services using an established model for effective therapeutic service development. In addition to a detailed description of the group therapy programme, staff training initiatives, methods for ensuring treatment integrity and a methodology for service evaluation is given. Copyright (c) 2008 John Wiley & Sons, Ltd.

  19. Cloud computing basics

    CERN Document Server

    Srinivasan, S

    2014-01-01

    Cloud Computing Basics covers the main aspects of this fast moving technology so that both practitioners and students will be able to understand cloud computing. The author highlights the key aspects of this technology that a potential user might want to investigate before deciding to adopt this service. This book explains how cloud services can be used to augment existing services such as storage, backup and recovery. Addressing the details on how cloud security works and what the users must be prepared for when they move their data to the cloud. Also this book discusses how businesses could prepare for compliance with the laws as well as industry standards such as the Payment Card Industry.

  20. Basic algebra

    CERN Document Server

    Jacobson, Nathan

    2009-01-01

    A classic text and standard reference for a generation, this volume and its companion are the work of an expert algebraist who taught at Yale for two decades. Nathan Jacobson's books possess a conceptual and theoretical orientation, and in addition to their value as classroom texts, they serve as valuable references.Volume I explores all of the topics typically covered in undergraduate courses, including the rudiments of set theory, group theory, rings, modules, Galois theory, polynomials, linear algebra, and associative algebra. Its comprehensive treatment extends to such rigorous topics as L

  1. Pedagogy and Quality in Indian Slum School Settings: A Bernsteinian Analysis of Visual Representations in the Integrated Child Development Service

    Science.gov (United States)

    Chawla-Duggan, Rita

    2016-01-01

    This paper focuses upon the micro level of the pre-school classroom, taking the example of the Indian Integrated Child Development Service (ICDS), and the discourse of "child-centred" pedagogy that is often associated with quality pre-schooling. Through an analysis of visual data, semi-structured and film elicitation interviews drawn…

  2. Improving Library Service Quality to Graduate Students: LibQual+[TM] Survey Results in a Practical Setting

    Science.gov (United States)

    Jankowska, Maria Anna; Hertel, Karen; Young, Nancy J.

    2006-01-01

    The LibQUAL+[TM] survey was conducted to determine user satisfaction and expectations concerning library service quality. The results of the "22 items and a box" constituted a rich source of information for the University of Idaho (UI) Library's strategic planning process. Focusing on graduate students, this study used three…

  3. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  4. COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

    Science.gov (United States)

    Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei

    2016-09-01

    The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

  5. Primary health care service delivery networks for the prevention and management of type 2 diabetes: using social network methods to describe interorganisational collaboration in a rural setting.

    Science.gov (United States)

    McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort

    2011-01-01

    Adults with type 2 diabetes or with behavioural risk factors require comprehensive and well coordinated responses from a range of health care providers who often work in different organisational settings. This study examines three types of collaborative links between organisations involved in a rural setting. Social network methods were employed using survey data on three types of links, and data was collected from a purposive sample of 17 organisations representing the major provider types. The analysis included a mix of unconfirmed and confirmed links, and network measures. General practices were the most influential provider group in initiating referrals, and they referred to the broadest range of organisations in the network. Team care arrangements formed a small part of the general practice referral network. They were used more for access to private sector allied health care providers and less for sharing care with public sector health services. Involvement in joint programs/activities was limited to public and non-government sector services, with no participation from the private sector. The patterns of interactions suggest that informal referral networks provide access to services and coordination of care for individual patients with diabetes. Two population subgroups would benefit from more proactive approaches to ensure equitable access to services and coordination of care across organisational boundaries: people with more complex health care needs and people at risk of developing diabetes.

  6. Mental Health Service Use for Patients with Co-occurring Mental and Physical Chronic Health Care Needs in Primary Care Settings

    Science.gov (United States)

    Haynes-Maslow, Lindsey; Roberts, Megan C.; Dusetzina, Stacie B.

    2016-01-01

    Background Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Objectives Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Research Design Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3,000 physicians in office-based settings. Subjects Office visits from 2007–2010 were pooled for adults ages 35–85 with a depression diagnosis at the time of visit (N=3,659 visits). Measures Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Results Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least one physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (pneeded on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves towards an integrated care model. PMID:26147863

  7. Personality Change During Military Basic Training

    National Research Council Canada - National Science Library

    Vickers, R

    1996-01-01

    .... Combined with the results of recent meta-analyses of personality and job performance, the results indicate that basic training graduates are better prepared psychologically to be effective service members than they were when they entered the service.

  8. Experiencing mental health diagnosis: a systematic review of service user, clinician, and carer perspectives across clinical settings.

    Science.gov (United States)

    Perkins, Amorette; Ridler, Joseph; Browes, Daniel; Peryer, Guy; Notley, Caitlin; Hackmann, Corinna

    2018-04-18

    Receiving a mental health diagnosis can be pivotal for service users, and it has been described in both positive and negative terms. What influences service-user experience of the diagnostic process is unclear; consequently, clinicians report uncertainty regarding best practice. This Review aims to understand and inform diagnostic practice through a comprehensive synthesis of qualitative data on views and experiences from key stakeholders (service users, clinicians, carers, and family). We searched five databases and identified 78 papers for inclusion, originating from 13 countries and including 2228 participants. Eligible papers were assessed for quality, and data were coded and then developed into themes, which generated a model representing factors to consider for clinicians conveying, and individuals receiving, mental health diagnoses. Themes included disclosure, information provision, collaboration, timing, stigma, and functional value of diagnosis for recovery. Variations between different stakeholders and clinical contexts are explored. Findings support an individualised, collaborative, and holistic approach to mental health diagnosis. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Googling Service Boundaries for Endovascular Clot Retrieval Hub Hospitals in a Metropolitan Setting: Proof-of-Concept Study.

    Science.gov (United States)

    Phan, Thanh G; Beare, Richard; Chen, Jian; Clissold, Benjamin; Ly, John; Singhal, Shaloo; Ma, Henry; Srikanth, Velandai

    2017-05-01

    There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface. Boundary maps generated based on traveling time at various times of day for combinations of hubs. In a 2-hub model, catchment was best distributed when RMH was paired with MMC (model 1a, RMH 1765 km 2 and MMC 1164 km 2 ) or with AUS (model 1c, RMH 1244 km 2 and AUS 1685 km 2 ), with no statistical difference between models ( P =0.20). Catchment was poorly distributed when RMH was paired with ALF (model 1b, RMH 2252 km 2 and ALF 676 km 2 ), significantly different from both models 1a and 1c (both P AUS was superior to that of RMH, MMC, and ALF in catchment distribution and travel time. The method was also successfully applied to the city of Adelaide demonstrating wider applicability. We provide proof of concept for a novel computational method to objectively designate service boundaries for endovascular clot retrieval hubs. © 2017 American Heart Association, Inc.

  10. Working with the 'difficult' patient: the use of a contextual cognitive-analytic therapy based training in improving team function in a routine psychiatry service setting.

    Science.gov (United States)

    Caruso, Rosangela; Biancosino, Bruno; Borghi, Cristiana; Marmai, Luciana; Kerr, Ian B; Grassi, Luigi

    2013-12-01

    The clinical management of 'difficult' patients is a major challenge which exposes mental health teams to an increased risk of frustration and stress and may lead to professional burnout. The aim of the present study was to investigate whether a cognitive-analytic therapy (CAT) based training undertaken by a mental health team working with 'difficult' patients reduced professional burnout symptoms, improved patients' service engagement and increased the levels of team-cohesion. Twelve mental health staff members from different professional and educational backgrounds took part in five 2-hour sessions providing a basic CAT training intervention, an integrative and relational model of psychotherapy for the treatment of borderline personality disorders. Participants were administered the Maslach Burnout Inventory (MBI), the Service Engagement Scale (SES) and the Group Environment Questionnaire (GEQ) before (T0) and after (T1) CAT training, and at 1-month follow-up (T2). A significant decrease were found, at T2, on the MBI Emotional Exhaustion scores, the SES Availability subscale, the GEQ Attraction to Group-Social and Group Integration-Social, while the MBI-Personal Accomplishment scores increased from baseline.The results of this study suggest that a CAT-based training can facilitate team cohesion and patient engagement with a service and reduce burnout levels among mental health team members dealing with 'difficult' patients.

  11. Effective Practices in Providing Online, In-Service Training to Health Professionals in Low-Resource Settings

    Science.gov (United States)

    Chio, Karen Sherk

    2012-01-01

    As doctors, nurses and public health professionals are promoted into management and leadership positions in resource-poor countries around the world, they are tasked with leading teams and managing drugs and financial and material resources. These responsibilities require a set of skills and knowledge different from that needed for their clinical…

  12. Exploration of Pre-Service Teachers' Beliefs in Relation to Mathematics Teaching Activities in Classroom-Based Setting

    Science.gov (United States)

    Kul, Umit; Celik, Sedef

    2017-01-01

    This paper has been conducted to determine future teachers' mathematical beliefs and to explore the relationship between their mathematical beliefs and initial teaching practice in a classroom setting, in terms of how they design the content of teaching activities, they employed the style of teaching in mathematics, and they engaged with pupils. A…

  13. Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria: How Does a Large Funder of Basic Health Services Meet the Challenge of Rights-Based Programs?

    Science.gov (United States)

    Jürgens, Ralf; Csete, Joanne; Lim, Hyeyoung; Timberlake, Susan; Smith, Matthew

    2017-12-01

    The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to greatly expand access to basic services to address the three diseases in its name. From its beginnings, its governance embodied some human rights principles: civil society is represented on its board, and the country coordination mechanisms that oversee funding requests to the Global Fund include representatives of people affected by the diseases. The Global Fund's core strategies recognize that the health services it supports would not be effective or cost-effective without efforts to reduce human rights-related barriers to access and utilization of health services, particularly those faced by socially marginalized and criminalized persons. Basic human rights elements were written into Global Fund grant agreements, and various technical support measures encouraged the inclusion in funding requests of programs to reduce human rights-related barriers. A five-year initiative to provide intensive technical and financial support for the scaling up of programs to reduce these barriers in 20 countries is ongoing.

  14. Interação de atributos atrativos e obrigatórios de um serviço na satisfação do cliente Interaction of basic and excitement service attributes in customer satisfaction

    Directory of Open Access Journals (Sweden)

    Gérson Tontini

    2008-01-01

    Full Text Available O Modelo Kano de Qualidade faz distinção entre três tipos de atributos que influenciam a satisfação do cliente: obrigatórios, atrativos e unidimensionais. Este trabalho teve como objetivo estudar a interação entre atributos atrativos e obrigatórios. Para tanto, utilizou-se um delineamento experimental do tipo fatorial completo com quatro atributos de video-locadoras (dois obrigatórios e dois atrativos, cada um a dois níveis, entrevistando-se 152 clientes. Verificou-se que os atributos atrativos apresentaram um maior impacto na satisfação dos clientes se os atributos obrigatórios estiverem presentes. A implicação gerencial desse resultado é que os atributos obrigatórios devem ser identificados e mantidos em um nível adequado, pois somente assim os atributos atrativos terão pleno efeito no aumento da satisfação dos clientes.Kano Model distinguishes service attributes in three types: basic, excitement and performance attributes. This work has as objective to verify how these attributes interact to proportionate satisfaction to customers. A full factorial experiment, using a sample of 152 customers of video rental stores, was used to study the interaction among four attributes (two basic and two excitements. The results show that the excitement attributes had less impact on customer satisfaction if the basic attributes were not fulfilled. The managerial implication of these results is that service companies should identify and fulfill the basic attributes in order to the excitement attributes having full impact on customer satisfaction.

  15. Basic instincts

    Science.gov (United States)

    Hutson, Matthew

    2018-05-01

    In their adaptability, young children demonstrate common sense, a kind of intelligence that, so far, computer scientists have struggled to reproduce. Gary Marcus, a developmental cognitive scientist at New York University in New York City, believes the field of artificial intelligence (AI) would do well to learn lessons from young thinkers. Researchers in machine learning argue that computers trained on mountains of data can learn just about anything—including common sense—with few, if any, programmed rules. But Marcus says computer scientists are ignoring decades of work in the cognitive sciences and developmental psychology showing that humans have innate abilities—programmed instincts that appear at birth or in early childhood—that help us think abstractly and flexibly. He believes AI researchers ought to include such instincts in their programs. Yet many computer scientists, riding high on the successes of machine learning, are eagerly exploring the limits of what a naïve AI can do. Computer scientists appreciate simplicity and have an aversion to debugging complex code. Furthermore, big companies such as Facebook and Google are pushing AI in this direction. These companies are most interested in narrowly defined, near-term problems, such as web search and facial recognition, in which blank-slate AI systems can be trained on vast data sets and work remarkably well. But in the longer term, computer scientists expect AIs to take on much tougher tasks that require flexibility and common sense. They want to create chatbots that explain the news, autonomous taxis that can handle chaotic city traffic, and robots that nurse the elderly. Some computer scientists are already trying. Such efforts, researchers hope, will result in AIs that sit somewhere between pure machine learning and pure instinct. They will boot up following some embedded rules, but will also learn as they go.

  16. Birth choices in Timor-Leste: a framework for understanding the use of maternal health services in low resource settings.

    Science.gov (United States)

    Wild, Kayli; Barclay, Lesley; Kelly, Paul; Martins, Nelson

    2010-12-01

    The high rate of maternal mortality in Timor-Leste is a persistent problem which has been exacerbated by the long history of military occupation and ongoing political crises since independence in 1999. It is similar to other developing countries where there have been slow declines in maternal mortality despite 20 years of Safe Motherhood interventions. The national Ministry of Health, United Nations (UN) agencies and non-government organisations (NGOs) have attempted to reduce maternal mortality by enacting policies and interventions to increase the number of births in health centres and hospitals. Despite considerable effort in promoting facility-based delivery, most Timorese women birth at home and the lack of midwives means few women have access to a skilled birth attendant. This paper investigates factors influencing access to and use of maternal health services in rural areas of Timor-Leste. It draws on 21 interviews and 11 group discussions with Timorese women and their families collected over two periods of fieldwork, one month in September 2006 and five months from July to December 2007. Theoretical concepts from anthropology and health social science are used to explore individual, social, political and health system issues which affect the way in which maternal health services are utilised. In drawing together a range of theories this paper aims to extend explanations around access to maternal health services in developing countries. An empirically informed framework is proposed which illustrates the complex factors that influence women's birth choices. This framework can be used by policy-makers, practitioners, donors and researchers to think critically about policy decisions and where investments can have the most impact for improving maternal health in Timor-Leste and elsewhere. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Bridging the triple divide: performance and innovative multimedia in the service of behavioural health change in remote Indigenous settings.

    Science.gov (United States)

    Hunter, Ernest; Travers, Helen; Gibson, Julie; Campion, Jonathan

    2007-01-01

    The use of innovative information technology is now well established in health. However, while the gap in health status between Indigenous and other Australians is both significant and unchanging, there is limited application of these new approaches to addressing this national health priority. This may in part reflect the 'digital divide', which is another facet of Indigenous disadvantage. This paper describes an approach to address both issues in remote Indigenous settings. The Health Interactive Technology Network began as a proof-of-concept study of touchscreen technology in two Indigenous health settings. It has subsequently expanded to a number of remote Indigenous communities and developed new platforms and applications to respond to emerging health issues. In creating narrative, interactive approaches to address choices in relation to health behaviours, the community development and engagement effects of the creative process have been highlighted. These findings suggest that these approaches will be suited to further expansion in the area of mental health.

  18. Naloxone Administration for Suspected Opioid Overdose: An Expanded Scope of Practice by a Basic Life Support Collegiate-Based Emergency Medical Services Agency

    Science.gov (United States)

    Jeffery, Ryan M.; Dickinson, Laura; Ng, Nicholas D.; DeGeorge, Lindsey M.; Nable, Jose V.

    2017-01-01

    Opioid abuse is a growing and significant public health concern in the United States. Naloxone is an opioid antagonist that can rapidly reverse the respiratory depression associated with opioid toxicity. Georgetown University's collegiate-based emergency medical services (EMS) agency recently adopted a protocol, allowing providers to administer…

  19. C# Database Basics

    CERN Document Server

    Schmalz, Michael

    2012-01-01

    Working with data and databases in C# certainly can be daunting if you're coming from VB6, VBA, or Access. With this hands-on guide, you'll shorten the learning curve considerably as you master accessing, adding, updating, and deleting data with C#-basic skills you need if you intend to program with this language. No previous knowledge of C# is necessary. By following the examples in this book, you'll learn how to tackle several database tasks in C#, such as working with SQL Server, building data entry forms, and using data in a web service. The book's code samples will help you get started

  20. Back to basics audio

    CERN Document Server

    Nathan, Julian

    1998-01-01

    Back to Basics Audio is a thorough, yet approachable handbook on audio electronics theory and equipment. The first part of the book discusses electrical and audio principles. Those principles form a basis for understanding the operation of equipment and systems, covered in the second section. Finally, the author addresses planning and installation of a home audio system.Julian Nathan joined the audio service and manufacturing industry in 1954 and moved into motion picture engineering and production in 1960. He installed and operated recording theaters in Sydney, Austra

  1. Learning motivational interviewing in a real-life setting: a randomised controlled trial in the Swedish Prison Service.

    Science.gov (United States)

    Forsberg, Lars; Ernst, Denise; Farbring, Carl Åke

    2011-07-01

    Motivational interviewing (MI) is a client-centred, directive counselling style for helping people to explore and resolve ambivalence about behaviour change and shown to decrease drug and alcohol use. A five-session semi-structured MI intervention [Beteende, Samtal, Förändring (BSF; Behaviour, Counselling, Change)] was implemented in Swedish prisons. To examine whether, in a real-life implementation of semi-structured MI, staff receiving ongoing MI training, based on audio-recorded feedback in peer groups (BSF+), possess greater MI skill compared with staff receiving workshop-only MI training (BSF), and staff conducting usual prison planning interviews (UPI). Prisoners were randomised to one of the three interventions. The fi rst sessions between staff and prisoner with complete data were assessed with the Motivational Interviewing Treatment Integrity Code 3.0. Content analysis of 45 staff: prisoner sessions revealed that counsellors in the BSF+ group were significantly more competent in MI than those in the UPI group, but there was no difference in MI competency between the BSF and UPI groups. Overall, staff were rated as not having achieved beginning proficiency. Our findings suggest that staff delivering motivational interviewing programmes for substance-misusing prisoners in Sweden are not being given sufficient training for the task. Previous literature has suggested that staff need more than a basic 3- to 5-day workshop training, but our findings suggest that they may need longer-term continuing supervision and support than previously recognised.

  2. Setting Up an ePathology Service at Cleveland Clinic Abu Dhabi: Joint Collaboration With Cleveland Clinic, United States.

    Science.gov (United States)

    Nahal, Ayoub; Batac, Crystal Mildred O; Slaw, Renee J; Bauer, Thomas W

    2018-04-24

    - The production of whole slide images is the most advanced form of digital pathology, in which a high-resolution digital scanner is used to rapidly scan glass microscope slides and produce a computer-generated whole slide image that can be saved, stored in a network-attached storage device, and accessed through slide management software within the hospital domain and remotely by authorized users. Digital transformation of glass slides has revolutionized the practice of anatomic pathology by facilitating and expediting consultative services, improving clinical workflow, and becoming an indispensable tool in education and research. - To highlight the institutional need of Cleveland Clinic Abu Dhabi (Abu Dhabi, United Arab Emirates) and the cultural background for obtaining the United Arab Emirates' first comprehensive digital pathology program; to describe a multiphase road map for achieving full implementation of this platform; and to describe the system's clinical applications and its future potential growth. - At Cleveland Clinic Abu Dhabi, we prioritized our efforts to initiate digital consultations (eConsultations) and digital immunohistochemistry services (eIHC) with Cleveland Clinic Laboratories (Cleveland, Ohio). After this, we established an internal archiving system together with a subspecialty-based, organ-specific digital library of pathologic diseases. - We describe the strategic adoption and implementation of digital pathology into the clinical workflow of the pathology and laboratory medicine institute of Cleveland Clinic Abu Dhabi, and we highlight its impact on clinical operations, educational activities, and patient care.

  3. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

    Science.gov (United States)

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-11-01

    The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

  4. Use of programme budgeting and marginal analysis to set priorities for local NHS dental services: learning from the north east of England.

    Science.gov (United States)

    Holmes, R D; Steele, J G; Exley, C; Vernazza, C R; Donaldson, C

    2018-05-03

    Priority setting is necessary where competing demands exceed the finite resources available. The aim of the study was to develop and test a prioritization framework based upon programme budgeting and marginal analysis (PBMA) as a tool to assist National Health Service (NHS) commissioners in their management of resources for local NHS dental services. Twenty-seven stakeholders (5 dentists, 8 commissioners and 14 patients) participated in a case-study based in a former NHS commissioning organization in the north of England. Stakeholders modified local decision-making criteria and applied them to a number of different scenarios. The majority of financial resources for NHS dental services in the commissioning organization studied were allocated to primary care dental practitioners' contracts in perpetuity, potentially constraining commissioners' abilities to shift resources. Compiling the programme budget was successful, but organizational flux and difficulties engaging local NHS commissioners significantly impacted upon the marginal analysis phase. NHS dental practitioners' contracts resemble budget-silos which do not facilitate local resource reallocation. 'Context-specific' factors significantly challenged the successful implementation and impact of PBMA. A local PBMA champion embedded within commissioning organizations should be considered. Participants found visual depiction of the cost-value ratio helpful during their initial priority setting deliberations.

  5. Barriers to the use of the library service amongst clinical staff in an acute hospital setting: an evaluation.

    Science.gov (United States)

    Thomas, Gaynor; Preston, Hugh

    2016-06-01

    This article reports on research into the reasons why clinical staff in an acute hospital may be reluctant to use library services. The research was conducted by Gaynor Thomas at the Prince Philip Hospital in Llanelli in Wales as part of the dissertation she completed for an MSc in Economics. She graduated in July 2014 from Aberystwyth University and has co-written the article with Hugh Preston, her dissertation supervisor. The article summarises the key findings from the interviews undertaken as part of the research process and lists the resulting recommendations. Gaynor also highlights the initiatives which have been put in place with the express aim of removing barriers to use and encouraging clinical staff to make the most of the library which is, she argues, a time-saving resource. AM. © 2016 Health Libraries Group.

  6. Is it feasible and effective to provide osteopathy and acupuncture for patients with musculoskeletal problems in a GP setting? A service evaluation

    Directory of Open Access Journals (Sweden)

    Peters David

    2011-06-01

    Full Text Available Abstract Background Spinal manipulation and acupuncture can be helpful in reducing the symptoms of musculoskeletal (MSK pain. Both approaches are currently recommended by NICE as treatment options for patients with persistent low back pain. However, there has been no previous evaluation of a GP service using them together for MSK pain. The purpose of this study was to evaluate acceptability and outcomes for an osteopathy and acupuncture service (delivered by complementary therapy practitioners for patients with MSK problems provided within a General Practice. Methods Patients were asked to complete a questionnaire before and after their course of treatment. Outcome measures included the Bournemouth Questionnaire (measuring MSK problems, EuroQoL-5D (measuring quality of life, medication use, physical activity and general well-being. Non-parametric tests were used to compare pre- and post- treatment variables. Qualitative data, regarding participants' views on the service, were collected from patients via a service survey and healthcare professionals via interviews. Qualitative data were analysed using thematic analysis. Results 123 adults with MSK problems were referred into the service (79 female and 44 male, mean age 49 years. Complete patient questionnaire data sets (pre- and post- treatment were available for 102 participants; 91 completed a service survey. All healthcare professionals involved in the service participated in interviews including all seven GPs and the administration manager at the practice, as well as the three acupuncture/osteopathy practitioners. Patient outcomes: comparisons between pre and post-treatment revealed a statistically significant improvement in MSK pain (p Acceptability of the service: overall patients and healthcare professionals were satisfied with the service and its provision within the Practice. Patients reported wanting increased appointment availability and flexibility, and more sessions. Complementary

  7. Application of Digital Object Identifiers to data sets at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Science.gov (United States)

    Vollmer, B.; Ostrenga, D.; Johnson, J. E.; Savtchenko, A. K.; Shen, S.; Teng, W. L.; Wei, J. C.

    2013-12-01

    Digital Object Identifiers (DOIs) are applied to selected data sets at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). The DOI system provides an Internet resolution service for unique and persistent identifiers of digital objects. Products assigned DOIs include data from the NASA MEaSUREs Program, the Earth Observing System (EOS) Aqua Atmospheric Infrared Sounder (AIRS) and EOS Aura High Resolution Dynamics Limb Sounder (HIRDLS). DOIs are acquired and registered through EZID, California Digital Library and DataCite. GES DISC hosts a data set landing page associated with each DOI containing information on and access to the data including a recommended data citation when using the product in research or applications. This work includes participation with the earth science community (e.g., Earth Science Information Partners (ESIP) Federation) and the NASA Earth Science Data and Information System (ESDIS) Project to identify, establish and implement best practices for assigning DOIs and managing supporting information, including metadata, for earth science data sets. Future work includes (1) coordination with NASA mission Science Teams and other data providers on the assignment of DOIs for other GES DISC data holdings, particularly for future missions such as Orbiting Carbon Observatory -2 and -3 (OCO-2, OCO-3) and projects (MEaSUREs 2012), (2) construction of landing pages that are both human and machine readable, and (3) pursuing the linking of data and publications with tools such as the Thomson Reuters Data Citation Index.

  8. Service use, charge, and access to mental healthcare in a private Kenyan inpatient setting: the effects of insurance.

    Directory of Open Access Journals (Sweden)

    Victoria Pattison de Menil

    Full Text Available The gap in Kenya between need and treatment for mental disorders is wide, and private providers are increasingly offering services, funded in part by private health insurance (PHI. Chiromo, a 30-bed psychiatric hospital in Nairobi, forms part of one of the largest private psychiatric providers in East Africa. The study evaluated the effects of insurance on service use and charge, questioning implications on access to care. Data derive from invoices for 455 sequential patients, including 12-month follow-up. Multi-linear and binary logistic regressions explored the effect of PHI on readmission, cumulative length of stay, and treatment charge. Patients were 66.4% male with a mean age of 36.8 years. Half were employed in the formal sector. 70% were admitted involuntarily. Diagnoses were: substance use disorder 31.6%; serious mental disorder 49.5%; common mental disorder 7%; comorbid 7%; other 4.9%. In addition to daily psychiatric consultations, two-thirds received individual counselling or group therapy; half received lab tests or scans; and 16.2% received ECT. Most took a psychiatric medicine. Half of those on antipsychotics were given only brands. Insurance paid in full for 28.8% of patients. Mean length of stay was 11.8 days and, in 12 months, 16.7 days (median 10.6. 22.2% were readmitted within 12 months. Patients with PHI stayed 36% longer than those paying out-of-pocket and had 2.5 times higher odds of readmission. Mean annual charge per patient was Int$ 4,262 (median Int$ 2,821. Insurers were charged 71% more than those paying out-of-pocket--driven by higher fees and longer stays. Chiromo delivers acute psychiatric care each year to approximately 450 people, to quality and human rights standards higher than its public counterpart, but at considerably higher cost. With more efficient delivery and wider insurance coverage, Chiromo might expand from its occupancy of 56.6% to reach a larger population in need.

  9. Advocacy for the Provision of Dental Hygiene Services Within the Hospital Setting: Development of a Dental Hygiene Student Rotation.

    Science.gov (United States)

    Juhl, Jacqueline A; Stedman, Lynn

    2016-06-01

    Educational preparation of dental hygiene students for hospital-based practice, and advocacy efforts promote inclusion of dental hygienists within hospital-based interdisciplinary health care teams. Although the value of attending to the oral care needs of patients in critical care units has been recognized, the potential impact of optimal oral health care for the general hospital population is now gaining attention. This article describes a hospital-based educational experience for dental hygiene students and provides advocacy strategies for inclusion of dental hygienists within the hospital interdisciplinary team. The dental hygienist authors, both educators committed to evidence-based oral health care and the profession of dental hygiene, studied hospital health care and recognized a critical void in oral health care provision within that setting. They collaboratively developed and implemented a hospital-based rotation within the curriculum of a dental hygiene educational program and used advocacy skills to encourage hospital administrators to include a dental hygiene presence within hospital-based care teams. Hospital-based dental hygiene practice, as part of interprofessional health care delivery, has the potential to improve patient well-being, shorten hospital stays, and provide fiscal savings for patients, institutions, and third party payers. Advocacy efforts can promote dental hygienists as members of hospital-based health care teams. Further research is needed to document: (1) patient outcomes resulting from optimal oral care provision in hospitals; (2) best ways to prepare dental hygienists for career opportunities within hospitals and other similar health care settings; and (3) most effective advocacy strategies to promote inclusion of dental hygienists within care teams. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide

    Science.gov (United States)

    Elsabbagh, Mayada; Barbaro, Josephine; Gladstone, Melissa; Happe, Francesca; Hoekstra, Rosa A.; Lee, Li‐Ching; Rattazzi, Alexia; Stapel‐Wax, Jennifer; Stone, Wendy L.; Tager‐Flusberg, Helen; Thurm, Audrey; Tomlinson, Mark; Shih, Andy

    2015-01-01

    Most research into the epidemiology, etiology, clinical manifestations, diagnosis and treatment of autism is based on studies in high income countries. Moreover, within high income countries, individuals of high socioeconomic status are disproportionately represented among participants in autism research. Corresponding disparities in access to autism screening, diagnosis, and treatment exist globally. One of the barriers perpetuating this imbalance is the high cost of proprietary tools for diagnosing autism and for delivering evidence‐based therapies. Another barrier is the high cost of training of professionals and para‐professionals to use the tools. Open‐source and open access models provide a way to facilitate global collaboration and training. Using these models and technologies, the autism scientific community and clinicians worldwide should be able to work more effectively and efficiently than they have to date to address the global imbalance in autism knowledge and at the same time advance our understanding of autism and our ability to deliver cost‐effective services to everyone in need. Autism Res 2015, 8: 473–476. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. PMID:26437907

  11. Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

    Science.gov (United States)

    Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

    2015-09-08

    Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective. Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

  12. Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide.

    Science.gov (United States)

    Durkin, Maureen S; Elsabbagh, Mayada; Barbaro, Josephine; Gladstone, Melissa; Happe, Francesca; Hoekstra, Rosa A; Lee, Li-Ching; Rattazzi, Alexia; Stapel-Wax, Jennifer; Stone, Wendy L; Tager-Flusberg, Helen; Thurm, Audrey; Tomlinson, Mark; Shih, Andy

    2015-10-01

    Most research into the epidemiology, etiology, clinical manifestations, diagnosis and treatment of autism is based on studies in high income countries. Moreover, within high income countries, individuals of high socioeconomic status are disproportionately represented among participants in autism research. Corresponding disparities in access to autism screening, diagnosis, and treatment exist globally. One of the barriers perpetuating this imbalance is the high cost of proprietary tools for diagnosing autism and for delivering evidence-based therapies. Another barrier is the high cost of training of professionals and para-professionals to use the tools. Open-source and open access models provide a way to facilitate global collaboration and training. Using these models and technologies, the autism scientific community and clinicians worldwide should be able to work more effectively and efficiently than they have to date to address the global imbalance in autism knowledge and at the same time advance our understanding of autism and our ability to deliver cost-effective services to everyone in need. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

  13. Changes in Default Alarm Settings and Standard In-Service are Insufficient to Improve Alarm Fatigue in an Intensive Care Unit: A Pilot Project.

    Science.gov (United States)

    Sowan, Azizeh Khaled; Gomez, Tiffany Michelle; Tarriela, Albert Fajardo; Reed, Charles Calhoun; Paper, Bruce Michael

    2016-01-11

    Clinical alarm systems safety is a national concern, specifically in intensive care units (ICUs) where alarm rates are known to be the highest. Interventional projects that examined the effect of changing default alarm settings on overall alarm rate and on clinicians' attitudes and practices toward clinical alarms and alarm fatigue are scarce. To examine if (1) a change in default alarm settings of the cardiac monitors and (2) in-service nursing education on cardiac monitor use in an ICU would result in reducing alarm rate and in improving nurses' attitudes and practices toward clinical alarms. This quality improvement project took place in a 20-bed transplant/cardiac ICU with a total of 39 nurses. We implemented a unit-wide change of default alarm settings involving 17 parameters of the cardiac monitors. All nurses received an in-service education on monitor use. Alarm data were collected from the audit log of the cardiac monitors 10 weeks before and 10 weeks after the change in monitors' parameters. Nurses' attitudes and practices toward clinical alarms were measured using the Healthcare Technology Foundation National Clinical Alarms Survey, pre- and postintervention. Alarm rate was 87.86 alarms/patient day (a total of 64,500 alarms) at the preintervention period compared to 59.18 alarms/patient day (49,319 alarms) postintervention (P=.01). At baseline, Arterial Blood Pressure (ABP), Pair Premature Ventricular Contractions (PVCs), and Peripheral Capillary Oxygen Saturation (SpO2) alarms were the highest. ABP and SpO2 alarms remained among the top three at the postproject period. Out of the 39 ICU nurses, 24 (62%) provided complete pre- and postproject survey questionnaires. Compared to the preintervention survey, no remarkable changes in the postproject period were reported in nurses' attitudes. Themes in the narrative data were related to poor usability of cardiac monitors and the frequent alarms. The data showed great variation among nurses in terms of changing

  14. Locating distribution/service centers based on multi objective decision making using set covering and proximity to stock market

    Directory of Open Access Journals (Sweden)

    Mazyar Dabibi

    2016-09-01

    Full Text Available In the present competitive world, facility location is an important aspect of the supply chain (sc optimization. It involves selecting specific locations for facility construction and allocation of the distribution channel among different SC levels. In fact, it is a strategic issue which directly affects many operational/tactical decisions. Besides the accessibility, which results in customer satisfaction, the present paper optimizes the establishment costs of a number of distribution channels by considering their proximity to the stock market of the goods they distribute, and proposes mathematical models for two objective functions using the set covering problem. Then, two objective functions are proposed into one through the ε-constraint method and solved by the metaheuristic Genetic Algorithm (GA. To test the resulted model, a smaller scale problem is solved. Results from running the algorithm with different ε-values show that, on average, a 10% increase in ε, which increases the value of the second objective function - distance covered by customers will cause a 2% decrease in the value of the first objective function including the costs of establishing distribution centers. The repeatability and solution convergence of the two-objective model presented by the GA are other results obtained in this study.

  15. Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

    Science.gov (United States)

    Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

    2017-08-01

    To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

  16. 15. Basic economic indicators

    International Nuclear Information System (INIS)

    Carless, J.; Dow, B.; Farivari, R.; O'Connor, J.; Fox, T.; Tunstall, D.; Mentzingen, M.

    1992-01-01

    The clear value of economic data and analysis to decisionmakers has motivated them to mandate the creation of extensive global economic data sets. This chapter contains a set of these basic economic data, which provides the context for understanding the causes and the consequences of many of the decisions that affect the world's resources. Many traditional economic indicators fail to account for the depletion or deterioration of natural resources, the long-term consequences of such depletion, the equitable distribution of income within a country, or the sustainability of current economic practices. The type of measurement shown here, however, is still useful in showing the great differences between the wealthiest and the poorest countries. Tables are given on the following: Gross national product and official development assistance 1969-89; External debt indicators 1979-89; Central government expenditures; and World commodity indexes and prices 1975-89

  17. Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Akshatha Rao Aroor

    2014-01-01

    Full Text Available Background: The knowledge and skills about the basic life support (BLS and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR success rates. Objectives: To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups, course of study (nursing, dental, and medical groups, and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Results: Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10. Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05. Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05. About 322 (61.9% subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1% responded that BLS training should be a part of medical curriculum. Conclusion: Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

  18. Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India.

    Science.gov (United States)

    Aroor, Akshatha Rao; Saya, Rama Prakash; Attar, Nazir Rahim; Saya, Ganesh Kumar; Ravinanthanan, Manikandan

    2014-07-01

    The knowledge and skills about the basic life support (BLS) and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups), course of study (nursing, dental, and medical groups), and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10). Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05). Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05). About 322 (61.9%) subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1%) responded that BLS training should be a part of medical curriculum. Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

  19. Complexity aspects of web services composition

    OpenAIRE

    Ennaoui, Karima; Nourine, Lhouari; Toumani, Farouk

    2015-01-01

    The web service composition problem can be stated as follows: given a finite state machine M , representing a service business protocol, and a set of finite state machines R, representing the business protocols of existing services, the question is to check whether there is a simulation relation between M and the shuffle product closure of R. In fact the shuffle product is a subclass of the communication free petri net and basic parallel processes, for which the same problem of simulation is ...

  20. Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

    Directory of Open Access Journals (Sweden)

    Cabral de Mello Meena

    2011-09-01

    Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for

  1. Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan.

    Science.gov (United States)

    Adam, Izzeldin Fadl; Nakamura, Keiko; Kizuki, Masashi; Al Rifai, Rami; Vanching, Urnaa

    2015-09-15

    (1) To examine changes in women's awareness and utilisation of reproductive healthcare services in emergency settings following provision of interpersonal communication (IPC) and mass education campaigns, and (2) to describe factors associated with reproductive healthcare service use in internally displaced person (IDP) camps. Three camps containing 88 984 IDPs in Darfur, Sudan. 640 women aged 15-49 who had experienced pregnancy in the camp during the previous 2 years were enrolled in each of two independent cross-sectional surveys 26 months apart. IPC and mass education campaigns where community health workers disseminated information by home/shelter visits, clinic sessions, public meetings and other means to raise awareness and promote reproductive healthcare service use. Awareness of the existence of antenatal care (ANC) and tetanus toxoid (TT) vaccination services, reception of ANC and TT vaccination, place of delivery and use of postnatal care (PNC). The percentage of women who received home visits, and attended in-clinic sessions and public meetings increased from 61.6% to 86.7%, from 43.0% to 68.8%, and from 3.8% to 39.8%, respectively, between the initial and follow-up surveys. More women were aware of ANC (OR 18.6, 95% CI 13.1 to 26.5) and TT vaccination (OR 3.2, 95% CI 2.4 to 4.4) in the follow-up than the initial survey, after multivariable adjustment. More women received ≥3 ANC visits (OR 8.8, 95% CI 6.4 to 12.0) and ≥3 doses of TT (OR 2.5, 95% CI 1.9 to 3.3), delivered at a healthcare facility (OR 5.4, 95% CI 4.0 to 7.4) and received a PNC visit (OR 5.5, 95% CI 4.0 to 7.7) in the follow-up than in the initial survey, after multivariable adjustment. Awareness about and utilisation of reproductive healthcare services were higher in the follow-up survey. An integrated IPC and mass education campaign is effective for improving women's reproductive health in emergency settings. Published by the BMJ Publishing Group Limited. For permission to use

  2. Women’s experiences of referral to a domestic violence advocate in UK primary care settings: a service-user collaborative study

    Science.gov (United States)

    Malpass, Alice; Sales, Kim; Johnson, Medina; Howell, Annie; Agnew-Davies, Roxane; Feder, Gene

    2014-01-01

    Background Women experiencing domestic violence and abuse (DVA) are more likely to be in touch with health services than any other agency, yet doctors and nurses rarely ask about abuse, often failing to identify signs of DVA in their patients. Aim To understand women’s experience of disclosure of DVA in primary care settings and subsequent referral to a DVA advocate in the context of a DVA training and support programme for primary care clinicians: Identification and Referral to Improve Safety (IRIS). Design and setting A service-user collaborative study using a qualitative study design. Recruitment was from across IRIS trial settings in Bristol and Hackney, London. Method Twelve women who had been referred to one of two specialist DVA advocates (based at specialist DVA agencies) were recruited by a GP taking part in IRIS. Women were interviewed by a survivor of DVA and interviews were recorded and transcribed verbatim. Analysis was thematic using constant comparison. Results GPs and nurses can play an important role in identifying women experiencing DVA and referring them to DVA specialist agencies. GPs may also have an important role to play in helping women maintain any changes they make as a result of referral to an advocate, by asking about DVA in subsequent consultations. Conclusion A short time interval between a primary care referral and initial contact with an advocate was valued by some women. For the initial contact with an advocate to happen as soon as possible after a primary care referral has been made, a close working relationship between primary care and the third sector needs to be cultivated. PMID:24567654

  3. Interdialect Translatability of the Basic Programming Language.

    Science.gov (United States)

    Isaacs, Gerald L.

    A study was made of several dialects of the Beginner's All-purpose Symbolic Instruction Code (BASIC). The purpose was to determine if it was possible to identify a set of interactive BASIC dialects in which translatability between different members of the set would be high, if reasonable programing restrictions were imposed. It was first…

  4. Using lot quality assurance sampling to assess access to water, sanitation and hygiene services in a refugee camp setting in South Sudan: a feasibility study.

    Science.gov (United States)

    Harding, Elizabeth; Beckworth, Colin; Fesselet, Jean-Francois; Lenglet, Annick; Lako, Richard; Valadez, Joseph J

    2017-08-08

    Humanitarian agencies working in refugee camp settings require rapid assessment methods to measure the needs of the populations they serve. Due to the high level of dependency of refugees, agencies need to carry out these assessments. Lot Quality Assurance Sampling (LQAS) is a method commonly used in development settings to assess populations living in a project catchment area to identify their greatest needs. LQAS could be well suited to serve the needs of refugee populations, but it has rarely been used in humanitarian settings. We adapted and implemented an LQAS survey design in Batil refugee camp, South Sudan in May 2013 to measure the added value of using it for sub-camp level assessment. Using pre-existing divisions within the camp, we divided the Batil catchment area into six contiguous segments, called 'supervision areas' (SA). Six teams of two data collectors randomly selected 19 respondents in each SA, who they interviewed to collect information on water, sanitation, hygiene, and diarrhoea prevalence. These findings were aggregated into a stratified random sample of 114 respondents, and the results were analysed to produce a coverage estimate with 95% confidence interval for the camp and to prioritize SAs within the camp. The survey provided coverage estimates on WASH indicators as well as evidence that areas of the camp closer to the main road, to clinics and to the market were better served than areas at the periphery of the camp. This assumption did not hold for all services, however, as sanitation services were uniformly high regardless of location. While it was necessary to adapt the standard LQAS protocol used in low-resource communities, the LQAS model proved to be feasible in a refugee camp setting, and program managers found the results useful at both the catchment area and SA level. This study, one of the few adaptations of LQAS for a camp setting, shows that it is a feasible method for regular monitoring, with the added value of enabling camp

  5. Using lot quality assurance sampling to assess access to water, sanitation and hygiene services in a refugee camp setting in South Sudan: a feasibility study

    Directory of Open Access Journals (Sweden)

    Elizabeth Harding

    2017-08-01

    Full Text Available Abstract Background Humanitarian agencies working in refugee camp settings require rapid assessment methods to measure the needs of the populations they serve. Due to the high level of dependency of refugees, agencies need to carry out these assessments. Lot Quality Assurance Sampling (LQAS is a method commonly used in development settings to assess populations living in a project catchment area to identify their greatest needs. LQAS could be well suited to serve the needs of refugee populations, but it has rarely been used in humanitarian settings. We adapted and implemented an LQAS survey design in Batil refugee camp, South Sudan in May 2013 to measure the added value of using it for sub-camp level assessment. Methods Using pre-existing divisions within the camp, we divided the Batil catchment area into six contiguous segments, called ‘supervision areas’ (SA. Six teams of two data collectors randomly selected 19 respondents in each SA, who they interviewed to collect information on water, sanitation, hygiene, and diarrhoea prevalence. These findings were aggregated into a stratified random sample of 114 respondents, and the results were analysed to produce a coverage estimate with 95% confidence interval for the camp and to prioritize SAs within the camp. Results The survey provided coverage estimates on WASH indicators as well as evidence that areas of the camp closer to the main road, to clinics and to the market were better served than areas at the periphery of the camp. This assumption did not hold for all services, however, as sanitation services were uniformly high regardless of location. While it was necessary to adapt the standard LQAS protocol used in low-resource communities, the LQAS model proved to be feasible in a refugee camp setting, and program managers found the results useful at both the catchment area and SA level. Conclusions This study, one of the few adaptations of LQAS for a camp setting, shows that it is a feasible

  6. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings.

    Science.gov (United States)

    Heffron, Renee; Davies, Natasha; Cooke, Ian; Kaida, Angela; Mergler, Reid; van der Poel, Sheryl; Cohen, Craig R; Mmeje, Okeoma

    2015-01-01

    that integrate HIV treatment and prevention, sexual and reproductive health and fertility care services in a manner responsive to user values and preferences offer opportunities to maximize demand for and use of these services. For HIV-affected women and couples attempting pregnancy, the provision of comprehensive services using available tools - and the development of new tools that are adaptable to many settings and follow consensus recommendations - is a public health imperative. The impetus now is to design and deliver value-driven inclusive programming to achieve the greatest coverage and impact to reduce HIV transmission during pregnancy attempts.

  7. Stem Cell Basics

    Science.gov (United States)

    ... Tips Info Center Research Topics Federal Policy Glossary Stem Cell Information General Information Clinical Trials Funding Information Current ... Basics » Stem Cell Basics I. Back to top Stem Cell Basics I. Introduction: What are stem cells, and ...

  8. Axiomatic set theory

    CERN Document Server

    Suppes, Patrick

    1972-01-01

    This clear and well-developed approach to axiomatic set theory is geared toward upper-level undergraduates and graduate students. It examines the basic paradoxes and history of set theory and advanced topics such as relations and functions, equipollence, finite sets and cardinal numbers, rational and real numbers, and other subjects. 1960 edition.

  9. Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of national health service hospitals in England

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2012-04-01

    Full Text Available Abstract Background Although acute hospitals offer a twenty-four hour seven day a week service levels of staffing are lower over the weekends and some health care processes may be less readily available over the weekend. Whilst it is thought that emergency admission to hospital on the weekend is associated with an increased risk of death, the extent to which this applies to elective admissions is less well known. We investigated the risk of death in elective and elective patients admitted over the weekend versus the weekdays. Methods Retrospective statistical analysis of routinely collected acute hospital admissions in England, involving all patient discharges from all acute hospitals in England over a year (April 2008-March 2009, using a logistic regression model which adjusted for a range of patient case-mix variables, seasonality and admission over a weekend separately for elective and emergency (but excluding zero day stay emergency admissions discharged alive admissions. Results Of the 1,535,267 elective admissions, 91.7% (1,407,705 were admitted on the weekday and 8.3% (127,562 were admitted on the weekend. The mortality following weekday admission was 0.52% (7,276/1,407,705 compared with 0.77% (986/127,562 following weekend admission. Of the 3,105,249 emergency admissions, 76.3% (2,369,316 were admitted on the weekday and 23.7% (735,933 were admitted on the weekend. The mortality following emergency weekday admission was 6.53% (154,761/2,369,316 compared to 7.06% (51,922/735,933 following weekend admission. After case-mix adjustment, weekend admissions were associated with an increased risk of death, especially in the elective setting (elective Odds Ratio: 1.32, 95% Confidence Interval 1.23 to 1.41; vs emergency Odds Ratio: 1.09, 95% Confidence Interval 1.05 to 1.13. Conclusions Weekend admission appears to be an independent risk factor for dying in hospital and this risk is more pronounced in the elective setting. Given the planned

  10. Communication and well-being outcomes of a hybrid service delivery model of intensive impairment-based treatment for aphasia in the hospital setting: a pilot study.

    Science.gov (United States)

    Wenke, Rachel; Cardell, Elizabeth; Lawrie, Melissa; Gunning, Dana

    2018-06-01

    This pilot study aimed to evaluate the effects of an intensive hybrid service delivery model (i.e., combining face-to-face individual, computer and group therapy) on communication and well-being for people with aphasia (PWA) in the hospital setting. The study explored two different intensities of the hybrid model, 4 h/week (Hybrid-4) and 8 h/week (Hybrid-8) both for 8 weeks. Participants ranging from 1 month to 5 years post-onset were allocated using matched-pair randomisation to receive either Hybrid-4 (n = 5) or Hybrid-8 (n = 4) and assessed using a comprehensive language battery by a blinded assessor, as well as selected activity, participation and well-being measures before, immediately after and 4-week post-treatment. All participants in Hybrid-4 and three out of four participants in Hybrid-8 demonstrated clinically significant improvement to measures of language impairment immediately post-treatment, with the majority also demonstrating maintenance effects 4-week post-treatment. Clinically significant improvements to activity, participation and well-being measures were also observed across participants in both groups. Findings support the potential benefit of employing an intensive hybrid service model and suggest that both 4 and 8 h per week of impairment-based treatment for 8 weeks may result in improvements in communication and well-being for some PWA across different stages of recovery. Implications for rehabilitation The present findings help bridge the gap between what evidence suggests is effective intensity of rehabilitation for aphasia and what can be practically delivered in real-world hospital settings. Findings support the potential clinical value of employing a hybrid service model (using computer, group and individual therapy) to deliver intensive rehabilitation to people with aphasia in the hospital setting, and suggest that clinically significant improvements to communication and well-being can result when the model is

  11. Permeability of public and private spaces in reproductive healthcare seeking: barriers to uptake of services among low income African American women in a smaller urban setting.

    Science.gov (United States)

    Golden, Annis G

    2014-05-01

    This study was undertaken in partnership with a publicly funded reproductive healthcare organization to better understand barriers to utilization of its services as perceived by low income African American women in its community and how those barriers might be managed. The study uses a place-based, ecological perspective to theorize privacy challenges across different levels of the communication ecology. Analysis of participant observation, interviews, and focus group data identified three key public-private problematics in African American women's experience of reproductive healthcare seeking in a smaller urban setting: a public-private problematic of organizational identity, of organizational regions, and of organizational members. Potential strategies are identified for managing these problematics by the organization and community members. Copyright © 2014. Published by Elsevier Ltd.

  12. Programming services with correlation sets

    DEFF Research Database (Denmark)

    Montesi, Fabrizio; Carbone, Marco

    2011-01-01

    -oriented systems, such as distribution, loose coupling, open-endedness and integration. Distinguishing features of our approach are the notion of correlation aliases and an asynchronous communication model. Our language is equipped with formal syntax, semantics, and a typing system for ensuring desirable...

  13. The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.

    Science.gov (United States)

    Berglas, Nancy F; Battistelli, Molly F; Nicholson, Wanda K; Sobota, Mindy; Urman, Richard D; Roberts, Sarah C M

    2018-01-01

    Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear. We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions. More and higher quality research is needed to determine if there is a public health problem to be addressed through facility

  14. Accounting & Finance; a Basic Introduction

    NARCIS (Netherlands)

    drs. Ewoud Jansen

    2011-01-01

    The book is about finance and accounting, subjects widely discussed in many other books. What sets this book apart from most others is that it discusses all the basic aspects of finance and accounting in one single textbook. Three areas of interest are discussed: Financial Management; Management

  15. The setting up and running of a cross-county out-of-hours gastrointestinal bleed service: a possible blueprint for the future.

    Science.gov (United States)

    Shokouhi, Bahman N; Khan, Mohammad; Carter, Martyn J; Khan, Nasser Q; Mills, Philip; Morris, Danielle; Rowlands, David E; Samsheer, Kote; Sargeant, Ian R; McIntyre, Peter B; Greenfield, Simon M

    2013-07-01

    Acute upper gastrointestinal bleeding (AUGIB) results in 25 000 hospital admissions annually. Patients admitted at weekends with AUGIB have increased mortality, and guidelines advise out-of-hours endoscopy. We present retrospective data from our service involving the interhospital transfer of patients. We pooled resources of two neighbouring general hospitals, just north of London. Emergency endoscopy is performed at the start of the list followed by elective endoscopy in the endoscopy unit on Saturday and Sunday mornings. From Friday evening to Sunday morning, patients admitted to Queen Elizabeth II Hospital (QEII) are medically stabilised and transferred to Lister Hospital by ambulance. 240 endoscopies were performed out of hours from December 2007 to March 2011. Of these, 54 patients were transferred: nine had emergency endoscopy at QEII as they were medically unstable; eight of the patients transferred required therapeutic intervention for active bleeding. The mean pre-endoscopy Rockall score of those transferred was 2.5. We examined the records of 51 of the 54 patients transferred. There were three deaths within 30 days after endoscopy not associated with the transfer process. 19 (37%) patients had reduced hospitalisation after having their endoscopy at the weekend. The introduction of the out-of-hours endoscopy service in our trust has had multiple benefits, including patients consistently receiving timely emergency endoscopy, significantly reduced disruption to emergency operating theatres, and participation of endoscopy nurses ensures a better and safer experience for patients, and better endoscopy decontamination. We suggest our model is safe and feasible for other small units wishing to set up their own out-of-hours endoscopy service to adopt.

  16. The impact of the World Health Organization 8-steps in wheelchair service provision in wheelchair users in a less resourced setting: a cohort study in Indonesia.

    Science.gov (United States)

    Toro, Maria L; Eke, Chika; Pearlman, Jonathan

    2016-01-22

    For people who have a mobility impairment, access to an appropriate wheelchair is an important step towards social inclusion and participation. The World Health Organization Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings emphasize the eight critical steps for appropriate wheelchair services, which include: referral, assessment, prescription, funding and ordering, product preparation,fitting and adjusting, user training, and follow-up and maintenance/repairs. The purpose of this study was to investigate how the provision of wheelchairs according to the World Health Organization's service provision process by United Cerebral Palsy Wheels for Humanity in Indonesia affects wheelchair recipients compared to wait-listed controls. This study used a convenience sample (N = 344) of Children, Children with proxies, Adults, and Adults with proxies who were on a waiting list to receive a wheelchair as well as those who received one. Interviews were conducted at baseline and a 6 month follow-up to collect the following data: Demographics and wheelchair use questions, the World Health Organization Quality of Life-BREF, Functional Mobility Assessment, Craig Handicap Assessment Recording Technique Short Form. The Wheelchair Assessment Checklist and Wheelchair Skills Test Questionnaire were administered at follow up only. 167 participants were on the waiting list and 142 received a wheelchair. Physical health domain in the World Health Organization Quality of Life-BREF improved significantly for women who received a wheelchair (p = 0.044) and environmental health improved significantly for women and men who received a wheelchair as compared to those on the waiting list (p received a wheelchair reported being able to perform a "wheelie". The condition of Roughrider wheelchairs was significantly better than the condition of kids wheelchairs for Children with proxies as measured by the Wheelchair Assessment Checklist (p = 0

  17. Value Set Authority Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — The VSAC provides downloadable access to all official versions of vocabulary value sets contained in the 2014 Clinical Quality Measures (CQMs). Each value set...

  18. Examination of the utility of the promoting action on research implementation in health services framework for implementation of evidence based practice in residential aged care settings.

    Science.gov (United States)

    Perry, Lin; Bellchambers, Helen; Howie, Andrew; Moxey, Annette; Parkinson, Lynne; Capra, Sandra; Byles, Julie

    2011-10-01

    This study examined the relevance and fit of the PARiHS framework (Promoting Action on Research Implementation in Health Services) as an explanatory model for practice change in residential aged care. Translation of research knowledge into routine practice is a complex matter in health and social care environments. Examination of the environment may identify factors likely to support and hinder practice change, inform strategy development, predict and explain successful uptake of new ways of working. Frameworks to enable this have been described but none has been tested in residential aged care. This paper reports preliminary qualitative analyses from the Encouraging Best Practice in Residential Aged Care Nutrition and Hydration project conducted in New South Wales in 2007-2009. We examined congruence with the PARiHS framework of factors staff described as influential for practice change during 29 digitally recorded and transcribed staff interviews and meetings at three facilities. Unique features of the setting were flagged, with facilities simultaneously filling the roles of residents' home, staff's workplace and businesses. Participants discussed many of the same characteristics identified by the PARiHS framework, but in addition temporal dimensions of practice change were flagged. Overall factors described by staff as important for practice change in aged care settings showed good fit with those of the PARiHS framework. This framework can be recommended for use in this setting. Widespread adoption will enable cross-project and international synthesis of findings, a major step towards building a cumulative science of knowledge translation and practice change. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  19. Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

    Science.gov (United States)

    Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

    2014-12-01

    Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Basic Stand Alone Medicare Inpatient Claims PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Inpatient Public Use Files (PUF) named CMS 2008 BSA Inpatient Claims PUF with information from 2008 Medicare...

  1. Basic Stand Alone Carrier Line Items PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Carrier Line Items Public Use Files (PUF) with information from Medicare Carrier claims. The CMS BSA Carrier Line...

  2. A Methodological Approach to Encourage the Service-Oriented Learning Systems Development

    Science.gov (United States)

    Diez, David; Malizia, Alessio; Aedo, Ignacio; Diaz, Paloma; Fernandez, Camino; Dodero, Juan-Manuel

    2009-01-01

    The basic idea of service-oriented learning is that a learning environment should be conceived as a set of independent units of learning packaged as learning services. The design, development and deployment of a learning system based on integrating different learning services needs both a technological platform to support the system as well as a…

  3. 5 CFR 551.401 - Basic principles.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...

  4. Basic Course Deskbook. Volume 1: Client Services

    Science.gov (United States)

    2002-03-01

    8, AR 20-1]. 1. IG has jurisdiction to investigate [AR 20-1, para. 8-3]: a. Violations of policy, regulation or law. b. Mismanagement, unethical ...due process. Bolling v. Sharpe, 347 U.S. 497 (1954). 2. 13th Amendment. a) “Neither slavery nor involuntary servitude, except as punishment for...Applicable to private conduct; prohibits slavery and the “badges and incidents of slavery .” Jones v. Alfred H. Mayer Co., 392 U.S. 409 (1968). 3. 14th

  5. Strengthening close to community provision of maternal health services in fragile settings: an exploration of the changing roles of TBAs in Sierra Leone and Somaliland.

    Science.gov (United States)

    Orya, Evelyn; Adaji, Sunday; Pyone, Thidar; Wurie, Haja; van den Broek, Nynke; Theobald, Sally

    2017-07-05

    Efforts to take forward universal health coverage require innovative approaches in fragile settings, which experience particularly acute human resource shortages and poor health indicators. For maternal and newborn health, it is important to innovate with new partnerships and roles for Traditional Birth Attendants (TBAs) to promote maternal health. We explore perspectives on programmes in Somaliland and Sierra Leone which link TBAs to health centres as part of a pathway to maternal health care. Our study aims to understand the perceptions of communities, stakeholder and TBAs themselves who have been trained in new roles to generate insights on strategies to engage with TBAs and to promote skilled birth attendance in fragile affected settings. A qualitative study was carried out in two chiefdoms in Bombali district in Sierra Leone and the Maroodi Jeex region of Somaliland. Purposively sampled participants consisted of key players from the Ministries of Health, programme implementers, trained TBAs and women who benefitted from the services of trained TBAs. Data was collected through key informants and in-depth interviews and focus group discussions. Data was transcribed, translated and analyzed using the framework approach. For the purposes of this paper, a comparative analysis was undertaken reviewing similarities and differences across the two different contexts. Analysis of multiple viewpoints reveal that with appropriate training and support it is possible to change TBAs practices so they support pregnant women in new ways (support and referral rather than delivery). Participants perceived that trained TBAs can utilize their embedded and trusted community relationships to interact effectively with their communities, help overcome barriers to acceptability, utilization and contribute to effective demand for maternal and newborn services and ultimately enhance utilization of skilled birth attendants. Trained TBAs appreciated cordial relationship at the health

  6. Utilization of HIV testing services among pregnant mothers in low income primary care settings in northern Ethiopia: a cross sectional study.

    Science.gov (United States)

    Alemu, Yihun Mulugeta; Ambaw, Fentie; Wilder-Smith, Annelies

    2017-06-24

    HIV testing of women in child bearing age is an entry point for preventing mother-to-child transmission of HIV (MTCT). This study aims to identify the proportion of women tested for HIV and to determine factors associated with utilization of HIV testing services among pregnant mothers in primary care settings in northern Ethiopia. A cross sectional study was conducted in 416 pregnant women from four primary care centers between October 2, 2012 and May 31, 2013 in East Gojjam, Ethiopia. The proportion of mothers who tested for HIV was 277(67%). Among mothers who were not tested for HIV, lack of HIV risk perception (n = 68, 49%) was a major self-reported barrier for HIV testing. A multivariable logistic regression analysis showed that those pregnant women who had comprehensive knowledge about MTCT had an Adjusted Odd Ratio (AOR) of 3.73 (95% CI: 1.56, 8.94), having comprehensive knowledge on prevention of mother to child transmission (PMTCT) of HIV an AOR of 2.56 (95% CI: 1.26, 5.19), and a favorable attitude towards persons living with HIV an AOR of 2.42 (95%CI, 1.20, 4.86) were more likely to be tested for HIV. One third of pregnant women had never been tested for HIV until the time of the study. Efforts should be made to improve mother's knowledge about MTCT and PMTCT to increase uptake of HIV testing. Enhancing mother's HIV risk perception to scale up HIV testing in resource limited setting is highly recommended.

  7. Basic Research Firing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Basic Research Firing Facility is an indoor ballistic test facility that has recently transitioned from a customer-based facility to a dedicated basic research...

  8. Basic Cake Decorating Workbook.

    Science.gov (United States)

    Bogdany, Mel

    Included in this student workbook for basic cake decorating are the following: (1) Drawings of steps in a basic way to ice a layer cake, how to make a paper cone, various sizes of flower nails, various sizes and types of tin pastry tubes, and special rose tubes; (2) recipes for basic decorating icings (buttercream, rose paste, and royal icing);…

  9. Basic concepts of epidemiology

    International Nuclear Information System (INIS)

    Savitz, D.A.

    1984-01-01

    Epidemiology can be defined simply as the science of the distribution and determinants of disease in human populations. As a descriptive tool, epidemiology can aid health care service providers, for example, in allocation of resources. In its analytic capacity, the epidemiologic approach can help identify determinants of disease through the study of human populations. Epidemiology is primarily an observational rather than experimental methodology, with corresponding strengths and limitations. Relative to other approaches for assessing disease etiology and impacts of potential health hazards, epidemiology has a rather unique role that is complementary to, but independent of, both basic biologic sciences and clinical medicine. Experimental biologic sciences such as toxicology and physiology provide critical information on biologic mechanisms of disease required for causal inference. Clinical medicine often serves as the warning system that provides etiologic clues to be pursued through systematic investigation. The advantage of the epidemiologic approach is its reliance on human field experience, that is, the real world. While laboratory experimentation is uniquely well suited to defining potential hazards, it can neither determine whether human populations have actually been affected nor quantify that effect. Building all the complexities of human behavior and external factors into a laboratory study or mathematical model is impossible. By studying the world as it exists, epidemiology examines the integrated, summarized product of the myriad factors influencing health

  10. Cleaning Services.

    Science.gov (United States)

    Sharpton, James L.

    This curriculum guide provides cleaning services instructional materials for a ninth- and tenth-grade Coordinated Vocational Education and Training: Home and Community Services program. It includes 2 sections and 11 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities,…

  11. SEA ODC - An Implementation of Web Portal and B2B Services for Managing of Oceanographic Data Sets Collected in South-East Adriatic

    Science.gov (United States)

    Jovicic, A.; Castelli, A.; Kljajic, Z.

    2012-04-01

    As a result of efforts to standardize oceanographic data sets collected since year 2002 in the area of south-east Adriatic, relational data model suitable for storage of meta-data and in situ measurements was designed and implemented. Using combination of customized tools developed for extraction of meta-data and data records from CTD files as well as standard office applications, data were extracted, transformed, processed and unified by attributes and units of measurement. To make those data available for wider scientific community, we have developed web portal able to be used for data retrieval based on various filters (spatial, temporal, by project and/or by sampling instrument). Selected data model proves to be also very efficient for generating of data-exchange formats required by various projects and initiatives (e.g. SeaDataNet) so extended by particular dictionaries it can allow fast implementation of integration services. As a part of Ecoport 8 project, newly available type of data was recently introduced. Real-time data provided by permanent sensors need to be automatically collected and stored into database. Visualization of such data was also required as well as exchange with project data center. To fulfill those requirements, additional data scheme and appropriate B2B services were developed. Additional care was taken about data transfer security as database was not hosted at the same place as workstation used for remote access to sensor equipment. Third section of portal is "Tide Tables", interactive, graphical application that visualize tide predictions for ports of Bar and Kotor, allowing also correction by atmospheric pressure. Developed in Java, based on well known Mike Foreman's Fortran 77 code it can be used as stand-alone product without Internet connection. Last section of portal is Google Earth file containing position of stations as well as some spatial features that can be useful during planning of future oceanographic cruises in this area

  12. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    Directory of Open Access Journals (Sweden)

    Coluccia A

    2014-09-01

    Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

  13. Sustainability in Health care by Allocating Resources Effectively (SHARE) 8: developing, implementing and evaluating an evidence dissemination service in a local healthcare setting.

    Science.gov (United States)

    Harris, Claire; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Waller, Cara; King, Richard; Ramsey, Wayne

    2018-03-02

    This is the eighth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for disinvestment within a large Australian health service. One of the aims was to explore methods to deliver existing high quality synthesised evidence directly to decision-makers to drive decision-making proactively. An Evidence Dissemination Service (EDS) was proposed. While this was conceived as a method to identify disinvestment opportunities, it became clear that it could also be a way to review all practices for consistency with current evidence. This paper reports the development, implementation and evaluation of two models of an in-house EDS. Frameworks for development of complex interventions, implementation of evidence-based change, and evaluation and explication of processes and outcomes were adapted and/or applied. Mixed methods including a literature review, surveys, interviews, workshops, audits, document analysis and action research were used to capture barriers, enablers and local needs; identify effective strategies; develop and refine proposals; ascertain feedback and measure outcomes. Methods to identify, capture, classify, store, repackage, disseminate and facilitate use of synthesised research evidence were investigated. In Model 1, emails containing links to multiple publications were sent to all self-selected participants who were asked to determine whether they were the relevant decision-maker for any of the topics presented, whether change was required, and to take the relevant action. This voluntary framework did not achieve the aim of ensuring practice was consistent with current evidence. In Model 2, the need for change was established prior to dissemination, then a summary of the evidence was sent to the decision-maker responsible for practice in the relevant area who was required to take appropriate action and

  14. Specialist palliative care services for adults with advanced, incurable illness in hospital, hospice, or community settings--protocol for a systematic review.

    Science.gov (United States)

    Gaertner, Jan; Siemens, Waldemar; Antes, Gerd; Meerpohl, Joerg J; Xander, Carola; Schwarzer, Guido; Stock, Stephanie; Becker, Gerhild

    2015-09-25

    Specialist palliative care (SPC) interventions aim to relieve and prevent suffering in the physical, psychological, social, and spiritual domain. Therefore, SPC is carried out by a multi-professional team with different occupations (e.g., physician, nurse, psychologist, and social worker). Remaining skepticism concerning the need for SPC may be based on the scarcity of high-quality evaluations about the external evidence for SPC. Therefore, we will conduct a systematic review according to Cochrane standards to examine the effects of SPC for adults with advanced illness. The comprehensive systematic literature search will include randomized controlled trials (RCTs) and cluster RCTs. We will search the databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO. Patients must be adults suffering from life-limiting diseases. Proxy and caregiver outcomes will not be assessed in order to ensure a clear and well-defined research question for this review. Interventions may be in an in- or outpatient setting, e.g., consulting service, palliative care ward, and palliative outpatient clinic. In line with the multi-dimensional scope of palliative care, the primary outcome is quality of life (QoL). Key secondary outcomes are patients' symptom burden, place of death and survival, and health economic aspects. Subgroup analysis will assess results according to cancer type, age, early vs not early SPC, site of care, and setting. Analysis will be performed with the current RevMan software. We will use the Cochrane Collaboration risk of bias assessment tool. The quality of evidence will be judged according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The available evidence will be summarized and discussed to provide a basis for decision-making among health care professionals and policy makers. For SPC, we believe that multi-professional care is of utmost importance. Therefore, single

  15. Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Kondo, Yutaka; Fukuda, Tatsuma; Uchimido, Ryo; Hifumi, Toru; Hayashida, Kei

    2017-10-22

    Advanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature. We will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ 2 test of homogeneity, and any observed heterogeneity will be quantified using the I 2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence. Our study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information. PROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Predictive validity of a service-setting-based measure to identify infancy mental health problems: a population-based cohort study.

    Science.gov (United States)

    Ammitzbøll, Janni; Thygesen, Lau Caspar; Holstein, Bjørn E; Andersen, Anette; Skovgaard, Anne Mette

    2018-06-01

    Measures to identify infancy mental health problems are essential to guide interventions and reduce the risk of developmental psychopathology in early years. We investigated a new service-setting-based measure the Copenhagen Infant Mental Health Screening (CIMHS) within the general child health surveillance by community health nurses (CHN). The study population of 2973 infants was assessed by CIMHS at age 9-10 months. A subsample of 416 children was examined at age 1½ years, using parent interviews including the Child Behavior Checklist (CBCL 1½-5), Check List of Autism and Toddlers (CHAT), Infant-Toddler Symptom Checklist (ITSCL), and the Bayley Scales of Infant and Toddler Development (BSID) and observations of behavior, communication, and interaction. Child mental disorders were diagnosed according to ICD-10 and parent-child relationship disorders according to DC:0-3R. Statistical analyses included logistic regression analyses adjusted and weighted to adjust for sampling and bias. CIMHS problems of sleep, feeding and eating, emotions, attention, communication, and language were associated with an up to fivefold increased risk of child mental disorders across the diagnostic spectrum of ICD-10 diagnoses. Homo-type continuity was seen in problems of sleep and feeding and eating being associated with a threefold increased risk of disorders within the same area, OR 3.0 (95% CI 1.6-5.4) and OR 2.7 (95% CI 1.7-4.2), respectively. The sensitivity at high CIMHS problem scores was 32% and specificity 86%. In summary, CIMHS identify a broad range of infants' mental health problems that are amenable to guide intervention within the general child health surveillance.

  17. Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the Emergency Medical Services Setting: A Systematic Review.

    Science.gov (United States)

    Patterson, P Daniel; Weaver, Matthew D; Fabio, Anthony; Teasley, Ellen M; Renn, Megan L; Curtis, Brett R; Matthews, Margaret E; Kroemer, Andrew J; Xun, Xiaoshuang; Bizhanova, Zhadyra; Weiss, Patricia M; Sequeira, Denisse J; Coppler, Patrick J; Lang, Eddy S; Higgins, J Stephen

    2018-02-15

    This study sought to systematically search the literature to identify reliable and valid survey instruments for fatigue measurement in the Emergency Medical Services (EMS) occupational setting. A systematic review study design was used and searched six databases, including one website. The research question guiding the search was developed a priori and registered with the PROSPERO database of systematic reviews: "Are there reliable and valid instruments for measuring fatigue among EMS personnel?" (2016:CRD42016040097). The primary outcome of interest was criterion-related validity. Important outcomes of interest included reliability (e.g., internal consistency), and indicators of sensitivity and specificity. Members of the research team independently screened records from the databases. Full-text articles were evaluated by adapting the Bolster and Rourke system for categorizing findings of systematic reviews, and the rated data abstracted from the body of literature as favorable, unfavorable, mixed/inconclusive, or no impact. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the quality of evidence. The search strategy yielded 1,257 unique records. Thirty-four unique experimental and non-experimental studies were determined relevant following full-text review. Nineteen studies reported on the reliability and/or validity of ten different fatigue survey instruments. Eighteen different studies evaluated the reliability and/or validity of four different sleepiness survey instruments. None of the retained studies reported sensitivity or specificity. Evidence quality was rated as very low across all outcomes. In this systematic review, limited evidence of the reliability and validity of 14 different survey instruments to assess the fatigue and/or sleepiness status of EMS personnel and related shift worker groups was identified.

  18. Basic digital signal processing

    CERN Document Server

    Lockhart, Gordon B

    1985-01-01

    Basic Digital Signal Processing describes the principles of digital signal processing and experiments with BASIC programs involving the fast Fourier theorem (FFT). The book reviews the fundamentals of the BASIC program, continuous and discrete time signals including analog signals, Fourier analysis, discrete Fourier transform, signal energy, power. The text also explains digital signal processing involving digital filters, linear time-variant systems, discrete time unit impulse, discrete-time convolution, and the alternative structure for second order infinite impulse response (IIR) sections.

  19. Hydromechanics - basic properties

    International Nuclear Information System (INIS)

    Lee, Sung Tak; Lee, Je Geun

    1987-03-01

    This book tells of hydromechanics, which is about basic properties of hydromechanics such as conception, definition, mass, power and weight, and perfect fluid and perfect gas, hydrostatics with summary, basic equation of hydrostatics, relative balance of hydrostatics, and kinematics of hydromechanics, description method of floating, hydromechanics about basic knowledge, equation of moment, energy equation and application of Bernoulli equation, application of momentum theory, inviscid flow and fluid measuring.

  20. Basic molecular spectroscopy

    CERN Document Server

    Gorry, PA

    1985-01-01

    BASIC Molecular Spectroscopy discusses the utilization of the Beginner's All-purpose Symbolic Instruction Code (BASIC) programming language in molecular spectroscopy. The book is comprised of five chapters that provide an introduction to molecular spectroscopy through programs written in BASIC. The coverage of the text includes rotational spectra, vibrational spectra, and Raman and electronic spectra. The book will be of great use to students who are currently taking a course in molecular spectroscopy.

  1. Track 4: basic nuclear science variance reduction for Monte Carlo criticality simulations. 2. Assessment of MCNP Statistical Analysis of keff Eigenvalue Convergence with an Analytical Criticality Verification Test Set

    International Nuclear Information System (INIS)

    Sood, Avnet; Forster, R. Arthur; Parsons, D. Kent

    2001-01-01

    Monte Carlo simulations of nuclear criticality eigenvalue problems are often performed by general purpose radiation transport codes such as MCNP. MCNP performs detailed statistical analysis of the criticality calculation and provides feedback to the user with warning messages, tables, and graphs. The purpose of the analysis is to provide the user with sufficient information to assess spatial convergence of the eigenfunction and thus the validity of the criticality calculation. As a test of this statistical analysis package in MCNP, analytic criticality verification benchmark problems have been used for the first time to assess the performance of the criticality convergence tests in MCNP. The MCNP statistical analysis capability has been recently assessed using the 75 multigroup criticality verification analytic problem test set. MCNP was verified with these problems at the 10 -4 to 10 -5 statistical error level using 40 000 histories per cycle and 2000 active cycles. In all cases, the final boxed combined k eff answer was given with the standard deviation and three confidence intervals that contained the analytic k eff . To test the effectiveness of the statistical analysis checks in identifying poor eigenfunction convergence, ten problems from the test set were deliberately run incorrectly using 1000 histories per cycle, 200 active cycles, and 10 inactive cycles. Six problems with large dominance ratios were chosen from the test set because they do not achieve the normal spatial mode in the beginning of the calculation. To further stress the convergence tests, these problems were also started with an initial fission source point 1 cm from the boundary thus increasing the likelihood of a poorly converged initial fission source distribution. The final combined k eff confidence intervals for these deliberately ill-posed problems did not include the analytic k eff value. In no case did a bad confidence interval go undetected. Warning messages were given signaling that

  2. Route effect on the perception of public transport services quality

    Energy Technology Data Exchange (ETDEWEB)

    Chica-Olmo, J.; Gachs-Sanchez, H.M.; Lizarraga, C.

    2016-07-01

    User satisfaction sets a basic example for public service quality, especially those considered as basic necessities. The quality in transport service related to conceptualization and measurement, as a decisive demand key, presents challenges for both economic and mobility policies.Several operator companies are involved in the transport sector. Therefore this report aims to design a model of overall satisfaction based on the level of satisfaction with a specific set of factors, considering individual characteristics of users and the differential effect of different bus lines.The current presentation has applied a combined method, using Nonlinear Principal Component Analysis (NLPCA) and a Logit Multilevel Model (LMLM) in two-steps. (Author)

  3. A comprehensive review of HIV/STI prevention and sexual and reproductive health services among sex Workers in Conflict-Affected Settings: call for an evidence- and rights-based approach in the humanitarian response.

    Science.gov (United States)

    Ferguson, Alyssa; Shannon, Kate; Butler, Jennifer; Goldenberg, Shira M

    2017-01-01

    While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. This review identified significant gaps in HIV/STI and SRH research, policy

  4. Health technology assessment of utilization, practice and ethical issues of self-pay services in the German ambulatory health care setting.

    Science.gov (United States)

    Hunger, Theresa; Schnell-Inderst, Petra; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe

    2014-02-01

    The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.

  5. The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

    Science.gov (United States)

    Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

    2014-05-01

    Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries.

  6. Finding Basic Writing's Place.

    Science.gov (United States)

    Sheridan-Rabideau, Mary P.; Brossell, Gordon

    1995-01-01

    Posits that basic writing serves a vital function by providing writing support for at-risk students and serves the needs of a growing student population that universities accept yet feel needs additional writing instruction. Concludes that the basic writing classroom is the most effective educational support for at-risk students and their writing.…

  7. Biomass Energy Basics | NREL

    Science.gov (United States)

    Biomass Energy Basics Biomass Energy Basics We have used biomass energy, or "bioenergy" keep warm. Wood is still the largest biomass energy resource today, but other sources of biomass can landfills (which are methane, the main component in natural gas) can be used as a biomass energy source. A

  8. Wind Energy Basics | NREL

    Science.gov (United States)

    Wind Energy Basics Wind Energy Basics We have been harnessing the wind's energy for hundreds of grinding grain. Today, the windmill's modern equivalent-a wind turbine can use the wind's energy to most energy. At 100 feet (30 meters) or more aboveground, they can take advantage of the faster and

  9. Solar Energy Basics | NREL

    Science.gov (United States)

    Solar Energy Basics Solar Energy Basics Solar is the Latin word for sun-a powerful source of energy that can be used to heat, cool, and light our homes and businesses. That's because more energy from the technologies convert sunlight to usable energy for buildings. The most commonly used solar technologies for

  10. Health Insurance Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

  11. Body Basics Library

    Science.gov (United States)

    ... Body Basics articles explain just how each body system, part, and process works. Use this medical library to find out about basic human anatomy, how ... Teeth Skin, Hair, and Nails Spleen and Lymphatic System ... Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  12. Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

    Science.gov (United States)

    Sperber, Nina R; Carpenter, Janet S; Cavallari, Larisa H; J Damschroder, Laura; Cooper-DeHoff, Rhonda M; Denny, Joshua C; Ginsburg, Geoffrey S; Guan, Yue; Horowitz, Carol R; Levy, Kenneth D; Levy, Mia A; Madden, Ebony B; Matheny, Michael E; Pollin, Toni I; Pratt, Victoria M; Rosenman, Marc; Voils, Corrine I; W Weitzel, Kristen; Wilke, Russell A; Ryanne Wu, R; Orlando, Lori A

    2017-05-22

    To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic

  13. The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services.

    Science.gov (United States)

    Spira, Thomas; Lindegren, Mary Lou; Ferris, Robert; Habiyambere, Vincent; Ellerbrock, Tedd

    2009-06-01

    The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms.

  14. 38 CFR 21.142 - Adult basic education.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...

  15. HEDIS Limited Data Set

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of Americas health plans to measure performance on important...

  16. From basic needs to basic rights.

    Science.gov (United States)

    Facio, A

    1995-06-01

    After arriving at an understanding that basic rights refer to all human needs, it is clear that a recognition of the basic needs of female humans must precede the realization of their rights. The old Women in Development (WID) framework only understood women's needs from an androcentric perspective which was limited to practical interests. Instead, women's primary need is to be free from their subordination to men. Such an understanding places all of women's immediate needs in a new light. A human rights approach to development would see women not as beneficiaries but as people entitled to enjoy the benefits of development. Discussion of what equality before the law should mean to women began at the Third World Conference on Women in Nairobi where the issue of violence against women was first linked to development. While debate continues about the distinction between civil and political rights and economic, social, and cultural rights, the realities of women's lives do not permit such a distinction. The concept of the universality of human rights did not become codified until the UN proclaimed the Universal Declaration of Human Rights in 1948. The declaration has been criticized by feminists because the view of human rights it embodies has been too strongly influenced by a liberal Western philosophy which stresses individual rights and because it is ambiguous on the distinction between human rights and the rights of a citizen. The protection of rights afforded by the Declaration, however, should not be viewed as a final achievement but as an ongoing struggle. International conferences have led to an analysis of the human-rights approach to sustainable development which concludes that women continue to face the routine denial of their rights. Each human right must be redefined from the perspective of women's needs, which must also be redefined. Women must forego challenging the concept of the universality of human rights in order to overcome the argument of cultural

  17. Basic rocks in Finland

    International Nuclear Information System (INIS)

    Piirainen, T.; Gehoer, S.; Iljina, M.; Kaerki, A.; Paakkola, J.; Vuollo, J.

    1992-10-01

    Basic igneous rocks, containing less than 52% SiO 2 , constitute an important part of the Finnish Archaean and Proterozoic crust. In the Archaean crust exist two units which contain the majority of the basic rocks. The Arcaean basic rocks are metavolcanics and situated in the Greenstone Belts of Eastern Finland. They are divided into two units. The greenstones of the lower one are tholeiites, komatiites and basaltic komatiites. The upper consists of bimodal series of volcanics and the basic rocks of which are Fe-tholeiites, basaltic komatiites and komatiites. Proterozoic basic rocks are divided into seven groups according to their ages. The Proterozoic igneous activity started by the volominous basic magmatism 2.44 Ga ago. During this stage formed the layered intrusions and related dykes in the Northern Finland. 2.2 Ga old basic rocks are situated at the margins of Karelian formations. 2.1 Ga aged Fe-tholeiitic magmatic activity is widespread in Eastern and Northern Finland. The basic rocks of 1.97 Ga age group are met within the Karelian Schist Belts as obducted ophiolite complexes but they occur also as tholeiitic diabase dykes cutting the Karelian schists and Archean basement. The intrusions and the volcanics of the 1.9 Ga old basic igneous activity are mostly encountered around the Granitoid Complex of Central Finland. Subjotnian, 1.6 Ga aged tholeiitic diabases are situated around the Rapakivi massifs of Southern Finland, and postjotnian, 1.2 Ga diabases in Western Finland where they form dykes cutting Svecofennian rocks

  18. USGS Elevation Availability (NED) Overlay Map Service from The National Map - National Geospatial Data Asset (NGDA) National Elevation Data Set (NED)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Elevation Availability service from The National Map (TNM) shows the best available resolution of downloadable elevation data, and is updated approximately...

  19. U.S. Food Safety and Inspection Service testing for Salmonella in selected raw meat and poultry products in the United States, 1998 through 2003: analysis of set results.

    Science.gov (United States)

    Naugle, Alecia Larew; Barlow, Kristina E; Eblen, Denise R; Teter, Vanessa; Umholtz, Robert

    2006-11-01

    The U.S. Food Safety and Inspection Service (FSIS) tests sets of samples of selected raw meat and poultry products for Salmonella to ensure that federally inspected establishments meet performance standards defined in the pathogen reduction-hazard analysis and critical control point system (PR-HACCP) final rule. In the present report, sample set results are described and associations between set failure and set and establishment characteristics are identified for 4,607 sample sets collected from 1998 through 2003. Sample sets were obtained from seven product classes: broiler chicken carcasses (n = 1,010), cow and bull carcasses (n = 240), market hog carcasses (n = 560), steer and heifer carcasses (n = 123), ground beef (n = 2,527), ground chicken (n = 31), and ground turkey (n = 116). Of these 4,607 sample sets, 92% (4,255) were collected as part of random testing efforts (A sets), and 93% (4,166) passed. However, the percentage of positive samples relative to the maximum number of positive results allowable in a set increased over time for broilers but decreased or stayed the same for the other product classes. Three factors associated with set failure were identified: establishment size, product class, and year. Set failures were more likely early in the testing program (relative to 2003). Small and very small establishments were more likely to fail than large ones. Set failure was less likely in ground beef than in other product classes. Despite an overall decline in set failures through 2003, these results highlight the need for continued vigilance to reduce Salmonella contamination in broiler chicken and continued implementation of programs designed to assist small and very small establishments with PR-HACCP compliance issues.

  20. Quantum electronics basic theory

    CERN Document Server

    Fain, V M; Sanders, J H

    1969-01-01

    Quantum Electronics, Volume 1: Basic Theory is a condensed and generalized description of the many research and rapid progress done on the subject. It is translated from the Russian language. The volume describes the basic theory of quantum electronics, and shows how the concepts and equations followed in quantum electronics arise from the basic principles of theoretical physics. The book then briefly discusses the interaction of an electromagnetic field with matter. The text also covers the quantum theory of relaxation process when a quantum system approaches an equilibrium state, and explai

  1. Appropriate levels of service

    CSIR Research Space (South Africa)

    Wall, K

    2010-02-01

    Full Text Available The term "services", as used in this article, broadly refers to infrastructure (in particular, civil and electrical engineering infrastructure), and also the infrastructure elements such as schools, clinics and halls. The term "basic services...

  2. Service Marketing Competitiveness In The New Economy

    OpenAIRE

    Aleksandar Grubor

    2008-01-01

    In the new economy the basic characteristics of services determine service consumption, just as customer relationship management impacts on the approach to services marketing. Contemporary service customers perceive service quality in service encounters and in ongoing relationships as well. The perception of service quality may be presented as a basic model of perception, known in service marketing reference sources as The Perceived Service Quality Model. Service marketers and marketing manag...

  3. Basic Financial Accounting

    DEFF Research Database (Denmark)

    Wiborg, Karsten

    This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects...

  4. HIV Treatment: The Basics

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Treatment: The Basics Last Reviewed: March 22, 2018 ...

  5. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children ...

  6. Powassan (POW) Virus Basics

    Science.gov (United States)

    ... Health Professionals Related Topics For International Travelers Powassan Virus Disease Basics Download this fact sheet formatted for ... Virus Disease Fact Sheet (PDF) What is Powassan virus? Powassan virus is a tickborne flavivirus that is ...

  7. Brain Basics: Understanding Sleep

    Science.gov (United States)

    ... You are here Home » Disorders » Patient & Caregiver Education Brain Basics: Understanding Sleep Anatomy of Sleep Sleep Stages ... t form or maintain the pathways in your brain that let you learn and create new memories, ...

  8. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of ... injury? What is a Spinal Cord Injury? SCI Medical Experts People Living With SCI Personal Experiences By ...

  9. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David ...

  10. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD Kristine Cichowski, MS Read Bio Founding ...

  11. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 ...

  12. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  13. Physical Activity Basics

    Science.gov (United States)

    ... Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Physical Activity Basics Recommend on Facebook Tweet Share Compartir How much physical activity do you need? Regular physical activity helps improve ...

  14. Radionuclide Basics: Iodine

    Science.gov (United States)

    ... Centers Radiation Protection Contact Us Share Radionuclide Basics: Iodine Iodine (chemical symbol I) is a chemical element. ... in the environment Iodine sources Iodine and health Iodine in the Environment All 37 isotopes of iodine ...

  15. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... health care products or services, or control the information found on external websites. The Hill Foundation is ... health care products or services, or control the information found on external websites. The Hill Foundation is ...

  16. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... does not provide medical advice, recommend or endorse health care products or services, or control the information ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  17. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... does not provide medical advice, recommend or endorse health care products or services, or control the information found ... does not provide medical advice, recommend or endorse health care products or services, or control the information found ...

  18. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... or endorse health care products or services, or control the information found on external websites. The Hill ... or endorse health care products or services, or control the information found on external websites. The Hill ...

  19. Basic Finite Element Method

    International Nuclear Information System (INIS)

    Lee, Byeong Hae

    1992-02-01

    This book gives descriptions of basic finite element method, which includes basic finite element method and data, black box, writing of data, definition of VECTOR, definition of matrix, matrix and multiplication of matrix, addition of matrix, and unit matrix, conception of hardness matrix like spring power and displacement, governed equation of an elastic body, finite element method, Fortran method and programming such as composition of computer, order of programming and data card and Fortran card, finite element program and application of nonelastic problem.

  20. Paediatric airway management: basic aspects

    DEFF Research Database (Denmark)

    Holm-Knudsen, R J; Rasmussen, L S

    2009-01-01

    Paediatric airway management is a great challenge, especially for anaesthesiologists working in departments with a low number of paediatric surgical procedures. The paediatric airway is substantially different from the adult airway and obstruction leads to rapid desaturation in infants and small...... children. This paper aims at providing the non-paediatric anaesthesiologist with a set of safe and simple principles for basic paediatric airway management. In contrast to adults, most children with difficult airways are recognised before induction of anaesthesia but problems may arise in all children...

  1. Security basics for computer architects

    CERN Document Server

    Lee, Ruby B

    2013-01-01

    Design for security is an essential aspect of the design of future computers. However, security is not well understood by the computer architecture community. Many important security aspects have evolved over the last several decades in the cryptography, operating systems, and networking communities. This book attempts to introduce the computer architecture student, researcher, or practitioner to the basic concepts of security and threat-based design. Past work in different security communities can inform our thinking and provide a rich set of technologies for building architectural support fo

  2. Perceptions of Recidivism Among Incarcerated Youth: The Relationship Between Exposure to Childhood Trauma, Mental Health Status, and the Protective Effect of Mental Health Services in Juvenile Justice Settings

    Directory of Open Access Journals (Sweden)

    Jamie R. Yoder

    2017-09-01

    Full Text Available Research suggests that youth involved the juvenile justice system have trauma histories that are two times higher than the general youth population. Juvenile justice-involved youth also have high rates of mental health symptoms. Fewer studies have examined how trauma links to mental health symptoms among youth offenders, and even less research focuses on how mental health status and service delivery can impact their perceived likelihood for success. This study examines the effects of mental health screening and service delivery on perceived future criminal justice interactions— arrest and incarceration—among adjudicated youth (n=7,073 housed in correctional facilities. Secondary data were used to examine trauma histories, mental health needs, and mental health screening and service delivery. Significant relationships between traumatic events and mental health problems were found, along with relationships between mental health problems and mental health screening and service delivery. Most interestingly, results pointed to the strong inverse relationship between mental health service delivery and youth’s perceived likelihood for recidivism. These findings show the promise of juvenile justice systems appropriately responding to the mental health concerns of youth.

  3. HOW GOOD IS GOODS AND SERVICES TAX

    OpenAIRE

    Dr. Sreemoyee Guha Roy

    2016-01-01

    Goods and Services Tax is a broad based and a single comprehensive tax levied on goods and services consumed in an economy. GST is levied at every stage of the production-distribution chain with applicable set offs in respect of the tax remitted at previous stages. It is basically a tax on final consumption. The Goods and Services Tax (GST) is a value added tax to be implemented in India, the decision on which is pending. GST is the only indirect tax that directly affects all sectors and sect...

  4. Pharmacists in humanitarian crisis settings: Assessing the impact of pharmacist-delivered home medication management review service to Syrian refugees in Jordan.

    Science.gov (United States)

    Al Alawneh, Majdoleen; Nuaimi, Nabeel; Basheti, Iman A

    2018-04-10

    Refugees all over the world are facing several health-related problems. Chronic diseases among Syrian refugees in Jordan are high. The Home Medication Management Review (HMMR) service could be ideal to optimize refugees' health management. To assess the impact of the HMMR service on the type and frequency of Treatment Related Problems (TRPs) among Syrian refugees living in Jordan. This prospective randomized single blinded intervention-control study was conducted in three main cities in Jordan, between May and October 2016. Syrian refugees with chronic conditions were recruited and randomized into intervention and control groups. The HMMR service was conducted for all patients to identify TRPs at baseline. Data were collected via two home visits for all study participants. Clinical pharmacist's recommendations were written in a letter format to the physicians managing the patients in the intervention group only. Physicians' approved recommendations were conveyed to the patients via the pharmacist. Interventions at the patient level were delivered by the pharmacist directly. Patients were reassessed for their TRPs and satisfaction 3 months after baseline. Syrian refugees (n = 106) were recruited with no significant differences between the intervention (n = 53) and control groups (n = 53). A total of 1141 TRPs were identified for both groups at baseline, with a mean number of 10.8 ± 4.2 TRPs per patient. At follow-up, there was a significant decrease in the number of TRPs among the intervention group (P service. Identified TRPs are high amongst Syrian refugees living in Jordan. The HMMR service significantly reduced the number of TRPs, and was highly accepted by the physicians. Refugees reported high satisfaction with this service. Copyright © 2018. Published by Elsevier Inc.

  5. Is an ecosystem services-based approach developed for setting specific protection goals for plant protection products applicable to other chemicals?

    Science.gov (United States)

    Maltby, Lorraine; Jackson, Mathew; Whale, Graham; Brown, A Ross; Hamer, Mick; Solga, Andreas; Kabouw, Patrick; Woods, Richard; Marshall, Stuart

    2017-02-15

    Clearly defined protection goals specifying what to protect, where and when, are required for designing scientifically sound risk assessments and effective risk management of chemicals. Environmental protection goals specified in EU legislation are defined in general terms, resulting in uncertainty in how to achieve them. In 2010, the European Food Safety Authority (EFSA) published a framework to identify more specific protection goals based on ecosystem services potentially affected by plant protection products. But how applicable is this framework to chemicals with different emission scenarios and receptor ecosystems? Four case studies used to address this question were: (i) oil refinery waste water exposure in estuarine environments; (ii) oil dispersant exposure in aquatic environments; (iii) down the drain chemicals exposure in a wide range of ecosystems (terrestrial and aquatic); (iv) persistent organic pollutant exposure in remote (pristine) Arctic environments. A four-step process was followed to identify ecosystems and services potentially impacted by chemical emissions and to define specific protection goals. Case studies demonstrated that, in principle, the ecosystem services concept and the EFSA framework can be applied to derive specific protection goals for a broad range of chemical exposure scenarios. By identifying key habitats and ecosystem services of concern, the approach offers the potential for greater spatial and temporal resolution, together with increased environmental relevance, in chemical risk assessments. With modifications including improved clarity on terminology/definitions and further development/refinement of the key concepts, we believe the principles of the EFSA framework could provide a methodical approach to the identification and prioritization of ecosystems, ecosystem services and the service providing units that are most at risk from chemical exposure. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights

  6. Readers in Adult Basic Education.

    Science.gov (United States)

    Barnes, Adrienne E; Kim, Young-Suk; Tighe, Elizabeth L; Vorstius, Christian

    The present study explored the reading skills of a sample of 48 adults enrolled in a basic education program in northern Florida, United States. Previous research has reported on reading component skills for students in adult education settings, but little is known about eye movement patterns or their relation to reading skills for this population. In this study, reading component skills including decoding, language comprehension, and reading fluency are reported, as are eye movement variables for connected-text oral reading. Eye movement comparisons between individuals with higher and lower oral reading fluency revealed within- and between-subject effects for word frequency and word length as well as group and word frequency interactions. Bivariate correlations indicated strong relations between component skills of reading, eye movement measures, and both the Test of Adult Basic Education ( Reading subtest) and the Woodcock-Johnson III Diagnostic Reading Battery Passage Comprehension assessments. Regression analyses revealed the utility of decoding, language comprehension, and lexical activation time for predicting achievement on both the Woodcock Johnson III Passage Comprehension and the Test of Adult Basic Education Reading Comprehension.

  7. Basic education in communist Hungary. A commons approach

    Directory of Open Access Journals (Sweden)

    Ferenc Gyuris

    2014-08-01

    Full Text Available In commons research, the study of the ‘knowledge commons’ has emerged as a new field of interest over the last few years. Our paper begins by providing a brief overview of the state of research in the field, and proceeds by discussing some crucial but relatively underconceptualised issues. The difference between information and knowledge, and the ambiguities surrounding the claim that all sorts of knowledge can be considered part of the commons, are the focal point here. We also pay close attention to education, arguing that it is not a common good, but rather a common-pool resource institution that ensures that some forms of knowledge can be governed as a commons. With regard to these issues, the article provides a case study, one in which we analyse basic education in Communist Hungary, and look for evidence of the commons design principles as outlined in Elinor Ostrom’s IAD Framework. Given the complex nature of basic education, we investigate it from three points of view: as a service, as a set of physical structures (e.g. school buildings, and as a complex of organizational structures (e.g. legal and financial arrangements. On the basis of empirical findings we argue that basic education in the Stalinist epoch did not correspond to Ostromian design principles. Basic education, therefore, was not managed in an equitable way, and its geographical accessibility was uneven. During the ‘technocratic’ Communism of the 1960s, 1970s, and 1980s, the education system underwent important changes. However, though the circle of those who had some impact on the governance of education expanded, most individuals involved with the education system were still excluded. As a result, the commons approach did not become stronger in general, nor did spatial unevenness with respect to access to basic education decrease. The paper finishes with a brief conclusion of our findings and a discussion of some questions for future research.

  8. Set theory essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Set Theory includes elementary logic, sets, relations, functions, denumerable and non-denumerable sets, cardinal numbers, Cantor's theorem, axiom of choice, and order relations.

  9. Geometry of Kaluza-Klein theory. I. Basic setting

    International Nuclear Information System (INIS)

    Maia, M.D.

    1985-01-01

    Kaluza-Klein space theory is derived from the hypothesis that the four-dimensional space-time is locally and isometrically embedded in a high-dimensional space which presumably originated at the big bang. For mathematical simplicity the high-dimensional space is taken to be a flat, Minkowski space with 14 dimensions assumed to be the ground state of the theory. The resulting metric is more general than the usual zero-mode metric ansatz but it reduces to the latter in the low-energy sector of the theory. The compactification of the internal space results from the existence of the second quadratic form of the embedded V 4 . A simple model of spherical compact space is considered as a working example, where the spontaneous compactification is a hyperbolic function of the strength of the gravitational field. The symmetry group of the embedding is a combined symmetry which breaks into P 4 x SO(10) in the flat limit of the space-time

  10. Basic architecture and design of storage simulation construction set

    International Nuclear Information System (INIS)

    Sehgal, A.; Volz, R.

    1999-02-01

    Regular practice these days has been to build a simulation prototype of an actual entity needing to be built prior to building an actual physical model. Computer simulation and modeling techniques aid greatly in this practice. In a critical system such as a fissile material storage system, various issues such as safety, security, and automation of handling processes can be assessed through virtual environments, thereby creating a safe atmosphere for research versus hands-on experimentation and possible worker exposures. By utilizing the approaches presented in this study, the concepts can be applied for rapid virtual prototyping of other systems, as this type of system is not limited to the storage of nuclear materials

  11. Paired fuzzy sets as a basic structure for knowledge representation

    DEFF Research Database (Denmark)

    Montero, Javier; Franco de los Ríos, Camilo; Gómez, Daniel

    2015-01-01

    In this paper we present an unifying approach to a number of fuzzy models that share the existence of two opposite concepts. In particular, we stress that standard structures for knowledge representation are being built from a family of related concepts, paired concepts in case we simply consider...

  12. Basic principles set out in the Codex Alimentarius

    International Nuclear Information System (INIS)

    Carrillo, M.

    2013-01-01

    The power point presentation is about food innocuousness, toxicology , nutrition, incertitude, availability data and interpretation, certitude grade, when evaluate the risk, danger identification, exposition population, qualitative probability and estimation, cuantitative risk, exposure limits, methods, methods based on the concept of threshold, general equation

  13. Impact of specialist home-based palliative care services in a tertiary oncology set up: a prospective non-randomized observational study.

    Science.gov (United States)

    Dhiliwal, Sunil R; Muckaden, Maryann

    2015-01-01

    Home-based specialist palliative care services are developed to meet the needs of the patients in advanced stage of cancer at home with physical symptoms and distress. Specialist home care services are intended to improve symptom control and quality of life, enable patients to stay at home, and avoid unnecessary hospital admission. Total 690 new cases registered under home-based palliative care service in the year 2012 were prospectively studied to assess the impact of specialist home-based services using Edmonton symptom assessment scale (ESAS) and other parameters. Out of the 690 registered cases, 506 patients received home-based palliative care. 50.98% patients were cared for at home, 28.85% patients needed hospice referral and 20.15% patients needed brief period of hospitalization. All patients receiving specialist home care had good relief of physical symptoms (P care (OOH) through liaising with local general practitioners; 42.68% received home based bereavement care and 91.66% had good bereavement outcomes. Specialist home-based palliative care improved symptom control, health-related communication and psychosocial support. It promoted increased number of home-based death, appropriate and early hospice referral, and averted needless hospitalization. It improved bereavement outcomes, and caregiver satisfaction.

  14. The Effects of a Combined Task Clarification, Goal Setting, Feedback, and Performance Contingent Consequence Intervention Package on Telephone Customer Service in a Medical Clinic Environment

    Science.gov (United States)

    Slowiak, Julie M.; Madden, Gregory J.; Mathews, Ramona

    2006-01-01

    Appointment coordinators at a mid-western medical clinic were to provide exceptional telephone customer service. This included using a standard greeting, speaking in an appropriate tone of voice during the conversation, and using a standard closing to end the call. An analysis suggested performance deficiencies resulted from weak antecedents, poor…

  15. Family food purchases of high- and low-calorie foods in full-service supermarkets and other food retailers by Black women in an urban US setting

    Directory of Open Access Journals (Sweden)

    Benjamin W. Chrisinger

    2018-06-01

    Full Text Available Public health interventions to increase supermarket access assume that shopping in supermarkets is associated with healthier food purchases compared to other store types. To test this assumption, we compared purchasing patterns by store-type for certain higher-calorie, less healthy foods (HCF and lower-calorie, healthier foods (LCF in a sample of 35 black women household shoppers in Philadelphia, PA. Data analyzed were from 450 food shopping receipts collected by these shoppers over four-week periods in 2012. We compared the likelihood of purchasing the HCF (sugar-sweetened beverages, sweet/salty snacks, and grain-based snacks and LCF (low-fat dairy, fruits, and vegetables at full-service supermarkets and six other types of food retailers, using generalized estimating equations. Thirty-seven percent of participants had household incomes at or below the poverty line, and 54% had a BMI >30. Participants shopped primarily at full-service supermarkets (55% or discount/limited assortment supermarkets (22%, making an average of 11 shopping trips over a 4-week period and spending mean (SD of $350 ($222. Of full-service supermarket receipts, 64% included at least one HCF item and 58% at least one LCF. Most trips including HCF (58% and LCF (60% expenditures were to full-service or discount/limited assortment supermarkets rather than smaller stores. Spending a greater percent of total dollars in full-service supermarkets was associated with spending more on HCF (p = 0.03 but not LCF items (p = 0.26. These findings in black women suggest a need for more attention to supermarket interventions that change retailing practices and/or consumer shopping behaviors related to foods in the HCF categories examined. Keywords: Obesity, Store choice, Food choice, Food shopping, Supermarkets, African Americans

  16. Family food purchases of high- and low-calorie foods in full-service supermarkets and other food retailers by Black women in an urban US setting.

    Science.gov (United States)

    Chrisinger, Benjamin W; DiSantis, Katherine Isselmann; Hillier, Amy E; Kumanyika, Shiriki K

    2018-06-01

    Public health interventions to increase supermarket access assume that shopping in supermarkets is associated with healthier food purchases compared to other store types. To test this assumption, we compared purchasing patterns by store-type for certain higher-calorie, less healthy foods (HCF) and lower-calorie, healthier foods (LCF) in a sample of 35 black women household shoppers in Philadelphia, PA. Data analyzed were from 450 food shopping receipts collected by these shoppers over four-week periods in 2012. We compared the likelihood of purchasing the HCF (sugar-sweetened beverages, sweet/salty snacks, and grain-based snacks) and LCF (low-fat dairy, fruits, and vegetables) at full-service supermarkets and six other types of food retailers, using generalized estimating equations. Thirty-seven percent of participants had household incomes at or below the poverty line, and 54% had a BMI >30. Participants shopped primarily at full-service supermarkets (55%) or discount/limited assortment supermarkets (22%), making an average of 11 shopping trips over a 4-week period and spending mean (SD) of $350 ($222). Of full-service supermarket receipts, 64% included at least one HCF item and 58% at least one LCF. Most trips including HCF (58%) and LCF (60%) expenditures were to full-service or discount/limited assortment supermarkets rather than smaller stores. Spending a greater percent of total dollars in full-service supermarkets was associated with spending more on HCF (p = 0.03) but not LCF items (p = 0.26). These findings in black women suggest a need for more attention to supermarket interventions that change retailing practices and/or consumer shopping behaviors related to foods in the HCF categories examined.

  17. Basic Electromagnetism and Materials

    CERN Document Server

    Moliton, André

    2007-01-01

    Basic Electromagnetism and Materials is the product of many years of teaching basic and applied electromagnetism. This textbook can be used to teach electromagnetism to a wide range of undergraduate science majors in physics, electrical engineering or materials science. However, by making lesser demands on mathematical knowledge than competing texts, and by emphasizing electromagnetic properties of materials and their applications, this textbook is uniquely suited to students of materials science. Many competing texts focus on the study of propagation waves either in the microwave or optical domain, whereas Basic Electromagnetism and Materials covers the entire electromagnetic domain and the physical response of materials to these waves. Professor André Moliton is Director of the Unité de Microélectronique, Optoélectronique et Polymères (Université de Limoges, France), which brings together three groups studying the optoelectronics of molecular and polymer layers, micro-optoelectronic systems for teleco...

  18. Barbecue Basics: Tips to Prevent Foodborne Illness

    Medline Plus

    Full Text Available ... common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration A to ... in FDA’s Center for Food Safety and Applied Nutrition. Wash hands. It seems basic, but not everyone ...

  19. Project BASIC: Building Art Systems into Curriculum.

    Science.gov (United States)

    Benson, Cal; Doane, Mitzi

    1982-01-01

    Describes Duluth, Minnesota's interdisciplinary program, Project BASIC, which incorporates five major art forms into the elementary curriculum. Schools employ artists-in-residence and in-service training to expand teacher use of arts in the classroom. Results of a research study to measure gains in self-concept and creativity are included. (AM)

  20. Basic properties of semiconductors

    CERN Document Server

    Landsberg, PT

    2013-01-01

    Since Volume 1 was published in 1982, the centres of interest in the basic physics of semiconductors have shifted. Volume 1 was called Band Theory and Transport Properties in the first edition, but the subject has broadened to such an extent that Basic Properties is now a more suitable title. Seven chapters have been rewritten by the original authors. However, twelve chapters are essentially new, with the bulk of this work being devoted to important current topics which give this volume an almost encyclopaedic form. The first three chapters discuss various aspects of modern band theory and the