WorldWideScience

Sample records for care service hubs

  1. Defining a Payment Services Hub

    Directory of Open Access Journals (Sweden)

    Zilvinas Bareisis

    2011-04-01

    Full Text Available Payment services hub concept is gaining ground as an accepted way forward to modernizing banks’ payments architectures. Howe ver, the confusion over definitions and terminology remains. This paper proposes a visionary definition of a payment services hub and clarifies the key terms. It also describes the four types of payment services hubs banks are currently implementing in practice.

  2. The determinants of full-service carriers airfares in European hub-to-hub markets

    OpenAIRE

    Zhang, Shengrun; Derudder, Ben; Witlox, Frank

    2014-01-01

    This paper explores the factors influencing the pricing behaviour of full-service carriers in European hub-to-hub markets. Drawing on a 2009 dataset containing route and airfare information, we establish an econometric model to estimate the impact of route structure, alliances, and market concentration on the pricing of European full-service carriers in these markets. The results suggest that alliances on routes connecting two primary hubs, airport concentration, market share inequality and c...

  3. Pricing of logistics services - Case HUB logistics Oy

    OpenAIRE

    Kallio, Henri

    2010-01-01

    PRICING OF LOGISTICS SERVICES – Case HUB logistics Oy Research objectives The purpose of theoretical part of the study was to examine pricing from logistics point of view, related to principles of pricing and to pricing process. In addition, the objective was to examine possible factors affecting the price in logistics outsourcing relationship such as costs, risks, performance measurement, and service level agreements. The objective of empirical part of the study was to develop pricin...

  4. Strategies for contracting gas storage and hub services

    International Nuclear Information System (INIS)

    The many efficiencies that can be gained by the natural gas industry in effectively using storage, were demonstrated. The circumstances under which the natural gas industry uses storage and how Market Centres or Hub Services can be strategically used in offering companies the highest flexibility in a tough marketplace, were explained. For example, in North America, storage played an important role during the winter of 95/96, which will be remembered for its extreme cold. That year provided the first true opportunity to test the natural gas delivery system since deregulation in 1985. The fact that natural gas supplies continued to be delivered throughout the entire winter was attributed to the use of stored gas held in reserves to meet the severe demand. The companies that did well, relied on storage and also on the services offered by Hub Services which increased margins for all players in the natural gas industry. Using storage, companies can ensure that field deliveries of gas are kept constant by having storage facilities absorb the swings in market demand. The companies that learn to use storage effectively can create competitive edges over their competition and provide more value to their customers. The three main categories of hub services were also described. These are parking (interruptible storage), gas loans (stored gas can be offered to customers on a term basis for low daily rates), and title exchange (the transfer of gas between buyer and seller). The strategic use of parking, loaned gas, title exchange, direct connections, and InterHub Services can provide customers even greater benefits than are provided by storage-based services. 6 figs

  5. Make emergency department 'a hub for other services'.

    Science.gov (United States)

    Blakemore, Sophie

    2016-06-10

    A LANDMARK event to debate the problems facing emergency care services was hosted by the RCN's Emergency Care Association (ECA) and the Royal College of Emergency Medicine (RCEM) last month. PMID:27286012

  6. Home Care Services

    Science.gov (United States)

    ... ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with bathing, ... your home. Some types of care and community services are free or donated. Many other types you ...

  7. Research and Design on Passengers Traffic Information Services Mode of Hongqiao Transport Hub

    Directory of Open Access Journals (Sweden)

    Honglin Xiong

    2010-03-01

    Full Text Available This paper firstly have analyzed how do Hongqiao Transport Hub provide passengers with humanizedinformation service. Then, combined with the space structure and the modes of transportation, from the point ofview of information published location, this paper discusses Hongqiao Transport Hub’s information services,information dissemination channels and information forms based on location.

  8. Sharing environmental models: An Approach using GitHub repositories and Web Processing Services

    Science.gov (United States)

    Stasch, Christoph; Nuest, Daniel; Pross, Benjamin

    2016-04-01

    The GLUES (Global Assessment of Land Use Dynamics, Greenhouse Gas Emissions and Ecosystem Services) project established a spatial data infrastructure for scientific geospatial data and metadata (http://geoportal-glues.ufz.de), where different regional collaborative projects researching the impacts of climate and socio-economic changes on sustainable land management can share their underlying base scenarios and datasets. One goal of the project is to ease the sharing of computational models between institutions and to make them easily executable in Web-based infrastructures. In this work, we present such an approach for sharing computational models relying on GitHub repositories (http://github.com) and Web Processing Services. At first, model providers upload their model implementations to GitHub repositories in order to share them with others. The GitHub platform allows users to submit changes to the model code. The changes can be discussed and reviewed before merging them. However, while GitHub allows sharing and collaborating of model source code, it does not actually allow running these models, which requires efforts to transfer the implementation to a model execution framework. We thus have extended an existing implementation of the OGC Web Processing Service standard (http://www.opengeospatial.org/standards/wps), the 52°North Web Processing Service (http://52north.org/wps) platform to retrieve all model implementations from a git (http://git-scm.com) repository and add them to the collection of published geoprocesses. The current implementation is restricted to models implemented as R scripts using WPS4R annotations (Hinz et al.) and to Java algorithms using the 52°North WPS Java API. The models hence become executable through a standardized Web API by multiple clients such as desktop or browser GIS and modelling frameworks. If the model code is changed on the GitHub platform, the changes are retrieved by the service and the processes will be updated

  9. A Real-Time Web Services Hub to Improve Situation Awareness during Flash Flood Events

    Science.gov (United States)

    Salas, F. R.; Liu, F.; Maidment, D. R.; Hodges, B. R.

    2011-12-01

    The central Texas corridor is one of the most flash flood-prone regions in the United States. Over the years, flash floods have resulted in hundreds of flood fatalities and billions of dollars in property damage. In order to mitigate risk to residents and infrastructure during flood events, both citizens and emergency responders need to exhibit proactive behavior instead of reactive. Real-time and forecasted flood information is fairly limited and hard to come by at varying spatial scales. The University of Texas at Austin has collaborated with IBM Research-Austin and ESRI to build a distributed real-time flood information system through a framework that leverages large scale data management and distribution, Open Geospatial Consortium standardized web services, and smart map applications. Within this paradigm, observed precipitation data encoded in WaterML is ingested into HEC-HMS and then delivered to a high performance hydraulic routing software package developed by IBM that utilizes the latest advancements in VLSI design, numerical linear algebra and numerical integration techniques on contemporary multicore architecture to solve fully dynamic Saint Venant equations at both small and large scales. In this paper we present a real-time flood inundation map application that in conjunction with a web services Hub, seamlessly integrates hydrologic information available through both public and private data services, model services and mapping services. As a case study for this project, we demonstrate how this system has been implemented in the City of Austin, Texas.

  10. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life. PMID:23898737

  11. DisasterHub: A mobile application for enabling crowd generated data fusion in Earth Observation disaster management services

    Science.gov (United States)

    Tsironis, Vassilis; Herekakis, Themistocles; Tsouni, Alexia; Kontoes, Charalampos Haris

    2016-04-01

    by DisasterHub, an application proposal that won the MYGEOSS Second Call for Innovative Apps (http://beyond-eocenter.eu/index.php/ann-blog/197-disasterhub-mygeoss). DisasterHub will fill the gap by introducing a mobile application that will act as a middleware between mobile users and BEYOND services, building on the concept of citizen observatories in support of Copernicus, GEO, GEOSS, and UN-SPIDER. In this context the roadmap for generating beneficial EO services through DisasterHub is sketched in two main branches: (i) ingestion, processing and fusion of big multimodal data with additional spatiotemporal evidences (originated from Core Copernicus, GEO, GEOSS) for deriving higher value DRR and EMS products, (ii) interlinking the web and mobile platforms for the exchange and ease access of the societies to open EO/crowd generated data. The benefited communities will be effectively enlarged through DisasterHub mobile app. Mutually the BEYOND ecosystem will profit from the large amount of tagged information returned from the field, forming a unique input to the production chains and assimilation of predictive modeling. In conclusion DisasterHub will showcase in the EO community an enhanced EO services ecosystem with a software infrastructure for easy access of mobile users to the real-time monitoring and early-warning systems of BEYOND and tools for incorporating crowd-sourced data with open geospatial and socioeconomic data via open/linked data ingestion mechanisms (APIs), retrieved from the GEOSS Data-CORE, Copernicus and other EU portals.

  12. Contracting for intensive care services.

    Science.gov (United States)

    Dorman, S

    1996-01-01

    Purchasers will increasingly expect clinical services in the NHS internal market to provide objective measures of their benefits and cost effectiveness in order to maintain or develop current funding levels. There is limited scientific evidence to demonstrate the clinical effectiveness of intensive care services in terms of mortality/morbidity. Intensive care is a high-cost service and studies of cost-effectiveness need to take account of case-mix variations, differences in admission and discharge policies, and other differences between units. Decisions over development or rationalisation of intensive care services should be based on proper outcome studies of well defined patient groups. The purchasing function itself requires development in order to support effective contracting. PMID:9873335

  13. Care Services in Periurban Ghana

    Directory of Open Access Journals (Sweden)

    Paa Kobina Turkson

    2011-01-01

    Full Text Available The study used logistic regression modelling to determine predictors of satisfaction with delivery of animal health care services for 889 clients (livestock and poultry keepers in periurban Ghana. Of the 15 indicators tested as predictors of satisfaction in this study, 8 were included in the best fit model. These were accessibility, availability of services, service charge, effectiveness, efficiency, quality of services, meeting client needs, and getting help. Efficiency and effectiveness were perceived by the respondents to be synonymous, as were service quality and effectiveness, as suggested by ORs>10 when cross tabulated. Therefore, one or the other could be used in future studies but not both to avoid collinearity. The identified predictors could be targeted for improvement in quality of service delivery to livestock and poultry keepers in Ghana.

  14. The impact of hub hierarchy, alliances and concentration on airfare pricing in European hub-to-hub markets

    OpenAIRE

    Zhang, Shengrun; Derudder, Ben; Witlox, Frank

    2013-01-01

    Over the past years, full-service carriers in Europe have deployed multi-hub-and-spoke systems by joining alliances to exploit network economies. The concentration of flights on a small group of airports leads to the emergence of ‘fortress hubs’ and subsequently creates hub-to-hub markets in Europe reminiscent of the US aviation market. This paper explores the factors influencing the pricing behaviour of full-service carriers in European hub-to-hub markets. Drawing on a 2009 dataset containin...

  15. Innovation hubs

    DEFF Research Database (Denmark)

    O´Hara, J.; Hansen, Poul H. Kyvsgård; Turner, N.;

    2008-01-01

    "Whilst ‘incremental innovation' is an imperative for the short-to-medium term success of a company, there is also a need for companies to engage in innovation activity that goes beyond the incremental in order to guarantee long-term success. However, such ‘radical innovation' (RI) poses new...... challenges and requires new competencies, some of which may conflict with existing best-practices for incremental innovations. ‘Innovation hubs' are a type of organisational structure dedicated to RI projects that have been used by companies to manage these conflicts by maintaining a certain degree...... of separation from the culture and routines of the mainstream organisation. Unfortunately, it would appear that many attempts to set-up innovation hubs have ended in failure within a few years; not before considerable time, effort and resource has been expended. This paper reports on a study of six innovation...

  16. A STUDY ON THE POTENTIAL OF BRAZIL AS AN OFFSHORING SERVICE HUB

    OpenAIRE

    Paulo Roberto Gião; Moacir de Miranda Oliveira Júnior

    2009-01-01

    The transfer of part of or an entire value chain to a low-cost site—a practice known as offshoring—has expanded across various countries in the world.Initially, companies began outsourcing their services to developing countries solely to reduce costs, but today, they also continue this practice in order to have access to a qualified workforce.The goal of this study is to identify Brazil’s potential as a service provider for other countries. To this end, a comparison was established between th...

  17. Improving Customer Service in Elderly Care

    OpenAIRE

    Nielsen, Chris

    2015-01-01

    The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...

  18. A STUDY ON THE POTENTIAL OF BRAZIL AS AN OFFSHORING SERVICE HUB

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Gião

    2009-10-01

    Full Text Available The transfer of part of or an entire value chain to a low-cost site—a practice known as offshoring—has expanded across various countries in the world.Initially, companies began outsourcing their services to developing countries solely to reduce costs, but today, they also continue this practice in order to have access to a qualified workforce.The goal of this study is to identify Brazil’s potential as a service provider for other countries. To this end, a comparison was established between the characteristics of Brazil and India, taking into consideration the drivers that transformed the latter into today’s primary offshoring nerve center.It was verified that despite worldwide acknowledgement of the creative and professional capability of Brazilians, the percentage of fluent English-speaking people is insufficient to allow for the expansion of call centers, back-office services and other kinds of offshoring in Brazil.Key-words: Offshoring, outsourcing, comparative study, Brazil, India.

  19. Child-care Services for Working Parents.

    Science.gov (United States)

    Seguret, M. C.

    1981-01-01

    Examines the attitudes of the public authorities in various countries concerning child-care services for working parents and the different systems of care in operation in industrial and developing nations. (Author/CT)

  20. Solving Hub Network Problem Using Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Mursyid Hasan Basri

    2012-01-01

    Full Text Available This paper addresses a network problem that described as follows. There are n ports that interact, and p of those will be designated as hubs. All hubs are fully interconnected. Each spoke will be allocated to only one of available hubs. Direct connection between two spokes is allowed only if they are allocated to the same hub. The latter is a distinct characteristic that differs it from pure hub-and-spoke system. In case of pure hub-and-spoke system, direct connection between two spokes is not allowed. The problem is where to locate hub ports and to which hub a spoke should be allocated so that total transportation cost is minimum. In the first model, there are some additional aspects are taken into consideration in order to achieve a better representation of the problem. The first, weekly service should be accomplished. Secondly, various vessel types should be considered. The last, a concept of inter-hub discount factor is introduced. Regarding the last aspect, it represents cost reduction factor at hub ports due to economies of scale. In practice, it is common that the cost rate for inter-hub movement is less than the cost rate for movement between hub and origin/destination. In this first model, inter-hub discount factor is assumed independent with amount of flows on inter-hub links (denoted as flow-independent discount policy. The results indicated that the patterns of enlargement of container ship size, to some degree, are similar with those in Kurokawa study. However, with regard to hub locations, the results have not represented the real practice. In the proposed model, unsatisfactory result on hub locations is addressed. One aspect that could possibly be improved to find better hub locations is inter-hub discount factor. Then inter-hub discount factor is assumed to depend on amount of inter-hub flows (denoted as flow-dependent discount policy. There are two discount functions examined in this paper. Both functions are characterized by

  1. Innovation in care services for the elderly

    OpenAIRE

    Djellal, Faridah; Gallouj, FaÏz; Gallouj, Karim

    2004-01-01

    Ageing and innovation are usually considered to be contradictory phenomena. This article on innovation in care services for the elderly seeks to counter this established view. Taking as its starting point a definition of care services for the elderly that draws on the economics of services, the article advances a simple framework for analysing innovation in terms of 'targets'. These targets, which make it possible to circumvent the usual economic categories (product and process innovation), a...

  2. Innovation in care services for the elderly

    OpenAIRE

    Djellal, Faridah; Gallouj, FaÏz

    2006-01-01

    International audience Ageing and innovation are usually considered to be contradictory phenomena. This article on innovation in care services for the elderly seeks to counter this established view. Taking as its starting point a definition of care services for the elderly that draws on the economics of services, the article advances a simple framework for analysing innovation in terms of 'targets'. These targets, which make it possible to circumvent the usual economic categories (product ...

  3. Oral Health Care in Home Care Service – Personnels’ Perspective

    OpenAIRE

    Lundqvist, Pontus; Mathson, Anton

    2014-01-01

    Elderly nowadays stay longer in their own home. This raises the standards on home care service to contribute to the maintenance of elderly’s general and oral health. Our objective is therefore to explore attitudes about how home care workers view oral health care and the importance of good oral health for elderly clients. 8 subjects (22 to 61 years of age) were selected for the study working in home care service, which all gave their informed consent. Semi-structured interviews were performed...

  4. The CDS information hub

    CERN Document Server

    Genova, F; Bienaymé, O; Bonnarel, F; Dubois, P; Fernique, P; Jasniewicz, G; Lesteven, S; Monier, R; Ochsenbein, F; Wenger, M; Genova, Francoise; Egret, Daniel; Bienayme, Olivier; Bonnarel, Francois; Dubois, Pascal; Fernique, Pierre; Jasniewicz, Gerard; Lesteven, Soizick; Monier, Richard; Ochsenbein, Francois; Wenger, Marc

    2000-01-01

    The Centre de Donnees astronomiques de Strasbourg (CDS) provides homogeneousaccess to heterogeneous information of various origins: information aboutastronomical objects in Simbad; catalogs and observation logs in VizieR and inthe catalogue service; reference images and overlays in Aladin; nomenclature inthe Dictionary of Nomenclature; Yellow Page services; the AstroGLU resourcediscovery tool; mirror copies of other reference services; and documentation.With the implementation of links between the CDS services, and with otheron--line reference information, CDS has become a major hub in the rapidlyevolving world of information retrieval in astronomy, developing efficienttools to help astronomers to navigate in the world-wide `Virtual Observatory'under construction, from data in the observatory archives to results publishedin journals. The WWW interface to the CDS services is available at:http://cdsweb.u-strasbg.fr/

  5. The once & future repository, HKU's Scholars Hub

    OpenAIRE

    Palmer, DT; Castro, P.; Bollini, A; Mennielli, M

    2015-01-01

    The HKU Scholars Hub (the Hub) began service as a traditional institutional repository of The University of Hong Kong (HKU). However this format was not compelling to HKU researchers. Fortunately a subsequent reformation of the HKU statement on university mission and vision infused new life and purpose into the project. Over the next five years, in partnership with the Italian University Consortium, Cineca, the HKU Libraries transformed the Hub from an IR to a Current Research Information ...

  6. Day Care Services: Industry's Involvement. Bulletin 296.

    Science.gov (United States)

    Besner, Arthur

    This bulletin provides an overview of the need for services for the children of working mothers. Topics discussed include historical developments in industry day care programs, alternative roles for industry involvement, costs of operating day care centers, and income tax allowances. Also given are examples of unique programs which suggest various…

  7. Web services synchronization health care application

    CERN Document Server

    Limam, Hela

    2011-01-01

    With the advance of Web Services technologies and the emergence of Web Services into the information space, tremendous opportunities for empowering users and organizations appear in various application domains including electronic commerce, travel, intelligence information gathering and analysis, health care, digital government, etc. In fact, Web services appear to be s solution for integrating distributed, autonomous and heterogeneous information sources. However, as Web services evolve in a dynamic environment which is the Internet many changes can occur and affect them. A Web service is affected when one or more of its associated information sources is affected by schema changes. Changes can alter the information sources contents but also their schemas which may render Web services partially or totally undefined. In this paper, we propose a solution for integrating information sources into Web services. Then we tackle the Web service synchronization problem by substituting the affected information sources....

  8. Beijing: Next International Financial Hub?

    Institute of Scientific and Technical Information of China (English)

    Li Zhen

    2008-01-01

    @@ Beijing's new financial dream On May 5,the Beijing Municipal Government released a notice regarding its plans to spur the financial industry,vowing to put forth a strong effort to become the national financial decision-making center,financial management center and financial information and services center,and formally announcing its ambitious aspiration to become a financial hub with international influence.

  9. Enriching the Tactical Network Design of Express Service Carriers with Fleet Scheduling Characteristics

    OpenAIRE

    Meuffels, W.J.M.; Fleuren, H.A.; Cruijssen, F.C.A.M.; van Dam, E.R.

    2009-01-01

    Express service carriers provide time-guaranteed deliveries of parcels via a network consisting of nodes and hubs. In this, nodes take care of the collection and delivery of parcels, and hubs have the function to consolidate parcels in between the nodes. The tactical network design problem assigns nodes to hubs, determines arcs between hubs, and routes parcels through the network. Afterwards, fleet scheduling creates a schedule for vehicles operated in the network. The strong relation between...

  10. Indico: A Collaboration Hub

    CERN Document Server

    Ferreira, P; Bossy, C; Gonzalez, J B; Pugh, M; Resco, A; Trzaskoma, J; Wachter, C

    2012-01-01

    Since 2009, the development of Indico has focused on usability, performance and new features, especially the ones related to meeting collaboration. Usability studies have resulted in the biggest change Indico has experienced up to now, a new web layout that makes user experience better. Performance improvements were also a key goal since 2010; the main features of Indico have been optimized remarkably. Along with usability and performance, new features have been added to Indico such as webchat integration, video services bookings, webcast and recording requests, designed to really reinforce Indico position as the main hub for all CERN collaboration services, and many others which aim is to complete the conference lifecycle management. Indico development is also moving towards a broader collaboration where other institutes, hosting their own Indico instance, can contribute to the project in order make it a better and more complete tool.

  11. Indico: A Collaboration Hub

    International Nuclear Information System (INIS)

    Since 2009, the development of Indico has focused on usability, performance and new features, especially the ones related to meeting collaboration. Usability studies have resulted in the biggest change Indico has experienced up to now, a new web layout that makes user experience better. Performance improvements were also a key goal since 2010; the main features of Indico have been optimized remarkably. Along with usability and performance, new features have been added to Indico such as webchat integration, video services bookings, webcast and recording requests, designed to really reinforce Indico's position as the main hub for all CERN collaboration services, and many others which aim to complete the conference lifecycle management. Indico development is also moving towards a broader collaboration where other institutes, hosting their own Indico instance, can contribute to the project in order to make it a better and more complete tool.

  12. Marketing service guarantees for health care.

    Science.gov (United States)

    Levy, J S

    1999-01-01

    The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises. PMID:10711165

  13. Ask! Your Library at the HUB: Penn State Libraries’ Experiences Providing Reference Services at the Campus Student Union Building

    OpenAIRE

    Anne Charlotte Behler; Wendy J. Girven

    2008-01-01

    The Web 2.0 generation presents many service challenges to libraries. College students of today have work styles that emphasize collaboration, preference for flexible and comfortable spaces, and independent discovery of information. Given that challenge, it is important for libraries to experiment with new and unique models of service. Librarians and Staff at the Penn State University Libraries explored offering library service at the main campus’s student union building during two trials, ...

  14. PolarHub: A Global Hub for Polar Data Discovery

    Science.gov (United States)

    Li, W.

    2014-12-01

    This paper reports the outcome of a NSF project in developing a large-scale web crawler PolarHub to discover automatically the distributed polar dataset in the format of OGC web services (OWS) in the cyberspace. PolarHub is a machine robot; its goal is to visit as many webpages as possible to find those containing information about polar OWS, extract this information and store it into the backend data repository. This is a very challenging task given huge data volume of webpages on the Web. Three unique features was introduced in PolarHub to make it distinctive from earlier crawler solutions: (1) a multi-task, multi-user, multi-thread support to the crawling tasks; (2) an extensive use of thread pool and Data Access Object (DAO) design patterns to separate persistent data storage and business logic to achieve high extendibility of the crawler tool; (3) a pattern-matching based customizable crawling algorithm to support discovery of multi-type geospatial web services; and (4) a universal and portable client-server communication mechanism combining a server-push and client pull strategies for enhanced asynchronous processing. A series of experiments were conducted to identify the impact of crawling parameters to the overall system performance. The geographical distribution pattern of all PolarHub identified services is also demonstrated. We expect this work to make a major contribution to the field of geospatial information retrieval and geospatial interoperability, to bridge the gap between data provider and data consumer, and to accelerate polar science by enhancing the accessibility and reusability of adequate polar data.

  15. C-HUB: a communication and network platform targeting the Generation Plus and their social and care networks

    DEFF Research Database (Denmark)

    Asboe, Mark; Fernandes, Joao; Grönvall, Erik

    2010-01-01

    This paper presents an ongoing project that focuses on improving the quality of life for senior citizens by developing IT support for independent living in their homes. We introduce a concept that explores and supports coordination within a social and care community targeting elderly people. The...... paper reports on early project findings such as how elderly perceive a touch screen based interface and why a touch screen based interface might be favorable for this category of users in respect to a standard PC. Furthermore, This paper contributes to the societal debate on how IT may support ageing in...

  16. Ask! Your Library at the HUB: Penn State Libraries’ Experiences Providing Reference Services at the Campus Student Union Building

    Directory of Open Access Journals (Sweden)

    Anne Charlotte Behler

    2008-06-01

    Full Text Available The Web 2.0 generation presents many service challenges to libraries. College students of today have work styles that emphasize collaboration, preference for flexible and comfortable spaces, and independent discovery of information. Given that challenge, it is important for libraries to experiment with new and unique models of service. Librarians and Staff at the Penn State University Libraries explored offering library service at the main campus’s student union building during two trials, during the Spring and Fall semesters of 2006.

  17. A Scheduling Model for a High Speed Containership Service: A Hub and Spoke Short-Sea Application

    OpenAIRE

    H B Bendall; A F Stent

    2001-01-01

    Advances in ship technology must be demonstrably beneficial and profitable before shipowners invest. Since the capital costs are large, investment in new technology will tend to be incremental rather than radical and will be affected by the financial viability of the service in which the ship is employed. While operating costs depend on the technology used for a given freight task, revenue from operations depends on transit time, frequency of service, freight rates, and volume of containers c...

  18. Quadratic Assignment of Hubs in p-Hub Median Problem

    DEFF Research Database (Denmark)

    Gelareh, Shahin

    We introduce Generalized p-Hub Median Problem (GpHMP) that seeks to locate p hub nodes and install p distinct hub facilities/operators on the hubs while discount factor resulted by consolidation of flow on the hub links depends on the facilities/operators that are installed/operating on both hub ......-points. The mathematical model is presented and numerical results on the instances of CAB and AP data sets are reported....

  19. Family Planning Services: An Essential Component of Preconception Care

    OpenAIRE

    Klerman, Lorraine V.

    2006-01-01

    Family planning services are necessary for the widespread adoption of preconception care for two reasons. First, preconception care is more likely if pregnancies are planned, and family planning services encourage pregnancy planning. Second, family planning services usually include counseling, and counseling provides an opportunity to discuss the advantages of preconception care. However, the potential of family planning services to promote preconception care is limited by underutilization of...

  20. A new transport hub

    CERN Multimedia

    Corinne Pralavorio

    2016-01-01

    CERN’s new Mobility Centre, allowing you to switch easily from one mode of transport to another, has just been officially opened.   Inauguration of the CERN Mobility Centre by Martin Steinacher, Director for Finance and Human Resources, and Lluis Miralles, Head of the SMB department. CERN’s new Mobility Centre, on the car park next to the Globe of Science and Innovation was officially opened on Tuesday, 22 March. The centre brings together all of CERN’s transport options in a single location. "Our aim is to create an intermodal hub where CERN users and personnel can switch from one mode of transport to another, and from CERN transport to public transport," explains Lluis Miralles, head of the Site Management and Buildings (SMB) department. The Mobility Centre incorporates the CERN bike and car rental services, the self-service car- and bike-sharing schemes, and SIXT car rental facilities (for long-distance journeys). It is located right ne...

  1. Barriers to emergency obstetric care services

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique;

    2014-01-01

    Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... the hospital, contribute to ineffective treatment upon arrival at the hospital. Interventions to reduce maternal mortality and morbidity must adequately consider the pre-hospital challenges faced by pregnant women in order to influence decision making towards addressing the three delays....

  2. Aircraft Propeller Hub Repair

    Energy Technology Data Exchange (ETDEWEB)

    Muth, Thomas R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Peter, William H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-02-13

    The team performed a literature review, conducted residual stress measurements, performed failure analysis, and demonstrated a solid state additive manufacturing repair technique on samples removed from a scrapped propeller hub. The team evaluated multiple options for hub repair that included existing metal buildup technologies that the Federal Aviation Administration (FAA) has already embraced, such as cold spray, high velocity oxy-fuel deposition (HVOF), and plasma spray. In addition the team helped Piedmont Propulsion Systems, LLC (PPS) evaluate three potential solutions that could be deployed at different stages in the life cycle of aluminum alloy hubs, in addition to the conventional spray coating method for repair. For new hubs, a machining practice to prevent fretting with the steel drive shaft was recommended. For hubs that were refurbished with some material remaining above the minimal material condition (MMC), a silver interface applied by an electromagnetic pulse additive manufacturing method was recommended. For hubs that were at or below the MMC, a solid state additive manufacturing technique using ultrasonic welding (UW) of thin layers of 7075 aluminum to the hub interface was recommended. A cladding demonstration using the UW technique achieved mechanical bonding of the layers showing promise as a viable repair method.

  3. Models for Designing Long-Term Care Service Plans and Care Programs for Older People

    OpenAIRE

    Shogo Kato; Satoko Tsuru; Yoshinori Iizuka

    2013-01-01

    The establishment of a system for providing appropriate long-term care services for older people is a national issue in Japan, and it will likely become a worldwide issue in the years to come. Under Japanese Long-term Care Insurance System, long-term care is provided based on long-term care programs, which were designed by care providers on the basis of long-term care service plans, which were designed by care managers. However, defined methodology for designing long-term care service plans a...

  4. Flow Merging and Hub Route Optimization in Collaborative Transportation

    OpenAIRE

    2013-01-01

    This paper studies the optimal hub routing problem of merged tasks in collaborative transportation. This problem allows all carriers’ transportation tasks to reach the destinations optionally passing through 0, 1, or 2 hubs within limited distance, while a cost discount on arcs in the hub route could be acquired after paying fixed charges. The problem arises in the application of logistics, postal services, airline transportation, and so forth. We formulate the problem as a mixed-integer prog...

  5. Communicating for Quality in School Age Care Services

    Science.gov (United States)

    Cartmel, Jennifer; Grieshaber, Susan

    2014-01-01

    School Age Care (SAC) services have existed in Australia for over 100 years but they have tended to take a back seat when compared with provision for school-aged children and those under school age using early childhood education and care (ECEC) services. Many SAC services are housed in shared premises and many children attending preparatory or…

  6. Marriage, Cohabitation, and Men's Use of Preventive Health Care Services

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Marriage, Cohabitation, and Men's Use of Preventive Health Care ... health care visit in the past 12 months. Marriage was associated with greater likelihood of a health ...

  7. Medical home care services for the housebound elderly.

    OpenAIRE

    Clarfield, A M; Bergman, H

    1991-01-01

    In our health jurisdiction the proportion of elderly people is more than double the national average, and there is a severe shortage of both home care services and long-term care beds. To help the many elderly housebound people without primary medical care we initiated a medical services home care program. The goals were patient identification, clinical assessment, medical and social stabilization, matching of the housebound patient with a nearby family physician willing and able to provide h...

  8. Liner Shipping Hub Network Design in a Competitive Environment

    DEFF Research Database (Denmark)

    Gelareh, Shahin; Nickel, Stefan; Pisinger, David

    A new mixed integer programming formulation is proposed for hub-and-spoke network design in a competitive environment. It addresses competition between a newcomer liner service provider and an alliance, both operating on hub-and-spoke networks. The newcomer company maximizes its market share...

  9. Liner shipping hub network design in a competitive environment

    DEFF Research Database (Denmark)

    Gelareh, Shahin; Nickel, Stefan; Pisinger, David

    2010-01-01

    A mixed integer programming formulation is proposed for hub-and-spoke network design in a competitive environment. It addresses the competition between a newcomer liner service provider and an existing dominating operator, both operating on hub-and-spoke networks. The newcomer company maximizes its...

  10. The Demand for Child Care Services in Canada

    OpenAIRE

    Henriques, I; Vaillancourt, F.

    1986-01-01

    This Paper Examines the Determinants of the Demand for Child Care Services in Canada. Using Survey Data Collected for 1981 by Statistics Canada and Probit Analysis We Find That the Likelihood of Using Child Care Services Increases with Variables Such As the Education of the Mother and the Age of the Child and Decreases with the Number of Children in the Family.

  11. 20 CFR 638.542 - Child care services.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Child care services. 638.542 Section 638.542 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.542 Child care services. (a)...

  12. Models for Primary Eye Care Services in India

    Directory of Open Access Journals (Sweden)

    Vasundhra Misra

    2015-01-01

    In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. Other models functioning with the newer technology of tele-ophthalmology or mobile clinics also add to the positive outcome in providing primary eye care services. This review highlights the strengths and weaknesses of various models presently functioning in the country with the idea of providing useful inputs for eye care providers and enabling them to identify and adopt an appropriate model for primary eye care services.

  13. Health Care Delivery Performance: Service, Outcomes, and Resource Stewardship

    OpenAIRE

    Cowing, Michelle; Davino-Ramaya, Carrie M; Ramaya, Krishnan; Szmerekovsky, Joseph

    2009-01-01

    As competition intensifies within the health care industry, patient satisfaction and service quality are providing the evidentiary basis for patient outcomes. We propose a conceptual model of three interrelated areas, service, health outcomes, and resource stewardship, all affected by the clinician-patient relationship. Our model considers the perspectives of the health care organization, the clinician, and the patient to define a more comprehensive measure of health care delivery performance...

  14. Service Users’ Experiences of Liaison Mental Health Care

    OpenAIRE

    Eales, S. J.

    2013-01-01

    Liaison mental health services provide mental health care, including assessment, interventions and sign posting to further specialist care, for those who present with mental health needs in non-mental health settings. Liaison mental health services in the United Kingdom most frequently exist within, but are not limited to general hospital provision. The commissioning of these services is however inconsistent, having developed in an ad hoc manner, and the evidence base for an appropriate struc...

  15. Prehospital outcomes for ambulance service care: systematic review

    OpenAIRE

    Phung, Viet-Hai; Booth, Andrew; Joanne, Coster; Turner, Janette; Wilson, Richard; Siriwardena, A Niroshan

    2013-01-01

    Background: Ambulance service performance measurement has previously focused on response times and survival. We conducted a systematic review of the international literature on quality measures and outcomes relating to pre-hospital ambulance service care, aiming to identify a broad range of outcome measures to provide a more meaningful assessment of ambulance service care. Methods: We searched a number of electronic databases including CINAHL, the Cochrane Library, EMBASE, Medline, and Web...

  16. Integration in stroke services: the challenges for primary and community care services

    OpenAIRE

    Baeza, Juan I; Fraser, Alec; Boaz, Dr Annette

    2012-01-01

    Objectives A number of evidence-based interventions are now available for stroke patients. Good quality stroke care involves a range of health professionals located across ambulance, hospital, community and primary care services. This study examined the perspectives of healthcare workers involved in stroke care in two different English case study sites on the integration challenges stroke care presents.

  17. Enriching the tactical network design of express service carriers with fleet scheduling characteristics

    NARCIS (Netherlands)

    Meuffels, W.J.M.; Fleuren, H.A.; Cruijssen, F.C.A.M.; Dam, E.R.

    2010-01-01

    Express service carriers provide time-guaranteed deliveries of parcels via a network consisting of nodes and hubs. In this, nodes take care of the collection and delivery of parcels, and hubs have the function to consolidate parcels in between the nodes. The tactical network design problem assigns n

  18. Internationalization of health care services : Networking aspects

    OpenAIRE

    Hreinsson, Julius; Woldearegay, Yonathan

    2015-01-01

    Principles of business management are increasingly being used to analyze health care systems. Conceptualizing health care as business networks offers the possibility to apply the ARA model of Actors, Resources and Activities to understand the functioning of the system. We have used this model to study the phenomenon of networking in cross-border care using Uppsala University Hospital as a research case. The aim of the study was to understand actor’s perceptions of networking activities and ho...

  19. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2013 Through June 30, 2014 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  20. Review of Integrated Psychological Services in Primary Care.

    Science.gov (United States)

    Smith, Michele S

    2016-06-01

    Reviews the book, Integrated Psychological Services in Primary Care edited by William Scott Craig (see record 2016-01850-000). This book opens with an article by the editor, in which he outlines the behavioral health needs of primary care patients and the rationale behind integrating mental health services in primary care settings. Subsequent chapters address basic and practical information for a variety of practice locations, such as Patient Centered Medical Home clinics, the Veteran's Administration medical centers, and primary care settings where the concept of integrated health is new. This is an excellent primer for anyone planning to implement an integrated care program or for those considering moving from an independent practice, agency, or traditional health care/hospital environment into an integrated primary care environment. The authors' writing styles made difficult concepts easy to understand and their knowledge of the utility of integration was evident. (PsycINFO Database Record PMID:27270257

  1. Nutrition services in managed care: new paradigms for dietitians.

    Science.gov (United States)

    Laramee, S H

    1996-04-01

    Managed care systems are transforming the health care system in the United States. Dietitians will need to review practice opportunities in new and different settings, and develop additional skills to make a successful transition to the transformed health care environment. The shift in health care financing from a fee-for-service model to a capitated system will have the most dramatic impact on the profession. Not all the answers are available, but the focus for the future is clear--customer satisfaction, outcomes research, and cost-effective nutrition services. PMID:8598432

  2. Barriers to formal emergency obstetric care services' utilization.

    Science.gov (United States)

    Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

    2011-06-01

    Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

  3. Palliative Care Consultation Service and Palliative Care Unit: Why Do We Need Both?

    OpenAIRE

    Gaertner, Jan; Frechen, Sebastian, 1982-; Sladek, Markus; Ostgathe, Christoph; Voltz, Raymond

    2012-01-01

    Patients treated in a palliative care unit were compared with those treated by a palliative care consultation service at the same center. The coexistence of the two institutions at one hospital contributed to the goal of ensuring optimal palliative care for patients in complex and challenging clinical situations.

  4. Consumerism in the financial services industry: lessons for managed care.

    Science.gov (United States)

    Peyser, N; Wong, A

    2000-01-01

    Managed care today is being shaped by the emergence of a savvier, better informed health care consumer. Facing a strikingly similar consumer movement over the past two decades, the banking industry experienced a market transformation that holds important lessons for managed care. Nontraditional entrants in the financial services industry, offering focused "monoline" products and services closely analogous to "carve-out" providers in health care, targeted rising consumer demands and stronger preferences. Banks in time answered these formidable new competitive forces with innovative consolidation and globalization strategies. The most successful initiatives in healthcare, as in banking, will focus on satisfying the consumer's hunger for information, improved levels of service, and enhanced outcomes. Managed care plans may play a lead role in accelerating the impact of consumerism by bridging the disconnect between patients and their purchasing decisions. PMID:11010386

  5. 'Caring hands' reach out to others in service

    OpenAIRE

    Felker, Susan B.

    2008-01-01

    Following the events of April 16, 2007, Virginia Tech's Adult Day Services activity director, Ila Schepisi channeled her active seniors' overwhelming desire to give back to the community and formed the Caring Hands organization.

  6. Quality indicators for primary care mental health services

    OpenAIRE

    Shield, T; Campbell, S; Rogers, A; Worrall, A; Chew-Graham, C; Gask, L

    2003-01-01

    Objectives: To identify a generic set of face valid quality indicators for primary care mental health services which reflect a multi-stakeholder perspective and can be used for facilitating quality improvement.

  7. Facility Service Environments, Staffing, and Psychosocial Care in Nursing Homes

    OpenAIRE

    Zhang, Ning Jackie; Gammonley, Denise; Paek, Seung Chun; Frahm, Kathryn

    2008-01-01

    Using 2003 Online Survey Certification and Reporting (OSCAR) data for Medicare and Medicaid certified facilities (N=14, 184) and multinomial logistic regression this study investigated if (1) psychosocial care quality was better in facilities where State requirements for qualified social services staffing exceeded Federal minimum regulations and (2) facility service environments are associated with psychosocial care quality. For-profit status and higher percentage of Medicaid residents are as...

  8. Prenatal Care Services in Aydin Province

    Directory of Open Access Journals (Sweden)

    Erdal BESER

    2007-04-01

    Full Text Available Aim of the study was to evaluate the quality and quantity of prenatal care in Aydin province. It was a cross-sectional study. 195 women (pregnant/women at postpartum period living in the Aydin province participated in the study. Cluster and simple random sampling method was used in the selection of women from 10 health centers (one rural-one urban health station each. Data obtained by face to face interview technique. Turkey Demografic Health Survey criteria were used for evaluation of the quantity of prenatal care as “sufficient” or “insufficient” and quality of prenatal care was scored as “1-2”(bad, “3-4”(moderate and “5-6”(good. Chi-square, Mann Whitney-U and t tests were used for analysis. One fifth of each pregnant women who were in last trimester and 11.3% of women in postpartum period stated that they were not followed up by an health personnel during pregnancy. One third of pregnant women who were in last trimester and 58.5% of women in postpartum period said they weren’t visited by an health personnel in the first trimester. Besides, quality points of prenatal care were found low, both in pregnant women and women in post partum period. It was found that living in urban areas, high education level and presence of social security effected getting adequate prenatal care. The quality and quantity of prenatal care was found less than expected in Aydin province which is located in the western region of Turkey. It is necessary that, health personnel must be more sensitive to convey “adequate” prenatal care especially women who are living in rural areas, who have low educational level and who have no social security. [TAF Prev Med Bull. 2007; 6(2: 137-141

  9. The management of health care service quality. A physician perspective.

    Science.gov (United States)

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective. PMID:27453745

  10. Public health capacity in the provision of health care services.

    Science.gov (United States)

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services. PMID:24687803

  11. Does health insurance impede trade inhealth care services?

    OpenAIRE

    MATTOO, Aaditya; Rathindran, Randeep

    2005-01-01

    There is limited trade in health services despite big differences in the price of health care across countries. Whether patients travel abroad for health care depends on the coverage of treatments by their health insurance plan. Under existing health insurance contracts, the gains from trade are not fully internalized by the consumer. The result is a strong"local-market bias"in the consumption of health care. A simple modification of existing insurance products can create sufficient incentive...

  12. Does Health Insurance Impede Trade in Health Care Services?

    OpenAIRE

    MATTOO, Aaditya; Rathindran, Randeep

    2005-01-01

    There is limited trade in health services despite big differences in the price of health care across countries. Whether patients travel abroad for health care depends on the coverage of treatments by their health insurance plan. Under existing health insurance contracts, the gains from trade are not fully internalized by the consumer. The result is a strong "local-market bias" in the consumption of health care. A simple modification of existing insurance products can create sufficient incenti...

  13. Effectiveness of the Smart Care Service for Diabetes Management

    OpenAIRE

    Chung, Young-Soon; Kim, Yongsuk; Lee, Chang Hee

    2014-01-01

    Objectives The aim of this study was to assess the effectiveness of the Smart Care service for the diabetes management. Methods Fifty-six patients with diabetes mellitus were recruited in Daegu, Korea. All participants completed a diabetes management education course (diet, exercise, and complications) for their self-care and received access to a care management website through a netbook and smartphone. The website accepts uploads of glucose level, body weight, HbA1c, low-density lipoprotein ...

  14. Shared services: strengthening early care and education

    OpenAIRE

    Louise Stoney; Naman Libbie Poppick

    2010-01-01

    Early learning lasts a lifetime. We now have a strong body of evidence that learning is especially significant in the first five years of life and affects brain architecture for years to come.1 That’s why high-quality early care and education (ECE) is vital for children’s academic and social success.2 And given that more than 60 percent of U.S. mothers of children younger than 5 years old are working and that 73 percent of those children are regularly in child care, making sure that ECE is a ...

  15. Medical Service: 40 years of outpatient care

    CERN Multimedia

    2005-01-01

    On 1st June 2005 the Medical Service will be celebrating its fortieth birthday. This will mark forty years of service to the health of CERN's personnel by the Medical Service's small team of doctors, nurses, laboratory assistants and secretaries. Since 1965, 27 280 medical files have been archived and computerised. The Medical Service. From left to right, front row : Mireille Vosdey, Marloeke Bol and Nicole De Matos. From left to right, back row : Katie Warrilow-Thomson, Dr Eric Reymond, Dr Véronique Fassnacht, Isabelle Auvigne and Françoise Lebrun-Klauser. The Medical Service was founded on 1st June 1965, with a staff of four: the doctor, Jean-Paul Diss, a nurse, a laboratory assistant and a secretary. Previously, a private medical practitioner had come to CERN to perform the medical check-ups on the personnel and the Fire Brigade was responsible for first aid. However, in view of increasing staff numbers and the specific needs of a Laboratory like CERN, an on-site Medical Service had become ess...

  16. The Effect of Free Adult Preventive Care Services on Subsequent Utilization of Inpatient Services in Taiwan.

    Science.gov (United States)

    Tian, Wei-Hua

    2016-07-01

    The objective of this article is to investigate the relationship between the utilization of free adult preventive care services and subsequent utilization of inpatient services among elderly people under the National Health Insurance program in Taiwan. The study used secondary data from the 2005 Taiwan National Health Interview Survey and claim data from the 2006 Taiwan National Health Insurance Research Database for the elderly aged 65 or over. A bivariate probit model was used to avoid the possible endogeneity in individuals' utilization of free adult preventive care and inpatient services. This study finds that, when individuals had utilized the preventive care services in 2005, the probability that they utilized inpatient services in 2006 was significantly reduced by 13.89%. The findings of this study may provide a good reference for policy makers to guide the efficient allocation of medical resources through the continuous promotion of free adult preventive care services under the National Health Insurance program. PMID:27287671

  17. Scheduling Movements in the Network of an Express Service Provider

    OpenAIRE

    Louwerse, Ilse; Mijnarends, Jos; Meuffels, Ineke; Huisman, Dennis; Fleuren, H.A.

    2012-01-01

    textabstractExpress service providers manage shipments from senders to receivers under strict service level agreements. Such shipments are usually not sufficient to justify a single transportation, so it is preferred to maximize consolidation of these shipments to reduce cost. The consolidation is organized via depots and hubs: depots are local sorting centers that take care of the collection and delivery of the parcels at the customers, and hubs are used to consolidate the transportation bet...

  18. Reimbursement for critical care services in India

    Directory of Open Access Journals (Sweden)

    Raja Jayaram

    2013-01-01

    Full Text Available There are significant variations in critical care practices, costs, and reimbursements in various countries. Of note, there is a paucity of reliable information on remuneration and reimbursement models for intensivists in India. This review article aims to analyze the existing reimbursement models in United States and United Kingdom and propose a frame-work model that may be applicable in India.

  19. Cultural Support Workers and Long Day Care Services

    Science.gov (United States)

    Miller, Melinda G.; Knowles, Meg; Grieshaber, Susan

    2011-01-01

    In Australia, eligible long day care services may apply for support at the state level to assist with the transition of children from culturally or linguistically diverse backgrounds into childcare settings. For staff in childcare services, this support comes in the form of a cultural support worker (CSW). The primary role of a CSW is to build…

  20. GitHub Android

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    代码托管仓库GitHub发布了官方,Android客户端,手机和平板用户可以从GoogleP1ay下载。它的出现,将方便更多用户融入GitHub社区。GitHubAndroid本身也是开源软件,其源代码可以从GitHub浏览。此前,GitHub已经推出了Windows和Mac版客户端。

  1. Business model - HUB Praha

    OpenAIRE

    Centnerová, Michala

    2010-01-01

    Social business is type of business, which primary objective is very different from the profit-driven business. Social business objective is to create an added value to society and achieve at least some profit, which serves as a means to achieve this goal. For my thesis I have chosen a business model analysis of the new organization Hub Prague, which is a representative of a social entrepreneurship and which has entered Czech market in 2010. I have examined mainly its income and expenditures ...

  2. PORTS WRESTLE FOR HUB STATUS

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Due to the fact that there has been nocontainer transport hub port in NorthernChina,northern ports are striving fordevelopment and trying to secure a positionof being the hub port in Northern Chinaahead of others. According to media reports,EasternChina’s Shandong Province will invest 5billion yuan(US$604 million)in buildinga Qingdao international shipping hub thatisbased on existing ports in theShandong Peninsula.

  3. Optimising steel hub location in Thailand

    Directory of Open Access Journals (Sweden)

    Sakaradhorn Boontaveeyuwat

    2012-11-01

    Full Text Available The optimal location of a steel hub in Thailand was analysed by applying aspecific research methodology designed to evaluate locations near the seaports. The growth of Thailand’s steel industry has become a centre of attention in the last decade, resulting in substantial efforts to form a distribution service centre to minimise the logistic costs associated with handling large steel flows in the future. The main analysis of the steel hublocation focused on areas situated near Laem Cha Bang, Map Ta Phut and Prachuab ports since these top three ports are considered important in terms of their steel throughput in Thailand. The transport costs associated with the shipment and inland transport together with port tariffs were calculated for the proposed scenarios of steel hub establishment andthese were compared with the existing situation without steel hub. The findings showed that a steel hub located near Laem Cha Bang port was the optimal option involving a saving of 9.4% on the total system costs incurred under the existing situation.

  4. P-1139 - Increased utilization of health care services after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt;

    2012-01-01

    period of four years before intake and four years after ended treatment. Changes in utilization of health care services in eight health parameters were analyzed with t-test and with ANCOVA one and four year pre-post treatment. Results Of the 761 patients, 216 patients did not show up for treatment, while......Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... services for patients referred to psychotherapeutic treatment in 2004 and 2005. Method The study was a matched control study, which included 716 consecutive patients and 15,220 matched controls. Data from a comprehensive set of health care services were collected from central registries for an observation...

  5. Temporary services for patients in need of chronic care

    DEFF Research Database (Denmark)

    Hesse, Morten

    2008-01-01

    Background A project is a temporary endeavour undertaken to create a product or service. Projects are frequently used for the testing and development of new approaches in social work. Projects can receive grants from central, often national or international institutions, and allow for more...... experimentation than work placed within existing institutions. Discussion For socially marginalized groups who need continuing support and care, receiving help in a project means that the clients will have to be transferred to other services when the project ends. There is also a risk that clients will experience...... relating to continuity of services when serving vulnerable patients with a need for continuing care....

  6. Participative management in health care services

    Directory of Open Access Journals (Sweden)

    M. Muller

    1995-05-01

    Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

  7. Flow Merging and Hub Route Optimization in Collaborative Transportation

    Directory of Open Access Journals (Sweden)

    Kerui Weng

    2014-01-01

    Full Text Available This paper studies the optimal hub routing problem of merged tasks in collaborative transportation. This problem allows all carriers’ transportation tasks to reach the destinations optionally passing through 0, 1, or 2 hubs within limited distance, while a cost discount on arcs in the hub route could be acquired after paying fixed charges. The problem arises in the application of logistics, postal services, airline transportation, and so forth. We formulate the problem as a mixed-integer programming model, and provide two heuristic approaches, respectively, based on Lagrangian relaxation and Benders decomposition. Computational experiments show that the algorithms work well.

  8. Optimising steel hub location in Thailand

    OpenAIRE

    Sakaradhorn Boontaveeyuwat

    2012-01-01

    The optimal location of a steel hub in Thailand was analysed by applying aspecific research methodology designed to evaluate locations near the seaports. The growth of Thailand’s steel industry has become a centre of attention in the last decade, resulting in substantial efforts to form a distribution service centre to minimise the logistic costs associated with handling large steel flows in the future. The main analysis of the steel hublocation focused on areas situated near Laem Cha Bang, M...

  9. Impact of pain and palliative care services on patients

    Directory of Open Access Journals (Sweden)

    S Santha

    2011-01-01

    Full Text Available Background: Palliative care has become an emerging need of the day as the existing health-care facilities play only a limited role in the care of the chronically ill in the society. Patients with terminal illness in most cases spend their lives in the community among their family and neighbors, so there is the need for a multi disciplinary team for their constant care. Volunteers are primary care givers who originate normally from the same locality with local knowledge and good public contact through which they can make significant contributions in a team work by bridging the gap between the patient community and outside world. Aim: The present study has been undertaken to analyze the impact of palliative care services on patients by considering 51 variables. Materials and Methods: The respondents of the study include 50 pain and palliative care patients selected at random from 15 palliative care units functioning in Ernakulam district. The analysis was made by using statistical techniques viz. weighted average method, Chi-square test, Friedman repeated measures analysis of variance on ranks and percentages. Results: The study revealed that the major benefit of palliative care to the patients is the reduction of pain to a considerable extent, which was unbearable for them earlier. Second, the hope of patients could be maintained or strengthened through palliative care treatment. Conclusion: It is understood that the services of the doctors and nurses are to be improved further by making available their services to all the palliative care patients in a uniform manner.

  10. Exploring care for human service profession

    DEFF Research Database (Denmark)

    Høy, Bente

    2015-01-01

    Maintaining dignity in vulnerability Aim: To explore the meaning of maintaining dignity in eldercare from the perspective of nursing home residents. Background: Elderly people living in nursing homes are exposed to diverse situations which may be associated with loss of dignity. To help them...... maintain their dignity, it is important to explore, how dignity is maintained in such situations. Views of dignity and factors influencing dignity have been studied from both the nursing homes residents´ and the care providers´ perspective. However, little is known about how the residents’ experience their...

  11. Enhancing Health-Care Services with Mixed Reality Systems

    Science.gov (United States)

    Stantchev, Vladimir

    This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

  12. Occupational Therapy experience in family care in a primary health care service

    OpenAIRE

    Gisele Baissi; Bruno Souza Bechara Maxta

    2013-01-01

    Occupational therapy is presented as the core knowledge involved in the remodeling and strengthening of Primary Health Care in the Brazilian Unified Health Care System (Sistema Único de Saúde – SUS). In this study, we aimed to describe the interventions in the process of occupational therapy in supervised family care in a primary health care service in the municipality of Várzea Paulista, São Paulo state. In this case study, the moments of care were described and analyzed in light of narrativ...

  13. Collaborative Cardiac Care Service: A Multidisciplinary Approach to Caring for Patients with Coronary Artery Disease

    OpenAIRE

    Sandhoff, Brian G; Kuca, Susan; Rasmussen, Jon; Merenich, John A

    2008-01-01

    Background: Coronary artery disease (CAD) remains the leading cause of death in the US. In 1996, Kaiser Permanente of Colorado (KPCO) developed the Collaborative Cardiac Care Service (CCCS) with the goal of improving the health of patients with CAD.

  14. Service Users' and Caregivers' Perspectives on Continuity of Care in Out-of-Hours Primary Care.

    LENUS (Irish Health Repository)

    Gallagher, Niamh

    2012-12-20

    Modernization policies in primary care, such as the introduction of out-of-hours general practice cooperatives, signify a marked departure from many service users\\' traditional experiences of continuity of care. We report on a case study of accounts of service users with chronic conditions and their caregivers of continuity of care in an out-of-hours general practice cooperative in Ireland. Using Strauss and colleagues\\' Chronic Illness Trajectory Framework, we explored users\\' and caregivers\\' experiences of continuity in this context. Whereas those dealing with "routine trajectories" were largely satisfied with their experiences, those dealing with "problematic trajectories" (characterized by the presence of, for example, multimorbidity and complex care regimes) had considerable concerns about continuity of experiences in this service. Results highlight that modernization policies that have given rise to out-of-hours cooperatives have had a differential impact on service users with chronic conditions and their caregivers, with serious consequences for those who have "problematic" trajectories.

  15. Providing home care services in a for-profit environment.

    Science.gov (United States)

    Shamansky, S L

    1988-06-01

    It is no surprise that politics and ideology will determine the future of home health and long-term care. Those same forces will also dictate whether home care services will become more or less dependent upon federal support. At the moment the prospects are not promising. Over the last several years our national reimbursement policies have pointed toward more and more stringent use of Medicare home health care benefits, despite the assumptions (and the data) that prospective payment systems might legitimately increase their use. The implementation of tight cost limits, consolidation to ten regional fiscal intermediaries, and increased claim denials have signaled home care agencies that cost containment is the aim of the present conservative administration. Private insurance companies, however, have begun to examine the prospects for long-term care and home care policies. Presently, most home care benefits are available through employment-based policies, which, of course, are nearly useless to the elderly, the major users of home care services. But what if businesses provided more comprehensive health care policies so that their employees could have better protection in the case of long-term illnesses? What if the giant corporation such as IBM, Xerox, General Electric, General Motors, and so forth, established programs to underwrite the cost of long-term care? What if private insurance companies attempted to spread the risks among thousands of policy holders so that long-term care insurance premiums were affordable to most older Americans? Rather than new sources of funding, it is more reasonable to expect that the financing of home care services will be reshaped by innovative reimbursement strategies. The future will probably bring prospective, resource-sensitive, or capitated schemes. There are no easy remedies. We must secure the participation of all sectors of our country--both public and private--in a cooperative endeavor. And at the same time we are struggling

  16. Health care governance in the UK National Health Service.

    Science.gov (United States)

    Wilson, Jo H

    2004-01-01

    The NHS Plan sets out a challenging agenda for modernising the UK National Health Service (NHS), governing the organisation's performance and improving and extending service provision. Good health care governance is an essential prerequisite for all modernisation effort. This article will explore the responsibilities and implications for health care boards, managers and clinical staff in providing assurances for health care governance. Health care organisation directors, executive and non-executive, all share responsibility for the direction and control of the organisation. They are required to act in the best interest of the patients, staff and the general public and have statutory obligations to provide safe systems of work under the Health and Safety Regulations. Each director has a role in ensuring openness, being honest and acting with integrity, taking responsibility for their own personal learning and development, constructively challenge and develop strategy and ensuring the probity of the organisation's activities. PMID:15566273

  17. Diagnostic ultrasound: a primary care-led service?

    OpenAIRE

    Robinson, L; J. Potterton; Owen, P.

    1997-01-01

    BACKGROUND: A training programme has been proposed for general practitioners (GPs) to perform ultrasound in primary care. This has generated considerable concern among radiologists as to the adequacy and appropriateness of such training. AIM: To assess the current provision of ultrasound services to primary care in the former Northern health region of England, the level of interest among GPs in undertaking recommended training, and the willingness or ability of radiology departments to provid...

  18. 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.

  19. Introducing low vision care into the Government eye care services in South Africa

    OpenAIRE

    A.O. Oduntan

    2007-01-01

    There are many visually impaired people all over the world including South Africa, unfortunately, vision rehabilitation services are lacking  in many countries. Currently in South Africa, low vision care is offered by a few private optometric practitioners, optometric institutions and non-governmental organizations. Although most of the major Government hospitals in the country provide ophthalmological services to patients, only a few of these provide optometric services and none provides low...

  20. Cloud based emergency health care information service in India.

    Science.gov (United States)

    Karthikeyan, N; Sukanesh, R

    2012-12-01

    A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the

  1. A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities.

    Science.gov (United States)

    Conway, Jane; Dilworth, Sophie; Hullick, Carolyn; Hewitt, Jacqueline; Turner, Catherine; Higgins, Isabel

    2015-11-01

    This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person. PMID:25981903

  2. Innovation Hub How-To

    DEFF Research Database (Denmark)

    Berger, Andreas; Brem, Alexander

    2016-01-01

    Firms around the world are eager to replicate the successes of enterprises that have established innovation labs in California's Silicon Valley. An analysis of four leading US companies that have set up idea incubators in the Valley—Xerox, Apple, Google, and Cisco—point to eight factors for succe...... disruptive over incremental innovation, and being patient. Regardless of where an innovation hub is established, the key to success lies in hiring creative, intrinsically motivated staff and then giving them the freedom to do what they do best.......Firms around the world are eager to replicate the successes of enterprises that have established innovation labs in California's Silicon Valley. An analysis of four leading US companies that have set up idea incubators in the Valley—Xerox, Apple, Google, and Cisco—point to eight factors for success...... in establishing an innovative environment: carefully considering the decision to set up such a center, hiring the right people, designing a framework for effective output, creating a buffer from bureaucratic distractions, securing a leader to champion the effort, focusing on business outcomes, fostering...

  3. Adolescents perception of reproductive health care services in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Agampodi Thilini C

    2008-05-01

    Full Text Available Abstract Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners

  4. Health Services for Behavioral Problems in Pediatric Primary Care.

    Science.gov (United States)

    Nasir, Arwa; Watanabe-Galloway, Shinobu; DiRenzo-Coffey, Gina

    2016-07-01

    The aim of this research was to explore primary care pediatricians' experiences in delivering behavioral health services in their own practices within the Nebraska context. An online survey was sent to the 154 primary care pediatricians who are members of the Nebraska chapter of the American Academy of Pediatrics. Questions explored their management of behavioral problems, attitudes, and perceived barriers to providing behavioral health services in their practices. Seventy pediatricians completed the survey (47%). The majority of pediatricians reported seeing substantial numbers of children with behavioral problems. Eighty-five percent believed that most emotional and behavioral complaints could be managed by the pediatrician. Eighty-eight percent believed that the parents would prefer to receive services for their children's behavioral problems in the primary care office. Most felt that their training in mental health issues was inadequate. Pediatricians in this survey feel that pediatric behavioral problems are best managed in the primary care office and perceive that parents also prefer this setting. Improving training in behavioral health in pediatrics is necessary to meet the delivery of much needed behavioral health care to children and families. PMID:25398258

  5. Integrating service user participation in mental health care: what will it take?

    Directory of Open Access Journals (Sweden)

    Sharon Lawn

    2015-03-01

    Full Text Available Participation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience within mental health services, raising the visibility of service users as leaders and our teachers within services and redefining integrated care from the service user perspective.

  6. Occupational Therapy experience in family care in a primary health care service

    Directory of Open Access Journals (Sweden)

    Gisele Baissi

    2013-08-01

    Full Text Available Occupational therapy is presented as the core knowledge involved in the remodeling and strengthening of Primary Health Care in the Brazilian Unified Health Care System (Sistema Único de Saúde – SUS. In this study, we aimed to describe the interventions in the process of occupational therapy in supervised family care in a primary health care service in the municipality of Várzea Paulista, São Paulo state. In this case study, the moments of care were described and analyzed in light of narratives on the supervised practice of occupational therapy with a family. The results showed forms of intervention that characterize the process of occupational therapy focused on family health needs in favor of creativity and the role for changes in health practices in everyday life. Through the accomplishment of occupational activities directed to self-care, Occupational Therapy can aid families to cope with daily life adversity.

  7. The Virtual Campus Hub Concept

    DEFF Research Database (Denmark)

    Badger, Merete; Prag, Sidsel-Marie Winther; Monaco, Lucio;

    The research infrastructure project Virtual Campus Hub (VCH) runs from October 1, 2011 to September 30, 2013. Four technical universities in Europe, who are all active in the field of sustainable energy, form the project consortium: the Technical University of Denmark, The Royal Institute of...... overview of the project achievements and recommends best practices for the use of the Virtual Campus Hub elements: a series of applications for online teaching and collaboration which are connected to a technical platform, the Virtual Campus Hub portal, using the European research infrastructure Géant/eduGAIN....... Technology in Sweden, Politecnico di Torino in Italy, and Eindhoven University of Technology in the Netherlands. The project is partially funded by the European Commission under the 7th Framework Programme (project no. RI-283746). This report describes the final concept of Virtual Campus Hub. It gives an...

  8. Teaching wound care to family medicine residents on a wound care service

    Directory of Open Access Journals (Sweden)

    Little SH

    2013-08-01

    Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

  9. 78 FR 20318 - Advisory Council on Alzheimer's Research, Care, and Services; Meeting

    Science.gov (United States)

    2013-04-04

    ... HUMAN SERVICES Advisory Council on Alzheimer's Research, Care, and Services; Meeting AGENCY: Assistant... public meeting of the Advisory Council on Alzheimer's Research, Care, and Services (Advisory Council). The Advisory Council on Alzheimer's Research, Care, and Services provides advice on how to prevent...

  10. 78 FR 38346 - Advisory Council on Alzheimer's Research, Care, and Services; Meeting

    Science.gov (United States)

    2013-06-26

    ... HUMAN SERVICES Advisory Council on Alzheimer's Research, Care, and Services; Meeting AGENCY: Assistant... public meeting of the Advisory Council on Alzheimer's Research, Care, and Services (Advisory Council). The Advisory Council on Alzheimer's Research, Care, and Services provides advice on how to prevent...

  11. 77 FR 796 - Meeting of the Advisory Council on Alzheimer's Research, Care, and Services

    Science.gov (United States)

    2012-01-06

    ... HUMAN SERVICES Meeting of the Advisory Council on Alzheimer's Research, Care, and Services AGENCY... announces public meeting of the Advisory Council on Alzheimer's Research, Care, and Services (Advisory..., section 10(a)(1) and (a)(2)). The Advisory Council on Alzheimer's Research, Care, and Services...

  12. 78 FR 61362 - Advisory Council on Alzheimer's Research, Care, and Services; Meeting

    Science.gov (United States)

    2013-10-03

    ... HUMAN SERVICES Advisory Council on Alzheimer's Research, Care, and Services; Meeting AGENCY: Assistant... public meeting of the Advisory Council on Alzheimer's Research, Care, and Services (Advisory Council). The Advisory Council on Alzheimer's Research, Care, and Services provides advice on how to prevent...

  13. 77 FR 58557 - Meeting of the Advisory Council on Alzheimer's Research, Care, and Services

    Science.gov (United States)

    2012-09-21

    ... HUMAN SERVICES Meeting of the Advisory Council on Alzheimer's Research, Care, and Services AGENCY... announces the public meeting of the Advisory Council on Alzheimer's Research, Care, and Services (Advisory..., section 10(a)(1) and (a)(2)). The Advisory Council on Alzheimer's Research, Care, and Services...

  14. The Perceived Needs and Availability of Eye Care Services for Older Adults in Long-term Care Facilities

    OpenAIRE

    Kergoat, Hélène; Boisjoly, Hélène; Freeman, Ellen E.; Monette, Johanne; Roy, Sylvie; Kergoat, Marie-Jeanne

    2014-01-01

    Background The objective was to evaluate the eye care services offered to older residents living in long-term care facilities (LTCFs). Methods A questionnaire targeting residents aged ≥65 years was sent to all LTCFs in Quebec. Questions related to the institution’s characteristics, demographic data related to residents, oculovisual health of residents and barriers to eye care, eye care services offered within and outside the institution, and degree of satisfaction regarding the eye care servi...

  15. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document...

  16. Patient Preferences for Information on Post-Acute Care Services.

    Science.gov (United States)

    Sefcik, Justine S; Nock, Rebecca H; Flores, Emilia J; Chase, Jo-Ana D; Bradway, Christine; Potashnik, Sheryl; Bowles, Kathryn H

    2016-07-01

    The purpose of the current study was to explore what hospitalized patients would like to know about post-acute care (PAC) services to ultimately help them make an informed decision when offered PAC options. Thirty hospitalized adults 55 and older in a Northeastern U.S. academic medical center participated in a qualitative descriptive study with conventional content analysis as the analytical technique. Three themes emerged: (a) receiving practical information about the services, (b) understanding "how it relates to me," and (c) having opportunities to understand PAC options. Study findings inform clinicians what information should be included when discussing PAC options with older adults. Improving the quality of discharge planning discussions may better inform patient decision making and, as a result, increase the numbers of patients who accept a plan of care that supports recovery, meets their needs, and results in improved quality of life and fewer readmissions. [Res Gerontol Nurs. 2016; 9(4):175-182.]. PMID:26815304

  17. Health service utilization patterns of primary care patients with osteoarthritis

    Directory of Open Access Journals (Sweden)

    Laux Gunter

    2007-10-01

    Full Text Available Abstract Background To assess factors associated with visits to GPs, orthopaedists, and non-physician practitioners of complementary medicine (alternative practitioners by primary care patients with osteoarthritis (OA. Methods Cross-sectional survey among 1250 consecutively addressed patients from 75 primary care practices in Germany. All patients suffered from OA of the knee or hip according to ACR criteria. They received questionnaires collecting sociodemographic data, data about health service utilisation, prescriptions, comorbidities. They also included established instruments as the Arthritis Impact Measurement Scale (AIMS2-SF to assess disease-specific quality of life and the Patient Health Questionnaire (PHQ-9 to assess depression. Hierarchical stepwise multiple linear regression models were used to reveal significant factors influencing health service utilization. Results 1021 of 1250 (81.6% questionnaires were returned. Nonrespondents did not differ from participants. Factors associated with health service use (HSU varied between providers of care. Not being in a partnership, achieving a high score on the PHQ-9, increased pain severity reflected in the “symptom” scale of the AIMS2-SF, and an increased number of drug prescriptions predicted a high frequency of GP visits. The PHQ-9 score was also a predictor for visits to orthopaedists, as were previous GP contacts, a high score in the "symptom" scale as well as a high score in the "lower limb scale" of the AIMS2-SF. Regarding visits to alternative practitioners, a high score in the AIMS -"social" scale was a positive predictor as older people were less likely to visit them. Conclusion Our results emphasize the need for awareness of psychological factors contributing to the use of health care providers. Addressing the revealed factors associated with HSU appropriately may lead to decreased health care utilization. But further research is needed to assess how this can be done

  18. Emergency Medical Services Capacity for Prehospital Stroke Care

    Centers for Disease Control (CDC) Podcasts

    2013-09-05

    In this audio podcast, lead author and Preventing Chronic Disease’s 2013 Student Research Contest Winner, Mehul D. Patel, talks about his article on stroke care and emergency medical services.  Created: 9/5/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/5/2013.

  19. Care services for older people in Europe - Challenges for Labour

    OpenAIRE

    Lethbridge, Jane

    2011-01-01

    This report is published (March 2011) at a time when Europe stands at a crossroads. The economic crisis, austerity measures and the proposed European economic governance package risk not only to increase poverty and social exclusion but to have a devastating impact on the potential to build a sustainable and cohesive Europe. As the report notes, there is growing demand for more and better care services to address the needs of an ageing population. Potentially, Europe has the capacity to c...

  20. Establishment of Pediatric Cardiac Intensive Care Advanced Practice Provider Services.

    Science.gov (United States)

    Gilliland, Jill; Donnellan, Amy; Justice, Lindsey; Moake, Lindy; Mauney, Jennifer; Steadman, Page; Drajpuch, David; Tucker, Dawn; Storey, Jean; Roth, Stephen J; Koch, Josh; Checchia, Paul; Cooper, David S; Staveski, Sandra L

    2016-01-01

    The addition of advanced practice providers (APPs; nurse practitioners and physician assistants) to a pediatric cardiac intensive care unit (PCICU) team is a health care innovation that addresses medical provider shortages while allowing PCICUs to deliver high-quality, cost-effective patient care. APPs, through their consistent clinical presence, effective communication, and facilitation of interdisciplinary collaboration, provide a sustainable solution for the highly specialized needs of PCICU patients. In addition, APPs provide leadership, patient and staff education, facilitate implementation of evidence-based practice and quality improvement initiatives, and the performance of clinical research in the PCICU. This article reviews mechanisms for developing, implementing, and sustaining advance practice services in PCICUs. PMID:26714997

  1. Cancer patients, emergencies service and provision of palliative care

    Directory of Open Access Journals (Sweden)

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  2. 78 FR 10117 - Use of Medicare Procedures To Enter Into Provider Agreements for Extended Care Services

    Science.gov (United States)

    2013-02-13

    ... of nursing home care, adult day health care, and other community-based extended care services under...) Handbooks 1143.2, ``VHA Community Nursing Home Oversight Procedures''; 1140.6, ``Purchased Home Health Care... alternative to nursing home care. Under this proposed rule, VA would be able to obtain extended care...

  3. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ..., 2010, at 75 FR 41793. Child and Adult Care Food Program (CACFP) [Per meal rates in whole or fractions... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 AGENCY: Food and Nutrition...

  4. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ..., 2009, at 74 FR 34295. Child and Adult Care Food Program (CACFP) Lunch and Centers Breakfast supper \\1... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2010 Through June 30, 2011 AGENCY: Food and Nutrition...

  5. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Science.gov (United States)

    2010-10-01

    ... mental diseases. 440.140 Section 440.140 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... services for individuals age 65 or older in institutions for mental diseases. (a) Inpatient hospital services. “Inpatient hospital services for individuals age 65 or older in institutions for mental...

  6. Introducing a hand-held urinal service in secondary care.

    Science.gov (United States)

    Pomfret, Ian; Vickerman, Julie; Tonge, Pauline

    Chorley & South Ribble Primary Care Trust's multiprofessional continence service was established in 2000 (Pomfret, 2001). An integral part of this service development was the creation of a community-based, hand-held urinal library. There are 28 female hand-held urinals available in the UK and many more for males. Some of the urinals are available on prescription and others have to be purchased by the patient. The urinal library allows patients in the community to use the urinals before they are prescribed or buy them, because it is only by using them that they will know that the product will be suitable. The service is proving to be hugely successful. PMID:15895500

  7. Spatial analysis of elderly access to primary care services

    Directory of Open Access Journals (Sweden)

    Lozano-Gracia Nancy

    2006-05-01

    Full Text Available Abstract Background Admissions for Ambulatory Care Sensitive Conditions (ACSCs are considered preventable admissions, because they are unlikely to occur when good preventive health care is received. Thus, high rates of admissions for ACSCs among the elderly (persons aged 65 or above who qualify for Medicare health insurance are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. Results We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the U.S. in the late 1990s. Using 6,475 natural markets in the mainland U.S. defined by The Health Resources and Services Administration's Primary Care Service Area Project, spatial regression is used to estimate the model, controlling for disease severity using detailed information from Medicare claims files. Our evidence suggests that elderly living in impoverished rural areas or in sprawling suburban places are about equally more likely to be admitted for ACSCs. Greater availability of physicians does not seem to matter, but greater prevalence of non-physician clinicians and international medical graduates, relative to U.S. medical graduates, does seem to reduce ACSC admissions, especially in poor rural areas. Conclusion The relative importance of non-physician clinicians and international medical graduates in providing primary care to the elderly in geographic areas of greatest need can inform the ongoing debate regarding whether there is an impending shortage of physicians in the United States. These findings support other authors who claim that the existing supply of physicians is perhaps adequate, however the distribution of them across

  8. Integrating service user participation in mental health care: what will it take?

    OpenAIRE

    2015-01-01

    Participation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience wi...

  9. Integrating evidence into policy and sustainable disability services delivery in western New South Wales, Australia: the 'wobbly hub and double spokes' project

    Directory of Open Access Journals (Sweden)

    Veitch Craig

    2012-03-01

    Full Text Available Abstract Background Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. Methods/Design The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and

  10. The Israeli Long-Term Care Insurance Law: selected issues in providing home care services to the frail elderly.

    Science.gov (United States)

    Schmid, Hillel

    2005-05-01

    The paper describes and analyses selected issues related to the provision of home care services to frail elderly people following the Israeli Long-Term Care Insurance Law (1988). The goals and principles of the Law, which mandates the provision of home care services to frail elderly people, are presented. The paper also evaluates its contribution toward enhancing the well-being of elderly clients. Several major dilemmas that arose following implementation of the Law are analysed and evaluated in comparison with other countries that have enacted and implemented similar laws. These dilemmas are community vs institutional care; services in kind vs monetary allowances; service provision through contracting out with nongovernmental agencies; unstable and unskilled labour force; and service quality. Finally, policy implications are discussed, mainly in the following areas: investment in human resources as a condition for achieving high service quality, and the need for coordination between the agencies that provide long-term care services to elderly people. PMID:15819740

  11. Expectations of Health Care Professionals Regarding the Services

    Directory of Open Access Journals (Sweden)

    Somayeh Hanafi

    2015-10-01

    Full Text Available Background: The provision of accurate and timely drug information to health care professionals is an important mechanism to promote safe and effective drug therapy for patients. World’s Drug and Poison Information Centers (DPICs are mainly affiliated to hospitals, rather rarely with faculties of pharmacy or with faculties of medicine and other related organizations.Methods: Data was collected from a questionnaire which was distributed among 400 health care providers in April 2009. Data were analyzed using SPSS software (version 17.Results: Medical reference books and drug information textbooks (36.7% and expert colleagues (29.7% were the “most commonly” used drug information resources. In addition, 77.8% of respondents “almost never” use DPICs. About 77% of respondents were non- acquainted with these centers’ activities. Five expectations were considered ‘very important’ by respondents: Provide information on IV drugs incompatibilities (74%, Provide drug interaction information (70.1%, Provide new drugs information (56.5%, Education/training of health care professionals regarding rational drug therapy and prevention of medication errors (54.9%, Providing information on dosage forms of drugs available in Iran (53.5%.Conclusion: Being non acquaintance with services of DPIC centers can be considered as the most important reason of not using them. Considering “announcement of availability of drugs in pharmacy” as one of the activities of DPICs, shows that the health care professionals are not acquainted with real services of these centers. It shows an urgent need for culture building activities to introduce them to these centers services.

  12. The 4 Pi Sky Transient Alerts Hub

    CERN Document Server

    Staley, Tim D

    2016-01-01

    We introduce the 4 Pi Sky 'hub', a collection of open data-services and underlying software packages built for rapid, fully automated reporting and response to astronomical transient alerts. These packages build on the mature 'VOEvent' standardized message-format, and aim to provide a decentralized and open infrastructure for handling transient alerts. In particular we draw attention to the initial release of voeventdb, an archive and remote-query service that allows astronomers to make historical queries about transient alerts. By employing spatial filters and web-of-citation lookups, voeventdb enables cross-matching of transient alerts to bring together data from multiple sources, as well as providing a point of reference when planning new follow-up campaigns. We also highlight the recent addition of optical-transient feeds from the ASASSN and GAIA projects to our VOEvent distribution stream. Both the source-code and deployment-scripts which implement these services are freely available and permissively lic...

  13. 78 FR 55671 - Hospital Care and Medical Services for Camp Lejeune Veterans

    Science.gov (United States)

    2013-09-11

    ... hospital care and medical services. As discussed in a separate notice (78 FR 39832, July 2, 2013), we are... their service at Camp Lejeune. Section 102 of Public Law 112-154 requires VA to provide hospital care... AFFAIRS 38 CFR Part 17 RIN 2900-AO78 Hospital Care and Medical Services for Camp Lejeune Veterans...

  14. The Perceived Needs and Availability of Eye Care Services for Older Adults in Long-term Care Facilities

    Science.gov (United States)

    Kergoat, Hélène; Boisjoly, Hélène; Freeman, Ellen E.; Monette, Johanne; Roy, Sylvie; Kergoat, Marie-Jeanne

    2014-01-01

    Background The objective was to evaluate the eye care services offered to older residents living in long-term care facilities (LTCFs). Methods A questionnaire targeting residents aged ≥65 years was sent to all LTCFs in Quebec. Questions related to the institution’s characteristics, demographic data related to residents, oculovisual health of residents and barriers to eye care, eye care services offered within and outside the institution, and degree of satisfaction regarding the eye care services offered to residents. Results 196/428 (45.8%) LTCFs completed the questionnaire. Participating LTCFs had an average of 97.0 ± 5.1 residents with a mean age of 82.8 ± 3.0 yrs and 69% women. Eye care services were mostly offered outside the institution, on a “per request” basis. The main barriers to eye care were the perception that residents could not cooperate and the lack of eye care professionals. Most LTCFs were satisfied with the eye care services offered to residents. Conclusions The fact that the LTCFs were satisfied with the eye care services offered to their residents, although it was neither provided on a regular basis nor to all residents, suggests that eye care professionals should take a proactive educational role for improving services to older institutionalized adults. PMID:25232370

  15. Postrape care services to minors in Kenya: are the services healing or hurting survivors?

    Science.gov (United States)

    Wangamati, Cynthia Khamala; Combs Thorsen, Viva; Gele, Abdi Ali; Sundby, Johanne

    2016-01-01

    Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors’ rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors’ rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused minors in Kenya require amendment.

  16. Postrape care services to minors in Kenya: are the services healing or hurting survivors?

    Science.gov (United States)

    Wangamati, Cynthia Khamala; Combs Thorsen, Viva; Gele, Abdi Ali; Sundby, Johanne

    2016-01-01

    Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors' rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors' rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused minors in Kenya require amendment. PMID:27445506

  17. Collaborative Cardiac Care Service: A Multidisciplinary Approach to Caring for Patients with Coronary Artery Disease

    Science.gov (United States)

    Sandhoff, Brian G; Kuca, Susan; Rasmussen, Jon; Merenich, John A

    2008-01-01

    Background: Coronary artery disease (CAD) remains the leading cause of death in the US. In 1996, Kaiser Permanente of Colorado (KPCO) developed the Collaborative Cardiac Care Service (CCCS) with the goal of improving the health of patients with CAD. Description: CCCS consists of a nursing team (the KP Cardiac Rehabilitation program) and a pharmacy team (the Clinical Pharmacy Cardiac Risk Service). CCCS works collaboratively with patients, primary care physicians, cardiologists, and other health care professionals to coordinate proven cardiac risk reduction strategies for patients with CAD. Activities such as lifestyle modification, medication initiation and adjustment, patient education, laboratory monitoring, and management of adverse events are all coordinated through CCCS. The CCCS uses an electronic medical record and patient-tracking software to document all interactions with patients, track patient appointments, and collect data for evaluation of both short- and long-term outcomes. Outcomes: The CCCS currently follows over 12,000 patients with CAD. The CCCS has demonstrated improvement in surrogate outcomes including: cholesterol screening (55% to 96.3%), the proportion of patients with a goal of low-density lipoprotein cholesterol (LDL-c) <100 mg/dL (22% to 76.9%), and has reduced the average LDL-c to 78.3 mg/dL for the CAD population it follows. The CCCS has shown a reduction in all-cause mortality associated with CAD by 76% in the patients followed by the service. Patient and physician satisfaction have been high with CCCS. Conclusion: The CCCS coordinates many aspects of cardiac risk reduction care resulting in excellent continuity of care. The CCCS has continued to grow and expand the number of patients enrolled by using innovative strategies and technology and has resulted in excellent care and improved outcomes of the CAD population at KPCO. PMID:21331203

  18. The Library as Hub of the Network Universe

    OpenAIRE

    Kelly, Patrick

    2012-01-01

    In submitting a proposed paper for this conference I made four definitive statements: The library is positioned at the hub or cross-over point of three network levels: the library network, the University LAN and WANs/VANs. There is a perfect marriage between the library and networks: the satisfaction of mutual need. Academic networks need the services the libraries can deliver as much as the library needs network services. The metamorphoses of the traditional 'computer services' function to...

  19. Patients' perceptions of services and preferences for care in amyotrophic lateral sclerosis: A review.

    LENUS (Irish Health Repository)

    Foley, Geraldine

    2012-02-01

    Abstract Service providers and service users often have different perspectives on health and social care services. We have undertaken a systematic review of empirical data between 1988 and March 2011 relating to ALS service users\\' perspectives on health and social care services. Forty-seven texts were extracted and a narrative synthesis conducted. Few studies have explored ALS patients\\' experiences in relation to their satisfaction with services. Our review showed that ALS patients expect dignified care but they are often dissatisfied with health care services and have unmet expectations of their care. Most studies of decision-making and preferences for care have focused on end-of-life intervention. Various factors influence preferences for care from the service user perspective and people with ALS may adjust their use of services as they negotiate change. In conclusion, further research on the timeliness of services to meet changing needs of service users is required. The service user experience of allied health care services prior to end-of-life care also warrants investigation. Service providers need to support people with ALS as they negotiate feelings of acceptance and independence. Research to identify the key parameters of the ALS patient experience of services is required.

  20. Increasing Registered Nurse Retention Using Mentors in Critical Care Services.

    Science.gov (United States)

    Schroyer, Coreena C; Zellers, Rebecca; Abraham, Sam

    2016-01-01

    Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale. PMID:27455367

  1. Counseling and Wellness Services Integrated with Primary Care: A Delivery System That Works

    OpenAIRE

    Van Beek, Ken; Duchemin, Steve; Gersh, Geniene; Pettigrew, Susanne; Silva, Pamela; Luskin, Barb

    2008-01-01

    Introduction: The continuity and coordination of care between medical and behavioral health services is a major issue facing our health care delivery system. Barriers to basic communication between providers of medical services and providers of behavioral health services, include: no coordination of services, and poor recognition of the relationship between medical and behavioral issues.

  2. Planning the Marketing Activity in the Health Care Services

    OpenAIRE

    Violeta Radulescu; Iuliana Cetina; Gheorghe Orzan

    2008-01-01

    The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access ...

  3. Estimating the sustainability of hubs

    NARCIS (Netherlands)

    R. Lieshout; J. Zuidberg; J. Veldhuis

    2008-01-01

    Several airports in the world are or will be confronted with capacity problems in the near future. As a result of this congestion, many airports will face a selectivity problem: which traffic segments must be accommodated and which segments are less crucial? At hub airports there is generally one (d

  4. Use of Health Care Services and Associated Factors among Women.

    Directory of Open Access Journals (Sweden)

    Nader Esmailnasab

    2014-01-01

    Full Text Available To estimate the prevalence and analyze factors associated with both public and private health services utilization in women population in a western district of Iran.A cross-sectional study with 1200 individuals aged 18-49 years carried out in different districts of Sanandaj City, western Iran, in 2012. The main outcome variable was use of health service in the previous 12 months. The in-dependent variables were age, education level, place of residence, marital and pregnancy status, household wealth, oc-cupation and duration time of employment, and rating of quality of health services.The prevalence of public and private health services utilization were 60.8% [95%CI: 57.8, 63.8] and 53.8% [95%CI: 50.8%, 56.8%], respectively (P=0.001. After controlling other investigated factors using logistic regression; the academic educational level (OR=1.36, 95%CI: 1.03, 1.80; OR=1.76, 95%CI: 1.33, 2.33, residents of urban (OR=1.65, 95%CI: 1.10, 2.47; OR=1.60, 95%CI: 1.10, 2.42, pregnancy status (OR=2.38, 95%CI: 1.60, 3.55; OR=2.36, 95%CI: 1.61, 3.47, and high level of quality of health services (OR=1.61, 95%CI: 1.15, 2.27; OR=1.70, 95%CI: 1.20, 2.40 were found to be predictors of utilization of both public and private health care respectively. There was also statistically relation between high level of household wealth (OR=3.01, 95% CI: 2.00, 4.57 and private health services utilization.Prevalence of health services utilization varied according to the individual and social factors of popula-tion studied. Present study emphasizes the need to develop care models that focus on the characteristics and demands of the subjects.

  5. Postrape care services to minors in Kenya: are the services healing or hurting survivors?

    Directory of Open Access Journals (Sweden)

    Wangamati CK

    2016-07-01

    Full Text Available Cynthia Khamala Wangamati,1 Viva Combs Thorsen,1 Abdi Ali Gele,2 Johanne Sundby1 1Department of Community Medicine, Faculty of Medicine, University of Oslo, 2Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway Abstract: Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors’ rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors’ rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused

  6. Obstacles to continuity of care in young mental health service users' pathways - an explorative study

    OpenAIRE

    Ådnanes, Marian; Steihaug, Sissel

    2013-01-01

    Background: Users of mental health services often move between different primary and specialised health and care services, depending on their current condition, and this often leads to fragmentation of care. The aim of this study was to map care pathways in the case of young adult mental health service users and to identify key obstacles to continuity of care.Method: Quarterly semi-structured interviews were performed with nine young adults with mental health difficulties, following their pat...

  7. Immigrants' use of primary health care services for mental health problems

    OpenAIRE

    Straiton, Melanie Lindsay; Reneflot, Anne; Diaz, Esperanza

    2014-01-01

    Background: Equity in health care across all social groups is a major goal in health care policy. Immigrants may experience more mental health problems than natives, but we do not know the extent to which they seek help from primary health care services. This study aimed to determine a) the rate immigrants use primary health care services for mental health problems compared with Norwegians and b) the association between length of stay, reason for immigration and service use among immigrants. ...

  8. Berth Allocation with Service Priority for Container Terminal of Hub Port%集装箱枢纽港泊位分配问题优化研究

    Institute of Scientific and Technical Information of China (English)

    代丽利

    2014-01-01

    通过分析船舶大型化对船公司和码头运营商的影响,文中提出在泊位分配的过程中,码头需站在共赢的角度,箱位大的船舶的服务优先级高于箱位小的船舶。建立了具有优先权的动态泊位分配模型,采用改进的广义遗传算法对模型求解。算例结果证明模型和算法正确有效。%Through analyzing the effects of container ships with larger size to the shipping companies and terminal operators,this paper put forward a view,from a win-win perspective,that container ships with larger Twenty-foot Equivalent Units (TEUs)capacity should be given the higher priority in the process of berth allocation.Following the above view,a dynamic berth allocation model considering the service priority was developed and an improved generalized genetic algorithms was used to solve the model.Example application results show that the model and the algorithm are correct and effective.

  9. Fracture prevention service to bridge the osteoporosis care gap

    Directory of Open Access Journals (Sweden)

    Ruggiero C

    2015-06-01

    Full Text Available Carmelinda Ruggiero,1 Elena Zampi,1 Giuseppe Rinonapoli,2 Marta Baroni,1 Rocco Serra,1 Elisa Zengarini,1 Gregorio Baglioni,3 Giuliana Duranti,3 Sara Ercolani,1 Francesco Conti,4 Auro Caraffa,2 Patrizia Mecocci,1 Maria Luisa Brandi5 1Geriatric Unit, University of Perugia, Hospital S Maria della Misericordia, 2Orthopedic and Traumatologic Unit, University of Perugia, Hospital S Maria della Misericordia, 3Primary Care Physicians, SIMG Umbria, Perugia, 4Department of Clinical and Molecular Medicine, Sapienza University of Rome, AO Sant’Andrea Hospital, Rome, 5Department of Internal Medicine, University of Florence, Florence, Italy Background: A care gap exists between the health care needs of older persons with fragility fractures and the therapeutic answers they receive. The Fracture Prevention Service (FPS, a tailored in-hospital model of care, may effectively bridge the osteoporosis care gap for hip-fractured older persons. The purpose of this study was to evaluate the efficacy of the FPS in targeting persons at high risk of future fracture and to improve their adherence to treatment.Methods: This was a prospective observational study conducted in a teaching hospital with traumatology and geriatric units, and had a pre-intervention and post-intervention phase. The records of 172 participants were evaluated in the pre-intervention phase, while data from 210 participants were gathered in the post-intervention phase. All participants underwent telephone follow-up at 12 months after hospital discharge. The participants were patients aged ≥65 years admitted to the orthopedic acute ward who underwent surgical repair of a proximal femoral fracture. A multidisciplinary integrated model of care was established. Dedicated pathways were implemented in clinical practice to optimize the identification of high-risk persons, improve their evaluation through bone mineral density testing and blood examinations, and initiate an appropriate treatment for

  10. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  11. MEDICAL TOURISTS' EXPECTATIONS WHEN CHOOSING LITHUANIA FOR HEALTH CARE SERVICES

    Directory of Open Access Journals (Sweden)

    Miglė Eleonora Černikovaitė

    2015-07-01

    Full Text Available Purpose – Identify medical expectations of tourists choosing Lithuania as medical tourism country and to make comparative analysis with situation in Thailand. Medical tourism is one of the most promising fields of business in the world. International trade in medical services also has huge economic potential and gradually increasing outcome for the global economy (Bookman & Bookman, 2007. Major medical tourism destinations: Thailand, India, Singapore and Malaysia attracted more than 2.5 million medical travellers (United Nations Economic and Social Commission for Asia and the Pacific, 2008. Lithuania is among the major emerging markets in medical tourism that is increasing every year. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good quality services with affordable prices and location, while people choosing Thailand – mainly is affected by advertising. The main recommendation for attracting medical tourists to Lithuania is to initiate the advertising campaign to the targeted audiences. Design/methodology/approach – The comparative analysis of scientific literature and empirical comparative quantitative research was executed for acquiring the expectations for medical tourists in Lithuania. Findings – Overview of health and medical tourism situation in Lithuania and other emerging markets. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services and other. Comparative empirical analysis of medical tourist expectations in Lithuania and Thailand. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good

  12. Structuring a palliative care service in Brazil: experience report

    Directory of Open Access Journals (Sweden)

    João Batista Santos Garcia

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: in Brazil, palliative care (PC is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. EXPERIENCE REPORT: the hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. CONCLUSION: this experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals.

  13. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in... economical hospital care or medical services because of geographic inaccessibility or are not capable...

  14. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2012-11-21

    ... 2013 Rates and to the Long Term Care Hospital PPS and FY 2013 Rates'' (77 FR 53257). Therefore, the... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2013 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for...

  15. 48 CFR 831.7001-4 - Medical services and hospital care.

    Science.gov (United States)

    2010-10-01

    ... hospital care. 831.7001-4 Section 831.7001-4 Federal Acquisition Regulations System DEPARTMENT OF VETERANS... and Procedures 831.7001-4 Medical services and hospital care. (a) VA may pay the customary student... Government. (b) When the customary student's health fee does not cover medical services or hospital care,...

  16. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    Science.gov (United States)

    2010-07-01

    ... medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities for outpatient medical services and inpatient hospital care. In scheduling appointments for outpatient...

  17. 77 FR 38291 - Meeting of the Advisory Council on Alzheimer's Research, Care, and Services

    Science.gov (United States)

    2012-06-27

    ... HUMAN SERVICES Meeting of the Advisory Council on Alzheimer's Research, Care, and Services AGENCY...: This notice announces the public meeting of the Advisory Council on Alzheimer's Research, Care, and... U.S.C. App. 2, section 10(a)(1) and (a)(2)). The Advisory Council on Alzheimer's Research, Care,...

  18. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Science.gov (United States)

    2010-01-01

    ... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day... amount of food service payments shall be disbursed to each day care home on the basis of the number of meals served, by type, to enrolled children. For tier II day care homes, the full amount of food...

  19. The role of affect in consumer evaluation of health care services.

    Science.gov (United States)

    Ng, Sandy; Russell-Bennett, Rebekah

    2015-01-01

    Health care services are typically consumed out of necessity, typically to recover from illness. While the consumption of health care services can be emotional given that consumers experience fear, hope, relief, and joy, surprisingly, there is little research on the role of consumer affect in health care consumption. We propose that consumer affect is a heuristic cue that drives evaluation of health care services. Drawing from cognitive appraisal theory and affect-as-information theory, this article tests a research model (N = 492) that investigates consumer affect resulting from service performance on subsequent service outcomes. PMID:25751317

  20. Socioeconomic inequalities in the access to and quality of health care services

    Directory of Open Access Journals (Sweden)

    Bruno Pereira Nunes

    2014-12-01

    Full Text Available OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days for assistance, and waiting time (in hours in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

  1. Barriers to utilization of antenatal care services in Eastern Nepal

    Directory of Open Access Journals (Sweden)

    Krishna Kumar eDeo

    2015-08-01

    Full Text Available BackgroundWorld Health Organization (WHO recommends at least four pregnancy check-ups for normal pregnancies. Ministry of Health and Population (MOHP Nepal has introduced various strategies to promote prenatal care and institutional delivery to reduce maternal and child deaths. However, maternal health service utilization is low in some selected and socio-economic and ethnic groups. Hence, this study aims to assess barriers to the recommended four antenatal care (4ANC visits in eastern Nepal.MethodsA cross-sectional quantitative study was conducted in Sunsari district. A total of 372 randomly selected women who delivered in the last year preceding the survey were interviewed using a semi-structured questionnaire. Bivariate and multivariate logistic regression analysis was carried out to identify barriers associated with 4ANC visits.ResultsMore than two-third women (69% attended at least 4ANC visits. The study revealed that women exposed to media had higher chance of receiving four or more ANC visits with an adjusted Odds Ratio (aOR=3.5, 95% CI: 1.2-10.1 in comparison to women who did not. Women from an advantaged ethnic group had more chance of having 4ANC visits than respondents from a disadvantaged ethnic group (aOR=2.4, 95% CI: 2.1-6.9. Similarly, women having a higher level of autonomy were nearly three times more likely (aOR= 2.9, 95%CI: 1.5-5.6 and richer women were twice (aOR=2.3, 95% CI: 1.1-5.3 as likely to have at least 4ANC visits compared to women who had a lower level of autonomy and were economically poor.ConclusionBeing from disadvantaged ethnicity, lower women?s autonomy, poor knowledge of maternal health service and incentive upon completion of ANC, less media exposure related to maternal health service, and lower wealth rank were significantly associated with fewer than the recommended 4ANC visits. Thus, maternal health programs need to address such socio-cultural barriers for effective health care utilization.

  2. [Internationalized medical care services increase need of health care providers to improve English communication skills].

    Science.gov (United States)

    Yang, Chia-Ling

    2011-02-01

    English is the most important language used in international communication. Nurses today have significantly more opportunities to come into contact with clients of different nationalities. Therefore, English communication abilities are a critical to the effective care of foreign clients. Miscommunication due to language barriers can endanger the health and safety of foreign clients and hinder their access to healthcare resources. Basic English communicate skills allow nurses to better understand the feelings of foreign clients and to affect their satisfaction with healthcare services provided. The majority of clinical nurses in Taiwan are inadequately prepared to communicate with foreign clients or use English when delivering nursing care services. Although English is not an official language in Taiwan, strengthening English communication skills is necessary for Taiwan's healthcare service system. Faced with increasing numbers of foreign clients in their daily work, first-line nursing staffs need more training to improve English proficiency. In order to do so, support from the hospital director is the first priority. The second priority is to motivate nursing staffs to learn English; the third is to incorporate different English classes into the medical system and schedule class times to meet nurse scheduling needs; and the fourth is to establish international medical wards, with appropriate incentives in pay designed to attract and retain nursing staff proficient in English communication. PMID:21328212

  3. 77 FR 14804 - Advisory Council on Alzheimer's Research, Care, and Services; Request for Nominations

    Science.gov (United States)

    2012-03-13

    ... HUMAN SERVICES Advisory Council on Alzheimer's Research, Care, and Services; Request for Nominations... member of the Advisory Council on Alzheimer's Research, Care, and Services to fill the position of... (202) 690-7996, helen.lamont@hhs.gov . ] SUPPLEMENTARY INFORMATION: The Advisory Council on...

  4. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies. PMID:26630301

  5. Technologies for HIV prevention and care: challenges for health services

    Directory of Open Access Journals (Sweden)

    Ivia Maksud

    2015-09-01

    Full Text Available ABSTRACTThis article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP and pre-exposure prophylaxis (PrEP, treatment as prevention (TASP and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  6. Performance Measurement in Social Care Services for Older People

    Directory of Open Access Journals (Sweden)

    Mihaela GHENŢA

    2015-12-01

    Full Text Available Taking into account the current social and economic environment, managers of social organizations are under a constant pressure to get results and to optimize costs with an efficient allocation of resources. Performance management allows measuring the results of public and private organizations which provide social care for the elderly. The potential of social services to respond to current challenges is linked not only to financial resources, but also to the ability of social managers to develop methods, techniques and innovative practices. Since innovation requires change, the providers should promote management practices and structures that favour the expression of new ideas. The article presents the results of a mixed-type research methodology based on qualitative and quantitative methods, such as the in-depth semi-structured interview, focus-group, and questionnaire with public policymakers, as well as with private and public providers of social services for older people. Research was conducted during October – November 2014 and the instruments were developed by the team members. The aim of the research has been to find out the importance of performance and performance measurement among public and private managers of social services for older people, and also from the perspective of policymakers. Conclusions reveal that the managers of social services for elderly should be aware that measurement alone is not sufficient, as long as the information obtained is not used in other decision-making processes like: strategic planning, quality management, budgeting activities, increased productivity. The findings have implications for practitioners, researchers and policymakers.

  7. Access to special care dentistry, part 6. Special care dentistry services for young people.

    Science.gov (United States)

    Dougall, A; Fiske, J

    2008-09-13

    This article brings together some of the 'hidden disabilities' common amongst adolescents and young adults. Many of these conditions carry a social stigma and some are associated with secretive behaviour and even denial. The article will describe the features, management and oral implications of five eating disorders (Prader-Willi syndrome, anorexia nervosa, bulimia nervosa, binge eating disorder and pica) and three types of mental health problems (schizophrenia, obsessive-compulsive disorder and bipolar disorder). Without the input of the dental profession, and in the main the primary dental care service, all these conditions can have a detrimental effect on the dentition at a relatively early stage in life. Mental health problems are more common in adolescents and young adults than most people realise and this article will also consider the impact on oral health and delivery of dental care to young people who have experienced childhood sexual abuse. PMID:18791579

  8. Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle, Pharm.D.

    2012-01-01

    Full Text Available This study explored primary care providers’ (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2 “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3 “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4 “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6 “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients

  9. States, Congress confront abortion services under Medicaid, health care plan.

    Science.gov (United States)

    1994-01-13

    Abortion coverage under various health care reform proposals has dominated the political reproductive rights debate, while poor women's access to abortion under Medicaid presents a current practical concern. Under the Clinton administration's proposed Health Security Act, abortion would be covered under "services for pregnant women," and Medicaid would eventually be incorporated into the national health plan. A final version is a long way off. For now, the Hyde amendment, limiting Medicaid coverage of abortion, controls the issue. Congress has made only negligible progress in freeing federal funds for Medicaid abortions: only in situations of life endangerment, rape, or incest. States are required to cover abortions that are medically necessary under the new guidelines, which now include pregnancy arising from rape and incest. The federal policy defers to state law on the definition of rape and incest, allowing for reasonable reporting or documentation requirements, while disallowing unduly burdensome regulations by allowing the treating physician reimbursement when the physician certifies that the patient was unable for physical or psychological reasons to comply with the requirement. States disagreeing with the new abortion policy immediately registered their opposition. Utah's health department, which has a "life only" law, has pledged not to implement the new federal policy until there is further clarification. The Health Care Financing Administrator responded by writing that "the decision to implement this policy nationwide was not discretionary." Congress chose not to add statutory language deferring to the states, and under U.S. Constitutional law, where state law or policy conflicts with federal law, federal law takes precedence. The next battle will certainly center on attempts to amend the Hyde amendment itself as well as health care legislation along the "states' option" lines. PMID:12345518

  10. Public Service Announcement: Heart Disease Doesn't Care What You Wear

    Science.gov (United States)

    ... Home Current Issue Past Issues Public Service Announcement Heart Disease Doesn't Care What You Wear Past Issues / ... version of this page please turn Javascript on. Heart Disease Doesn't Care What You Wear IT'S THE # ...

  11. 25 CFR 20.508 - What must the social services agency do when a child is placed in foster care, residential care...

    Science.gov (United States)

    2010-04-01

    ... placed in foster care, residential care or guardianship home? 20.508 Section 20.508 Indians BUREAU OF... PROGRAMS Child Assistance Foster Care § 20.508 What must the social services agency do when a child is placed in foster care, residential care or guardianship home? The social services agency must...

  12. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    LENUS (Irish Health Repository)

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  13. How integrated are neurology and palliative care services?:Results of a multicentre mapping exercise

    OpenAIRE

    van Vliet, Liesbeth M.; Gao, Wei; DiFrancesco, Daniel; Crosby, Vincent; Wilcock, Andrew; Byrne, Anthony; Al-Chalabi, Ammar; Chaudhuri, K. Ray; Evans, Catherine; Silber, Eli; Young, Carolyn; Malik, Farida; Quibell, Rachel; Irene J Higginson; OPTCARE Neuro

    2016-01-01

    BACKGROUND: Patients affected by progressive long-term neurological conditions might benefit from specialist palliative care involvement. However, little is known on how neurology and specialist palliative care services interact. This study aimed to map the current level of connections and integration between these services.METHODS: The mapping exercise was conducted in eight centres with neurology and palliative care services in the United Kingdom. The data were provided by the respective ne...

  14. Branding in senior care home services in China and Finland : Comparative case study in private sector

    OpenAIRE

    Kittilä, Petri

    2011-01-01

    ABSTRACT Kittilä, Petri 2011. Branding in senior care home services in China and Finland: Comparative case study in private sector. Bachelor’s Thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 88. Appendix 1. The objective of this thesis was to study how the private sector senior care home services are branded and how significant the care homes see the brand building. In addition, my objective was to study differences in service branding between China and...

  15. Building effective service linkages in primary mental health care: a narrative review part 2

    OpenAIRE

    Parker Sharon; Holdsworth Louise; Perkins David; Fuller Jeffrey D; Kelly Brian; Roberts Russell; Martinez Lee; Fragar Lyn

    2011-01-01

    Abstract Background Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health ...

  16. How integrated are neurology and palliative care services? Results of a multicentre mapping exercise

    OpenAIRE

    van Vliet, Liesbeth M.; Gao, Wei; DiFrancesco, Daniel; Crosby, Vincent; Wilcock, Andrew; Byrne, Anthony; Al-Chalabi, Ammar; Chaudhuri, K Ray; Evans, Catherine; Silber, Eli; Young, Carolyn; Malik, Farida; Quibell, Rachel; Higginson, Irene J; ,

    2016-01-01

    Background Patients affected by progressive long-term neurological conditions might benefit from specialist palliative care involvement. However, little is known on how neurology and specialist palliative care services interact. This study aimed to map the current level of connections and integration between these services. Methods The mapping exercise was conducted in eight centres with neurology and palliative care services in the United Kingdom. The data were provided by the respective neu...

  17. Quality of care in psychosis and bipolar disorder from the service user perspective.

    Science.gov (United States)

    Skelly, Niamh; Schnittger, Rebecca I; Butterly, Lisa; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul

    2013-12-01

    According to the recovery model of mental health care, service development should incorporate the expert knowledge of service users. To date, there has been limited research into conceptualizations of mental health care quality among services users diagnosed with bipolar disorder or psychosis. To investigate service user perspectives on quality of care, we conducted six focus groups (N = 29) with inpatients and outpatients of an independent Irish mental health service. We undertook an inductive thematic analysis of the data. Participants identified proactive staff, meaningful and warm staff-patient interactions, and safety and sociability in the inpatient environment as components of good quality mental health care. Participants also discussed how the implementation of best practice guidelines does not necessarily improve quality of care from the service user perspective. This and similar qualitative research should be used to inform service development and the creation of evaluation instruments compatible with the recovery model. PMID:24163347

  18. Prioritising outcomes measures for ambulance service care: a three stage consensus study

    OpenAIRE

    Coster, Joanne; Turner, Janette; Siriwardena, A Niroshan; Wilson, Richard; Phung, Viet-Hai

    2013-01-01

    Background Historically ambulance care quality and performance has been measured by response times rather than clinical need or effectiveness. This limits the evidence about the effectiveness of the care the ambulance service provides. The Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) project is a 5 year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care that better reflect the care provided. Meth...

  19. Speak Up: Help Prevent Errors in Your Care: Laboratory Services

    Science.gov (United States)

    ... role in making health care safe. That includes doctors, nurses, laboratory technologists, phlebotomists (health care staff who take ... if you don't understand something that your doctor, nurse, or other health care professional tells you. • Don’ ...

  20. USDA Southwest Regional Hub for Adaptation to and Mitigation of Climate Change

    Science.gov (United States)

    Rango, A.; Elias, E.; Steele, C. M.; Havstad, K.

    2014-12-01

    The USDA Southwest (SW) Climate Hub was created in February 2014 to develop risk adaptation and mitigation strategies for coping with climate change effects on agricultural productivity. There are seven regional hubs across the country with three subsidiary hubs. The SW Climate Hub Region is made up of six states: New Mexico, Arizona, Utah, Nevada, California and Hawaii (plus the Trust Territories of the Pacific Islands). The SW Climate Hub has a subsidiary hub located in Davis, California. The Southwest region has high climatic diversity, with the lowest and highest average annual rainfall in the U.S.(6.0 cm in Death Valley, CA and 1168 cm at Mt. Waialeale, HI). There are major deserts in five of the six states, yet most of the states, with exception of Hawaii, depend upon the melting of mountain snowpacks for their surface water supply. Additionally, many of the agricultural areas of the SW Regional Hub depend upon irrigation water to maintain productivity. Scientific climate information developed by the Hub will be used for climate-smart decision making. To do this, the SW Regional Hub will rely upon existing infrastructure of the Cooperative Extension Service at Land-Grant State Universities. Extension service and USDA-NRCS personnel have existing networks to communicate with stakeholders (farmers, ranchers, and forest landowners) through meetings and workshops which have already started in the six states. Outreach through the development of a weather and climate impact modules designed for seventh grade students and their teachers will foster education of future generations of rural land managers. We will be synthesizing and evaluating existing reports, literature and information on regional climate projections, water resources, and agricultural adaptation strategies related to climate in the Southwest. The results will be organized in a spatial format and provided through the SW Hub website (http://swclimatehub.info) and peer-reviewed articles.

  1. Counselling in Swedish Community Pharmacies : Understanding the Process of a Pharmaceutical Care Service

    OpenAIRE

    Montgomery, Anna

    2009-01-01

    Community pharmacy practice is moving towards patient care and away from the mere dispensing of medicines. In this movement, which is guided by the philosophy of Pharmaceutical care (PC), new counselling services emerge. The purpose of the thesis was to add knowledge about the real-world provision of PC services by studying a defined PC service in Swedish pharmacies. Specific aims of this thesis were to investigate the experiences of professionals working with or close to the service and to d...

  2. Innovation Hub How-To

    DEFF Research Database (Denmark)

    Berger, Andreas; Brem, Alexander

    2016-01-01

    Firms around the world are eager to replicate the successes of enterprises that have established innovation labs in California's Silicon Valley. An analysis of four leading US companies that have set up idea incubators in the Valley—Xerox, Apple, Google, and Cisco—point to eight factors for succe......, fostering disruptive over incremental innovation, and being patient. Regardless of where an innovation hub is established, the key to success lies in hiring creative, intrinsically motivated staff and then giving them the freedom to do what they do best....

  3. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    OpenAIRE

    Dale, Bjørg

    2013-01-01

    Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficie...

  4. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    OpenAIRE

    Dale B; Hvalvik S

    2013-01-01

    Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The pur...

  5. On GitHub's Programming Languages

    OpenAIRE

    Sanatinia, Amirali; Noubir, Guevara

    2016-01-01

    GitHub is the most widely used social, distributed version control system. It has around 10 million registered users and hosts over 16 million public repositories. Its user base is also very active as GitHub ranks in the top 100 Alexa most popular websites. In this study, we collect GitHub's state in its entirety. Doing so, allows us to study new aspects of the ecosystem. Although GitHub is the home to millions of users and repositories, the analysis of users' activity time-series reveals tha...

  6. Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries

    OpenAIRE

    Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

    2016-01-01

    Background: The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with...

  7. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    Science.gov (United States)

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important. PMID:11727291

  8. Is There Time Enough? Temporal Resources and Service Performance in the Danish Home Care Sector

    DEFF Research Database (Denmark)

    Tufte, Pernille

    2013-01-01

    scarcity in the daily work performance, care workers relate the issue of time to a more fundamental discussion of what the performance of care does and should entail. The purpose of the article is to examine care workers’ perceptions of the temporal conditions of care work, investigating how time pressure...... performance of care work. Care workers do, however, not accept this notion. Relying on their experience of work, they perceive additional services as an ambiguous concept, which recognizes the multiple character of care work. Conclusions are that time scarcity constitutes a pressure on work performance as a...

  9. Developing a framework of service convenience in health care: An exploratory study for a primary care provider.

    Science.gov (United States)

    Tuzovic, Sven; Kuppelwieser, Volker

    2016-01-01

    From retail health clinics and online appointment scheduling to (mobile) kiosks that enable patient check-in and automate the collection of copays and open balances, convenience has become an important topic in the health care sector over the last few years. While service convenience has also gained much interest in academia, one common limitation is that authors have adopted a "goods-centered" perspective focusing primarily on retail settings. Results of this exploratory study reveal that health care service convenience encompasses seven different dimensions: decision, access, scheduling, registration and check-in, transaction, care delivery, and postconsultation convenience. Implications and future research suggestions are discussed. PMID:27215644

  10. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2010-11-09

    ... 2011 LTCH PPS) (75 FR 50042-50677).'' Therefore, the percentage increase for hospitals paid under the... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for...

  11. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2013-10-30

    ...; Payment Policies Related to Patient Status '' (78 FR 50608). Therefore, the percentage increase for... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2014 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for...

  12. Public/Private Partnership--A Cost Effective Model for Child Day Care Services.

    Science.gov (United States)

    Alisberg, Helene R.

    Trends suggest that 11 million children in the United States will need day care services by 1995. Presently, corporations provide child care support through subsidies to low income employees or through community facilities, parent education, and information and referral (I & R) services. Such support results in reduced rates of absenteeism and…

  13. Racial/Ethnic Differences in Use of Health Care Services for Diabetes Management

    Science.gov (United States)

    Chandler, Raeven Faye; Monnat, Shannon M.

    2015-01-01

    Research demonstrates consistent racial/ethnic disparities in access to and use of health care services for a variety of chronic conditions. Yet we know little about whether these disparities exist for use of health care services for diabetes management. Racial/ethnic minorities disproportionately suffer from diabetes, complications from diabetes,…

  14. 77 FR 64390 - Agency Information Collection (Food Service and Nutritional Care Analysis) Activities Under OMB...

    Science.gov (United States)

    2012-10-19

    ... determine whether improvements are needed to enhance patient's nutritional therapy. An agency may not... AFFAIRS Agency Information Collection (Food Service and Nutritional Care Analysis) Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Food Service and Nutritional Care Analysis, VA Form 10-5387. OMB...

  15. 77 FR 45717 - Proposed Information Collection (Food Service and Nutritional Care Analysis) Activity; Comment...

    Science.gov (United States)

    2012-08-01

    ... are needed to enhance patient's nutritional therapy. Affected Public: Individuals and Households... AFFAIRS Proposed Information Collection (Food Service and Nutritional Care Analysis) Activity; Comment.... Title: Food Service and Nutritional Care Analysis, VA Form 10-5387. OMB Control Number: 2900-0227....

  16. The application of design criteria for locating a hub configured supply chain for a restaurant cluster in the Stellenbosch area

    Directory of Open Access Journals (Sweden)

    Claudia B. Struwig

    2013-05-01

    Full Text Available Restaurants, in general, utilise numerous suppliers. Normally they deliver on different days in the week and at different times during the day, logistically not an optimum approach. Not only does the current practice cause frequent interruptions, but by segregating the food supply chain unnecessary traffic is generated. This article investigated the need for developing a third party supplier hub, the best positioning of that hub and the most economical routes to the customers. With the aim of providing non-franchised restaurants with the necessary leverage to become market leaders, the hub is planned to only service the restaurants within the vicinity of the Stellenbosch area. In such a hub-configured supply chain, the suppliers would be delivering to the proposed hub, from where once-off deliveries to all the restaurants may be made on days and/or times determined by them. In order to investigate the benefits of providing such a hub structure, a systematic implementation approach was used. The first step was to do market research in order to establish the need for such a hub. That is, the viability of the hub from a restaurant’s perspective was established. The next step entailed the investigation of the design criteria needed in determining a favourable hub location. Four possible hub locations were identified. The Clark and Wright’s savings algorithm was then used to determine the optimal hub location and the feasibility of the results was verified with the aid of a global positioning system (GPS device. The last steps followed involved the determination of an effective hub floor plan that may be utilised, possible products that can be supplied to the restaurants and the necessary assets needed to provide the hub’s service. Finally, by incorporating all these facets, a cost analysis was done to determine the hub’s profitability.

  17. What Proportion of Terminally Ill and Dying People Require Specialist Palliative Care Services?

    Directory of Open Access Journals (Sweden)

    Donna M. Wilson

    2014-01-01

    Full Text Available Currently, around 55 million people die each year worldwide. That number is expected to increase rapidly with accelerating population aging. Despite growth in the number of palliative care specialists and specialist services in most countries, the prospect of an increasing number of terminally ill and dying persons is daunting. This paper attempts to answer the question: what proportion of terminally ill and dying persons require specialist palliative care services? To address this question and highlight which persons require specialist palliative care, the current state of access to specialist palliative care services and specialists in Canada and other countries is highlighted, along with available evidence-based information on specialist services utilization and the care needs of terminally ill and dying persons. Current evidence and information gaps reveal that this question cannot be answered now, but it should be answered in advance of a crisis of unmet end-of-life care needs with the rising death toll.

  18. Assessing the acceptability of community pharmacy based pharmaceutical care services in Karachi

    Directory of Open Access Journals (Sweden)

    Muhammad Amir, B.Pharmacy, MSc. MBA, Assistant Professor/Clinical Pharmacist

    2011-01-01

    Full Text Available Provision of pharmaceutical care services in community pharmacies is a new trend in pharmacy practice worldwide. Published literature from developed countries is available showing benefits of pharmaceutical care services provided in community pharmacies. However, relatively little published literature is available from developing countries in which unique market environments are encountered. This study was conducted to assess the acceptability of community pharmacy based pharmaceutical care services in Karachi. Pharmaceutical care services were developed and offered to pharmacy customers for a period of two months. Acceptability was evaluated with respect to enrollment of participants in the program, discontinuation, and complaints registered. The findings provide a better understanding of pharmaceutical care marketing strategies and are discussed within the context of the health care environment in Karachi.

  19. 38 CFR 17.111 - Copayments for extended care services.

    Science.gov (United States)

    2010-07-01

    ...—$97. (iv) Institutional geriatric evaluation—$97. (v) Non-institutional geriatric evaluation—$15. (vi... each day that adult day health care, non-institutional geriatric evaluation, and non-institutional... care, institutional geriatric evaluation, noninstitutional geriatric evaluation, nursing home...

  20. The use of health care services: is illness the only motivator?

    Science.gov (United States)

    Gould, S J

    1989-01-01

    Increasingly, consumer researchers and marketers have turned their attention to the marketing of health care services. In that vein, this paper addresses the question of what determines a consumer's use of these services. Through a review of relevant studies, an examination is made of such factors as illness, social and behavioral variables, and changing attitudes toward health, which have been prompted by various social movements. It is concluded that while illness is a critical factor in the use of health care services, other factors are playing an increasingly important role. Strategic marketing implications are offered as to how health care marketers should address the illness factor in the promotion and delivery of care services. Finally, future research directions are suggested which would help to define and gauge the role of illness in the consumption and strategic marketing of health care services. PMID:10303941

  1. Implementation of the Care Programme Approach across Health and Social Services for Dual Diagnosis Clients

    Science.gov (United States)

    Kelly, Michael; Humphrey, Charlotte

    2013-01-01

    Background: Care for clients with mental health problems and concurrent intellectual disability (dual diagnosis) is currently expected to be provided through the care programme approach (CPA), an approach to provide care to people with mental health problems in secondary mental health services. When CPA was originally introduced into UK mental…

  2. Trends in Care and Services for Elderly Individuals in Denmark and Sweden.

    Science.gov (United States)

    Cates, Norman

    1993-01-01

    Notes that Denmark and Sweden have achieved reduction in institutionalization of elderly individuals by increasing home care and housing with services and adaptation. Describes innovative model of nursing home care in Denmark--a self-care model that fosters independent living and decision making as long as possible. (Author/NB)

  3. Essays on Health Care: The Impact of Insurance and Use of Medical Services on Health

    OpenAIRE

    Choi, Moonkyung Kate

    2012-01-01

    The United States per capita health care spending is the highest in the world. This dissertation addresses the impact of additional health care spending/medical service usage on health status. First two chapters investigate the role of insurance on medical service use in understudied dental market. The third chapter examines the effectiveness of additional health care spending on infant health outcomes.The first chapter estimates the causal relationship between adult Medicaid dental benefits ...

  4. Obstacles to continuity of care in young mental health service users’ pathways - an explorative study

    Directory of Open Access Journals (Sweden)

    Marian Ådnanes

    2013-08-01

    Full Text Available Background: Users of mental health services often move between different primary and specialised health and care services, depending on their current condition, and this often leads to fragmentation of care. The aim of this study was to map care pathways in the case of young adult mental health service users and to identify key obstacles to continuity of care.Method: Quarterly semi-structured interviews were performed with nine young adults with mental health difficulties, following their pathways in and out of different services in the course of a year.Results: Key obstacles to continuity of care included the mental health system's lack of access to treatment, lack of integration between different specialist services, lack of progress in care and inadequate coordination tools such as ‘Individual Plan’ and case conferences that did not prevent fragmented care pathways.Conclusions: Continuity of care should be more explicitly linked to aspirations for development and progress in the users' care pathways, and how service providers can cooperate with users to actually develop and make progress. Coordination tools such as case conferences and ‘individual plans’ should be upgraded to this end and utilised to the utmost. This may be the most effective way to counteract the system obstacles.

  5. Virtual Hubs for facilitating access to Open Data

    Science.gov (United States)

    Mazzetti, Paolo; Latre, Miguel Á.; Ernst, Julia; Brumana, Raffaella; Brauman, Stefan; Nativi, Stefano

    2015-04-01

    In October 2014 the ENERGIC-OD (European NEtwork for Redistributing Geospatial Information to user Communities - Open Data) project, funded by the European Union under the Competitiveness and Innovation framework Programme (CIP), has started. In response to the EU call, the general objective of the project is to "facilitate the use of open (freely available) geographic data from different sources for the creation of innovative applications and services through the creation of Virtual Hubs". In ENERGIC-OD, Virtual Hubs are conceived as information systems supporting the full life cycle of Open Data: publishing, discovery and access. They facilitate the use of Open Data by lowering and possibly removing the main barriers which hampers geo-information (GI) usage by end-users and application developers. Data and data services heterogeneity is recognized as one of the major barriers to Open Data (re-)use. It imposes end-users and developers to spend a lot of effort in accessing different infrastructures and harmonizing datasets. Such heterogeneity cannot be completely removed through the adoption of standard specifications for service interfaces, metadata and data models, since different infrastructures adopt different standards to answer to specific challenges and to address specific use-cases. Thus, beyond a certain extent, heterogeneity is irreducible especially in interdisciplinary contexts. ENERGIC-OD Virtual Hubs address heterogeneity adopting a mediation and brokering approach: specific components (brokers) are dedicated to harmonize service interfaces, metadata and data models, enabling seamless discovery and access to heterogeneous infrastructures and datasets. As an innovation project, ENERGIC-OD will integrate several existing technologies to implement Virtual Hubs as single points of access to geospatial datasets provided by new or existing platforms and infrastructures, including INSPIRE-compliant systems and Copernicus services. ENERGIC OD will deploy a

  6. Health care service for ostomy patients: profile of the clientele

    Directory of Open Access Journals (Sweden)

    Vanessa Damiana Menis Sasaki

    2012-09-01

    Full Text Available The study aimed to identify the profile of ostomy patients in a Health Care Service in São José do Rio Preto, São Paulo, Brazil. This is an exploratory, descriptive and retrospective study. Data were obtained by registration forms of patients assisted from January 1st, 2000, to December 31st, 2010. Out of the 252 ostomy patients, 51.1% were females and 48.9% were males; the age group with the highest concentration was from 68 to 78 years old (26.3% for both genders, with mean age of 73 years old. The main reason for making the stoma was rectal (35.0% and colon neoplasm (14.1%. The prevalent stoma was temporary colostomy (41.4% and the period of permanence of the collecting equipment was longer than 36 months. Even though the service provides full assistance to the ostomy patients, it is necessary to review human resources aspects to provide appropriate assistance to its clientele.O estudo teve como objetivo identificar o perfil de pacientes estomizados de um Serviço de Atenção ao Estomizado de São José do Rio Preto e Região. A pesquisa é exploratória, descritiva e retrospectiva. Os dados foram obtidos das fichas cadastrais dos pacientes atendidos no período de 1º de janeiro de 2000 a 31 de dezembro de 2010. Dos 252 estomizados, 51,1% eram mulheres e 48,9% homens, a faixa etária de maior concentração encontrou-se, em ambos os sexos, entre 68 a 78 anos (26,3% com média de idade de 73 anos. O principal motivo da confecção do estoma foi a neoplasia de reto (35,0% e cólon (14,1%. O estoma prevalente foi a colostomia temporária (41,4% e o tempo de permanência do equipamento coletor foi superior a 36 meses. O Serviço, embora proporcione assistência integral ao estomizado, necessita rever aspectos de recursos humanos à assistência adequada à clientela.

  7. The Impact of Health Service Provider Agreeableness on Care Quality Variation

    OpenAIRE

    Ching-I Teng; Wen-Hsin Hsu

    2012-01-01

    Variation of customer-perceived care quality may trigger customer complaints, negative word of mouth, and reduced revisit behavior; for health services especially, this area warrants additional research. This study investigates whether health service provider agreeableness is related to the variation of customer-perceived care quality. Questionnaires were sent to health service providers and customers in two medical centers. In total, 411 sets of responses were collected, with each one compri...

  8. A semantic cache for enhancing Web services communities activities: Health care case study

    OpenAIRE

    Hela Limam; Jalel Akaichi

    2012-01-01

    Collective memories are strong support for enhancing the activities of capitalization, management and dissemination inside a Web services community. To take advantages of collective memory, we propose an approach for indexing a health care Web services community’s’ resources with semantic annotations explaining and formalizing its informative content. Then we show how the health care Web services community’ members exploit their collective memory by expressing their queries allowing them sear...

  9. Hub discovery in partial correlation graphical models

    CERN Document Server

    Hero, Alfred

    2011-01-01

    This paper treats the problem of screening a p-variate sample for strongly and multiply connected vertices in the partial correlation graph associated with the the partial correlation matrix of the sample. This problem, called hub screening, is important in many applications ranging from network security to computational biology to finance to social networks. In the area of network security, a node that becomes a hub of high correlation with neighboring nodes might signal anomalous activity such as a coordinated flooding attack. In the area of computational biology the set of hubs of a gene expression correlation graph can serve as potential targets for drug treatment to block a pathway or modulate host response. In the area of finance a hub might indicate a vulnerable financial instrument or sector whose collapse might have major repercussions on the market. In the area of social networks a hub of observed interactions between criminal suspects could be an influential ringleader. The techniques and theory pr...

  10. Location of an intermediate hub for port activities

    Science.gov (United States)

    Burciu, Ş.; Ştefănică, C.; Roşca, E.; Dragu, V.; Ruscă, F.

    2015-11-01

    An intermediate hub might increase the accessibility level of ports but also hinterland and so it can be considered more than a facility with a transhipment role. These hubs might lead to the development of other transport services and enhance their role in gathering and covering economic centres within hinterlands and also getting the part of logistic facility for the ports, with effects on port utilization and its connectivity to global economy. A new location for a hub terminal leads to reduced transport distances within hinterland, with decreased transport costs and external effects, so with gains in people's life quality. Because the production and distribution systems are relatively fixed on short and medium term and the location decisions are strategic and on long term, the logistic chains activities location models have to consider the uncertainties regarding the possible future situations. In most models, production costs are considered equal, the location problem reducing itself to a problem that aims to minimize the total transport costs, meaning the transport problem. The main objective of the paper is to locate a hub terminal that links the producers of cereals that are going to be exported by naval transportation with the Romanian fluvial-maritime ports (Galaţi, Brăila). GIS environment can be used to integrate and analyse a great amount of data and has the ability of using functions as location - allocation models necessary both to private and public sector, being able to determine the optimal location for services like factories, warehouses, logistic platforms and other public services.

  11. Using Patient Experiences on Dutch Social Media to Supervise Health Care Services: Exploratory Study

    OpenAIRE

    Belt, T. H.; Engelen, J.L.P.G.; Verhoef, L.M.; Weide, M.J.A. van der; Schoonhoven, Lisette; Kool, R B

    2015-01-01

    Background: social media has become mainstream and a growing number of people use it to share health care-related experiences, for example on health care rating sites. These users’ experiences and ratings on social media seem to be associated with quality of care. Therefore, information shared by citizens on social media could be of additional value for supervising the quality and safety of health care services by regulatory bodies, thereby stimulating participation by consumers. Objectiv...

  12. Demand for Health Care Services in Uganda: Implications for Poverty Reduction

    OpenAIRE

    Kasirye, Ibrahim; Ssewanyana, Sarah; Nabyonga, Juliet; Lawson, David

    2004-01-01

    Using the 2002/03 Uganda National Household Survey data we empirically examine the nature and determinants of individuals' decision to seek care on condition of illness reporting. The major findings include: cost of care is regressive and sustainability reduces the health care utilization for any formal provider by the poorer individuals afters controlling for other factors. In other words, even among public facilities cost of care remains a barrier to utilization of these services. Second, t...

  13. Palliative care services for Indian migrants in Australia: Experiences of the family of terminally Ill patients

    Directory of Open Access Journals (Sweden)

    Sujatha Shanmugasundaram

    2009-01-01

    Full Text Available Background: The way that health care systems in developing countries like India care for dying patients, has an impact on the expectations of such care for those who migrate to other countries faces. At the end of life, cultural issues may impact on the quality of life remaining and for that reason, it is important that particular cultural practices are understood. This paper describes a study that investigated the cultural issues of access to palliative care services for Indian migrants in Australia. Purpose of the Study: To investigate the experiences of the family members of terminally ill Indian migrants in Victoria, Australia. Objective of the Study: To explore the issues related to accessing palliative care services for Indian migrants; to identify the effectiveness of palliative care in supporting the patient and family and to recommend strategies for improving this care. Materials and Methods: A qualitative descriptive design was utilized. Up to 6 family members were selected for in-depth interviews in understanding cultural issues related to the palliative care services for a family member. Results: Analysis of the interviews revealed that families of Indian patients experience difficulties whilst receiving palliative care services, which fell into three main categories: Indian support systems, cultural issues, and caring experiences. Although each of these issues had a direct influence on the experience of terminal care that their family member received, cultural issues and support systems also influenced the caring experiences. Conclusion: Despite the successful implementation of palliative care services across Australia, there are still problems in accessing and receiving the services among minority and disadvantaged groups like various cultural groups.

  14. Traveling abroad for medical care: U.S. medical tourists' expectations and perceptions of service quality.

    Science.gov (United States)

    Guiry, Michael; Vequist, David G

    2011-01-01

    The SERVQUAL scale has been widely used to measure service quality in the health care industry. This research is the first study that used SERVQUAL to assess U.S. medical tourists' expectations and perceptions of the service quality of health care facilities located outside the United States. Based on a sample of U.S. consumers, who had traveled abroad for medical care, the results indicated that there were significant differences between U.S. medical tourists' perceived level of service provided and their expectations of the service that should be provided for four of the five dimensions of service quality. Reliability had the largest service quality gap followed by assurance, tangibles, and empathy. Responsiveness was the only dimension without a significantly different gap score. The study establishes a foundation for future research on service quality in the rapidly growing medical tourism industry. PMID:21815742

  15. Supply and demand for long-term care services from the perspective of leaders of health care institutions1

    Science.gov (United States)

    Samoliński, Bolesław

    2015-01-01

    Introduction Poland's transition into the stage of intensive population aging imposes changes in demand for different forms of care (including long-term). The proportion of dependent persons (requiring care) in the population continues to increase. The number of people aged 80 and above (in 2013 – 1.48 million) will double by 2050 and reach 3.54 million. The research objective was to gain knowledge on the supply and demand of different institutionalized forms of care services from the healthcare system perspective. Material and methods A computer-assisted personal interview (CAPI) survey was carried out on a Poland-wide quota sample of health care and nursing centres operating within the healthcare system. The respondent group consisted of 96 directors of health care facilities. Results In the opinion of more than a half of surveyed directors, supply of health care and nursing centres in their region is insufficient in terms of the needs of both patients and elderly people. In the context of patients, the deficit is observed primarily in health care and treatment centres, long-term nursing care and health care institutions, whereas for the elderly people the main concern is availability of nursing care, day care or social aid centres. More than half of surveyed institutions admit patients requiring care on an ongoing basis; however, in the case of health care and treatment centres more than a year-long waiting time proved to be a frequent phenomenon. In the opinion of the surveyed directors, the key factors influencing the number of available places and waiting time are insufficient financing and personnel deficit. Conclusions Introduction of multiple changes to the operation of the care system in Poland is necessary in order to improve its availability, effectiveness and quality. Achievement of this objective requires implementation of a cohesive and integrated system dedicated to monitoring and diagnosing both the supply and demand for different forms of care

  16. Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

    Directory of Open Access Journals (Sweden)

    Burnham Gilbert

    2011-12-01

    Full Text Available Abstract Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are

  17. A systematic review of different models of home and community care services for older persons

    Directory of Open Access Journals (Sweden)

    Brodaty Henry

    2011-05-01

    Full Text Available Abstract Background Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia. Methods A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, Scopus and PubMed were searched from 1994 to May 2009. Two researchers independently reviewed search results. Results Thirty five papers were included in this review. Evidence from randomized controlled trials showed that case management improves function and appropriate use of medications, increases use of community services and reduces nursing home admission. Evidence, mostly from non-randomized trials, showed that integrated care increases service use; randomized trials reported that integrated care does not improve clinical outcomes. The lowest quality evidence was for consumer directed care which appears to increase satisfaction with care and community service use but has little effect on clinical outcomes. Studies were heterogeneous in methodology and results were not consistent. Conclusions The outcomes of each model of care differ and correspond to the model's focus. Combining key elements of all three models may maximize outcomes.

  18. Standards for Psychological Services in Long-Term Care Facilities.

    Science.gov (United States)

    Morrow-Howell, Nancy; Lichtenberg, Peter A.; Smith, Michael; Frazer, Deborah; Molinari, Victor; Rosowsky, Erlene; Crose, Royda; Stillwell, Nick; Kramer, Nanette; Hartman-Stein, Paula; Qualls, Sara; Salamon, Michael; Duffy, Michael; Parr, Joyce; Gallagher-Thompson, Dolores

    1998-01-01

    Describes the development of standards for psychological practice in long-term care facilities. The standards, which were developed by Psychologists in Long-Term Care, address provider characteristics, methods of referral, assessment practices, treatment, and ethical issues. Offers suggestions for use of the standards. (MKA)

  19. Providing Perinatal Mental Health Services in Pediatric Primary Care

    Science.gov (United States)

    Talmi, Ayelet; Stafford, Brian; Buchholz, Melissa

    2009-01-01

    After birth, newborns and their caregivers are seen routinely and frequently in pediatric primary care settings. The close succession of visits in the first few months of life puts pediatric primary care professionals in a unique position to enhance infant mental health by developing strong relationships with caregivers, supporting babies and…

  20. Managing cultural diversity in the workplace (care homes and cleaning services

    OpenAIRE

    Noamesi, Paul; Tetteh, Theodora

    2015-01-01

    This study examines how cultural diversity is managed in the work environment in care homes and cleaning services in Finland. The health care and cleaning services sectors were chosen primarily due to the high number of immigrants working in these sectors. The Finnish Labour Ministry pro-jects that the number of immigrant workers will increase by the year 2025 particularly in the health care and other services sectors due to the aging population of the Finnish labour force and the low birth r...

  1. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    OpenAIRE

    Dale, Bjørg; Hvalvik, Sigrun

    2013-01-01

    BACKGROUND: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes. METHODS: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway par...

  2. Measuring efficiency in health care: an application to out of hours primary care services in the island of Ireland

    OpenAIRE

    Grace Lordan

    2007-01-01

    This paper is a cross border study that explores isolating the efficiency component and measuring its overall contribution to productivity in the case of out of hours (OOH) primary care services operating on the Island of Ireland. Out of hours GP care is supplied throughout the Island of Ireland by OOH co-operatives. Although Northern Ireland (NI) and the Republic of Ireland (ROI) have their own individual health systems the OOH organisations themselves are relatively homogenous in structure....

  3. A systematic review of different models of home and community care services for older persons

    OpenAIRE

    Brodaty Henry; Yap Melvyn; Low Lee-Fay

    2011-01-01

    Abstract Background Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia. Methods A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, ...

  4. An exploratory study of services marketing in global markets: major areas of inquiry for the health care services industry.

    Science.gov (United States)

    Young, S; Erdem, S A

    1996-01-01

    It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research. PMID:10163027

  5. Service Quality of Delivered Care from the Perception of Women with Caesarean Section and Normal Delivery

    OpenAIRE

    Jafar S Tabrizi; Samira Askari; Zahra Fardiazar; Hossein Koshavar; Kamal Gholipour

    2014-01-01

    Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women‟s...

  6. Older adults’ home- and community-based care service use and residential transitions: a longitudinal study

    OpenAIRE

    Chen Ya-Mei; Berkowitz Bobbie

    2012-01-01

    Abstract Background As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults’ use of home- and...

  7. Sources of helicopter rotor hub inplane shears

    Science.gov (United States)

    Kottapalli, Sesi

    1993-01-01

    Sources of helicopter rotor hub inplane shears are identified using simplified equations and the full aeroelastic analysis code, CAMRAD/JA (Johnson, 1988). Analytical results are obtained for an articulated rotor operating at moderate thrust and high airspeed. It is found that the blade chordwise inplane shear, which includes the aerodynamic component, the Coriolis contribution, and the inertial component, and the hub inplane shears are strongly dependent on the out-of-plane response. The sources of helicopter rotor hub inplane shears lie not only in the inplane response but depend on the flap and elastic flatwise responses/modes.

  8. Analysis of Wheel Hubs : Student Car

    OpenAIRE

    Rincón García, Jesús

    2014-01-01

    The aim of this thesis work is to do the study and analysis of Student Car wheel hubs. The first part is a briefing of the “StudentCar” competition and a short explanation of the problem. Also it talks about the information and files that the team have about their hubs. After that, the document has short information about the basics knowledge of Strength of Materials necessary for to do the analysis in hubs and information about the material used by the team (Aluminum Alloy 7075-T6). ...

  9. The effect of Value Added Tax change on health care services

    OpenAIRE

    Ylämö, Katja

    2016-01-01

    The aim of this thesis was to examine the effect of value added tax (VAT) change on certain health care services. VAT is a consumption tax which is added on the value of goods and services. The Finnish Tax Administration changed the value added tax (VAT) on Health care services and personnel renting (Terveydenhuollon työvoiman luovutus) to 0% instead of the previous 24% on 19 December 2013. Based on the same decision, VAT on some services such as aesthetic surgery rose from 0% to 24%. Th...

  10. Family Day Care Mothers Work Together to Improve Services

    Science.gov (United States)

    Sale, June Solnit

    1975-01-01

    Describes the history of Women Attentive to Children's Happiness (WATCH), a self-help organization of family day care mothers which has developed an effective method of producing developmental programs for children and families. (ED)

  11. Mental health service provision for adults with intellectual disability: sources of referrals, clinical characteristics and pathways to care

    OpenAIRE

    Tsakanikos, Elias

    2006-01-01

    There is a certain amount of ambiguity and confusion over the provision of mental health services for people with intellectual disabilities (ID) referred by both primary care services (Primary Care (PC) / Social Services (SS)) and secondary care services (Generic Mental Health Services (GMHS)). Psychosocial and clinical characteristics of new referrals (N = 791) were compared with regard to their source of referral. GMHS referrals were more likely to have schizophrenia spectrum disorder, pers...

  12. Accessibility to primary health care services in the state of Goiás

    Directory of Open Access Journals (Sweden)

    Juliana Pires Ribeiro

    2015-09-01

    Full Text Available The objective of this study was to evaluate accessibility to primary health care services in the state of Goiás. A descriptive cross-sectional study was conducted based on secondary data from the National Program to Improve Access to and Quality of Primary Health Care. The study sample was composed of health professionals from 1,216 primary health care units. Results showed that 68.5% of the health units miss a screening room, thus considerably damaging prompt decision-making by professionals. The lack of medical offices in 2% of the sites hinders the primary health care services accessibility in Goiás. As regards opening hours and work shifts, 86% of the units are open five days a week in eight-hour shifts, which does not favor accessibility for users. This study confirms the lack of accessibility to health services and the need for additional investments to strengthen primary health care.

  13. Bundling Post-Acute Care Services into MS-DRG Payments

    Data.gov (United States)

    U.S. Department of Health & Human Services — A bundled hospital payment system that encompasses both acute and post-acute care has been proposed as a means of creating financial incentives in the Medicare...

  14. Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

    Directory of Open Access Journals (Sweden)

    N. Mlenzana

    2012-12-01

    Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction

  15. Mental Health Care in a High School Based Health Service.

    Science.gov (United States)

    Jepson, Lisa; Juszczak, Linda; Fisher, Martin

    1998-01-01

    Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…

  16. General practitioners' use and experiences of palliative care services: a survey in south east England

    Directory of Open Access Journals (Sweden)

    Higginson Irene J

    2008-11-01

    Full Text Available Abstract Background The role of the General Practitioner (GP is central to community palliative care. Good liaison between the different professionals involved in a patient's care is extremely important in palliative care patients. In cases where GPs have previously been dissatisfied with palliative services, this may be seen as a barrier to referral when caring for other patients. The aim of this survey is to investigate the use and previous experiences of GPs of two palliative care services, with particular emphasis on barriers to referral and to explore issues surrounding the GP's role in caring for palliative patients. Methods Design: Descriptive postal survey of use and experience of palliative care services with particular emphasis on barriers to referral. Setting: One Primary Care Trust (PCT, south London, England, population 298,500. Subjects: 180 GPs in the PCT, which is served by two hospice services (A&B. Results An overall questionnaire response rate of 77% (138 was obtained, with 69% (124 used in analysis. Over 90% of GPs were satisfied with the palliative care services over the preceding two years. Two areas of possible improvement emerged; communication and prescribing practices. GPs identified some patients that they had not referred, most commonly when patients or carers were reluctant to accept help, or when other support was deemed sufficient. Over half of the GPs felt there were areas where improvement could be made; with clarification of the rules and responsibilities of the multi disciplinary team being the most common. The majority of GPs were working, and want to work with, the specialist services as part of an extended team. However, a greater number of GPs want to hand over care to the specialist services than are currently doing so. Conclusion A large number of GPs were happy with the service provision of the palliative care services in this area. They suggested that 3 out of 4 terminally ill patients needed specialist

  17. Characteristics of collaborative care in increasing access to mental health service in the Asian community.

    Science.gov (United States)

    Sung, Jeehee; Mayo, Nicolle; Ko, Mei-Ju; Lasley, Chandra

    2013-09-01

    This study examined the use of thematic analysis to determine how characteristics of collaborative care facilitate accessibility to mental health services among the Asian community in the United States. This investigation explored characteristics of collaborative care in patient treatment, barriers that prevent the Asian community from utilizing care, and how collaborative settings can facilitate mental health care access in the Asian community. Mental health providers with relevant experiences in collaborative care were recruited through snowball sampling to participate in a telephone interview with the researchers. The results suggested a collectivistic culture, valuing authority, acculturation, language, and stigma as themes of Asian patients as well as key providers (mental and medical health providers), colocation, the physician's leading role, the provider's language, and collaboration among providers as themes for collaborative care. The study suggests that collaborative care's foundational characteristics can promote easier access to mental health care for the Asian community. PMID:23937434

  18. What influences patients’ acceptance of a blood pressure telemonitoring service in primary care? A qualitative study

    Directory of Open Access Journals (Sweden)

    Abdullah A

    2016-01-01

    Full Text Available Adina Abdullah,1 Su May Liew,1 Nik Sherina Hanafi,1 Chirk Jenn Ng,1 Pauline Siew Mei Lai,1 Yook Chin Chia,1 Chu Kiong Loo2 1Department of Primary Care Medicine, Faculty of Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia Background: Telemonitoring of home blood pressure (BP is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients’ acceptance of such service in routine clinical care.Objective: This study aimed to explore patients’ acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM.Methods: A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis.Results: Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and

  19. The home health care routing and scheduling problem with interdependent services.

    Science.gov (United States)

    Mankowska, Dorota Slawa; Meisel, Frank; Bierwirth, Christian

    2014-03-01

    This paper presents a model for the daily planning of health care services carried out at patients' homes by staff members of a home care company. The planning takes into account individual service requirements of the patients, individual qualifications of the staff and possible interdependencies between different service operations. Interdependencies of services can include, for example, a temporal separation of two services as is required if drugs have to be administered a certain time before providing a meal. Other services like handling a disabled patient may require two staff members working together at a patient's home. The time preferences of patients are included in terms of given time windows. In this paper, we propose a planning approach for the described problem, which can be used for optimizing economical and service oriented measures of performance. A mathematical model formulation is proposed together with a powerful heuristic based on a sophisticated solution representation. PMID:23780750

  20. Changing the Graduate Medical Education Funding Path to Reduce the Price of Health Care Services.

    Science.gov (United States)

    Martin, Ralph A

    2015-01-01

    An analysis of the current Graduate Medical Education (GME) funding stream reveals undesired aspects that limit the number of graduates and may tend to raise the price of health care services. The author shows that a different model of GME funding changes the economic dynamics and takes advantage of economic forces to increase the supply of graduates, while potentially reducing the price of health care services. PMID:26731880

  1. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration

    OpenAIRE

    Sperber, Nina R.; Sara M. Andrews; Voils, Corrine I.; Gregory L. Green; Dawn Provenzale; Sara Knight

    2016-01-01

    We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by tw...

  2. Income inequality, disinvestment in health care and use of dental services

    OpenAIRE

    Bhandari, Bishal; Newton, Jonathan T; Bernabé, Eduardo

    2015-01-01

    Objective To explore the interrelationships between income inequality, disinvestment in health care, and use of dental services at country level. Methods This study pooled national estimates for use of dental services among adults aged 18 years or older from the 70 countries that participated in the World Health Survey from 2002 to 2004, together with aggregate data on national income (GDP per capita), income inequality (Gini coefficient), and disinvestment in health care (total health expend...

  3. Who pays for and who benefits from health care services in Uganda?

    OpenAIRE

    Kwesiga, Brendan; Ataguba, John E.; Abewe, Christabel; Kizza, Paul; Zikusooka, Charlotte M

    2015-01-01

    Background Equity in health care entails payment for health services according to the capacity to pay and the receipt of benefits according to need. In Uganda, as in many African countries, although equity is extolled in government policy documents, not much is known about who pays for, and who benefits from, health services. This paper assesses both equity in the financing and distribution of health care benefits in Uganda. Methods Data are drawn from the most recent nationally representativ...

  4. Integrating regional and community lung cancer services to improve patient care

    OpenAIRE

    Dahele, M.; Ung, Y.; Meharchand, J.; Shulman, H.; Zeldin, R.; Behzadi, A.; Simone, C; Cheng, S.; Weigensberg, C.; Sivjee, K.

    2007-01-01

    Lung cancer is the leading cause of cancer death in Canada. The organization of health care services is central to the delivery of accessible, high-quality medical care and may be one factor that influences patient outcome. An exciting opportunity arose for clinicians to initiate the redesign of lung cancer services provided by three institutions in the Greater Toronto Area. This qualitative report describes the integrated lung cancer network that they developed, the innovation it has facilit...

  5. Developing new ways of measuring the impact of ambulance service care

    OpenAIRE

    Turner, Janette; Coster, Joanne; Wilson, Richard; Siriwardena, A Niroshan; Phung, Viet-Hai

    2014-01-01

    Background Pre-hospital care in England is provided by ambulance services who deliver a diverse range of services to over 9 million patients a year but there is limited evidence about the effectiveness of this care. Historically ambulance performance has been measured by response times rather than clinical need or effectiveness. Progress on developing more appropriate performance measures is constrained by a lack of information about what happens to patients and their outcome after the pre...

  6. A new horizon for planning services and health care infrastructure for the elderly

    OpenAIRE

    Nauta, N.J.; Perenboom, R.J.M.; Galindo Garre, F.

    2009-01-01

    Since the devolution of capacity planning for care for the elderly in the Netherlands in 1998, no innovations on assessing health needs and on forecasting were made for planning health care services for the elderly. The introduction of Horizon in 2006, which uses needs and deficiencies instead of linear demographic planning has been warmly welcomed. The innovation is to step away from planning on the basis of policies and to forecast demands of services on the basis of actual deficiencies and...

  7. Provision of critical care services for the obstetric population.

    Science.gov (United States)

    Sultan, P; Arulkumaran, N; Rhodes, A

    2013-12-01

    Management of the peripartum patient is a challenging aspect of critical care that requires consideration of both the physiological changes associated with pregnancy as well as the well-being of the foetus. In the UK, for every maternal death, approximately 118 near-miss events or severe acute maternal morbidities (SAMMs) occur. While a dedicated anaesthetic cover is usually provided on larger labour wards in the UK and US, a close communication with intensive care and other medical specialties must still be maintained. Medical outreach teams and early warning scores may help facilitate the early identification of clinical deterioration and prompt treatment. Ultimately level of care is allocated according to the clinical need, not the location, which may be a designated room, a normal labour room or a recovery area. Specialist obstetric units that provide high-dependency care facilities show lower rates of maternal transfer to critical care units and improved continuity of care before and after labour. The benefits of obstetric high-dependency units (HDUs) are likely to be determined by a number of logistic aspects of the hospital organisation, including hospital size and available resources. There remains a striking contrast in the burden of maternal mortality and morbidity and intensive care unit (ICU) resources between high- and low-income countries. The countries with the highest maternal mortality rates have the lowest number of ICU beds per capita. In under-resourced countries, patients admitted to ICUs tend to have higher illness severity scores, suggesting delayed admission to the ICU. The appropriate training of midwives is essential for successful HDUs located within labour wards. PMID:23972289

  8. [The network of mental health care from the family health strategy service].

    Science.gov (United States)

    Wetzel, Christine; de Pinho, Leandro Barbosa; Olschowsky, Agnes; Guedes, Ariane da Cruz; Camatta, Marcio Wagner; Schneider, Jacó Fernando

    2014-06-01

    The Family Health Strategy Service (FHSS) is an important ally in the mental health system, contributing to the completeness and effectiveness of care. This study aimed to discuss the mental health care network as compared to the daily routine of an FHSS. It is an evaluative study with a qualitative methodological approach. It was developed in an FHSS in Porto Alegre-RS, Brazil. Data was collected between July and December of 2010 through interviews with 16 workers and ten relatives. We identified important resources in primary health care, such as partnerships with academia. However, the constitution of this care is still based on specialty, following the logic of patient referral. Our intention for this study was to contribute to the operationalization of the mental health care network, consolidating the partnership with the FHSS and developing activities in the territorial space, raising awareness, demystifying health care service in the area, and countering the perception that it is uniquely specialized. PMID:25158457

  9. 75 FR 21301 - Office of Clinical and Preventive Services; Elder Care Initiative Long-Term Care Grant Program

    Science.gov (United States)

    2010-04-23

    ...-term care services for American Indians and Alaska Native (AI/AN) elders. This program is authorized...). Background The AI/AN elder population is growing rapidly and the AI/AN population as a whole is aging. The... dignity. While families continue to be the backbone of LTC for AI/AN elders, there is well documented...

  10. Solomon Islands: Malaita Hub scoping report

    OpenAIRE

    Schwarz, A.M.; Andrew, N.; Govan, H.; Harohau, D.; Oeta, J.

    2013-01-01

    The CGIAR Research Program (CRP) Aquatic Agricultural Systems (AAS) will target five countries, including Solomon Islands. The proposed hubs for Solomon Islands were to cover most provinces, referencing the Western, Central and Eastern regions. Scoping of the initial ‘Central’ hub was undertaken in Guadalcanal, Malaita and Central Islands provinces and this report details findings from all three. As scoping progressed however, it was agreed that, based on the AAS context and priority need...

  11. Norway – a global maritime knowledge hub

    OpenAIRE

    Reve, Torger

    2009-01-01

    Knowledge based industrial development takes place in Global Knowledge Hubs or superclusters characterized by a high concentration of innovative industrial actors interacting closely with advanced research institutions, venture capital and competent ownership. The extreme example of a global knowledge hub is the biotech and life science industry in Boston. The greater Boston area has a higher concentration of advanced universities, research labs and specialized biotech firms, than anywhere el...

  12. GitHub como herramienta docente

    OpenAIRE

    Francisco J. Lopez-Pellicer; Béjar, Rubén; Latre, Miguel A.; Nogueras-Iso, Javier; Zarazaga-Soria, Francisco Javier

    2015-01-01

    Resumen: El sistema de control distribuido de versiones Git se ha convertido en una herramienta esencial para manejar proyectos de software. Uno de los motivos de la creciente popularidad de Git es el éxito de GitHub, una plataforma Web de desarrollo colaborativo basada en Git. GitHub ofrece toda la funcionalidad de Git e integra diversas herramientas de control de acceso, colaboración, trazabilidad, gestión de tareas y control de proyectos. Recientemente, educadore...

  13. International Airline Hubbing in a Competitive Environment

    OpenAIRE

    Hansen, Mark M.; Kanafani, Adib

    1987-01-01

    Changes in the U.S. domestic airline route system have increased competition between international gateways. To assist in understanding this phenomenon, a system of models that predicts airline passenger flows resulting from different airline gateway hubbing strategies has been developed. The calibrated models predict baseline passenger flows quite accurately. The system was then used to project future traffic at a specific airport under alternative hubbing strategies of an airline. The resul...

  14. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Science.gov (United States)

    2010-07-01

    ... reasons enumerated in 38 CFR 17.47(i)(2). (Authority: 38 U.S.C. 1724) Enrollment Provisions and Medical... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  15. Access to and Use of Eye Care Services in Rural Arkansas

    Science.gov (United States)

    Kilmer, Greta; Bynum, LaTonya; Balamurugan, Appathurai

    2010-01-01

    Context: Rural residents are more likely to be uninsured and have low income. Purpose: To determine if rural residents in Arkansas have decreased access to eye care services and use them less frequently than urban residents. Methods: Data from the 2006 Visual Impairment and Access to Eye Care Module from the Arkansas Behavioral Risk Factor…

  16. Interest in Long-Term Care among Health Services Administration Students

    Science.gov (United States)

    Temple, April; Thompson, Jon M.

    2011-01-01

    The aging of the population has created increased opportunities for health administrators in long-term care. This study consisted of a cross-sectional survey of 68 undergraduate health services administration students to explore factors related to interest in a career in long-term care administration. One third expressed interest working in the…

  17. Child Development: Day Care. 6. Health Services: A Guide for Project Directors and Health Personnel.

    Science.gov (United States)

    North, A. Frederick, Jr.

    This manual is written to help day care directors, physicians, and others concerned with the health of children in day care to plan and carry out a group of services that will meet the health needs of children and their parents. It is divided into three parts. Part One is primarily concerned with Planners and Project Directors, and includes…

  18. Medical Service Utilization among Youth with School-Identified Disabilities in Residential Care

    Science.gov (United States)

    Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald

    2016-01-01

    Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with…

  19. Increased utilization of health care services after psychotherapy: a register based study

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Poulsen, Stig Bernt; Mortensen, Erik Lykke;

    2012-01-01

    Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... long-term period psychotherapy patients increased their utilization of health care services with a factor 3 compared to a control group....

  20. Assessment of distress with physical and psychological symptoms of patients in german palliative care services.

    OpenAIRE

    Neuwöhner, Karl; Lindena, Gabriele

    2011-01-01

    BACKGROUND: Within the framework of the nationwide Hospice and Palliative Care Evaluation (HOPE), the German Basic Documentation for Psycho-oncology (PO-Bado) was used from 2004 to 2006 as an optional module in most participating palliative care services to investigate how patient distress due to symptom burdens in different palliative care settings should be assessed and how professional interventions could be derived. PATIENTS AND METHODS: The distress scores of 3,317 PO-Bado records o...

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

    OpenAIRE

    Farooq, Fizzah; Khan, Robyna; Ahmed, Aliya

    2016-01-01

    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 dem...

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

    OpenAIRE

    Fizzah Farooq; Robyna Khan; Aliya Ahmed

    2016-01-01

    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 de...

  3. ICT Enabled Business Model to Modern China Elderly-care Service

    OpenAIRE

    Yan, Ke

    2015-01-01

    The aging population was becoming an unavoidable global problem especially in the largest developing country, China in past 20 years. Apparently the traditional elderly-care approach has been being lowly productive and leading more and more social problems by time. But in the other hand, it is a great opportunity to the modern elderly-care business vendors world-widely to introducing new innovative ICT enabled elderly-care services. To understand the true demands in the market and identify a ...

  4. Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

    Science.gov (United States)

    ... icio.us Digg Facebook Google Bookmarks Women’s Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for ... are delivered by a network provider. Women's Preventive Services Guidelines Supported by the Health Resources and Services ...

  5. Why Care About Aquatic Insects: Uses, Benefits, and Services

    Science.gov (United States)

    Mayflies and other aquatic insects are common subjects of ecological research, and environmental monitoring and assessment. However, their important role in protecting and restoring aquatic ecosystems is often challenged, because their benefits and services to humans are not obv...

  6. Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Kwedza Ru K

    2011-03-01

    Full Text Available Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4 were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal

  7. Princeton HealthCare System name reflects comprehensive services. New brand identity focuses on 'Redefining Care'.

    Science.gov (United States)

    Botvin, Judith D

    2004-01-01

    The Medical Center at Princeton, Princeton, N.J., introduced its new name last June, both to its community and its internal stakeholders. It is now known as Princeton HealthCare System, a name chosen to reflect its growth and diversity. It's being branded as a unique institution that combines the sensitive, caring serice of a community hospital with the sophisticated care of a teaching hospital. PMID:15162577

  8. Priorities for health services research in primary care.

    NARCIS (Netherlands)

    Schäfer, W.; Groenewegen, P.P.; Hansen, J.; Black, N.

    2011-01-01

    Background: All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would be

  9. Adult Basic Education. Child Care, Transportation, Support Services Workbook.

    Science.gov (United States)

    Porter, Deborah; Morris, Jamie, Ed.

    This workbook focuses on two primary needs of adult basic education (ABE) students--child care and transportation--and provides ideas to assist program administrators (especially in Texas) to develop appropriate, workable, community-based strategies to meet these needs. The book contains five chapters. Each chapter addresses a particular aspect of…

  10. Providing Outreach Services in a Rural Setting Utilizing a Multidisciplinary Team: The CARES Project.

    Science.gov (United States)

    Page, Charles M.; And Others

    1985-01-01

    The CARES project (Coordinated Ambulatory Rehabilitation Evaluation Services) presents a model to provide multidisciplinary services for multiply disabled children in rural settings. Background, information about model components, and descriptive data are presented to illustrate project evolution and operation. Nearly 400 children with multiple…

  11. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S. EXCHANGE VISITOR PROGRAM-REQUEST FOR WAIVER OF THE TWO-YEAR FOREIGN RESIDENCE REQUIREMENT § 50.5...

  12. Patient Views on Three Key Service Areas within Hospital COPD Care

    Science.gov (United States)

    Roberts, C. Michael; Seiger, Anil; Ingham, Jane

    2009-01-01

    Objective: The views of patients with Chronic Obstructive Pulmonary Disease (COPD) about three key services (non-invasive ventilation [NIV], early discharge schemes and rehabilitation) were sought in order to inform recommendations for the delivery of optimum care within a national programme of hospital COPD service development. Design: Four focus…

  13. Agency Ownership, Patient Payment Source, and Length of Service in Home Care, 1992-2000

    Science.gov (United States)

    Han, Beth; McAuley, William J.; Remsburg, Robin E.

    2007-01-01

    Purpose: Little is known about whether an association exists between agency ownership and length of service among home care patients with different payment sources. This study investigated how for-profit and not-for-profit agencies responded to policy changes in the 1990s with respect to length of service. Design and Methods: We examined length of…

  14. Comparison between two mobile pre-hospital care services for trauma patients

    OpenAIRE

    Gonsaga Ricardo; Brugugnolli Izabela; Fraga Gustavo

    2012-01-01

    Abstract Objectives Pre-hospital care (PH) in Brazil is currently in the phase of implementation and expansion, and there are few studies on the impacts of this public health service. The purpose of this study is to assess the quality of care and severity of trauma among the population served, using trauma scores, attendance response times, and mortality rates. This work compares two pre-hospital systems: the Mobile Emergency Care Service, or SAMU 192, and the Fire Brigade Group, or CB. Metho...

  15. Patient Satisfaction with Health Care Services Provided at HIV Clinics at Amana and Muhimbili Hospitals in Dar es Salaam.

    OpenAIRE

    Kagashe, G A B; Rwebangila, F

    2011-01-01

    Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided. To determine satisfaction of HIV patients with health care services provided at the HIV clinics and specifically, to determine patients' satisfaction with the general physical environment o...

  16. A review of factors influencing the utilization of eye care services

    OpenAIRE

    M. D. Ntsoane; O. A. Oduntan

    2010-01-01

    Visual impairment (low vision and blindness) is a major health concern all over the world. Three main reasons for the high prevalence of visual impairment are non-availability, non-accessibility andnon-affordability of eye care services. However, there are several factors that may act as barriers to the use of available, accessible and affordable eye care services. These include the lack of knowledge of the services, lack of knowledge of the possible impact of an eye disease and lack of knowl...

  17. The Use of Smartphones in Norwegian Social Care Services.

    Science.gov (United States)

    Hansen, Linda Iren Mihaila; Fruhling, Ann; Fossum, Mariann

    2016-01-01

    This study aims to understand how smartphone technology was perceived by social workers responsible for piloting social services software and the experiences of involving end-users as co-developers. The pilot resulted in an improved match between the smartphone software and workflow as well as mutual learning experiences among the social workers, clients, and the vendor. The pilot study revealed several graphical user interface (GUI) and functionality challenges. Implementing an ICT social service smartphone application may further improve efficiencies for social workers serving citizens, however; this study validates the importance to study end-users' experiences with communication and the real-time use of the system in order reap the anticipated benefits of ICT capabilities for smart phone social service applications. PMID:27577375

  18. Mental health service users' experiences of mental health care: an integrative literature review.

    Science.gov (United States)

    Newman, D; O'Reilly, P; Lee, S H; Kennedy, C

    2015-04-01

    A number of studies have highlighted issues around the relationship between service users and providers. The recovery model is predominant in mental health as is the recognition of the importance of person-centred practice. The authors completed an in-depth search of the literature to answer the question: What are service users' experiences of the mental health service? Three key themes emerged: acknowledging a mental health problem and seeking help; building relationships through participation in care; and working towards continuity of care. The review adds to the current body of knowledge by providing greater detail into the importance of relationships between service users and providers and how these may impact on the delivery of care in the mental health service. The overarching theme that emerged was the importance of the relationship between the service user and provider as a basis for interaction and support. This review has specific implications for mental health nursing. Despite the recognition made in policy documents for change, issues with stigma, poor attitudes and communication persist. There is a need for a fundamental shift in the provider-service user relationship to facilitate true service-user engagement in their care. The aim of this integrative literature review was to identify mental health service users' experiences of services. The rationale for this review was based on the growing emphasis and requirements for health services to deliver care and support, which recognizes the preferences of individuals. Contemporary models of mental health care strive to promote inclusion and empowerment. This review seeks to add to our current understanding of how service users experience care and support in order to determine to what extent the principles of contemporary models of mental health care are embedded in practice. A robust search of Web of Science, the Cochrane Database, Science Direct, EBSCO host (Academic Search Complete, MEDLINE, CINAHL Plus

  19. Dental care in geriatric patients—a cross-sectorial service

    OpenAIRE

    Lerch, Michael; Mertens, Matthias; Decker-Maruska, Mechthild

    2010-01-01

    Purpose Evaluation of a customer-designed dental service network across the service sectors for geriatric patients. Context The lack in accessibility of dental services and the non-awareness of possible dental causes to medical problems by clinicians often prevents the geriatric patient from receiving the dental care needed. In cooperation with the Dental Board a geriatric dentist was appointed, multi-professional rounds, training in oral hygiene organized and a documentation system for cross...

  20. Caregiver Participation in Community-based Mental Health Services for Children Receiving Outpatient Care

    OpenAIRE

    Fawley-King, Kya; Haine-Schlagel, Rachel; Trask, Emily V.; Zhang, Jinjin; Garland, Ann F

    2013-01-01

    Caregiver participation in child mental health treatment has been associated with better youth outcomes, but little is known about the amount and type of caregiver participation in usual care services for children. This study examined 1255 caregivers’ reports of their participation in the outpatient services their children received through a large, public mental health system in the Southwest. The majority of the caregivers reported that they participated in their child's services. Extent of ...

  1. The relationship between staff skill mix, costs and outcomes in intermediate care services

    Directory of Open Access Journals (Sweden)

    Martin Graham P

    2010-07-01

    Full Text Available Abstract Background The purpose of this study was to assess the relationship between skill mix, patient outcomes, length of stay and service costs in older peoples' intermediate care services in England. Methods We undertook multivariate analysis of data collected as part of the National Evaluation of Intermediate Care Services. Data were analysed on between 337 and 403 older people admitted to 14 different intermediate care teams. Independent variables were the numbers of different types of staff within a team and the ratio of support staff to professionally qualified staff within teams. Outcome measures include the Barthel index, EQ-5D, length of service provision and costs of care. Results Increased skill mix (raising the number of different types of staff by one is associated with a 17% reduction in service costs (p = 0.011. There is weak evidence (p = 0.090 that a higher ratio of support staff to qualified staff leads to greater improvements in EQ-5D scores of patients. Conclusions This study provides limited evidence on the relationship between multidisciplinary skill mix and outcomes in intermediate care services.

  2. Public hospitals and substance abuse services for pregnant women and mothers: Implications for managed-care programs and medicaid

    OpenAIRE

    Andrulis, Dennis; Hopkins, Sarah

    2001-01-01

    Although an increasing proportion of the US population receives health services through managed care, pregnant women and mothers eligible for Medicaid who are involved with alcohol or other drugs are often excluded from these programs due in large part to lack of information on costs, service needs, and service use. To develop such information policy, service settings, and managed-care plans, the project conducted a national survey using a provider group with experience in caring for this pop...

  3. Awareness and utilization of preventive care services among the elderly under National Health Insurance.

    Science.gov (United States)

    Chen, Chun-Chih; Lin, Yen-Ju; Lin, Ying-Tzu

    2013-12-01

    This empirical study investigates the factors affecting the awareness and the utilization of preventive care among the elderly in Taiwan. We use data obtained from the 2005 National Health Interview Survey. A recursive bivariate probit model is adopted to analyze the factors affecting the awareness and the utilization of preventive care. The probability of awareness of free preventive care under the National Health Insurance is higher for those who are younger, Mainlanders, have received more education, have a spouse, exercise regularly, have better self-rated health status, and have chronic diseases; the probability of awareness is lower for those who are aborigines and who live in the south and the east. Awareness of preventive care services, having a spouse, living alone, having better health status, and the existence of chronic diseases increase the probability of preventive care utilization; working reduces the probability of preventive care utilization. Our result supports the views in Arrow (Am Econ Rev 53(5):941-973, 1963) that health information is an important factor determining the demand for medical care. Policymakers may enhance such preventive care service utilization by increasing the awareness of such services among the elderly. PMID:23754318

  4. Mobile economics and pricing of health care services.

    Science.gov (United States)

    Huttin, Christine C

    2012-01-01

    This paper presents tools and concepts to analyze the business environment of the biopharmaceutical industry. It was presented at MEDETEL 2010. Emerging paradigms appear in that industry and new ways to value life science technologies are developed especially using mobile economics analysis. At a time, mobile computing technologies revolutionize the field of health care, this paper contributes to show how the value chain concept can be useful to analyze the value system in a mobile computing environment. It is also a milestone for the designs of future technology platforms and of health care infrastructure, in order to retain enough value between innovators, new and traditionnal players from life science, IT and other new comers, in a fragmented global competitive environment. PMID:23079949

  5. Implementation of operational meteorological information service for CARE REMDAS

    International Nuclear Information System (INIS)

    The scope of this study consists of : improve of CARE REMDAS - identification of meteorolgical information required for nuclear emergency response and their efficient use on a real-time basis, review of the production and operation of KMA NWP nodels and their applications. Suggestions on the improvements in nuclear emergency response systme from the care studies of both domestic and foreign countries - case study of a domestic model for radioactivity T/D in terms of model dynamics and operation, investigation of promising support systems by reviewing the current status of T/D model in UK. Recommendations on a promising meteorological information sevices based on foreign cases - examinations of DWD system, including EU for nuclear emergency response, review on the meteorogical information support by DWD for NERS

  6. Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    Nokulunga H. Cele

    2015-07-01

    Full Text Available Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC services in Umlazi in the province ofKwaZulu-Natal (KZN.Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

  7. Racial/Ethnic Differences in Use of Health Care Services for Diabetes Management

    Science.gov (United States)

    Chandler, Raeven Faye; Monnat, Shannon M.

    2015-01-01

    Research demonstrates consistent racial/ethnic disparities in access to and use of health care services for a variety of chronic conditions. Yet we know little about whether these disparities exist for use of health care services for diabetes management. Racial/ethnic minorities disproportionately suffer from diabetes, complications from diabetes, and diabetes-related mortality. Proper diabetes management can reduce the risk of complications and premature mortality. Using a large national data set (N=37,705) of white, black, Hispanic, Asian, and Native American U.S. adults aged 65 and older who have been diagnosed with diabetes, we examine three specific types of health care provider use for diabetes management: number of times seen by a healthcare professional for diabetes, number of times feet have been checked by a health care professional, and number of visits for a glycosylated hemoglobin check. We found that net of controls for a variety of demographic and socioeconomic characteristics, blacks and Hispanics had significantly more visits to a health care provider (HCP) for their diabetes and significantly more glycosylated hemoglobin checks than whites, and blacks and Native Americans had significantly more HCP feet checks than whites. Our results suggest that the reduced access to health care services traditionally found among racial/ethnic minorities does not hold for access to health care services for diabetes management, where racial/ethnic minority diabetics are actually more likely to use care than are white diabetics. Future research should examine whether higher use of health care services for diabetes among racial/ethnic minorities is due to greater disease severity among racial/ethnic minorities than among non-Hispanic whites. PMID:25842386

  8. Quality in public services: the challenges of Primary Care

    OpenAIRE

    Leonardo Cançado Monteiro Savassi

    2012-01-01

    The Brazilian Ministry of Health has signaled a policy of evaluating the quality of primary care through the 1654 decree of 19.07.2011. Any organizational change interferes with the culture of any institution, especially when this change is directed toward the issue of quality. It involves processes, internal resources and people, and cannot be artificially produced by the power of the pen. In the health sector, management based on quality involves changes in business focus and technology, su...

  9. Reshaping maternal services in Nigeria: any need for spiritual care?

    OpenAIRE

    Adanikin, Abiodun I; Onwudiegwu, Uche; Akinyemi A Akintayo

    2014-01-01

    Background High maternal and perinatal mortalities occur from deliveries conducted in prayer houses in Nigeria. Although some regulatory efforts have been deployed to tackle this problem, less attention has been placed on the possible motivation for seeking prayer house intervention which could be hinged on the spiritual belief of patients about pregnancy and childbirth. This study therefore seeks to determine the perception of booked antenatal patients on spiritual care during pregnancy and ...

  10. ServicePro. A comprehensive customer care tool for highly penetrated markets

    International Nuclear Information System (INIS)

    Contemporary marketing measures focus on recruiting new customers as a means of boosting sales. As the share of the market occupied by natural gas increases, the more probable it is that there will be dissatisfied customers who are prepared to switch to other energy sources. Systematic customer care measures are therefore a necessity ServicePro is a customer care concept that has been developed in response to this need. Its three modules are technical, contractual and general customer care. Practical local implementation is assisted by database software and a manual containing tools and examples. Customer care activities also strengthen customer relations and improve the gas utility's image. (au)

  11. A cost-consequences analysis of a primary care librarian question and answering service.

    Directory of Open Access Journals (Sweden)

    Jessie McGowan

    Full Text Available BACKGROUND: Cost consequences analysis was completed from randomized controlled trial (RCT data for the Just-in-time (JIT librarian consultation service in primary care that ran from October 2005 to April 2006. The service was aimed at providing answers to clinical questions arising during the clinical encounter while the patient waits. Cost saving and cost avoidance were also analyzed. The data comes from eighty-eight primary care providers in the Ottawa area working in Family Health Networks (FHNs and Family Health Groups (FHGs. METHODS: We conducted a cost consequences analysis based on data from the JIT project. We also estimated the potential economic benefit of JIT librarian consultation service to the health care system. RESULTS: The results show that the cost per question for the JIT service was $38.20. The cost could be as low as $5.70 per question for a regular service. Nationally, if this service was implemented and if family physicians saw additional patients when the JIT service saved them time, up to 61,100 extra patients could be seen annually. A conservative estimate of the cost savings and cost avoidance per question for JIT was $11.55. CONCLUSIONS: The cost per question, if the librarian service was used at full capacity, is quite low. Financial savings to the health care system might exceed the cost of the service. Saving physician's time during their day could potentially lead to better access to family physicians by patients. Implementing a librarian consultation service can happen quickly as the time required to train professional librarians to do this service is short.

  12. What influences patients’ acceptance of a blood pressure telemonitoring service in primary care? A qualitative study

    Science.gov (United States)

    Abdullah, Adina; Liew, Su May; Hanafi, Nik Sherina; Ng, Chirk Jenn; Lai, Pauline Siew Mei; Chia, Yook Chin; Loo, Chu Kiong

    2016-01-01

    Background Telemonitoring of home blood pressure (BP) is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients’ acceptance of such service in routine clinical care. Objective This study aimed to explore patients’ acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM). Methods A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis. Results Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and suggested improvement to the BP telemonitoring functionalities to improve interactions. Patients cited being involved in research as the main reason for their intention to use the service. They felt that patients with limited experience with the internet and information technology, who worked out of town, or who had an outdoor hobby would not be able to benefit from such a service. Conclusion Patients found BP telemonitoring service in

  13. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

  14. Providing Health Care Service-learning Experiences for IPPE Credit

    Directory of Open Access Journals (Sweden)

    Kassandra M. Bartelme, Pharm.D.

    2011-01-01

    Full Text Available Service-learning (SL provides an opportunity for students to learn personal and professional skills while providing a useful service to the community. Many pharmacy education programs use SL within their curriculum because of the benefits to the community, the faculty, the learning institution and the student(s. While SL has been used in schools/colleges of pharmacy for many years, SL that also fulfills IPPE requirements is newer. This paper seeks to promote the use of combined SL/IPPE experiences. It provides an example where students volunteered at federally qualified health centers and also reviews the ACPE Standards related to SL. Schools/colleges of pharmacy are encouraged to design mechanisms for students to participate in combined SL/IPPE experiences as part of their IPPE requirements.

  15. Development of monofilar rotor hub vibration absorber

    Science.gov (United States)

    Duh, J.; Miao, W.

    1983-01-01

    A design and ground test program was conducted to study the performance of the monofilar absorber for vibration reduction on a four-bladed helicopter. A monofilar is a centrifugal tuned two degree-of-freedom rotor hub absorber that provides force attenuation at two frequencies using the same dynamic mass. Linear and non-linear analyses of the coupled monofilar/airframe system were developed to study tuning and attenuation characteristics. Based on the analysis, a design was fabricated and impact bench tests verified the calculated non-rotating natural frequencies and mode shapes. Performance characteristics were measured using a rotating absorber test facility. These tests showed significant attenuation of fixed-system 4P hub motions due to 3P inplane rotating-system hub forces. In addition, detuning effects of the 3P monofilar modal response were small due to the nonlinearities and tuning pin slippage. However, attenuation of 4P hub motions due to 5P inplane hub forces was poor. The performance of the 5P monofilar modal response was degraded by torsional motion of the dynamic mass relative to the support arm which resulted in binding of the dynamic components. Analytical design studies were performed to evaluate this torsional motion problem. An alternative design is proposed which may alleviate the torsional motion of the dynamic mass.

  16. MEDICAL TOURISTS' EXPECTATIONS WHEN CHOOSING LITHUANIA FOR HEALTH CARE SERVICES

    OpenAIRE

    Miglė Eleonora Černikovaitė; Mantas Jonas Mameniškis

    2015-01-01

    Purpose – Identify medical expectations of tourists choosing Lithuania as medical tourism country and to make comparative analysis with situation in Thailand. Medical tourism is one of the most promising fields of business in the world. International trade in medical services also has huge economic potential and gradually increasing outcome for the global economy (Bookman & Bookman, 2007). Major medical tourism destinations: Thailand, India, Singapore and Malaysia attracted more than 2.5 mill...

  17. The variability and predictors of quality of AIDS care services in Brazil

    Directory of Open Access Journals (Sweden)

    de Britto e Alves Maria

    2009-03-01

    Full Text Available Abstract Background Since establishing universal free access to antiretroviral therapy in 1996, the Brazilian Health System has increased the number of centers providing HIV/AIDS outpatient care from 33 to 540. There had been no formal monitoring of the quality of these services until a survey of 336 AIDS health centers across 7 Brazilian states was undertaken in 2002. Managers of the services were asked to assess their clinics according to parameters of service inputs and service delivery processes. This report analyzes the survey results and identifies predictors of the overall quality of service delivery. Methods The survey involved completion of a multiple-choice questionnaire comprising 107 parameters of service inputs and processes of delivering care, with responses assessed according to their likely impact on service quality using a 3-point scale. K-means clustering was used to group these services according to their scored responses. Logistic regression analysis was performed to identify predictors of high service quality. Results The questionnaire was completed by 95.8% (322 of the managers of the sites surveyed. Most sites scored about 50% of the benchmark expectation. K-means clustering analysis identified four quality levels within which services could be grouped: 76 services (24% were classed as level 1 (best, 53 (16% as level 2 (medium, 113 (35% as level 3 (poor, and 80 (25% as level 4 (very poor. Parameters of service delivery processes were more important than those relating to service inputs for determining the quality classification. Predictors of quality services included larger care sites, specialization for HIV/AIDS, and location within large municipalities. Conclusion The survey demonstrated highly variable levels of HIV/AIDS service quality across the sites. Many sites were found to have deficiencies in the processes of service delivery processes that could benefit from quality improvement initiatives. These findings could

  18. Complex Home Care: Part I-Utilization and Costs to Families for Health Care Services Each Year

    OpenAIRE

    Piamjariyakul, Ubolrat; Ross, Vicki M.; Yadrich, Donna Macan; Williams, Arthur R; Howard, Lyn; Smith, Carol E.

    2010-01-01

    The goal of this study was to determine the annual average utilization and non-reimbursed costs of health services needed by 80 families managing lifelong complex home care. Results indicate that per patient per year there was an average of 36 appointments with a variety of health service professionals that resulted in non-reimbursed annual costs of $4,716. These costs were greater for those that were hospitalized. In follow-up articles, data collected on annual insurance premium payments and...

  19. Model for the evaluation of drug-dispensing services in primary health care

    Science.gov (United States)

    Sartor, Vanessa de Bona; de Freitas, Sergio Fernando Torres

    2014-01-01

    OBJECTIVE To develop a model for evaluating the efficacy of drug-dispensing service in primary health care. METHODS An efficacy criterion was adopted to determine the level of achievement of the service objectives. The evaluation model was developed on the basis of a literature search and discussions with experts. The applicability test of the model was conducted in 15 primary health care units in the city of Florianópolis, state of Santa Catarina, in 2010, and data were recorded in structured and pretested questionnaires. RESULTS The model developed was evaluated using five dimensions of analysis for analysis. The model was suitable for evaluating service efficacy and helped to identify the critical points of each service dimension. CONCLUSIONS Adaptations to the data collection technique may be required to adjust for the reality and needs of each situation. The evaluation of the drug-dispensing service should promote adequate access to medications supplied through the public health system. PMID:25372174

  20. Perspectives of HIV agencies on improving HIV prevention, treatment, and care services in the USA.

    Science.gov (United States)

    Khosla, Nidhi; Zachary, Iris

    2016-10-01

    HIV healthcare services in the USA are made available through a complex funding and delivery system. We present perspectives of HIV agencies on improvements that could lead to an ideal system of HIV prevention, treatment and care. We conducted semi-structured interviews with representatives from 21 HIV agencies offering diverse services in Baltimore, MD. Thematic analysis revealed six key themes: (1) Focusing on HIV prevention, (2) Establishing common entry-points for services, (3) Improving information availability, (4) Streamlining funding streams, (5) Removing competitiveness and (6) Building trust. We recommend that in addition to addressing operational issues regarding service delivery and patient care, initiatives to improve HIV service systems should address underlying social issues such as building trust. PMID:26875546

  1. QuickStats: Percentages* of Residential Care Communities and Adult Day Services Centers That Provided(†) Selected Services - United States, 2014.

    Science.gov (United States)

    2016-01-01

    In 2014, a greater percentage of residential care communities than adult day service centers provided five of seven selected services. The majority of residential care communities provided pharmacy services (82%); followed by transportation for social activities (79%); physical, occupational, or speech therapy (69%); hospice (62%); skilled nursing (59%); and mental health services (52%). Fewer than half provided social work services (48%). The majority of adult day services centers provided transportation for social activities (69%); skilled nursing (66%); and social work (52%). %). Fewer than half provided physical, occupational, or speech therapy (49%). One third or less provided mental health (33%), pharmacy (27%), and hospice services (12%). PMID:27607333

  2. Building effective service linkages in primary mental health care: a narrative review part 2

    Directory of Open Access Journals (Sweden)

    Parker Sharon

    2011-03-01

    Full Text Available Abstract Background Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored. Results A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings. Conclusion The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of

  3. Culture and long-term care: the bath as social service in Japan.

    Science.gov (United States)

    Traphagan, John W

    2004-01-01

    A central feature of Japan's approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difflcult task of bathing a frail or disabled elder--a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States. PMID:15792331

  4. [Medical Care for Refugees by the Public Health Services: Always Ready - But for How Much Longer?].

    Science.gov (United States)

    Tinnemann, P; Gundlach, F; Nitschke, H; Bunte, A; Teichert, U

    2016-04-01

    Refugees continue seeking sanctuary in Germany and it can reasonably be expected that their health will be affected by the conditions they lived in before and during flight. Ensuring nationwide care for refugees should be demand oriented, effective and efficient, which requires tackling mostly similar challenges a community level in a consistent manner. The aim must be providing adequate medical care based on the principle of respect for human dignity and ensuring public health standards. Within the currently situation, this basic expectations are often not sufficiently met. Generally accepted national standards, longer-term strategies and sustainable care are not yet achieved noticeably by public health services in Germany.To warrant permanent and sustainable high-quality medical care for refugees, local networks of involved institutions should be established with a longer-term perspective. Moreover, the financially eroded and personnel thinned public health service will only be able to fulfil statutory requirements and expectations of the local, state and federal policy makers for a limited amount of time only. Safeguarding that services are coping with the size of challenges over longer periods of time and anchoring the acquired expertise of medical care for refugees within the public health services, requires immediately better financial and personnel resources. Then the public health services will be a reliable partner supporting all people in Germany, particularly those that require subsidiary and socially-compensatory supply. PMID:27078828

  5. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

    Directory of Open Access Journals (Sweden)

    Srijana Pandey, PhD

    2014-09-01

    Full Text Available Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

  6. Institutional Elderly Care Services and Moroccan and Turkish Migrants in Belgium: A Literature Review.

    Science.gov (United States)

    Ahaddour, Chaïma; van den Branden, Stef; Broeckaert, Bert

    2016-10-01

    In several European countries, including Belgium, the rapid ageing of the migrant population has emerged only recently on the political agenda. The aim of this literature review is threefold. Firstly, it provides a review of the available studies on the accessibility and use of institutional care services by Moroccan and Turkish migrants in the Flemish part of Belgium including Flanders and Brussels. Secondly, it identifies their specific needs regarding elderly care services. Finally, it provides an overview of the way in which Belgian policy has dealt with the issue of migration and elderly care. Literature published between 1965 and 2014 and relevant to the Belgian context has been included. This search yielded 21 references, of which 8 empirical studies, 5 policy literature, 3 theoretical studies, 3 news articles and 2 popularized reports. Mainstream elderly care remains relatively inaccessible for these migrants due to the language and a series of cultural and religious barriers, a low level of education, financial constraints, a lack of knowledge of health care systems, and the so-called return and care dilemmas. Their religious and cultural needs are currently not met by elderly care services. The inclusive and neutral Belgian policy seems to pay insufficient attention to these issues. PMID:26141810

  7. Serving transgender people: clinical care considerations and service delivery models in transgender health.

    Science.gov (United States)

    Wylie, Kevan; Knudson, Gail; Khan, Sharful Islam; Bonierbale, Mireille; Watanyusakul, Suporn; Baral, Stefan

    2016-07-23

    The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people. PMID:27323926

  8. EVALUATION OF UNSAFE BIRTHS AND POSTPARTUM HOME CARE SERVICES

    Directory of Open Access Journals (Sweden)

    Filiz ERGIN

    2005-12-01

    Full Text Available Introduction: It is known that mother/child deaths can be prevented by having safe births and taking routine postnatal home care. The aim of this study is to evaluate safety of births and postnatal home care visits of mothers having 0-11 month babies in the Center of Aydin. Methods: A cross-sectional design was used to study a group of 806 mothers. Multistage sampling method was used. Health stations was taken as cluster units. One rural-one urban health station from ten health-centers was selected by random sampling method. Safety of births, type of births, complications after births, home visits by health personel at postpartum period were asked. Results: Unsafe births was 6,0% in Aydin. It was found that family income, mother?s age/occupation/educational level, social security, number of children, father?s occupation/educational level and household size, effects the safety of births. 59,9% of women were visited by widwives at the postpartum period and mean number of visits were 2,0 ±1,7. At this period 9,4% of women had complications, and these complications were two times greater at unsafe births. Conclusion: Although Aydin is in the west part of Turkey, unsafe births and inadequate postpartum home visits are seen. In order to prevent these problems, health centers must take more active role. [TAF Prev Med Bull 2005; 4(6.000: 321-329

  9. Caring and curing: paediatric cancer services since 1960.

    Science.gov (United States)

    Barnes, E

    2005-09-01

    This paper traces the history of the specialist meanings of 'cure' in paediatric oncology in the UK, how they have changed with increasing organization of the discipline, ever-rising survival rates for all childhood cancers, and with feedback from patients and families. It examines the differing ways in which those involved in researching, treating, and raising funds for work on childhood cancers have understood and used the language of cure, and speculates as to why talking about the 'cure' of survivors of childhood cancers is so problematic. The paper discusses the particular importance of holistic care in the development of paediatric oncology. Psychosocial support is delivered alongside surgery, radiotherapy and chemotherapy. The focus for support is the patient's whole family, building a tenet of palliative care into curative treatment. The concept of the 'truly cured child' is argued to have been crucial in the discipline's decision in the 1970s and 1980s to make the psychosocial needs of patients and their families central in the programme of curing children with cancer. PMID:16098123

  10. The association between the utilization of long-term care services and mortality in elderly Koreans.

    Science.gov (United States)

    Choi, Jung-Kyu; Joung, Euisin

    2016-01-01

    It is necessary to confirm the effect of long-term care insurance (LTCI) by identifying changes in mortality, whether benefits are used or not, as well as the effects of in-home and institutional services on mortality. The goal of this study was to identify the association between service use and the mortality rate in elderly Koreans. We used Cox proportional hazard regression models and the Kaplan-Meier survival curve method to estimate the hazard ratio and survival probability for death while adjusting for covariates. We detected a 27.8% mortality rate at the 40-month follow-up period. Male gender, advanced age and activities of daily living were risk factors for mortality. In all models, the hazard ratio of participant death of those using long-term care services was significantly lower than for those who did not use these services. Among the service users, the hazard ratio for participant death of institutional service users was significantly higher than it was for in-home service users. This study also identified the impact of the transition from in-home services to institutional services. A primary goal of LTCI is to promote health and life stabilization in the elderly. To both delay and prevent institutionalization, it is necessary to develop assistive devices and effective in-home services and ensure access of these for elderly patients. PMID:27017418

  11. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

    Science.gov (United States)

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-09-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level. PMID:25187892

  12. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities.

    Science.gov (United States)

    Fronczak, Nancy; Oyediran, Kola' A; Mullen, Stephanie; Kolapo, Usman M

    2016-04-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect-that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and

  13. Divided care and the Third Way: user involvement in statutory and voluntary sector cancer services.

    Science.gov (United States)

    Tritter, J Q; Barley, V; Daykin, N; Evans, Simon; McNeill, Judith; Rimmer, James; Sanidas, M; Turton, Pat

    2003-07-01

    In health care, as in much of the public sphere, the voluntary sector is playing an increasingly large role in the funding, provision and delivery of services and nowhere is this more apparent than in cancer care. Simultaneously the growth of privatisation, marketisation and consumerism has engendered a rise in the promotion of 'user involvement' in health care. These changes in the organisation and delivery of health care, in part inspired by the 'Third Way' and the promotion of public and citizen participation, are particularly apparent in the British National Health Service. This paper presents initial findings from a three-year study of user involvement in cancer services. Using both case study and survey data, we explore the variation in the definition, aims, usefulness and mechanisms for involving users in the evaluation and development of cancer services across three Health Authorities in South West England. The findings have important implications for understanding shifts in power, autonomy and responsibility between patients, carers, clinicians and health service managers. The absence of any common definition of user involvement or its purpose underlines the limited trust between the different actors in the system and highlights the potentially negative impact of a Third Way health service. PMID:14498919

  14. Diversification of health care services: the effects of ownership, environment, and strategy.

    Science.gov (United States)

    Shortell, S M; Morrison, E M; Hughes, S L; Friedman, B S; Vitek, J L

    1987-01-01

    The present findings suggest that the trend toward greater diversification of hospital services is likely to be most strongly influenced by state Medicaid policies and certain hospital characteristics. Increasing Medicaid eligibility and payment levels is likely to have a positive effect on services diversification. Growth in the number of inpatient services provided and a more severe case mix are also likely to be involved with greater service diversification. Affiliation with a not-for-profit hospital system is likely to be associated with more diversified hospital services but not affiliation with an investor-owned system. There is also some indication that the overall portfolio of services which a hospital offers in regard to market share and market growth characteristics influences diversification. Specifically, a low market share portfolio is likely to be associated with less diversification. Competition is likely to be associated with more diversification; particularly for hospitals belonging to systems. The effect of competition on hospital strategy and services diversification is a particularly important area for further investigation. Increasing Medicaid payment and eligibility levels are also likely to have a positive effect on the provision of services which are usually unprofitable. Raising such levels is likely to be particularly beneficial to inner-city hospitals who are already providing a greater number of such services. However, the present data suggest that investor-owned hospitals are least likely to provide such services. Increasing Medicaid eligibility levels is also likely to be associated with fewer services for which charity care has to be provided. State regulation in the form of rate review and certificate of need is likely to be associated with more services for which hospitals provide some charity care. But such policies alone do not deal with the larger issue of how to finance care for the medically indigent. Present data suggest the

  15. On the Predictability of Hub Height Winds

    DEFF Research Database (Denmark)

    Draxl, Caroline

    grids. These systems require forecasts with temporal scales of tens of minutes to a few days in advance at wind farm locations. Traditionally these forecasts predict the wind at turbine hub heights; this information is then converted by transmission system operators and energy companies into predictions...... of power output at wind farms. Since the power available in the wind is proportional to the wind speed cubed, even small wind forecast errors result in large power prediction errors. Accurate wind forecasts are worth billions of dollars annually; forecast improvements will result in reduced costs to...... cannot be reduced solely to forecasting winds at hub height. Calculating only the power output from hub height winds can result in erroneous estimates due to the vertical wind shear in the atmospheric boundary layer (PBL). Results show that the accuracy of modeled wind conditions and wind proles in the...

  16. Report on survey on international hub

    International Nuclear Information System (INIS)

    Japan Atomic Energy Agency (JAEA) is promoting initiative to form an international hub in line with its aim to accept more researchers/engineers from all over the world. Establishment of 'the Committee for JAEA Internationalization Initiative' was planned in 2010 so as to intensify this initiative, and in February, 2010, we visited research institutions in Europe, which include European Organization for Nuclear Research (CERN), the construction site of ITER in Cadarache, and Rutherford Appleton Laboratory (RAL), with the intention to survey and learn their advanced activities and systems in regard to the International Hub, so that the committee will be able to make fruitful discussion. This report describes strategy taken in each institution for an International Hub, and the state of each institution regarding acceptance and management of overseas researchers and engineers, research environment, living environment/health and welfare, and PR activities/coexistence with the local community. (author)

  17. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    Directory of Open Access Journals (Sweden)

    Dale B

    2013-10-01

    Full Text Available Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes.Methods: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway participated in individual interviews. The interview texts were audio taped, transcribed verbatim and analyzed by use of a phenomenological-hermeneutic approach.Results: Three main themes and seven subthemes were deduced from the data. The first main theme was that the home nursing leaders felt challenged by the organization of home care services. Two subthemes were identified related to this. The first was that the leaders lacked involvement in the transitional process, and the second was that they were challenged by administration of care being decided at another level in the municipality. The second main theme found was that the leaders felt that they were acting in a shifting and unsettled context. Related to this, they had to adjust internal resources to external demands and expectations, and experienced lack of communication with significant others. The third main theme identified was that the leaders endeavored to deliver care in accordance with professional values. The two related subthemes were, first, that they provided for appropriate internal systems and routines, and, second, that they prioritized available professional competence, and made an effort to promote a professional

  18. An Adaptive Sensor Data Segments Selection Method for Wearable Health Care Services.

    Science.gov (United States)

    Chen, Shih-Yeh; Lai, Chin-Feng; Hwang, Ren-Hung; Lai, Ying-Hsun; Wang, Ming-Shi

    2015-12-01

    As cloud computing and wearable devices technologies mature, relevant services have grown more and more popular in recent years. The healthcare field is one of the popular services for this technology that adopts wearable devices to sense signals of negative physiological events, and to notify users. The development and implementation of long-term healthcare monitoring that can prevent or quickly respond to the occurrence of disease and accidents present an interesting challenge for computing power and energy limits. This study proposed an adaptive sensor data segments selection method for wearable health care services, and considered the sensing frequency of the various signals from human body, as well as the data transmission among the devices. The healthcare service regulates the sensing frequency of devices by considering the overall cloud computing environment and the sensing variations of wearable health care services. The experimental results show that the proposed service can effectively transmit the sensing data and prolong the overall lifetime of health care services. PMID:26490152

  19. Utilization of maternal health care services in post-conflict Nepal

    Directory of Open Access Journals (Sweden)

    Bhandari TR

    2015-08-01

    Full Text Available Tulsi Ram Bhandari, Prabhakaran Sankara Sarma, Vellappillil Raman Kutty Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India Background: Despite a decade-long armed conflict in Nepal, the country made progress in reducing maternal mortality and is on its way to achieve the Millennium Development Goal Five. This study aimed to assess the degree of the utilization of maternal health care services during and after the armed conflict in Nepal.Methods: This study is based on Nepal Demographic and Health Survey data 2006 and 2011. The units of analysis were women who had given birth to at least one child in the past 5 years preceding the survey. First, we compared the utilization of maternal health care services of 2006 with that of 2011. Second, we merged the two data sets and applied logistic regression to distinguish whether the utilization of maternal health care services had improved after the peace process 2006 was underway.Results: In 2011, 85% of the women sought antenatal care at least once. Skilled health workers for delivery care assisted 36.1% of the women, and 46% of the women attended postnatal care visit at least once. These figures were 70%, 18.7%, and 16%, respectively, in 2006. Similarly, women were more likely to utilize antenatal care at least once (odds ratio [OR] =2.18, confidence interval [CI] =1.95–2.43, skilled care at birth (OR =2.58, CI =2.36–2.81, and postnatal care at least once (OR =4.13, CI =3.75–4.50 in 2011.Conclusion: The utilization of maternal health care services tended to increase continuously during both the armed conflict and the post-conflict period in Nepal. However, the increasing proportion of the utilization was higher after the Comprehensive Peace Process Agreement 2006. Keywords: antenatal care, armed conflict, Nepal, post-conflict, postnatal care, skilled care at birth

  20. Effectiveness of service linkages in primary mental health care: a narrative review part 1

    Directory of Open Access Journals (Sweden)

    Parker Sharon

    2011-04-01

    Full Text Available Abstract Background With the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. Studies of analytic, descriptive and qualitative designs from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted to examine what service linkages have been used in studies of collaboration in primary mental health care. Findings from the randomised trials were tabulated to show the proportion that demonstrated clinical, service delivery and economic benefits. Results A review of 119 studies found ten linkage types. Most studies used a combination of linkage types and so the 42 RCTs were grouped into four broad linkage categories for meaningful descriptive analysis of outcomes. Studies that used multiple linkage strategies from the suite of "direct collaborative activities" plus "agreed guidelines" plus "communication systems" showed positive clinical (81%, service (78% and economic (75% outcomes. Most evidence of effectiveness came from studies of depression. Long term benefits were attributed to medication concordance and the use of case managers with a professional background who received expert supervision. There were fewer randomised trials related to collaborative care of people with psychosis and there were almost none related to collaboration with the wider human service sectors. Because of the variability of study types we did not exclude on quality or attempt to weight findings according to power or effect

  1. Efficiency and functionality of an internal purchaser-provider model in public specialized health care services

    OpenAIRE

    Iso-Mustajärvi, Anni

    2016-01-01

    There is an increasing demand to find solutions for improving cost-efficiency in health care. The demand for services continues to increase and there is a need to control the increasing resource requirements. Market-oriented organization models and management methods have been seen as one way to address the challenge and as an alternative to traditional hierarchical organization models in health care. Researchers highlight the importance of investigating how different kinds of changes actuall...

  2. A framework for outcome-level evaluation of in-service training of health care workers

    OpenAIRE

    O’Malley, Gabrielle; Perdue, Thomas; Petracca, Frances

    2013-01-01

    Background In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President’s Emergency Plan for AIDS Relief’s Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results o...

  3. Managing Performance in Intermediate Care Services – A Balanced Scorecard Approach

    OpenAIRE

    Philip, Ajith

    2008-01-01

    In a free market economy, achieving the highest performance and thereby the organization’s goals is the ultimate responsibility of management. Performance needs to be managed to ensure that the organization is meeting its vision and goals. The Balanced Scorecard is a concept for measuring whether the activities of an organization are in line with its objectives in terms of its vision and its goals. Intermediate Care describes a range of short term health and social care services and intervent...

  4. Health care services to diabetics in the territory of the Lha Napoli 2: quality perceived

    OpenAIRE

    Antonino Parlato; Daniela Ugliano; Aniello Visciano; Giorgio Liguori

    2007-01-01

    Background: Worldwide, diabetes mellitus is a chronic disease which now appears to be substantially increasing especially in industrialized countries. In recent years important improvements have been achieved in the treatment of the disease and the prevention of complications, but adherence of health care workers to these indicators varies considerably and often the results are inadequate. Our study relates to health care services supplied to diabetics wi...

  5. Association between fee-for-service expenditures and morbidity burden in primary care

    DEFF Research Database (Denmark)

    Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik;

    2014-01-01

    BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES: To...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....

  6. PATIENT SATISFACTION WITH INTEGRATED HIV AND ANTENATAL CARE SERVICES IN RURAL KENYA

    OpenAIRE

    Vo, Baotran N.; Cohen, Craig R.; Smith, Rachel M.; Bukusi, Elizabeth A.; Onono, Maricianah; Doolan, Katie; Washington, Sierra; Turan, Janet M.

    2012-01-01

    A cluster randomized controlled trial was initiated in Kenya to determine if full integration (FI) of HIV care, including HAART, into antenatal care (ANC) clinics improves health outcomes among HIV-infected women and exposed infants, compared to a non-integrated (NI) model. This paper examines ANC clients’ satisfaction with and preferences regarding HIV-integrated services. In this cross-sectional study, pregnant women attending five FI clinics (n=185) and four NI clinics (n=141) completed an...

  7. Improving Olympic health services: what are the common health care planning issues?

    OpenAIRE

    Kononovas, K.; Black, G.; Taylor, J; Raine, R

    2014-01-01

    INTRODUCTION: Due to their scale, the Olympic and Paralympic Games have the potential to place significant strain on local health services. The Sydney 2000, Athens 2004, Beijing 2008, Vancouver 2010, and London 2012 Olympic host cities shared their experiences by publishing reports describing health care arrangements. HYPOTHESIS: Olympic planning reports were compared to highlight best practices, to understand whether and which lessons are transferable, and to identify recurring health care p...

  8. The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia

    OpenAIRE

    Bayou, Yibeltal T.; Mashalla, Yohana S.; Thupayagale-Tshweneagae, Gloria

    2016-01-01

    Background There are recent efforts made to eliminate inequalities in the utilisation of basic health care services. More emphasis is given for improvement of health in developing countries including maternal and child health. However, disparities for the fast-growing population of urban poor are masked by the urban averages. The aim of this paper is to report on the findings of antenatal care adequacy among slum residents in Addis Ababa, Ethiopia. Methods This was a quantitative and cross-se...

  9. Patterns of care for patients with advanced soft tissue sarcoma: experience from Australian sarcoma services

    OpenAIRE

    Bae, Susie; Crowe, Philip; Gowda, Raghu; Joubert, Warren; Carey-Smith, Richard; Stalley, Paul; Desai, Jayesh

    2016-01-01

    Background There is a paucity of data on the current management of patients with advanced soft tissue sarcoma (STS) in the Australian health care setting. This study utilised the Australian sarcoma database to evaluate the patterns of care delivered to patients with advanced STS at Australian sarcoma services. Methods Prospectively collected data from six sarcoma centres in Australia were sourced to identify patients diagnosed with advanced STS between 1 January 2010 and 31 December 2012. Des...

  10. A descriptive phenomenology study of newcomers’ experience of maternity care services: Chinese women’s perspectives

    OpenAIRE

    Lee, Tsorng-Yeh; Landy, Christine Kurtz; Wahoush, Olive; Khanlou, Nazilla; Liu, Yin-Chun; Li, Chia-Chi

    2014-01-01

    Background Maternity health care available in Canada is based on the needs of women born in Canada and often lacks the flexibility to meet the needs of immigrant women. The purpose of this study was to explore immigrant Chinese women’s experiences in accessing maternity care, the utilization of maternity health services, and the obstacles they perceived in Canada. Methods This descriptive phenomenology study used in-depth semi-structured interviews to examine immigrant Chinese women’s experie...

  11. PATIENTS’ SATISFACTION WITH PRIMARY HEALTH CARE CENTERS SERVICES IN KUWAIT CITY, KUWAIT

    OpenAIRE

    Al-Doghaither, Abdullah H.; Abdelrhman, Badreldin M.; Saeed, Abdalla A.W.; Al-Kamil, Abdullah A.; Majzoub, Mohieldin M.

    2001-01-01

    Background: Assessment of patient satisfaction offers a way of optimizing health status and prevents waste of medical resources. The direct measurement of patient satisfaction is a new phenomenon in Kuwait. Objective: Assess patient satisfaction with respect to primary health care services and study any patterns of association of sociodemographic variables on the patient satisfaction level. Methods: The sample consisted of 301 patients selected systematically from five primary health care cen...

  12. Social Services will not Touch us with a Barge Pole’: Social Care Provision for Older Prisoners

    OpenAIRE

    O'Hara, Kate; Forsyth, Katrina; Senior, Jane; Stevenson, Caroline; Hayes, Adrian; Challis, David; Shaw, Jenny

    2015-01-01

    Older prisoners are the fastest growing subgroup in the English and Welsh prison estate. Older prisoners have high levels of health and social care needs. This mixed method study involved the distribution of a questionnaire examining the availability of health and social care services for older prisoners to all prisons housing adult males in England and Wales, followed by qualitative telephone interviews with representatives from eight prisons. Over half of establishments had some contact wit...

  13. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    OpenAIRE

    Buykx Penny; Kinsman Leigh; Humphreys John S; Tham Rachel; Asaid Adel; Tuohey Kathy

    2011-01-01

    Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations ...

  14. CUSTOMER CARE - A TOTALLY IGNORED MANAGEMENT TOOL ON THE ROMANIAN SERVICES MARKET

    Directory of Open Access Journals (Sweden)

    Roxana SÂRBU

    2009-06-01

    Full Text Available Quality and customer satisfaction are important subjects receiving increasing attention worldwide. An organization's ability to remain in business depends entirely on its ability to win and retain customers. The nature and number of competitors and their ability to offer similar products/services at similar prices has led to increasing emphasis being placed on customer care. Customer care is about people pleasing people and it involves specific actions that keep customers satisfied and coming back for more.

  15. CUSTOMER CARE - A TOTALLY IGNORED MANAGEMENT TOOL ON THE ROMANIAN SERVICES MARKET

    OpenAIRE

    Roxana SÂRBU; Anca Gabriela ILIE; Constanţa PÂSLARU; Dan DUMITRIU

    2009-01-01

    Quality and customer satisfaction are important subjects receiving increasing attention worldwide. An organization's ability to remain in business depends entirely on its ability to win and retain customers. The nature and number of competitors and their ability to offer similar products/services at similar prices has led to increasing emphasis being placed on customer care. Customer care is about people pleasing people and it involves specific actions that keep customers satisfied and coming...

  16. Assessment of status of patients receiving palliative home care and services provided in a rural area-Kerala, India

    Directory of Open Access Journals (Sweden)

    Jayakrishnan Thayyil

    2012-01-01

    Conclusions: The service could address most of the medical, psychosocial, and supportive needs of the patients and reduce their pain and symptoms. The interface between institutional-based care and home care needs more exploration and prospective studies.

  17. Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

    Science.gov (United States)

    Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

    2015-06-01

    Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. PMID:26115858

  18. Grid Infrastructure for HealthCare Web Services

    Directory of Open Access Journals (Sweden)

    G. Senthil Kumar1 , D. Karthik2, N. Malathy3

    2011-06-01

    Full Text Available HealthGrids are Grid infrastructures comprising applications, services or middleware components that deal with the specific problems arising in the processing of biomedical data. Resources in HealthGrids are databases, computing power, medical expertise and even medical devices. Health Grids are thus closely related to eHealth. Although the ultimate goal for eHealth in Europe would be the creation of a single Health Grid, i.e. a Grid comprising all eHealth resources, naturally including security and authorization features to handle subsidiary of independent nodes of the Heath Grid, the development path will mostly likely include a set of specific HealthGrids with perhaps simple inter-Grid interaction/interoperational capabilities

  19. The use of bedside ultrasound and community-based paracentesis in a palliative care service

    Directory of Open Access Journals (Sweden)

    Landers A

    2014-06-01

    Full Text Available INTRODUCTION: There is little information, particularly in New Zealand, on the use of ultrasound to enhance clinical decision-making in a specialist palliative care service. Technological advances have resulted in increasingly portable, user-friendly ultrasound machines that can be used in the home setting to offer convenient access to this treatment option. AIM: To evaluate the clinical use of portable ultrasonography in the management of abdominal ascites in a community palliative care service. METHODS: Patients referred to the Nurse Maude Hospice and Palliative Care Service requiring assessment for abdominal ascites over 12 months were scanned using a newly purchased handheld ultrasound machine. The patients had a variety of diagnoses; the most common diagnosis was ovarian cancer. RESULTS: Forty-one ultrasound scans performed for 32 patients to assess for ascites drainage were recorded. Fluid was identified in 19 assessments and drainage undertaken in 17. Over half the scans were completed at home, allowing nine procedures to be performed safely and conveniently, which reduced time spent at the local hospital. There were no major complications. DISCUSSION: Ultrasonography is a tool that has not previously been utilised in palliative care locally, but has significant potential patient benefits. This novel use of technology also highlighted potential cost savings to the patient and health system, which may be beneficial to other palliative care services in New Zealand.

  20. Proposal to integrate the service on radiation hygiene at the primary health care services for workers exposed to ionizing radiation

    International Nuclear Information System (INIS)

    The National Health System implemented in the last few years a new pattern of primary attention for workers by creating doctors offices in work centers. At the same time, the Ministry of Public Health (MINSAP) carries the medical surveillance of the staff exposed to ionizing radiation. This work proposes a program to integrate the consulting room on radiation hygiene to primary health care services for workers that work with ionizing radiation sources, aiming to ameliorate and improve them

  1. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

    Directory of Open Access Journals (Sweden)

    Li Zhijian

    2012-06-01

    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  2. Providing primary health care through integrated microfinance and health services in Latin America.

    Science.gov (United States)

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  3. Performance of Primary Dental Care Services: An Ecological Study in a Large Brazilian City

    Directory of Open Access Journals (Sweden)

    Rita Sibele Souza Esteves

    2013-01-01

    Full Text Available This study explored the association between area-level primary dental care performance and area-level demographics, dental treatment need, and health care service indicators. An ecological cross-sectional study was performed in Belo Horizonte, Brazil, in 2010. The 142 primary health care (PHC units were grouped based on the following variables: access to individual dental treatment, frequency of dental emergencies, and frequency of individual preventive procedures. The independent variables analyzed were demographic variables, dental treatment need, and health care service indicators. The data were obtained from the information systems of the Brazilian Ministry of Health and the city of Belo Horizonte. We explored the associations between membership in a specific PHC cluster type and the independent variables using multinomial logistic regression with a significance level of 5%. Variables such as the high/very high vulnerability of population, rate of completed treatment, and rate of referrals of users to secondary care were independently associated with the clusters (P<0.05. The performance of primary dental care services was associated with patient demographics, dental treatment need, and referrals. The results of this study have implications for the planning of public policies.

  4. Entrepreneurs ' perspective on public-private partnership in health care and social services.

    Science.gov (United States)

    Sinisammal, Janne; Leviäkangas, Pekka; Autio, Tommi; Hyrkäs, Elina

    2016-03-21

    Purpose - The purpose of this paper is to probe experiences of entrepreneurs in the social and health care service provision. Design/methodology/approach - Information was collected regarding entrepreneurs' views on the factors affecting the collaboration between public and private sectors. A sample of social and health care entrepreneurs was interviewed using open-ended questions. The interviews were transcribed and analysed using inductive content analysis. Findings - Three main categories of factors affecting the success of partnership were identified: the nature of partnership, business aspects and tension builders. Research limitations/implications - The research was undertaken in rural Finland and the sample consisted 13 entrepreneurs. The results must be considered as observations with more generalised conclusions. Practical implications - The results of this study support municipalities in their social and health care service strategy work and especially in consideration of how to also facilitate a fruitful public-private partnership (PPP)-framework, which will largely depend on mutual understanding and consensus. Originality/value - The reform of the social and health care system has raised intensive public debate throughout Europe. Key issues include the reorganising of social and health care processes as well as PPPs in provision of services. This study observes the views and experiences of private entrepreneurs and points out where some potential problems and solutions of social and health care PPPs are. PMID:26964856

  5. Assessment and Availability of Trauma Care Services in a District Hospital of South India; A Field Observational Study

    OpenAIRE

    Pallavi Sarji Uthkarsh; Gopalkrishna Gururaj; Sai Sabharish Reddy; Mandya Siddalingaiah Rajanna

    2016-01-01

    Objective: To assess the availability of trauma care services in a district referral hospital of Southern India. Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-d...

  6. LOCATING HUBS IN TRANSPORT NETWORKS: AN ARTIFICIAL INTELLIGENCE APPROACH

    Directory of Open Access Journals (Sweden)

    Dušan Teodorović

    2014-09-01

    Full Text Available Hub facilities serve as switching and transshipment points in transportation and communication networks as well as in logistic systems. Hub networks have an influence on flows on the hub-to-hub links and ensure benefit from economies of scale in inter-hub transportation. The key factors for designing a successful hub-and-spoke network are to determine the optimal number of hubs, to properly locate hubs, and to allocate the non-hubs to the hubs. This paper presents the model to determine the locations of the p-hub facilities in the network and to allocate the non-hubs to the hubs. The problem is solved by the Bee Colony Optimization (BCO algorithm, and the results are compared with the optimal solutions obtained by CPLEX. The BCO algorithm belongs to the class of stochastic swarm optimization methods. The proposed algorithm is inspired by the foraging habits of bees in the nature. The BCO algorithm was able to obtain the optimal value of objective functions in all test problems. The CPU times required to find the best solutions by the BCO are acceptable.

  7. Service Users and Providers Expectations of Mental Health Care in Iran: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Ameneh Setareh Forouzan

    2013-10-01

    Full Text Available Mental disorders are known to be an important cause of disabilities worldwide. Despite their importance, about two thirds of mentally ill people do not seek treatment, probably because of the mental health system's inability to decrease the negative side effects of the interaction with the mental health services. The World Health Organization has suggested the concept of responsiveness as a way to better understand the active interaction between the health system and the population. This study aimed to explore the expectations of mental health service users and providers.Six focus group discussions were carried in Tehran, the capital of Iran. In total, seventy-four participants comprising twenty-one health providers and fifty-three users of mental health system were interviewed. Interviews were analyzed through content analysis. The coding was synchronized between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility.Five common domains among all groups were identified: accessibility, quality of interpersonal relationships, adequate infrastructure, participation in decisions, and continuity of care. The importance of cultural appropriateness of care was only raised by service users as an expectation of an ideal mental health service.Both users and providers identified the most relevant expectations from the mental health care system in Iran. More flexible community mental health services which are responsive to users' experiences may contribute to improving the process of care for mental health patients.

  8. Medical Service Provision and Costs: Do Walk-In Clinics Differ from Other Primary Care Delivery Settings?

    OpenAIRE

    Darrel J. Weinkauf; Boris Kralj

    1998-01-01

    Reductions in health care funding by both the federal and provincial governments in recent years have focused attention on the cost-effectiveness of health care delivery, particularly on the delivery of primary care services. We use data extracted from the Ontario Health Insurance Plan (OHIP) claims database to assess differences between walk-in clinics and other primary care delivery settings in initial visit costs, follow-up visit costs, service duplication, and diagnoses treated. Our analy...

  9. Should the provision of home help services be contained?: Validation of the new preventive care policy in Japan

    OpenAIRE

    Ishibashi Tomoaki; Ikegami Naoki

    2010-01-01

    Abstract Background To maintain the sustainability of public long-term care insurance (LTCI) in Japan, a preventive care policy was introduced in 2006 that seeks to promote active improvement in functional status of elderly people who need only light care. This policy promotes the use of day care services to facilitate functional improvement, and contains the use of home help services that provide instrumental activity of daily living (IADL) support. However, the validity of this approach rem...

  10. School Health Services for Children With Special Health Care Needs in California.

    Science.gov (United States)

    Baker, Dian L; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S; Knauer, Heather

    2015-10-01

    Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study used the following two methods: (a) analysis of administrative data from the California Basic Educational Data System and (b) a cross-sectional online survey of 446 practicing California school nurses. Only 43% of California's school districts employ school nurses. Unlicensed school personnel with a variety of unregulated training provide school health services. There is a lack of identification of CSHCN, and communication barriers impair the ability to deliver care. Study results indicate that California invests minimally in school health services. PMID:25854694

  11. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  12. Reasons for attending dental-care services in Ouagadougou, Burkina Faso.

    OpenAIRE

    2005-01-01

    OBJECTIVE: To determine why patients attend dental-care facilities in Ouagadougou, Burkina Faso and to improve understanding of the capacity of oral health-care services in urban west Africa. METHODS: We studied a randomly selected sample of patients attending 15 dental-care facilities in Ouagadougou over a 1-year period in 2004. Data were collected using a simple daily record form. FINDINGS: From a total of 44,975 patients, the final sample was established at 14,591 patients, of whom 55.4% w...

  13. Implementation of TeleCare services: benefit assessment and organisational models.

    Science.gov (United States)

    Stroetmann, Karl A; Stroetmann, Veli N; Westerteicher, Chris

    2003-01-01

    All industrial societies are ageing. This has profound socio-economic and health sector implications. Innovative services based on Information Society Technologies (IST), like telehomecare are regarded as promising avenues to follow both to allow (national) health systems to cope with these challenges and to improve the quality of life of chronically ill and frail older citizens. The aim of the TEN-HMS project is to convincingly prove that telemonitoring of congestive heart failure (CHF) patients at home can improve medical outcome for these patients as well as their quality of life and the efficiency of healthcare delivery processes. But this will not (yet) be enough for the sustained success of such a service. Unless it takes into account the interests of the various players in the health care arena and a long-term Business Case can be proven, it will be very difficult to integrate such services into routine health care delivery processes. Before developing concrete delivery models for such a telemonitoring service, the "players" directly involved in such a service need to be identified--customers/patients, health services providers, IT services suppliers, and public/private insurance funds as payers--and their assessment perspectives considered. Then four concrete telemonitoring delivery models and their probability of success are discussed. Our analysis suggests that telemonitoring will presently only be successful if the service delivery model applied reflects national health system idiosyncrasies, takes into account established organisational boundaries and adapts to patient quality of life and health professional preferences. In the longer term, the new paradigm of seamless, patient-centred care will, however, require new, more efficient service delivery models integrating all aspects of the health services value chain. PMID:15537237

  14. Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

    Science.gov (United States)

    Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

    2016-03-01

    Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. PMID:26169927

  15. Access to Maternal Health Care Services in the Cape Coast Metropolitan Area, Ghana

    OpenAIRE

    D. Adei; Y.B. Fiscian; L. Ephraim; S.K. Diko

    2012-01-01

    Maternal mortality can be prevented if mothers had routine obstetric care and access to emergency obstetric services. However, in accessing healthcare most expecting mothers will have to struggle with distance and financial problems. The study sought to; assess the barriers that discourage women from accessing antenatal, delivery and postnatal services in the Cape coast Metropolis and give recommendations to inform policy. Questionnaire was administered to 150 pregnant women and nursing mothe...

  16. Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care program, 2004-2008

    OpenAIRE

    Menz Hylton B

    2009-01-01

    Abstract Background In 2004, as an extension of the Enhanced Primary Care (EPC) program, the Australian Government introduced a policy of providing Medicare rebates for allied health services provided to patients with chronic or complex health conditions. The objective of this study was to evaluate the utilisation of podiatry services provided under this scheme between 2004 and 2008. Methods Data pertaining to the Medicare item 10962 for the calendar years 2004-2008 were extracted from the Au...

  17. Experiences of asylum seeking women on housing and health care services in Bradford

    OpenAIRE

    Fuseini, Sulemana

    2009-01-01

    The purpose of this study was to look at housing and health care services provided for asylum seeking women in Bradford, and whether service delivery meets their needs and expectations. This study used a qualitative research approach; the method of data collection was focused group interviews. The participants were selected from the Bradford Ecumenical Asylum Concern (BEACON) project. 10 women seeking asylum were interviewed and the interview data was analysed through the method of conten...

  18. Evaluating the Quality of Health Care Services in the Hashemite Kingdom of Jordan

    OpenAIRE

    Suliman Kharmeh

    2012-01-01

    The purpose of this study is to evaluate the quality of health care services provided in the Hashemite Kingdom ofJordan. An instrument of the quality of health service was developed in order to achieve the purpose of this study.The instrument consisted of (31) items, distributed on five dimensions: tangibles, reliability, responsiveness,assurance and empathy. The indications of validity and reliability were confirmed.The sample of this study consisted of (556) patients admitted in hospitals l...

  19. Physicians in health care management: 5. Payment of physicians and organization of medical services.

    OpenAIRE

    Vayda, E

    1994-01-01

    The financing, payment and organization of medical services are closely related. Canada's health care system is financed publicly, from tax revenue, and administered in each province by a single government payer. Although the chief method of payment to physicians is fee for service (FFS), the need to control costs and organize practice more efficiently has led to increased interest in FFS variants, such as capping payments at a certain level or fixing a budget, and alternative payment methods...

  20. Systematic review of pre-hospital outcomes for evidence-based evaluation of ambulance service care

    OpenAIRE

    Phung, Viet-Hai; Coster, Joanne; Wilson, Richard; Turner, Janette; Booth, Andrew; Siriwardena, A Niroshan

    2013-01-01

    Background: Ambulance service performance measurement has previously focused on response times and survival (particularly from out-of-hospital cardiac arrest). The PhOEBE (Pre-hospital Outcomes for Evidence Based Evaluation) project is a 5-year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care. As part of this programme we conducted a systematic review of the international literature on quality measures and outcomes re...

  1. Integration of Antiretroviral Therapy Services into Antenatal Care Increases Treatment Initiation during Pregnancy: A Cohort Study

    OpenAIRE

    Stinson, Kathryn; Jennings, Karen; Myer, Landon

    2013-01-01

    Objectives Initiation of antiretroviral therapy (ART) during pregnancy is critical to promote maternal health and prevent mother-to-child HIV transmission (PMTCT). The separation of services for antenatal care (ANC) and ART may hinder antenatal ART initiation. We evaluated ART initiation during pregnancy under different service delivery models in Cape Town, South Africa. Methods A retrospective cohort study was conducted using routinely collected clinic data. Three models for ART initiation i...

  2. The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care.

    Science.gov (United States)

    Goldstein, Judah; McVey, Jennifer; Ackroyd-Stolarz, Stacy

    2016-01-01

    Caring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step. PMID:26282932

  3. Fleet deployment, network design and hub location of liner shipping companies

    DEFF Research Database (Denmark)

    Gelareh, Shahin; Pisinger, David

    2011-01-01

    A mixed integer linear programming formulation is proposed for the simultaneous design of network and fleet deployment of a deep-sea liner service provider. The underlying network design problem is based on a 4-index (5-index by considering capacity type) formulation of the hub location problem w...... in comparison with a general-purpose mixed integer programming solver....

  4. Transformation management of primary health care services in two selected local authorities in Gauteng

    Directory of Open Access Journals (Sweden)

    W Sibaya

    2000-09-01

    Full Text Available The transformation of health services in South Africa today is governed by the political, policy and legislative frameworks. This article focuses on the transformation of a primary health care service within a local authority in Gauteng. The purpose with this article is to explore and describe the perceptions (expectations and fears of selected managers employed in this primary health care service. The results are utilised to compile a strategy (framework for transformation management and leadership within the primary health care service. A qualitative research design was utilised and the data was collected by means of individual interviews with selected managers in the service, followed by a content analysis. The expectations and fears of managers focus mainly on personnel matters, community participation/satisfaction, salaries and parity, inadequate stocks/supplies and medication, the deterioration of quality service delivery and the need for training and empowerment. These results are divided into structure, process and outcome dimensions and are embodied in the conceptual framework for the transformation and leadership strategy. It is recommended that standards for transformation management be formulated and that the quality of transformation management be evaluated accordingly.

  5. Delivery of Services of Day Care Workers In Sta. Maria, Laguna

    Directory of Open Access Journals (Sweden)

    ROLANDO R. CRUZADA, JR.

    2014-02-01

    Full Text Available This study focused on the determination of the delivery of services of day care workers in the municipality of Sta. Maria, Province of Laguna during the first semester of school year 2012-2013. Descriptive research was used in this study. Among the key findings were that Day Care Workers with respect to interactional relationship accomplished the functions with outstanding adequacy such as constantly giving feedback and praises on the performance of children, along with workers and parents coordination and cooperation, with verbal interpretation of Always Observe. In terms of instructional quality both group of respondents perceived that day care workers in-charge had adequate abilities and competencies concerning their education and trainings in connection with teaching small children with verbal interpretation of Always Observe. The parents had confidence to the day care workers in-charge of their children aside from regularly consulting the day care workers about their children’s progress with verbal interpretation of Always Observe. There were only 871 households who availed of the services of day care centers in which 27 workers were employed and each of them assigned to handle an average of 33 children. Notable along with other findings was the day care workers and parents had the same perception as to the extent of services provided by the Day Care Center with respect to interactional relationship, instructional quality and parental participation. Subsequently the study ensued with these five factual remarks: Children’s interactions with parents in the centers were the direct mechanisms through which children learn. The educational qualification and the capability of the day care workers to handle small children were the primary essentials in children’s learning. Parents’ participation in the day care centers premises brought harmonious relationship between the Day Care Workers and children as well. The capacity of day care worker

  6. An evaluation of the implementation of integrated community home-based care services in Vhembe District, South Africa

    Directory of Open Access Journals (Sweden)

    Gandi J Moetlo

    2011-01-01

    Conclusion: Community home-based caregivers are largely able to implement home-based care services but would need more support (training, financial, career structure, and health system to improve on their services.

  7. Institutional delivery and postnatal care services utilizations in Abuna Gindeberet District, West Shewa, Oromiya Region, Central Ethiopia: A Community-based cross sectional study

    OpenAIRE

    Darega, Birhanu; Dida, Nagasa; Tafese, Fikru; Ololo, Shimeles

    2016-01-01

    Background Delivery at health institutions under the care of trained health-care providers and utilization of postnatal cares services plays vital roles in promoting child survival and reducing the risk of maternal mortality. More than 80 % of maternal deaths can be prevented if pregnant women access to essential maternity cares like antenatal care, institutional delivery and postnatal care services. Thus, this study aimed to assess institutional delivery and postnatal care services utilizati...

  8. Composite hubs for low cost gas turbine engines

    Science.gov (United States)

    Chamis, C. C.

    1977-01-01

    A detailed stress analysis was performed using NASTRAN to demonstrate theoretically the adequacy of composite hubs for low cost turbine engine applications. Composite hubs are adequate for this application from the steady state stress view point.

  9. Impact of an oncology palliative care clinic on access to home care services.

    Science.gov (United States)

    Jang, Raymond W; Burman, Debika; Swami, Nadia; Kotler, Jennifer; Banerjee, Subrata; Ridley, Julia; Mak, Ernie; Bryson, John; Rodin, Gary; Le, Lisa W; Zimmermann, Camilla

    2013-08-01

    Home care (HC) is important for patients with cancer as performance status declines. Our study of 1224 patients at a Canadian cancer center examined the impact of an oncology palliative care clinic (OPCC) on HC referral. The HC referral frequency was calculated before and after the first OPCC consultation, in total and according to performance status (Palliative Performance Scale, PPS). Characteristics associated with HC referral were investigated. After the first OPCC consultation, there was an increase in HC referral from 39% (477 of 1224; 49% of those with PPS ≤60) to 69% (841 of 1224; 88% of those with PPS ≤60). Factors independently associated with HC referral were poor PPS (P < .001) and older age (P = .003). Thus OPCC involvement resulted in markedly increased HC referrals, particularly for older patients with poor performance status. PMID:22777408

  10. Emerging Education Hubs: The Case of Singapore

    Science.gov (United States)

    Sidhu, Ravinder; Ho, K.-C.; Yeoh, Brenda

    2011-01-01

    In anticipation of a globalising post-Fordist political economy, countries and universities are increasingly pursuing strategic transnational education and research alliances. This article analyses the Global Schoolhouse, a key education policy platform that aims to transform Singapore into a knowledge and innovation hub by establishing networks…

  11. Hub location problems in transportation networks

    DEFF Research Database (Denmark)

    Gelareh, Shahin; Nickel, Stefan

    2011-01-01

    In this paper we propose a 4-index formulation for the uncapacitated multiple allocation hub location problem tailored for urban transport and liner shipping network design. This formulation is very tight and most of the tractable instances for MIP solvers are optimally solvable at the root node...

  12. IEEE 1394 Hub With Fault Containment

    Science.gov (United States)

    Paulitsch, Michael; Hall, Brendan; Driscoll, Kevin R.

    2009-01-01

    This innovation is designed to prevent a single end system communication node from negatively influencing the whole system s behavior so that the network system can still operate if an end node is faulty. Placing a hub (star) in the middle of the system prevents propagation of critical control information that other end systems would react to, like block reset messages.

  13. Modelagem para localização de hubs no transporte de encomendas expressas Modelling for location hubs in the express cargo transport

    Directory of Open Access Journals (Sweden)

    Javier Antonio Timaná Alamo

    2006-12-01

    Full Text Available Na presente pesquisa se propõe um modelo matemático de programação linear com variáveis binárias 0/1, para projetar a configuração de uma rede de distribuição de encomendas expressas, visando minimizar os custos e garantindo um bom nível de serviço. O modelo, que é uma modificação da formulação proposta por O’Kelly, define as posições dos hubs, a alocação deles às demais instalações físicas e a construção de roteiros com apenas uma parada intermediária, o que confere mais agilidade ao atendimento da demanda de transporte de carga. Considera-se a instalação de um único hub maior (Hub Principal, que serve como ponto de transbordo para os fluxos de carga entre as distintas regiões de um território, e um conjunto de terminais regionais (mini-hubs, servindo como ponto de conexão, unicamente, para os fluxos de carga existentes em um determinado raio de cobertura. Foram propostas extensões que incluem uma restrição da capacidade operacional do Hub Principal, para evitar seu congestionamento, e duas diferentes estratégias de induzir o aumento de fluxo de carga manipulado pelos mini-hubs. O modelo proposto e suas extensões foram aplicados ao estudo de um caso real, obtendo-se resultados consistentes e uma redução significativa no custo total da rede de distribuição da empresa analisada.This study proposes a mathematical model of linear programming with binary variables 0/1 to project the configuration of a distribution network for express cargo which aims to minimize costs and guarantee a high level of service. The model, which is a modification of the formulation proposed by O’Kelly, defines the position of the hubs, their allocation regarding the other physical installations, and the building of itineraries with only one intermediate stop, which increases agility in meeting the demand of cargo transport. It assumes the installation of a single, major hub (Main Hub, which serves as the transfer point for

  14. Constructing Hongqiao Hub and Serving Regional Economy:Planning and Operation of Hongqiao Comprehensive Transportation Hub

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Taking Hongqiao Integrated Transportation Hub Project as a case, this paper introduces its origin, orientation, development programming, planning and design, road planning, information system planning, air-rail integrated transportation planning, disaster prevention planning, and so on.

  15. The impact of organisational culture on the delivery of person-centred care in services providing respite care and short breaks for people with dementia.

    Science.gov (United States)

    Kirkley, Catherine; Bamford, Claire; Poole, Marie; Arksey, Hilary; Hughes, Julian; Bond, John

    2011-07-01

    Ensuring the development and delivery of person-centred care in services providing respite care and short breaks for people with dementia and their carers has a number of challenges for health and social service providers. This article explores the role of organisational culture in barriers and facilitators to person-centred dementia care. As part of a mixed-methods study of respite care and short breaks for people with dementia and their carers, 49 telephone semi-structured interviews, two focus groups (N= 16) and five face-to-face in-depth interviews involving front-line staff and operational and strategic managers were completed in 2006-2007. Qualitative thematic analysis of transcripts identified five themes on aspects of organisational culture that are perceived to influence person-centred care: understandings of person-centred care, attitudes to service development, service priorities, valuing staff and solution-focused approaches. Views of person-centred care expressed by participants, although generally positive, highlight a range of understandings about person-centred care. Some organisations describe their service as being person-centred without the necessary cultural shift to make this a reality. Participants highlighted resource constraints and the knowledge, attitudes and personal qualities of staff as a barrier to implementing person-centred care. Leadership style, the way that managers' support and value staff and the management of risk were considered important influences. Person-centred dementia care is strongly advocated by professional opinion leaders and is prescribed in policy documents. This analysis suggests that person-centred dementia care is not strongly embedded in the organisational cultures of all local providers of respite-care and short-break services. Provider organisations should be encouraged further to develop a shared culture at all levels of the organisation to ensure person-centred dementia care. PMID:21545358

  16. Over-heated Investment in Aluminum Hub Industry

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    <正>Aluminum hub is one of typical products with the comparative advantages.China’s aluminum hub industry is very competitive.In recent years,the value of export for the aluminum hub soared,increasing from USD130 millions in 1999 up to nearly USD1 billion in 2004.The main exporter are Wanfeng Auto Holding Group,Shanghai Fervent Alloy Wheel MFG Co.,Ltd.,Nanhai Zhongnan Aluminum Co., Ltd.,Taian Huatai Aluminum Hub Co.,Ltd.

  17. Service user views of spiritual and pastoral care (chaplaincy) in NHS mental health services: a co-produced constructivist grounded theory investigation

    OpenAIRE

    Raffay, Julian; Wood, Emily; Todd, Andrew

    2016-01-01

    Background Within the UK National Health Service (NHS), Spiritual and Pastoral Care (SPC) Services (chaplaincies) have not traditionally embraced research due to the intangible nature of their work. However, small teams like SPC can lead the way towards services across the NHS becoming patient- centred and patient-led. Using co-production principles within research can ensure it, and the resulting services, are truly patient-led. Methods A series of interviews were conducted with service user...

  18. Hub-and-Spoke System in Air Transportation and Its Implications to Regional Economic Development——A Case Study of United States

    Institute of Scientific and Technical Information of China (English)

    SONG Wei; MA Yanji

    2006-01-01

    Considerable changes have taken place in commercial passenger air transport since the enactment of the 1978Airline Deregulation Act in the US and the deregulation of airline networks that has occurred elsewhere. The commercial and operational freedoms have led most of the larger carriers to develop hub-and-spoke networks, within which certain cities or metropolitan areas emerge as key nodes possessing tremendous advantages over other locations in the air transport system. This paper examines the nature of hub-and-spoke operations in air transportation services, and the benefits that accrue to a city or geographical region that is host to an airline hub. In particular, it looks into linkages between the air service hub and local economic development. Four potential types of impact of airports on the regional economy are defined and discussed. As an example, the assessment of the economic impacts of Cincinnati-Northern Kentucky International Airport (CVG), a major Delta Airlines hub, is introduced.

  19. Coming out to care: gay and lesbian carers' experiences of dementia services.

    Science.gov (United States)

    Price, Elizabeth

    2010-03-01

    This article reports on findings from a qualitative study, undertaken in England that explored the experiences of 21 gay men and lesbian women who care, or cared, for a person with dementia. The aim of the study was to explore how a person's gay or lesbian sexuality might impact upon their experience of providing care in this context. This paper reports on one theme that emerged from the wider study--carers' experiences of 'coming out' to service providers. Respondents were recruited using 'snowballing' methods and the study employed semi-structured interviewing techniques. Data collection occurred over a protracted period (2003-2007), the time scale being determined by (the well documented) difficulties in recruiting respondents from this group of people. Data analysis was undertaken with the intent of developing common and contrary themes using a constant thematic comparative method. The results reported here demonstrate the ways in which carers mediated disclosures of their sexualities to health and social care service providers and, for some, their wider support network. For many carers, responses to these disclosures proved to be a critical issue and one that coloured their experience of providing care. Service providers' reactions are demonstrated as being characterised by, at best, a broad acceptance of gay and lesbian people's circumstances, through to a pervasive disregard of their needs. PMID:19708866

  20. Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services.

    Science.gov (United States)

    Silver, Julie K; Raj, Vishwa S; Fu, Jack B; Wisotzky, Eric M; Smith, Sean Robinson; Kirch, Rebecca A

    2015-12-01

    Palliative care and rehabilitation practitioners are important collaborative referral sources for each other who can work together to improve the lives of cancer patients, survivors, and caregivers by improving both quality of care and quality of life. Cancer rehabilitation and palliative care involve the delivery of important but underutilized medical services to oncology patients by interdisciplinary teams. These subspecialties are similar in many respects, including their focus on improving cancer-related symptoms or cancer treatment-related side effects, improving health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision-making. They also aim to improve healthcare efficiencies and minimize costs by means such as reducing hospital lengths of stay and unanticipated readmissions. Although their goals are often aligned, different specialized skills and approaches are used in the delivery of care. For example, while each specialty prioritizes goal-concordant care through identification of patient and family preferences and values, palliative care teams typically focus extensively on using patient and family communication to determine their goals of care, while also tending to comfort issues such as symptom management and spiritual concerns. Rehabilitation clinicians may tend to focus more specifically on functional issues such as identifying and treating deficits in physical, psychological, or cognitive impairments and any resulting disability and negative impact on quality of life. Additionally, although palliative care and rehabilitation practitioners are trained to diagnose and treat medically complex patients, rehabilitation clinicians also treat many patients with a single impairment and a low symptom burden. In these cases, the goal is often cure of the underlying neurologic or musculoskeletal condition. This report defines and describes cancer rehabilitation and palliative care, delineates their

  1. Virtual Campus Hub: A single sign-on system for cross-border collaboration

    DEFF Research Database (Denmark)

    Badger, Merete; Vercoulen, F.; Monaco, L.;

    2013-01-01

    ’s own pace and to revisit the learning material (e.g. recorded presentations and video demonstrations of exercises). The technical concept of Virtual Campus Hub may be reused in the future by other institutions who wish to add their services or start new collaboration environments. It is thus highly...... applications used there. The objective of Virtual Campus Hub is to use state-of-the-art European e-Infrastructures (Géant) in combination with federated authentication to establish a single sign-on system between universities. A pilot environment, which links applications from the four partner universities......Four technical universities in Europe work together in the EU-funded project Virtual Campus Hub (FP7 RI-283746, www.virtualcampushub.eu) to lower the technical barriers for cross-border collaboration. Universities have many connections to the outside world (e.g. to other universities, to joint...

  2. Promoting High Quality Early Childhood Education and Care Services: Beyond Risk Management, Performative Constructions of Regulation

    Science.gov (United States)

    Fenech, Marianne; Sumsion, Jennifer

    2007-01-01

    Whilst regulation is utilized by governments in Australia and internationally as a means of promoting quality standards in early childhood education and care (ECEC) services, a growing body of literature is critical of the detrimental effect of this regulation. Drawing on our investigation into early childhood teachers' perceptions of the impact…

  3. Transformation Education: A Vehicle for Structuring Group Care Organizations to Increase Service Quality and Effectiveness

    Science.gov (United States)

    Ross, Andrew L.

    2007-01-01

    Transformation Education, an organizational philosophy and operating system, is designed to increase service quality and effectiveness of group care through aligning its organizational structure with its purpose. This alignment is achieved through creating a culture designed to dispense transformation rather than treatment. The author presents how…

  4. SUM (Service Unit Management): An Organizational Approach To Improved Patient Care.

    Science.gov (United States)

    Jelinek, Richard C.; And Others

    To evaluate the effectiveness of Service Unit Management (SUM) in reducing costs, improving quality of care, saving professional nursing time, increasing personnel satisfaction, and setting a stage for further improvements, a national questionnaire survey identified the characteristics of SUM units, and compared the performance of a total of 55…

  5. 42 CFR 418.56 - Condition of participation: Interdisciplinary group, care planning, and coordination of services.

    Science.gov (United States)

    2010-10-01

    ... professional roles: (i) A doctor of medicine or osteopathy (who is an employee or under contract with the hospice). (ii) A registered nurse. (iii) A social worker. (iv) A pastoral or other counselor. (2) If the... supervise the care and services. The hospice must designate a registered nurse that is a member of...

  6. The Value of Geriatric Care Enhancement Training for Direct Service Workers

    Science.gov (United States)

    Coogle, Constance L.; Parham, Iris A.; Jablonski, Rita; Rachel, Jason S.

    2007-01-01

    This study reports on the evaluation of a skills-enhancement training series for direct service providers in home care that was part of a federally funded state-level initiative to improve employee recruitment and retention. The gerontological training curriculum included content to improve problem-solving, communication, and stress management…

  7. [Quality of care and risk management in hospital at home services].

    Science.gov (United States)

    Franzin-Garrec, Martine; Hoden, Romy

    2016-04-01

    Hospital at home structures are healthcare institutions in their own right, with the same obligations in terms of governance with regard to quality of care and risk management. However, hospital at home services are characterised by the remote management of the activity and the nursing staff, with specific constraints. PMID:27085929

  8. 45 CFR 234.130 - Assistance in the form of institutional services in intermediate care facilities.

    Science.gov (United States)

    2010-10-01

    ... under the provisions of 42 CFR 449.33 as to a facility's eligibility to receive payments for... services in intermediate care facilities, available income will be applied, first for personal and... of safety and sanitation as are applicable to nursing homes under State law; and (iv)...

  9. Teaching Students To Develop a Website as a Tool for Marketing Pharmaceutical Care Services.

    Science.gov (United States)

    Anderson-Harper, Heidi M.; Kavookjian, Jan; Munden, C. Dianne

    1998-01-01

    Describes a classroom project in which pharmacy student teams developed a World Wide Web page to market a hypothetical pharmacy and promote pharmaceutical care services. The exercise successfully involved students in using both creative and analytic skills to gain hands-on experience in constructing a mission statement and marketing plan for a new…

  10. 78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Science.gov (United States)

    2013-06-27

    ... all alleged violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse... receive services under the Medicare hospice benefit. Medicare does not have a separate payment rate for... patients in their homes, the routine home care hospice rate does not include any payment for room or...

  11. Differences in the structure of outpatient diabetes care between endocrinologist-led and general physician-led services.

    LENUS (Irish Health Repository)

    O Donnell, Máire

    2013-11-25

    Despite a shift in diabetes care internationally from secondary to primary care, diabetes care in the Republic of Ireland remains very hospital-based. Significant variation in the facilities and resources available to hospitals providing outpatient diabetes care have been reported in the UK. The aim of this study was to ascertain the structure of outpatient diabetes care in public hospitals in the Republic of Ireland and whether differences existed in services provided across hospitals.

  12. Older adults’ home- and community-based care service use and residential transitions: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Chen Ya-Mei

    2012-08-01

    Full Text Available Abstract Background As Home-and Community-Based Services (HCBS, such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults’ use of home- and community-based services and their residential transitions. Methods The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults’ residential status at the three follow-up interviews, four residential transitions were tracked: (1 Community-Community-Community (CCC: Resided in community during the entire study period; (2 Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3; (3 Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3; (4 Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.. Results Older adults’ use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults’ use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other

  13. Effect of interventions to improve health care services for ethnic minority populations

    Directory of Open Access Journals (Sweden)

    Louise Forsetlund

    2011-03-01

    Full Text Available Objectives: Since the early 1990s there has been an increasing awareness of social and ethnic inequity in health and for the last few years there has also been an increasing focus on disparities in the quality of health services to ethnic minority groups. The aim of this review was to collect and summarise in a systematic and transparent manner the effect of interventions to improve health care services for ethnic minorities.Methods: We searched several medical databases for systematic reviews and randomised controlled trials. Two researchers independently screened for and selected studies, assessed risk of bias, extracted data and graded the quality of the evidence for each outcome in the included studies. The analysis was done qualitatively by describing studies and presenting them in tables.Results: We included 19 primary studies. The interventions were targeted at reducing clinical, structural and organisational barriers against good quality health care services. Eight studies examined the effect of educational interventions in improving outcomes within cross-cultural communication, smoking cessation, asthma care, cancer screening and mental health care. In six comparisons the effect of reminders for improving health care services and patient outcomes within cancer screening and diabetes care was examined. Two studies compared professional remote interpretation services to traditional interpretation services, two studies compared ethnic matching of client and therapist and two studies examined the effect of providing additional support in the form of more personnel in the treatment of diabetes and kidney transplant patients. Most patients were African-Americans and Latin-Americans and all ages were represented.Conclusions: Educational interventions and electronic reminders to physicians may in some contexts improve health care and health outcomes for minority patients. The quality of the evidence varied from low to very low. The quality of

  14. The Regional Dimension of Education Hubs: Leading and Brokering Geopolitics

    Science.gov (United States)

    Lee, Jack T.

    2015-01-01

    Several education hubs have emerged in the last decade in Asia and the Middle East. These ambitious policy initiatives share a common interest in cross-border higher education even though diverse rationales underpin their development. While some claim to be an international education hub, others claim to be a regional education hub or…

  15. Access to general health care services by a New Zealand population with serious mental illness.

    Directory of Open Access Journals (Sweden)

    Wheeler A

    2014-03-01

    Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.

  16. Using Patient Experiences on Dutch Social Media to Supervise Health Care Services: Exploratory Study

    Science.gov (United States)

    Engelen, Lucien JLPG; Verhoef, Lise M; van der Weide, Marian JA; Schoonhoven, Lisette; Kool, Rudolf B

    2015-01-01

    Background Social media has become mainstream and a growing number of people use it to share health care-related experiences, for example on health care rating sites. These users’ experiences and ratings on social media seem to be associated with quality of care. Therefore, information shared by citizens on social media could be of additional value for supervising the quality and safety of health care services by regulatory bodies, thereby stimulating participation by consumers. Objective The objective of the study was to identify the added value of social media for two types of supervision by the Dutch Healthcare Inspectorate (DHI), which is the regulatory body charged with supervising the quality and safety of health care services in the Netherlands. These were (1) supervision in response to incidents reported by individuals, and (2) risk-based supervision. Methods We performed an exploratory study in cooperation with the DHI and searched different social media sources such as Twitter, Facebook, and healthcare rating sites to find additional information for these incidents and topics, from five different sectors. Supervision experts determined the added value for each individual result found, making use of pre-developed scales. Results Searches in social media resulted in relevant information for six of 40 incidents studied and provided relevant additional information in 72 of 116 cases in risk-based supervision of long-term elderly care. Conclusions The results showed that social media could be used to include the patient’s perspective in supervision. However, it appeared that the rating site ZorgkaartNederland was the only source that provided information that was of additional value for the DHI, while other sources such as forums and social networks like Twitter and Facebook did not result in additional information. This information could be of importance for health care inspectorates, particularly for its enforcement by risk-based supervision in care of

  17. PROVIDER CHOICE FOR OUTPATIENT HEALTH CARE SERVICES IN INDONESIA: THE ROLE OF HEALTH INSURANCE

    Directory of Open Access Journals (Sweden)

    Budi Hidayat

    2012-11-01

    Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

  18. [Principles of universality, comprehensiveness and equity in a hearing health care service].

    Science.gov (United States)

    Vianna, Nubia Garcia; Cavalcanti, Maria de Lourdes Tavares; Acioli, Moab Duarte

    2014-07-01

    This article analyzed whether the practices of hearing health care were consistent with the principles of universality, comprehensiveness and equity from the standpoint of professionals. It involved qualitative research conducted at a Medium Complexity Hearing Health Care Center. A social worker, three speech therapists, a physician and a psychologist constituted the study subjects. Interviews were conducted as well as observation registered in a field diary. The thematic analysis technique was used in the analysis of the material. The analysis of interviews resulted in the construction of the following themes: Universality and access to hearing health, Comprehensive Hearing Health Care and Hearing Health and Equity. The study identified issues that interfere with the quality of service and run counter to the principles of Brazilian Unified Health System. The conclusion reached was that a relatively simple investment in training and professional qualification can bring about significant changes in order to promote a more universal, comprehensive and equitable health service. PMID:25014297

  19. A study on coverage utilization and quality of maternal care services

    Directory of Open Access Journals (Sweden)

    Neeraj Agarwal, Abhiruchi Galhotra, H M Swami

    2011-01-01

    Full Text Available The objectives of the study were yo assess the utilization of various maternal services and to compare the quality of services provided by doctors and health workers in terms of components and advice received by pregnant women during antenatal period. It was a Cross-sectional Study conducted in a village on the border of Chandigarh (U.T. and Mohali (Punjab. All the women who had delivered in the past three years in the village Palsora were included in the study. 92.4% of the pregnancies were registered, 53.2% of which received antenatal care by a Doctor and 46.8% by a health worker. The measuring of blood pressure was significantly higher by the doctor than the health workers who recorded weight more significantly. The advice provided by doctors was significantly higher than health workers regarding diet, danger signs, newborn care, family planning and natal care.

  20. Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study

    Directory of Open Access Journals (Sweden)

    Ukkola Anniina

    2012-09-01

    Full Text Available Abstract Background Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet. Methods A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed. Results Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month and painkillers (6.8-5.5 pills/month and the number of antibiotic courses (0.6-0.5 prescriptions/year was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment. Conclusions Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease. Trial registration ClinicalTrials.gov NCT01145287

  1. Cloud based intelligent system for delivering health care as a service.

    Science.gov (United States)

    Kaur, Pankaj Deep; Chana, Inderveer

    2014-01-01

    The promising potential of cloud computing and its convergence with technologies such as mobile computing, wireless networks, sensor technologies allows for creation and delivery of newer type of cloud services. In this paper, we advocate the use of cloud computing for the creation and management of cloud based health care services. As a representative case study, we design a Cloud Based Intelligent Health Care Service (CBIHCS) that performs real time monitoring of user health data for diagnosis of chronic illness such as diabetes. Advance body sensor components are utilized to gather user specific health data and store in cloud based storage repositories for subsequent analysis and classification. In addition, infrastructure level mechanisms are proposed to provide dynamic resource elasticity for CBIHCS. Experimental results demonstrate that classification accuracy of 92.59% is achieved with our prototype system and the predicted patterns of CPU usage offer better opportunities for adaptive resource elasticity. PMID:24139021

  2. Mergers and acquisitions in Western European health care: exploring the role of financial services organizations.

    Science.gov (United States)

    Angeli, Federica; Maarse, Hans

    2012-05-01

    Recent policy developments in Western European health care - for example in the Netherlands - aim to enhance efficiency and curb public expenditures by strengthening the role of private sector. Mergers and acquisitions (M&As) play an important role in this respect. This article presents an analysis of 1606 acquisition deals targeting health care provider organizations in Western Europe between 1990 and 2009. We particularly investigate the role of financial services organisations as acquirers. Our analysis highlights (a) a rise of M&As in Western Europe since 2000, (b) an increase of M&As with financial service organisations acting as acquirer in absolute terms, and (c) a dominant role of the latter type of M&As in cross-border deals. To explain these developments, we make a distinction between an integration and a diversification rationale for M&As and we argue that the deals with financial services organisations in the role of acquirer are driven by a diversification rationale. We then provide arguments why health care, from the acquirer's perspective, can be considered as an interesting target in a diversification strategy and we advance reasons why health care providers may welcome this development. Although caution in drawing conclusions is needed, our findings suggest a penetration of private capital into health care provision that may be interpreted as a specific form of privatisation. Furthermore, they point to a rising internationalisation of health care. Both findings may entail far-reaching implications for health care, as they may induce both cultural privatisation and cultural internationalisation. PMID:22440195

  3. Care Models of eHealth Services: A Case Study on the Design of a Business Model for an Online Precare Service

    NARCIS (Netherlands)

    Van Meeuwen, D.; Van Walt Meijer, Q.; Simonse, W.L.

    2015-01-01

    Background: With a growing population of health care clients in the future, the organization of high-quality and cost-effective service providing becomes an increasing challenge. New online eHealth services are proposed as innovative options for the future. Yet, a major barrier to these services app

  4. Care Models of eHealth Services: A Case Study on the Design of a Business Model for an Online Precare Service

    NARCIS (Netherlands)

    Van Meeuwen, D.P.D.; Van Walt Meijer, Q.J.; Simonse, L.W.L.

    2015-01-01

    Background With a growing population of health care clients in the future, the organization of high-quality and cost-effective service providing becomes an increasing challenge. New online eHealth services are proposed as innovative options for the future. Yet, a major barrier to these services appe

  5. Minority ethnic groups in dementia care: a review of service needs, service provision and models of good practice.

    Science.gov (United States)

    Daker-White, G; Beattie, A M; Gilliard, J; Means, R

    2002-05-01

    Sixty-seven English language articles were obtained for the review, the majority of which (44, 65.7%) had US origins. Broadly, the main issues covered in the literature were the under-utilization of services by minority ethnic groups; the prevalence of dementia in different ethnic groups; the experience of care giving in different racial groups and language as a factor in cognitive assessment. Although it has been argued that the instruments used to assess cognitive function are culturally biased, the available published evidence would seem to suggest that the fundamental issue is language ability, rather than minority group membership per se. Studies into the care giving experience amongst different ethnic or racial groups suffer from theoretical and methodological weaknesses. Studies of help-seeking among various ethnic groups in the US have found that many do not prioritize dementia as a health problem in the face of more pressing concerns. There was little consensus amongst the articles about whether services should be provided specifically for different ethnic groups, reflecting a lack of evidence concerning the efficacy of different models of service provision. PMID:12028878

  6. A force field evaluation tool for telephone service in ambulatory health care.

    Science.gov (United States)

    da Silva, V L; Steinberg, B

    1991-10-01

    The tool presented here is useful in analyzing the constraints and capabilities of a health care telephone service. It also provides a systematic method for assessing systems problems. As part of our analysis, we recommended that the manager implement the following steps. First, the manager determines whether the driving force on the unit is continuity of care by an individual provider or consistency of response. This focus directly affects how the unit's telephone service can be best organized (i.e., decentralized or centralized) and clarifies the factors most needed for success. For example, to function effectively and efficiently, a centralized phone service needs strong provider-endorsed protocols. Second, the manager should carefully examine neutral constraint factors to determine methods to transform these constraints into capabilities, such as planning for extra staff or office hours (or both) during influenza season. Planning for extra hours or staff depends largely on whether budget and resource planning is done in advance and whether value is placed on customer access and satisfaction during peak demand periods. The manager must next determine whether the service delivery format (centralized or decentralized) is consistent with the force field analysis findings. If the findings are not consistent, can the analysis present a compelling argument for using the opposite approach? Finally, the manager must create a plan of action for minimizing the constraints revealed and maximizing existing capabilities to achieve the overall goal of excellent phone service. The process of analysis and creating a plan of action is an excellent opportunity to involve staff, providers, and administrators in efforts to achieve better health care telephone service for all customers. PMID:10112997

  7. Chronic obstructive pulmonary disease involves substantial health-care service and social benefit costs

    DEFF Research Database (Denmark)

    Jensen, Martin Bach; Fenger-Grøn, Morten; Fonager, Kirsten;

    2013-01-01

    cohort study performed in Denmark during 2004-2006 were linked with national register data that identified the costs of social benefits and health-care services. The cohort comprised 546 participants with COPD (forced expiratory volume in the first sec. (FEV1)/forced vital capacity (FVC) ratio < 0.......7 following bronchodilator administration] and 3,995 without COPD (in addition, 9,435 invited participants were non-responders and 331 were excluded). The costs were adjusted for gender, age, co-morbidity and educational level. RESULTS: Health care-related costs were 4,779 (2,404- 7,154) Danish kroner (DKK......) higher for participants with COPD than for those without COPD, and 2,882 (556-5,208) DKK higher than for those for non-responders. The higher costs were mainly due to the cost of medicines and inpatient care. The health-care costs increased with disease severity Global Initiative for Chronic Obstructive...

  8. A Health Services Research Agenda for Cellular, Molecular and Genomic Technologies in Cancer Care

    Science.gov (United States)

    Wideroff, Louise; Phillips, Kathryn A.; Randhawa, Gurvaneet; Ambs, Anita; Armstrong, Katrina; Bennett, Charles L.; Brown, Martin L.; Donaldson, Molla S.; Follen, Michele; Goldie, Sue J.; Hiatt, Robert A.; Khoury, Muin J.; Lewis, Graham; McLeod, Howard L.; Piper, Margaret; Powell, Isaac; Schrag, Deborah; Schulman, Kevin A.; Scott, Joan

    2009-01-01

    Background In recent decades, extensive resources have been invested to develop cellular, molecular and genomic technologies with clinical applications that span the continuum of cancer care. Methods In December 2006, the National Cancer Institute sponsored the first workshop to uniquely examine the state of health services research on cancer-related cellular, molecular and genomic technologies and identify challenges and priorities for expanding the evidence base on their effectiveness in routine care. Results This article summarizes the workshop outcomes, which included development of a comprehensive research agenda that incorporates health and safety endpoints, utilization patterns, patient and provider preferences, quality of care and access, disparities, economics and decision modeling, trends in cancer outcomes, and health-related quality of life among target populations. Conclusions Ultimately, the successful adoption of useful technologies will depend on understanding and influencing the patient, provider, health care system and societal factors that contribute to their uptake and effectiveness in ‘real-world’ settings. PMID:19367091

  9. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

    Directory of Open Access Journals (Sweden)

    Dastjerdi Mahdieh

    2012-09-01

    Full Text Available Abstract Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men who were adults (at least 18 years old and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP, becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains

  10. 25 CFR 36.90 - What recreation, academic tutoring, student safety, and health care services must homeliving...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What recreation, academic tutoring, student safety, and... What recreation, academic tutoring, student safety, and health care services must homeliving programs..., recreation, and health care services for their students, as deemed necessary by the local school board...

  11. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    Science.gov (United States)

    2010-10-01

    ... of the beneficiary's inpatient admission and the hospital does not attest that such service is... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care...

  12. Medicaid Personal Care Services for Children with Intellectual Disabilities: What Assistance Is Provided? When Is Assistance Provided?

    Science.gov (United States)

    Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.

    2014-01-01

    We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy…

  13. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    Directory of Open Access Journals (Sweden)

    Canavan Réamonn

    2012-07-01

    Full Text Available Abstract Background Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities. Method Two methods of data collection were employed; (i In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them. Results Across the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision. Conclusions While there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of

  14. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    LENUS (Irish Health Repository)

    Canavan, Réamonn

    2012-07-27

    AbstractBackgroundMental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities.MethodTwo methods of data collection were employed; (i) In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii) Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them.ResultsAcross the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision.ConclusionsWhile there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of homeless specific and generic

  15. Exploring the Barriers of Home Care Services in Iran: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Heshmatolah Heydari

    2016-01-01

    Full Text Available With increasing chronic diseases, the use of home care is rising in the world. Home care in Iran has many challenges and to improve that, we should identify the challenges and barriers of home care. The aim of this study was to identify and explore the barriers of home care in Iran. This is a qualitative study with content analysis approach that was conducted in Iran in 2015. Fourteen key informants comprising health policymakers, faculty members, nurses, and physicians as well as patients and families engaged in home care purposefully participated in this study. Data was obtained using face-to-face semistructured interviews. A focus group discussion was also used to complete the findings. Graneheim and Lundman’s approach was used for analysis of data and Lincoln and Guba’s criteria were used to confirm the trustworthiness of study’s findings. The data were divided into three main categories and eight subcategories. Main categories included treatment-based approach in the healthcare system, cultural dimensions, and the lack of adequate infrastructure. A position for home care in the healthcare system, considering cultural dimensions in Iranian society and providing an appropriate infrastructure, can be beneficial to improve the situation of home care services in Iran.

  16. What is next after transfer of care from hospital to home for stroke patients? Evaluation of a community stroke care service based in a primary care clinic

    Directory of Open Access Journals (Sweden)

    Aznida Firzah Abdul Aziz

    2013-01-01

    Full Text Available Context: Poststroke care in developing countries is inundated with poor concordance and scarce specialist stroke care providers. A primary care-driven health service is an option to ensure optimal care to poststroke patients residing at home in the community. Aims: We assessed outcomes of a pilot long-term stroke care clinic which combined secondary prevention and rehabilitation at community level. Settings and Design: A prospective observational study of stroke patients treated between 2008 and 2010 at a primary care teaching facility. Subjects and Methods: Analysis of patients was done at initial contact and at 1-year post treatment. Clinical outcomes included stroke risk factor(s control, depression according to Patient Health Questionnaire (PHQ9, and level of independence using Barthel Index (BI. Statistical Analysis Used: Differences in means between baseline and post treatment were compared using paired t-tests or Wilcoxon-signed rank test. Significance level was set at 0.05. Results: Ninety-one patients were analyzed. Their mean age was 62.9 [standard deviation (SD 10.9] years, mean stroke episodes were 1.30 (SD 0.5. The median interval between acute stroke and first contact with the clinic 4.0 (interquartile range 9.0 months. Mean systolic blood pressure decreased by 9.7 mmHg (t = 2.79, P = 0.007, while mean diastolic blood pressure remained unchanged at 80mmHg (z = 1.87, P = 0.06. Neurorehabilitation treatment was given to 84.6% of the patients. Median BI increased from 81 (range: 2−100 to 90.5 (range: 27−100 (Z = 2.34, P = 0.01. Median PHQ9 scores decreased from 4.0 (range: 0−22 to 3.0 (range: 0−19 though the change was not significant (Z= −0.744, P = 0.457. Conclusions: Primary care-driven long-term stroke care services yield favorable outcomes for blood pressure control and functional level.

  17. Perspective of patients, patients' families, and healthcare providers towards designing and delivering hospice care services in a middle income Country

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2015-01-01

    Conclusion: Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.

  18. Do homosexual persons use health care services more frequently than heterosexuals persons: findings from a Dutch population survey.

    NARCIS (Netherlands)

    Bakker, F.C.; Sandfort, T.G.M.; Vanwesenbeeck, I.; Lindert, H. van; Westert, G.P.

    2006-01-01

    Use of health care services has been suggested to be lower among homo- or bisexual persons than among heterosexual persons, due to a lack of trust in the health care system. However, population-based studies on differences in health care utilization according to sexual orientation are scarce. The pu

  19. Sociodemographic Correlates of Choice of Health Care Services in Six Rural Communities in North Central Nigeria

    Directory of Open Access Journals (Sweden)

    Onyemocho Audu

    2014-01-01

    Full Text Available Household expenditure on health has increasingly remained a major source of health care financing in Nigeria despite the introduction of several social health scheme policies provided by the government for meeting the health care costs of patients. Recognizing these limitations, this study assessed the type of health care services people commonly use in various illnesses and the sociodemographic correlates of the preferred health care services by household heads in six rural communities of North Central Nigeria. A cross-sectional community-based descriptive study design was used to study 154 household heads in the settlements using a multistage sampling method. Multiple logistic regressions were performed to investigate independent predictors that had significant chi-square at P<0.05. The leading causes of illness experienced by respondents were medical conditions (42.0% and 41.7% of them sought treatment from patent medicine vendors. The dominant reasons for health-seeking preferences were financial access (53.7% and proximity (48.6%. Age had a higher impact (Beta = 0.892 on the health-seeking preferences of the respondents as compared to their occupation and religion (Beta = 0.368 and −0.746, resp.. Therefore, in order to meet the health care of patients, it is pertinent that the unmet needs of patients are properly addressed by appropriate agencies.

  20. Study of utilization of antenatal care services iin tribal area of Thane district

    Directory of Open Access Journals (Sweden)

    Kalpalata Abhiman Bhaisare

    2015-04-01

    Full Text Available Background: Many health problems among pregnant women are preventable, detectable or treatable through visits to health facility before birth. This enables women to receive important services, such as tetanus vaccinations and screening and treatment for infections, as well as potentially life-saving information on warning signs during pregnancy.2 The objective of this study is to understand the current status of utilization of maternal health services in rural area by elucidating the various factors influencing the use of these services. Methods: It is a community based, cross sectional study carried out in a primary health centre in tribal area of Thane district. Results: 93% women received ANC care for 3 or more than 3 times. 73% women received recommended antenatal care. 68% women received ANC care exclusively from public health facility. Conclusions: Inspite of implementation of various programmes like Janani Suraksha Yojana, Matrutva Anudan Yojana and NRHM in the area percentage of registration during first trimester was less. There was lack of awareness and motivation in study subjects to come on their own to PHC for early registration of pregnancy. Though the coverage of ANC services was good it was not of good quality. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 378-383

  1. Report on survey on international Hub

    International Nuclear Information System (INIS)

    Japan Atomic Energy Agency (JAEA) is promoting initiative to form an international Center of Excellence in line with its aim to accept more researchers/engineers from all over the world. Establishment of 'the Committee for JAEA Internationalization Initiative' was planned in 2010 so as to intensify this initiative, and in February, 2010, we visited research institutions in Europe, which include European Organization for Nuclear Research (CERN), the construction site of ITER in Cadarache, and Rutherford Appleton Laboratory (RAL), with the intention to survey and learn their advanced activities and systems in regard to the International Hub, so that the committee will be able to make fruitful discussion. This report describes strategy taken in each institution for an International Hub, and the state of each institution regarding acceptance and management of overseas researchers and engineers, research environment, living environment/health and welfare, and PR activities/coexistence with the local community. (author)

  2. Spatial Economic Hubs and State Power

    Institute of Scientific and Technical Information of China (English)

    Xuan Xingzhang; Huang Jing

    2008-01-01

    The paper seeks to analyze the rise of state power in the light of spatial economic shifts and examines the historical context of China's rise and challenges facing it. In world history, only countries that were spatial economic hubs have been able to enjoy prosperity over centuries. China is not yet such a country, despite its persistent efforts. Nor is China likely to become an economic hub in the foreseeable future. China is under mounting pressure from new economic demands posed by shifts in the geo-economic status of the U.S.. The fact that the global economy thrives along coastlines also causes problems for China, a country with a long coastline and a vast hinterland, creating rifts between northern and southern China, central and local governments, and different provinces. All these factors might well hinder China's development in the future.

  3. Functional Hubs in Mild Cognitive Impairment

    Science.gov (United States)

    Navas, Adrián; Papo, David; Boccaletti, Stefano; Del-Pozo, F.; Bajo, Ricardo; Maestú, Fernando; Martínez, J. H.; Gil, Pablo; Sendiña-Nadal, Irene; Buldú, Javier M.

    We investigate how hubs of functional brain networks are modified as a result of mild cognitive impairment (MCI), a condition causing a slight but noticeable decline in cognitive abilities, which sometimes precedes the onset of Alzheimer's disease. We used magnetoencephalography (MEG) to investigate the functional brain networks of a group of patients suffering from MCI and a control group of healthy subjects, during the execution of a short-term memory task. Couplings between brain sites were evaluated using synchronization likelihood, from which a network of functional interdependencies was constructed and the centrality, i.e. importance, of their nodes was quantified. The results showed that, with respect to healthy controls, MCI patients were associated with decreases and increases in hub centrality respectively in occipital and central scalp regions, supporting the hypothesis that MCI modifies functional brain network topology, leading to more random structures.

  4. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    OpenAIRE

    Nxumalo, Nonhlanhla; Goudge, Jane; Thomas, Liz

    2013-01-01

    Introduction: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods: The compa...

  5. Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India

    OpenAIRE

    Mahajan, Hemant; Sharma, Bhuwan

    2014-01-01

    Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in t...

  6. Use of Palliative Care Consultation for Patients with End-Stage Liver Disease: Survey of Liver Transplant Service Providers.

    OpenAIRE

    Beck, KR; Pantilat, SZ; O'Riordan, DL; Peters, MG

    2016-01-01

    Palliative care services (PCS) are recommended to enhance quality of care for hospitalized patients.We evaluated the attitudes of liver transplant (LT) providers and perceived barriers to PCS for their patients by conducting a web-based survey of intensive care unit nurses, postgraduate year 1 (PGY1) physician trainees, nurse practitioners, fellows, and attending physicians on the LT service at an academic medical center.The response rate was 44% (88/200). Providers agreed that LT and PCS are...

  7. Exploring limits to market-based reform: managed competition and rehabilitation home care services in Ontario.

    Science.gov (United States)

    Randall, Glen E; Williams, A Paul

    2006-04-01

    The rise of neo-liberalism, which suggests that only markets can deliver maximum economic efficiency, has been a driving force behind the trend towards using market-based solutions to correct health care problems. However, the broad application of market-based reforms has tended to assume the presence of fully functioning markets. When there are barriers to markets functioning effectively, such as the absence of adequate competition, recourse to market-based solutions can be expected to produce less than satisfactory, if not paradoxical results. One such case is rehabilitation homecare in Ontario, Canada. In 1996, a "managed competition" model was introduced as part of a province-wide reform of home care in an attempt to encourage high quality at competitive prices. However, in the case of rehabilitation home care services, significant obstacles to achieving effective competition existed. Notably, there were few private provider agencies to bid on contracts due to the low volume and specialized nature of services. There were also structural barriers such as the presence of unionized employees and obstacles to the entry of new providers. This paper evaluates the impact of Ontario's managed competition reform on community-based rehabilitation services. It draws on data obtained through 49 in-depth key informant interviews and a telephone survey of home care coordinating agencies and private rehabilitation provider agencies. Instead of reducing costs and improving quality, as the political rhetoric promised, the analysis suggests that providing rehabilitation homecare services under managed competition resulted in higher per-visit costs and reduced access to services. These findings support the contention that there are limits to market-based reforms. PMID:16198035

  8. Preconception Care: A New Standard of Care within Maternal Health Services

    Science.gov (United States)

    Genuis, Stephen J.; Genuis, Rebecca A.

    2016-01-01

    Emerging research suggests that much pediatric affliction has origins in the vulnerable phase of fetal development. Prenatal factors including deficiency of various nutrients and exposure to assorted toxicants are major etiological determinants of myriad obstetrical complications, pediatric chronic diseases, and perhaps some genetic mutations. With recent recognition that modifiable environmental determinants, rather than genetic predestination, are the etiological source of most chronic illness, modification of environmental factors prior to conception offers the possibility of precluding various mental and physical health conditions. Environmental and lifestyle modification through informed patient choice is possible but evidence confirms that, with little to no training in clinical nutrition, toxicology, or environmental exposures, most clinicians are ill-equipped to counsel patients about this important area. With the totality of available scientific evidence that now exists on the potential to modify disease-causing gestational determinants, failure to take necessary precautionary action may render members of the medical community collectively and individually culpable for preventable illness in children. We advocate for environmental health education of maternity health professionals and the widespread adoption and implementation of preconception care. This will necessitate the translation of emerging knowledge from recent research literature, to health professionals, to reproductive-aged women, and to society at large. PMID:27314031

  9. Preconception Care: A New Standard of Care within Maternal Health Services

    Directory of Open Access Journals (Sweden)

    Stephen J. Genuis

    2016-01-01

    Full Text Available Emerging research suggests that much pediatric affliction has origins in the vulnerable phase of fetal development. Prenatal factors including deficiency of various nutrients and exposure to assorted toxicants are major etiological determinants of myriad obstetrical complications, pediatric chronic diseases, and perhaps some genetic mutations. With recent recognition that modifiable environmental determinants, rather than genetic predestination, are the etiological source of most chronic illness, modification of environmental factors prior to conception offers the possibility of precluding various mental and physical health conditions. Environmental and lifestyle modification through informed patient choice is possible but evidence confirms that, with little to no training in clinical nutrition, toxicology, or environmental exposures, most clinicians are ill-equipped to counsel patients about this important area. With the totality of available scientific evidence that now exists on the potential to modify disease-causing gestational determinants, failure to take necessary precautionary action may render members of the medical community collectively and individually culpable for preventable illness in children. We advocate for environmental health education of maternity health professionals and the widespread adoption and implementation of preconception care. This will necessitate the translation of emerging knowledge from recent research literature, to health professionals, to reproductive-aged women, and to society at large.

  10. Abortion services in a high-needs district: a community-based model of care

    Directory of Open Access Journals (Sweden)

    Snook S

    2013-06-01

    Full Text Available INTRODUCTION: In 2009, a high-deprivation district health board in New Zealand set up a community-based abortion clinic in order to provide a local service and to avoid out-of-region referrals. The service offers medical abortions for women with pregnancies of up to 63 days' gestation, and surgical abortion with local anaesthetic for women with pregnancies of up to 14 weeks' gestation. AIM: To describe the services developed and assess safety and timeliness for the first year of community-based services. METHODS: An audit of clinical records for patients seen in 2010 was performed in order to obtain data on location of services, timeliness, safety and complications. RESULTS: Eighty-two percent of locally provided abortions in 2010 were medical abortions, completed on average less than two days after referral to the service. One percent of patients experienced haemorrhaging post abortion, and 4% had retained products. These rates are within accepted standards for an abortion service. DISCUSSION: This report illustrates that a community-based model of care can be both clinically and culturally safe, while providing a much-needed service to a high-needs population.

  11. Neighbourhood Hubs : Engaging Communities for Sustainability

    OpenAIRE

    Gurr, Charlotte; McCurdy, Adrienne; Robert, Sarah Rose

    2012-01-01

    Society is facing a great sustainability challenge, where the design of its social systems has made it increasingly difficult for the planet to support humanity. Given the complexity of the sustainability challenge, the planet requires a shift in the way society is organised and a commitment to sustainability from individuals and communities. This thesis explores how neighbourhood hubs can serve as a platform to engage individuals to take an active participatory role in their community. Neigh...

  12. Passenger flows prediction in major transportation hubs

    OpenAIRE

    Ozerova, O. O.

    2013-01-01

    Purpose. An effective organization of passenger traffic, due to the reliability prediction of traffic flow in passenger transport hubs. In order to determine the parameters of prospective passenger transport areas it is essential to analyze the impact of various factors and determine the most influential ones. Methodology. The article presents the method of paired linear correlation for a more influential factors on passengers in intercity and commuter and possible use in predicting the linea...

  13. On the Predictability of Hub Height Winds

    OpenAIRE

    Draxl, Caroline; Giebel, Gregor; Hahmann, Andrea N.; Delle Monache, Luca

    2012-01-01

    Wind energy is a major source of power in over 70 countries across the world, and the worldwide share of wind energy in electricity consumption is growing. The introduction of signicant amounts of wind energy into power systems makes accurate wind forecasting a crucial element of modern electrical grids. These systems require forecasts with temporal scales of tens of minutes to a few days in advance at wind farm locations. Traditionally these forecasts predict the wind at turbine hub heights;...

  14. Community Health Service in Urban China: Rebuilding Health Care Systems in New Ways

    Institute of Scientific and Technical Information of China (English)

    赵志广; 卢祖洵

    2004-01-01

    IN THE 1970s, the World Health Organization(WHO) put forward a community-oriented healthservice model based on the experience of Europeancountries such as Britain. At present, this model hasbeen adopted as the key strategy to make health ser-vices accessible, affordable and socially acceptableand is an important component of health servicesystem in many countries.1,2In the early 1950s, China set out to establish athree-level primary health care network in urban andrural areas in order to provide health care...

  15. A call for better care: the impact of postnatal contact services on women’s parenting confidence and experiences of postpartum care in Queensland, Australia

    OpenAIRE

    Miller, Yvette D; Dane, Aimée C; Thompson, Rachel

    2014-01-01

    Background Universal postnatal contact services are provided in several Australian states, but their impact on women’s postnatal care experience has not been evaluated. Furthermore, there is lack of evidence or consensus about the optimal type and amount of postpartum care after hospital discharge for maternal outcomes. This study aimed to assess the impact of providing Universal Postnatal Contact Service (UPNCS) funding to public birthing facilities in Queensland, Australia on women’s postna...

  16. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

    OpenAIRE

    Alhamdan , A.A.; Alshammari , S.A.; Al-Amoud, M.M.; Hameed , T.A.; Al-Muammar , M.N.; Bindawas , S.M.; Al-Orf , S.M.; Mohamed , A.G.; Al-Ghamdi , E.A.; P.C. Calder

    2015-01-01

    Objectives: to evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Methods: between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by o...

  17. Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers

    OpenAIRE

    Lang, Katherine; Neil, Jaycie; Wright, Judith; Dell, Colleen Anne; Berenbaum, Shawna; El-Aneed, Anas

    2013-01-01

    Background People who inject drugs (PWID) often encounter barriers when attempting to access health care and social services. In our previous study conducted to identify barriers to accessing care from the perspective of PWIDs in Saskatoon, Canada: poverty, lack of personal support, discrimination, and poor knowledge and coordination of service providers among other key barriers were identified. The purpose of the present investigation was to explore what service providers perceive to be the ...

  18. Strengthening Health Systems at Facility-Level: Feasibility of Integrating Antiretroviral Therapy into Primary Health Care Services in Lusaka, Zambia

    OpenAIRE

    Topp, Stephanie M; Chipukuma, Julien M; Giganti, Mark; Mwango, Linah K.; Chiko, Like M.; Tambatamba-Chapula, Bushimbwa; Wamulume, Chibesa S; Reid, Stewart

    2010-01-01

    Introduction HIV care and treatment services are primarily delivered in vertical antiretroviral (ART) clinics in sub-Saharan Africa but there have been concerns over the impact on existing primary health care services. This paper presents results from a feasibility study of a fully integrated model of HIV and non-HIV outpatient services in two urban Lusaka clinics. Methods Integration involved three key modifications: i) amalgamation of space and patient flow; ii) standardization of medical r...

  19. Should violence services be integrated within abortion care? A UK situation analysis.

    Science.gov (United States)

    Kekana, Loveday Penn; Hall, Megan; Motta, Silvia; Bewley, Susan

    2016-05-01

    The prevalence of violence against women worldwide raises the question of the desirability and feasibility of integrating interpersonal violence (IPV) services within abortion care. By examining present services and context in an Inner London borough in the UK, this situation analysis explored the hypothesis that an established, integrated, health-based service (comprising raised awareness, staff training in routine IPV enquiry and referral to a community-based in-reach IPV service) would be transferable into abortion services. Four sources of qualitative data investigated views on integrating services: key stakeholder in-depth interviews including with providers of abortion and IPV services and commissioners and IPV survivors with past abortion service use (3 user, 15 provider); qualitative analysis of the open-ended part of a survey of current abortion service users with and without experience of IPV; feedback from an interactive workshop and data from field observations. While there was consensus among all informants that women experiencing IPV and seeking abortion have unidentified, unaddressed needs, how any intervention might be organised to address these needs was contested; thus questions remain about whether, when and how to raise the topic of IPV and what to offer. Two major anxieties surfaced: a practical concern in terms of interrupting a streamlined abortion service that suits the majority of staff and patients, and a conceptual concern about risk of stigmatising abortion seekers as 'victims in crisis'. Thus, our findings indicate: when integrating IPV interventions into abortion services, local context, the integrity of separate pathways, and women's safety and agency must be considered, especially when abortion rights are under attack. Novel approaches are required and should be researched. PMID:27578344

  20. Perceived quality of health care services among people with osteoarthritis – results from a nationwide survey

    Directory of Open Access Journals (Sweden)

    Grønhaug G

    2015-09-01

    Full Text Available Gudmund Grønhaug,1 Jon Hagfors,2 Ingebjørg Borch,2 Nina Østerås,1 Kåre Birger Hagen11National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, 2Norwegian Rheumatism Association, Oslo, NorwayObjective: To assess the perceived quality of care received by people with osteoarthritis (OA in Norway and explore factors associated with the quality of care.Methods: A national survey in which members of the Norwegian Rheumatism Association with OA registered as their main diagnosis completed a questionnaire. The perceived quality of care was reported on a 17-item OsteoArthritis Quality Indicator questionnaire, covering both pharmacological and non-pharmacological aspects of OA care. In addition, the four-page questionnaire covered areas related to demographic characteristics, the location and impact of the OA, and utilization and satisfaction with health care services. The quality of care is calculated as pass rates, where the numerator represents the number of indicators passed and the denominator represents the number of eligible persons.Results: In total, 1,247 participants (response rate 57% completed the questionnaire. Mean age was 68 years (standard deviation 32 and 1,142 (92% were women. Respondents reported OA in hand only (12.4%, hip only (7.3%, knee only (10.4%, in two locations (42% or all three locations (27%. The overall OsteoArthritis Quality Indicator pass rate was 47% (95% confidence interval [CI] 46%–48%, and it was higher for pharmacological aspects (53% [51%–54%] than for non-pharmacological aspects of care (44% [43%–46%]. The pass rate for the individual quality indicators ranged from 8% for “referral for weight reduction” to 81% for “receiving advice about exercises”. Satisfaction with care was strongly associated with perceived quality. The pass rate for those who were “very satisfied” was 33% (25%–40% higher than those who were “very unsatisfied” with care.Conclusion: While the OA

  1. Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs.

    Science.gov (United States)

    Rosen-Reynoso, Myra; Porche, Michelle V; Kwan, Ngai; Bethell, Christina; Thomas, Veronica; Robertson, Julie; Hawes, Eva; Foley, Susan; Palfrey, Judith

    2016-05-01

    Objectives Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services. By examining data from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2009-2010) and using the revised criteria for "ease of use," we were able to assess the percentage of parents who reported that their experiences seeking services for their children met those criteria. Methods We performed Chi square tests to examine associations between the independent variables and their relationship to the difficulties or delays assessed in the survey; including: eligibility, availability of services, waiting lists, cost, and access to information. We used logistic regression to determine the association of meeting the "ease of use" criteria with socio-demographic, complexity of need, and access variables. Results Overall, a third of families of CSHCN (35.3 %) encounter difficulties, delays, or frustrations in obtaining health and related services. The lack of access to health and community services in this study fell most heavily on children from racial/ethnic minority backgrounds, those in poverty, and those with complex emotional/behavioral or developmental needs and functional limitations. Conclusions for Practice CSHCN require services from a broad array of providers across multiple systems. Unfortunately, there are certain difficulties that hamper the accessibility of these systems. These findings underscore the need for both practice-level response and systems-level reform to ensure equitable distribution of health and community resources. PMID:26728898

  2. Access to diagnostics in primary care and the impact on a primary care led health service.

    LENUS (Irish Health Repository)

    O'Riordan, M

    2015-02-01

    We undertook a postal survey of GPs to establish their current access to radiological and endoscopic tests. More than one fifth of GPs do not have direct access to abdominal (n = 42, 21.4%) or pelvic (n = 49, 24.6%) ultrasound in the public system. Where access is available public patients have an average 14 week waiting period. In stark contrast in the private system virtually all GPs have direct access (n = 159, 99.2% and n = 156, 98.8% respectively for abdominal and pelvic ultrasound) with an average wait of just over four days. Direct access to CT scan in the public system is available to the minority of GPs, e.g. n = 31, 18.4% for chest scan, in the public system; even where available, there is an average 12 week wait for this. In comparison 151 (88.6%) GPs have access to CT chest scanning in the private sector with an average waiting time of 5.4 working days. Such limited access to diagnostics impacts on the delivery of a quality service.

  3. Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care program, 2004-2008

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2009-10-01

    Full Text Available Abstract Background In 2004, as an extension of the Enhanced Primary Care (EPC program, the Australian Government introduced a policy of providing Medicare rebates for allied health services provided to patients with chronic or complex health conditions. The objective of this study was to evaluate the utilisation of podiatry services provided under this scheme between 2004 and 2008. Methods Data pertaining to the Medicare item 10962 for the calendar years 2004-2008 were extracted from the Australian Medicare Benefits Schedule (MBS database and cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number of consultations provided and to assess for temporal trends over the five-year assessment period. The total cost to Medicare over this period was also determined. Results During the 2004-2008 period, a total of 1,338,044 EPC consultations were provided by podiatrists in Australia. Females exhibited higher utilisation than males (63 versus 37%, and those aged over 65 years accounted for 75% of consultations. There was a marked increase in the number of consultations provided from 2004 to 2008, and the total cost of providing EPC podiatry services during this period was $62.9 M. Conclusion Podiatry services have been extensively utilised under the EPC program by primary care patients, particularly older women, and the number of services provided has increased dramatically between 2004 and 2008. Further research is required to determine whether the EPC program enhances clinical outcomes compared to standard practice.

  4. The Kaiser Permanente Colorado Clinical Pharmacy Anticoagulation Service as a model of modern anticoagulant care.

    Science.gov (United States)

    Witt, Daniel M

    2008-01-01

    The Clinical Pharmacy Anticoagulation Service (CPAS) at Kaiser Permanente Colorado grew from a single pharmacist assisting a single physician to a comprehensive service staffed by over 20 employees. CPAS provides care for over 7200 patients with each CPAS pharmacist managing all aspects of anticoagulation therapy for 150 to 500 patients. Unique aspects of CPAS include its centralized organization structure, the use of telepharmacy, collaboration drug therapy management agreement with referring physicians and a robust research agenda. Results of various CPAS research projects have been published in the peer-reviewed medical literature. PMID:18804262

  5. Demand and Supply–Based Operating Modes—A Framework for Analyzing Health Care Service Production

    Science.gov (United States)

    Lillrank, Paul; Groop, P Johan; Malmström, Tomi J

    2010-01-01

    Context: The structure of organizations that provide services should reflect the possibilities of and constraints on production that arise from the market segments they serve. Organizational segmentation in health care is based on urgency and severity as well as disease type, bodily function, principal method, or population subgroup. The result is conflicting priorities, goals, and performance metrics. A managerial perspective is needed to identify activities with similar requirements for integration, coordination, and control. Methods: The arguments in this article apply new reasoning to the previous literature. Findings: The method used in this article to classify health care provision distinguishes different types of health problems that share generic constraints of production. Conclusions: The analysis leads to seven different demand-supply combinations, each with its own operational logic. These are labeled demand and supply–based operating modes (DSO modes), and constitute the managerial building blocks of health care organizations. The modes are Prevention, Emergency, One visit, Project, Elective, Cure, and Care. As analytical categories the DSO modes can be used to understand current problems. Several operating modes in one unit create managerial problems of conflicting priorities, goals, and performance metrics. The DSO modes are constructed as managerially homogeneous categories or care platforms responding to general types of demand, and supply constraints. The DSO modes bring methods of industrial management to bear on efforts to improve health care. PMID:21166870

  6. Experiences of primary health care nurses regarding the provision of free health care services in the Northern region of the Limpopo Province

    OpenAIRE

    VO Netshandama; L Nemathaga; SN Shai-Mahoko

    2005-01-01

    The purpose of the study was to explore the experiences of primary health care nurses working in the clinics and health centres involved in the provision of free health care services. The research design followed was exploratory, descriptive and qualitative. The population of the study included all primary health care nurses working at the clinics and health centres in the Vhembe (northern) region of the Limpopo Province. The sampling method used was purposive for the samples of both the clin...

  7. Pathways to Care for Critically Ill or Injured Children: A Cohort Study from First Presentation to Healthcare Services through to Admission to Intensive Care or Death.

    OpenAIRE

    Peter Hodkinson; Andrew Argent; Lee Wallis; Steve Reid; Rafael Perera; Sian Harrison; Matthew Thompson; Mike English; Ian Maconochie; Alison Ward

    2016-01-01

    Purpose Critically ill or injured children require prompt identification, rapid referral and quality emergency management. We undertook a study to evaluate the care pathway of critically ill or injured children to identify preventable failures in the care provided. Methods A year-long cohort study of critically ill and injured children was performed in Cape Town, South Africa, from first presentation to healthcare services until paediatric intensive care unit (PICU) admission or emergency dep...

  8. The impact of NHS based primary care complementary therapy services on health outcomes and NHS costs: a review of service audits and evaluations

    Directory of Open Access Journals (Sweden)

    Wye Lesley

    2009-03-01

    Full Text Available Abstract Background The aim of this study was to review evaluations and audits of primary care complementary therapy services to determine the impact of these services on improving health outcomes and reducing NHS costs. Our intention is to help service users, service providers, clinicians and NHS commissioners make informed decisions about the potential of NHS based complementary therapy services. Methods We searched for published and unpublished studies of NHS based primary care complementary therapy services located in England and Wales from November 2003 to April 2008. We identified the type of information included in each document and extracted comparable data on health outcomes and NHS costs (e.g. prescriptions and GP consultations. Results Twenty-one documents for 14 services met our inclusion criteria. Overall, the quality of the studies was poor, so few conclusions can be made. One controlled and eleven uncontrolled studies using SF36 or MYMOP indicated that primary care complementary therapy services had moderate to strong impact on health status scores. Data on the impact of primary care complementary therapy services on NHS costs were scarcer and inconclusive. One controlled study of a medical osteopathy service found that service users did not decrease their use of NHS resources. Conclusion To improve the quality of evaluations, we urge those evaluating complementary therapy services to use standardised health outcome tools, calculate confidence intervals and collect NHS cost data from GP medical records. Further discussion is needed on ways to standardise the collection and reporting of NHS cost data in primary care complementary therapy services evaluations.

  9. Opinion versus practice regarding the use of rehabilitation services in home care: an investigation using machine learning algorithms

    OpenAIRE

    Cheng, Lu; Zhu, Mu; Poss, Jeffrey W.; Hirdes, John P; Glenny, Christine; Stolee, Paul

    2015-01-01

    Background Resources for home care rehabilitation are limited, and many home care clients who could benefit do not receive rehabilitation therapy. The interRAI Contact Assessment (CA) is a new screening instrument comprised of a subset of interRAI Home Care (HC) items, designed to be used as a preliminary assessment to identify which potential home care clients should be referred for a full assessment, or for services such as rehabilitation. We investigated which client characteristics are mo...

  10. Primary health services at district level in South Africa: a critique of the primary health care approach

    OpenAIRE

    Dookie Sunitha; Singh Shenuka

    2012-01-01

    Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, an...

  11. Integrated primary care and behavioral health services for Latinos: a blueprint and research agenda.

    Science.gov (United States)

    Manoleas, Peter

    2008-01-01

    Disparities in Latino utilization of mental health services have been documented for some years. Factors such as stigma, low rates of health insurance, paucity of culturally competent providers, and linguistic inaccessibility have contributed to this underutilization. The documented tendency of many Latinos to experience the mind and body as a unified whole, often referred to as "non-dualism"; provides a unique opportunity to address these disparities in utilization. This article advocates a specific model of engagement of Latinos into a continuum of needed behavioral health services via the primary care clinic, and suggests a variety of clinical and administrative outcome measures for evaluating the effectiveness of the model. The model centers on the inclusion of a behavioral health specialist who is "nested" within the primary care team. The preparation and perspectives of clinically trained social workers make them ideal for this role. PMID:19042495

  12. Early nutrition intervention services for children with special health care needs.

    Science.gov (United States)

    Hine, R J; Cloud, H H; Carithers, T; Hickey, C; Hinton, A W

    1989-11-01

    Dietitians must be responsive to the changing needs of their clients and employers, to societal concerns, and to legal mandates. A recently passed amendment (PL 99-457) to the Federal Education for the Handicapped Act gives nutrition professionals the opportunity to have a voice in establishing nutrition policy and standards of care for young handicapped and high-risk children. The new law extends preventive services to children as young as 3 years of age, and Part H of the law provides financial incentives for states to provide services to children with special health care needs from birth to 2 years of age. This article reviews relevant provisions of the new law and describes two projects undertaken by nutritionists from Alabama, Mississippi, and Texas. It also summarizes challenges to nutritionists that will result from the law's implementation. PMID:2809041

  13. Unmet Health Care Service Needs of Children With Disabilities in Penang, Malaysia.

    Science.gov (United States)

    Tan, Seok Hong

    2015-11-01

    Information on unmet health care needs reveal problems that are related to unavailability and inaccessibility of services. The study objectives were to determine the prevalence, and the reasons for unmet service needs among children with disabilities in the state of Penang, Malaysia. Caregivers of children with disabilities aged 0 to 12 years registered with the Penang Social Welfare Department in 2012 answered a self-administered mailed questionnaire. A total of 305 questionnaires were available for analysis (response rate 37.9%). Services that were very much needed and yet highly unmet were dental services (49.6% needed, 59.9% unmet), dietary advice (30.9% needed, 63.3% unmet), speech therapy (56.9% needed, 56.8% unmet), psychology services (25.5% needed, 63.3% unmet), and communication aids (33.0% needed, 79.2% unmet). Access problems were mainly due to logistic issues and caregivers not knowing where to obtain services. Findings from this study can be used to inform strategies for service delivery and advocacy for children with disabilities in Penang, Malaysia. PMID:26122314

  14. Omni directional mobile robot capable of variable foot printing based on hub type drive module

    International Nuclear Information System (INIS)

    In recent years, an increased amount of research has been carried out on mobile robots to improve the performance of service robots. Mobile robots maximize the mobility of service robots, thus allowing them to work in different areas. However, conventional service robots have their center of mass placed high above the ground, which may cause them to fall when moving at high speed. Furthermore, hub type actuators, which are often used for mobile robots, are large and expensive. In this study, we propose a mobile robot with a hub type actuator unit and a variable footprint mechanism. The proposed variable footprint mechanism greatly improves the stability and mobility of the robot, allowing it to move freely in a narrow space and carry out various tasks. The performance of the proposed robot is verified experimentally

  15. Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

    Directory of Open Access Journals (Sweden)

    Oldenburg Brian

    2009-12-01

    Full Text Available Abstract Background Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia. Methods Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA and internal reliability testing (Cronbach's alpha were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent. Results The PCA identified five scales with acceptable levels of internal consistency were: (1 social support (ten items, alpha 0.86; (2 perceived interpersonal care (five items, alpha 0.87, (3 concerns about availability of health care and accessibility to health care (eight items, alpha 0.80, (4 value of good health (five items, alpha 0.79, and (5 attitudes towards health care (three items, alpha 0.75. Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

  16. Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?

    NARCIS (Netherlands)

    ten Have, M; Oldehinkel, A; Vollebergh, W; Ormel, J

    2003-01-01

    Objective: To investigate whether (1) education predicts the use of care services for mental health problems, independently of mental disorder and functional impairment and (2) education modifies the association between mental disorder and service use. Method: Predictors of service use were recorded

  17. How does mental health care perform in respect to service users' expectations? Evaluating inpatient and outpatient care in Germany with the WHO responsiveness concept

    Directory of Open Access Journals (Sweden)

    Elgeti Hermann

    2007-07-01

    Full Text Available Abstract Background Health systems increasingly try to make their services more responsive to users' expectations. In the context of the World Health Report 2000, WHO developed the concept of health system responsiveness as a performance parameter. Responsiveness relates to the system's ability to respond to service users' legitimate expectations of non-medical aspects. We used this concept in an effort to evaluate the performance of mental health care in a catchment area in Germany. Methods In accordance with the method WHO used for its responsiveness survey, responsiveness for inpatient and outpatient mental health care was evaluated by a standardised questionnaire. Responsiveness was assessed in the following domains: attention, dignity, clear communication, autonomy, confidentiality, basic amenities, choice of health care provider, continuity, and access to social support. Users with complex mental health care needs (i.e., requiring social and medical services or inpatient care were recruited consecutively within the mental health services provided in the catchment area of the Hanover Medical School. Results 221 persons were recruited in outpatient care and 91 in inpatient care. Inpatient service users reported poor responsiveness (22% more often than outpatients did (15%; however this was significant only for the domains dignity and communication. The best performing domains were confidentiality and dignity; the worst performing were choice, autonomy and basic amenities (only inpatient care. Autonomy was rated as the most important domain, followed by attention and communication. Responsiveness within outpatient care was rated worse by people who had less money and were less well educated. Inpatient responsiveness was rated better by those with a higher level of education and also by those who were not so well educated. 23% of participants reported having been discriminated against in mental health care during the past 6 months. The results

  18. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

    Directory of Open Access Journals (Sweden)

    Bath B

    2011-12-01

    Full Text Available Brenna Bath1, Bonnie Janzen21School of Physical Therapy, College of Medicine, University of Saskatchewan, 2Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaPurpose: To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons.Methods: People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding.Results: A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction, negative (ie, lack of detail, time to follow-up, cost and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.Conclusion: The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given

  19. The nurse’s leadership within the context of emergency care services

    OpenAIRE

    Danielle Soares Silva; Andrea Bernardes; Carmen Silvia Gabriel; Fernanda Ludmilla Rossi Rocha; Graziela Caldana

    2014-01-01

    The objective of this study was to analyze the contributions that research has made to leadership in nursing within the context of emergency care services from 2001 to 2012. This Integrative Literature Review included studies indexed in the following databases: Latin American and Caribbean Health Sciences (LILACS), Medical Literature Analysis and Retrieval Systems Online (MEDLINE) and SCOPUS. Publications were grouped into three categories: “The styles of leadership adopted by the nurses of t...

  20. Determining the Level of Satisfaction of Patients in Nursing Care and Health Services

    OpenAIRE

    Sevban Arslan; Evsen Nazik; Derya Tanriverdi; Seher Gurdil

    2012-01-01

    This study was conducted to determine patients’ satisfaction with nursing care and health services. This descriptive study was performed with 320 inpatients at University Hospital’s internal diseases and surgical units in July and November 2011. The data were collected by a questionnaire and the Visual Analog Patient Satisfaction Scale and the Scale of Patient Perception of Hospital Experience With Nursing. For statistical evalution , SPSS(Statistical Package for Social Science) 1...

  1. UR Well Eye Care: a model for medical student ophthalmology education and service in the community

    OpenAIRE

    MacLean K; Hindman HB

    2014-01-01

    Kyle MacLean,1 Holly B Hindman2,3 1University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 2The Flaum Eye Institute, University of Rochester, Rochester, NY, USA; 3Center for Visual Science, University of Rochester, Rochester, NY, USA Purpose: To assess medical student ophthalmic educational exposure and service provided through the University of Rochester’s UR Well Eye Care (URWEC) program, a student-run initiative in which medical students provide s...

  2. Childhood eye care services in South Darfur State of Sudan: Learner and parent perspectives

    OpenAIRE

    Saif H. Alrasheed; Naidoo, Kovin S; Peter C. Clarke-Farr

    2016-01-01

    Purpose: Most causes of childhood visual impairment are either treatable or preventable. Eye health education plays an important role in reducing avoidable causes of visual impairment as well as to help ensure a healthy and educated community. The main objective of this study was to assess the Knowledge, Attitudes and Practices of the students and their parents on childhood eye services and barriers for accessing child eye care.Methods: The study was conducted in South Darfur State of Sudan b...

  3. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

  4. Prevalence of high utilizers of health services with positive history for depression in Primary Health Care

    OpenAIRE

    Iana Pires do Amaral Carvalho; Cesar Gattermann Xavier Carvalho; José Mauro Ceratti Lopes

    2015-01-01

    Objective: to study the association between history of depression and high use of health services (HUHS) among persons seen in Primary Health Care (PHC), and to establish the prevalence of HUHS, the average number of visits and the epidemiological profile of groups with positive and negative history of depression. Methods: we collected data from family medical records of two Health Units. In order to analyze data regarding the primary outcome and to compare the epidemiological profile of the ...

  5. Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review

    OpenAIRE

    George, Asha S.; Branchini, Casey; Portela, Anayda

    2015-01-01

    Twenty years after the rights of women to go through pregnancy and childbirth safely were recognized by governments, we assessed the effects of interventions that promote awareness of these rights to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet search and contact with experts. From the 707 unique docu...

  6. Experiences of primary health care nurses regarding the provision of free health care services in the northern region of the Limpopo Province.

    Science.gov (United States)

    Netshandama, V O; Nemathaga, L; Shai-Mahoko, S N

    2005-02-01

    The purpose of the study was to explore the experiences of primary health care nurses working in the clinics and health centres involved in the provision of free health care services. The research design followed was exploratory, descriptive and qualitative. The population of the study included all primary health care nurses working at the clinics and health centres in the Vhembe (northern) region of the Limpopo Province. The sampling method used was purposive for the samples of both the clinics and the nurses. The inclusion criteria for the nurses included experience of two or more years in providing primary health care. The inclusion criteria for the selection of clinics included being a busy clinic (a minimum of 2000 patients per month) with a staff establishment of four or more primary health care nurses. In conducting this research, ethical principles were taken into account. Data was collected from 23 participants in the Northern Region. The research question read as follows: What are your experiences regarding the provision of free health care services? An open coding method consisting of eight steps provided by Tesch's (1990:140-145) eight-step method of analysing data was used. The research findings revealed that the primary health care nurses working in the clinics experience feelings of failure to provide adequate primary health care services due to the increased workload, misuse of the service, and fear associated with lack of security in the clinics and health centres. The conclusions drawn from this research are that on the one hand a poor mechanism exists for the monitoring of the implementation of free health services, and on another hand, there has been misuse of the facilities by the community. The concept "free health care service" has been misinterpreted. PMID:15850154

  7. The Impact of Direct Provision Accommodation for Asylum Seekers on Organisation and Delivery of Local Primary Care and Social Care Services: A Case Study

    LENUS (Irish Health Repository)

    Pieper, Hans-Olaf

    2011-05-15

    Abstract Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

  8. Experimental Investigation of a Helicopter Rotor Hub Wake

    Science.gov (United States)

    Reich, David; Elbing, Brian; Schmitz, Sven

    2013-11-01

    A scaled model of a notional helicopter rotor hub was tested in the 48'' Garfield Thomas Water Tunnel at the Applied Research Laboratory Penn State. The main objectives of the experiment were to understand the spatial- and temporal content of the unsteady wake downstream of a rotor hub up to a distance corresponding to the empennage. Primary measurements were the total hub drag and velocity measurements at three nominal downstream locations. Various flow structures were identified and linked to geometric features of the hub model. The most prominent structures were two-per-revolution (hub component: scissors) and four-per-revolution (hub component: main hub arms) vortices shed by the hub. Both the two-per-revolution and four-per-revolution structures persisted far downstream of the hub, but the rate of dissipation was greater for the four-per-rev structures. This work provides a dataset for enhanced understanding of the fundamental physics underlying rotor hub flows and serves as validation data for future CFD analyses.

  9. Determinants of maternity care services utilization among married adolescents in rural India.

    Directory of Open Access Journals (Sweden)

    Prashant Kumar Singh

    Full Text Available BACKGROUND: Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed. METHODOLOGY/PRINCIPAL FINDINGS: Using the data from third wave of National Family Health Survey (2005-06, available in public domain for the use by researchers, this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15-19 years in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care, safe delivery, and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994, selected socioeconomic, demographic, and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion, and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment, economic status and region of residence. Muslim women, and women belonged to Scheduled Castes, Scheduled Tribes, and Other Backward Classes are less likely to avail safe delivery services. Additionally, adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions. CONCLUSIONS: The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start

  10. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration

    Directory of Open Access Journals (Sweden)

    Nina R. Sperber

    2016-04-01

    Full Text Available We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC, but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines.

  11. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

    Science.gov (United States)

    Sperber, Nina R; Andrews, Sara M; Voils, Corrine I; Green, Gregory L; Provenzale, Dawn; Knight, Sara

    2016-01-01

    We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines. PMID:27136589

  12. Beyond the GAO Cleveland study: client selection for home care services.

    Science.gov (United States)

    Willemain, T R

    1980-01-01

    The General Accounting Office (GAO) study of home care services in the Cleveland area is a prominent attempt to inform the selection of clients for these services. This paper critiques two major portions of the GAO study: the "break even" analysis relating level of client impairment to the comparative costs of care in home and institutional settings, and the analysis of risk of institutionalization as a function of client characteristics. Detailed review shows serious flaws in the GAO methodology which undermine the credibility of its estimates of relative service costs and risks of institutionalization. This paper proceeds to place the GAO study within a conceptual framework that permits more systematic consideration of the issue of client selection. Analysis of a model of institutionalization shows that the strategy recommended by GAO of targeting the highest risk individuals may be an inefficient way to use home care resources. Factors pertinent to client selection include not only risk of institutionalization but also level of private support, changes in risk and private support occasioned by an increase in public support, number of clients in the target group, and political attractiveness of the target group. PMID:10309874

  13. Coverage and development of specialist palliative care services across the World Health Organization European region (2005-2012): results from a European association for palliative care task force survey of 53 countries

    OpenAIRE

    Centeno, Carlos; Lynch, Thomas; Garralda, Eduardo; Carrasco, José Miguel; Guillen-Grima, Francisco; Clark, David

    2016-01-01

    Background: The evolution of the provision of palliative care specialised services is important for planning and evaluation. Aim: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region – home care teams, hospital support teams and inpatient palliative care services. Design and setting: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Pal...

  14. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    Directory of Open Access Journals (Sweden)

    Nonhlanhla Nxumalo

    2013-01-01

    Full Text Available Introduction: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO, a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods: The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results: The local satellite (of a national NGO, successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion: Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures.

  15. The Cascade of Care for an Australian Community-Based Hepatitis C Treatment Service.

    Directory of Open Access Journals (Sweden)

    Amanda J Wade

    Full Text Available Hepatitis C treatment uptake in Australia is low. To increase access to hepatitis C virus treatment for people who inject drugs, we developed a community-based, nurse-led service that linked a viral hepatitis service in a tertiary hospital to primary care clinics, and resulted in hepatitis C treatment provision in the community.A retrospective cohort study of patients referred to the community hepatitis service was undertaken to determine the cascade of care. Logistic regression analyses were used to identify predictors of hepatitis C treatment uptake.Four hundred and sixty-two patients were referred to the community hepatitis service; 344 attended. Among the 279 attendees with confirmed chronic hepatitis C, 257 (99% reported ever injecting drugs, and 124 (48% injected in the last month. Of 201 (72% patients who had their fibrosis staged, 63 (31% had F3-F4 fibrosis. Fifty-five patients commenced hepatitis C treatment; 26 (47% were current injectors and 25 (45% had F3-F4 fibrosis. Nineteen of the 27 (70% genotype 1 patients and 14 of the 26 (54% genotype 3 patients eligible for assessment achieved a sustained virologic response. Advanced fibrosis was a significant predictor of treatment uptake in adjusted analysis (AOR 2.56, CI 1.30-5.00, p = 0.006.Our community hepatitis service produced relatively high rates of fibrosis assessment, hepatitis C treatment uptake and cure, among people who inject drugs. These findings highlight the potential benefits of providing community-based hepatitis C care to people who inject drugs in Australia-benefits that should be realised as direct-acting antiviral agents become available.

  16. FACTORS RELATED TO THE USE OF HOME CARE SERVICES BY STROKE PATIENTS UNDER JAPAN’S LONG TERM CARE INSURANCE SYSTEM

    OpenAIRE

    Kazuya Ikenishi

    2015-01-01

    Introduction: As the population aged 65 years or older in Japan grows, the number of people who receive long-term care is increasing. Amongst the various disease groups, stroke sufferers are currently the largest group who use home care nursing services. This study explores the factors that affect the insurance system’s home care services use rate among stroke patients and their main caregivers in Japan. Aims: This study aims to identify the key factors of stroke patients and that of their ma...

  17. The Starting Early Starting Smart Integrated Services Model: Improving Access to Behavioral Health Services in the Pediatric Health Care Setting for At-Risk Families with Young Children

    Science.gov (United States)

    Morrow, Connie E.; Mansoor, Elana; Hanson, K. Lori; Vogel, April L.; Rose-Jacobs, Ruth; Genatossio, Carolyn Seval; Windham, Amy; Bandstra, Emmalee S.

    2010-01-01

    We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting, mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented from five pediatric care (PC) sites, drawing from families at risk due to demographic and…

  18. Protocol and baseline data from The Inala Chronic Disease Management Service evaluation study: a health services intervention study for diabetes care

    Directory of Open Access Journals (Sweden)

    Ware Robert S

    2010-05-01

    Full Text Available Abstract Background Type 2 Diabetes Mellitus is one of the most disabling chronic conditions worldwide, resulting in significant human, social and economic costs and placing huge demands on health care systems. The Inala Chronic Disease Management Service aims to improve the efficiency and effectiveness of care for patients with type 2 diabetes who have been referred by their general practitioner to a specialist diabetes outpatient clinic. Care is provided by a multidisciplinary, integrated team consisting of an endocrinologist, diabetes nurse educators, General Practitioner Clinical Fellows (general practitioners who have undertaken focussed post-graduate training in complex diabetes care, and allied health personnel (a dietitian, podiatrist and psychologist. Methods/Design Using a geographical control, this evaluation study tests the impact of this model of diabetes care provided by the service on patient outcomes compared to usual care provided at the specialist diabetes outpatient clinic. Data collection at baseline, 6 and 12-months will compare the primary outcome (glycaemic control and secondary outcomes (serum lipid profile, blood pressure, physical activity, smoking status, quality of life, diabetes self-efficacy and cost-effectiveness. Discussion This model of diabetes care combines the patient focus and holistic care valued by the primary care sector with the specialised knowledge and skills of hospital diabetes care. Our study will provide empirical evidence about the clinical effectiveness of this model of care. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12608000010392.

  19. Protocol and baseline data from The Inala Chronic Disease Management Service evaluation study: a health services intervention study for diabetes care

    OpenAIRE

    Ware Robert S; Jackson Claire L; Askew Deborah A; Russell Anthony

    2010-01-01

    Abstract Background Type 2 Diabetes Mellitus is one of the most disabling chronic conditions worldwide, resulting in significant human, social and economic costs and placing huge demands on health care systems. The Inala Chronic Disease Management Service aims to improve the efficiency and effectiveness of care for patients with type 2 diabetes who have been referred by their general practitioner to a specialist diabetes outpatient clinic. Care is provided by a multidisciplinary, integrated t...

  20. Should the provision of home help services be contained?: Validation of the new preventive care policy in Japan

    Directory of Open Access Journals (Sweden)

    Ishibashi Tomoaki

    2010-08-01

    Full Text Available Abstract Background To maintain the sustainability of public long-term care insurance (LTCI in Japan, a preventive care policy was introduced in 2006 that seeks to promote active improvement in functional status of elderly people who need only light care. This policy promotes the use of day care services to facilitate functional improvement, and contains the use of home help services that provide instrumental activity of daily living (IADL support. However, the validity of this approach remains to be demonstrated. Methods Subjects comprised 241 people aged 65 years and over who had recently been certified as being eligible for the lightest eligibility level and had began using either home help or day care services between April 2007 and October 2008 in a suburban city of Tokyo. A retrospective cohort study was conducted ending October 2009 to assess changes in the LTCI eligibility level of these subjects. Cox's proportional hazards model was used to calculate the relative risk of declining in function to eligibility Level 4 among users of the respective services. Results Multivariate analysis adjusted for factors related to service use demonstrated that the risk of decline in functional status was lower for users of home help services than for users of day care services (HR = 0.55, 95% CI: 0.31-0.98. The same result was obtained when stratified by whether the subject lived with family or not. Furthermore, those who used two or more hours of home help services did not show an increase in risk of decline when compared with those who used less than two hours. Conclusions No evidence was obtained to support the effectiveness of the policy of promoting day care services and containing home help services for those requiring light care.

  1. [The impact of frailty on the oral care behaviour and dental service use of elderly people].

    Science.gov (United States)

    Niesten, D; van der Sanden, W J M; Gerritsen, A E

    2015-04-01

    In order to explore how the level of frailty and various frailty factors affect the dental service use and oral self-care behaviour of frail elderly people, 51 frail elderly people were interviewed. Additional information on age, gender, living situation, prosthetic status, self-reported health and oral health, chronic diseases and an index for frailty was collected. A thematic qualitative analysis of the collected data reveals that frail elders maintain long-established oral hygiene routines as long as possible to sustain a sense of self-worth. When burdened by severe health complaints they discontinue visits to the dentist first and oral hygiene routines subsequently. A loss of confidence in the results of dental service use, the trivializing of complaints and a diminishing sense of the importance of oral health play a role in these developments. Frail elderly people also experience psychological and social barriers to oral healthcare and dental service use when they are institutionalized. PMID:26210121

  2. Adolescent mothers’ non-utilisation of antenatal care services in Bulawayo, Zimbabwe

    Directory of Open Access Journals (Sweden)

    C. N. Chaibva

    2009-09-01

    Full Text Available Adolescent pregnancies are high risk obstetric occurrences. Antenatal care (ANC provides opportunities to recognise and treat obstetric complications, enhancing the pregnancy outcomes for mothers and babies. The purpose of the study was to identify factors influencing adolescents' non-utilisation of ANC services in Bulawayo. The Health Belief Model (HBM was used to contextualise the study. A quantitative, non-experimental, descriptive research design was adopted, using structured interviews to collect data. Purposive, non-probability sampling was used to conduct structured interviews with 80 adolescent mothers from the postnatal wards who had delivered their babies without attending ANC. Factors influencing these adolescent mothers’ non-utilisation of ANC services included socio-economic issues, individuals' perceptions about ANC, limited knowledge about ANC, policies and structural barriers. However, these adolescents knew that delivering their babies with skilled attendance could enhance the outcomes for the mothers and babies, would help secure documents to facilitate the acquisition of their children's birth certificates, and that obstetric complications required the services of skilled midwives/doctors. Policy-related issues, such as requiring national identity cards from pregnant adolescents (or from their spouses prohibited some of them from utilising ANC services. There is a need to improve adolescents’ reproductive health outreach (including ANC programmes and to offer free ANC services in Zimbabwe. Restrictive policies, such as the required identity cards of the pregnant adolescents (or their husbands, impacted negatively on the accessibility of ANC services and should be addressed as a matter of urgency in Bulawayo.

  3. Experiences of primary health care nurses regarding the provision of free health care services in the Northern region of the Limpopo Province

    Directory of Open Access Journals (Sweden)

    VO Netshandama

    2005-09-01

    Full Text Available The purpose of the study was to explore the experiences of primary health care nurses working in the clinics and health centres involved in the provision of free health care services. The research design followed was exploratory, descriptive and qualitative. The population of the study included all primary health care nurses working at the clinics and health centres in the Vhembe (northern region of the Limpopo Province. The sampling method used was purposive for the samples of both the clinics and the nurses. The inclusion criteria for the nurses included experience of two or more years in providing primary health care. The inclusion criteria for the selection of clinics included being a busy clinic (a minimum of 2000 patients per month with a staff establishment of four or more primary health care nurses. In conducting this research, ethical principles were taken into account. Data was collected from 23 participants in the Northern Region. The research question read as follows: What are your experiences regarding the provision of free health care services? An open coding method consisting of eight steps provided by Tesch's (1990:140-145 eight-step method of analysing data was used. The research findings revealed that the primary health care nurses working in the clinics experience feelings of failure to provide adequate primary health care services due to the increased workload, misuse of the service, and fear associated with lack of security in the clinics and health centres. The conclusions drawn from this research are that on the one hand a poor mechanism exists for the monitoring of the implementation of free health services, and on another hand, there has been misuse of the facilities by the community. The concept “free health care service” has been misinterpreted.

  4. Bridging the Gaps in Obstetric Care: Perspectives of Service Delivery Providers on Challenges and Core Components of Care in Rural Georgia.

    Science.gov (United States)

    Pinto, Meredith; Rochat, Roger; Hennink, Monique; Zertuche, Adrienne D; Spelke, Bridget

    2016-07-01

    Objectives In 2011, a workforce assessment conducted by the Georgia Maternal and Infant Health Research Group found that 52 % of Primary Care Service Areas outside metropolitan Atlanta, Georgia, had an overburdened or complete lack of obstetric care services. In response to that finding, this study's aim was twofold: to describe challenges faced by providers who currently deliver or formerly delivered obstetric care in these areas, and to identify essential core components that can be integrated into alternative models of care in order to alleviate the burden placed on the remaining obstetric providers. Methods We conducted 46 qualitative in-depth interviews with obstetricians, maternal-fetal medicine specialists, certified nurse midwives, and maternal and infant health leaders in Georgia. Interviews were digitally recorded, transcribed verbatim, uploaded into MAXQDA software, and analyzed using a Grounded Theory Approach. Results Providers faced significant financial barriers in service delivery, including low Medicaid reimbursement, high proportions of self-pay patients, and high cost of medical malpractice insurance. Further challenges in provision of obstetric care in this region were related to patient's late initiation of prenatal care and lacking collaboration between obstetric providers. Essential components of effective models of care included continuity, efficient use of resources, and risk-appropriate services. Conclusion Our analysis revealed core components of improved models of care that are more cost effective and would expand coverage. These components include closer collaboration among stakeholder populations, decentralization of services with effective use of each type of clinical provider, improved continuity of care, and system-wide changes to increase Medicaid benefits. PMID:27090413

  5. Integration of antiretroviral therapy services into antenatal care increases treatment initiation during pregnancy: a cohort study.

    Directory of Open Access Journals (Sweden)

    Kathryn Stinson

    Full Text Available OBJECTIVES: Initiation of antiretroviral therapy (ART during pregnancy is critical to promote maternal health and prevent mother-to-child HIV transmission (PMTCT. The separation of services for antenatal care (ANC and ART may hinder antenatal ART initiation. We evaluated ART initiation during pregnancy under different service delivery models in Cape Town, South Africa. METHODS: A retrospective cohort study was conducted using routinely collected clinic data. Three models for ART initiation in pregnancy were evaluated ART 'integrated' into ANC, ART located 'proximal' to ANC, and ART located some distance away from ANC ('distal'. Kaplan-Meier methods and Poisson regression were used to examine the association between service delivery model and antenatal ART initiation. RESULTS: Among 14 617 women seeking antenatal care in the three services, 30% were HIV-infected and 17% were eligible for ART based on CD4 cell count <200 cells/µL. A higher proportion of women started ART antenatally in the integrated model compared to the proximal or distal models (55% vs 38% vs 45%, respectively, global p = 0.003. After adjusting for age and gestation at first ANC visit, women who at the integrated service were significantly more likely to initiate ART antenatally (rate ratio 1.33; 95% confidence interval: 1.09-1.64 compared to women attending the distal model; there was no difference between the proximal and distal models in antenatal ART initiation however (p = 0.704. CONCLUSIONS: Integration of ART initiation into ANC is associated with higher levels of ART initiation in pregnancy. This and other forms of service integration may represent a valuable intervention to enhance PMTCT and maternal health.

  6. Future of Colombo Airport (CMB) as an Airline Hub

    Science.gov (United States)

    Jayalath, J. T. D.; Bandara, J. M. S. J.

    2001-01-01

    Aviation throughout the world has seen profound changes within the last two decades. Today more and more airports are looking for hub operations. However, as the success of hub operation would depend on a number of parameters such as geographic location, route network, facilities available, passengers' acceptance etc., not all airports would be able to operate as successful hubs. This paper investigates the possibility for (he Bandaranayake international airport, Colombo, Sri Lanka (CMB) to emerge as a hub airport in the South Asian region. It is found that CMB is situated in a geographically advantageous position in the region with respect to the airline route network. Comparison of travel distances between CMB and prominent O-D pairs and evaluation of airline schedules at relevant established hub airports indicates that CMB could operate as a directional hub serving the South Asian market if the number of destinations with daily flights could be increased.

  7. Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review.

    Science.gov (United States)

    George, Asha S; Branchini, Casey; Portela, Anayda

    2015-01-01

    Twenty years after the rights of women to go through pregnancy and childbirth safely were recognized by governments, we assessed the effects of interventions that promote awareness of these rights to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet search and contact with experts. From the 707 unique documents found, 219 made reference to rights, with 22 detailing interventions promoting awareness of rights for maternal and newborn health. Only four of these evaluated effects on health outcomes. While all four interventions promoted awareness of rights, they did so in different ways. Interventions included highly-scripted dissemination meetings with educational materials and other visual aids, participatory approaches that combined raising awareness of rights with improving accountability of services, and broader multi-stakeholder efforts to improve maternal health. Study quality ranged from weak to strong. Measured health outcomes included increased antenatal care and facility birth. Improvements in human rights outcomes such as availability, acceptability, accessibility, quality of care, as well as the capacity of rights holders and duty bearers were also reported to varying extents. Very little information on costs and almost no information on harms or risks were described. Despite searching multiple sources of information, while some studies did report on activities to raise awareness of rights, few detailed how they did so and very few measured effects on health outcomes. Promoting awareness of rights is one element of increasing demand for and use of quality maternity care services for women during pregnancy, birth and after birth. To date efforts have not been well documented in the literature and the program theories, processes and costs, let alone health effects have

  8. Biaxial wheel/hub test facility. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, G.; Grubisic, V. [eds.

    2000-07-01

    The 4{sup th} meeting aims to exchange the experience and knowledge of engineers during several presentations and discussions about new developments required for a reliable, time and cost reducing validation of the wheel/hub assembly. Tremendous development of the wheel performance, described by the ratio of the rated load (kg) versus the wheel weight (kg) had taken place during the last 5000 years. Starting from the ratio of 3 for wooden 2-piece-disc-wheels in Mesopotamia it needed nearly 1000 years to increase the ratio to approx 5 at light-weight spoke wheels for fighting carriages, found in the grave of king Tutenchamon in Egypt. Modern light alloy wheels of commercial vehicles reach values up to 160 kg/kg. Additionally the comlex design of the modern systems for cars and commercial vehicles comprising wheel, brake, hub, bearing, spindle and hub carrier, including different materials and their treatment, fasteners, press-fits, require an appropriate testing procedure. The variable loading conditions, caused by operational wheel forces, brake and torque moments including heating, may result in changing tolerances and press-fits during operation and consequently in different damage mechanisms. This can be simulated in the Biaxial Wheel Test Machine, whereby corresponding load programs are necessary. An overview about all biaxial test machines in usage at the end of 1999 is shown in the introduction. The total number is 17 for cars, 7 for commercial vehicles and 1 for trains. The six presentations of this meeting were consequently concentrated on: (a) recommendations for a standardization of load programs of the German Wheel Committee, (b) the simulation of brake and torque events and (c) the possibility for a numerical stress analyses and fatigue life assessment. (orig./AKF)

  9. Evaluating Pennsylvania Pharmacists’ Provision of Community-based Patient Care Services to Develop a Statewide Practice Network

    Directory of Open Access Journals (Sweden)

    Maria A. Osborne, PharmD

    2011-01-01

    Full Text Available Objective: To identify and describe Pennsylvania pharmacists who currently provide or are interested in providing community-basedpatient care services and are interested in joining a statewide practice network. Design: Cross-sectional survey. Setting: February toJune 2009 in Pennsylvania. Participants: 1700 pharmacists. Intervention: Mailed and electronic survey. Main outcome measures:Number and geographic location of pharmacists providing or interested in providing community-based patient care in Pennsylvania.Description of patient care documentation methods; physical space; services provided; perceived barriers to providing patient care;training needs; and interest in joining a statewide practice network. Results: The final analysis included data from 1700 pharmacists.Approximately one-third of pharmacists (n=554 were providing patient care services to community-based patients. Most wereroutinely documenting (67.5% and many had a semi-private or private space to provide care. MTM and immunizations were themost common services provided. Respondents reported the most significant barrier to providing MTM, diabetes education, andsmoking cessation education was time constraints, whereas training was a barrier for immunization provision. Most pharmacistswere not being compensated for patient care services. Of the 869 pharmacists interested in joining a statewide network, thoseproviding care were more interested in joining than those who were not (70.8% vs. 43.8%, p < 0.001. Conclusion: Pennsylvaniapharmacists are interested in providing community-based patient care services and joining a statewide practice network focused onproviding community-based patient care services. This research serves as a foundation for building a pharmacist practice network inPennsylvania.

  10. Adolescents leaving mental health or social care services: predictors of mental health and psychosocial outcomes one year later

    OpenAIRE

    Memarzia, Jessica; St Clair, Michelle C.; Owens, Matt; Goodyer, Ian M.; Dunn, Valerie J.

    2015-01-01

    Background UK service structure necessitates a transition out of youth services at a time of increased risk for the development and onset of mental disorders. Little is currently known about the mental health and psychosocial outcomes of leaving services at this time. The aim of this study was to determine predictors of mental health and social adjustment in adolescents leaving mental health or social care services. Methods A cohort (n?=?53) of 17 year olds were interviewed and ass...

  11. How do small rural primary health care services sustain themselves in a constantly changing health system environment?

    OpenAIRE

    Buykx Penny; Humphreys John S; Tham Rachel; Kinsman Leigh; Wakerman John; Asaid Adel; Tuohey Kathy

    2012-01-01

    Abstract Background The ability to sustain comprehensive primary health care (PHC) services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. Methods A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS) located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of...

  12. Supervised hub-detection for brain connectivity

    DEFF Research Database (Denmark)

    Kasenburg, Niklas; Liptrot, Matthew George; Reislev, Nina Linde;

    2016-01-01

    A structural brain network consists of physical connections between brain regions. Brain network analysis aims to find features associated with a parameter of interest through supervised prediction models such as regression. Unsupervised preprocessing steps like clustering are often applied......-detection and a linear regression using the original network connections as features. The results show that the SHD is able to retain regression performance, while still finding hubs that represent the underlying variation in the population. Although here we applied the SHD to brain networks, it can be applied to any...

  13. Personalized Web Search Using Trust Based Hubs And Authorities

    OpenAIRE

    Dr. Suruchi Chawla

    2014-01-01

    In this paper method has been proposed to improve the precision of Personalized Web Search (PWS) using Trust based Hubs and Authorities(HA) where Hubs are the high quality resource pages and Authorities are the high quality content pages in the specific topic generated using Hyperlink- Induced Topic Search (HITS). The Trust is used in HITS for increasing the reliability of HITS in identifying the good hubs and authorities for effective web search and overcome the problem of to...

  14. Hub Promiscuity in Protein-Protein Interaction Networks

    OpenAIRE

    Haruki Nakamura; Kengo Kinoshita; Ashwini Patil

    2010-01-01

    Hubs are proteins with a large number of interactions in a protein-protein interaction network. They are the principal agents in the interaction network and affect its function and stability. Their specific recognition of many different protein partners is of great interest from the structural viewpoint. Over the last few years, the structural properties of hubs have been extensively studied. We review the currently known features that are particular to hubs, possibly affecting their binding ...

  15. Pharmaceutical services in a Mexican pain relief and palliative care institute

    Directory of Open Access Journals (Sweden)

    Escutia Gutierrez R

    2007-12-01

    Full Text Available Neither the purchase nor the distribution of pharmaceuticals in hospitals and community pharmacies in Mexico is under the care of pharmacists. Some are under control of physicians.This report presents the results of the implementation of somef pharmaceutical services for the Jalisco Pain Relief, and Palliative Care Institute (Palia Institute, under the direction of the Secretary of Health, Government of Jalisco. The services implemented were drug distribution system, Drug Information Service, Pharmacovigilance Program , and home pharmacotherapy follow-up pilot program for patients with advanced illness, with the ultimate using the appropriate medication. The drug distribution system included dispensing of opioid pain medications, antidepressants, anticonvulsants, NSAIDs, anxiolytic drugs, steroid drugs, laxatives, and anti-emetics. The frequently used drugs were morphine sulfate (62%, amitriptyline (6.4%, and dextropropoxyphene (5.8%. The Drug Information Service answered 114 consultations, mainly asked by a physician (71% concerned with adverse drug reactions and contraindications (21%. The pharmacovigilance program identified 146 suspected adverse drug reactions and classified them reasonably as possible (27%, probable (69%, and certain (4%. These were attributed mainly to pregabalin and tramadol. The home pharmacotherapy follow-up pilot program cared patients with different cancer diagnoses and drug-related problems (DRP, which were identified and classified (according to second Granada Consensus for pharmaceutical intervention as DRP 1 (5%, DRP 2 (10%, DRP 3 (14%, DRP 4 (19%, DRP 5 (24%, or DRP 6 (28%. This report provides information concerning the accurate use of medication and, above all, an opportunity for Mexican pharmacists to become an part of health teams seeking to resolve drug-related problems.

  16. Contracting with private providers for primary care services: evidence from urban China.

    Science.gov (United States)

    Wang, Yan; Eggleston, Karen; Yu, Zhenjie; Zhang, Qiong

    2013-01-01

    Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China's recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance.We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services. PMID:23327666

  17. The status of IT service management in health care - ITIL® in selected European countries

    Directory of Open Access Journals (Sweden)

    Hoerbst Alexander

    2011-12-01

    Full Text Available Abstract Background Due to the strained financial situation in the healthcare sector, hospitals and other healthcare providers are facing an increasing pressure to improve their efficiency and to reduce costs. These trends challenge health care organizations to introduce innovative information technology (IT based supportive processes. To guarantee that IT supports the clinical processes perfectly, IT must be managed proactively. However, until now, there is only very few research on IT service management especially on ITIL® implementations in the health care context. Methods The current study aims at exploring knowledge about and acceptance of IT service management (especially ITIL® in hospitals in Austria and its neighboring regions Bavaria (Germany, Slovakia, South Tyrol (Italy and Switzerland. Therefore highly standardized interviews with the respective head of information technology (CIO, IT manager were conducted for selected hospitals from the different regions. In total 75 hospitals were interviewed. Data gathered was analyzed using descriptive statistics and where necessary methods of qualitative content analysis. Results In most regions, two-thirds or more of the participating IT managers claim to be familiar with the concepts of IT service management and of ITIL®. IT managers expect from ITIL® mostly better IT services, followed by an increased productivity and a reduction of IT cost. But only five hospitals said to have implemented at least parts of ITIL®, and eight hospitals stated to be planning to do this in the next two years. When it comes to ITIL®, Switzerland and Bavaria seem to be ahead of the other countries. There, the highest levels of knowledge, the highest number of implementations or plans of an implementation as well as the highest number of ITIL® certified staff members were observed. Conclusion The results collected through this study indicate that the idea of IT services and IT service management is still not

  18. Primary care palliative and supportive care services: Experiences and perceptions of patients with advanced progressive disease and their informal carers

    OpenAIRE

    Hardy, Beth

    2009-01-01

    Palliative care can be defined as the active, holistic care of patients with advanced progressive illness, and incorporates symptom management with psychological, social and spiri-tual care (WHO, 1990). Palliative care is for patients in the advanced stages of illness. Supportive care follows people throughout the process of their disease, from pre-diagnosis, treatment, cure, continuing illness, death and into bereavement. The aim of supportive care is to maximise benefits of treatment and...

  19. Numerical study of hub taper angle on podded propeller performance

    International Nuclear Information System (INIS)

    Presently, the majority of podded propulsion systems are of the pulling type, because this type provides better hydrodynamic efficiency than the pushing type. There are several possible explanations for the better overall performance of a puller type podded propulsor. One is related to the difference in hub shape. Puller and pusher propellers have opposite hub taper angles, hence different hub and blade root shape. These differences cause changes in the flow condition and possibly influence the overall performance. The current study focuses on the variation in performance of pusher and puller propellers with the same blade sections, but different hub taper angles. A hyperboloidal low order source doublet steady/unsteady time domain panel method code was modified and used to evaluate effects of hub taper angle on the open water propulsive performance of some fixed pitch screw propellers used in podded propulsion systems. The modified code was first validated against measurements of two model propellers in terms of average propulsive performance and good agreement was found. Major findings include significant effects of hub taper angle on propulsive performance of tapered hub propellers and noticeable effects of hub taper angle on sectional pressure distributions of tapered hub propeller blades. (author)

  20. Cloud computing in nanoHUB powering education and research

    OpenAIRE

    Madhavan, Krishna

    2014-01-01

    nanoHUB.org is designed to provide instructors and students enjoyable and effective learning tools through which to explore nanotechnology across a range of application areas. In fact, a significant number of nanoHUB users are learners. Furthermore, nanoHUB is used in all of the top 50 US engineering schools and is increasingly used in the flipped mode in the engineering and science curricula. In this discussion, we discuss the educational strategy that drives nanoHUB and its impact on studen...