Background: In Ethiopia, utilization of post-abortion care service is minimal and it seems that the expanding services are underutilized. The purpose of this study was to assess factors which influence decisions for utilization of abortion related services at community level. Methodology: The study was carried out in six ...
White, Kari; deMartelly, Victoria; Grossman, Daniel; Turan, Janet M
In Alabama, more than one-half of reproductive-aged women live in counties without an abortion provider. State regulations require in-person counseling (or confirmed receipt of materials sent by certified mail) followed by a 48-hour waiting period. We explored the impact of this service and policy environment on experiences accessing abortion care for women traveling long distances to clinics. We conducted in-depth interviews with 25 women who traveled more than 30 miles to an Alabama clinic providing abortion care between July and September 2014. Women were interviewed by telephone at least 1 day after their consultation, procedure, or follow-up visit. We used content analysis methods to code and analyze interview transcripts. Almost all women found a clinic by searching online or talking to others in their social networks who had abortions. These strategies did not always direct women to the closest clinic, and some described searches that yielded inaccurate information. The majority of women did not believe an in-person consultation visit was necessary and found it to be burdensome because of the extra travel required and long waits at the clinic. Two-thirds of the women were unable to schedule their abortion 48 hours later owing to work schedules or because appointments were offered only once a week, and four women were delayed until their second trimester even though they sought services earlier in pregnancy. It is often difficult for women in communities without an abortion provider to find and access timely abortion care. Efforts are needed to make abortion more accessible and prevent further restrictions on services. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Aantjes, Carolien J; Gilmoor, Andrew; Syurina, Elena V; Crankshaw, Tamaryn L
OBJECTIVE: To conduct a systematic review of the status of post-abortion care (PAC) provision in Eastern and Southern Africa with particular reference to reach, quality and costs of these services. STUDY DESIGN: We searched Pubmed, EMBASE, Science Direct, POPLINE and Web of Science for articles
Rasch, Vibeke; Yambesi, Fortunata; Massawe, Siriel
OBJECTIVE: To assess the acceptance and outcome of voluntary HIV counselling and testing (VCT) among women who had an unsafe abortion. METHOD: 706 women were provided with post-abortion contraceptive service and offered VCT. We collected data on socioeconomic characteristics and contraceptive use......-24 years and 25% among single women aged 25-45 years. CONCLUSION: HIV testing and condoms were accepted by most women who had an unsafe abortion. The poor reproductive health of these women could be improved by good post-abortion care that includes contraceptive counselling, VCT and condom promotion....
李小芬; 许培坤; 周秋燕
目的：探讨流产后关爱服务的应用效果。方法：收治人工流产妇女120例，随机分为观察组和对照组，对照组给予常规护理，观察组给予流产后关爱服务，比较两组的护理效果。结果：在观察组，重复流产率20.0%，高危流产率13.3%，5个月后再次人工流产率8.3%，未避孕率6.7%，常规避孕率18.3%，高效避孕率75.0%，均优于对照组(P＜0.05)。结论：流产后关爱服务应用于人工流产后的女性中，能够降低重复流产率，保障女性的生殖健康。%Objective:To explore the application effect of post abortion care services.Methods:120 women with induced abortion were selected,they were randomly divided into the observation group and the control group,the control group was given routine care,the observation group was given post abortion care service,we compared the nursing effect of two groups.Results:In the observation group,the repeated abortion rate was 20%,the rate of high-risk abortion was 13.3%,the abortion rate after 5 months was 8.3%,the no contraception rate was 6.7%,the conventional contraception rate was 18.3%,and the effective contraception rate was 75%,which were better than those of the control group(P<0.05).Conclusion:The application of post abortion care service for women with induced abortion can reduce the rate of repeated abortion and protect women's reproductive health.
Awoyemi, Bosede O; Novignon, Jacob
While induced abortion is considered to be illegal and socially unacceptable in Nigeria, it is still practiced by many women in the country. Poor family planning and unsafe abortion practices have daunting effects on maternal health. For instance, Nigeria is on the verge of not meeting the Millennium development goals on maternal health due to high maternal mortality ratio, estimated to be about 630 maternal deaths per 100,000 live births. Recent evidences have shown that a major factor in this trend is the high incidence of abortion in the country. The objective of this paper is, therefore, to investigate the factors determining the demand for abortion and post-abortion care in Ibadan city of Nigeria. The study employed data from a hospital-based/exploratory survey carried out between March to September 2010. Closed ended questionnaires were administered to a sample of 384 women of reproductive age from three hospitals within the Ibadan metropolis in South West Nigeria. However, only 308 valid responses were received and analysed. A probit model was fitted to determine the socioeconomic factors that influence demand for abortion and post-abortion care. The results showed that 62% of respondents demanded for abortion while 52.3% of those that demanded for abortion received post-abortion care. The findings again showed that income was a significant determinant of abortion and post-abortion care demand. Women with higher income were more likely to demand abortion and post-abortion care. Married women were found to be less likely to demand for abortion and post-abortion care. Older women were significantly less likely to demand for abortion and post-abortion care. Mothers' education was only statistically significant in determining abortion demand but not post-abortion care demand. The findings suggest that while abortion is illegal in Nigeria, some women in the Ibadan city do abort unwanted pregnancies. The consequence of this in the absence of proper post-abortion
in the absence of proper post-abortion care is daunting. There is the need for policymakers to intensify public education against indiscriminate abortion and to reduce unwanted pregnancies. In effect, there is need for effective alternative family planning methods. This is likely to reduce the demand for abortion. Further, with income found as a major constraint, post abortion services should be made accessible to both the rich and poor alike so as to prevent unnecessary maternal deaths as a result of abortion related complications. PMID:25024929
Gebrehiwot, Yirgu; Fetters, Tamara; Gebreselassie, Hailemichael; Moore, Ann; Hailemariam, Mengistu; Dibaba, Yohannes; Bankole, Akinrinola; Getachew, Yonas
CONTEXT In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care—i.e., legal abortion and treatment of abortion complications—changed over time. METHODS Between December 2013 and May 2014, data were collected on symptoms, procedures and treatment from 5,604 women who sought abortion care at a sample of 439 public and private health facilities; the sample did not include lower-level private facilities—some of which provide abortion care—to maintain comparability with the sample from a 2008 study. These data were combined with monitoring data from 105,806 women treated in 74 nongovernmental organization facilities in 2013. Descriptive analyses were conducted and annual estimates were calculated to compare the numbers and types of abortion care services provided in 2008 and 2014. RESULTS The estimated annual number of women seeking a legal abortion in the types of facilities sampled increased from 158,000 in 2008 to 220,000 in 2014, and the estimated number presenting for postabortion care increased from 58,000 to 125,000. The proportion of abortion care provided in the public sector increased from 36% to 56% nationally. The proportion of women presenting for postabortion care who had severe complications rose from 7% to 11%, the share of all abortion procedures accounted for by medical abortion increased from 0% to 36%, and the proportion of abortion care provided by midlevel health workers increased from 48% to 83%. Most women received postabortion contraception. CONCLUSIONS Ethiopia has made substantial progress in expanding comprehensive abortion care; however, eradication of morbidity from unsafe abortion has not yet been achieved. PMID:28825903
Wang, A G
A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...
Stålhandske, Maria L; Ekstrand, Maria; Tydén, Tanja
To explore Swedish women's experiences of clinical abortion care in relation to their need for existential support. Individual in-depth interviews with 24 women with previous experience of unwanted pregnancy and abortion. Participants were recruited between 2006 and 2009. Interviews were analysed by latent content analysis. Although the women had similar experiences of the abortion care offered, the needs they expressed differed. Swedish abortion care was described as rational and neutral, with physical issues dominating over existential ones. For some women, the medical procedures triggered existential experiences of life, meaning, and morality. While some women abstained from any form of existential support, others expressed a need to reflect upon the existential aspects and/or to reconcile their decision emotionally. As women's needs for existential support in relation to abortion vary, women can be disappointed with the personnel's ability to respond to their thoughts and feelings related to the abortion. To ensure abortion care personnel meet the physical, psychological and existential needs of each patient, better resources and new lines of education are needed to ensure abortion personnel are equipped to deal with the existential aspects of abortion care.
While various reports have been published concerning ethical dilemmas in nursing and midwifery, and while many nurses and midwives struggle with the conflict between personal feelings raised by abortion and the duties of their position, few studies investigate the extent and conditions of abortion-care education for registered nurses (RNs) and certified nurse-midwives (CNMs) in Japan. To describe Japanese abortion-care education programs and to investigate program directors' or other relevant persons' perceptions of abortion-care education. Descriptive study was used to determine the extent of abortion-care education programs and the respondents' perceptions of abortion-care education. All 228 Japanese nursing and/or midwifery schools were invited to participate in the study. The response rate was 33.8% (n=77). Response rate varied by program type: 18.4% (n=45) for nursing programs and 29.0% (n=32) for midwifery programs. A confidential survey requesting information about curricular coverage of ten reproductive health topics related to abortion was mailed to program directors. The results show that the majority of CNM and RN programs surveyed offer didactic exposure to instruction in family planning and contraception, emergency contraception, legal considerations, and possible medical complications. However, few programs offer clinical exposure to all 10 topics. Of the respondents, 36% reported that lack of time and the low priority given to abortion-care education were issues of curriculum priority. As for educational materials, few textbooks or guidebooks exist on abortion care in Japan, and most educators use general nursing textbooks to cover this topic. Regardless of interest in or intention to provide abortion services as part of their practice, all providers of abortion-care education need to be knowledgeable about the full range of reproductive health options, including family planning and abortion, and to be able to convey this information to clients
years and less were 37(7.1%) and single women were 132, constituting 25.3% of all cases. About 31% of the PAC .... Missed Abortion is defined as the retention of dead products of ... service providers transcending all cadres of staff in ... Married women were .... post abortion care, which is the unmarried teenage girls who ...
The Challenges Procuring of Safe Abortion Care in Botswana. Stephanie Samantha Smith. Abstract. Botswana's national healthcare system has experienced substantial investment as a result of a growing economy and stable government, and improvements in quality and access are notable. Despite these advances ...
Yang, Cheng-Fang; Che, Hui-Lian; Hsieh, Hsin-Wan; Wu, Shu-Mei
To explore the experiences of nurses involved with induced abortion care in the delivery room in Taiwan. Induced abortion has emotional, ethical and legal facets. In Taiwan, several studies have addressed the ethical issues, abortion methods and women's experiences with abortion care. Although abortion rates have increased, there has been insufficient attention on the views and experiences of nurses working in the delivery room who are involved with induced abortion care. Qualitative, semistructured interviews. This study used a purposive sampling method. In total, 22 nurses involved with induced abortion care were selected. Semistructured interviews with guidelines were conducted, and the content analysis method was used to analyse the data. Our study identified one main theme and five associated subthemes: concealing emotions, which included the inability to refuse, contradictory emotions, mental unease, respect for life and self-protection. This is the first specific qualitative study performed in Taiwan to explore nurses' experiences, and this study also sought to address the concealing of emotions by nurses when they perform induced abortion care, which causes moral distress and creates ethical dilemmas. The findings of this study showed that social-cultural beliefs profoundly influence nurses' values and that the rights of nurses are neglected. The profession should promote small-group and case-study discussions, the clarification of values and reflective thinking among nurses. Continued professional education that provides stress relief will allow nurses to develop self-healing and self-care behaviours, which will enable them to overcome the fear of death while strengthening pregnancy termination counselling, leading to better quality professional care. © 2016 John Wiley & Sons Ltd.
Full Text Available Given the prevalence of sexual and gender-basedviolence in Darfur, why are safe abortion services andtreatment of complications resulting from unsafeabortions or miscarriages not provided at all refugee/IDP health facilities?
Perry, Rachel; Murphy, Molly; Rankin, Kristin M; Cowett, Allison; Harwood, Bryna
We aimed to explore current practices regarding screening for rape and response to disclosure of rape-related pregnancy in the abortion care setting. We performed a cross-sectional, nonprobability survey of U.S. abortion providers. Individuals were recruited in person and via emailed invitations to professional organization member lists. Questions in this web-based survey pertained to providers' practice setting, how they identify rape-related pregnancy, the availability of support services, and their experiences with law enforcement. Providers were asked their perceptions of barriers to care for women who report rape-related pregnancy. Surveys were completed by 279 providers (21% response rate). Most respondents were female (93.1%), and the majority were physicians in a clinical role (69.4%). One-half (49.8%) reported their practice screens for pregnancy resulting from rape, although fewer (34.8%) reported that screening is the method through which most patients with this history are identified. Most (80.6%) refer women with rape-related pregnancy to support services such as rape crisis centers. Relatively few (19.7%) have a specific protocol for care of women who report rape-related pregnancy. Clinics that screen were 79% more likely to have a protocol for care than centers that do not screen. Although the majority (67.4%) reported barriers to identification of women with rape-related pregnancy, fewer (33.3%) reported barriers to connecting them to support services. Practices for identifying and providing care to women with rape-related pregnancy in the abortion care setting are variable. Further research should address barriers to care provision, as well as identifying protocols for care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Cochrane, Rosemary A; Cameron, Sharon T
In Scotland, in contrast to the rest of Great Britain, abortion at gestations over 20 weeks is not provided, and provision of procedures above 16 weeks varies considerably between regions. Women at varying gestations above 16 weeks must travel outside Scotland, usually to England, for the procedure. To determine the views of professionals working within Scottish abortion care about a Scottish late abortion service. Delegates at a meeting for abortion providers in Scotland completed a questionnaire about their views on abortion provision over 16 weeks and their perceived barriers to service provision. Of 95 distributed questionnaires, 70 (76%) were analysed. Fifty-six respondents (80%) supported a Scottish late abortion service, ten (14%) would maintain current service arrangements, and five (7%) were undecided. Forty (57%) of the supporters of a Scottish service would prefer a single national service, and 16 (22%) several regional services. Perceived barriers included lack of trained staff (n = 39; 56%), accommodation for the service (n = 34; 48%), and perception of lack of support among senior management (n = 28; 40%). The majority of health professionals surveyed who work in Scottish abortion services support provision of abortion beyond 16 weeks within Scotland, and most favour a single national service. Further work on the feasibility of providing this service is required.
Reproductive governance operates through calculating demographic statistics that offer selective truths about reproductive practices, bodies, and subjectivities. Post-abortion care, a global reproductive health intervention, represents a transnational reproductive regime that establishes motherhood as women's primary legitimate reproductive status. Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I illustrate how post-abortion care accomplishes reproductive governance in a context where abortion is prohibited altogether and the US is the primary bilateral donor of population aid. Reproductive governance unfolds in hospital gynecological wards and the national health information system through the mobilization and interpretation of post-abortion care data. Although health workers search women's bodies and behavior for signs of illegal abortion, they minimize police intervention in the hospital by classifying most post-abortion care cases as miscarriage. Health authorities deploy this account of post-abortion care to align the intervention with national and global maternal health policies that valorize motherhood. Although post-abortion care offers life-saving care to women with complications of illegal abortion, it institutionalizes abortion stigma by scrutinizing women's bodies and masking induced abortion within and beyond the hospital. Post-abortion care reinforces reproductive inequities by withholding safe, affordable obstetric care from women until after they have resorted to unsafe abortion.
Huebner, Ruth A.; Jones, Blake L.; Miller, Viola P.; Custer, Melba; Critchfield, Becky
Comprehensive Family Services (CFS) is a strengths-based and partnership-oriented approach to casework implemented through multiple initiatives. This study examines the relationship between the practice of CFS and satisfaction of clients, foster parents, and community partners. CFS indicators are paired with statewide customer satisfaction survey…
Keogh, Sarah C; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola
Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence. To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar). A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology. In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15-49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone. The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies.
Vlassoff, Michael; Musange, Sabine F; Kalisa, Ina R; Ngabo, Fidele; Sayinzoga, Felix; Singh, Susheela; Bankole, Akinrinola
Based on research conducted in 2012, we estimate the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalization. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs. PMID:24548846
Zulu, Joseph M; Ali, Joseph; Hallez, Kristina; Kass, Nancy; Michelo, Charles; Hyder, Adnan A
An increase in post abortion care (PAC) research with adolescents, particularly in low- and middle-income countries, has brought to attention several associated research ethics challenges. In order to better understand the ethics context of PAC research with adolescents, we conducted a scoping review of published literature. Following a systematic search of PubMed, HINARI, and Google Scholar, we analysed articles meeting inclusion criteria to determine common themes across both the ethical challenges related to PAC research with adolescents and any available guidance on the identified challenges. The literature search identified an initial 3321 records of which 14 were included in analysis following screening. Several ethical challenges stem from abortion being a controversial, sensitive, and stigmatized topic in many settings. Ethical dilemmas experienced by researchers conducting adolescent PAC research included: difficulties in convincing local health providers to permit PAC research; challenges in recruiting and seeking consent due to sensitivity of the subject; effectively protecting confidentiality; managing negative effects of interventions; creating a non-prejudicial atmosphere for research; managing emotional issues among adolescents; and dealing with uncertainty regarding the role of researchers when observing unethical health care practices. Suggested strategies for addressing some of these challenges include: using several sources to recruit study participants, using research to facilitate dialogue on abortion, briefing health workers on any observed unethical practices after data collection, fostering a comprehensive understanding of contextual norms and values, selecting staff with experience working with study populations, and avoiding collection of personal identifiers. Addressing ethical challenges that researchers face when conducting PAC research with adolescents requires guidance at the individual, institutional, community, and international
Ansari, N.; Zainullah, P.; Kim, Y.M.; Tappis, H.; Kols, A.; Currie, S.; Haver, J; van Roosmalen, J.; Broerse, J.E.W.; Stekelenburg, J.
Background: Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents
Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E. W.; Stekelenburg, Jelle
Background: Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents
Full Text Available Abstract Background Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider
Perry, Rachel; Murphy, Molly; Haider, Sadia; Harwood, Bryna
We sought to explore the experiences of women who disclosed that their pregnancies resulted from rape in the abortion care setting, as well as the experiences of professionals involved in care of women with rape-related pregnancy. In-depth interviews were conducted with 9 patients who had terminated rape-related pregnancies and 12 professionals working in abortion care or rape crisis advocacy (5 abortion providers, 4 rape crisis center advocates, 2 social workers, and 1 clinic administrator). Transcribed interviews were coded and analyzed for themes related to the experiences of disclosing rape and the consequences of disclosure in the abortion care setting. Patients and professionals involved in care of women with rape-related pregnancy described opportunities arising from disclosure, including interpersonal (explaining abortion decision making in the context of assault, belief, and caring by providers), as well as structural opportunities (funding assistance, legal options, and mental health options). Whereas most patients did not choose to pursue all three structural opportunities, both patients and professionals emphasized the importance of offering them. The most important consequence of disclosure for patients was being believed and feeling that providers cared about them. Rape-related pregnancy disclosure in the abortion care setting can lead to opportunities for interpersonal support and open options for funding, legal recourse, and mental health care. Those working in abortion care should create environments conducive to disclosure and opportunities for rape survivors to access these additional options if they desire. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
McLemore, Monica R; Levi, Amy; James, E Angel
The purpose of this thematic analysis is to describe recruitment, retention and career development strategies for expert nurses in abortion care provision. Thematic analysis influenced by grounded theory methods were used to analyze interviews, which examined cognitive, emotional, and behavioral processes associated with how nurses make decisions about participation in abortion care provision. The purposive sample consisted of 16 nurses, who were interviewed between November 2012 and August 2013, who work (or have worked) with women seeking abortions in abortion clinics, emergency departments, labor and delivery units and post anesthesia care units. Several themes emerged from the broad categories that contribute to successful nurse recruitment, retention, and career development in abortion care provision. All areas were significantly influenced by engagement in leadership activities and professional society membership. The most notable theme specific to recruitment was exposure to abortion through education as a student, or through an employer. Retention is most influenced by flexibility in practice, including: advocating for patients, translating one's skill set, believing that nursing is shared work, and juggling multiple roles. Lastly, providing on the job training opportunities for knowledge and skill advancement best enables career development. Clear mechanisms exist to develop expert nurses in abortion care provision. The findings from our study should encourage employers to provide exposure opportunities, develop activities to recruit and retain nurses, and to support career development in abortion care provision. Additionally, future workforce development efforts should include and engage nursing education institutions and employers to design structured support for this trajectory. Copyright © 2015 Elsevier Inc. All rights reserved.
Gould, Heather; Perrucci, Alissa; Barar, Rana; Sinkford, Danielle; Foster, Diana Greene
Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Esber, Allahna; Foraker, Randi E; Hemed, Maryam; Norris, Alison
We examined the effect of partner approval of contraception on intention to use contraception among women obtaining post-abortion care in Zanzibar. Our data source was a 2010 survey of 193 women obtaining post-abortion care at a large public hospital in Zanzibar. We used multivariable logistic regression analysis to assess associations between partner approval and intention to use contraception. Overall, 23% of participants had used a contraceptive method in the past, and 66% reported intending to use contraception in the future. We found that partner approval of contraception and ever having used contraception in the past were each associated with intending to use contraception in the future. In the multivariable model, adjusting for past contraception use, partner approval of contraception was associated with 20 times the odds of intending to use contraception (odds ratio, 20.25; 95% confidence interval, 8.45-48.56). We found a strong association between partner approval and intention to use contraception. Efforts to support contraceptive use must include both male and female partners. Public health and educational efforts to increase contraceptive use must include men and be targeted to both male and female partners. Given that male partners are often not present when women obtain health care, creative efforts will be required to meet men in community settings. Copyright © 2014 Elsevier Inc. All rights reserved.
Pringle, Janice L; Emptage, Nicholas P; Hubbard, Robert L
Many addiction treatment patients suffer from health and psychosocial problems in addition to substance misuse at the time of their treatment entry. Outpatient treatment programs have attempted to address these problems by providing or facilitating access to comprehensive health and social services. Nevertheless, previous research have suggested high levels of unmet needs for these services in the addiction treatment population. Using data from a large study on community-based outpatient addiction treatment, this article provides additional information on levels of unmet service needs and the relationship between need and receipt of services during treatment. Our results suggest extremely high levels of unmet needs for a wide variety of health and psychosocial services. Specifically, the data suggest that unmet service needs may be far more prevalent than previous estimates and that addiction treatment populations in rural areas may be particularly disadvantaged.
Reeve, Carole; Humphreys, John; Wakerman, John
To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services. A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders. The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable. Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available "nObjective: abortion either medical or criminal has distinctive physical, social, and psychological side effects. Detecting types and frequent psychological side effects of abortion among post abortion care seeking women in Tehran was the main objective of the present study. "n Method: 278 women of reproductive age (15-49 interviewed as study population. Response rate was 93/8. Data collected through a questionnaire with 2 parts meeting broad socio-economic characteristics of the respondents and health- related abortion consequences. Tehran hospitals were the site of study. "nResults: The results revealed that at least one-third of the respondents have experienced psychological side effects. Depression, worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents. Decreased self-esteem, nightmare, guilt, and regret with 43.7%, 39.5%, 37.5%, and 33.3% prevalence rates have been placed in the lower status, respectively. "nConclusion: Psychological consequences of abortion have considerably been neglected. Several barriers made findings limited. Different types of psychological side effects, however, experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders, and women's health impact on family and population health.
Steele, Cynthia; Chiarotti, Susana
At the suggestion of a social worker who witnessed abusive post-abortion care at a public hospital in Rosario, Argentina, two human rights NGOs collaborated to investigate women's experiences seeking treatment for abortion complications at area public hospitals. During the year-long enquiry, more than 300 women took part. Role play was successfully used to surmount women's initial reluctance to reveal pervasive discriminatory and humiliating mistreatment. Thirty-one women later gave personal testimonies about their experiences, which were contained in the report of the research and later dramatised in a public meeting and video. The report, Con Todo al Aire (With Everything Exposed), was disseminated widely, including to the media, and a formal complaint was made to the local Ombudsman, who called for high-level action to resolve the problems. Initial denial by some health professionals that there was a serious problem was replaced by critical self-assessment within the provincial government, hospitals and medical and nursing schools, who made commitments to reform hospital practices and the medical school curriculum. Women participants also gained an understanding of their right to appropriate and humane health care. The findings from Rosario are not isolated. They are now being shored with activists and researchers in other provinces of Argentina and other countries.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...
Lipp, Allyson; Fothergill, Anne
In this paper, we have taken a previously published article on nurses' judgements in abortion care performing a systematic critique of the merits of this research using a recognised critiquing framework. The qualitative paper chosen for the critique is a grounded theory design and the research terms and terminology associated with this method such as symbolic interactionism are defined. The published paper reported on findings from a study exploring the characteristics of nurses in abortion care. A published critiquing tool has been applied. It was chosen because it is pragmatic, clearly laid out and accessible as full text to the people likely to need it. It comprises two stages, the first of which centres on the believability of the research. The second stage is more detailed and examines the research process and establishes the credibility of the research in its application to practice. Develop critical and analytical skills through methodically appraising the merits of published research. Nursing as an evidence-based profession requires nurses at both pre- and post-registration levels to be able to understand, synthesise and critique research, this being a fundamental part of many nursing curricula. These have become core skills to acquire since implementing up to date evidence is the cornerstone of contemporary nursing practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
Walter, Heather J.; Gouze, Karen; Cicchetti, Colleen; Arend, Richard; Mehta, Tara; Schmidt, Janet; Skvarla, Madelynn
Background: National policy statements increasingly espouse the delivery of comprehensive mental health services in schools. In response to the limited evidence supporting this recommendation, the purpose of this study was to assess the need for, and feasibility, desirability, and outcomes of a full model of comprehensive mental health services in…
Roten, Shelby Jean
Reviewed are present and potential services and social programs for handicapped children in Mississippi through purchase of service contracts under Title XX of the Social Security Act. Sections cover the following topics: background and purpose of Title XX which gives states greater control over social service programs, planning state supported…
Full Text Available Big data has attracted extensive interest due to its potential tremendous social and scientific value. Researchers are also trying to extract potential value from agriculture big data. This paper presents a study of information services based on big data from the perspective of a rural comprehensive information service. First, we introduce the background of the rural comprehensive information service, and then we present in detail the National Rural Comprehensive Information Service Platform (NRCISP, which is supported by the national science and technology support program. Next, we discuss big data in the NRCISP according to data characteristics, data sources, and data processing. Finally, we discuss a service model and services based on big data in the NRCISP.
Nutescu, Edith A; Drozda, Katarzyna; Bress, Adam P; Galanter, William L; Stevenson, James; Stamos, Thomas D; Desai, Ankit A; Duarte, Julio D; Gordeuk, Victor; Peace, David; Kadkol, Shrihari S; Dodge, Carol; Saraf, Santosh; Garofalo, John; Krishnan, Jerry A; Garcia, Joe G N; Cavallari, Larisa H
To determine the procedural feasibility of a pharmacist-led interdisciplinary service for providing genotype-guided warfarin dosing for hospitalized patients newly starting warfarin. Prospective observational study. A 438-bed tertiary care hospital affiliated with a large academic institution. Eighty patients who started warfarin therapy and were managed by a newly implemented pharmacogenetics service. All patients received routine warfarin genotyping and clinical pharmacogenetics consultation. The primary outcomes were percentage of genotype-guided dose recommendations available prior to the second warfarin dose and adherence of the medical staff to doses recommended by the pharmacogenetics service. Of 436 genotype orders placed during the first 6 months of the service, 190 (44%) were deemed appropriate. For the 80 patients on the service who consented to data collection, 76% of the genotypes were available prior to the second warfarin dose. The median (range) time from genotype order to genotype result was 26 hours (7-80 hrs), and the time to genotype-guided dose recommendation was 30 hours (7-80 hrs). A total of 73% of warfarin doses ordered by the medical staff were within 0.5 mg of the daily dose recommended by the pharmacogenetics consult service. Providing routine genotype-guided warfarin dosing supported by a pharmacogenetics consult service is feasible from a procedural standpoint, with most genotypes available prior to the second warfarin dose and good adherence to genotype-guided dose recommendations by the medical staff. © 2013 Pharmacotherapy Publications, Inc.
Lee, S.K. [Korea Energy Economics Institute, Euiwang (Korea)
Traditionally, energy industry has been regarded as supply- oriented and characterized by its vertically integrated structure and monopolized market. In particular, network industries such as electricity, natural gas, and district heating and cooling, because of their large initial capital investments, were inevitably state-owned. As their sizes have ever increased, government-owned corporations are confronted with internal crises such as financial limitations, increasing internal transaction costs, etc. In addition to these internal problems, fundamental changes in the external environment such as advances in communication and modular technologies, globalization, and market liberalization have forced energy industries to undergo a restructuring process. Restructuring in the energy industry is intended to introduce competition in the market by unbundling the energy service into production, transportation, and distribution. The energy service has been vertically as well as horizontally integrated by suppliers. Restructuring, which has been implemented in the United States and the European countries, is now being introduced in Korea. However, energy services have not yet been regulated as a separate industry even in those countries which are well advanced in their restructuring. WTO negotiation is under way to separate the service sector in 'General Agreement on Tariffs and Trade(GATT).' Areas that can be categorized as a service sector are 17 subdivided sub-sectors as dispersed in each sector. Energy service business models expected to be emerged in the restructuring process of energy industry include: transmission/trunk pipeline projects, distribution/local pipeline projects, trading, brokerage, metering service, local distribution of natural gas, to name a few, for electricity and natural gas sectors; rational use of energy such as CES business and ESCOs for district heating and cooling, and energy conservation sector. Rational use of energy, in
目的：探讨人工流产术后即时开展人工流产后服务（ post abortion care， PAC）的临床意义。方法：将行人工流产的年轻未生育妇女480例随机分为2组，人工流产术后接受PAC者为治疗组（240例），不采用PAC者为观察组（240例）。观察2组术后出血及月经情况，采取避孕措施及再次非意愿妊娠情况。结果：观察组出血时间短，术后并发感染及宫腔粘连等并发症发生率低，流产后月经恢复快，且避孕效果优于观察组（P＜0．05），再次非意愿妊娠率低。结论：人工流产后立即开展PAC是安全、有效，并具有额外益处的避孕方法。%Objective:To investigate the clinical significance of immediate post abortion care after artificial abortion.Methods:The induced abortion young nulliparous women 480 cases were randomly divided into two groups, who accepted PAC after abortion are the treatment group (240cases), who do not accepted PAC after abortion are the observation group (240 case)s.The amount and duration of vaginal bleeding after induced abortion,the recovery of menstruation,take contraceptive measures and unwanted pregnancy once again after treatment were evaluated.Results:Shorter duration of vaginal bleeding,lower rate of complications such as intrauterine adhesions and ac -companying infection ,faster recovery of menstrual cycle after abortion , better contraception effect and lower unintended pregnancy rate once again were observed in the treatment group (P <0.05),.Conclusion:Immediate application of post abortion care after artificial a-bortion should be safe and effective and has additional benefit of contraception.
Garcia-Gomez, S.; Jimenez-Ganan, M.; Taher, Y.; Momm, C.; Junker, F.; Biro, J.; Menychtas, A.; Andrikopoulos, V.; Strauch, S.
The 4CaaSt project aims at developing a PaaS framework that enables flexible definition, marketing, deployment and management of Cloud-based services and applications. This paper describes the major challenges tackled by 4CaaSt for the comprehensive management of applications and services in a PaaS.
Hariharan, Seetharaman; Dey, Prasanta Kumar
The purpose of this paper is to develop a comprehensive framework for improving intensive care unit performance. The study introduces a quality management framework by combining cause and effect diagram and logical framework. An intensive care unit was identified for the study on the basis of its performance. The reasons for not achieving the desired performance were identified using a cause and effect diagram with the stakeholder involvement. A logical framework was developed using information from the cause and effect diagram and a detailed project plan was developed. The improvement projects were implemented and evaluated. Stakeholders identified various intensive care unit issues. Managerial performance, organizational processes and insufficient staff were considered major issues. A logical framework was developed to plan an improvement project to resolve issues raised by clinicians and patients. Improved infrastructure, state-of-the-art equipment, well maintained facilities, IT-based communication, motivated doctors, nurses and support staff, improved patient care and improved drug availability were considered the main project outputs for improving performance. The proposed framework is currently being used as a continuous quality improvement tool, providing a planning, implementing, monitoring and evaluating framework for the quality improvement measures on a sustainable basis. The combined cause and effect diagram and logical framework analysis is a novel and effective approach to improving intensive care performance. Similar approaches could be adopted in any intensive care unit. The paper focuses on a uniform model that can be applied to most intensive care units.
Kim, Minji; Choi, Mona; Youm, Yoosik
As comprehensive nursing care service has gradually expanded, it has become necessary to explore the various opinions about it. The purpose of this study is to explore the large amount of text data regarding comprehensive nursing care service extracted from online news and social media by applying a semantic network analysis. The web pages of the Korean Nurses Association (KNA) News, major daily newspapers, and Twitter were crawled by searching the keyword 'comprehensive nursing care service' using Python. A morphological analysis was performed using KoNLPy. Nodes on a 'comprehensive nursing care service' cluster were selected, and frequency, edge weight, and degree centrality were calculated and visualized with Gephi for the semantic network. A total of 536 news pages and 464 tweets were analyzed. In the KNA News and major daily newspapers, 'nursing workforce' and 'nursing service' were highly rated in frequency, edge weight, and degree centrality. On Twitter, the most frequent nodes were 'National Health Insurance Service' and 'comprehensive nursing care service hospital.' The nodes with the highest edge weight were 'national health insurance,' 'wards without caregiver presence,' and 'caregiving costs.' 'National Health Insurance Service' was highest in degree centrality. This study provides an example of how to use atypical big data for a nursing issue through semantic network analysis to explore diverse perspectives surrounding the nursing community through various media sources. Applying semantic network analysis to online big data to gather information regarding various nursing issues would help to explore opinions for formulating and implementing nursing policies. © 2017 Korean Society of Nursing Science
The "rightness" of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the "job" they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. I explore how negotiations over the rightness of MVA as well as PAC unfold at the intersection of national and global reproductive politics during the daily treatment of abortion complications at three hospitals in Senegal, where PAC is permitted but induced abortion is legally prohibited. Although state health authorities have championed MVA as the "preferred" PAC technology, the primary donor for PAC, the United States Agency for International Development, does not support the purchase of abortifacient technologies. I conducted an ethnography of Senegal's PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage. Anxieties about MVA's capacity to induce abortion have constrained its integration into routine obstetric care. This capacity also raises questions about what the "job," PAC, represents in Senegalese hospitals. The prioritization of MVA's security over women's access to the preferred technology reinforces gendered inequalities in health care. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH. Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48 were from urban area and 41 were from rural area.46 (51.7% of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.
Towbin, Alexander J; Hall, Seth; Moskovitz, Jay; Johnson, Neil D; Donnelly, Lane F
Communication of acute or critical results between the radiology department and referring clinicians has been a deficiency of many radiology departments. The failure to perform or document these communications can lead to poor patient care, patient safety issues, medical-legal issues, and complaints from referring clinicians. To mitigate these factors, a communication and documentation tool was created and incorporated into our departmental customer service program. This article will describe the implementation of a comprehensive customer service program in a hospital-based radiology department. A comprehensive customer service program was created in the radiology department. Customer service representatives were hired to answer the telephone calls to the radiology reading rooms and to help convey radiology results. The radiologists, referring clinicians, and customer service representatives were then linked via a novel workflow management system. This workflow management system provided tools to help facilitate the communication needs of each group. The number of studies with results conveyed was recorded from the implementation of the workflow management system. Between the implementation of the workflow management system on August 1, 2005, and June 1, 2009, 116,844 radiology results were conveyed to the referring clinicians and documented in the system. This accounts for more than 14% of the 828,516 radiology cases performed in this time frame. We have been successful in creating a comprehensive customer service program to convey and document communication of radiology results. This program has been widely used by the ordering clinicians as well as radiologists since its inception.
Zhang, H.; Jiang, J.; Huang, W.; Wang, Q.; Gu, X.
With the flourish development of China's Internet market, all kinds of users for map service demand is rising continually, within it contains tremendous commercial interests. Many internet giants have got involved in the field of online map service, and defined it as an important strategic product of the company. The main purpose of this research is to evaluate these online map service websites comprehensively with a model, and analyse the problems according to the evaluation results. Then some corresponding solving measures are proposed, which provides a theoretical and application guidance for the future development of fiercely competitive online map websites. The research consists of three stages: (a) the mainstream online map service websites in China are introduced and the present situation of them is analysed through visit, investigation, consultant, analysis and research. (b) a whole comprehensive evaluation quota system of online map service websites from the view of functions, layout, interaction design color position and so on, combining with the data indexes such as time efficiency, accuracy, objectivity and authority. (c) a comprehensive evaluation to these online map service websites is proceeded based on the fuzzy evaluation mathematical model, and the difficulty that measure the map websites quantitatively is solved.
Full Text Available With the flourish development of China's Internet market, all kinds of users for map service demand is rising continually, within it contains tremendous commercial interests. Many internet giants have got involved in the field of online map service, and defined it as an important strategic product of the company. The main purpose of this research is to evaluate these online map service websites comprehensively with a model, and analyse the problems according to the evaluation results. Then some corresponding solving measures are proposed, which provides a theoretical and application guidance for the future development of fiercely competitive online map websites. The research consists of three stages: (a the mainstream online map service websites in China are introduced and the present situation of them is analysed through visit, investigation, consultant, analysis and research. (b a whole comprehensive evaluation quota system of online map service websites from the view of functions, layout, interaction design color position and so on, combining with the data indexes such as time efficiency, accuracy, objectivity and authority. (c a comprehensive evaluation to these online map service websites is proceeded based on the fuzzy evaluation mathematical model, and the difficulty that measure the map websites quantitatively is solved.
Cowan, Katherine C.; Vaillancourt, Kelly
The tragedy at Sandy Hook Elementary School, Newtown, CT (USA) has brought the conversation about how to reduce violence, make schools safer, improve school climate, and increase access to mental health services to the forefront of the national conversation. Advocating for comprehensive initiatives to address school safety, school climate, and…
An argument is presented for a comprehensive and universal system of care and education for preschool children outside the family. Current institutional arrangements in the United Kingdom for government provision of education and care for young children are discussed and proposals are made for alternative ways of providing this service. It is…
Pearce, Joshua M.; Miller, Laura L.
Purpose: This paper aims to quantify and critically analyze the best practices of a comprehensive environmental stewardship strategy (ESS), which included a guaranteed energy savings program (GESP) that utilized an energy service company (ESCO). Design/methodology/approach: The environmental and economic benefits and limitations of an approach…
Chia, Sin Eng; Wah, Lim John; Khim, Judy Sng Gek; Yoong, Joanne; Lim, Raymond Boon Tar; Seng, Chia Kee
The aim of this study was to evaluate the level of comprehensiveness and integration of workplace safety and health (WSH) services (safety, occupational health, and well-being) in Singapore. Thirty workplaces from five different sectors comprising more than 28,000 workers were assessed using three custom-developed tools. One quarter of the workplaces have applied the principles of comprehensive and integrated WSH. Among those that managed WSH comprehensively, workers were 4.4 times (95% confidence interval [CI], 2.33 to 8.25) more likely to be proud to work for their company, 7.4 times (95% CI, 3.96 to 13.90) more likely to be satisfied with their current job, and 1.7 times (95% CI, 1.21 to 2.32) more likely to balance the demands of work and home. There is a need to enhance awareness and education on comprehensive and integrated WSH in Singapore companies.
Bagstad, Kenneth J.; Johnson, Gary W.; Voigt, Brian; Villa, Ferdinando
Recent ecosystem services research has highlighted the importance of spatial connectivity between ecosystems and their beneficiaries. Despite this need, a systematic approach to ecosystem service flow quantification has not yet emerged. In this article, we present such an approach, which we formalize as a class of agent-based models termed “Service Path Attribution Networks” (SPANs). These models, developed as part of the Artificial Intelligence for Ecosystem Services (ARIES) project, expand on ecosystem services classification terminology introduced by other authors. Conceptual elements needed to support flow modeling include a service's rivalness, its flow routing type (e.g., through hydrologic or transportation networks, lines of sight, or other approaches), and whether the benefit is supplied by an ecosystem's provision of a beneficial flow to people or by absorption of a detrimental flow before it reaches them. We describe our implementation of the SPAN framework for five ecosystem services and discuss how to generalize the approach to additional services. SPAN model outputs include maps of ecosystem service provision, use, depletion, and flows under theoretical, possible, actual, inaccessible, and blocked conditions. We highlight how these different ecosystem service flow maps could be used to support various types of decision making for conservation and resource management planning.
Knight, Louise; Cooper, Rhonda S; Hypki, Cinder
Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.
Full Text Available Services composition is fundamental to software development in multi-service wireless sensor networks (WSNs. The quality of service (QoS of services composition applications (SCAs are confronted with severe challenges due to the open, dynamic, and complex natures of WSNs. Most previous research separated various QoS indices into different fields and studied them individually due to the computational complexity. This approach ignores the mutual influence between these QoS indices, and leads to a non-comprehensive and inaccurate analysis result. The universal generating function (UGF shows the speediness and precision in QoS analysis. However, only one QoS index at a time can be analyzed by the classic UGF. In order to efficiently analyze the comprehensive QoS of SCAs, this paper proposes an improved UGF technique—vector universal generating function (VUGF—which considers the relationship between multiple QoS indices, including security, and can simultaneously analyze multiple QoS indices. The numerical examples demonstrate that it can be used for the evaluation of the comprehensive QoS of SCAs subjected to the security constraint in WSNs. Therefore, it can be effectively applied to the optimal design of multi-service WSNs.
Xiong, Naixue; Wu, Zhao; Huang, Yannong; Xu, Degang
Services composition is fundamental to software development in multi-service wireless sensor networks (WSNs). The quality of service (QoS) of services composition applications (SCAs) are confronted with severe challenges due to the open, dynamic, and complex natures of WSNs. Most previous research separated various QoS indices into different fields and studied them individually due to the computational complexity. This approach ignores the mutual influence between these QoS indices, and leads to a non-comprehensive and inaccurate analysis result. The universal generating function (UGF) shows the speediness and precision in QoS analysis. However, only one QoS index at a time can be analyzed by the classic UGF. In order to efficiently analyze the comprehensive QoS of SCAs, this paper proposes an improved UGF technique-vector universal generating function (VUGF)-which considers the relationship between multiple QoS indices, including security, and can simultaneously analyze multiple QoS indices. The numerical examples demonstrate that it can be used for the evaluation of the comprehensive QoS of SCAs subjected to the security constraint in WSNs. Therefore, it can be effectively applied to the optimal design of multi-service WSNs.
Pritchard, A M; Page, D
The World Health Organization (WHO) has identified primary healthcare reform as a global priority whereby innovative practice changes are directed at improving health. This transformation to health reform in haemophilia service requires clarification of comprehensive care to reflect the WHO definition of health and key elements of primary healthcare reform. While comprehensive care supports effective healthcare delivery, comprehensive care must also be regarded beyond immediate patient management to reflect the broader system purpose in the care continuum with institutions, community agencies and government. Furthermore, health reform may be facilitated through integrated service delivery (ISD). ISD in specialty haemophilia care has the potential to reduce repetition of assessments, enhance care plan communication between providers and families, provide 24-h access to care, improve information availability regarding care quality and outcomes, consolidate access for multiple healthcare encounters and facilitate family self-efficacy and autonomy . Three core aspects of ISD have been distinguished: clinical integration, information management and technology and vertical integration in local communities . Selected examples taken from Canadian haemophilia comprehensive care illustrate how practice innovations are bridged with a broader system level approach and may support initiatives in other contexts. These innovations are thought to indicate readiness regarding ISD. Reflecting on the existing capacity of haemophilia comprehensive care teams will assist providers to connect and direct their existing strengths towards ISD and health reform.
Bowman, Elizabeth K; Palley, Howard A
Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.
Kocoglu, Deniz; Emiroglu, Oya Nuran
Introduction: School nursing services should be evaluated through health and academic outcomes of students; however, it is observed that the number of studies in this field is limited. The aim of this study is to evaluate the impact of comprehensive school nursing services provided to 4th grade primary school students on academic performance of students. Methods: The quasi-experimental study was conducted with 31 students attending a randomly selected school in economic disadvantaged area in Turky. Correlation analysis, repeated measures analyses of variance, multiple regression analysis were used to analyze the data with SPSS software. Results: At the end of school nursing practices, an increase was occurred in students' academic achievement grades whereas a decrease was occurred in absenteeism and academic procrastination behaviors. Whilst it was determined that nursing interventions including treatment/ procedure and surveillance was associated to the decrease of absenteeism, it also was discovered that the change in the health status of the student after nursing interventions was related to the increase of the academic achievement grade and the decrease of the academic procrastination behavior score. Conclusion: In this study, the conclusion that comprehensive school nursing services contributed positively to the academic performance of students has been reached. In addition, it can be suggested that effective school nursing services should include services such as acute-chronic disease treatment, first aid, health screening, health improvement-protection, health education, guidance and counseling and case management.
Full Text Available Introduction: School nursing services should be evaluated through health and academic outcomes of students; however, it is observed that the number of studies in this field is limited. The aim of this study is to evaluate the impact of comprehensive school nursing services provided to 4th grade primary school students on academic performance of students. Methods: The quasi-experimental study was conducted with 31 students attending a randomly selected school in economic disadvantaged area in Turky. Correlation analysis, repeated measures analyses of variance, multiple regression analysis were used to analyze the data with SPSS software. Results: At the end of school nursing practices, an increase was occurred in students’ academic achievement grades whereas a decrease was occurred in absenteeism and academic procrastination behaviors. Whilst it was determined that nursing interventions including treatment/ procedure and surveillance was associated to the decrease of absenteeism, it also was discovered that the change in the health status of the student after nursing interventions was related to the increase of the academic achievement grade and the decrease of the academic procrastination behavior score. Conclusion: In this study, the conclusion that comprehensive school nursing services contributed positively to the academic performance of students has been reached. In addition, it can be suggested that effective school nursing services should include services such as acute-chronic disease treatment, first aid, health screening, health improvement-protection, health education, guidance and counseling and case management.
Chávez, Elisa M; LaBarre, Eugene; Fredekind, Richard; Isakson, Paul
The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to educate future dentists to provide oral health care for similar populations.
Graciela Cordero Arroyo
Full Text Available This article analyzes the initial drafts of the Technical Assistance for Schools (SATE—acronym in Spanish—a comprehensive coaching service for which federal guidelines have yet to be established—in the context of current educational reform in Mexico. To this end, an analysis was made of all legal documents as well as various programmatic documents related to compulsory education that were released during 2013 and 2014. The paper is organized in three sections: the first describes the history of this type of service in Mexico; the second reviews the information provided on SATE in the legal documents of the current educational policy; and the third section discusses what should be taken into account for proper implementation of a service of this nature.
Moore, David T; Rosenheck, Robert A
Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites. Multiple imputation was used to account for missing data and differential rates of attrition between the cohorts. Longitudinal models were constructed to compare ED use between the 2 groups during the first year after initiation of CICH services. A mediation analysis was performed to determine the relative contributions of being housed, the receipt of outpatient services, and health status to group differences in ED utilization. Participants receiving CICH services were significantly less likely to report ED use (odds ratio = 0.78, 95% confidence interval [0.65, 0.93]) in the year after program entry. Decreased ED use was primarily mediated by decreased homelessness-not by increased access to other services or health status. This suggests that becoming housed is a key driver of reduced ED utilization and that efforts to provide housing for homeless adults may result in significantly decreased ED use. Further research is needed to determine the long-term effects of housing on health status and to develop services to improve health outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Bentley, Michael; Freeman, Toby; Baum, Fran; Javanparast, Sara
This article draws on data from a 5-year project that examined the effectiveness of Comprehensive primary healthcare (CPHC) in local communities. A hallmark of CPHC services is interprofessional teamwork. Drawing from this study, our article presents factors that enabled, or hindered, healthcare teams working interprofessionally in Australian primary healthcare (PHC) services. The article reports on the experiences of teams working in six Australian PHC services (four managed by state governments, one non-government sexual health organisation, and one Aboriginal community-controlled health service) during a time of significant health sector restructure. Findings are drawn from two key methods: an online survey of practitioners and managers (n = 154), and interviews with managers and practitioners (n = 60) from the six study sites. The majority of survey respondents worked with other health professionals in their service to provide interprofessional care to clients. Processes included formal team meetings, case conferencing, referring clients to other health professionals if needed, informal communication with other health professionals about clients, and team-based delivery of care. A range of interrelated factors affected interprofessional work at the services, from contextual, organisational, processual, and relational domains. Funding cuts and policy changes that saw a reorientation and re-medicalisation of South Australian services undermined interprofessional work, while a shared CPHC culture and commitment among some staff was helpful in resisting some of these effects. The co-location of services was a factor in PHC teams working interprofessionally and not only enabled some PHC teams to work more interprofessionally but also created barriers to interprofessional teamwork through disruption resulting from restructuring of services. Our study indicates the importance of decision makers taking into account the potential effects of policy and structural
Kågesten, Anna; Parekh, Jenita; Tunçalp, Ozge; Turke, Shani; Blum, Robert William
We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998-2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects.
Kehoe, T.; Rugg, L.
A hierarchy of dosimetry, planning and machine performance checks and evaluations of clinical outcomes have been widely used in radiotherapy for decades. Procedures, codes of practice and guidance are readily available on the technical aspects of radiotherapy treatments, maintenance of which is achieved by quality control checks within a quality assurance approach to radiotherapy. Recently a series of high profile, well-publicised treatment accidents resulting in damage to patients have focused the attention of both professionals and the public. There is now pressure to introduce formal quality management systems. Patients and their relatives/carers are having their expectations raised but their definition of a quality service differs from that generally considered by the oncology professionals. Most departmental managers and staff have wide experience of quality control checks. They understand the philosophy of quality assurance. However the idea of formal quality systems/quality management is alien to them. What is a professional/departmental manager to do? This paper addresses that question by discussing the underlying principles of quality management covering service provision as well as technical radiotherapy treatment delivery and by providing some guidance based on experience in the practical implementation of quality management through three stages of development: a QA programme incorporating checks on essential parts of the technical treatment delivery, a formal documented certified QA system focusing on technical treatment delivery, a comprehensive quality management system covering all parts of a service. One possible action plan is provided indicating progress through the three stages of development based on experience in one large Radiation Oncology Department. With planning, resources and commitment. a comprehensive quality of service management system is achievable in radiotherapy. (author.)
Andaya, Elise; Mishtal, Joanna
Women's rights to legal abortion in the United States are now facing their greatest social and legislative challenges since its 1973 legalization. Legislation restricting rights and access to abortion care has been passed at state and federal levels at an unprecedented rate. Given the renewed vigor of anti-abortion movements, we call on anthropologists to engage with this shifting landscape of reproductive politics. This article examines recent legislation that has severely limited abortion access and maps possible directions for future anthropological analysis. We argue that anthropology can provide unique contributions to broader abortion research. The study of abortion politics in the United States today is not only a rich opportunity for applied and policy-oriented ethnographic research. It also provides a sharply focused lens onto broader theoretical concerns in anthropology and new social formations across moral, medical, political, and scientific fields in 21st-century America. © 2016 by the American Anthropological Association.
Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah
Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values quality measures in cancer hospitals. Copyright © 2015 by American Society of Clinical Oncology.
Sharbafchi, Mohammad Reza; Heydari, Mostafa
Historically, substance misuse has been a serious problem faced by worldwide military personnel. Some research showed that military personnel have higher rates of unhealthy substance use than their age peers in the general population. These problems have serious consequences and may lead to significant military difficulties in the field of readiness, discipline, and mental or physical health. In this review, we gathered various methods for prevention, diagnosis, and treatment of substance use disorders and suggested a comprehensive plan for Iran Armed Forces to improve existing services. This article is a narrative review study, which was carried out on 2016. A careful literature review was performed between January 1970 and April 2016 on several national and international databases. Articles were screened according to the following inclusion criteria: (1) review articles about prevention and treatment protocols, (2) executive guidance, (3) cohort articles about risk factors of addiction, and (4) randomized controlled trials about prevention or treatment of substance use disorders in army service members. After screening by title and abstract, 130 articles selected of 832 founded articles, and after quality assessment, finally, 63 articles included in the review. There is a necessity to manage substance use disorder through prevention, screening, and then referral to proper services for diagnosis and treatment. Urinalysis programs for screening are cost-effective and should be considered as a main method. Effective treatment includes both behavioral and pharmacological methods. The ideal prevention program will include multiple and mutually reinforcing evidence-based universal, selective, and indicated attempts at both the individual and environmental levels. The implementation of screening and treatment strategies needs strict rules and national guideline for the comprehensive management of substance use disorders in army.
Pimental, Patricia A; O'Hara, John B; Jandak, Jessica L
By virtue of their extensive knowledge base and specialized training in brain-behavior relationships, neuropsychologists are especially poised to execute a unique broad-based approach to overall cognitive wellness and should be viewed as primary care providers of cognitive health. This article will describe a novel comprehensive cognitive wellness service delivery model including cognitive health, anti-aging, lifelong wellness, and longevity-oriented practices. These practice areas include brain-based cognitive wellness, emotional and spiritually centric exploration, and related multimodality health interventions. As experts in mind-body connections, neuropsychologists can provide a variety of evidence-based treatment options, empowering patients with a sense of value and purpose. Multiple areas of clinical therapy skill-based learning, tailor-made to fit individual needs, will be discussed including: brain stimulating activities, restorative techniques, automatic negative thoughts and maladaptive thinking reduction, inflammation and pain management techniques, nutrition and culinary focused cognitive wellness, spirituality based practices and mindfulness, movement and exercise, alternative/complimentary therapies, relationship restoration/social engagement, and trauma healing/meaning. Cognitive health rests upon the foundation of counteracting mind-body connection disruptions from multiple etiologies including inflammation, chronic stress, metabolic issues, cardiac conditions, autoimmune disease, neurological disorders, infectious diseases, and allergy spectrum disorders. Superimposed on these issues are lifestyle patterns and negative health behaviors that develop as ill-fated compensatory mechanisms used to cope with life stressors and aging. The brain and body are electrical systems that can "short circuit." The therapy practices inherent in the proposed cognitive wellness service delivery model can provide preventative insulation and circuit breaking against
Othman Rani Diana
Full Text Available In line with the implementation of value added tax (VAT by 160 countries, Malaysia has taken its own path with the introduction of goods and services tax (GST starting from 1 April 2015 to replace its previous tax system. This new tax system has been announced on 25 October 2013, which has given about 17 months for businesses and people in Malaysia to make a complete preparation for GST. GST is proven to be the fairer tax system to overcome the previous one which was not only limited in scope, but also came with a number of inherent weaknesses. Therefore, in order to achieve the desired awareness regarding GST, it is essential that all Malaysians have the required level of understanding in terms of its concepts, scopes, charges and mechanisms. This paper discusses the benefits of GST for the nation in the long run as well as the negative perceptions from the public. This should reveal the additional steps to be taken by the regulators in ensuring a better comprehension of this new tax system among the citizens as a support for the government’s tax reform, which has been programmed for Malaysia to move towards a high-income nation.
Substance Abuse and Mental Health Services Administration, 2010
This report to Congress provides critical information about the Comprehensive Community Mental Health Services for Children and their Families Program (CMHI), including the characteristics of children, youth, and families as they enter the CMHI; the outcomes attained for children and youth, and their caregivers and families after entry into the…
Briggs, Marilyn; Mueller, Constance G.; Fleischhacker, Sheila
It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health,…
Gollin, Gerald; Moores, Donald
Some pediatric surgeons rarely document nonoperative services, believing that the reimbursement provided for such care is negligible. We evaluated the impact of comprehensive documentation and billing for nonoperative, pediatric surgical care. All bills submitted for inpatient, nonoperative care for 1 year were reviewed. Total receipts for documented admissions, consultations, critical care, and daily care were determined. The Evaluation and Management code billed for each service was recorded, and the total and average payments attributable to each Evaluation and Management code were calculated. Fifty-six percent of services were covered by Medicaid and 26% by a commercial insurer. There were 607 billed admission history and physical exams for which reimbursement totaled 43,493 dollars. Critical care services were provided to 49 patients and yielded 8964 dollars in payments. Six hundred thirty-nine inpatient consultations were performed with a reimbursement of 42,830 dollars. Daily care services were billed 1044 times and produced 71,579 dollars in payments. Overall reimbursement for documented, nonoperative services was 166,866 dollars. This represented 16.2% of total, noncontracted income for the practice. Despite a payer mix heavily weighted toward Medicaid, comprehensive documentation and billing for nonoperative services increased total, noncontracted reimbursement by almost 20% over what it would have been had only operative services been billed. The yield from properly documented, nonoperative care can be substantial.
Madeiro, Alberto Pereira; Rufino, Andréa Cronemberger
Treatment of complications resulting from induced abortion may be hampered by discriminatory attitudes manifested by healthcare professionals in hospitals and abortion services. This article retrieved stories of institutional abuse directed at women who had an induced abortion in illegal and unsafe conditions. Seventy-eight women admitted to a public hospital in Teresina for complications after an induced abortion were interviewed. A semi-structured script was used with questions about practices and itineraries of abortion and institutional violence during hospitalization. Discriminatory practices and maltreatment during care were reported by 26 women, especially among those who confessed to induction of the abortion. Moral judgement, threat of filing a complaint to the police, negligence in the control of pain, long wait for uterine curettage, and hospitalization with mothers who have recently given birth were the main types of institutional violence reported by women. Cases of institutional violence in the care of induced abortion violates the duty of the healthcare service and prevents women from receiving the necessary health care.
В. В. Мацюк
Full Text Available Problem setting. The status of comprehensive support of military units in the world’s leading powers is considered to be one of the key factors which defines the success of the social emergency settling operations. The experience of service and military application of the National Guard of Ukraine in the anti-terrorist operation zone on the South-East of Ukraine shows that emergency response tasks are generally carried out in cooperation with other Ukrainian security sector authorities, mostly with the Security Service of Ukraine. However, the forces joint managing authority chiefs usually do not cover the matter of such activities’ comprehensive support, which forces the commanders of the military units to rely on themselves in this question. Recent research and publications analysis. The analysis of research of status and development prospects of the comprehensive support of the Armed Forces of Ukraine, other security authorities, armies of the world’s leading powers, peculiarities of creation and functioning of such systems, application of their means and powers, scientific thought on the problems of service and military application of the National Guard units has shown the problematic tasks of the joint unit comprehensive support system optimization. Therefore, the question of regulatory and legal support of this process is of current importance. Paper objective. The objective of this paper is to define regulatory and legal aspects of comprehensive support optimization of the Security Service of Ukraine and the National Guard of Ukraine service and combat activities during social emergencies. Paper main body. According to the current legislation, comprehensive support comprises of the following types of support: operative (also called military, moral and psychological, materiel (logistical. All other types of support are parts of these three basic ones. Their examination is necessary due to the fact, that there is confusion in the
Ramamurthy, M. K.
This paper presents Unidata's vision for providing comprehensive, well-integrated, and end-to-end data services for the geosciences. These include an array of functions for collecting, finding, and accessing data; data management tools for generating, cataloging, and exchanging metadata; and submitting or publishing, sharing, analyzing, visualizing, and integrating data. When this vision is realized, users no matter where they are or how they are connected to the Internetwill be able to find and access a plethora of geosciences data and use Unidata-provided tools and services both productively and creatively in their research and education. What that vision means for the Unidata community is elucidated by drawing a simple analogy. Most of users are familiar with Amazon and eBay e-commerce sites and content sharing sites like YouTube and Flickr. On the eBay marketplace, people can sell practically anything at any time and buyers can share their experience of purchasing a product or the reputation of a seller. Likewise, at Amazon, thousands of merchants sell their goods and millions of customers not only buy those goods, but provide a review or opinion of the products they buy and share their experiences as purchasers. Similarly, YouTube and Flickr are sites tailored to video- and photo-sharing, respectively, where users can upload their own content and share it with millions of other users, including family and friends. What all these sites, together with social-networking applications like MySpace and Facebook, have enabled is a sense of a virtual community in which users can search and browse products or content, comment and rate those products from anywhere, at any time, and via any Internet- enabled device like an iPhone, laptop, or a desktop computer. In essence, these enterprises have fundamentally altered people's buying modes and behavior toward purchases. Unidata believes that similar approaches, appropriately tailored to meet the needs of the scientific
The “rightness” of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the “job” they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. I explore how negotiations over the rightness of MVA as well as PAC unfold at the intersection of national and global reproductive politics during the daily treatment of abortion complications at three hospitals in Senegal, where PAC is permitted but induced abortion is legally prohibited. Although state health authorities have championed MVA as the “preferred” PAC technology, the primary donor for PAC, the United States Agency for International Development, does not support the purchase of abortifacient technologies. I conducted an ethnography of Senegal's PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage. Anxieties about MVA's capacity to induce abortion have constrained its integration into routine obstetric care. This capacity also raises questions about what the “job,” PAC, represents in Senegalese hospitals. The prioritization of MVA's security over women's access to the preferred technology reinforces gendered inequalities in health care. PMID:25948127
Y. VAN VAERENBERGH; B. LARIVIÈRE; I. VERMEIR
Purpose – Services recoveries following service failures not only imply customer recovery opportunities in which customer-company relationships can be restored, they can also result in process improvements (i.e. process recoveries in literature). This paper seeks to identify the additional impact of process recoveries on four customer outcome variables (satisfaction with service recovery, overall satisfaction, repurchase intent and word-of-mouth) by communicating these improvements back to th...
Garcia-Gomez, S.; Lelli, F.; Eschriche-Vicente, M.; Arozarena-Llopis, P.; Taher, Y.; Momm, C.; Spriestersbach, A.; Jimenez-Ganan, M.; Le Jeune, G.; Dao, M.; Carrie, S.P.; Niemoller, J.; Mazmanov, D.; Biro, J.; Giesmann, A.; Junker, F.
The 4CaaSt project aims at developing a PaaS framework that enables flexible definition, marketing, deployment and management of Cloud-based services and applications. The major innovations proposed by 4CaaSt are the blueprint and its lifecycle management, a one stop shop for Cloud services and a
Full Text Available Aiming at the problem of lack of security equipment for airborne reconnaissance camera and universal difference between internal and external field and model, the design scheme of comprehensive universal system based on PC-104 bus architecture and ARM wireless test module is proposed is proposed using the ATE design. The scheme uses the "embedded" technology to design the system, which meets the requirements of the system. By using the technique of classified switching, the hardware resources are reasonably extended, and the general protection of the various types of aerial reconnaissance cameras is realized. Using the concept of “wireless test”, the test interface is extended to realize the comprehensive protection of the aerial reconnaissance camera and the field. The application proves that the security system works stably, has good generality, practicability, and has broad application prospect.
School Psychology Review, 2010
The mission of the National Association of School Psychologists (NASP) is to represent school psychology and support school psychologists to enhance the learning and mental health of all children and youth. "School psychologists" provide effective services to help children and youth succeed academically, socially, behaviorally, and emotionally.…
Saharan Africa, that has the highest preva lenceof the disease, has been quite significant in recent years. Millions of people are now benefiting from the services rendered for people living with HIV/AIDS. Considering the state of health systems in ...
... preservation and family support services; (iv) Parents, including birth and adoptive parents, foster parents... federally assisted programs which may include: Head Start; the local education agency (school-linked social... OMB Control Number 0980-0047. In accordance with the Paperwork Reduction Act of 1995, an agency may...
McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla
Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271
Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.
McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla
Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.
Kranti Suresh Vora
Full Text Available Background: The high rate of maternal mortality in India is of grave concern. Poor rural Indian women are most vulnerable to preventable maternal deaths primarily because they have limited availability of affordable emergency obstetric care (EmOC within reasonable geographic proximity. Scarcity of obstetricians in the public sector combined with financial barriers to accessing private sector obstetrician services preclude this underserved population from availing lifesaving functions of comprehensive EmOC such as C-section. In order to overcome this limitation, Government of Gujarat initiated a unique public–private partnership program called Chiranjeevi Yojana (CY in 2005. The program envisaged leveraging private sector providers to increase availability and thereby accessibility of EmOC care for vulnerable sections of society. Under CY, private sector providers render obstetric care services to poor women at no cost to patients. This paper examines the CY's effectiveness in improving availability of CEmOC services between 2006 and 2012 in three districts of Gujarat, India. Methods: Primary data on facility locations, EmOC functionality, and obstetric bed availability were collected in the years 2012 and 2013 in three study districts. Secondary data from Census 2001 and 2011 were used along with required geographic information from Topo sheets and Google Earth maps. ArcGIS version 10 was used to analyze the availability of services using two-step floating catchment area (2SFCA method. Results: Our analysis suggests that the availability of CEmOC services within reasonable travel distance has greatly improved in all three study districts as a result of CY. We also show that the declining participation of the private sector did not result in an increase in distance to the nearest facility, but the extent of availability of providers for several villages was reduced. Spatial and temporal analyses in this paper provide a comprehensive
Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N
LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.
Othman Rani Diana; Mohd Pauzi Nur Farahah; Abu Bakar Siti Anis Nadia; Sapari Afidah; Karim Mohd Syazwan
In line with the implementation of value added tax (VAT) by 160 countries, Malaysia has taken its own path with the introduction of goods and services tax (GST) starting from 1 April 2015 to replace its previous tax system. This new tax system has been announced on 25 October 2013, which has given about 17 months for businesses and people in Malaysia to make a complete preparation for GST. GST is proven to be the fairer tax system to overcome the previous one which was not only limited in sco...
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)
Baron, Silja; Hoek, Jannis; Kaufmann Alves, Inka; Herz, Sabine
Adaptations of existing central water supply and wastewater disposal systems to demographic, climatic and socioeconomic changes require a profound knowledge about changing influencing factors. The paper presents a scenario management approach for the identification of future developments of drivers influencing water infrastructures. This method is designed within a research project with the objective of developing an innovative software-based optimisation and decision support system for long-term transformations of existing infrastructures of water supply, wastewater and energy in rural areas. Drivers of water infrastructures comprise engineering and spatial factors and these are predicted by different methods and techniques. The calculated developments of the drivers are illustrated for a model municipality. The developed scenario-manager enables the generation of comprehensive scenarios by combining different drivers. The scenarios are integrated into the optimisation model as input parameters. Furthermore, the result of the optimisation process - an optimal transformation strategy for water infrastructures - can have impacts on the existing fee system. General adaptation possibilities of the present fee system are presented.
Prayitno, S. H.; Suwarsono, St.; Siswono, T. Y. E.
Conceptual comprehension in this research is the ability to use the procedures that are owned by pre-service teachers to solve problems by finding the relation of the concept to another, or can be done by identifying the type of problem and associating it with a troubleshooting procedures, or connect the mathematical symbols with mathematical ideas and incorporate them into a series of logical reasoning, or by using prior knowledge that occurred directly, through its conceptual knowledge. The goal of this research is to describe the profile of conceptual comprehensin of pre-service teachers with low emotional intelligence in mathematical problems solving. Through observation and in-depth interview with the research subject the conclusion was that: pre-service teachers with low emotional intelligence pertained to the level of formal understanding in understanding the issues, relatively to the level of intuitive understanding in planning problem solving, to the level of relational understanding in implementing the relational problem solving plan, and pertained to the level of formal understanding in looking back to solve the problem.
Fischer, Frida Marina; Martinez, Maria Carmen
The work of hospital food service is characterized by demands that can be associated with work ability--WA. The aim of this study was to evaluate factors associated with WA among hospital food service professionals and recommend intervention measures. This is a cross sectional study carried out in 2009, conducted in a hospital of São Paulo, Brazil. Participants were 76 (96.2%) of the eligible. They filled out a questionnaire including socio-demographic data, life styles, working conditions and WA. Multivariate linear regression analyses were performed. Factors associated with WA were age (p = 0.051), over commitment (p = 0.011), effort-reward ratio (p = 0.002) and work injuries (p work injuries is consistent with the theoretical model that demonstrated that health status is the basis to maintain the WA. The association of effort-reward imbalance shows that issues related with work organization are relevant for these workers. The association of overcommittment suggests that workers recognize their responsibility with the therapeutic processes of patients. Results showed a number of features of different nature that should be taken into account when implementing measures to improve the WA, to be applied at different levels: individual, task and institutional.
Heinz, Adrienne J; Freeman, Michael A; Harpaz-Rotem, Ilan; Pietrzak, Robert H
American military veterans are nearly twice as likely to be self-employed compared to non-veterans, and are majority owners in nine percent of all businesses nationwide. Despite their contribution to the broader economy and the potential for training programs to cultivate and foster successful self-employment and veteran-lead entrepreneurial ventures, research on veteran entrepreneurs remains limited. In order to gain a better understanding of the potential strengths and vulnerabilities of veteran entrepreneurs, the current study utilized data from a large, nationally representative sample to profile self-employed veterans (n=230) and compare them to veterans who work as employees (n=1,055) with respect to demographic, military service history, and psychosocial characteristics. Results indicated that self-employed veterans were older and more educated and more likely to utilize VA healthcare. Self-employed veterans were more likely to serve in Vietnam and to serve in the military for fewer years. No differences were noted in perceived military experience, level of combat exposure, or military branch served as a function of self-employment. Although reporting more lifetime traumas, self-employed veterans did not experience higher rates of current or lifetime psychopathology or lower perceived quality of life. Potential protective resilience-promoting factors may be associated with the higher levels of openness, extraversion, optimism, achievement-orientation (purpose in life), and greater need for autonomy and professional development observed among self-employed veterans. Moreover, self-employed veterans demonstrated higher levels of gratitude, community integration, and altruistic service to others. Findings have potential to inform human resources management strategies and vocational training and reintegration initiatives for veterans.
Heinz, Adrienne J.; Freeman, Michael A.; Harpaz-Rotem, Ilan; Pietrzak, Robert H.
American military veterans are nearly twice as likely to be self-employed compared to non-veterans, and are majority owners in nine percent of all businesses nationwide. Despite their contribution to the broader economy and the potential for training programs to cultivate and foster successful self-employment and veteran-lead entrepreneurial ventures, research on veteran entrepreneurs remains limited. In order to gain a better understanding of the potential strengths and vulnerabilities of veteran entrepreneurs, the current study utilized data from a large, nationally representative sample to profile self-employed veterans (n=230) and compare them to veterans who work as employees (n=1,055) with respect to demographic, military service history, and psychosocial characteristics. Results indicated that self-employed veterans were older and more educated and more likely to utilize VA healthcare. Self-employed veterans were more likely to serve in Vietnam and to serve in the military for fewer years. No differences were noted in perceived military experience, level of combat exposure, or military branch served as a function of self-employment. Although reporting more lifetime traumas, self-employed veterans did not experience higher rates of current or lifetime psychopathology or lower perceived quality of life. Potential protective resilience-promoting factors may be associated with the higher levels of openness, extraversion, optimism, achievement-orientation (purpose in life), and greater need for autonomy and professional development observed among self-employed veterans. Moreover, self-employed veterans demonstrated higher levels of gratitude, community integration, and altruistic service to others. Findings have potential to inform human resources management strategies and vocational training and reintegration initiatives for veterans. PMID:29290645
Hoang, Ha; Le, Quynh; Ogden, Kathryn
Understanding the needs of rural women in maternity care and service models available to them is significant for the development of effective policies and the sustainability of rural communities. Nevertheless, no systematic review of studies addressing these needs has been conducted. To synthesise the best available evidence on the experiences of women's needs in maternity care and existing service models in rural areas. Literature search of ten electronic databases, digital theses, and reference lists of relevant studies applying inclusion/exclusion criteria was conducted. Selected papers were assessed using standardised critical appraisal instruments from JBI-QARI. Data extracted from these studies were synthesised using thematic synthesis. 12 studies met the inclusion criteria. There were three main themes and several sub-themes identified. A comprehensive set of the maternity care expectations of rural women was reported in this review including safety (7), continuity of care (6) and quality of care (6), and informed choices needs (4). In addition, challenges in accessing maternity services also emerged from the literature such as access (6), risk of travelling (9) and associated cost of travel (9). Four models of maternity care examined in the literature were medically led care (5), GP-led care (4), midwifery-led care (7) and home birth (6). The systematic review demonstrates the importance of including well-conducted qualitative studies in informing the development of evidence-based policies to address women's maternity care needs and inform service models. Synthesising the findings from qualitative studies offers important insight for informing effective public health policy. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Beyrer, Chris; Sullivan, Patrick S; Sanchez, Jorge; Dowdy, David; Altman, Dennis; Trapence, Gift; Collins, Chris; Katabira, Elly; Kazatchkine, Michel; Sidibe, Michel; Mayer, Kenneth H
Where surveillance has been done, it has shown that men (MSM) who have sex with men bear a disproportionate burden of HIV. Yet they continue to be excluded, sometimes systematically, from HIV services because of stigma, discrimination, and criminalisation. This situation must change if global control of the HIV epidemic is to be achieved. On both public health and human rights grounds, expansion of HIV prevention, treatment, and care to MSM is an urgent imperative. Effective combination prevention and treatment approaches are feasible, and culturally competent care can be developed, even in rights-challenged environments. Condom and lubricant access for MSM globally is highly cost effective. Antiretroviral-based prevention, and antiretroviral access for MSM globally, would also be cost effective, but would probably require substantial reductions in drug costs in high-income countries to be feasible. To address HIV in MSM will take continued research, political will, structural reform, community engagement, and strategic planning and programming, but it can and must be done. Copyright © 2012 Elsevier Ltd. All rights reserved.
The government of Nangong City, a newly instituted city with a relatively large proportion of agricultural workers has integrated family planning into the building up of mental civilization. As a result, in 1986, the family planning practice rate was 98.4%. One way the government accomplished this was by developing production to eliminate poverty, to show that population development has a significant impact on socioeconomic development. To help change people's attitudes about family planning, the government 1) used publicity, such as speechmaking, mass media, and courses in population theory; 2) awarded those who made contributions; 3) carried out publicity and education in accordance with characteristics of different groups of people; and 4) encouraged bridegrooms to live with their wives' families if the wives' parents had had no son. Another technique the government used as the popularization of scientific knowledge about population theory, physiology and hygiene, birth control, and eugenics and health in births. A 4th method was to popularize knowledge of laws and regulations, such as of early marriage and consanguineous marriage. 5th, the government developed social security undertakings: 1) giving priority to single-child families and 2) taking care of the elderly. Finally, the government improved maternal and child care by 1) providing premarital health care; 2) creating a project for healthier births and better upbringing; 3) family planning workers showing warm concern for reproductive women; and 4) controlling women's diseases and providing health care knowledge, as well as family planning services. These 6 activities have resulted in 1) the decreasing momentum of per capita arable land being controlled, 2) 1-child couples having more time to learn, 3) the development of educational undertakings, 4) a change in people's traditional practices, and 5) improvement in the understanding of patriotism.
Orda, Ulrich; Orda, Sabine; Sen Gupta, Tarun; Knight, Sabina
Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, CONCLUSIONS: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU. © 2016 National Rural Health Alliance Inc.
Penfold, Suzanne; Wendot, Susy; Nafula, Inviolata; Footman, Katharine
. Women's pathways to safe abortion care can be complex, including use of multiple abortion methods, delays due to financial barriers, and challenges accessing safe providers. Improvements in community knowledge of safe abortion care and accessibility of services are needed to reduce recourse to unsafe abortion. PAFP counselling is valued by clients but quality of counselling can be improved by exploring women's contraceptive histories, including information on more contraceptive methods, and inclusion of support for women who want to delay family planning uptake until their abortion is complete.
K P White; A P Sage; F A Rodammer; C T Peters
The Environmental Advisory Service (EASe) is a decision support system which can provide assistance to local planning agencies in selecting land-development alternatives or in formulating land-use plans. EASe offers a comprehensive and consistent procedure for rating either a development proposal or a proposed plan. This procedure is based upon qualitative assessments of the impact of developments or plans on the natural environment, zoning and land use. public and private services, transport...
Gebreselassie, Tesfayi; Stephens, Robert L.; Maples, Connie J.; Johnson, Stacy F.; Tucker, Alyce L.
Predictors of retention of participants in a longitudinal study and heterogeneity between communities were investigated using a multilevel logistic regression model. Data from the longitudinal outcome study of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families program and information on…
Niedergesaess, Ulrike; Pollmann, Birgitt [imug Beratungsgesellschaft fuer sozial-oekologische Innovationen mbH, Hamburg (Germany)
Quality of service is becoming an increasingly important issue among power supply companies because it represents an effective means of distinguishing oneself from competitors. Moreover, insights gained from service work can provide decisive information for the control of entrepreneurial processes. A new study on customer service offers guidance to energy suppliers seeking to achieve an outstanding market position.
Incik, Eylem Yalcin; Akay, Cenk
The main purpose of this research is to identify the competency and the perceptions of pre-service teachers on technopedagogical education. While study group of quantitative dimension is composed of 626 pre-service teachers; study group of qualitative extent is composed of 67 pre-service teachers. The sample represents 35% of the population of…
Linker, Jenny M.; Ford, Kristen M.; Knutson, Julie M.; Goplen, Hailey A.
Physical educators have been identified as ideal school champions to lead comprehensive school physical activity program (CSPAP) efforts within their schools. As such, they should be adequately prepared to take on this role. Faculty from three physical and health education teacher education programs have collaboratively developed the…
Shahid, Shaouli; Taylor, Emma V; Cheetham, Shelley; Woods, John A; Aoun, Samar M; Thompson, Sandra C
Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples' preferences, needs, opportunities and barriers to palliative care. A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly's hierarchy of evidence-for-practice in qualitative research. Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples' experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. The results provide a comprehensive overview of identified effective practices with regards to
... Comprehensive Care Share this page Facebook Twitter Email Comprehensive Care Understand the importance of comprehensive MS care ... In this article A complex disease requires a comprehensive approach Today multiple sclerosis (MS) is not a ...
Kubota, Satoshi; Kawai, Hiromi
In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.
Wu, Xianhua; Wei, Guo; Yang, Lingjuan; Guo, Ji; Lu, Huaguo; Chen, Yunfeng; Sun, Jian
Concentrating on consuming coefficient, partition coefficient, and Leontief inverse matrix, relevant concepts and algorithms are developed for estimating the impact of meteorological services including the associated (indirect, complete) economic effect. Subsequently, quantitative estimations are particularly obtained for the meteorological services in Jiangxi province by utilizing the input-output method. It is found that the economic effects are noticeably rescued by the preventive strategies developed from both the meteorological information and internal relevance (interdependency) in the industrial economic system. Another finding is that the ratio range of input in the complete economic effect on meteorological services is about 1 : 108.27-1 : 183.06, remarkably different from a previous estimation based on the Delphi method (1 : 30-1 : 51). Particularly, economic effects of meteorological services are higher for nontraditional users of manufacturing, wholesale and retail trades, services sector, tourism and culture, and art and lower for traditional users of agriculture, forestry, livestock, fishery, and construction industries.
Full Text Available Concentrating on consuming coefficient, partition coefficient, and Leontief inverse matrix, relevant concepts and algorithms are developed for estimating the impact of meteorological services including the associated (indirect, complete economic effect. Subsequently, quantitative estimations are particularly obtained for the meteorological services in Jiangxi province by utilizing the input-output method. It is found that the economic effects are noticeably rescued by the preventive strategies developed from both the meteorological information and internal relevance (interdependency in the industrial economic system. Another finding is that the ratio range of input in the complete economic effect on meteorological services is about 1 : 108.27–1 : 183.06, remarkably different from a previous estimation based on the Delphi method (1 : 30–1 : 51. Particularly, economic effects of meteorological services are higher for nontraditional users of manufacturing, wholesale and retail trades, services sector, tourism and culture, and art and lower for traditional users of agriculture, forestry, livestock, fishery, and construction industries.
Wu, Xianhua; Yang, Lingjuan; Guo, Ji; Lu, Huaguo; Chen, Yunfeng; Sun, Jian
Concentrating on consuming coefficient, partition coefficient, and Leontief inverse matrix, relevant concepts and algorithms are developed for estimating the impact of meteorological services including the associated (indirect, complete) economic effect. Subsequently, quantitative estimations are particularly obtained for the meteorological services in Jiangxi province by utilizing the input-output method. It is found that the economic effects are noticeably rescued by the preventive strategies developed from both the meteorological information and internal relevance (interdependency) in the industrial economic system. Another finding is that the ratio range of input in the complete economic effect on meteorological services is about 1 : 108.27–1 : 183.06, remarkably different from a previous estimation based on the Delphi method (1 : 30–1 : 51). Particularly, economic effects of meteorological services are higher for nontraditional users of manufacturing, wholesale and retail trades, services sector, tourism and culture, and art and lower for traditional users of agriculture, forestry, livestock, fishery, and construction industries. PMID:24578666
Saravia-Pinilla, Martha H; Daza-Beltrán, Carolina; García-Acosta, Gabriel
This article presents the results of a documentary-exploratory review of design methods and concepts associated with human and environmental factors, based on a qualitative-quantitative analysis of coincidences with the fundamentals of ergoecology and in line with sustainable dynamics, with a view to putting the principles of ergoecology into practice in product/service design and development. 61.6% of 696 documents found represent work on conceptual developments, while the remaining 38.4% refer to design methods. Searches were refined using Nvivo-10 software, and 101 documents were obtained about theoretical aspects while 17 focused on the application of methods, and these formed the analysis universe. The results show how little concern there is for working comprehensively on human and environmental aspects, and a trend toward segmentation of human and environmental aspects in the field of product/service design and development can be seen, at both concept and application/methodology levels. It was concluded from the above that comprehensive, simultaneous work is needed on human and environmental aspects, clarity and conceptual unity, in order to achieve sustainability in practical matters and ensure that ergoecology-compatible design methods are applied. Copyright © 2015 Elsevier Ltd. All rights reserved.
Mackenzie, A. Graham
This technical report presents recommendations and plans which are the result of a mission undertaken as part of a project to promote a scientific and technological information service and establish a popular science resource center in Korea. The mission's main emphasis was to help Korean authorities and the United Nations Development Programme…
Hirve, Siddhivinayak S
Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion services to the district level, punitive measures to deter provision of unsafe abortions, rationalisation of physical requirements for facilities to provide early abortion, and approval of medical abortion, have all aimed to expand safe services. Proposed amendments to the MTP Act to prevent sex-selective abortions would have been unethical and violated confidentiality, and were not taken forward. Continuing problems include poor regulation of both public and private sector services, a physician-only policy that excludes mid-level providers and low registration of rural compared to urban clinics; all restrict access. Poor awareness of the law, unnecessary spousal consent requirements, contraceptive targets linked to abortion, and informal and high fees also serve as barriers. Training more providers, simplifying registration procedures, de-linking clinic and provider approval, and linking policy with up-to-date technology, research and good clinical practice are some immediate measures needed to improve women's access to safe abortion care.
Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I
Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.
De Klerk, Elizabeth Petronella Johanna
Adolescents who are subjected to adverse health risks which limit school attendance and academic performance, is a national as well as an international recognised problem considering healthy youth to be productive members of society. The South African Department of Health has introduced a re-engineering program for primary health care of which school-health is one of three main areas of the primary health care services focusing on, but not limited to immunization, teenage pregnancy, education...
Francesconi, M; Minichino, A; Carrión, R E; Delle Chiaie, R; Bevilacqua, A; Parisi, M; Rullo, S; Bersani, F Saverio; Biondi, M; Cadenhead, K
Accuracy of risk algorithms for psychosis prediction in "at risk mental state" (ARMS) samples may differ according to the recruitment setting. Standardized criteria used to detect ARMS individuals may lack specificity if the recruitment setting is a secondary mental health service. The authors tested a modified strategy to predict psychosis conversion in this setting by using a systematic selection of trait-markers of the psychosis prodrome in a sample with a heterogeneous ARMS status. 138 non-psychotic outpatients (aged 17-31) were consecutively recruited in secondary mental health services and followed-up for up to 3 years (mean follow-up time, 2.2 years; SD=0.9). Baseline ARMS status, clinical, demographic, cognitive, and neurological soft signs measures were collected. Cox regression was used to derive a risk index. 48% individuals met ARMS criteria (ARMS-Positive, ARMS+). Conversion rate to psychosis was 21% for the overall sample, 34% for ARMS+, and 9% for ARMS-Negative (ARMS-). The final predictor model with a positive predictive validity of 80% consisted of four variables: Disorder of Thought Content, visuospatial/constructional deficits, sensory-integration, and theory-of-mind abnormalities. Removing Disorder of Thought Content from the model only slightly modified the predictive accuracy (-6.2%), but increased the sensitivity (+9.5%). These results suggest that in a secondary mental health setting the use of trait-markers of the psychosis prodrome may predict psychosis conversion with great accuracy despite the heterogeneity of the ARMS status. The use of the proposed predictive algorithm may enable a selective recruitment, potentially reducing duration of untreated psychosis and improving prognostic outcomes. Copyright Â© 2016 Elsevier Masson SAS. All rights reserved.
Hayes, Dayle; Contento, Isobel R; Weekly, Carol
It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. Through the continued use of multidisciplinary teams, local school needs will be better identified and addressed within updated wellness policies. Updated nutrition standards are providing students with a wider variety of fruits, vegetables, and whole grains, while limiting sodium, calories, and saturated fat. Millions of students enjoy school meals every day in the US, with the majority of these served to children who are eligible for free and reduced-priced meals. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus, nutrition initiatives such as farm to school and school gardens, wellness policies, nutrition education and promotion, food and beverage marketing at school, and consideration of roles and responsibilities. It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus; nutrition initiatives such as farm to school and school gardens; wellness policies; nutrition education and promotion; food and beverage marketing at school; and consideration of
Bleda, Marta; Tarraga, Joaquin; de Maria, Alejandro; Salavert, Francisco; Garcia-Alonso, Luz; Celma, Matilde; Martin, Ainoha; Dopazo, Joaquin; Medina, Ignacio
During the past years, the advances in high-throughput technologies have produced an unprecedented growth in the number and size of repositories and databases storing relevant biological data. Today, there is more biological information than ever but, unfortunately, the current status of many of these repositories is far from being optimal. Some of the most common problems are that the information is spread out in many small databases; frequently there are different standards among repositories and some databases are no longer supported or they contain too specific and unconnected information. In addition, data size is increasingly becoming an obstacle when accessing or storing biological data. All these issues make very difficult to extract and integrate information from different sources, to analyze experiments or to access and query this information in a programmatic way. CellBase provides a solution to the growing necessity of integration by easing the access to biological data. CellBase implements a set of RESTful web services that query a centralized database containing the most relevant biological data sources. The database is hosted in our servers and is regularly updated. CellBase documentation can be found at http://docs.bioinfo.cipf.es/projects/cellbase.
Tewes, Mitra; Rettler, Teresa; Wolf, Nathalie; Hense, Jörg; Schuler, Martin; Teufel, Martin; Beckmann, Mingo
Early integration of palliative care (PC) is recommended. The determination of predictors for patients' request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC. Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters. Additionally, patients' request for palliative and psychosocial support was assessed. Groups of patients with PC request were compared to patients without PC request regarding their symptom clusters. Logistic regression analysis was applied to discover significant predictors for the requested inclusion of PC. A total of 159 patients (25.5%) requested additional support by PC. Moderate and severe tiredness (40.3%), weakness (37.9%), pain (25.0%), loss of appetite (22.3%), and dyspnea (19.1%) were the most frequent symptoms. The group of patients requesting PC differed significantly in terms of pain, nausea, dyspnea, constipation, weakness, loss of appetite, tiredness, depression, and anxiety from patients without request for PC (p < .01). The perceived need for PC was identified by the significant predictors "depression," "anxiety," and "weakness" with an explained variance of 22%. Combining a standardized screening questionnaire and the assessment of patients' request for PC allows systematic monitoring for patients' need for PC in a large Medical Oncology clinic. Depression, anxiety, and weakness are predictors of requesting PC service by patients receiving outpatient cancer treatment.
U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) implemented the Comprehensive Error Rate Testing (CERT) program to measure improper payments in the Medicare...
Full Text Available Sport is a multi-billion dollar industry that has become an important marketingtool toattracta higher calibre of students to universities.Studentsdo not onlyconsider the educational value a university can offer but alsowhat it can offer interms of advancing their sporting achievements and their sporting careers. Highperformance programmes (HPP which includesuperior facilities, highqualitycoaching and management staff, educational subsidies, body/health conditioningfacilities as well as supportive staff for the purpose of driving and maintaining ahigh calibre of development are required to assist students in meeting theirsporting aspirations. The aim of this study was to gain constructive insightsregarding perceptions ofservice quality and satisfaction of the different memberassociates of the High Performance Programmes (HPP of Rugby, Hockey,Soccer, Netball, Athletics, Rowing and Cricket at a comprehensive university inSouth Africa (SA. Aconcurrent mixed method approachwas used to collectdata.Ko and Pastore’s (2005 Scale of Service Quality in Recreational Sports(SSQRSwas used to collect the quantitative data from one hundred and nineteen(n=119 first team players. Qualitative data was collected throughsemi-structuredinterviews with the respective sport managers(n=7and team captains(n=7within each sport programme.Quantitative data was analysed usingthestatistical package for the social sciences (SPSS, whereas the qualitative data were analysed using the Atlas.tisoftware package. The results from the studyrevealedthat the service quality of theHPPranged from moderate to highindicating thatsome dimensions requiredattention.The study provided usefulinsights regarding service quality which couldassistthemanagement of the HPPsin developing effective strategies to maintain and improve the quality of theirservices.
Schneider, Helen; Schaay, Nikki; Dudley, Lilian; Goliath, Charlyn; Qukula, Tobeka
Similar to other countries in the region, South Africa is currently reorienting a loosely structured and highly diverse community care system that evolved around HIV and TB, into a formalized, comprehensive and integrated primary health care outreach programme, based on community health workers (CHWs). While the difficulties of establishing national CHW programmes are well described, the reshaping of disease specific and care oriented community services, based outside the formal health system, poses particular challenges. This paper is an in-depth case study of the challenges of implementing reforms to community based services (CBS) in one province of South Africa. A multi-method situation appraisal of CBS in the Western Cape Province was conducted over eight months in close collaboration with provincial stakeholders. The appraisal mapped the roles and service delivery, human resource, financing and governance arrangements of an extensive non-governmental organisation (NGO) contracted and CHW based service delivery infrastructure that emerged over 15-20 years in this province. It also gathered the perspectives of a wide range of actors - including communities, users, NGOs, PHC providers and managers - on the current state and future visions of CBS. While there was wide support for new approaches to CBS, there are a number of challenges to achieving this. Although largely government funded, the community based delivery platform remains marginal to the formal public primary health care (PHC) and district health systems. CHW roles evolved from a system of home based care and are limited in scope. There is a high turnover of cadres, and support systems (supervision, monitoring, financing, training), coordination between CHWs, NGOs and PHC facilities, and sub-district capacity for planning and management of CBS are all poorly developed. Reorienting community based services that have their origins in care responses to HIV and TB presents an inter-related set of resource
Shepherd-Banigan, Megan; Smith, Valerie A.; Stechuchak, Karen M.; Miller, Katherine E. M.; Hastings, Susan Nicole; Wieland, Gilbert Darryl; Olsen, Maren K.; Kabat, Margaret; Henius, Jennifer; Campbell-Kotler, Margaret; Van Houtven, Courtney Harold
Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and community-based services (HCBS), through information resources and referrals, might alleviate family caregiver burden and delay nursing home entry for the patient. The aim of this study was to evaluate the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) (established by P.L. 111-163 for family caregivers of seriously injured post-9/11 Veterans) on Veteran use of LTSS. A two-cohort pre-post design with a nonequivalent comparison group (treated n = 15 650; comparison n = 8339) was used to (1) examine the association between caregiver enrollment in PCAFC and any VA-purchased or VA-provided LTSS use among Veterans and (2) describe program-related trends in HCBS and institutional LTSS use. The comparison group was an inverse-propensity-score weighted sample of Veterans whose caregivers applied for, but were not accepted into, the program. From baseline through 24 months post application, use of any LTSS ranged from 13.1% to 17.8% for Veterans whose caregivers were enrolled in PCAFC versus from 3.8% to 5.3% for Veterans in the comparison group. Participation in PCAFC was associated with a statistically significant increased use of any LTSS from 1 to 24 months post application (over time odds ratios ranged from 2.71 [95% confidence interval: 2.31-3.17] to 4.86 [3.93-6.02]). Support for family caregivers may enhance utilization of LTSS for Veterans with physical, emotional, and/or cognitive conditions. PMID:29591540
The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described
Federal Laboratory Consortium — The TVA Central Laboratories Services is a comprehensive technical support center, offering you a complete range of scientific, engineering, and technical services....
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Singh, Kundan; Wu, Xiaotao; Lennox, Jonathan; Schulzrinne, Henning G.
We describe the architecture and implementation of our comprehensive multi-platform collaboration framework known as Columbia InterNet Extensible Multimedia Architecture (CINEMA). It provides a distributed architecture for collaboration using synchronous communications like multimedia conferencing, instant messaging, shared web-browsing, and asynchronous communications like discussion forums, shared files, voice and video mails. It allows seamless integration with various communication means like telephones, IP phones, web and electronic mail. In addition, it provides value-added services such as call handling based on location information and presence status. The paper discusses the media services needed for collaborative environment, the components provided by CINEMA and the interaction among those components.
Auer, Stefanie R; Span, Edith; Reisberg, Barry
Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. © The Author(s) 2013.
A comprehensive review of HIV/STI prevention and sexual and reproductive health services among sex Workers in Conflict-Affected Settings: call for an evidence- and rights-based approach in the humanitarian response.
Ferguson, Alyssa; Shannon, Kate; Butler, Jennifer; Goldenberg, Shira M
While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. This review identified significant gaps in HIV/STI and SRH research, policy
This final rule implements a new Medicare Part A and B payment model under section 1115A of the Social Security Act, called the Comprehensive Care for Joint Replacement (CJR) model, in which acute care hospitals in certain selected geographic areas will receive retrospective bundled payments for episodes of care for lower extremity joint replacement (LEJR) or reattachment of a lower extremity. All related care within 90 days of hospital discharge from the joint replacement procedure will be included in the episode of care. We believe this model will further our goals in improving the efficiency and quality of care for Medicare beneficiaries with these common medical procedures.
Aiken, Abigail R A; Guthrie, Katherine A; Schellekens, Marlies; Trussell, James; Gomperts, Rebecca
To examine reasons for seeking abortion services outside the formal healthcare system in Great Britain, where abortion is legally available. We conducted a mixed-methods study among women resident in England, Scotland, and Wales who requested at-home medication abortion through online telemedicine initiative Women on Web (WoW) between November 22, 2016, and March 22, 2017. We examined the demographics and circumstances of all women requesting early medication abortion and conducted a content analysis of a sample of their anonymized emails to the service to explore their reasons for seeking help. Over a 4-month period, 519 women contacted WoW seeking medication abortion. These women were diverse with respect to age, parity, and circumstance. One hundred eighty women reported 209 reasons for seeking abortion outside the formal healthcare setting. Among all reasons, 49% were access barriers, including long waiting times, distance to clinic, work or childcare commitments, lack of eligibility for free NHS services, and prior negative experiences of abortion care; 30% were privacy concerns, including lack of confidentiality of services, perceived or experienced stigma, and preferring the privacy and comfort of using pills at home; and 18% were controlling circumstances, including partner violence and partner/family control. Despite the presence of abortion services in Great Britain, a diverse group of women still experiences logistical and personal barriers to accessing care through the formal healthcare system, or prefer the privacy of conducting their abortions in their own homes. Health services commissioning bodies could address existing barriers if supported by policy frameworks. The presence of multiple barriers to accessing abortion care in Great Britain highlights the need for future guidelines to recommend a more woman-centered approach to service provision. Reducing the number of clinic visits and designing services to meet the needs of those living in
Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, P A
The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.
Schiavon, Raffaela; Collado, Maria Elena; Troncoso, Erika; Soto Sánchez, José Ezequiel; Zorrilla, Gabriela Otero; Palermo, Tia
In 2007, first trimester abortion was legalized in Mexico City, and the public sector rapidly expanded its abortion services. In 2008, to obtain information on the effect of the law on private sector abortion services, we interviewed 135 physicians working in private clinics, located through an exhaustive search. A large majority of the clinics offered a range of reproductive health services, including abortions. Over 70% still used dilatation and curettage (D&C); less than a third offered vacuum aspiration or medical abortion. The average number of abortions per facility was only three per month; few reported more than 10 abortions monthly. More than 90% said they had been offering abortion services for less than 20 months. Many women are still accessing abortion services privately, despite the availability of free or low-cost services at public facilities. However, the continuing use of D&C, high fees (mean of $157-505), poor pain management practices, unnecessary use of ultrasound, general anaesthesia and overnight stays, indicate that private sector abortion services are expensive and far from optimal. Now that abortions are legal, these results highlight the need for private abortion providers to be trained in recommended abortion methods and quality of private abortion care improved. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Despite the extensive interest in trust within information systems (IS) and e-commerce disciplines, only few studies examine trust in the post-adoption phase of the customer relationship. Not only gaining new customers by increasing adoption, but also keeping the existing ones loyal, is largely considered important for e-business success. This paper scrutinizes the role of trust in customer loyalty, focusing on B2C e-services by conducting a three-sectional literature review stemming from IS, e-commerce and marketing. The key findings of this study are: 1. Literature discussing the role of trust after the adoption phase is relatively scarce and fragmented 2. In the empirical testing trust is mostly viewed as a monolith 3. Quantitative research methods dominate the field 4. Since trust may play a role during the whole relationship, also dynamic ways to scrutinize trust would be appropriate. Implications of these findings are discussed and ideas for further research suggested.
Hawaii State Dept. of Education, Honolulu. Office of Instructional Services.
This document presents guidelines developed by the Hawaii State Department of Education's Comprehensive School Alienation Program to consolidate and strengthen the delivery of services to alienated students. It is intended to assist district staff, school administrators, and project personnel in planning and implementing program activities and…
Trauma quality improvement: The Pietermaritzburg Metropolitan Trauma Service experience with the development of a comprehensive structure to facilitate quality improvement in rural trauma and acute care in KwaZulu-Natal, South Africa.
Clarke, Damian Luiz
Improving the delivery of efficient and effective surgical care in rural South Africa is a mammoth task bedevilled by conflict between the stakeholders, who include rural doctors, surgeons, ancillary staff, researchers, educators and administrators. Management training is not part of most medical school curricula, yet as they progress in their careers, many clinicians are required to manage a health system and find the shift from caring for individual patients to managing a complex system difficult. Conflict arises when management-type interventions are imposed in a top-down manner on surgical staff suspicious of an unfamiliar field of study. Another area of conflict concerns the place of surgical research. Researchers are often accused of not being sufficiently focused on or concerned about the tasks of service delivery. This article provides an overview of management theory and describes a comprehensive management structure that integrates a model for health systems with a strategic planning process, strategic planning tools and appropriate quality metrics, and shows how the Pietermaritzburg Metropolitan Trauma Service in KwaZulu-Natal Province, South Africa, successfully used this structure to facilitate and contextualise a diverse number of quality improvement programmes and research initiatives in the realm of rural acute surgery and trauma. We have found this structure to be useful, and hope that it may be applied to other acute healthcare systems.
Les renseignements ont été recueillis à l\\'aide d\\'un questionnaire de la part de 1876 femmes, à la recherche de l\\'avortement auprès des hôpitaux, les résultats montrent que la majorité (60%) avaient entre 15 et 24 ans dont les adolescentes ayant entre 1519 constituaient 32,7%. La majorité (63,2%) constituaient une ...
AJRH Managing Editor
unsafe abortions result in death, disability or complications. ... rape or incest, to protect the mental or physical health of the mother, or when ... Teenagers have their sexual debuts at young ages. .... Women also mentioned feeling contraception ...
Waddington, Ashley; Hahn, Philip M; Reid, Robert
To determine whether demographic or patient factors contribute to later presentation (10 to 12 weeks' gestational age) for induced abortion in a Canadian abortion clinic. Women attending a hospital-based abortion clinic between April and September 2012 were asked to complete a survey. The characteristics of women who presented early (EPs; gestational age abortion" (26.45% for EPs, 32.4% for LPs; P = 0.421), LPs were more likely to report that discouragement "caused a delay in making arrangements" (45.5% vs. 16.7%; P = 0.019). Of women who had access to a primary care provider, it was more common for the primary care provider to be aware of the pregnancy among LPs than among EPs (80.6% vs. 63.1%; P = 0.015). Some women delay presenting for abortion because of discouragement from friends and family. It is unclear whether there are educational or policy interventions that can have an impact on this delay, and this warrants further study. There may be ways of addressing the delay in referral by primary care providers. Further study into the causes for delay in referral for abortion is warranted.
The Government of Ghana has taken important steps to mitigate the impact of unsafe abortion. However, the expected decline in maternal deaths is yet to be realized. This literature review aims to present findings from empirical research directly related to abortion provision in Ghana and identify gaps for future research.
Context: Adolescent sexuality and its outcome in developed and developing countries differs most significantly at the point of prevention of adverse reproductive outcome. Objective: This article reviews the role of health care providers in meeting the peculiar challenges of the adolescent population in developing countries.
... Facts for Families Guide Facts for Families - Vietnamese Comprehensive Psychiatric Evaluation No. 52; Updated October 2017 Evaluation ... with serious emotional and behavioral problems need a comprehensive psychiatric evaluation. Comprehensive psychiatric evaluations usually require a ...
Segers, P.C.J.; Segers, E.; Broek, P. van den
The present chapter gives an overview of the literature on hypertext comprehension, children's hypertext comprehension and individual variation therein, ending with a perspective for future research. Hypertext comprehension requires the reader to make bridging inferences between the different parts
U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...
U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...
U.S. Environmental Protection Agency — The Facility Registry Service (FRS) provides an integrated source of comprehensive (air, water, and waste) environmental information about facilities across EPA,...
Lucieli Dias Pedreschi Chaves
Full Text Available ABSTRACT Objective: To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. Method: A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Results: Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Final considerations: Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks.
Social Security Administration — A comprehensive monthly report portraying customer experience with our various service options. The State of Services is shared with the ACOSS and is presented to...
In recent years, Chinese insurance companies introduced family planning (FP) insurance series. These schemes originated from the "one child" and life insurance and accident insurance of the early 1980s, which were established in response to the need that came with the "one child" policy. In order to help relieve the difficulties of rural FP work, the People's Insurance Corporation extended these programs to a series of schemes. These schemes included e.g., and old age security program for the families with 1 daughter only, old age security for families with an only child, and the program for FP workers' personal safety. The purpose of these schemes was to guarantee security in old age for families with few children, to ensure compensation if accident occurs during delivery or as a result of birth control operations; and compensation for FP workers for physical assaults they encountered. As FP organizations have been directly involved in advertising the insurance programs, there has been support from local governments with human and financial resources, and these insurance programs have been expanding every year. The payment of the policy has been either entirely or partially borne by the employers of the insured. In the process of the development of the insurance program, some problems have occurred. 1st, competition between FP organizations and insurance companies have evolved in sponsoring the program for its profit. 2nd, some media reports have confused the payment of premiums with the compulsory levy of undue fees, which in a way, hindered the expansion of program enrollment. 3rd, some local administrations are short of funds to pay for the insurance premiums. 4th, the accrued income from the premiums is lower than the expected sum of the principle and interest if the same funds were deposited in a bank at current interest rate. Therefore, some schemes lack appeal. FP series insurance is a longer term program which will have an important impact on the realization of the aim of population policy, and on the welfare of the population. The government should give adequate emphasis to the management of the program. The fund from the policy premiums could be used in high return and low risk investment in order to increase the appeal of the insurance schemes. Besides the current resources for the payment of premiums, funds from government allocation, penalty payment from those who have birth above the quota, one-child allowance, donations from communities or individuals, and income from special lotteries could also be used to pay the premiums.
Berail, J.F.; Bruneau, S.; Crouzet, D.; Haas, J.L.; Zbinden, M.
Electricite de France operates 58 PWR nuclear power stations, for which the behaviour of valves and fittings is of major importance for safety, for the availability of the plants, and for maintenance costs. Since the early 70's, EDF has developed a comprehensive range of facilities to test valves and fittings in PWR service and accident conditions. It has carried out studies, tests, development work, experimental and numerical research in collaboration with external organisations and manufacturers, to improve the technologies of these equipment as well as maintenance tools and methods. In the present paper, the authors quantify the importance of valves and fittings studies for EDF, which has led to the drawing up of a catalogue of approved equipment. They describe the principle test facilities, and the structure of the EDF 'valves and fittings tests results' data base. They show the importance of twenty-five years of testing experience for both the evolution of equipment and for the increase in French nuclear plants availability. (author)
Metabolic panel - comprehensive; Chem-20; SMA20; Sequential multi-channel analysis with computer-20; SMAC20; Metabolic panel 20 ... Chernecky CC, Berger BJ. Comprehensive metabolic panel (CMP) - blood. In: ... Tests and Diagnostic Procedures . 6th ed. St Louis, MO: ...
... 34 Education 2 2010-07-01 2010-07-01 false Comprehensive child find system. 303.321 Section 303... Services Identification and Evaluation § 303.321 Comprehensive child find system. (a) General. (1) Each system must include a comprehensive child find system that is consistent with part B of the Act (see 34...
Lissouba, Pascale; Taljaard, Dirk; Rech, Dino; Doyle, Sean; Shabangu, Daniel; Nhlapo, Cynthia; Otchere-Darko, Josephine; Mashigo, Thabo; Matson, Caitlin; Lewis, David; Billy, Scott; Auvert, Bertran
World Health Organization (WHO)/Joint United Nations Programme on AIDS (UNAIDS) has recommended adult male circumcision (AMC) for the prevention of heterosexually acquired HIV infection in men from communities where HIV is hyperendemic and AMC prevalence is low. The objective of this study was to investigate the feasibility of the roll-out of medicalized AMC according to UNAIDS/WHO operational guidelines in a targeted African setting. The ANRS 12126 "Bophelo Pele" project was implemented in 2008 in the township of Orange Farm (South Africa). It became functional in 5 mo once local and ethical authorizations were obtained. Project activities involved community mobilization and outreach, as well as communication approaches aimed at both men and women incorporating broader HIV prevention strategies and promoting sexual health. Free medicalized AMC was offered to male residents aged 15 y and over at the project's main center, which had been designed for low-income settings. Through the establishment of an innovative surgical organization, up to 150 AMCs under local anesthesia, with sterilized circumcision disposable kits and electrocautery, could be performed per day by three task-sharing teams of one medical circumciser and five nurses. Community support for the project was high. As of November 2009, 14,011 men had been circumcised, averaging 740 per month in the past 12 mo, and 27.5% of project participants agreed to be tested for HIV. The rate of adverse events, none of which resulted in permanent damage or death, was 1.8%. Most of the men surveyed (92%) rated the services provided positively. An estimated 39.1% of adult uncircumcised male residents have undergone surgery and uptake is steadily increasing. This study demonstrates that a quality AMC roll-out adapted to African low-income settings is feasible and can be implemented quickly and safely according to international guidelines. The project can be a model for the scale-up of comprehensive AMC services, which
Javier Fernández Eito
Full Text Available El progresivo envejecimiento de la población española conlleva un aumento de la atención sanitaria, por los servicios de urgencias extrahospitalarias (SUE, a este grupo de edad. El objetivo de este trabajo es evidenciar la importancia de realizar una valoración global del anciano en el contexto domiciliario y comunitario, que contemple tanto los aspectos físicos como los psicosociales y ambientales de la persona en situación de urgencia. Para ello, se desarrolla un caso clínico, que se apoya en la evidencia científica, para determinar la actuación más adecuada que mejore las intervenciones de los servicios de urgencias extrahospitalarias. El análisis del caso se estructura en tres apartados: la valoración de enfermería, el registro de los datos y la transmisión de la información a otros equipos de salud. Como conclusión, se identifica la necesidad de valorar y registrar datos sobre el estado físico y fisiológico del anciano al mismo tiempo que se recoge información sobre su contexto familiar, comunitario o ambiental, para proporcionar unos cuidados integrales y de calidad. Asimismo, se recomienda el desarrollo de herramientas de valoración geriátrica específicas para utilizar en situaciones de urgencias extrahospitalarias.The progressive aging of the Spanish population leads to increased health care for Outpatient Emergency Services (EUS, in this age group. The aim of this paper is to highlight the importance of an overall assessment of the elderly in the household and community context, which involves both the physical and psychosocial in the emergency environmental. To do this, we develop a clinical case, which is based on scientific evidence, to determine the most appropriate action to improve interventions in emergency services. The case analysis is divided into three sections: nursing assessment, data recording and transmission of information to other health teams. In conclusion, it identifies the need to assess and
a model for the scale-up of comprehensive AMC services, which could be tailored for other rural and urban communities of high HIV prevalence and low AMC rates in Eastern and Southern Africa. Please see later in the article for the Editors' Summary.
Whatley, Juanita T.
This booklet describes the Comprehensive Child Day Care Program for the Atlanta Public School System, a Title XX Program. This program provided day care services for children of clients in various categories. The program goals for 1975-76 were geared toward providing comprehensive day care to encompass social services to the family and…
Aim of this master thesis is to describe the service of Full Service Leasing, as a modern form of financing and management of assets, primarily automobile fleet. Description of full service leasing is designed as a comprehensive and complete guide to support reader's position when deciding to finance and manage a fleet by this service. Whether the reader is an entrepreneur, CFO, fleet manager, new employee of leasing company, or anyone who is interested in this service, this master thesis wil...
Bader, Markus; Lamers, Monique
Research on human language comprehension has been heavily influenced by properties of the English language. Since case plays only a minor role in English, its role for language comprehension has only recently become a topic for extensive research on psycholinguistics. In the psycholinguistic
Blasiak, W.; Godlewska, M.; Rosiek, R.; Wcislo, D.
The paper presents the results of research on the relationship between self-assessed comprehension of physics lectures and final grades of junior high school students (aged 13-15), high school students (aged 16-18) and physics students at the Pedagogical University of Cracow, Poland (aged 21). Students' declared level of comprehension was measured…
Full Text Available Quotients and comprehension are fundamental mathematical constructions that can be described via adjunctions in categorical logic. This paper reveals that quotients and comprehension are related to measurement, not only in quantum logic, but also in probabilistic and classical logic. This relation is presented by a long series of examples, some of them easy, and some also highly non-trivial (esp. for von Neumann algebras. We have not yet identified a unifying theory. Nevertheless, the paper contributes towards such a theory by introducing the new quotient-and-comprehension perspective on measurement instruments, and by describing the examples on which such a theory should be built.
Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O
OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....
Janfaza, Abusaied; Jelyani, Saghar Javidi; Soori, Afshin
With the advent of technology, the implication of authentic multimedia-based teaching materials are using widely in language classrooms. Technology can be in service of teaching different skills such as listening, reading, speaking and writing. Among these skills listening comprehension is a skill in which the learners have problems to master.…
Imison, Tamsyn, Ed.; Heilbronn, Ruth, Ed.; Williams, Liz, Ed.
Schools in England are radically changing their organization and governance, casting aside the founding principle of the 1944 Education Act that education is a public service and abandoning the ideal of education as nurturing a sense of community. This book presents a portrait of a successful comprehensive school, between the years 1980 and 2000.…
Carmen Ildes Rodrigues Fróes Asmus
Full Text Available Este artigo apresenta a experiência do Programa de Saúde do Trabalhador Adolescente (PSTA do Núcleo de Estudos da Saúde do Adolescente da Uerj. Na área assistencial, a equipe multidisciplinar do Núcleo vem desenvolvendo um modelo de atenção integral aos adolescentes trabalhadores, buscando analisar as questões ligadas ao nexo causal entre os agravos à saúde e o processo produtivo em que estão envolvidos. No que se refere à extensão, os profissionais, em associação com alguns adolescentes trabalhadores, vêm desenvolvendo uma metodologia de educação em saúde resgatando a discussão sobre o potencial produtivo de maneira abrangente, abordando temas que vão além da questão do trabalho. Devido ao conhecimento adquirido, a equipe, em parceria com a OIT, recebeu a incumbência de elaborar materiais pedagógicos para a formação e capacitação de recursos humanos sobre saúde e segurança no trabalho infanto-juvenil. Conclui-se que, diante das políticas públicas para a eliminação do trabalho infantil e proteção do trabalhador adolescente, já em vigência em nível nacional, a experiência relatada aponta para a necessidade da criação de programas semelhantes para a garantia dos direitos desta população.This article presents the collected experiences of the Health Program for Adolescent Workers (PSTA at the Center for the Study of Adolescent Health at the State University of Rio de Janeiro. In terms of health services, the multidisciplinary team has developed a model of comprehensive health care for adolescent workers that seeks to analyze the causal links between health problems and the work conditions in which these young people are usually involved. In terms of health outreach, the health professionals have been working with a group of adolescent workers to develop a specific health education methodology. This methodology seeks to promote a broad discussion of the meaning of work in a empowering way that transcends
Oppong-Darko, Prince; Amponsa-Achiano, Kwame; Darj, Elisabeth
Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. The aim of the study was to understand midwives' readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana's abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy.
Sep 14, 2007 ... i.e. difficulty performing simple physical and mental tasks necessary for daily life. ... Definition. Comprehensive geriatric assessment (CGA) is a multidimensional .... The formation of a programme of therapy is decided on.
Blasiak, W; Godlewska, M; Rosiek, R; Wcislo, D
The paper presents the results of research on the relationship between self-assessed comprehension of physics lectures and final grades of junior high school students (aged 13-15), high school students (aged 16-18) and physics students at the Pedagogical University of Cracow, Poland (aged 21). Students' declared level of comprehension was measured during a physics lecture on a prearranged scale of 1-10 with the use of a personal response system designed for the purpose of this experiment. Through the use of this tool, we obtained about 2000 computer records of students' declared comprehension of a 45 min lecture, which we named ‘the spectrum of comprehension’. In this paper, we present and analyse the correlation between students' declared comprehension of the content presented in the lecture and their final learning results. (paper)
Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna
In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.
U.S. Department of Health & Human Services — Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care:...
... health and public welfare resources; including— (i) Community mental health centers; (ii) Nursing homes... 42 Public Health 4 2010-10-01 2010-10-01 false Comprehensive mental health program. 441.106... Comprehensive mental health program. (a) If the plan includes services in public institutions for mental...
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Comprehensive plan alternative. 81.14 Section 81.14 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR... alternative. In the event that the State elects to operate under a comprehensive fish and wildlife resource...
Title 44 United States Code, ''Public Printing and Documents,'' regulations cited in the General Services Administration's (GSA) ''Federal Information Resources Management Regulations'' (FIRMR), Part 201-9, ''Creation, Maintenance, and Use of Records,'' and regulation issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter XII, Subchapter B, ''Records Management,'' require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA's General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 2, contains ''NRC's Comprehensive Records Disposition Schedule,'' and the original authorized approved citation numbers issued by NARA. Rev. 2 totally reorganizes the records schedules from a functional arrangement to an arrangement by the host office. A subject index and a conversion table have also been developed for the NRC schedules to allow staff to identify the new schedule numbers easily and to improve their ability to locate applicable schedules
CLELAND, DONALD L.
THE NATURE OF COMPREHENSION IS DEFINED AND CLARIFIED. THE LITERATURE IS SURVEYED TO SHOW THAT THE DEVELOPMENT OF CONCEPTS IS IMPORTANT IN INTELLECTUAL ACTIVITIES. IT IS POINTED OUT THAT CONCEPTS ARE BUILT FROM PERCEPTS, IMAGES, SENSATION, AND MEMORIES, AND THAT THE STEPS WHICH ARE EMPLOYED AS CONCEPTS ARE BUILT AND REFINED AND INCLUDE PERCEIVING,…
Describes the idea of creating a glove for each of the comprehension strategies for use with different text structures. Notes that the gloves serve as a multisensory approach by providing visual clues through icons on each finger and the palm. Discusses three different gloves: the prereading glove, the narrative text structure glove, and the…
Jones, EdD, Darolyn "Lyn"
Reading comprehension gets easier as students learn what kind of reader they are, discover how to keep facts in their head, and much more. Bonus Online Component: includes additional games, including Beat the Clock, a line match game, and a word scramble.
Hjeresen, D.L.; Roybal, S.L.
This report contains information about Los Alamos National Laboratory's Comprehensive Environmental Management Plan. The topics covered include: waste minimization, waste generation, environmental concerns, public relations of the laboratory, and how this plan will help to answer to the demands of the laboratory as their mission changes
Kim, Young-Suk; Phillips, Beth
In an effort to understand cognitive foundations of oral language comprehension (i.e., listening comprehension), we examined how inhibitory control, theory of mind, and comprehension monitoring are uniquely related to listening comprehension over and above vocabulary and age. A total of 156 children in kindergarten and first grade from…
Mun, S.K.; Benson, H.; Elliott, L.P.; Horii, S.
The authors' institution has installed a comprehensive PACS network involving a dozen work stations and ten imaging systems with electronic archiving and teleradiology capability based on the CommView (AT and T) system and its fiberoptic network. Diagnostic reporting stations are placed in neuroradiology, abdominal imaging, general radiology, and ultrasound service. Other review stations are located in intensive care units, radiation medicine, the emergency room, and other sites. Clinical acceptance of such technology varies depending on a number of factors: image quality, image data volume, service style, and personal preference. The general acceptance depends on the work station performance, network response time, and work station environment. Clinical acceptance by radiologists and referring physicians was evaluated. The evaluation project included work-station performance, network performance, system interface, RIS interface, and development of training methods and implementation strategy for other sites. A cost analysis and a study of administrative impact are integral parts of the comprehensive evaluation project
This paper discusses issues arising in the measurement of productivity in public services. Compared to measuring productivity in the private sector difficulties arise because the output of public services is often un-priced and because some public services are consumed collectively. A key problem is measuring the full range of outputs and quality improvements delivered by public sector organisations that are valued by society. Without comprehensive measures of output productivity statistics m...
Comprehensive Hard Materials deals with the production, uses and properties of the carbides, nitrides and borides of these metals and those of titanium, as well as tools of ceramics, the superhard boron nitrides and diamond and related compounds. Articles include the technologies of powder production (including their precursor materials), milling, granulation, cold and hot compaction, sintering, hot isostatic pressing, hot-pressing, injection moulding, as well as on the coating technologies for refractory metals, hard metals and hard materials. The characterization, testing, quality assurance and applications are also covered. Comprehensive Hard Materials provides meaningful insights on materials at the leading edge of technology. It aids continued research and development of these materials and as such it is a critical information resource to academics and industry professionals facing the technological challenges of the future. Hard materials operate at the leading edge of technology, and continued res...
This updated edition offers the most extensive and varied practice for all types of questions students might face on standardized and in-class tests. With this guide, students will learn to develop expert reading strategies, understand how to read faster and with greater comprehension, overcome reading anxiety, and increase appreciation of reading for pleasure. This book's step-by-step approach provides graduated coverage that moves from the basics to more advanced reading.
Zammuto, Raymond F.; And Others
A study investigated the quality of services in four student enrollment services administrative sub-units (recruiting, admissions, records and registration, financial aid) at a public comprehensive university, using student and staff evaluations and program evaluations. Specific changes needed to improve service delivery are identified and…
Oppong-Darko, Prince; Amponsa-Achiano, Kwame
Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. Objective: The aim of the study was to understand midwives’ readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. Methods: A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Results: Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana’s abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. Conclusion: The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy. PMID:29207521
Chaves, Lucieli Dias Pedreschi; Mininel, Vivian Aline; Silva, Jaqueline Alcântara Marcelino da; Alves, Larissa Roberta; Silva, Maria Ferreira da; Camelo, Silvia Helena Henriques
To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks. refletir a supervisão de enfermagem como instrumento gerencial do enfermeiro para integralidade do cuidado, considerando suas potencialidades e limitações no cenário atual. estudo reflexivo baseado na formulação discursiva sobre a supervisão de enfermagem, apresentando conceitos e enfoques teóricos e/ou práticos. limitações no exercício da supervisão estão relacionadas à organização dos serviços de saúde embasada no modelo funcional e clínico de atenção, assim como possíveis lacunas no processo de formação do enfermeiro e sobrecarga de trabalho. Quanto às potencialidades, destaca-se a supervisão como instrumento de articulação de ações assistenciais e gerenciais, que pode favorecer integralidade da atenção, estimular atitudes de cooperação e colaboração em equipe, além da corresponsabilização e promoção da educação no trabalho. supervisão de enfermagem pode contribuir para fortalecimento da integralidade do cuidado, pressupondo reflexão cont
Characterized by clear and accessible explanations, numerous examples and sample sentences, a new section on register and tone, and useful appendices covering topics including age and time, A Comprehensive French Grammar, Sixth Edition is an indispensable tool for advanced students of French language and literature.A revised edition of this established, bestselling French grammarIncludes a new section on register and medium and offers expanded treatment of French punctuationFeatures numerous examples and sample sentences, and useful appendices covering topics including age, time, and dimension
Baum, Fran; Freeman, Toby; Sanders, David; Labonté, Ronald; Lawless, Angela; Javanparast, Sara
This paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009-2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Berenson, Robert A.; Schoenbaum, Stephen C.; Gardner, Laurence B.
Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed. PMID:17356977
The Comprehensive Health Education Workers (CHEW) Project is a community-based initiative that educates sexual and gender minority (SGM or LGBTQ) young people about comprehensive--mental, physical, sexual, and social--health and that supports their comprehensive health needs with other services. Since October 2014, CHEW Project staff have served…
Khan, Farhan Ullah; Ihsan, Awais Ullah; Khan, Hidayat Ullah; Jana, Ruby; Wazir, Junaid; Khongorzul, Puregmaa; Waqar, Muhammad; Zhou, Xiaohui
Prostatitis is a common urinary tract syndrome that many doctors find problematic to treat effectively. It is the third most commonly found urinary tract disease in men after prostate cancer and Benign Prostate Hyperplasia (BPH). Prostatitis may account for 25% of all office visits made to the urological clinics complaining about the genital and urinary systems all over the world. In the present study, we classified prostatitis and comprehensively elaborated the etiology, pathogenesis, diagnosis, and treatment of acute bacterial prostatitis (category I), chronic bacterial prostatitis (category II), chronic pelvic pain syndrome (CPPS) (category III), and asymptomatic prostatitis (category IV). In addition, we also tried to get some insights about other types of prostatitis-like fungal, viral and gonococcal prostatitis. The aim of this review is to present the detail current perspective of prostatitis in a single review. To the best of our knowledge currently, there is not a single comprehensive review, which can completely elaborate this important topic in an effective way. Furthermore, this review will provide a solid platform to conduct future studies on different aspects such as risk factors, mechanism of pathogenesis, proper diagnosis, and rational treatment plans for fungal, viral, and gonococcal prostatitis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
This Comprehensive National Energy Strategy sets forth a set of five common sense goals for national energy policy: (1) improve the efficiency of the energy system, (2) ensure against energy disruptions, (3) promote energy production and use in ways that respect health and environmental values, (4) expand future energy choices, and (5) cooperate internationally on global issues. These goals are further elaborated by a series of objectives and strategies to illustrate how the goals will be achieved. Taken together, the goals, objectives, and strategies form a blueprint for the specific programs, projects, initiatives, investments, and other actions that will be developed and undertaken by the Federal Government, with significant emphasis on the importance of the scientific and technological advancements that will allow implementation of this Comprehensive National Energy Strategy. Moreover, the statutory requirement of regular submissions of national energy policy plans ensures that this framework can be modified to reflect evolving conditions, such as better knowledge of our surroundings, changes in energy markets, and advances in technology. This Strategy, then, should be thought of as a living document. Finally, this plan benefited from the comments and suggestions of numerous individuals and organizations, both inside and outside of government. The Summary of Public Comments, located at the end of this document, describes the public participation process and summarizes the comments that were received. 8 figs.
A comprehensive, multi-level investigation of the implementation of a novel digital substance misuse intervention, Breaking Free Online: conceptualising implementation processes within services using the MRC framework and health psychology theory.
Methods: Semi-structured qualitative interviews were conducted with staff, peer mentors and service users to investigate initial diffusion and subsequent normalisation of BFO within CRI, and the impact of BFO on peer mentors’ own substance misuse recovery journeys. Thematic analyses were conducted, and models derived from health psychology and implementation science used to conceptualise implementation processes from an organisational level. Further analyses using Interpretative Phenomenological Analysis (IPA expanded investigation down to the level of individual people within CRI, and the role of peer mentors delivering the programme within the organisation. Results: ‘Diffusion of innovation theory’ conceptualised initial implementation and diffusion of BFO throughout CRI. Although there were perceived barriers to implementation, such as lack of IT equipment, anxieties around staff and service user IT skills and the impact on staff’s professional roles, intentions to continue using BFO were reported. Analyses investigating continued implementation processes of the programme used ‘normalisation process theory’ to demonstrate how a process of normalisation of the programme is underway following initial diffusion. Findings suggested that staff were beginning to take greater ‘ownership’ of BFO since it was initially introduced into the organisation, and that the programme was influencing changes to work-role responsibilities in delivering BFO. Data using the ‘trans-theoretical model’ also indicated that peer mentors benefited from implementing BFO to support others and assist their own recovery maintenance. Conclusion: Whilst the principal focus must always be on establishing clinical effectiveness when developing and evaluating complex behaviour change interventions, such as digital interventions, implementation process analysis is also key. This analysis is important in order for interventions to be translated into real-world outcomes, as without
Full Text Available Psychodermatology is an interesting domain of dermatology that overlaps with psychiatry. This arena in dermatology has received limited diligence, partly due to lack of training in this realm. We present here a comprehensive review of salient features and treatment updates in primary psychiatric dermatoses and have also discussed the role of psyche in psychophysiological cutaneous disorders. Secondary psychiatric morbidity is relatively common among patients visiting the dermatologists but often overlooked and uncared for. Dermatologist should be able to initiate basic pharmacotherapy, should be knowledgeable about various non-pharmacological treatments and know the right time to refer the patient to the psychiatrist. Awareness and pertinent treatment of psychodermatological disorders among dermatologists will lead to a more holistic treatment approach and better prognosis in this unique group of patients.
The Environmental Management Program at Los Alamos National Laboratory is in the process of initiating and then implementing a Comprehensive Environmental Management Plan (CEMP). There are several environmental impact and compliance drivers for this initiative. The Los Alamos CEMP is intended to be a flexible, long-range process that predicts, minimizes, treats, and disposes of any waste generated in execution of the Los Alamos mission - even if that mission changes. The CEMP is also intended to improve stakeholder and private sector involvement and access to environmental information. The total quality environmental management (TQEM) process will benchmark Los Alamos to private sector and DOE operations, identify opportunities for improvement, prioritize among opportunities, implement projects, measure progress, and spur continuous improvement in Environmental Management operations
Allen, Todd; Stoller, Roger; Yamanaka, Shinsuke
Comprehensive Nuclear Materials encapsulates a panorama of fundamental information on the vast variety of materials employed in the broad field of nuclear technology. The work addresses, in five volumes, 3,400 pages and over 120 chapter-length articles, the full panorama of historical and contemporary international research in nuclear materials, from Actinides to Zirconium alloys, from the worlds' leading scientists and engineers. It synthesizes the most pertinent research to support the selection, assessment, validation and engineering of materials in extreme nuclear environments. The work discusses the major classes of materials suitable for usage in nuclear fission, fusion reactors and high power accelerators, and for diverse functions in fuels, cladding, moderator and control materials, structural, functional, and waste materials.
Hagos, Goshu; Tura, Gurmesa; Kahsay, Gizienesh; Haile, Kebede; Grum, Teklit; Araya, Tsige
leaving the facility. Private facilities should strengthen utilization of contraceptives on post abortion care service. Health providers should provide counseling on timing of fertility-return following abortion before women left the facility once they receive abortion care. Women empowerment through enhancing community's awareness focusing on own decision making in the family planning utilization including the partner should be strengthened.
South Africa's Choice on Termination of Pregnancy (CTOP) Act of 1996 allows provision of abortion on request up to 12 weeks of gestation and permits midwives who have completed required training to conduct termination of pregnancies. This unique codification of midwives' role in abortion care reflects legislators' ...
Daigle, Karen A; Logan, Christi M; Kotwal, Russ S
Special Operations Forces (SOF) training, combat, and contingency operations are unique and demanding. Performance nutrition within the Department of Defense has emphasized that nutrition is relative to factors related to the desired outcome, which includes successful performance of mentally and physically demanding operations and missions of tactical and strategic importance, as well as nonoperational assignments. Discussed are operational, nonoperational, and patient categories that require different nutrition strategies to facilitate category-specific performance outcomes. Also presented are 10 major guidelines for a SOF comprehensive performance nutrition program, practical nutrition recommendations for Special Operators and medical providers, as well as resources for dietary supplement evaluation. Foundational health concepts, medical treatment, and task-specific performance factors should be considered when developing and systematically implementing a comprehensive SOF performance nutrition program. When tailored to organizational requirements, SOF unit- and culture-specific nutrition education and services can optimize individual Special Operator performance, overall unit readiness, and ultimately, mission success. 2015.
Full Text Available The healthcare enterprises are very disconnected. This paper intends to propose a solution that will provide citizens, businesses and medical enterprises with improved access to medical virtual public services. Referred medical services are based on existing national medical Web services and which support medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures, clinics and hospitalsÃ¢Â€Â™ services. Requirements and specific rules of these medical services are considered, and personalization of user preferences will to be supported. The architecture is based on adaptable process management technologies, allowing for virtual services which are dynamically combined from existing national medical services. In this way, a comprehensive workflow process is set up, allowing for service-level agreements, an audit trail and explanation of the process to the end user. The process engine operates on top of a virtual repository, providing a high-level semantic view of information retrieved from heterogeneous information sources, such as national sources of medical services. The system relies on a security framework to ensure all high-level security requirements are met. SystemÃ¢Â€Â™s architecture is business oriented: it focuses on Service Oriented Architecture - SOA concepts, asynchronously combining Web services, Business Process Management Ã¢Â€Â“ BPM rules and BPEL standards.
A new approach for CERN to monitor the LHC-experiments' technical and scientific progress was introduced last year: The Comprehensive Reviews. A significant fraction of the full LHCC committee is mobilized during two days to review the complete project status. This event took place for ATLAS during 2-3 of July this year. With a rather exhaustive program we presented our status in 39 talks. It was a demanding and close to impossible task for the referees to comprehend the ATLAS status by listening to this massive amount of information, but from the ATLAS point-of-view we judged it important that the referees were exposed to both the progress and the remaining problem areas. The referees were satisfied with our status; probably more so this year than last year. They judged the main critical issues to be: The schedules of the barrel toroid, the end-cap TRT, the LAr barrel and end-cap A, and the MDTs. The procurement of radiation hard electronics was also thought to be a critical issue. They were informed of ...
The Ernest Orlando Lawrence Berkeley National Laboratory`s Comprehensive Facilities Plan (CFP) document provides analysis and policy guidance for the effective use and orderly future development of land and capital assets at the Berkeley Lab site. The CFP directly supports Berkeley Lab`s role as a multiprogram national laboratory operated by the University of California (UC) for the Department of Energy (DOE). The CFP is revised annually on Berkeley Lab`s Facilities Planning Website. Major revisions are consistent with DOE policy and review guidance. Facilities planing is motivated by the need to develop facilities for DOE programmatic needs; to maintain, replace and rehabilitate existing obsolete facilities; to identify sites for anticipated programmatic growth; and to establish a planning framework in recognition of site amenities and the surrounding community. The CFP presents a concise expression of the policy for the future physical development of the Laboratory, based upon anticipated operational needs of research programs and the environmental setting. It is a product of the ongoing planning processes and is a dynamic information source.
Agurto, C.; Nemeth, S.; Zamora, G.; Vahtel, M.; Soliz, P.; Barriga, S.
In recent years, several research groups have developed automatic algorithms to detect diabetic retinopathy (DR) in individuals with diabetes (DM), using digital retinal images. Studies have indicated that diabetics have 1.5 times the annual risk of developing primary open angle glaucoma (POAG) as do people without DM. Moreover, DM patients have 1.8 times the risk for age-related macular degeneration (AMD). Although numerous investigators are developing automatic DR detection algorithms, there have been few successful efforts to create an automatic algorithm that can detect other ocular diseases, such as POAG and AMD. Consequently, our aim in the current study was to develop a comprehensive eye evaluation algorithm that not only detects DR in retinal images, but also automatically identifies glaucoma suspects and AMD by integrating other personal medical information with the retinal features. The proposed system is fully automatic and provides the likelihood of each of the three eye disease. The system was evaluated in two datasets of 104 and 88 diabetic cases. For each eye, we used two non-mydriatic digital color fundus photographs (macula and optic disc centered) and, when available, information about age, duration of diabetes, cataracts, hypertension, gender, and laboratory data. Our results show that the combination of multimodal features can increase the AUC by up to 5%, 7%, and 8% in the detection of AMD, DR, and glaucoma respectively. Marked improvement was achieved when laboratory results were combined with retinal image features.
Boliver, Vikki; Swift, Adam
This paper investigates the claim that the shift from a selective to a comprehensive school system had a deleterious effect on social mobility in Great Britain. Using data from the National Child Development Study, we compare the chances, for both class and income mobility, of those who attended different kinds of school. Where media attention focuses exclusively on the chances for upward mobility of those children from lowly origins who were (or would have been) judged worthy of selection into a grammar school, we offer more rounded analyses. We match respondents in a way that helps us to distinguish those inequalities in mobility chances that are due to differences between children from those due to differences between the schools they attended; we look at the effects of the school system on the mobility chances of all children, not merely those from less advantaged origins; and we compare comprehensive- and selective-system schools, not merely comprehensive and grammar schools. After matching, we find, first, that going to a grammar school rather than a comprehensive does not make low-origin children more likely to be upwardly mobile but it helps them move further if they are; second, that grammar schools do not benefit working-class children, in terms of class mobility, more than they benefit service-class children, but, in terms of income mobility, such schools benefit low-income children somewhat more than they benefit higher-income children - that benefit relating only to rather modest and limited movements within the income distribution. Finally, however, the selective system as a whole yields no mobility advantage of any kind to children from any particular origins: any assistance to low-origin children provided by grammar schools is cancelled out by the hindrance suffered by those who attended secondary moderns. Overall, our findings suggest that comprehensive schools were as good for mobility as the selective schools they replaced. © London School of
This paper presents the main lines of the design and the findings of a reception study on news comprehension. This empirical study is a comparison of the comprehension processes of Danes and French Canadians over a set of news texts from both countries. Comprehension is explored from a cultural...... perspective, through the lens of cognition and pragmatics, revealing the role played by cultural knowledge in comprehension and the underlying relationship between a text and its intended audience. It is argued that recipients ‘problematise’ the news texts, a process by which the texts answer questions...
U.S. Environmental Protection Agency — The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access Database contains a selected set of...
Chan, Daniel K Y; Cordato, Dennis; O'Rourke, Fintan; Chan, Daniel L; Pollack, Michael; Middleton, Sandy; Levi, Chris
Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a 'before-and-after' comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services
Locks and Keys Service
The Locks and Keys service (ST/FM) will move from building 55 to building 570 from the 2nd August to the 9th August 2002 included. During this period the service will be closed. Only in case of extreme urgency please call the 164550. Starting from Monday, 12th August, the Locks and Keys Service will continue to follow the activities related to office keys (keys and locks) and will provide the keys for furniture. The service is open from 8h30 to 12h00 and from 13h00 to 17h30. We remind you that your divisional correspondents can help you in the execution of the procedures. We thank you for your comprehension and we remain at your service to help you in solving all the matters related to keys for offices and furniture. Locks and Keys Service - ST Division - FM Group
Singh, M; Jha, R
To see whether advocacy for abortion law and comprehensive abortion care (CAC) sites after legalization of abortion in Nepal is adequate among educated people (above school leaving certificate). 150 participants were assigned randomly who agreed to be in the survey and were given structured questionnaires to find out their perception of abortion and CAC sites. Majority know abortion is legalized and majority have positive attitude about legalization of abortion, however majority are not aware of abortion service in CAC sites and none knew the cost of abortion service. Proper and adequate advocacy of the new abortion law and CAC service is essential.
Digital reference service is an emerging trend of traditional reference service. Easily accessible digital reference service has become one of the hallmark of the library and information services. The paper highlights how new visage of traditional reference service is developing as a natural solution to keep pace with comprehensive technological environment. It discusses about the basic concepts, elements of digital reference service and give in detail modes, the advantages, limitations, and...
Rafieyan, Vahid; Sharafi-Nejad, Maryam; Khavari, Zahra; Eng, Lin Siew; Mohamed, Abdul Rashid
Pragmatic comprehension can be ideally developed through contact with target language speakers. This contact can be provided in English as Foreign Language contexts through telecollaboration. To test the actual effect of telecollaboration on the development of pragmatic comprehension, 30 Iranian undergraduates of English as a Foreign Language…
Murray, Laura L; Rutledge, Stefanie
Although individuals with Parkinson's disease (PD) self-report reading problems and experience difficulties in cognitive-linguistic functions that support discourse-level reading, prior research has primarily focused on sentence-level processing and auditory comprehension. Accordingly, the authors investigated the presence and nature of reading comprehension in PD, hypothesizing that (a) individuals with PD would display impaired accuracy and/or speed on reading comprehension tests and (b) reading performances would be correlated with cognitive test results. Eleven adults with PD and 9 age- and education-matched control participants completed tests that evaluated reading comprehension; general language and cognitive abilities; and aspects of attention, memory, and executive functioning. The PD group obtained significantly lower scores on several, but not all, reading comprehension, language, and cognitive measures. Memory, language, and disease severity were significantly correlated with reading comprehension for the PD group. Individuals in the early stages of PD without dementia or broad cognitive deficits can display reading comprehension difficulties, particularly for high- versus basic-level reading tasks. These reading difficulties are most closely related to memory, high-level language, and PD symptom severity status. The findings warrant additional research to delineate further the types and nature of reading comprehension impairments experienced by individuals with PD.
Neumann, Mary Spink; Finlayson, Teresa J; Pitts, Nicole L; Keatley, JoAnne
Transgender persons are at high risk for HIV infection, but prevention efforts specifically targeting these people have been minimal. Part of the challenge of HIV prevention for transgender populations is that numerous individual, interpersonal, social, and structural factors contribute to their risk. By combining HIV prevention services with complementary medical, legal, and psychosocial services, transgender persons' HIV risk behaviors, risk determinants, and overall health can be affected simultaneously. For maximum health impact, comprehensive HIV prevention for transgender persons warrants efforts targeted to various impact levels-socioeconomic factors, decision-making contexts, long-lasting protections, clinical interventions, and counseling and education. We present current HIV prevention efforts that reach transgender persons and present others for future consideration.
Haggerty, Jeannie L; Beaulieu, Marie-Dominique; Pineault, Raynald; Burge, Frederick; Lévesque, Jean-Frédéric; Santor, Darcy A; Bouharaoui, Fatima; Beaulieu, Christine
Comprehensiveness relates both to scope of services offered and to a whole-person clinical approach. Comprehensive services are defined as "the provision, either directly or indirectly, of a full range of services to meet most patients' healthcare needs"; whole-person care is "the extent to which a provider elicits and considers the physical, emotional and social aspects of a patient's health and considers the community context in their care." Among instruments that evaluate primary healthcare, two had subscales that mapped to comprehensive services and to the community component of whole-person care: the Primary Care Assessment Tool - Short Form (PCAT-S) and the Components of Primary Care Index (CPCI, a limited measure of whole-person care). To examine how well comprehensiveness is captured in validated instruments that evaluate primary healthcare from the patient's perspective. 645 adults with at least one healthcare contact in the previous 12 months responded to six instruments that evaluate primary healthcare. Scores were normalized for descriptive comparison. Exploratory and confirmatory (structural equation modelling) factor analysis examined fit to operational definition, and item response theory analysis examined item performance on common constructs. Over one-quarter of respondents had missing responses on services offered or doctor's knowledge of the community. The subscales did not load on a single factor; comprehensive services and community orientation were examined separately. The community orientation subscales did not perform satisfactorily. The three comprehensive services subscales fit very modestly onto two factors: (1) most healthcare needs (from one provider) (CPCI Comprehensive Care, PCAT-S First-Contact Utilization) and (2) range of services (PCAT-S Comprehensive Services Available). Individual item performance revealed several problems. Measurement of comprehensiveness is problematic, making this attribute a priority for measure development
Full Text Available With the advent of technology, the implication of authentic multimedia-based teaching materials are using widely in language classrooms. Technology can be in service of teaching different skills such as listening, reading, speaking and writing. Among these skills listening comprehension is a skill in which the learners have problems to master. Regarding this issue, utilizing captions for the education purposes has been a good motivation for conducting some research on the effects of captions of listening skills. However, it seems that there is a gap in the literature whether to use captioned movies in the classroom and whether they are effective in improving listening comprehension. Many studies have been conducted on this issue. However, their findings are conclusive. While some studies refer to the effectiveness of using captions, others revel that they are not so effective for improving the learner’s language skills. Hence, the present study is a review of the effects of captioned movies on the improvement of listening skill. In this case, the findings of this study can clarify the role of using captioned movies in improving the listening skill Keywords: captioned movie, technology, listening comprehension, instruction
Aspara, Jaakko; Klein, Jan F.; Luo, Xueming; Tikkanen, Henrikki
We conduct a systematic exploratory investigation of the effects of firms’ existing service productivity on the success of their new service innovations. Although previous research extensively addresses service productivity and service innovation, this is the first empirical study that bridges the gap between these two research streams and examines the links between the two concepts. Based on a comprehensive data set of new service introductions in a financial services market over a 14-year period, we empirically explore the relationship between a firm’s existing service productivity and the firm’s success in introducing new services to the market. The results unveil a fundamental service productivity-service innovation dilemma: Being productive in existing services increases a firm’s willingness to innovate new services proactively but decreases the firm’s capabilities of bringing these services to the market successfully. We provide specific insights into the mechanism underlying the complex relationship between a firm’s productivity in existing services, its innovation proactivity, and its service innovation success. For managers, we not only unpack and elucidate this dilemma but also demonstrate that a focused customer scope and growth market conditions may enable firms to mitigate the dilemma and successfully pursue service productivity and service innovation simultaneously. PMID:29706764
Didis, Nilufer; Eryilmaz, Ali; Erkoc, Sakir
When quantum theory caused a paradigm shift in physics, it introduced difficulties in both learning and teaching of physics. Because of its abstract, counter-intuitive and mathematical structure, students have difficulty in learning this theory, and instructors have difficulty in teaching the concepts of the theory. This case study investigates…
da Fonseca, Nelson L S
Cloud Services, Networking and Management provides a comprehensive overview of the cloud infrastructure and services, as well as their underlying management mechanisms, including data center virtualization and networking, cloud security and reliability, big data analytics, scientific and commercial applications. Special features of the book include: State-of-the-art content. Self-contained chapters for readers with specific interests. Includes commercial applications on Cloud (video services and games).
Saddichha, Sahoo; Prasad, M N V; Saxena, Mukul Kumar
Suicide continues to be one of the biggest killers in the world, with suicide rates varying between 8.1 and 58.3/100,000 population for different parts of India. Andhra Pradesh, the fourth largest state in India, is responsible for more than 11% of these. Unfortunately, most suicides are under-reported and there is scant data on attempted suicides. This study aimed to comprehensively study the characteristics of attempted suicides in Andhra Pradesh and using the primary data, make secondary projections for the forthcoming years. Using Patient Care Record (PCR) forms of all emergencies serviced by 108, the first comprehensive emergency service in India, an analysis of all cases was done to detect possible suicides during the period January-December 2007. A follow up 48 hours later was then done to confirm status and diagnosis. A total of 1007 cases were recorded as confirmed suicides. Hanging and insecticide poisoning (72%) were the most common methods used. Males preferred hanging and insecticide poisoning while females preferred self-immolation and hanging as common methods. Self-immolation and insecticide poisoning had the highest mortality (41.6%). Estimates of attempted suicides for the year 2008 revealed a mean of 3.2-3.8 per 1000 population for males, 3.3-3.7 per 1000 population for females and 6.4-7.6 per 1000 population combined. A serious epidemic of suicides seems to be in store in the coming years unless preventive steps in the form of policy changes are undertaken. Restricting access to poisonous substances or prescription drugs and taking into consideration the prevailing social, economic and cultural factors could help in reducing numbers. Starting tele-help services or offering brief interventions during hospital stays are other programs which may be considered.
Integralidade da atenção e integração de serviços de saúde: desafios para avaliar a implantação de um "sistema sem muros" Comprehensive health care and integrated health services: challenges for evaluating the implementation of a "system without walls"
Zulmira M. de Araújo Hartz
Full Text Available Neste texto, partimos do pressuposto de que a integralidade da atenção é um eixo prioritário da investigação e avaliação dos serviços e sistemas de saúde, estruturados como redes assistenciais interorganizacionais que articulam dimensões clínicas, funcionais, normativas e sistêmicas em sua operacionalização, reconhecendo que nenhuma organização reúne a totalidade dos recursos e competências necessárias para a solução dos problemas de saúde de uma população, em seus diversos ciclos de vida. Em virtude da complexidade desse "sistema sem muros", que elimina as barreiras de acesso entre os diversos níveis de atenção, em resposta às necessidades de saúde nos âmbitos local e regional, julgamos oportuno compartilhar algumas "lições preliminares" aprendidas em experiências pessoais e na literatura sobre a integração de serviços, que nos parecem de interesse comum aos pesquisadores e gestores comprometidos com a sua implantação.The premise of this paper is that comprehensive health care is a major component in the investigation and evaluation of health services and systems, structured as inter-organizational health care networks articulating clinical, functional, normative, and systemic dimensions in their operationalization and based on the understanding that no organization combines all the necessary resources and capabilities to solve the health problems of a population with its various life cycles. Given the complex nature of this "system without walls", eliminating barriers to access in the various health care levels in response to local and regional health, we take this opportunity to share a few "preliminary lessons" from our experience and from the literature on integrated health services which may interest researchers and managers concerned with the implementation of such services.
Aspara, Jaakko; Klein, Jan F; Luo, Xueming; Tikkanen, Henrikki
We conduct a systematic exploratory investigation of the effects of firms' existing service productivity on the success of their new service innovations. Although previous research extensively addresses service productivity and service innovation, this is the first empirical study that bridges the gap between these two research streams and examines the links between the two concepts. Based on a comprehensive data set of new service introductions in a financial services market over a 14-year period, we empirically explore the relationship between a firm's existing service productivity and the firm's success in introducing new services to the market. The results unveil a fundamental service productivity-service innovation dilemma: Being productive in existing services increases a firm's willingness to innovate new services proactively but decreases the firm's capabilities of bringing these services to the market successfully. We provide specific insights into the mechanism underlying the complex relationship between a firm's productivity in existing services, its innovation proactivity, and its service innovation success. For managers, we not only unpack and elucidate this dilemma but also demonstrate that a focused customer scope and growth market conditions may enable firms to mitigate the dilemma and successfully pursue service productivity and service innovation simultaneously.
Hazarika, Panna; Galligan, Stephen
Controlling warehousing operations and food inventory, administering school cafeteria activity, and measuring the profitability of food service operations are identified as food service administrative problems. A comprehensive school food services information system developed to address these problems is described. (Author/MLF)
A comprehensive inventory of ecosystem services across the entire Great Lakes basin is currently lacking and is needed to make informed management decisions. A greater appreciation and understanding of ecosystem services, including both use and non-use services, may have avoided ...
Buchbinder, Mara; Lassiter, Dragana; Mercier, Rebecca; Bryant, Amy; Lyerly, Anne Drapkin
Much of the debate on conscience has addressed the ethics of refusal: the rights of providers to refuse to perform procedures to which they object and the interests of the patients who might be harmed by their refusals. But conscience can also be a positive force, grounding decision about offering care.
Wu, Justine; Chaplin, William; Amico, Jennifer; Butler, Mark; Ojie, Mary Jane; Hennedy, Dina; Clemow, Lynn
The study objective was to explore the effect of music as an adjunct to local anesthesia on pain and anxiety during first-trimester surgical abortion. Secondary outcomes included patient satisfaction and coping. We conducted a randomized controlled pilot study of 26 women comparing music and local anesthesia to local anesthesia alone. We assessed pain, anxiety and coping with 11-point verbal numerical scales. Patient satisfaction was measured via a 4-point Likert scale. In the music group, we noted a trend toward a faster decline in anxiety postprocedure (p=.065). The music group reported better coping than the control group (mean±S.D., 8.5±2.3 and 6.2±2.8, respectively; pMusic as an adjunct to local anesthesia during surgical abortion is associated with a trend toward less anxiety postprocedure and better coping while maintaining high patient satisfaction. Music does not appear to affect abortion pain. Copyright © 2012 Elsevier Inc. All rights reserved.
Chor, Julie; Lyman, Phoebe; Ruth, Jean; Patel, Ashlesha; Gilliam, Melissa
Balancing the need to provide individual support for patients and the need for an efficient clinic can be challenging in the abortion setting. This study explores physician, staff, and specially trained abortion doula perspectives on doula support, one approach to patient support. We conducted separate focus groups with physicians, staff members, and doulas from a high-volume, first-trimester aspiration abortion clinic with a newly established volunteer abortion doula program. Focus groups explored 1) abortion doula training, 2) program implementation, 3) program benefits, and 4) opportunities for improvement. Interviews were transcribed and computer-assisted content analysis was performed; salient findings are presented. Five physicians, 5 staff members, and 4 abortion doulas participated in separate focus group discussions. Doulas drew on both their prior personal skills and experiences in addition to their abortion doula training to provide women with support at the time of abortion. Having doulas in the clinic to assist with women's emotional needs allowed physicians and staff to focus on technical aspects of the procedure. In turn, both physicians and staff believed that introducing doulas resulted in more patient-centered care. Although staff did not experience challenges to integrating doulas, physicians and doulas experienced initial challenges in incorporating doula support into the clinical flow. Staff and doulas reported exchanging skills and techniques that they subsequently used in their interactions with patients. Physicians, clinic staff, and doulas perceive abortion doula support as an approach to provide more patient-centered care in a high-volume aspiration abortion clinic. © 2018 by the American College of Nurse-Midwives.
Caplan, David; Waters, Gloria
Efforts to characterize the memory system that supports sentence comprehension have historically drawn extensively on short-term memory as a source of mechanisms that might apply to sentences. The focus of these efforts has changed significantly in the past decade. As a result of changes in models of short-term working memory (ST-WM) and developments in models of sentence comprehension, the effort to relate entire components of an ST-WM system, such as those in the model developed by Baddeley (Nature Reviews Neuroscience 4: 829-839, 2003) to sentence comprehension has largely been replaced by an effort to relate more specific mechanisms found in modern models of ST-WM to memory processes that support one aspect of sentence comprehension--the assignment of syntactic structure (parsing) and its use in determining sentence meaning (interpretation) during sentence comprehension. In this article, we present the historical background to recent studies of the memory mechanisms that support parsing and interpretation and review recent research into this relation. We argue that the results of this research do not converge on a set of mechanisms derived from ST-WM that apply to parsing and interpretation. We argue that the memory mechanisms supporting parsing and interpretation have features that characterize another memory system that has been postulated to account for skilled performance-long-term working memory. We propose a model of the relation of different aspects of parsing and interpretation to ST-WM and long-term working memory.
... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R4-R-2010-N277; 40136-1265-0000-S3] Cabo Rojo National Wildlife Refuge, Cabo Rojo, Puerto Rico; Draft Comprehensive Conservation Plan and... draft comprehensive conservation plan and environmental assessment (Draft CCP/EA) for Cabo Rojo National...
Measurment and Reporting of Comprehensive Income: Search, Challenges, ... of periods of stable and unstable economic situation and satisfies varied users' ... Keywords: Historical accounting; comprehensive income; asset valuation model.
Title 44 US Code, ''Public Printing and Documents,'' regulations issued by the General Service Administration (GSA) in 41 CFR Chapter 101, Subchapter B, ''Management and Use of Information and Records,'' and regulations issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter 12, Subchapter B, ''Records Management,'' require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA's General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 3, contains ''NRC's Comprehensive Records Disposition Schedule,'' and the original authorized approved citation numbers issued by NARA. Rev. 3 incorporates NARA approved changes and additions to the NRC schedules that have been implemented since the last revision dated March, 1992, reflects recent organizational changes implemented at the NRC, and includes the latest version of NARA's General Records Schedule (dated August 1995)
Onnela, A M; Vuokila-Oikkonen, P; Hurtig, T; Ebeling, H
The purpose of this paper is to describe a participatory action research process on the development of a professional practice model of mental health nurses in mental health promotion in a comprehensive school environment in the city of Oulu, Finland. The developed model is a new method of mental health promotion for mental health nurses working in comprehensive schools. The professional practice model has been developed in workshops together with school staff, interest groups, parents and students. Information gathered from the workshops was analysed using action research methods. Mental health promotion interventions are delivered at three levels: universal, which is an intervention that affects the whole school or community; selective, which is an intervention focusing on a certain group of students; and indicated, which is an individually focused intervention. All interventions are delivered within the school setting, which is a universal setting for all school-aged children. The interventions share the goal of promoting mental health. The purposes of the interventions are enhancing protective factors, reducing risk factors relating to mental health problems and early identification of mental health problems as well as rapid delivery of support or referral to specialized services. The common effect of the interventions on all levels is the increase in the experience of positive mental health. © 2014 John Wiley & Sons Ltd.
Title 44 US Code, ``Public Printing and Documents,`` regulations issued by the General Service Administration (GSA) in 41 CFR Chapter 101, Subchapter B, ``Management and Use of Information and Records,`` and regulations issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter 12, Subchapter B, ``Records Management,`` require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA`s General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 3, contains ``NRC`s Comprehensive Records Disposition Schedule,`` and the original authorized approved citation numbers issued by NARA. Rev. 3 incorporates NARA approved changes and additions to the NRC schedules that have been implemented since the last revision dated March, 1992, reflects recent organizational changes implemented at the NRC, and includes the latest version of NARA`s General Records Schedule (dated August 1995).
Swinney, David; Love, Tracy; Walenski, Matthew; Smith, Edward E.
This experiment examined the time course of integration of modifier-noun (conceptual) combinations during auditory sentence comprehension using cross-modal lexical priming. The study revealed that during ongoing comprehension, there is initial activation of features of the noun prior to activation of (emergent) features of the entire conceptual combination. These results support compositionality in conceptual combination; that is, they indicate that features of the individual words constituting a conceptual combination are activated prior to combination of the words into a new concept. PMID:17576278
Laplante, Philip A
The Comprehensive Dictionary of Electrical Engineering is a complete lexicon covering all the fields of electrical engineering.Areas examined include:applied electrical engineeringmicrowave engineeringcontrol engineeringpower engineeringdigital systems engineeringdevice electronicsand much more! The book provides workable definitions for practicing engineers, serves as a reference and research tool for students, and offers practical information for scientists and engineers in other disciplines.
Klein, Jeanne; Fitch, Marguerite
Two studies investigate the way in which children make sense of a play and the visual, aural, and psychological components of theatre which contribute to this comprehension. In the first study, 32 fifth graders saw "Don Quixote of La Mancha." In the second study, 45 third graders saw "Monkey, Monkey" (about the Chinese Monkey King). The day after…
Richards, Jack C.
Three dimensions in the teaching of listening comprehension are outlined: (1) a theory is presented that takes account of the cognitive processes used (approach); (2) listeners' needs are analyzed and a taxonomy of microskills and objectives for teaching them are proposed (design); and (3) classroom exercises and activities are suggested…
Sweeder, Ryan D.; Jeffery, Kathleen A.
This article describes the use of a comprehensive demonstration suitable for a high school or first-year undergraduate introductory chemistry class. The demonstration involves placing a burning candle in a container adjacent to a beaker containing a basic solution with indicator. After adding a lid, the candle will extinguish and the produced…
Full Text Available Electroconvulsive therapy (ECT is one of the most important discoveries of psychiatric treatments. This article comprehensively assesses historical progress, mechanism of actions, practical methods, indications, side effects, complications, drug interactions of ECT and attitudes towards ECT. [Archives Medical Review Journal 2003; 12(4.000: 340-377
Lindfors, Eila; Hilmola, Antti
The goal of this article is to clarify the concept of innovation and by presenting a research on the basic education outcome assessment data from an innovation learning perspective, answer to a question: Do students learn innovation in comprehensive education? The empirical information in this research is based on data collected in the national…
Willems, R.M.; Frank, S.L.; Nijhof, A.D.; Hagoort, P.; Bosch, A.P.J. van den
The notion of prediction is studied in cognitive neuroscience with increasing intensity. We investigated the neural basis of 2 distinct aspects of word prediction, derived from information theory, during story comprehension. We assessed the effect of entropy of next-word probability distributions as
National Institute of Justice, 2014
The National Institute of Justice (NIJ) developed the Comprehensive School Safety Initiative in consultation with federal partners and Congress. It is a research-focused initiative designed to increase the safety of schools nationwide through the development of knowledge regarding the most effective and sustainable school safety interventions and…
Ko, Myong Hee
This study, using both qualitative and quantitative measures, investigates how different types of gloss conditions affect Korean college students' reading comprehension. One hundred and six undergraduates at a university in Korea participated in the study. Twelve were assigned to think aloud, and the rest (ninety-four) took part in the main study…
A close similarity is demonstrated between context comprehension, such as discourse analysis, and constraint programming. The constraint store takes the role of a growing knowledge base learned throughout the discourse, and a suitable con- straint solver does the job of incorporating new pieces...
Full Text Available The purpose of this article is to synthesize the emerging neuroimaging literature that reveals how the brain responds when readers and listeners encounter texts that demand monitoring of their ongoing comprehension processes. Much of this research has been undertaken by cognitive scientists who do not frame their work in metacognitive terms, and therefore it is less likely to be familiar to psychologists who study metacognition in educational contexts. The important role of metacognition in the development and use of academic skills is widely recognized. Metacognition is typically defined as the awareness and control of one's own cognitive processes. In the domain of reading, the most important metacognitive skill is comprehension monitoring, the evaluation and regulation of comprehension. Readers who monitor their understanding realize when they have encountered difficulty making sense of the text, and they apply error correction procedures to attempt to resolve the difficulty. Metacognition depends on executive control skills that continue to develop into early adulthood, in parallel with the maturation of the executive control regions of the prefrontal cortex. Functional magnetic resonance imaging (fMRI and event-related potentials (ERP have been used for some time to study neural correlates of basic reading processes such as word identification, but it is only within recent years that researchers have turned to the higher-level processes of text comprehension. The article describes illustrative studies that reveal changes in neural activity when adults apply lexical, syntactic, or semantic standards to evaluate their understanding.
Fidalgo, Angel M; Tenenbaum, Harriet R; Aznar, Ana
This article examines whether there are gender differences in understanding the emotions evaluated by the Test of Emotion Comprehension (TEC). The TEC provides a global index of emotion comprehension in children 3-11 years of age, which is the sum of the nine components that constitute emotion comprehension: (1) recognition of facial expressions, (2) understanding of external causes of emotions, (3) understanding of desire-based emotions, (4) understanding of belief-based emotions, (5) understanding of the influence of a reminder on present emotional states, (6) understanding of the possibility to regulate emotional states, (7) understanding of the possibility of hiding emotional states, (8) understanding of mixed emotions, and (9) understanding of moral emotions. We used the answers to the TEC given by 172 English girls and 181 boys from 3 to 8 years of age. First, the nine components into which the TEC is subdivided were analysed for differential item functioning (DIF), taking gender as the grouping variable. To evaluate DIF, the Mantel-Haenszel method and logistic regression analysis were used applying the Educational Testing Service DIF classification criteria. The results show that the TEC did not display gender DIF. Second, when absence of DIF had been corroborated, it was analysed for differences between boys and girls in the total TEC score and its components controlling for age. Our data are compatible with the hypothesis of independence between gender and level of comprehension in 8 of the 9 components of the TEC. Several hypotheses are discussed that could explain the differences found between boys and girls in the belief component. Given that the Belief component is basically a false belief task, the differences found seem to support findings in the literature indicating that girls perform better on this task.
As from 1st of July 2002, responsibility for running the Fax Service will be transfered to the Printer Service. Future requests for machines, toner and breakdown should be sent to Printer.Support@cern.ch - tel 78888. Telephone Service
The conclusion of a comprehensive nuclear test ban is of critical importance for the future of arms limitation and disarmament. As the 1980 report of the Secretary-General concluded, a comprehensive nuclear test ban is regarded as the first and most urgent step towards the cessation of the nuclear arms race and, in particular, of its qualitative aspects. It could serve as an important measure for the non-proliferation of nuclear weapons, both vertical and horizontal. It would have a major arms limitation impact in that it would make it difficult, if not impossible, to develop new designs of nuclear weapons and would also place constraints on the modification of existing weapon designs. The permanent cessation of all nuclear-weapon tests has long been sought by the world community and its achievement would be an event of great international significance
Cohen, R.H.; Cohen, B.I.; Dubois, P.F.
We outline a plan for the development of a comprehensive numerical model of tokamaks. The model would consist of a suite of independent, communicating packages describing the various aspects of tokamak performance (core and edge transport coefficients and profiles, heating, fueling, magnetic configuration, etc.) as well as extensive diagnostics. These codes, which may run on different computers, would be flexibly linked by a user-friendly shell which would allow run-time specification of packages and generation of pre- and post-processing functions, including workstation-based visualization of output. One package in particular, the calculation of core transport coefficients via gyrokinetic particle simulation, will become practical on the scale required for comprehensive modelling only with the advent of teraFLOP computers. Incremental effort at LLNL would be focused on gyrokinetic simulation and development of the shell
The Atlantic Richfield Hanford Company (ARHCO) has developed comprehensive plans for coping with emergencies ranging from criticality to civil disturbance. A unique notification system provides for immediate contact with key personnel by using a central communications center, crash alarm warning networks, and a continuing telephone cascade notification system. There is also the capability of immediately contacting other contractor key personnel. Certain jobs have been predetermined as necessary for coping with an emergency. An emergency staff consisting of responsible management, with alternates, has been preselected to automatically fill these jobs when notified. Control centers for headquarters and ''field'' are established with telephone and radio communication capabilities and are also supplied with some source materials to assist initiating plans for containing an emergency for recovery. A comprehensive emergency procedures manual has been developed, which contains information of company-wide application and procedures for specific facilities covering almost all accident situations
Avlonitis, Viktor; Hsuan, Juliana
The purpose of this research is to investigate the studies on service modularity with a goal of informing service science and advancing contemporary service systems research. Modularity, a general systems property, can add theoretical underpinnings to the conceptual development of service science...... in general and service systems in particular. Our research is guided by the following question: how can modularity theory inform service system design? We present a review of the modularity literature and associated concepts. We then introduce the contemporary service science and service system discourse...
Cárdenas Beltrán Melba Libia
Full Text Available Listening practice is often neglected or handled inappropriately in the teachinglearning process. This poses problem because listening is an integral part of conversations. Oral skills without equally welldeveloped listening abilities are of little practical value. In this article, I will take a look at issues related to the area of listening that may be considered when guiding students toward developing listening comprehension.
Nisbeth Jensen, Matilde
The increasing demand for citizen engagement in areas traditionally belonging exclusively to experts, such as health, law and technology has given rise to the necessity of making expert knowledge available to the general public through genres such as instruction manuals for consumer goods, patien...... the functional text type of Patient Information Leaflet. Finally, the usefulness of applying the principles of Plain Language and intralingual translation for optimising comprehensibility in interlingual translation is discussed....
Lear, Scott A; Ignaszewski, Andrew
Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these stu...
Hollifield, Bill R
In this second edition, Alarm Management: A Comprehensive Guide, various problems of alarm systems are covered with precise guidance on how they come about and how to effectively correct them. It is written by individuals with vast experience in the different plants, processes, and environments requiring effective alarm management. The second edition is filled with good examples and explanations of procedures, with practical lists and tips on how one should proceed. It is based on hundreds of successful projects.
Lonsdale, Stephen J.; Volkas, Raymond R.
Asymmetric dark matter (ADM) is motivated by the similar cosmological mass densities measured for ordinary and dark matter. We present a comprehensive theory for ADM that addresses the mass density similarity, going beyond the usual ADM explanations of similar number densities. It features an explicit matter-antimatter asymmetry generation mechanism, has one fully worked out thermal history and suggestions for other possibilities, and meets all phenomenological, cosmological and astrophysical...
DECrad version II was recently tested by members of the Radiology Information System Consortium (RISC) and was found to meet the specifications prepared by the consortium. It is a comprehensive tailorable system that can be interfaced to practically any HIS. This paper provides an overall view of the major functions of the system which include registration, scheduling, tracking, film library management, reporting, statistics, and teaching modules. The evolution of the specification and user experiences is reported
Verbal communication does not rely only on the simple perception of auditory signals. It is rather a parallel and integrative processing of linguistic and non-linguistic information, involving temporal and frontal areas in particular. This review describes the inherent complexity of auditory speech comprehension from a functional-neuroanatomical perspective. The review is divided into two parts. In the first part, structural and functional asymmetry of language relevant structures will be discus. The second part of the review will discuss recent neuroimaging studies, which coherently demonstrate that speech comprehension processes rely on a hierarchical network involving the temporal, parietal, and frontal lobes. Further, the results support the dual-stream model for speech comprehension, with a dorsal stream for auditory-motor integration, and a ventral stream for extracting meaning but also the processing of sentences and narratives. Specific patterns of functional asymmetry between the left and right hemisphere can also be demonstrated. The review article concludes with a discussion on interactions between the dorsal and ventral streams, particularly the involvement of motor related areas in speech perception processes, and outlines some remaining unresolved issues. This article is part of a Special Issue entitled Human Auditory Neuroimaging. Copyright © 2013 Elsevier B.V. All rights reserved.
The complexity of pathogenesis of periodontitis makes the use of comprehensive treatment necessary. We observed 60 patients, 20 women and 40 men among them aged from 20 to 50. In the course of parodontitis, we determined the intensity of inflammatory-destructive changes (Pi) in the course of periodontitis, the degree of fang denudation, the depth of gum and parodontal recesses, degree of the teeth becoming loose; we conducted the microbiological study of the oral cavity microflora and drew up an antibiotic graph. We included laser therapy in the comprehensive treatment course of generalized parodontitis. We divided the patients into two groups. The patients of the first group were treated in two stages. We used peridex, composed of chlorhexidine for antiseptic treatment of oral cavity. We used a combined solution of sage, eucalyptus, camomile and calendula to irrigate the oral cavity. At the second stage we used ointment applications with the composition of 3% indometacin, heparin, vitamins, sea-buckthorn oil and antibiotics. In the course of comprehensive treatment of the patients of the II group we included laser therapy. Our interest in the laser beam, as in the means of parodontitis treatment was stimulated by a number of properties of the laser beam and namely, its anti-inflammatory, desensitizing and antibacterial action promotes intensifying the reparation processes and does not entail any complications. The mentioned method has produced the best therapeutic results and has resulted in the reduced treatment period.
...We, the U.S. Fish and Wildlife Service (Service), announce the availability of the Final Comprehensive Conservation Plan (CCP) and Finding of No Significant Impact (FONSI) for the Environmental Assessment (EA) for Swan Lake National Wildlife Refuge (NWR). Goals and objectives in the CCP describe how the agency intends to manage the refuge over the next 15 years.
... DEPARTMENT OF THE INTERIOR National Park Service [NPS-PWR-PWRO-11522; PX.P0131800B.00.1] Draft Environmental Impact Statement for Merced Wild and Scenic River Comprehensive Management Plan, Yosemite National Park, Madera and Mariposa Counties, CA AGENCY: National Park Service, Interior. ACTION: Notice of...
... develop and test innovative health care payment and service delivery models that show promise of reducing... test innovative payment and service delivery models that reduce spending under Medicare, Medicaid or...] Medicare Program: Comprehensive End-Stage Renal Disease Care Model Announcement AGENCY: Centers for...
Fuller, Alice K; Uglik, Kristin M; Braine, Hayden G; King, Karen E
Platelet (PLT) transfusions are essential for patients who are bleeding or have an increased risk of bleeding due to a decreased number or abnormal function of circulating PLTs. A shelf life of 5 days for PLT products presents an inventory management challenge. In 2006, greater than 10% of apheresis PLTs made in the United States outdated. It is imperative to have a sufficient number of products for patients requiring transfusion, but outdating PLTs is a financial burden and a waste of a resource. We present the approach used in our institution to anticipate inventory needs based on current patient census and usage. Strategies to predict usage and to identify changes in anticipated usage are examined. Annual outdating is reviewed for a 10-year period from 2000 through 2009. From January 1, 2000, through December 2009, there were 128,207 PLT transfusions given to 15,265 patients. The methods used to anticipate usage and adjust inventory resulted in an annual outdate rate of approximately 1% for the 10-year period reviewed. In addition we have not faced situations where inventory was inadequate to meet the needs of the patients requiring transfusions. We have identified three elements of our transfusion service that can minimize outdate: a knowledgeable proactive staff dedicated to PLT management, a comprehensive computer-based transfusion history for each patient, and a strong two-way relationship with the primary product supplier. Through our comprehensive program, based on the principles of providing optimal patient care, we have minimized PLT outdating for more than 10 years. © 2011 American Association of Blood Banks.
Selen, Willem; Roos, Göran; Green, Roy
Bringing together some of the world’s leading thinkers, academics and professionals to provide practitioners, students and academicians with comprehensive insights into implementing effective service innovation. This book presents service innovation holistically and systemically across various service areas, including health, education, tourism, hospitality, telecommunications, and retail. It addresses contemporary issues through conceptual and applied contributions across industry, academia, and government, providing insights for improved practice and policy making. Featuring cutting-edge research contributions, practical examples, implementations and a select number of case studies across several growth service industries, this book also includes examples of failed service innovation attempts in order to demonstrate a balanced view of the topic and to make clear the pitfalls to be avoided. Culminating in a suggested step-by-step guide to enable service organization’s managers to understand and implemen...
Panja, Asit K; Chattopadhyaya, Abichal; Chaudhuri, Supriyo
Nomenclature of the disease on the basis of vitiation of the body humors is stressed in ayurveda. Sannipatika, i.e., ‘conglomeration of vitiated tridosa’ is the final stage of process of manifestation of disease. In this specific state of pathogenesis, the disease becomes more advance and mostly irreversible. A detailed scientific study of Sannipatika-avastha has been documented in classics. Comprehensive analysis of sannipata-state and its ways of presentation is the main theme of the current article. PMID:22408295
Effective January 1, 1982, NRC will institute records retention and disposal practices in accordance with the approved Comprehensive Records Disposition Schedule (CRDS). CRDS is comprised of NRC Schedules (NRCS) 1 to 4 which apply to the agency's program or substantive records and General Records Schedules (GRS) 1 to 22 which apply to housekeeping or facilitative records. The schedules are assembled functionally/organizationally to facilitate their use. Preceding the records descriptions and disposition instructions for both NRCS and GRS, there are brief statements on the organizational units which accumulate the records in each functional area, and other information regarding the schedules' applicability
Singer, Sara J; Kerrissey, Michaela; Friedberg, Mark; Phillips, Russell
Efforts to transform health care delivery to improve care have increasingly focused on care integration. However, variation in how integration is defined has complicated efforts to design, synthesize, and compare studies of integration in health care. Evaluations of integration initiatives would be enhanced by describing them according to clear definitions of integration and specifying which empirical relationships they seek to test-whether among types of integration or between integration and outcomes of care. Drawing on previous work, we present a comprehensive theoretical model of relationships between types of integration and propose how to measure them.
Full Text Available The goal of this research was to examine how project changes can be prevented, and how to reduce their negative impact. Theoretical research examined risk management, project control and change management. Based on the study a “Comprehensive Change Management Model” was developed and verified after conducting empirical research in Slovenian enterprises. The research confirmed that risk management identifies possible changes and reduces their impact; project control ensures the timely detection of changes and an efficient response, while formal change management ensures the effective implementation of changes. The combined functioning of all three areas ensures effective project execution.
Hogan, Tiffany P; Adlof, Suzanne M; Alonzo, Crystle N
The simple view of reading highlights the importance of two primary components which account for individual differences in reading comprehension across development: word recognition (i.e., decoding) and listening comprehension. While assessments and interventions for decoding have been the focus of pedagogy in the past several decades, the importance of listening comprehension has received less attention. This paper reviews evidence showing that listening comprehension becomes the dominating influence on reading comprehension starting even in the elementary grades. It also highlights a growing number of children who fail to develop adequate reading comprehension skills, primarily due to deficient listening comprehension skills (i.e., poor comprehenders). Finally we discuss key language influences on listening comprehension for consideration during assessment and treatment of reading disabilities.
Hopman, Elise W M; MacDonald, Maryellen C
Language learners often spend more time comprehending than producing a new language. However, memory research suggests reasons to suspect that production practice might provide a stronger learning experience than comprehension practice. We tested the benefits of production during language learning and the degree to which this learning transfers to comprehension skill. We taught participants an artificial language containing multiple linguistic dependencies. Participants were randomly assigned to either a production- or a comprehension-learning condition, with conditions designed to balance attention demands and other known production-comprehension differences. After training, production-learning participants outperformed comprehension-learning participants on vocabulary comprehension and on comprehension tests of grammatical dependencies, even when we controlled for individual differences in vocabulary learning. This result shows that producing a language during learning can improve subsequent comprehension, which has implications for theories of memory and learning, language representations, and educational practices.
Considers the nature of motivation and its place in the development of reading comprehension. Uses A. Maslow's hierarchy of motivation as a heuristic for examining the motivational quality of several teaching methods commonly proposed for comprehension instruction. (FL)
This is a cookbook full of recipes with the essential code explained clearly and comprehensively. Each chapter is neatly compartmentalized with focused recipes which are perfectly organized for easy reference and understanding. This book is for Java/J2EE developers. As the books covers a variety of topics in Web-Service development, it will serve as a reference guide to those already familiar with Web-Services. Beginners can also use this book to gain real-world experience of Web-Service development.
Van den Bos, K.P.; Aarnoudse, C.C.; Brand-Gruwel, S.
The goal of this study was to investigate the effects of teaching text comprehension strategies to children with decoding and reading comprehension problems and with a poor or normal listening ability. Two experiments are reported. Four text comprehension strategies, viz., question generation,
Wolf, Mikyung Kim; Crosson, Amy C.; Resnick, Lauren B.
This study examined the quality of classroom talk and its relation to academic rigor in reading-comprehension lessons. Additionally, the study aimed to characterize effective questions to support rigorous reading comprehension lessons. The data for this study included 21 reading-comprehension lessons in several elementary and middle schools from…
Hsieh, Shelley Ching-Yu; Hsu, Chun-Chieh Natalie
This study examines the effect of familiarity, context, and linguistic convention on idiom comprehension in Mandarin speaking children. Two experiments (a comprehension task followed by a comprehension task coupled with a metapragmatic task) were administered to test participants in three age groups (6 and 9-year-olds, and an adult control group).…
... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Comprehensive plan. 801... POLICIES § 801.5 Comprehensive plan. (a) The Compact requires that the Commission formulate and adopt a comprehensive plan for the immediate and long-range development and use of the water resources of the basin. (1...
It is argued that the genre of the school reading comprehension exercise is a prime inculcator of thoughtless and non-interactive reading practices. Doing 'a comprehension' (the word is often nominalised in this manner) and answering the comprehension questions often 'counts as' reading and substitutes for other types of ...
... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Comprehensive review. 1018.43 Section 1018.43 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL ADVISORY COMMITTEE MANAGEMENT Records, Annual Reports and Audits § 1018.43 Comprehensive review. A comprehensive review of all...
Willems, Roel M; Frank, Stefan L; Nijhof, Annabel D; Hagoort, Peter; van den Bosch, Antal
The notion of prediction is studied in cognitive neuroscience with increasing intensity. We investigated the neural basis of 2 distinct aspects of word prediction, derived from information theory, during story comprehension. We assessed the effect of entropy of next-word probability distributions as well as surprisal A computational model determined entropy and surprisal for each word in 3 literary stories. Twenty-four healthy participants listened to the same 3 stories while their brain activation was measured using fMRI. Reversed speech fragments were presented as a control condition. Brain areas sensitive to entropy were left ventral premotor cortex, left middle frontal gyrus, right inferior frontal gyrus, left inferior parietal lobule, and left supplementary motor area. Areas sensitive to surprisal were left inferior temporal sulcus ("visual word form area"), bilateral superior temporal gyrus, right amygdala, bilateral anterior temporal poles, and right inferior frontal sulcus. We conclude that prediction during language comprehension can occur at several levels of processing, including at the level of word form. Our study exemplifies the power of combining computational linguistics with cognitive neuroscience, and additionally underlines the feasibility of studying continuous spoken language materials with fMRI. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: email@example.com.
Data as a Service shows how organizations can leverage "data as a service" by providing real-life case studies on the various and innovative architectures and related patterns. Comprehensive approach to introducing data as a service in any organization. A re-usable and flexible SOA based architecture framework. Roadmap to introduce 'big data as a service' for potential clients. Presents a thorough description of each component in the DaaS reference architecture so readers can implement solutions.
Hagaman, Jessica L.; Luschen, Kati; Reid, Robert
Reading problems are one of the most frequent reasons students are referred for special education services and the disparity between students with reading difficulties and those who read successfully appears to be increasing. As a result, there is now an emphasis on early intervention programs such as RTI. In many cases, early intervention in…
Sommers, Mitchell S
The purpose of this summary is to examine changes in listening comprehension across the adult lifespan and to identify factors associated with individual differences in listening comprehension. In this article, the author reports on both cross-sectional and longitudinal changes in listening comprehension. Despite significant declines in both sensory and cognitive abilities, listening comprehension remains relatively unchanged in middle-aged listeners (between the ages of 40 and 60 years) compared with young listeners. These results are discussed with respect to possible compensatory factors that maintain listening comprehension despite impaired hearing and reduced cognitive capacities.
Zhang, N.; Huang, H.; Su, Boni
China is a country that experiences a large number of disasters. The number of deaths caused by large-scale disasters and accidents in past 10 years is around 900,000. More than 92.8 percent of these deaths could be avoided if there were an effective pre-warning system deployed. Knowledge of the information dissemination characteristics of different information media taking into consideration governmental assistance (information published by a government) in disasters in urban areas, plays a critical role in increasing response time and reducing the number of deaths and economic losses. In this paper we have developed a comprehensive information dissemination model to optimize efficiency of pre-warning mechanics. This model also can be used for disseminating information for evacuees making real-time evacuation plans. We analyzed every single information dissemination models for pre-warning in disasters by considering 14 media: short message service (SMS), phone, television, radio, news portals, Wechat, microblogs, email, newspapers, loudspeaker vehicles, loudspeakers, oral communication, and passive information acquisition via visual and auditory senses. Since governmental assistance is very useful in a disaster, we calculated the sensitivity of governmental assistance ratio. The results provide useful references for information dissemination during disasters in urban areas.
Ecosystem goods and services are the many life-sustaining benefits we receive from nature and contribute to environmental and human health and well-being. Ecosystem-focused research will develop methods to measure ecosystem goods and services.
... topic data in XML format. Using the Web service, software developers can build applications that utilize MedlinePlus health topic information. The service accepts keyword searches as requests and returns relevant ...
Sørensen, Lene Tolstrup; Nicolajsen, Hanne Westh
This article discusses the challenges in relation to an ongoing project named converged advanced mobile media platform (CAMMP), where all the different stakeholders need to have a saying in the service development for the upcoming rich, mobile broadcasting services....
Grinstead, N; Timoney, R
Describes the process used by the Mater Infirmorum Hospital in Belfast in 1992-1994 to achieve high quality care (Seamless Service), motivate staff to deliver and measure performance. Aims of the project include focusing the organization on the customer, improving teamwork and motivation at all levels. After comprehensive data collection from GPs, patients and staff management forums developed a full TQM strategy to gain support and maintain momentum including innovative staff events (every staff member was given the opportunity to attend) where multilevel, multidisciplinary workshops enabled staff to design customer care standards, develop teams and lead customer-driven change.
strategic purchasing understanding markets communicating the contracting decision designing and drafting the contract the role of the consumer the regulation of service provision Illustrated throughout with practitioner case-studies from a range of OECD countries, this book presents an important new......Insightful and comprehensive and covering new subjects like globalization and IT, this text, international in its approach, provides a thorough introduction to the key phases of the contracting process and the skills required by managers in its implementation. These include: policy for contracting...
Full Text Available Countries, states and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centres are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment.This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centres, equipment, staff, education pr
This second edition of the popular textbook contains a comprehensive course in modern probability theory. Overall, probabilistic concepts play an increasingly important role in mathematics, physics, biology, financial engineering and computer science. They help us in understanding magnetism, amorphous media, genetic diversity and the perils of random developments at financial markets, and they guide us in constructing more efficient algorithms. To address these concepts, the title covers a wide variety of topics, many of which are not usually found in introductory textbooks, such as: • limit theorems for sums of random variables • martingales • percolation • Markov chains and electrical networks • construction of stochastic processes • Poisson point process and infinite divisibility • large deviation principles and statistical physics • Brownian motion • stochastic integral and stochastic differential equations. The theory is developed rigorously and in a self-contained way, with the c...
Fox, Michael Allen
Understanding Peace: A Comprehensive Introduction fills the need for an original, contemporary examination of peace that is challenging, informative, and empowering. This well-researched, fully documented, and highly accessible textbook moves beyond fixation on war to highlight the human capacity for nonviolent cooperation in everyday life and in conflict situations. After deconstructing numerous ideas about war and explaining its heavy costs to humans, animals, and the environment, discussion turns to evidence for the existence of peaceful societies. Further topics include the role of nonviolence in history, the nature of violence and aggression, and the theory and practice of nonviolence. The book offers two new moral arguments against war, and concludes by defining peace carefully from different angles and then describing conditions for creating a culture of peace. Understanding Peace brings a fresh philosophical perspective to discussions of peace, and also addresses down-to-earth issues about effecting ...
Full Text Available The article is addressed to provide a comprehensive review on recently accelerated development of the Information Technology within project market such as industrial, engineering, procurement and construction. Author’s aim is to cover the last decades of the growth of the Information and Communication Technology in construction industry in particular Building Information Modeling and testifies that the problem of a choice of the effective project realization method not only has not lost its urgency, but has also transformed into one of the major condition of the intensive technology development. All of it has created a great impulse on shortening the project duration and has led to the development of various schedule compression techniques what becomes a focus of modern construction.
Full Text Available http://dx.doi.org/10.5007/2175-8026.2012n63p69 Experimental studies point that different factors can influence reading comprehension, such as the topic, text type, reading task, and others. The advances in technologies for the past decades have provided researchers with several possibilities to investigate what goes on in one’s brain since their eyes meet the page until comprehension is achieved. Since the mid-80’s, numerous studies have been conducted with the use of the electroencephalogram (EEG to investigate the process of reading, through the analysis of different components – n400, n100 or n1, P2, among others. These components reveal, for example, how the brain integrates the meaning of a specific word in the semantic context of a given sentence. based on previous studies, which demonstrate that different types of words affect cognitive load, this paper aims at investigating how the brain processes function and content words inserted in expository and narrative texts with suitable / unsuitable conclusions. results showed that the type of text and word influence the cognitive load in different scalp areas (midline, right and left hemispheres. The n1s were more pronounced to the content words inserted in narrative texts and to the function words inserted in the expository type of texts, corroborating former studies.
Full Text Available Development of postindustrial society and services revolution created numerous changes in size of consumer demand, consumer reaction and priorities. Continuous change on the side of demand and offer must follow changes in marketing orientation. Leader in that change is services marketing which by knowing services range and all the changes builds a new concept called Relationship Marketing.
Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh
In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization
Görg, Holger; Hanley, Aoife
We provide a comprehensive empirical analysis of the links between international services outsourcing, domestic outsourcing, profits and innovation using plant level data. We find a positive effect of international outsourcing of services on innovative activity at the plant level. Such a positive effect can also be observed for domestic outsourcing of services, but the magnitude is smaller. This makes intuitive sense, as international outsourcing allows more scope for exploiting international...
...; Comprehensive Ecosystem-Based Amendment for the South Atlantic Region AGENCY: National Marine Fisheries Service...: NMFS issues this final rule to implement the Comprehensive Ecosystem-Based Amendment 1 (CE-BA1) to the... pristine deepwater coral ecosystems in the world while minimizing the effects on traditional fishing in the...
...; Comprehensive Ecosystem-Based Amendment for the South Atlantic Region AGENCY: National Marine Fisheries Service... for comments. SUMMARY: NMFS issues this proposed rule to implement the Comprehensive Ecosystem-Based... ecosystems in the world while minimizing the effects on traditional fishing in the Deepwater Coral HAPCs...
Chafcouloff, S.; Michel, G.; Trice, M.; Clark, G.; Cosad, C.; Forbes, K.
Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs
Chafcouloff, S.; Michel, G.; Trice, M. [Schlumberger Integrated Project Management Group, Montrouge (France); Clark, G. [Schlumberger Testing Services, Aberdeen (United Kingdom); Cosad, C.; Forbes, K. [Schlumberger Integrated Project Management Group, Aberdeen (United Kingdom)
Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs
Addington, Donald; Anderson, Elizabeth; Kelly, Martina; Lesage, Alain; Summerville, Chris
The objective of this review is to identify the features and components of a comprehensive system of services for people living with schizophrenia. A comprehensive system was conceived as one that served the full range of people with schizophrenia and was designed with consideration of the incidence and prevalence of schizophrenia. The system should provide access to the full range of evidence-based services, should be recovery oriented, and should provide patient-centred care. A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted were primarily drawn from the National Institute for Clinical Excellence (2014) Guideline on Psychosis and Schizophrenia in adults and the Scottish Intercollegiate Guidelines Network guidelines on management of schizophrenia. The recommendations adapted for Canada cover the range of services required to provide comprehensive services. Comprehensive services for people with schizophrenia can be organized and delivered to improve the quality of life of people with schizophrenia and their carers. The services need to be organized in a system that provides access to those who need them.
Marta, H.; Alvarez, P.; Jimenez, J.
Refuelling outages comprise a number of maintenance tasks scheduled long in advance to assure a reliable operation throughout the next cycle and, in the long run, a safer and more efficient plant. Most of these tasks are routine service of mechanical and electrical system and likewise fuel an be considered a critical component as to handling, inspection, cleaning and repair. ENUSA-ENWESA AIE has been working in this area since 1995 growing from fuel repair to a more integrated service that includes new and spent fuel handling, inserts, failed fuel rod detection systems, ultrasonic fuel cleaning, fuel repair and a comprehensive array of inspection and tests related to the reliability of the mechanical components in the fuel assembly, all this, performed in compliance with quality, safety, health physics and any other nuclear standard. (Author)
Kamhi, Alan G; Catts, Hugh W
In this epilogue, we review the 4 response articles and highlight the implications of a multidimensional view of reading for the assessment and instruction of reading comprehension. We reiterate the problems with standardized tests of reading comprehension and discuss the advantages and disadvantages of recently developed authentic tests of reading comprehension. In the "Instruction" section, we review the benefits and limitations of strategy instruction and highlight suggestions from the response articles to improve content and language knowledge. We argue that the only compelling reason to administer a standardized test of reading comprehension is when these tests are necessary to qualify students for special education services. Instruction should be focused on content knowledge, language knowledge, and specific task and learning requirements. This instruction may entail the use of comprehension strategies, particularly those that are specific to the task and focus on integrating new knowledge with prior knowledge.
Pozas, W. J
Full Text Available The paper describes a Teacher’s comprehensive training strategy for improving didactics performance, together with its theoretical foundations. The strategy is structured into several dimensions related to teachers’ development (lesson planning, continuing education and research. It is organized into two phases and seven stages intended to improve leadership in the teaching-learning process. The finding are the expression of a comprehensive approach to school organization at Services Polytechnic School “Horacio Cobiellas Domínguez” resulting in teachers’ academic and scientific development and a significant growth of the staff scientific potentials manifested in scientific forum enrolment. The resulting impact should lead to a general use of the proposed strategy in the Polytechnic school web. Key words: professional performance, pedagogic professional performance, didactic professional performance, teachers’ developmental strategy
Parker, Amy T; Nelson, Catherine
Students who are deafblind are a unique population with unique needs for learning, communication, and environmental access. Two roles have been identified as important to their education: teacher of the deafblind and intervener. However, these roles are not officially recognized in most states. Because of this lack of recognition and the low incidence of deafblindness, it is difficult to sustain systems that prepare highly qualified personnel with advanced training and knowledge in educational strategies for children and youth who are deafblind. The authors propose a comprehensive system of personnel development (CSPD) for deafblind education. The components of this system are standards, preservice training, in-service/professional development, leadership development, research, and, finally, planning coordination, and evaluation. The authors describe elements of the model that are being implemented and provide suggestions to support the future development of a comprehensive system.
Bush, P G; Drummond, S S
The comprehension and production of idioms was investigated in 10 dysphasic adults. Two different tasks, one comprehension and the other production, were developed. The production task required the subject to verbally explain 15 idioms. The comprehension task necessitated the selection of the correct figurative representation of the idiom from four illustrations: a literal, a literal variation, a figurative, and an unrelated picture. Results indicated no significant correlation between overall comprehension and production performances. No significant difference was found between the comprehension or the production of idioms when type or severity of dysphasia was considered. A significant difference was found, however, in the type of incorrect response, in that subjects selected the literal depiction more often than other foil representations for the comprehension.
Singh, Vandana; Sood, Meenakshi
The present article is aimed on comprehensive view of Swine flu. It was first isolated from pigs in 1930 in USA. Pandemic caused by H1N1 in 2009 brought it in limelight. Itís a viral respiratory disease caused by viruses that infects pigs, resulting in nasal secretions, barking cough, decreased appetite, and listless behavior. Swine virus consist of eight RNA strands, one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu spreads from infected person to healthy person by inhalation or ingestion of droplets contaminated with virus while sneezing or coughing. Two antiviral agents have been reported to help prevent or reduce the effects of swine flu, flu shot and nasal spray. WHO recommended for pandemic period to prevent its future outbreaks through vaccines or non-vaccines means. Antiviral drugs effective against this virus are Tamiflu and Relenza. Rapid antigen testing (RIDT), DFA testing, viral culture, and molecular testing (RT-PCR) are used for its diagnosis in laboratory
Effective January 1, 1982, NRC will institute records retention and disposal practives in accordance with the approved Comprehensive Records Disposition Schedule (CRDS). CRDS is comprised of NRC Schedules (NRCS) 1 to 4 which apply to the agency's program or substantive records and General Records Schedules (GRS) 1 to 24 which apply to housekeeping or facilitative records. NRCS-I applies to records common to all or most NRC offices; NRCS-II applies to program records as found in the various offices of the Commission, Atomic Safety and Licensing Board Panel, and the Atomic Safety and Licensing Appeal Panel; NRCS-III applies to records accumulated by the Advisory Committee on Reactor Safeguards; and NRCS-IV applies to records accumulated in the various NRC offices under the Executive Director for Operations. The schedules are assembled functionally/organizationally to facilitate their use. Preceding the records descriptions and disposition instructions for both NRCS and GRS, there are brief statements on the organizational units which accumulate the records in each functional area, and other information regarding the schedules' applicability
Full Text Available Diabetic nephropathy (DN is a leading cause of mortality and morbidity in patients with diabetes. This complication reflects a complex pathophysiology, whereby various genetic and environmental factors determine susceptibility and progression to end-stage renal disease. DN should be considered in patients with type 1 diabetes for at least 10 years who have microalbuminuria and diabetic retinopathy, as well as in patients with type 1 or type 2 diabetes with macroalbuminuria in whom other causes for proteinuria are absent. DN may also present as a falling estimated glomerular filtration rate with albuminuria as a minor presenting feature, especially in patients taking renin–angiotensin–aldosterone system inhibitors (RAASi. The pathological characteristic features of disease are three major lesions: diffuse mesangial expansion, diffuse thickened glomerular basement membrane, and hyalinosis of arterioles. Functionally, however, the pathophysiology is reflected in dysfunction of the mesangium, the glomerular capillary wall, the tubulointerstitium, and the vasculature. For all diabetic patients, a comprehensive approach to management including glycemic and hypertensive control with RAASi combined with lipid control, dietary salt restriction, lowering of protein intake, increased physical activity, weight reduction, and smoking cessation can reduce the rate of progression of nephropathy and minimize the risk for cardiovascular events. This review focuses on the latest published data dealing with the mechanisms, diagnosis, and current treatment of DN.
Erika F Rodriguez
Full Text Available Intraperitoneal spread may occur with gynecological epithelial neoplasms, as well as with non-gynecological malignancies, which may result in serosal involvement with or without concomitant effusion. Therefore, washings in patients with abdominopelvic tumors represent important specimens for cytologic examination. They are primarily utilized for staging ovarian cancers, although their role has decreased in staging of endometrial and cervical carcinoma. Abdominopelvic washings can be positive in a variety of pathologic conditions, including benign conditions, borderline neoplastic tumors, locally invasive tumors, or distant metastases. In a subset of cases, washings can be diagnostically challenging due to the presence of co-existing benign cells (e.g., mesothelial hyperplasia, endosalpingiosis, or endometriosis, lesions in which there is only minimal atypia (e.g., serous borderline tumors or scant atypical cells, and the rarity of specific tumor types (e.g., mesothelioma. Ancillary studies including immunocytochemistry and fluorescence in situ hybridization may be required in difficult cases to resolve the diagnosis. This article provides a comprehensive and contemporary review of abdominopelvic washings in the evaluation of gynecologic and non-gynecologic tumors, including primary peritoneal and mesothelial entities.
The Department of Energy (DOE) and its predecessor agencies have a long history of epidemiologic research programs. The main focus of these programs has been the Health and Mortality Study of the DOE work force. This epidemiologic study began in 1964 with a feasibility study of workers at the Hanford facility. Studies of other populations exposed to radiation have also been supported, including the classic epidemiologic study of radium dial painters and studies of atomic bomb survivors. From a scientific perspective, these epidemiologic research program have been productive, highly credible, and formed the bases for many radiological protection standards. Recently, there has been concern that, although research results were available, the data on which these results were based were not easily obtained by interested investigators outside DOE. Therefore, as part of an effort to integrate and broaden access to its epidemiologic information, the DOE has developed the Comprehensive Epidemiologic Data Resource (CEDR) Program. Included in this effort is the development of a computer information system for accessing the collection of CEDR data and its related descriptive information. The epidemiologic data currently available through the CEDAR Program consist of analytic data sets, working data sets, and their associated documentation files. In general, data sets are the result of epidemiologic studies that have been conducted on various groups of workers at different DOE facilities during the past 30 years.
Full Text Available The early skills of Emergent Literacy include the knowledge and abilities related to the alphabet, phonological awareness, symbolic representation, and communication. However, existing models of emergent literacy focus on discrete skills and miss the perspective of the surrounding environment. Early literacy skills, including their relationship to one another, and the substantial impact of the setting and context, are critical in ensuring that children gain all of the preliminary skills and awareness they will need to become successful readers and writers. Research findings over the last few decades have led to a fuller understanding of all that emergent literacy includes, resulting in a need for a new, more comprehensive model. A new model, described in this article, strives to explain how emergent literacy can be viewed as an interactive process of skills and context rather than a linear series of individual components. Early literacy learning opportunities are more likely to happen when teachers have a solid knowledge base of emergent literacy and child development. Research has shown that preschool teachers with limited knowledge about literacy development are significantly less able to provide such experiences for children. Teachers will be better able to facilitate all of the components of emergent literacy if they have access to, and understanding of, a model that describes the components, their interactions, and the importance of environmental factors in supporting children.
The book discusses the emerging topic of comprehensive energy management in electric vehicles from the viewpoint of academia and from the industrial perspective. It provides a seamless coverage of all relevant systems and control algorithms for comprehensive energy management, their integration on a multi-core system and their reliability assurance (validation and test). Relevant European projects contributing to the evolvement of comprehensive energy management in fully electric vehicles are also included.
U.S. Environmental Protection Agency — National Priorities List (NPL) Sites - The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access...
Stout, Karen A.
This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.
Full Text Available Endeavours to improve the efficiency and effectiveness of local government have been a persistent theme both of politicians in higher tiers of government and of interest groups, especially business. The two contenders for improvement which receive most coverage both in the research literature and in popular discussion are amalgamation and shared services. Arguments from the literature have generally favoured shared services over amalgamation. Bish (2001 in a comprehensive review of North American research dismisses the argument for amalgamation as a product of flawed nineteenth-century thinking and a bureaucratic urge for centralized control. He does so making the very reasonable point that the presumed economies of scale which will result from amalgamation are a function not of the size and scale of individual local authorities, but of the services for which those local authorities are responsible, and the point at which economies of scale will be optimised will be very different for different services. The case against amalgamation is also reinforced by the absence of any significant post-facto evidence that amalgamation achieves either the promised savings or the anticipated efficiency gains (McKinlay 2006.
Adkins, S.K.; Alford, D.R.; Barnette, A.B.
The Management Services Section provides coordinated professional administrative services to the Fusion Energy Division (FED), allowing the work of technical professionals to be more fully concentrated in their areas of specialty. Services are provided in general administration, personnel, financial management, communications (including text and graphics generation), management information, library, safety, quality assurance, and nonprogrammatic engineering services. Highlights of the past year included adoption of the Procurement Module in the FED Management Information System (MIS) for use by the entire Laboratory, completion of the Personnel Module of the MIS, greatly increased personnel recruiting activity, and increased industrial subcontracting activity
Cern Staff and Users can now consult their dose records for an individual or an organizational unit with HRT. Please see more information on our web page: http://cern.ch/rp-dosimetry Dosimetry Service is open every morning from 8.30 - 12.00. Closed in the afternoons. We would like to remind you that dosimeters cannot be sent to customers by internal mail. Short-term dosimeters (VCT's) must always be returned to the Service after the use and must not be left on the racks in the experimental areas or in the secretariats. Dosimetry Service Tel. 7 2155 Dosimetry.firstname.lastname@example.org http://cern.ch/rp-dosimetry
Lonsdale, Stephen J.; Volkas, Raymond R.
Asymmetric dark matter (ADM) is motivated by the similar cosmological mass densities measured for ordinary and dark matter. We present a comprehensive theory for ADM that addresses the mass density similarity, going beyond the usual ADM explanations of similar number densities. It features an explicit matter-antimatter asymmetry generation mechanism, has one fully worked out thermal history and suggestions for other possibilities, and meets all phenomenological, cosmological and astrophysical constraints. Importantly, it incorporates a deep reason for why the dark matter mass scale is related to the proton mass, a key consideration in ADM models. Our starting point is the idea of mirror matter, which offers an explanation for dark matter by duplicating the standard model with a dark sector related by a Z2 parity symmetry. However, the dark sector need not manifest as a symmetric copy of the standard model in the present day. By utilizing the mechanism of "asymmetric symmetry breaking" with two Higgs doublets in each sector, we develop a model of ADM where the mirror symmetry is spontaneously broken, leading to an electroweak scale in the dark sector that is significantly larger than that of the visible sector. The weak sensitivity of the ordinary and dark QCD confinement scales to their respective electroweak scales leads to the necessary connection between the dark matter and proton masses. The dark matter is composed of either dark neutrons or a mixture of dark neutrons and metastable dark hydrogen atoms. Lepton asymmetries are generated by the C P -violating decays of heavy Majorana neutrinos in both sectors. These are then converted by sphaleron processes to produce the observed ratio of visible to dark matter in the universe. The dynamics responsible for the kinetic decoupling of the two sectors emerges as an important issue that we only partially solve.
Contract medical transcription services can be of great assistance in meeting the demands for transcription, without jeopardizing patient, physician, or institutional confidentiality. You simply must require the contract service to provide at least the same degree of protection and preservation of confidentiality that you should require inhouse. To achieve this you must make these requirements explicit, comprehensive, comprehensible, believable, and enforceable. Discuss the requirements with prospective contractors. Review them at least annually with existing contractors and when contracts are due for renewal. Be sure to specify the consequence of breaching confidentiality, and if there are breaches, enforce the terms of the contract. Consult your institution's legal counsel both in developing the contract and in enforcing its provisions. Take into consideration your department's and institution's policies, AHIMA's statement on confidentiality, as well as local, state, and federal laws. Above all, never lose sight of the patient. Ultimately, it is not patient information that you are obligated to protect. It is the patient.
Newspaper librarians discussed the public use of their newspapers' libraries. Policies run the gamut from well-staffed public information services, within or outside the newspaper library, to no service at all to those outside the staff of the paper. Problems of dealing with tax and law enforcement agencies were covered, as well as cooperative…
Following a reorganization in Building 55, please note that the Registration Service is now organised as follows : Ground floor: access cards (76903). 1st floor : registration of external firms’ personnel (76611 / 76622); car access stickers (76633); biometric registration (79710). Opening hours: 07-30 to 16-00 non-stop. GS-SEM Group General Infrastructure Services Department
As part of the upgrade of telephone services, the CERN exchange switches will be updated on Thursday 2 June between 7.00 p.m. and midnight. Telephone services may be affected and possibly even disrupted during this operation.
Sharpton, James L.
This curriculum guide provides cleaning services instructional materials for a ninth- and tenth-grade Coordinated Vocational Education and Training: Home and Community Services program. It includes 2 sections and 11 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities,…
Shimomura, Yoshiki; Tomiyama, Tetsuo
Intensification of service and knowledge contents within product life cycles is considered crucial for dematerialization, in particular, to design optimal product-service systems from the viewpoint of environmentally conscious design and manufacturing in advanced post industrial societies. In addition to the environmental limitations, we are facing social limitations which include limitations of markets to accept increasing numbers of mass-produced artifacts and such environmental and social limitations are restraining economic growth. To attack and remove these problems, we need to reconsider the current mass production paradigm and to make products have more added values largely from knowledge and service contents to compensate volume reduction under the concept of dematerialization. Namely, dematerialization of products needs to enrich service contents. However, service was mainly discussed within marketing and has been mostly neglected within traditional engineering. Therefore, we need new engineering methods to look at services, rather than just functions, called "Service Engineering." To establish service engineering, this paper proposes a modeling technique of service.
Mun, S.K.; Goeringer, F.; Benson, H.; Horii, S.C.
The completion of a comprehensive picture archiving and communication system (PACS) at Georgetown University Hospital has allowed us to identify a number of technical, administrative, personnel, and operational issues that will affect a total digital radiology service. With a hospital-wide digital imaging network system, computer simulation of communications and storage options, and economic modeling, we have developed a feasibility study and implementation strategy for the smooth transition to a nearly filmless radiology service over the next several years. This paper describes the technical and operational requirements for various database operations, workstations (used in diagnosis, review, and education), and communications. Site and installation planning, personnel training, and transition operations are discussed
Khuziakhmetov, Anvar N.; Porchesku, Galina V.
Improving listening comprehension skills is one of the urgent contemporary educational problems in the field of second language acquisition. Understanding how L2 listening comprehension works can have a serious influence on language pedagogy. The aim of the paper is to discuss the practical and methodological value of the notion of the perception…
Georgiou, George K.; Das, J. P.
The present study aimed to examine the nature of the working memory and general cognitive ability deficits experienced by university students with a specific reading comprehension deficit. A total of 32 university students with poor reading comprehension but average word-reading skills and 60 age-word-matched controls with no comprehension…
Kruger, Evonne J.; Holtzman, Diane M.; Dagavarian, Debra A.
There are many types of student portfolios used within academia: the prior learning portfolio, credentialing portfolio, developmental portfolio, capstone portfolio, individual course portfolio, and the comprehensive education portfolio. The comprehensive education portfolio (CEP), as used by the authors, is a student portfolio, developed over…
Of specific concern is the lack of representation of the sampled South African learners at the PIRLS international benchmarks, revealing a distinct lack of their development of thinking and reasoning abilities for reading comprehension. To shed light on potential reasons for learners' reading comprehension difficulties, this ...
Aydin, Burcu; Barin, Muzaffer; Yagiz, Oktay
Brain damaged participants offer an opportunity to evaluate the cognitive and linguistic processes and make assumptions about how the brain works. Cognitive linguists have been investigating the underlying mechanisms of idiom comprehension to unravel the ongoing debate on hemispheric specialization in figurative language comprehension. The aim of…
Kashani, Ahmad Sabouri; Sajjadi, Samad; Sohrabi, Mohammad Reza; Younespour, Shima
The fact that visual aids such as pictures or graphs can lead to greater comprehension by language learners has been well established. Nonetheless, the order of presenting visuals to listeners is left unattended. This study examined listening comprehension from a strategy of introducing visual information, either prior to or during an audio…
American Association of Colleges for Teacher Education, Washington, DC.
Since 1992, AACTE and the DeWitt Wallace-Reader's Digest Fund have worked in partnership to advance the knowledge base of comprehensive teacher education. The AACTE/DeWitt Wallace-Reader's Digest Fund's Comprehensive Teacher Education National Demonstration Project is grounded in the mutual belief that preparation of classroom teachers must…
This study used both quantitative and qualitative methods to explore the role of lower- and higher-level language skills in classical Chinese (CC) text comprehension. A CC word and sentence translation test, text comprehension test, and questionnaire were administered to 393 Secondary Four students; and 12 of these were randomly selected to…
... of proposed waivers were supportive of the Comprehensive Centers program and the proposed waivers... Department to continue promoting this shared oversight by involving OSERS leadership in deliberations about... identification of the valuable contribution of OSERS leadership in supporting the Comprehensive Centers program...
At the same time research shows that little, if any, explicit and continuous strategy instruction takes place in classrooms. Reasons seem ... This article reports on the effect of a reading comprehension instruction course on university student teachers' lesson planning, strategy use and views about comprehension instruction.
Hersbach, S.; Denessen, E.J.P.G.; Droop, W.
Aim: In this study an attempt was made to give insight in the way reading comprehension is taught in Sierra Leone. Attention was paid to the didactical strategies and the materials used during reading comprehension instruction. Methodology: Primary school teachers in Sierra Leone (N=43) were
Essens, P.J.M.D.; Thompson, M.T.; Karrasch, A.; Jermalavičius, J.
The Comprehensive Approach (CA) to crisis management operations is an essential element in NATO’s transformation in modern operations. At the Bucharest Summit in April 2008, Allied leaders endorsed an Action Plan for the development and implementation of NATO’s contribution to a Comprehensive
Hospitals and health systems that wish to explore the shift to comprehensive care management should: Assess the investments in infrastructure necessary to support comprehensive care management, Gauge the financial implications and set quality and financial goals, Monitor performance using metrics such as patient satisfaction, avoidable admissions, out-of-group referrals, and average length of stay.
Nebraska's Coordinating Commission for Postsecondary Education, 2016
The constitution and statutes of Nebraska assign the Coordinating Commission for Postsecondary Education the responsibility for comprehensive planning for postsecondary education in Nebraska. The purpose of the "Comprehensive Plan for Postsecondary Education" is to provide direction for the future of postsecondary education in Nebraska.…
Full Text Available Provision of ubiquitous healthcare solutions which provide healthcare services at anytime anywhere has become more favorable nowadays due to the emphasis on healthcare awareness and also the growth of mobile wireless technologies. Following this approach, an Android™ smart phone device is proposed as a mobile monitoring terminal to observe and analyze ECG (electrocardiography waveforms from wearable ECG devices in real time under the coverage of a wireless sensor network (WSN. The exploitation of WSN in healthcare is able to substitute the complicated wired technology, moving healthcare away from a fixed location setting. As an extension to the monitoring scheme, medicine care is taken into consideration by utilizing the mobile phone as a barcode decoder, to verify and assist out-patients in the medication administration process, providing a better and more comprehensive healthcare service.
Schultz, Susan E; Glazier, Richard H
Given the changing landscape of primary care, there may be fewer primary care physicians available to provide a broad range of services to patients of all age groups and health conditions. We sought to identify physicians with comprehensive primary care practices in Ontario using administrative data, investigating how many and what proportion of primary care physicians provided comprehensive primary care and how this changed over time. We identified the pool of active primary care physicians in linked population-based databases for Ontario from 1992/93 to 2014/15. After excluding those who saw patients fewer than 44 days per year, we identified physicians as providing comprehensive care if more than half of their services were for core primary care and if these services fell into at least 7 of 22 activity areas. Physicians with 50% or less of their services for core primary care but with more than 50% in a single location or type of service were identified as being in focused practice. In 2014/15, there were 12 891 physicians in the primary care pool: 1254 (9.7%) worked fewer than 44 days per year, 1619 (12.6%) were in focused practice, and 1009 (7.8%) could not be classified. The proportion in comprehensive practice ranged from 67.5% to 74.9% between 1992/93 and 2014/15, with a peak in 2002/03 and relative stability from 2009/10 to 2014/15. Over this period, there was an increase of 8.8% in population per comprehensive primary care physician. We found that just over two-thirds of primary care physicians provided comprehensive care in 2014/15, which indicates that traditional estimates of the primary care physician workforce may be too high. Although implementation will vary by setting and available data, this approach is likely applicable elsewhere. Copyright 2017, Joule Inc. or its licensors.
Afolabi, Muhammed O; Okebe, Joseph U; McGrath, Nuala; Larson, Heidi J; Bojang, Kalifa; Chandramohan, Daniel
Previous reviews on participants' comprehension of informed consent information have focused on developed countries. Experience has shown that ethical standards developed on Western values may not be appropriate for African settings where research concepts are unfamiliar. We undertook this review to describe how informed consent comprehension is defined and measured in African research settings. We conducted a comprehensive search involving five electronic databases: Medline, Embase, Global Health, EthxWeb and Bioethics Literature Database (BELIT). We also examined African Index Medicus and Google Scholar for relevant publications on informed consent comprehension in clinical studies conducted in sub-Saharan Africa. 29 studies satisfied the inclusion criteria; meta-analysis was possible in 21 studies. We further conducted a direct comparison of participants' comprehension on domains of informed consent in all eligible studies. Comprehension of key concepts of informed consent varies considerably from country to country and depends on the nature and complexity of the study. Meta-analysis showed that 47% of a total of 1633 participants across four studies demonstrated comprehension about randomisation (95% CI 13.9-80.9%). Similarly, 48% of 3946 participants in six studies had understanding about placebo (95% CI 19.0-77.5%), while only 30% of 753 participants in five studies understood the concept of therapeutic misconception (95% CI 4.6-66.7%). Measurement tools for informed consent comprehension were developed with little or no validation. Assessment of comprehension was carried out at variable times after disclosure of study information. No uniform definition of informed consent comprehension exists to form the basis for development of an appropriate tool to measure comprehension in African participants. Comprehension of key concepts of informed consent is poor among study participants across Africa. There is a vital need to develop a uniform definition for
Department of Housing and Urban Development — CDBG activity related to public services, including senior services, legal services, youth services, employment training, health services, homebuyer counseling, food...
BNF is the UK nuclear industry's representative organisation and its membership is inclusive of the entire civil nuclear industry in the Britain. BNF members include Britain's two nuclear electricity generating companies, Nuclear Electric and Scottish Nuclear, who between them manage the seventeen nuclear power stations which provide approximately 20% of the country's generating capacity. An important role of the Forum is to act as the information centre for the industry as a whole and during 1992, the Forum has strengthened its information service with the setting up of an extensive, computer-based network. The network has been established to provide an effective way of managing UK domestic nuclear-related issues and for maximising the news value of our industry's achievements. Equally important is the service's role as an international source of information - particularly when nuclear incidents occur outside the UK. The Forum also acts as an international exchange centre, disseminating technical information, for example, and by promptly providing accurate and comprehensive information to minimise the potential damage to public confidence in nuclear power generation which may be caused by any reported nuclear incidents. Recent examples of the successful operation of the BNF information service and its communications network have been the Leningradskya incident in March 1992 and the hurricane Andrew situation which developed at the end of August 1992
Department of Homeland Security — Means of delivering value to customers by facilitating outcomes customers want to achieve without the ownership of specific costs and risks. The term 'service' is...
Steen, M.W.A.; Iacob, Maria Eugenia; Lankhorst, M.M.; Jonkers, H.; Zoet, M.; Engelsman, W.; Versendaal, J.; Proper, H.A.; Debije, L.; Gaaloul, K.; Lankhorst, M.
The development of enterprise services involves making design decisions at different levels, ranging from strategic to infrastructural choices, and concerning many different aspects, ranging from customer interaction to information registration concerns. In order to support an agile development
The Comprehensive Nuclear Test-Ban Treaty was adopted by the General Assembly on 10 September 1996 (Res/50/245) and was open for signature by all states on 24 September 1996. It will enter into force 180 days after the date of deposit of the instruments of ratification by all states listed in Annex 2 to the Treaty. This document reproduces the text of the Treaty and the Protocol to the Comprehensive Nuclear Test-Ban Treaty Protocol to the Comprehensive Nuclear Test-Ban Treaty
Adriana Benevides Soares
Full Text Available A question of interest for educational workers is the reading comprehension process, a fundamental ability for progress in more advanced years of schooling, and its effect on pedagogical practices. This is a study that explores this question. A reading comprehension instrument composed by four structural levels of text and a scale of pedagogical practice composed by four sub-scales involving: cognitive practices with linguistic focus, cognitive practices, affective and motor practices, continuous education, was used. The results of 53 children suggest a slight tendency of teacher to prioritize cognitive practices independently of their reading comprehension level.
The Comprehensive Nuclear Test-Ban Treaty was adopted by the General Assembly on 10 September 1996 (Res/50/245) and was open for signature by all states on 24 September 1996. It will enter into force 180 days after the date of deposit of the instruments of ratification by all states listed in Annex 2 to the Treaty. This document reproduces the text of the Treaty and the Protocol to the Comprehensive Nuclear Test-Ban Treaty Protocol to the Comprehensive Nuclear Test-Ban Treaty. 4 tabs.
... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R1-R-2010-N160; 1265-0000-10137-S3] Pearl Harbor National Wildlife Refuge, Honolulu County, HI; Comprehensive Conservation Plan and... Kamehameha Highway, Room 2C, Hale`iwa, HI 96712. Alternatively, you may fax comments to the refuge at (808...
Acknowledgments Contact Acknowledgments Related GAO Products Page 75 GAO-16-378 DOD Overseas Absentee Voting U.S. Postal Service: Actions... Products Page 76 GAO-16-378 DOD Overseas Absentee Voting Election Reform: Nine States’ Experiences Implementing Federal Requirements for...ELECTIONS DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges
... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R5-R-2011-N043; BAC-4311-K9-S3] Stewart B. McKinney National Wildlife Refuge, Middlesex County, CT; Comprehensive Conservation Plan and... headquarters located in Middlesex County, CT. This notice complies with our CCP policy to: (1) Advise other...
Gutu, Gabriel; Dascalu, Mihai; Trausan-Matu, Stefan; Dessus, Philippe
In this paper we introduce the online version of our ReaderBench framework, which includes multi-lingual comprehension-centered web services designed to address a wide range of individual and collaborative learning scenarios, as follows. First, students can be engaged in reading a course
including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations...2% Movember-Prostate Cancer Foundation $250,000/yr Challenge Award Interrogating DNA Repair Defects to Improve Management...Improve Treatment for Advanced Prostate Cancer Goal(s): Comprehensively interrogate DNA repair alterations in both AR-positive and AR-negative CRPC
This article considers equivalency recognition for goods and for services in the context of the applicable WTO agreements and provisions. The discussion of equivalency arises from certain elements presented by the Canada-EU Comprehensive Trade Agreement (CETA), in which economically developed
Julia Ann Fleming
Full Text Available BACKGROUND: There are few reports of the use of the lidocaine 5% patch (L5%P for neuropathic pain (NP in the cancer patient. Within a comprehensive cancer centre, L5%P has been prescribed by the Pain and Palliative Care Service (Peter McCallum Cancer Centre, East Melbourne, Victoria, Australia for selected patients with NP since 2001.
Shuchi Sharma; Rupendra Prakash Yadav.
Goods and Service Tax is a significant and logical step towards a comprehensive Indirect tax reform in India. This paper analyses the concept of Goods Service Tax and further discusses their impact on the various sectors in India. Brief description is given on Goods Service Tax background and Goods and Service Tax models helps to reduce tax burden. It aims at creating a single and unified market benefiting both corporate and economy because this is the only Indirect tax that directly affects ...
This paper reviews different major service quality concept and models which led to great developments in evaluating service quality with focusing on improvement process of the models through discussing criticisms of each model. Criticisms against these models are discussed to clarify development steps of newer models which led to the improvement of airline service quality models. The precise and accurate evaluation of service quality needs utilizing a reliable concept with comprehensive crite...
Shi , Xiaohui; Chen , Tian’en
International audience; According to characteristics of tea industry information service, this paper have built service quality evaluation index system for tea industry information service quality, R-cluster analysis and multiple regression have been comprehensively used to contribute evaluation model with a high practice and credibility. Proved by the experiment, the evaluation model of information service quality has a good precision, which has guidance significance to a certain extent to e...
National Oceanic and Atmospheric Administration, Department of Commerce — This data represents geographic terms used within the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). CERCLA, commonly known as...
"The Maryland State Highway Administration (SHA) has initiated major planning efforts to improve transportation : efficiency, safety, and sustainability on critical highway corridors through its Comprehensive Highway Corridor : (CHC) program. This pr...
Blom, Helen; Segers, Eliane; Knoors, Harry; Hermans, Daan; Verhoeven, Ludo
This study aims to investigate secondary school students' reading comprehension and navigation of networked hypertexts with and without a graphic overview compared to linear digital texts. Additionally, it was studied whether prior knowledge, vocabulary, verbal, and visual working memory moderated
Despite the increasing importance of comprehensive corridor management at the state and local government level, questions remain regarding effective methods for developing and implementing corridor management plans. Further insight is also needed int...
teaching practices for reading comprehension development from case study schools with achievement profiles at the PIRLS international .... who can understand the plot, character, setting, point of view ...... A teacher's handbook. Pretoria: DoE.
The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multi-center collaborations.
Sommers, Mitchell S; Hale, Sandra; Myerson, Joel; Rose, Nathan; Tye-Murray, Nancy; Spehar, Brent
Although age-related declines in perceiving spoken language are well established, the primary focus of research has been on perception of phonemes, words, and sentences. In contrast, relatively few investigations have been directed at establishing the effects of age on the comprehension of extended spoken passages. Moreover, most previous work has used extreme-group designs in which the performance of a group of young adults is contrasted with that of a group of older adults and little if any information is available regarding changes in listening comprehension across the adult lifespan. Accordingly, the goals of the current investigation were to determine whether there are age differences in listening comprehension across the adult lifespan and, if so, whether similar trajectories are observed for age-related changes in auditory sensitivity and listening comprehension. This study used a cross-sectional lifespan design in which approximately 60 individuals in each of 7 decades, from age 20 to 89 yr (a total of 433 participants), were tested on three different measures of listening comprehension. In addition, we obtained measures of auditory sensitivity from all participants. Changes in auditory sensitivity across the adult lifespan exhibited the progressive high-frequency loss typical of age-related hearing impairment. Performance on the listening comprehension measures, however, demonstrated a very different pattern, with scores on all measures remaining relatively stable until age 65 to 70 yr, after which significant declines were observed. Follow-up analyses indicated that this same general pattern was observed across three different types of passages (lectures, interviews, and narratives) and three different question types (information, integration, and inference). Multiple regression analyses indicated that low-frequency pure-tone average was the single largest contributor to age-related variance in listening comprehension for individuals older than 65 yr, but
Growing evidence indicates that international trade in healthcare services is growing. Nevertheless, a major literature gap exists with regard to the nature of international healthcare trade and its extent. Taking a comprehensive approach, this research examines the magnitude, directions, patterns of specialisation, growth and other aspects related to international trade in healthcare services. Within this framework, trade is analysed with regard to cross border trade, consumption of healthca...
Dahl, Hanne Marlene; Fahnøe, Kristian
European welfare systems are under increasing pressure to transform and adapt to the present and future challenges of our globalized world. This is especially true of the comprehensive field of health, welfare and informal education services –that we will all use at one point or another during ou......, (4) The governance of social service innovation, (5) The influence of national, regional and local contexts, (6) New technologies, (7) Measuring outcomes, quality and challenges....
Sfafi'i, Muhammad Lukman
Reading as one of language skills plays significant roles in the teaching English as a foreign language. Since the teacher still uses the conventional way to teach reading, students‘ ability in reading comprehension seems still unsatisfactory yet. So, teacher should explore and develop new strategies. One of strategies in reading comprehension that can trigger our students to attain that purpose is SMART (Self Monitoring Approach for Reading and Thinking) strategy. ...
A history of the development of rotorcraft comprehensive analyses is presented. Comprehensive analyses are digital computer programs that calculate the aeromechanical behavior of the rotor and aircraft, bringing together the most advanced models of the geometry, structure, dynamics, and aerodynamics available in rotary wing technology. The development of the major codes of the last five decades from industry, government, and universities is described. A number of common themes observed in this history are discussed.
Kempler, D; Van Lancker, D; Read, S
Twenty-nine patients diagnosed with Probable Alzheimer Disease were administered tests of word, familiar phrases (idioms and proverbs), and novel phrase comprehension. From the early stage of the disease, patients performed worse at understanding familiar phrases than single words or novel phrases. The results uphold common observations that AD patients have difficulty interpreting abstract meanings. Cognitive variables responsible for poor idiom/proverb comprehension and the clinical implications of this new protocol are discussed.
Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H
Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats. © 2011 New York Academy of Sciences.
Fuchs, Lynn S.; Fuchs, Douglas; Compton, Donald L.; Hamlett, Carol L.; Wang, Amber Y.
This study's hypotheses were that (a) word-problem (WP) solving is a form of text comprehension that involves language comprehension processes, working memory, and reasoning, but (b) WP solving differs from other forms of text comprehension by requiring WP-specific language comprehension as well as general language comprehension. At the start of…
Lv, Jie; Guo, Jianmin; Li, Jin
integrated transport hub or high-speed rail station often talked about, often known as the “city portal” and the title of “city window”, so the comprehensive transportation hub or the high-speed rail station of a city is very important to a region or a provincial. At the same time, it reflects that the managers and users of a city only focus on the comprehensive transportation hub of transportation service function and ignore her cities attributes and functions. Jinan east district comprehensive transportation hub in the beginning of design is given a feature that it has to serve both the traffic and city. We are trying to build a new center for Jinan east new town, the window to welcome people, the city hall of hospitality.
Charnay, J.; Chosson, L.; Croize, M.; Ducloux, A.; Flores, S.; Jarroux, D.; Melka, J.; Morgue, D.; Mottin, C.
This service assures the treatment and diffusion of the scientific information and the management of the scientific production of the institute as well as the secretariat operation for the groups and services of the institute. The report on documentation-library section mentions: the management of the documentation funds, search in international databases (INIS, Current Contents, Inspects), Pret-Inter service which allows accessing documents through DEMOCRITE network of IN2P3. As realizations also mentioned are: the setup of a video, photo database, the Web home page of the institute's library, follow-up of digitizing the document funds by integrating the CD-ROMs and diskettes, electronic archiving of the scientific production, etc
Grytten, J; Sørensen, R
Dental services for adults are different from all other Norwegian health services in that they are provided by private producers (dentists) who have full freedom to establish a practice. They have had this freedom since the end of World War II. A further liberalization of the market for dental services occurred in November 1995, when the so-called normal tariff was repealed. The system changed from a fixed fee system to a deregulated fee system. In principle, the market for dental services for adults operates as a free competitive market, in which dentists must compete for a market share. The aim of this study was to study the short-term effects of competition. A comprehensive set of data on fees, practice characteristics, treatment profiles and factors that dentists take into account when determining fees was analysed. The main finding was that competition has a weak effect. No support was found for the theory that the level of fees is the result of monopolistic competition or monopoly. The results also provided some evidence against the inducement hypothesis. At this stage, it is interesting to notice that dentists do not seem to exploit the power they have to control the market. One explanation, which is consistent with the more recent literature, is that physicians' behaviour to a large extent is influenced by professional norms and caring concerns about their patients. Financial incentives are important, but these incentives are constrained by norms other than self-interest. The interpretation of the results should also take into account that the deregulation has operated for a short time and that dentists and patients may not yet have adjusted to changes in the characteristics of the market. Copyright 2000 John Wiley & Sons, Ltd.
T. N. Van der Linde
Full Text Available Purpose: Shared services is a viable business model that can be used by organisations to reduce costs and enhance efficiency and effectiveness in the organisation. The purpose of this trilogy of articles is to introduce shared services as a business model, and how to efficiently and effectively manage a shared services business unit. The purpose of the first article in the trilogy, introduces shared services as a business model, defines what shared services is, the transformation required to successfully implement a shared services business model, as well as the benefits that can be derived from implementing a shared services business model. Methodology: A comprehensive literature study was conducted in order to: - Define and describe shared services as a business model, - Compare shared services with centralisation and de-centralisation, - Determine and describe the transformation required to successfully implement shared services. Findings: In the article, a framework is generated to help organisations understand the business concept of shared services. This work has further potential: when applied correctly, there are both tangible and intangible benefits that can be accrued above cost savings. Implications: The findings of this article are important for organisations that are in the process of implementing or have implemented shared services, as it will assist the organisation in determining if shared services is the correct business model for them to implement. Value: This article provides an understanding of shared services and the business environment required to successfully implement a shared services business model. Value created by a shared services business model is further enhanced once the organisation has embarked on the successful implementation of a shared services business model, which is the primary objective of the second article, Implementation and continuous evolution in shared services.
Jie, Wei; Chen, Jinjun
Offering a comprehensive discussion of advances in grid computing, this book summarizes the concepts, methods, technologies, and applications. It covers topics such as philosophy, middleware, architecture, services, and applications. It also includes technical details to demonstrate how grid computing works in the real world
Department of Veterans Affairs — This Service provides access to Tramatic Brain injury patient data consult notes. The service also provides one write service method writeNote. The Service supports...
Tuesday 19 October 2004 Please note that the distribution and collection of mail are likely to be disrupted on Tuesday, October 19, 2004, because of traffic and other restrictions enforced on that day in connection with CERN's fiftieth anniversary celebrations. The service may be completely interrupted in certain areas. Group TS-FM, Tel. 77551
Briti ettevõttest International Financial Services, mis viib maailmas läbi kampaaniat PPP (Public Private Partnership) ja PFI (Private Finance Initiative) - erasektori ja avaliku sektori vahelise koostöö reklaamimiseks ja edendamiseks. Firma esindajad kohtusid Eesti ametnikega
Please remember to read your dosimeter at least once a month. Regular read-outs are vital to ensure that your personal dose is periodically monitored. Dosimeters should be read even if you have not visited the controlled areas. Dosimetry Service - Tel. 7 2155 http://cern.ch/rp-dosimetry
Please remember to read your dosimeter at least once a month. Regular read-outs are vital to ensure that your personal dose is periodically monitored. Dosimeters should be read even if you have not visited the controlled areas. Dosimetry Service Tel. 7 2155 http://cern.ch/rp-dosimetry
Please remember to read your dosimeter at least once a month. Regular read-outs are vital to ensure that your personal dose is periodically monitored. Dosimeters should be read even if you have not visited the controlled areas. Dosimetry Service - Tel. 72155 http://cern.ch/rp-dosimetry
Wingerden-Fontein, E.G. van; Segers, P.C.J.; Balkom, L.J.M. van; Verhoeven, L.T.W.
Background Knowledge about predictors for reading comprehension in children with intellectual disabilities (ID) is still fragmented. Aims This study compared reading comprehension, word decoding, listening comprehension, and reading related linguistic and cognitive precursor measures in children
Fuchs, Lynn S.; Fuchs, Douglas; Compton, Donald L.; Hamlett, Carol L.; Wang, Amber Y.
This study’s hypotheses were that (a) word-problem (WP) solving is a form of text comprehension that involves language comprehension processes, working memory, and reasoning, but (b) WP solving differs from other forms of text comprehension by requiring WP-specific language comprehension as well as general language comprehension. At the start of the 2nd grade, children (n = 206; on average, 7 years, 6 months) were assessed on general language comprehension, working memory, nonlinguistic reasoning, processing speed (a control variable), and foundational skill (arithmetic for WPs; word reading for text comprehension). In spring, they were assessed on WP-specific language comprehension, WPs, and text comprehension. Path analytic mediation analysis indicated that effects of general language comprehension on text comprehension were entirely direct, whereas effects of general language comprehension on WPs were partially mediated by WP-specific language. By contrast, effects of working memory and reasoning operated in parallel ways for both outcomes. PMID:25866461
McTigue, Erin; Douglass, April; Wright, Katherine L.; Hodges, Tracey S.; Franks, Amanda D.
Inferential comprehension requires both emotional intelligence and cognitive skills, however instructional comprehension strategies typically underemphasize the emotional contribution. This article documents an intervention used by diverse third grade students which centers on teaching story comprehension through character perspective-taking…
Fynes, Brian; Lally, Anne Marie
ABSTRACT Identifying the nature of service experiences is recognised As being of primary importance in the shaping of an enhanced competitive position for industry; however service managers often have difficulty articulating the true nature of their service concept. The definition of service concept is a fundamental part of the strategic advantage seeking Processes of service design, service development and service innovation. In response to the competitive Imperative for improved product/...
V, Vignesh; Suresh, M.; Aramvalarthan, S.
Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.
Gefke, Gardell G.; Janas, Alex; Pellegrino, Joseph; Sammons, Matthew; Reed, Benjamin
NASA's Satellite Servicing Capabilities Office (SSCO) has matured robotic and automation technologies applicable to in-space robotic servicing and robotic exploration over the last six years. This paper presents the progress of technology development activities at the Goddard Space Flight Center Servicing Technology Center and on the ISS, with an emphasis on those occurring in the past year. Highlighted advancements are design reference mission analysis for servicing in low Earth orbit (LEO) and asteroid redirection; delivery of the engineering development unit of the NASA Servicing Arm; an update on International Space Station Robotic Refueling Mission; and status of a comprehensive ground-based space robot technology demonstration expanding in-space robotic servicing capabilities beginning fall 2015.
Asbjørnsen, Arve E; Helland, Turid
Dichotic listening performance is considered a reliable and valid procedure for the assessment of language lateralisation in the brain. However, the documentation of a relationship between language functions and dichotic listening performance is sparse, although it is accepted that dichotic listening measures language perception. In particular, language comprehension should show close correspondence to perception of language stimuli. In the present study, we tested samples of reading-impaired and normally achieving children between 10 and 13 years of age with tests of reading skills, language comprehension, and dichotic listening to consonant-vowel (CV) syllables. A high correlation between the language scores and the dichotic listening performance was expected. However, since the left ear score is believed to be an error when assessing language laterality, covariation was expected for the right ear scores only. In addition, directing attention to one ear input was believed to reduce the influence of random factors, and thus show a more concise estimate of left hemisphere language capacity. Thus, a stronger correlation between language comprehension skills and the dichotic listening performance when attending to the right ear was expected. The analyses yielded a positive correlation between the right ear score in DL and language comprehension, an effect that was stronger when attending to the right ear. The present results confirm the assumption that dichotic listening with CV syllables measures an aspect of language perception and language skills that is related to general language comprehension.
Corsetti, Cristiane Ruzicki
Full Text Available This article addresses the role of strategy-based listening as an alternative methodological approach to develop pragmatic comprehension in L2 contexts. Pragmatic comprehension refers to the understanding of speech acts and conversational implicatures. Listening comprehension comprises both bottom-up and top-down processes. Strategy-based listening encompasses the activation of pragmatic knowledge through pre-listening activities and the development of specific listening micro-skills. An empirical project which included a classroom project carried out with a group of eight learners preparing for the IELTS examination in 2009 corroborated the following assumptions: in order to achieve listening proficiency, learners need practice in making inferences as semantic and pragmatic inferences are embedded in verbal communication; semantic and pragmatic aspects affecting the meaning of utterances can be highlighted via comprehension activities focusing on specific listening subskills. The results of the classroom project suggested that strategy-based listening is potentially capable of directly enhancing pragmatic comprehension but were inconclusive with regards to pragmatic production
Nguyen, My H Ng; Gammeltoft, Tine; Rasch, Vibeke
observations. Both the women and the staff equated quality of care mainly with improved technical performance of abortion. Insufficient knowledge and skills had a negative impact on provision of information and good quality counselling in relation to understanding and uptake of contraception, treating...
Burigo, Michele; Sacchi, Simona
Typical spatial descriptions, such as "The car is in front of the house," describe the position of a located object (LO; e.g., the car) in space relative to a reference object (RO) whose location is known (e.g., the house). The orientation of the RO affects spatial language comprehension via the reference frame selection process. However, the effects of the LO's orientation on spatial language have not received great attention. This study explores whether the pure geometric information of the LO (e.g., its orientation) affects spatial language comprehension using placing and production tasks. Our results suggest that the orientation of the LO influences spatial language comprehension even in the absence of functional relationships. Copyright © 2013 Cognitive Science Society, Inc.
To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.
Arnold, Jennifer E.; Lao, Shin-Yi C.
Pronoun comprehension is facilitated for referents that are focused in the discourse context. Discourse focus has been described as a function of attention, especially shared attention, but few studies have explicitly tested this idea. Two experiments used an exogenous capture cue paradigm to demonstrate that listeners’ visual attention at the onset of a story influences their preferences during pronoun resolution later in the story. In both experiments trial-initial attention modulated listeners’ transitory biases while considering referents for the pronoun, whether it was in response to the capture cue or not. These biases even had a small influence on listeners’ final interpretation of the pronoun. These results provide independently-motivated evidence that the listener’s attention influences the on-line processes of pronoun comprehension. Trial-initial attentional shifts were made on the basis of non-shared, private information, demonstrating that attentional effects on pronoun comprehension are not restricted to shared attention among interlocutors. PMID:26191533
Shyu, Yea-Ing L; Liang, Jersey; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen
Few studies have investigated the effects of care models that combine interdisciplinary care with nutrition consultation, depression management, and fall prevention in older persons with hip fracture. The purpose of this study was to compare the effects of a comprehensive care program with those of interdisciplinary care and usual care for elderly patients with hip fracture. A randomized experimental trial was used to explore outcomes for 299 elderly patients with hip fracture receiving three treatment care models: interdisciplinary care (n = 101), comprehensive care (n = 99), and usual care (n = 99). Interdisciplinary care included geriatric consultation, continuous rehabilitation, and discharge planning with post-hospital services. Comprehensive care consisted of interdisciplinary care plus nutrition consultation, depression management, and fall prevention. Usual care included only in-hospital rehabilitation without geriatric consultation, in-home rehabilitation, and home environmental assessment. Participants in the comprehensive care group had better self-care ability (odds ratio, OR = 3.19, p malnutrition (OR = 0.48, p hip fracture benefitted more from the comprehensive care program than from interdisciplinary care and usual care. Older persons with hip fracture benefitted more from comprehensive care including interdisciplinary care and nutrition consultation, depression management, and fall prevention than simply interdisciplinary care.
Dr. Sreemoyee Guha Roy
Goods and Services Tax is a broad based and a single comprehensive tax levied on goods and services consumed in an economy. GST is levied at every stage of the production-distribution chain with applicable set offs in respect of the tax remitted at previous stages. It is basically a tax on final consumption. The Goods and Services Tax (GST) is a value added tax to be implemented in India, the decision on which is pending. GST is the only indirect tax that directly affects all sectors and sect...
Erstad, Brian L; Mann, Henry J; Weber, Robert J
Critical care medicine has grown from a small group of physicians participating in patient care rounds in surgical and medical intensive care units (ICUs) to a highly technical, interdisciplinary team. Pharmacy's growth in the area of critical care is as exponential. Today's ICU requires a comprehensive pharmaceutical service that includes both operational and clinical services to meet patient medication needs. This article provides the elements for a business plan to justify critical care pharmacy services by describing the pertinent background and benefit of ICU pharmacy services, detailing a current assessment of ICU pharmacy services, listing the essential ICU pharmacy services, describing service metrics, and delineating an appropriate timeline for implementing an ICU pharmacy service. The structure and approach of this business plan can be applied to a variety of pharmacy services. By following the format and information listed in this article, the pharmacy director can move closer to developing patient-centered pharmacy services for ICU patients.
Purpose: The paper aims to provide an overall methodology and case study for the innovation and extension of a digital library, especially the service system. Design/methodology/approach: Based on the three-dimensional structure theory of the information service industry, this paper combines a comprehensive analysis with the practical experiences…
Utah State Board of Education, Salt Lake City.
Evaluations of food service equipment, kitchen design and food service facilities are comprehensively reviewed for those concerned with the planning and equipping of new school lunchrooms or the remodeling of existing facilities. Information is presented in the form of general guides adaptable to specific local situations and needs, and is…
Kettunen, Jaana; Vuorinen, Raimo; Sampson, James P., Jr.
This article reports the outcomes of a study, undertaken from a phenomenographic perspective, of career practitioners' conceptions of social media usage in career services. Fifteen Finnish career practitioners--representing comprehensive, secondary and higher education as well as public employment services--were interviewed in focus groups. The…
Support Services As part of the comprehensive care provided at the NCI Pediatric Oncology Branch, we provide a wide range of services to address the social, psychological, emotional, and practical facets of pediatric cancer and to support patients and families while they are enrolled in clinical research protocols.
Nix, Mary P.
There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…
Hollensen, Svend; Grünbaum, Niels Nolsøe; Andresen, Marc
Early B2B buying-behavior literature strongly emphasizes the rational aspects of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies ...
This book presents the state of the art of the Network-as-a-Service (NaaS) paradigm, including its concepts, architecture, key technologies, applications, and development directions for future network service provisioning. It provides a comprehensive reference that reflects the most current technical developments related to NaaS.
Bardoel, J.L.H.; d'Haenens, L.S.J.
New information technologies, liberalizing policies and rapidly changing societies – from mono- to multicultural – entail serious consequences for the prospects of European public service broadcasters in a network society. The European concept of PSB as a comprehensive and universal service is
Naiyan, Yu; And Others
Describes the Chemical Integrated Information Service Network (ChI2Net), a comprehensive online information service system which includes chemical, technical, economic, market, news, and management information based on computer and modern communication technology that was built by the China National Chemical Information Centre. (Author/LRW)
In the ever-growing world of technology, it is becoming more important to understand the developments of new electronic services and mobile applications. Innovative Mobile Platform Developments for Electronic Services Design, and Delivery is a comprehensive look at all aspects of production manag...
This paper provides a comprehensive review on the concept of relationship marketing in the service sector of Mauritius, its foundation as well as its development. The various implications of using market segmentation and customer loyalty in these service companies as relational strategies are also discussed. The research ...
In this video-films services of the VUJE, a. s. are presented. The company VUJE provides reconstruction and modernization of nuclear installations, research, development and production of equipment for nuclear power plants and electric industry, development of diagnostic methods, training on simulator of reactor, increase of reactor safety, preparation of documentation about NPP for the Nuclear Regulatory Authority of the Slovak Republic, measures for radiation protection and protection of the environment as well as development and application of information technologies.
Edele, Aileen; Stanat, Petra
Although the simple view of reading and other theories suggest that listening comprehension is an important determinant of reading comprehension, previous research on linguistic transfer has mainly focused on the role of first language (L1) decoding skills in second language (L2) reading. The present study tested the assumption that listening…
Why do secondary school students differ in their text comprehension? This is an important question because many secondary school students are unable to achieve the level of text comprehension required to enable learning from their school book texts. This thesis contributes to answering this question
Edna Constanza García Melo
Full Text Available This paper narrates an educational experience during the Diploma course on Teacher Education Program in Reading Comprehension, aimed at teachers of public sector colleges in the municipalities of Castilla, Coyaima and guamo, located south of the department of Tolima. The program was organized by the Office of Departmental Education and the University of Ibague. Schools that took part in this experience were chosen because of their low historical results on the Icfes and Saber Tests. To develope the module on virtual tools oriented education participant teachers created blogs of their subjects or their workspaces. A conclusion out of this experience was that institutions should incorporate the use of ICT for teaching and visualize their pedagogical proposals and provide their school community with the opportunity to know and enjoy the benefits of technology in the service of education.
Even as newer cellular technologies and standards emerge, many of the fundamental principles and the components of the cellular network remain the same. Presenting a simple yet comprehensive view of cellular communications technologies, Cellular Communications provides an end-to-end perspective of cellular operations, ranging from physical layer details to call set-up and from the radio network to the core network. This self-contained source forpractitioners and students represents a comprehensive survey of the fundamentals of cellular communications and the landscape of commercially deployed
... empowerment activities. A Service Coordinator ensures that program participants are linked to the supportive.... Kokua Kalihi Valley Comprehensive 2239 North School Street, 365,623 Family Services. Honolulu, HI 96819...
Full Text Available Background: Goods distribution by containers has opened new opportunities for them in the global supply chain network. Standardization of transportation units allow to simplify transport logistics operations and enable the integration of different types of transport. Currently, container transport is the most popular means of transport by sea, but recent studies show an increase in its popularity in land transport. In the paper presented the concept of a comprehensive intermodal planning system in a distributed environment which enables more efficient use containers in the global transport. The aim of this paper was to formulate and develop new concept of Internet Intermodal Planning System in distribution environment, supporting the common interests of the consignors and the logistic service providers by integrating the transportation modes, routing, logistics operations and scheduling in order to create intermodal transport plans. Methods: In the paper presented and discussed the new approach to the management of logistics resources used in international intermodal transport. Detailed analysis of proposed classification of variety transportation means has been carried out along with their specific properties, which may affect the time and cost of transportation. Have been presented the modular web-based distribution planning system supporting container transportation planning. Conducted the analysis of the main planning process and curried out the discussion on the effectiveness of the new web-based container transport planning system. Result and conclusions: This paper presents a new concept of the distributed container transport planning system integrating the available on the market logistics service providers with freight exchange. Specific to container planning new transport categories has been identified which simplify and facilitate the management of intermodal planning process. The paper presents a modular structure of Integrated
The purpose of the paper is to present and evaluate the notion of service scenarios. A service is work done by a service executor in interaction with a service consumer. A service scenario is a model of a service system and the roles that are played by the actors participating and interacting...... during the execution of a service. The model represents the roles and the interactions between the participants. Service scenarios can be used to model specific services and roles played by human beings and IT systems in the execution of services. The use of service scenarios is demonstrated by means...... of a case study in a public library. The case study indicates that service systems should be understood as socio-technical systems in which service executors and service consumers co-create value in mutual interaction with each other and with a set of shared resources....
Full Text Available As the global economy becomes a service oriented economy, food service accounts for over 20% of service revenue, with an annual growth rate of more than 3%. Compared to physical products, service features are invisible, and the production and sale occurs simultaneously. There is not easy to measure the performance of service. Therefore, the service quality of catering services is considered to be an important topic of service management. According Market Intelligence & Consulting Institute (MIC to apply blog text analyzing to point out top 10 restaurants of blog in Taiwan, what it’s popular restaurant in food service industries. This paper attempts to identify both the importance and performance of restaurant service quality in the Taiwan food service industry using the SERVQUAL and IPA model. We can conclude with certainty that three methods (SERVQUAL, IF and IPA are able to explain significant amount of service quality. At the same time, the service quality factors of IPA model had more comprehensive consideration in comparison to those of SERVQUAL and IF.
Seyfarth, Robert M.; Cheney, Dorothy L.
In this review, we place equal emphasis on production, usage, and comprehension because these components of communication may exhibit different developmental trajectories and be affected by different neural mechanisms. In the animal kingdom generally, learned, flexible vocal production is rare, appearing in only a few orders of birds and few…
Food security is a multi-dimensional issue that has been difficult to measure comprehensively, given the one-dimensional focus of existing indicators. Three indicators dominate the food security measurement debate: Household Food Insecurity Access Scale (HFIAS), Dietary Diversity Score (DDS) and Coping Strategies ...
The study explains the process of learners' listening comprehension within Halliday's information theory in functional grammar, including the skills of identifying focuses while listening in college English teaching. Identifying information focuses in listening is proved to improve the students' communicative listening ability by the means of a…
Tøffner-Clausen, Lars; Sabaka, Terence; Olsen, Nils
In the framework of the ESA Earth Observation Magnetic Mapping Mission Swarm, the Expert Support Laboratories (ESL) provides high quality Level 2 Products describing a.o. the magnetic fields of the Earth. This poster provides details of the Level 2 Products from the Comprehensive Inversion chain...
Stenner, A. Jackson
This paper shows how the concept of general objectivity can be used to improve behavioral science measurement, particularly as it applies to the Lexile Framework, a tool for objectively measuring reading comprehension. It begins with a dialogue between a physicist and a psychometrician that details some of the differences between physical science…
Rafieyan, Vahid; Sharafi-Nejad, Maryam; Khavari, Zahra; Damavand, Ayoob; Eng, Lin Siew
The distance between language learners' culture and the culture of the target language community is considered to play a crucial role in determining the level of pragmatic comprehension. In this respect, a study was conducted over 30 German students, perceived as culturally close to the British, and 30 South Korean students, perceived as…
Full Text Available This study is aimed at discovering the benefits of the Reciprocal Teaching Method (RTM in the reading classroom, finding out the achievements of students after four comprehension training sessions of using RTM, and exploring the perceptions of students on the use of RTM. This method uses four comprehension strategies: predicting, questioning, clarifying, and summarizing, to help learners monitor their development of reading comprehension by themselves. Students work in groups of four or five and the members are divided into five roles which are the leader, predictor, clarifier, questioner, and summarizer. The subjects were 24 students from the twelfth grade at a high school in Banda Aceh. Observations, tests, documents and interviews were collected to get the data. The results showed that the students were more active and productive in the reading classroom after RTM sessions and their reading proficiency improved. They learnt how to apply several of the strategies from RTM while reading. The results also showed that they preferred this method for teaching-learning reading compared to the conventional one. Therefore, teachers are suggested to consider using this method for teaching reading that instils the students on how to apply the four comprehension strategies used in reading.
Grigoriadou, Maria; Tsaganou, Grammatiki; Cavoura, Theodora
The Reflective Tutorial Dialogue System (ReTuDiS) is a system for learner modelling historical text comprehension through reflective dialogue. The system infers learners' cognitive profiles and constructs their learner models. Based on the learner model the system plans the appropriate--personalized for learners--reflective tutorial dialogue in…
Storm, Susan R.
The purpose of this research was to determine young children's comprehension of selected TV program content. The subjects were 210 children in grades K-2. All subjects in groups of five, were shown segments from four TV programs: a scalloped potatoes commercial, a "Batman" and Robin episode, a news story on the MIG-25 and a segment of the…
Farhadi-Kangarlu, Mohammad; Babaei, Ebrahim; Blaabjerg, Frede
has been done in the field of DVR and the field is rather mature now. But, a survey on the published papers showed that there is not any published paper that reviews the DVR technology. This paper tends to provide a comprehensive review on the DVR topologies, control strategies and applications. We...
Comprehensive musicianship is a concept about teaching and learning music. It is an approach that suggests that the source of all musical study is the "literature" of music, and promotes the integration of all aspects of music study. This volume presents a synthesis of the philosophy and practice of 32 experimental programs based on the concept of…
Kucer, Stephen B.
This research explores the impact of flashbacks and changes in settings and narrators on reader comprehension. Individually, 34 fourth graders (9 and 10 years of age), mostly with above average reading abilities (5.0), orally read the first chapter of a novel. Both publisher and readability formulae estimated the text to be at a fourth- grade…
Barton, Janice S.
This article describes a comprehensive treatment of experimental enzyme kinetics strongly coupled to electronic data acquisition and use of spreadsheets to organize data and perform linear and nonlinear least-squares analyses, all in a manner that promotes development of important reasoning skills. Kinetic parameters are obtained for the stable…
A Comprehensive Mapping of Urinary Schistosomiasis Using Geographic Information Systems (GIS) in Kano State, Nigeria. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about ...
San Antonio Coll., TX.
The document describes San Antonio College's (Texas) strategic goals and objectives for 2000-2001. San Antonio College's comprehensive planning and evaluation process monitors the achievement of college-wide goals and initiatives supporting the college's Vision and Mission Statement and the Alamo Community College District's Strategic Plan. The…
S. Knapp (Sabine); Ph.H.B.F. Franses (Philip Hans)
textabstractThis report presents a comprehensive review of the maritime safety regimes and provides recommendations on how to improve the system. The results show a complex legal framework which generates a high amount of inspections and overlapping of inspection areas where no cross-recognition is
Fishbein, Lauren; Leshchiner, Ignaty; Walter, Vonn; Danilova, Ludmila; Robertson, A. Gordon; Johnson, Amy R.; Lichtenberg, Tara M.; Murray, Bradley A.; Ghayee, Hans K.; Else, Tobias; Ling, Shiyun; Jefferys, Stuart R.; de Cubas, Aguirre A.; Wenz, Brandon; Korpershoek, Esther; Amelio, Antonio L.; Makowski, Liza; Rathmell, W. Kimryn; Gimenez-Roqueplo, Anne Paule; Giordano, Thomas J.; Asa, Sylvia L.; Tischler, Arthur S.; Akbani, Rehan; Ally, Adrian; Amar, Laurence; Amelio, Antonio L.; Arachchi, Harindra; Asa, Sylvia L.; Auchus, Richard J.; Auman, J. Todd; Baertsch, Robert; Balasundaram, Miruna; Balu, Saianand; Bartsch, Detlef K.; Baudin, Eric; Bauer, Thomas; Beaver, Allison; Benz, Christopher; Beroukhim, Rameen; Beuschlein, Felix; Bodenheimer, Tom; Boice, Lori; Bowen, Jay; Bowlby, Reanne; Brooks, Denise; Carlsen, Rebecca; Carter, Suzie; Cassol, Clarissa A.; Cherniack, Andrew D.; Chin, Lynda; Cho, Juok; Chuah, Eric; Chudamani, Sudha; Cope, Leslie; Crain, Daniel; Curley, Erin; Danilova, Ludmila; de Cubas, Aguirre A.; de Krijger, Ronald R.; Demchok, John A.; Deutschbein, Timo; Dhalla, Noreen; Dimmock, David; Dinjens, Winand N M; Else, Tobias; Eng, Charis; Eschbacher, Jennifer; Fassnacht, Martin; Felau, Ina; Feldman, Michael; Ferguson, Martin L.; Fiddes, Ian; Fishbein, Lauren; Frazer, Scott; Gabriel, Stacey B.; Gardner, Johanna; Gastier-Foster, Julie M.; Gehlenborg, Nils; Gerken, Mark; Getz, Gad; Geurts, Jennifer; Ghayee, Hans K.; Gimenez-Roqueplo, Anne Paule; Giordano, Thomas J.; Goldman, Mary; Graim, Kiley; Gupta, Manaswi; Haan, David; Hahner, Stefanie; Hantel, Constanze; Haussler, David; Hayes, D. Neil; Heiman, David I.; Hoadley, Katherine A.; Holt, Robert A.; Hoyle, Alan P.; Huang, Mei; Hunt, Bryan; Hutter, Carolyn M.; Jefferys, Stuart R.; Johnson, Amy R.; Jones, Steven J M; Jones, Corbin D.; Kasaian, Katayoon; Kebebew, Electron; Kim, Jaegil; Kimes, Patrick; Knijnenburg, Theo; Korpershoek, Esther; Lander, Eric; Lawrence, Michael S.; Lechan, Ronald; Lee, Darlene; Leraas, Kristen M.; Lerario, Antonio; Leshchiner, Ignaty; Lichtenberg, Tara M.; Lin, Pei; Ling, Shiyun; Liu, Jia; LiVolsi, Virginia A.; Lolla, Laxmi; Lotan, Yair; Lu, Yiling; Ma, Yussanne; Maison, Nicole; Makowski, Liza; Mallery, David; Mannelli, Massimo; Marquard, Jessica; Marra, Marco A.; Matthew, Thomas; Mayo, Michael; Méatchi, Tchao; Meng, Shaowu; Merino, Maria J.; Mete, Ozgur; Meyerson, Matthew; Mieczkowski, Piotr A.; Mills, Gordon B.; Moore, Richard A.; Morozova, Olena; Morris, Scott; Mose, Lisle E.; Mungall, Andrew J.; Murray, Bradley A.; Naresh, Rashi; Nathanson, Katherine L.; Newton, Yulia; Ng, Sam; Ni, Ying; Noble, Michael S.; Nwariaku, Fiemu; Pacak, Karel; Parker, Joel S.; Paul, Evan; Penny, Robert; Perou, Charles M.; Perou, Amy H.; Pihl, Todd; Powers, James; Rabaglia, Jennifer; Radenbaugh, Amie; Ramirez, Nilsa C.; Rao, Arjun; Rathmell, W. Kimryn; Riester, Anna; Roach, Jeffrey; Robertson, A. Gordon; Sadeghi, Sara; Saksena, Gordon; Salama, Sofie; Saller, Charles; Sandusky, George; Sbiera, Silviu; Schein, Jacqueline E.; Schumacher, Steven E.; Shelton, Candace; Shelton, Troy; Sheth, Margi; Shi, Yan; Shih, Juliann; Shmulevich, Ilya; Simons, Janae V.; Sipahimalani, Payal; Skelly, Tara; Sofia, Heidi J.; Sokolov, Artem; Soloway, Matthew G.; Sougnez, Carrie; Stuart, Josh; Sun, Charlie; Swatloski, Teresa; Tam, Angela; Tan, Donghui; Tarnuzzer, Roy; Tarvin, Katherine; Thiessen, Nina; Thorne, Leigh B.; Timmers, Henri J.; Tischler, Arthur S.; Tse, Kane; Uzunangelov, Vlado; van Berkel, Anouk; Veluvolu, Umadevi; Vicha, Ales; Voet, Doug; Waldmann, Jens; Walter, Vonn; Wan, Yunhu; Wang, Zhining; Wang, Tracy S.; Weaver, Joellen; Weinstein, John N.; Weismann, Dirk; Wenz, Brandon; Wilkerson, Matthew D.; Wise, Lisa; Wong, Tina; Wong, Christopher; Wu, Ye; Yang, Liming; Zelinka, Tomas; Zenklusen, Jean C.; Zhang, Jiashan (Julia); Zhang, Wei; Zhu, Jingchun; Zinzindohoué, Franck; Zmuda, Erik; Pacak, Karel; Nathanson, Katherine L.; Wilkerson, Matthew D.
We report a comprehensive molecular characterization of pheochromocytomas and paragangliomas (PCCs/PGLs), a rare tumor type. Multi-platform integration revealed that PCCs/PGLs are driven by diverse alterations affecting multiple genes and pathways. Pathogenic germline mutations occurred in eight
Van Dyke, Julie A.; McElree, Brian
The role of interference as a primary determinant of forgetting in memory has long been accepted, however its role as a contributor to poor comprehension is just beginning to be understood. The current paper reports two studies, in which speed-accuracy tradeoff and eye-tracking methodologies were used with the same materials to provide converging…
Shiu, Ling-po; Chen, Qishan
The present study compared the effectiveness of 2 approaches to remedy the inaccuracy of self-monitoring of reading comprehension. The first approach attempts to enhance self-monitoring by strengthening the cues utilized in monitoring. The second approach replaces self-monitoring with external regulation based on objective evaluative information.…
Fahy, E.; Subramaniam, S.; Brown, H.A.; Glass, C.K.; Merrill, A.H.; Murphy, R.C.; Raetz, C.R.H.; Russell, D.W.; Seyama, Y.; Shaw, W.; Shimizu, T.; Spener, F.; van Meer, G.|info:eu-repo/dai/nl/068570368; VanNieuwenhze, M.S.; White, S.H.|info:eu-repo/dai/nl/304843539; Witztum, J.; Dennis, E.A.
Lipids are produced, transported, and recognized by the concerted actions of numerous enzymes, binding proteins, and receptors. A comprehensive analysis of lipid molecules, “lipidomics,” in the context of genomics and proteomics is crucial to understanding cellular physiology and pathology;
Decision making for water resource planning is often related to social, economic and environmental factors. There are various methods for making decisions about water resource planning alternatives and measures with various shortcomings. A comprehensive entropy weight observability-controllability risk analysis ...
Grimshaw, Shirley; Dungworth, Naomi; McKnight, Cliff; Morris, Anne
This study investigates the differences in children's comprehension and enjoyment of storybooks according to the medium of presentation. Two different storybooks were used and 132 children participated. Of these, 51 children read an extract from "The Magicians of Caprona," about half reading an electronic version with an online dictionary, and the…
Chevalier, Kim; Del Santo, Jolene; Scheiner, Deb; Skok, Elly; Tucci, Leah Rae
This report describes a program for using explicit instruction of reading strategies through the implementation of guided reading groups to improve student comprehension. The targeted population consisted of elementary school students in growing, middle class communities, located in northern Illinois. Evidence for the existence of a deficiency of…
Perfetti, Charles A.; Goldman, Susan R.
A study is reported in which short-term memory capacity, estimated by a probe digit task, and memory for structured language, measured by a probe discourse task, were investigated in an experiment with third and fifth grade IQ-matched children representing two levels of reading comprehension skill. (Author/RM)
Full Text Available Having a deeper understanding of determining factors in the quality of translation is in the interest of almost all scholars of translation studies. Students’ intelligence is being measured constantly in order to determine their aptitude for entering into different programs. However, in translation studies, the variable of intelligence quotient (IQ has been curiously ignored among researchers. This study aimed to explore the strength of both IQ and reading comprehension in predicting translation quality among Iranian translation students. A sample of forty-six translation students from Alborz University of Qazvin participated in this study. Data were collected using three tests including Raven’s Advanced Progressive Matrices, Colina’s (2008 componential translation quality rating scheme and the reading comprehension test of IELTS. The results show IQ test scores and reading comprehension significantly predict translation quality assessment. Surprisingly, the most significant finding is that IQ score is by far a better predictor of translation quality than reading comprehension. Overall, it is concluded that translation quality assessment is more of a deeper cognitive function than solely language process, which could lead to more research on cognitive aspects of translation.
Steward, Michelle D.; Lewis, Bruce R.
The purpose of this study is to offer a comprehensive assessment of journal standings in Marketing from two perspectives. The discipline perspective of rankings is obtained from a collection of published journal ranking studies during the past 15 years. The studies in the published ranking stream are assessed for reliability by examining internal…
Willems, R.M.; Özyürek, A.; Hagoort, P.
Although generally studied in isolation, action observation and speech comprehension go hand in hand during everyday human communication. That is, people gesture while they speak. From previous research it is known that a tight link exists between spoken language and such hand gestures. This study
... Staying Safe Videos for Educators Search English Español Blood Test: Comprehensive Metabolic Panel (CMP) KidsHealth / For Parents / Blood ... de sangre: panel metabólico ampliado What Is a Blood Test? A blood test is when a sample of ...
Jamal K. M. Ali
Full Text Available This paper presents a study of the effects of texting on English language comprehension. The authors believe that English used in texting causes a lack of comprehension for English speakers, learners, and texters. Wei, Xian-hai and Jiang (2008:3 declare “In Netspeak, there are some newly-created vocabularies, which people cannot comprehend them either from their partial pronunciation or from their figures.” Crystal (2007:23 claims; “variation causes problems of comprehension and acceptability. If you speak or write differently from the way I do, we may fail to understand each other.” In this paper, the authors conducted a questionnaire at Aligarh Muslim University to ninety respondents from five different Faculties and four different levels. To measure respondents’ comprehension of English texting, the authors gave the respondents abbreviations used by texters and asked them to write the full forms of the abbreviations. The authors found that many abbreviations were not understood, which suggested that most of the respondents did not understand and did not use these abbreviations.
Using Appropriate Strategies to Improve Students' Comprehension of Chemistry Texts: A Guide for Chemistry Teachers. ... African Research Review ... Unfortunately, contemporary research insight into science reading is lacking and science educators tend to focus on methods of teaching specific subject matter and ...
Chen Yuntang; Yang Baoan; Zhang Jianwei; Li Qiufang
Chinese chestnut can be preserved for a long time by using a comprehensive preserving technique, which consists of casing, irradiating, treating with preserving agent and controlling environment conditions. The shelftime of the treated chestnuts reaches 11 months keeping no insects, no germination and good quality for eating with the good fruit ratio of 97.5% and water losing ratio of 3.8%
Yarrington-Young, Susan; Castleberry, Stephen B.; Coleman, Joshua T.
A comprehensive project for the Advanced Selling course that has been tested at three universities is introduced. After selecting an industry and a company, students engage in a complete industry analysis, a company sales analysis, a sales-specific SWOT analysis, complete a ride day with a salesperson in that firm, then present their findings in a…
Useem, Elizabeth; Balfanz, Robert
This report describes "Philadelphia's Grand Experiment" in comprehensive school district reform, from its conception through its initial months of implementation. In 2001, as part of the remedy for low student performance, the governor ordered the state to take over governance of the Philadelphia School District, with a substantial…
Over the past decade, second language (L2) humor has attracted scholarly attention as both a means and a goal of L2 development. Much of this research, however, has focused on oral communication, whereas virtually no studies address humor as an aspect of reading comprehension. This exploratory study combines these two areas of inquiry, examining…
Takahashi, Satomi; Roitblat, Herbert L.
Examines the comprehension of English conventional indirect requests by native English speakers and Japanese learners of English. Subjects read stories inducing either a conventional or a literal interpretation of a priming sentence. Results suggest that both native and nonnative speakers process both meanings of an ambiguous conventional request.…
Tanner, Darren; Bulkes, Nyssa Z
We investigated factors that affect the comprehension of subject-verb agreement in English, using quantification as a window into the relationship between morphosyntactic processes in language production and comprehension. Event-related brain potentials (ERPs) were recorded while participants read sentences with grammatical and ungrammatical verbs, in which the plurality of the subject noun phrase was either doubly marked (via overt plural quantification and morphological marking on the noun) or singly marked (via only plural morphology on the noun). Both acceptability judgments and the ERP data showed heightened sensitivity to agreement violations when quantification provided an additional cue to the grammatical number of the subject noun phrase, over and above plural morphology. This is consistent with models of grammatical comprehension that emphasize feature prediction in tandem with cue-based memory retrieval. Our results additionally contrast with those of prior studies that showed no effects of plural quantification on agreement in language production. These findings therefore highlight some nontrivial divergences in the cues and mechanisms supporting morphosyntactic processing in language production and comprehension.
Feldman, Martha J.
Describes a novel approach to comprehensive questions in world history examinations. Recommends using current events as illustrative reference points for complex subjects such as nationalism, liberalism, and international trade. Students receive information packets on the events for several weeks and must relate the subjects to these events. (MJP)
Nardi, Antonio; Olesen, Søren-Peter
channels as a potentially attractive target, the design and synthesis of potent and selective BK modulators continue based on novel chemical ideas. A comprehensive overview of BK channel modulators is therefore timely and important to the current medicinal chemist for review, summary, and classification...
Sahin, Cenkhan; de Haan, Jakob
Using an event study approach, we examine financial markets' reactions to the publication of the ECB's Comprehensive Assessment of banks in the euro area. Our results suggest that banks' stock market prices and CDS spreads generally showed no reaction. (C) 2015 Elsevier B.V. All rights reserved.
Li, Xiyan; Yin, Chungen
Biomass gasification is still a promising technology after over 30 years’ research and development and has success only in a few niche markets. In this paper, a comprehensive mathematical model for biomass particle gasification is developed within a generic particle framework, assuming the feed...
Program comprehension is an essential part of software development and software maintenance, as software must be sufficiently understood before it can be properly modified. One of the common approaches in getting to understand a program is the study of its execution, also known as dynamic analysis.
Norris, D.; Cutler, A.; McQueen, J.M.; Butterfield, S.
We propose that speech comprehension involves the activation of token representations of the phonological forms of current lexical hypotheses, separately from the ongoing construction of a conceptual interpretation of the current utterance. In a series of cross-modal priming experiments,
Catts, Hugh W.; Nielsen, Diane Corcoran; Bridges, Mindy Sittner; Liu, Yi-Syuan
Most research on early identification of reading disabilities has focused on word reading problems and little attention has been given to reading comprehension difficulties. In this study, we investigated whether measures of language ability and/or response to language intervention in kindergarten uniquely predicted reading comprehension…
Oded, Brenda; Walters, Joel
Investigates the extent to which tasks involving processing differences in English-as-a-foreign-language (EFL) reading result in differences in performance on comprehension. Processing differences were created by the assignment of two tasks--writing a text summary and listing the examples in the text. (Author/VWL)
Grinstead, N; Timoney, R
Describes the process used by the Mater Infirmorum Hospital in Belfast in 1992-1994 to achieve high quality care (Seamless Service), and motivate staff to deliver and measure performance. Aims of the project include focusing the organization on the customer, improving teamwork and motivation at all levels. After comprehensive data collection from GPs, patients and staff forums developed a full TQM strategy to gain support and maintain momentum including innovative staff events (every staff member was given the opportunity to attend) where multilevel, multidisciplinary workshops enabled staff to design customer care standards, develop teams and lead customer-driven change.
Mousseau, J.; Magleby, M.; Litus, M.
Recurring waste management noncompliance problems have spurred a fundamental site-wide process revision to characterize and disposition wastes at the Idaho National Engineering and Environmental Laboratory. The reengineered method, termed Waste Generator Services, will streamline the waste acceptance process and provide waste generators comprehensive waste management services through a single, accountable organization to manage and disposition wastes in a timely, cost-effective, and compliant manner. This report outlines the strategy for implementing Waste Generator Services across the INEEL. It documents the culmination of efforts worked by the LMITCO Environmental Management Compliance Reengineering project team since October 1997. These efforts have included defining problems associated with the INEEL waste management process; identifying commercial best management practices; completing a review of DOE Complex-wide waste management training requirements; and involving others through an Integrated Process Team approach to provide recommendations on process flow, funding/charging mechanisms, and WGS organization. The report defines the work that will be performed by Waste Generator Services, the organization and resources, the waste acceptance process flow, the funding approach, methods for measuring performance, and the implementation schedule and approach. Field deployment will occur first at the Idaho Chemical Processing Plant in June 1998. Beginning in Fiscal Year 1999, Waste Generator Services will be deployed at the other major INEEL facilities in a phased approach, with implementation completed by March 1999.
Mousseau, J.; Magleby, M.; Litus, M.
Recurring waste management noncompliance problems have spurred a fundamental site-wide process revision to characterize and disposition wastes at the Idaho National Engineering and Environmental Laboratory. The reengineered method, termed Waste Generator Services, will streamline the waste acceptance process and provide waste generators comprehensive waste management services through a single, accountable organization to manage and disposition wastes in a timely, cost-effective, and compliant manner. This report outlines the strategy for implementing Waste Generator Services across the INEEL. It documents the culmination of efforts worked by the LMITCO Environmental Management Compliance Reengineering project team since October 1997. These efforts have included defining problems associated with the INEEL waste management process; identifying commercial best management practices; completing a review of DOE Complex-wide waste management training requirements; and involving others through an Integrated Process Team approach to provide recommendations on process flow, funding/charging mechanisms, and WGS organization. The report defines the work that will be performed by Waste Generator Services, the organization and resources, the waste acceptance process flow, the funding approach, methods for measuring performance, and the implementation schedule and approach. Field deployment will occur first at the Idaho Chemical Processing Plant in June 1998. Beginning in Fiscal Year 1999, Waste Generator Services will be deployed at the other major INEEL facilities in a phased approach, with implementation completed by March 1999
Clemmensen, Torkil; Nielsen, Jeppe Agger; Andersen, Kim Normann
The position presented in this paper is that in order to understand how service robots shape, and are being shaped by, the physical and social contexts in which they are used, we need to consider both work/organizational analysis and interaction design. We illustrate this with qualitative data...... and personal experiences to generate discussion about how to link these two traditions. This paper presents selected results from a case study that investigated the implementation and use of robot vacuum cleaners in Danish eldercare. The study demonstrates interpretive flexibility with variation...
Authors examining the developing dispute resolution alternatives to the adversarial system have identified nine converging "vectors" or alternatives in what has been termed the Comprehensive Law Movement. These authors have sought to understand how the developing vectors can remain separate and vibrant movements while sharing common ground. Some analyze these developments as being within law and legal practice, others see them as alternative approaches to law, and still others take a combined approach. It will be impossible to understand how these vectors have meaningful differences from law and legal practice if the search is limited to looking within law and legal practice. It will be impossible to understand how these vectors have meaningful commonalities with law and legal practice if the search is limited to looking external to law and legal practice. Instead of comparing the vectors with the adversarial system, higher order criteria are required. What is needed is a comprehensive and internally consistent super-system of norms; one that can be used to evaluate the adversarial system and the evolving vectors on an equal footing. An Aristotelian natural law virtue theory of justice can: (a) provide a functional guiding definition of justice; (b) serve as a comprehensive and internally consistent super-system of norms; and (c) provide the theoretical and evaluative foundation required to clarify the relationships among the adversarial system and the developing vectors. Finally, it will become clear why the Comprehensive Law Movement might be more appropriately conceptualized as the Comprehensive Justice Movement. Copyright © 2010 Elsevier Ltd. All rights reserved.
Gudiksen, Sune Klok; Brandt, Eva
Many companies investigate new business opportunities in a turn from product to service design. As service offerings expand over time and space, such notions as ‘customer journey’ or ‘service blueprint’ have been suggested to grasp and design the nature of the emergent services. However, we find ...... various customers’´service cycles....
Ferreira Pires, Luis; Wang, J.; van Oostrum, Arjen; Wijnhoven, Alphonsus B.J.M.
A service registry is a Service-Oriented Architecture (SOA) component that keeps a ‘catalogue’ of available services. It stores service specifications so that these specifications can be found by potential users. Discussions on the design of service registries currently focus on technical issues,
Spencer, Mercedes; Wagner, Richard K
The purpose of this meta-analysis was to examine the comprehension problems of children who have a specific reading comprehension deficit (SCD), which is characterized by poor reading comprehension despite adequate decoding. The meta-analysis included 86 studies of children with SCD who were assessed in reading comprehension and oral language (vocabulary, listening comprehension, storytelling ability, and semantic and syntactic knowledge). Results indicated that children with SCD had deficits in oral language ( d = -0.78, 95% CI [-0.89, -0.68], but these deficits were not as severe as their deficit in reading comprehension ( d = -2.78, 95% CI [-3.01, -2.54]). When compared to reading comprehension age-matched normal readers, the oral language skills of the two groups were comparable ( d = 0.32, 95% CI [-0.49, 1.14]), which suggests that the oral language weaknesses of children with SCD represent a developmental delay rather than developmental deviance. Theoretical and practical implications of these findings are discussed.
Start, coordinates the federal commodities food distribution program for low-income people, and maintains an updated human service resource manual for...organization also publishes a comprehensive resource manual on social services in Laramie County. One-to-One Tutoring provides volunteers to tutor...services by other organizacions . eoresent the total OOr-lati:n. Rate of volunteer ans •" ;rowth is forecast as follcs..: 1983 z 70.467, half tine green
Douma, Elaine L.
Intended for use in a comprehensive senior high school, this curriculum guide for an introductory laboratory course focuses on the development of abilities, attitudes, and personal qualities which would lead to job success at the entry level in the food service industry, including in the areas of cooking, waitressing, supermarkets, and similar…
Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi
AIM: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme ....... Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives....... overcome these difficulties. CONCLUSIONS: Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost-effectiveness, but not all stakeholders beyond mental health administrators are aware of this...
Iwaarden, van J.; Valk, van der W.; Aalders, L.; Virolainen, V.-M.
Organizations are increasingly sourcing services that are directly delivered to their (end) customers by external providers. Buying organization, supplier and (end) customer operate in a triadic service relationship. In these triads, the buying organization lacks direct control over service delivery
Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S
To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Ambulatory-based general internists in 13 states participated in the assessment. We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Performance on the individual and composite measures varied substantially within (range 5-86 percent compliance on 46 measures) and between physicians (ICC range 0.12-0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; pmeasures and by sampling feasible numbers of patients for each condition. © Health Research and Educational Trust.
Grünbaum, Niels Nolsøe; Hollensen, Svend; Kahle, Lynn
The purpose of this article is to extend the understanding of the industrial buying process in connection with purchasing professional business (B2B) services, specifically human resource (HR) consulting services. Early B2B buying-behavior literature strongly emphasizes the rational aspects...... of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies choose a consulting services supplier. Five hypotheses are developed based...
Cokelaer, Thomas; Pultz, Dennis; Harder, Lea M; Serra-Musach, Jordi; Saez-Rodriguez, Julio
Web interfaces provide access to numerous biological databases. Many can be accessed to in a programmatic way thanks to Web Services. Building applications that combine several of them would benefit from a single framework. BioServices is a comprehensive Python framework that provides programmatic access to major bioinformatics Web Services (e.g. KEGG, UniProt, BioModels, ChEMBLdb). Wrapping additional Web Services based either on Representational State Transfer or Simple Object Access Protocol/Web Services Description Language technologies is eased by the usage of object-oriented programming. BioServices releases and documentation are available at http://pypi.python.org/pypi/bioservices under a GPL-v3 license.
Alana Kercia Barros Demétrio
Full Text Available In this article, we address the reading issue from the point of view of complexity. Understanding, according to Beaugrande (1997, that the text is a communicative event whose configuration involves elements of different nature, including the participants of interaction, we think that traditional approaches to reading, even those which are focused on interaction, do not satisfactorily bolster comprehension of this phenomenon. In order to analyze how aspects that characterize reading as a complex activity show at (context comprehension in digital social media, we leaned on the articles by Pellanda (2005 and by Franco (2011 and we were supported by the autopoietic theory by Maturana and Varela (1995, as well as by the concepts of emergency and incorporation by Hanks (2008. Through the analysis of two examples of interaction conveyed in virtual environment, we observed that reading triggers readers’ autopoiesis as living systems.
Rønberg, Louise Flensted-Jensen; Petersen, Dorthe Klint
as measured on a phonological coding measure. However, the proportion was smaller than the often reported 10-15 % and even smaller when average sight word recognition was also set as a criterion for word reading ability. Compared to average comprehenders, the poor comprehenders’ sight word recognition......This study explores the occurrence of poor comprehenders, i.e., children identified with reading comprehension difficulties in spite of age-appropriate word reading skills. It supports the findings that some children do show poor reading comprehension in spite of age-appropriate word reading...... and daily reading of literary texts were significantly below that of average readers. This study indicates that a lack of reading experience and, likewise, a lack of fluent word reading may be important factors in understanding nine-year-old poor comprehenders’ difficulties....
Bandrova, T.; Konecny, M.
The authors are experienced in working with children and students in the field of early warning and crises management and cartography. All these topics are closely connected to Digital Earth (DE) ideas. On the basis of a questionnaire, the young generation's comprehension of DE concept is clarified. Students from different age groups (from 19 to 36) from different countries and with different social, cultural, economical and political backgrounds are asked to provide definition of DE and describe their basic ideas about meaning, methodology and applications of the concept. The questions aim to discover the young generation's comprehension of DE ideas. They partially cover the newest trends of DE development like social, cultural and environmental issues as well as the styles of new communications (Google Earth, Facebook, LinkedIn, etc.). In order to assure the future development of the DE science, it is important to take into account the young generation's expectations. Some aspects of DE development are considered in the Conclusions.
Let's Do Comprehension is a brand new series of six titles in the popular 'Let's Do' range. Each book contains a rich variety of stimulating reading passages, accompanied by questions of varying difficulty. Designed to be used at home, each book includes tips and clues from Alice the Alligator as well as extra challenges in Brodie's Brain Boosters. There is a clear answer section for reference by parents and children, together with bright, colourful reward stickers.
Rodolfo M. Posada Alvarez
Full Text Available In this article the integral formation fundamental than action Under the new legislation and contemporary predicaments on education, knowledge and research education is analyzed. This training involves not only students but the entire university community, particularly teachers, whose reflective responsibility for their work should bring them to operate the pillars identified in education. Likewise Institutional factors that can ensure and strengthen the comprehensive training in higher education are analyzed: disciplinary integration, flexibility, innovation, leadership, participation, self-evaluation and accreditation.
Kim, Gyeong Dong; Hong, Du Seung
This book explains the comprehension of nuclear energy with making approaches to social science. So it deals with disposal of radiation active waste as an social issue, recognition to nuclear energy of people and understanding of the region and support for the development of the region. It introduces two Anti-nuclear energy movements happened in Anmyondo and Yeongdeok. It reports these two cases approached with the method of social science.
Let's Do Comprehension is a brand new series of six titles in the popular 'Let's Do' range. Each book contains a rich variety of stimulating reading passages, accompanied by questions of varying difficulty. Designed to be used at home, each book includes tips and clues from Alice the Alligator as well as extra challenges in Brodie's Brain Boosters. There is a clear answer section for reference by parents and children, together with bright, colourful reward stickers.
Mohsen Askari; Azam Samadi Rahim
Having a deeper understanding of determining factors in the quality of translation is in the interest of almost all scholars of translation studies. Students’ intelligence is being measured constantly in order to determine their aptitude for entering into different programs. However, in translation studies, the variable of intelligence quotient (IQ) has been curiously ignored among researchers. This study aimed to explore the strength of both IQ and reading comprehension in predicting transla...
Full Text Available Theories of embodied cognition argue that language comprehension involves sensory-motor re-enactments of the actions described. However, the degree of specificity of these re-enactments as well as the relationship between action and language remains a matter of debate. Here we investigate these issues by examining how hand-specific information (left or right hand is recruited in language comprehension and action execution. An fMRI study tested right-handed participants in two separate tasks that were designed to be as similar as possible to increase sensitivity of the comparison across task: an action execution go/no-go task where participants performed right or left hand actions, and a language task where participants read sentences describing the same left or right handed actions as in the execution task. We found that language-induced activity did not match the hand-specific patterns of activity found for action execution in primary somatosensory and motor cortex, but it overlapped with pre-motor and parietal regions associated with action planning. Within these pre-motor regions, both right hand actions and sentences elicited stronger activity than left hand actions and sentences - a dominant hand effect -. Importantly, both dorsal and ventral sections of the left pre-central gyrus were recruited by both tasks, suggesting different action features being recruited. These results suggest that (a language comprehension elicits motor representations that are hand-specific and akin to multimodal action plans, rather than full action re-enactments; and (b language comprehension and action execution share schematic hand-specific representations that are richer for the dominant hand, and thus linked to previous motor experience.
This paper reviews the state-of-the art in comprehensive performance codes for fixed-wing aircraft. The importance of system analysis in flight performance is discussed. The paper highlights the role of aerodynamics, propulsion, flight mechanics, aeroacoustics, flight operation, numerical optimisation, stochastic methods and numerical analysis. The latter discipline is used to investigate the sensitivities of the sub-systems to uncertainties in critical state parameters or functional parameters. The paper discusses critically the data used for performance analysis, and the areas where progress is required. Comprehensive analysis codes can be used for mission fuel planning, envelope exploration, competition analysis, a wide variety of environmental studies, marketing analysis, aircraft certification and conceptual aircraft design. A comprehensive program that uses the multi-disciplinary approach for transport aircraft is presented. The model includes a geometry deck, a separate engine input deck with the main parameters, a database of engine performance from an independent simulation, and an operational deck. The comprehensive code has modules for deriving the geometry from bitmap files, an aerodynamics model for all flight conditions, a flight mechanics model for flight envelopes and mission analysis, an aircraft noise model and engine emissions. The model is validated at different levels. Validation of the aerodynamic model is done against the scale models DLR-F4 and F6. A general model analysis and flight envelope exploration are shown for the Boeing B-777-300 with GE-90 turbofan engines with intermediate passenger capacity (394 passengers in 2 classes). Validation of the flight model is done by sensitivity analysis on the wetted area (or profile drag), on the specific air range, the brake-release gross weight and the aircraft noise. A variety of results is shown, including specific air range charts, take-off weight-altitude charts, payload-range performance
Zheng, Kan; Liang, Dong; Zhang, Xirui
This paper describes and analyzes the coconut cultivation in China, and the current comprehensive utilization of waste resources generated during cultivation and processing of coconut. The wastes generated in the process of cultivation include old coconut tree trunk, roots, withered coconut leaves, coconut flower and fallen cracking coconut, mainly used for biogas extraction, direct combustion and power generation, brewing, pharmacy, and processing of building materials; the wastes generated ...
Moody-Triantis, Claire; Humphreys, Gina F; Gennari, Silvia P
Theories of embodied cognition argue that language comprehension involves sensory-motor re-enactments of the actions described. However, the degree of specificity of these re-enactments as well as the relationship between action and language remains a matter of debate. Here we investigate these issues by examining how hand-specific information (left or right hand) is recruited in language comprehension and action execution. An fMRI study tested self-reported right-handed participants in two separate tasks that were designed to be as similar as possible to increase sensitivity of the comparison across task: an action execution go/no-go task where participants performed right or left hand actions, and a language task where participants read sentences describing the same left or right handed actions as in the execution task. We found that language-induced activity did not match the hand-specific patterns of activity found for action execution in primary somatosensory and motor cortex, but it overlapped with pre-motor and parietal regions associated with action planning. Within these pre-motor regions, both right hand actions and sentences elicited stronger activity than left hand actions and sentences-a dominant hand effect. Importantly, both dorsal and ventral sections of the left pre-central gyrus were recruited by both tasks, suggesting different action features being recruited. These results suggest that (a) language comprehension elicits motor representations that are hand-specific and akin to multimodal action plans, rather than full action re-enactments; and (b) language comprehension and action execution share schematic hand-specific representations that are richer for the dominant hand, and thus linked to previous motor experience.
Laulainen, N.S.; Ulanski, S.L.
A comprehensive experiment to study drift from mechanical drift cooling towers was conducted during June 1978 at the PG and E Pittsburg Power Plant. The data from this study will be used for validation of drift deposition models. Preliminary results show the effects of tower geometry and orientation with respect to the wind and to single- or two-tower operation. The effect of decreasing relative humidity during a test run can also be seen
Presented diploma thesis is focused on reading problems of people with hearing impairment. The theoretical part deals a hearing impairment, process of acquisition of reading skills of healthy people and deaf people as well. The practical part efforts to clarify preparations, process and results of the research. I am presenting my own reading comprehension test, which was compiled on purpose due to the research. The goal of my diploma thesis is to determine when the level of reading acquiremen...
This thesis investigated reading comprehension levels amongst Maltese bilingual students. A total of 428 participants, aged between 8 and 13, from state schools across Malta, were tested and the results of five studies presented. The primary purpose underlying the research was to inform the development of assessment procedures that can be used in the identification of children who have specific difficulties in reading within the Maltese context. Initially, the suitability of reading comprehen...
Full Text Available Comprehensive or integrated positioning, navigation and timing is an obvious developing trend following the global navigation satellite system.This paper summarizes the current status of micro-PNT and its developing requirements. The related key technologies are described and the relationship between comprehensive PNT and micro-PNT is analyzed. It is stressed that the comprehensive PNT needs massive infrastructure construction and investment, however, the micro-PNT aims at the integrated applications of high-tech micro sensors. It is different from the current opinions appeared in the literatures, micro-PNT should include multi GNSS integration and micro components of navigation and timing in order to make the PNT outputs refer to a unified coordinate datum and time scale. Micro-PNT focuses on the personalized micro terminal applications. Except for the miniaturization of each PNT component, micro-PNT aims at the deep integration of the micro sensors, adaptive data fusion and self calibration of each component.
Muhammad Lukman Syafi’i
Full Text Available Reading as one of language skills plays significant roles in the teaching English as a foreign language. Since the teacher still uses the conventional way to teach reading, students‘ ability in reading comprehension seems still unsatisfactory yet. So, teacher should explore and develop new strategies. One of strategies in reading comprehension that can trigger our students to attain that purpose is SMART (Self Monitoring Approach for Reading and Thinking strategy. This study is developing SMART strategy to boost the reading comprehension achievement of the ninth grade students. The research applies a collaborative classroom action research design in which the researcher and the collaborative teacher work together in preparing a suitable procedure of SMART strategy, designing the lesson plan, determining the criteria of success, implementing the action, observing, and doing reflection. The finding indicated that SMART strategy was successful to enhance students‘ motivation to be actively involved in the instructional process. The improvement on the students‘ participation was 75% in Cycle 1 and 87% in Cycle 2.
Oyetunji, Christianah Oluwatoyin
Full Text Available This paper describes the effect of reading strategy instruction on Second Language (L2 students’ reading comprehension in a Botswana College of Education. The intervention programme was implemented based on the observation that some trainee teachers failed to improve on their L2 proficiency after spending a year in the L2 classroom. Prior to the intervention, difficulty in reading and comprehending had been identified as one of the contributing factors to their failure to improve on their proficiency level. A reading comprehension test was used to collect data from participants who were trainee teachers at a College of Education in Botswana before and after the intervention. The six-week intervention programme focused on seven reading strategies, namely the use of background knowledge, self-questioning, inferencing, rereading, drawing conclusions, identifying main ideas and summarising. The findings suggest that strategy training can increase L2 students’ reading comprehension. Based on the findings, it is recommended that strategy training be introduced into the L2 syllabus of the primary school teacher trainees in all Botswana Colleges of Education.
Fok, M.-C.; Buzulukova, N. Y.; Chen, S.-H.; Glocer, A.; Nagai, T.; Valek, P.; Perez, J. D.
Simulation studies of the Earth's radiation belts and ring current are very useful in understanding the acceleration, transport, and loss of energetic particles. Recently, the Comprehensive Ring Current Model (CRCM) and the Radiation Belt Environment (RBE) model were merged to form a Comprehensive Inner Magnetosphere-Ionosphere (CIMI) model. CIMI solves for many essential quantities in the inner magnetosphere, including ion and electron distributions in the ring current and radiation belts, plasmaspheric density, Region 2 currents, convection potential, and precipitation in the ionosphere. It incorporates whistler mode chorus and hiss wave diffusion of energetic electrons in energy, pitch angle, and cross terms. CIMI thus represents a comprehensive model that considers the effects of the ring current and plasmasphere on the radiation belts. We have performed a CIMI simulation for the storm on 5-9 April 2010 and then compared our results with data from the Two Wide-angle Imaging Neutral-atom Spectrometers and Akebono satellites. We identify the dominant energization and loss processes for the ring current and radiation belts. We find that the interactions with the whistler mode chorus waves are the main cause of the flux increase of MeV electrons during the recovery phase of this particular storm. When a self-consistent electric field from the CRCM is used, the enhancement of MeV electrons is higher than when an empirical convection model is applied. We also demonstrate how CIMI can be a powerful tool for analyzing and interpreting data from the new Van Allen Probes mission.
FitzPatrick, Ian; Indefrey, Peter
Electrophysiological studies consistently find N400 effects of semantic incongruity in nonnative (L2) language comprehension. These N400 effects are often delayed compared with native (L1) comprehension, suggesting that semantic integration in one's second language occurs later than in one's first language. In this study, we investigated whether such a delay could be attributed to (1) intralingual lexical competition and/or (2) interlingual lexical competition. We recorded EEG from Dutch-English bilinguals who listened to English (L2) sentences in which the sentence-final word was (a) semantically fitting and (b) semantically incongruent or semantically incongruent but initially congruent due to sharing initial phonemes with (c) the most probable sentence completion within the L2 or (d) the L1 translation equivalent of the most probable sentence completion. We found an N400 effect in each of the semantically incongruent conditions. This N400 effect was significantly delayed to L2 words but not to L1 translation equivalents that were initially congruent with the sentence context. Taken together, these findings firstly demonstrate that semantic integration in nonnative listening can start based on word initial phonemes (i.e., before a single lexical candidate could have been selected based on the input) and secondly suggest that spuriously elicited L1 lexical candidates are not available for semantic integration in L2 speech comprehension.
Full Text Available The aims of the research were to find out (a the level of the students’ ability in making comprehension questions, (b the students’ map of problems in making comprehension questions. The population of the research was all students joining Reading 4 academic year 2016, totaling to 30 students, while the sample was taken from all students. The result of data analysis showed that the average ability of the students, with score more than 70 reached 66.66%. In details, only 4 of the samples (13.33% got no wrong answers or an A. Those who got good achievement (B, considered as majority, amounted to 16 students (53.33%. The participants achieving enough grades (C reached 7 students or 23.33%. The last level achieved in this research was D with the number reaching 3 (10%. The map of problems laid on their inability in identifying between yes/no and WH questions, inverted sentence, choosing the right auxiliary and verbs and their spelling ability. Keyword: comprehension, questions, inversion, problem map, ability