How natural capital delivers ecosystem services: A typology derived from a systematic review

CSIR Research Space (South Africa)

Smith, Andrew C

2017-08-01

Full Text Available There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic...

Cost of delivering health care services at primary health facilities in Ghana

Directory of Open Access Journals (Sweden)

Maxwell Ayindenaba Dalaba

2017-11-01

Full Text Available Abstract Background There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs and Community-based Health Planning and Services (CHPS in Ghana. Methods The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD attendance were estimated. Results The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC. The cost per OPD attendance was higher at CHPS (US$8.79 than at HCs (US$5.16. The average Internally Generated Funds (IGF recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS reimbursement was the main source of revenue accounting for over 90% total IGF. Conclusions The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar

Readiness of health facilities to deliver safe male circumcision services in Tanzania: a descriptive study

Directory of Open Access Journals (Sweden)

Frank Felix Mosha

2013-03-01

Full Text Available Assessing the readiness of health facilities to deliver safe male circumcision services is more important in sub-Saharan Africa because of the inadequacy state of health facilities in many ways. The World Health Organization recommends that only facilities equipped with available trained staff, capable to perform at least minor surgery, able to offer minimum MC package and appropriate equipment for resuscitation, and compliant with requirements for sterilization and infection control should be allowed to deliver safe circumcision services. A cross-sectional study using quantitative data collection technique was conducted to assess the readiness of the health facilities to deliver safe circumcision services in selected districts of Tanzania. All hospitals, health centres and 30% of all dispensaries in these districts were selected to participate in the study. Face-toface questionnaires were administered to the heads of the health facilities and to health practitioners. Overall, 49/69 (59% of the facilities visited provided circumcision services and only 46/203 (24% of the health practitioners performed circumcision procedures. These were mainly assistant medical officers and clinical officers. The vast majority – 190/203 (95% – of the health practitioners require additional training prior to providing circumcision services. Most facilities – 63/69 (91% – had all basic supplies (gloves, basin, chlorine and waste disposal necessary for infection prevention, 44/69 (65% provided condoms, HIV counselling and testing, and sexuallytransmitted infections services, while 62/69 (90% had the capability to perform at least minor surgery. However, only 25/69 (36% and 15/69 (22% of the facilities had functioning sterilization equipment and appropriate resuscitation equipment, respectively. There is readiness for roll out of circumcision services; however, more practitioners need to be trained on circumcision procedures, demand forecasting

14 CFR 204.4 - Carriers proposing to provide essential air service.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Carriers proposing to provide essential air... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DATA TO SUPPORT FITNESS DETERMINATIONS Filing Requirements § 204.4 Carriers proposing to provide essential air service. Applicants proposing to provide essential air...

Increasing Customer Service Behaviors Using Manager-Delivered Task Clarification and Social Praise

Science.gov (United States)

Rice, Anna; Austin, John; Gravina, Nicole

2009-01-01

This project assessed an intervention to improve employee customer service behaviors (correct greetings and closing behaviors). A combination of task clarification and manager-delivered social praise resulted in increased correct greeting from 11.5% to 66% and correct closing from 8% to 70%. The effect was maintained at a 48-week follow-up for…

Short-Term Effectiveness of Psychotherapy Treatments Delivered at a University Counselling Service

Science.gov (United States)

Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico

2016-01-01

This work aimed to evaluate the short-term effectiveness of psychotherapy delivered at the counselling service of the University of Bologna (Italy), by means of a single group longitudinal study including a 6-months follow-up. To this end, sixty-six students completed the 6-months follow-up and filled in the Symptom Questionnaire (SQ) three times,…

34 CFR 4.1 - Service of process required to be served on or delivered to Secretary.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Service of process required to be served on or... OF PROCESS § 4.1 Service of process required to be served on or delivered to Secretary. Summons... authorized to accept service of such process. (Authority: 5 U.S.C. 301) [47 FR 16780, Apr. 20, 1982] ...

Performance Assessment of Aggregation Control Services for Demand Response

DEFF Research Database (Denmark)

Bondy, Daniel Esteban Morales; Costanzo, Giuseppe Tommaso; Heussen, Kai

2014-01-01

Aggregation algorithms that provide services to the grid via demand side management are moving from research ideas to the market. With the diversity of the technology delivering such services, it becomes essential to establish transparent performance standards from a service delivery perspective...... of the quality of service provided by an aggregation control algorithm. By a detailed case study we present and an application of the index, comparing the performance of two different control architectures for demand side management delivering a distribution grid service....

The delivery of primary care services.

NARCIS (Netherlands)

Wilson, A.; Windak, A.; Oleszczyk, M.; Wilm, S.; Hasvold, T.; Kringos, D.

2015-01-01

This chapter will be devoted to the dimensions which have been grouped in the framework as “process” and that focus on essential features of service delivery in primary care. In addition to the breadth of services delivered, a comparative overview will be provided of variation in access to services,

Afraid of Delivering at the Hospital or Afraid of Delivering at Home: A Qualitative Study of Thai Hmong Families' Decision-Making About Maternity Services.

Science.gov (United States)

Culhane-Pera, Kathleen A; Sriphetcharawut, Sarinya; Thawsirichuchai, Rasamee; Yangyuenkun, Wirachon; Kunstadter, Peter

2015-11-01

Thailand has high rates of maternity services; both antenatal care (ANC) and hospital delivery are widely used by its citizens. A recent Northern Thailand survey showed that Hmong women used maternity services at lower rates. Our objectives were to identify Hmong families' socio-cultural reasons for using and not using maternity services, and suggest ways to improve Hmong women's use of maternity services. In one Hmong village, we classified all 98 pregnancies in the previous 5 years into four categories: no ANC/home birth, ANC/home, no ANC/hospital, ANC/hospital. We conducted life-history case studies of 4 women from each category plus their 12 husbands, and 17 elders. We used grounded theory to guide qualitative analysis. Families not using maternity services considered pregnancy a normal process that only needed traditional home support. In addition, they disliked institutional processes that interfered with cultural birth practices, distrusted discriminatory personnel, and detested invasive, involuntary hospital procedures. Families using services perceived physical needs or potential delivery risks that could benefit from obstetrical assistance not available at home. While they disliked aspects of hospital births, they tolerated these conditions for access to obstetrical care they might need. Families also considered cost, travel distance, and time as structural issues. The families ultimately balanced their fear of delivering at home with their fear of delivering at the hospital. Providing health education about pregnancy risks, and changing healthcare practices to accommodate Hmong people's desires for culturally-appropriate family-centered care, which are consistent with evidence-based obstetrics, might improve Hmong women's use of maternity services.

Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens.

Science.gov (United States)

Desmond, Sharon

2017-03-02

The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.

Service quality of delivered care from the perception of women with caesarean section and normal delivery.

Science.gov (United States)

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

2014-01-01

Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 - (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women's perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. "Confidentiality", "autonomy", "choice of care provider" and "communication" achieved scores at the highest level of quality; and "support group", "prompt attention", "prevention and early detection", "continuity of care", "dignity", "safety", "accessibility and "basic amenities" got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008). A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

Operator models for delivering municipal solid waste management services in developing countries. Part A: The evidence base.

Science.gov (United States)

Wilson, David C; Kanjogera, Jennifer Bangirana; Soós, Reka; Briciu, Cosmin; Smith, Stephen R; Whiteman, Andrew D; Spies, Sandra; Oelz, Barbara

2017-08-01

This article presents the evidence base for 'operator models' - that is, how to deliver a sustainable service through the interaction of the 'client', 'revenue collector' and 'operator' functions - for municipal solid waste management in emerging and developing countries. The companion article addresses a selection of locally appropriate operator models. The evidence shows that no 'standard' operator model is effective in all developing countries and circumstances. Each city uses a mix of different operator models; 134 cases showed on average 2.5 models per city, each applying to different elements of municipal solid waste management - that is, street sweeping, primary collection, secondary collection, transfer, recycling, resource recovery and disposal or a combination. Operator models were analysed in detail for 28 case studies; the article summarises evidence across all elements and in more detail for waste collection. Operators fall into three main groups: The public sector, formal private sector, and micro-service providers including micro-, community-based and informal enterprises. Micro-service providers emerge as a common group; they are effective in expanding primary collection service coverage into poor- or peri-urban neighbourhoods and in delivering recycling. Both public and private sector operators can deliver effective services in the appropriate situation; what matters more is a strong client organisation responsible for municipal solid waste management within the municipality, with stable political and financial backing and capacity to manage service delivery. Revenue collection is also integral to operator models: Generally the municipality pays the operator from direct charges and/or indirect taxes, rather than the operator collecting fees directly from the service user.

Variation in the costs of delivering routine immunization services in Peru.

Science.gov (United States)

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

Graduate Student Services: A Study of the Delivery of Services at the Location Where Students Matriculate

Science.gov (United States)

Burlison, John G.

2010-01-01

This dissertation investigates and explores the best method for the delivery of graduate student services. Essentially, there are two methods for delivery of these services. They can be delivered by virtue of centralization or decentralization. Decentralized delivery, for the purpose of this dissertation is the delivery of graduate student…

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

Directory of Open Access Journals (Sweden)

Jafar S. Tabrizi

2014-12-01

Full Text Available Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance based on importance and performance of service quality aspects from the postpartum women‟s perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. Results: “Confidentiality”, “autonomy”, “choice of care provider” and “communication” achieved scores at the highest level of quality; and “support group”, “prompt attention”, “prevention and early detection”, “continuity of care”, “dignity”, “safety”, “accessibility and “basic amenities” got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008. Conclusion: A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

Preparedness of South African deep rural SMMEs to deliver e-government services to local communities

CSIR Research Space (South Africa)

Dlodlo, N

2009-10-01

Full Text Available This paper reports on a research to assess the readiness of Small, Medium and Micro Enterprises (SMMEs) to deliver e-government services to deep rural communities through information dissemination by the SMMEs. This research was conducted as a case...

Authenticated Location-Aware Publish/Subscribe Services in Untrusted Outsourced Environments

Directory of Open Access Journals (Sweden)

Han Yan

2017-01-01

Full Text Available Location-aware publish/subscribe is an important location-based service based on server-initiated model. Often times, the owner of massive spatio-textual messages and subscriptions outsources its location-aware publish/subscribe services to a third-party service provider, for example, cloud service provider, who is responsible for delivering messages to their relevant subscribers. The issue arising here is that the messages delivered by the service provider might be tailored for profit purposes, intentionally or not. Therefore, it is essential to develop mechanisms which allow subscribers to verify the correctness of the messages delivered by the service provider. In this paper, we study the problem of authenticating messages in outsourced location-aware publish/subscribe services. We propose an authenticated framework which not only can deliver the messages efficiently but also can make the subscribers’ authentication available with low cost. Extensive experiments on a real-world dataset demonstrate the effectiveness and efficiency of our proposed authenticated framework.

An evaluation of a collaborative bibliotherapy scheme delivered via a library service.

Science.gov (United States)

Macdonald, J; Vallance, D; McGrath, M

2013-12-01

This paper reports on the evaluation of a bibliotherapy scheme delivered via a local library service, in conjunction with General Practice (GP) practices, local social welfare agencies and through self-referral. The Read Yourself Well (RYW) scheme was based on principles established from other similar schemes and as a way of delivering support for adults experiencing mild to moderate mental health problems for whom clinical treatments are not appropriate. The intervention consisted of initial referral and evaluation by the scheme bibliotherapist, a one-hour session at the beginning and end of the intervention where a purpose-designed questionnaire and two mental health assessments were carried out (the General Health Questionnaire and the Clinical Outcomes in Routine Evaluation questionnaire). Contact and support from the bibliotherapist was provided during the intervention period. One hundred and fifty-seven participants were recruited to the evaluation of whom 114 provided full data. Statistical analyses of the mental health scores showed significant improvements post treatment, for, both male and female participants, for all three referral routes, and for participants who were previously library users, and those who joined the library service to participate in the RYW scheme. The results of this large sample evaluation support the proposal that library-based bibliotherapy can be effective in the treatment of mental health problems. © 2012 John Wiley & Sons Ltd.

The responsibility of business enterprises to restore access to essential public service at resettlement sites

NARCIS (Netherlands)

van der Ploeg, Lidewij; Vanclay, Francis; Lourenço, Ivo; Hesselman, Marlies; Hallo de Wolf, Antenor; Toebes, Brigit

2017-01-01

This chapter examines the provision of essential public services in resettlement sites associated with project induced displacement. Restoring and improving access to essential public services in resettlement sites is an important aspect of livelihood restoration of affected peoples. Project

NASA Enterprise Managed Cloud Computing (EMCC): Delivering an Initial Operating Capability (IOC) for NASA use of Commercial Infrastructure-as-a-Service (IaaS)

Science.gov (United States)

O'Brien, Raymond

2017-01-01

In 2016, Ames supported the NASA CIO in delivering an initial operating capability for Agency use of commercial cloud computing. This presentation provides an overview of the project, the services approach followed, and the major components of the capability that was delivered. The presentation is being given at the request of Amazon Web Services to a contingent representing the Brazilian Federal Government and Defense Organization that is interested in the use of Amazon Web Services (AWS). NASA is currently a customer of AWS and delivered the Initial Operating Capability using AWS as its first commercial cloud provider. The IOC, however, designed to also support other cloud providers in the future.

Integrity Assessment of Essential Service Water System of Ulchin unit 1 and 2

International Nuclear Information System (INIS)

Lee, Sun Ki; Lee, Sang Kook; Jeong, Il Suk; Song, Taek Ho; Kwon, Jong Ju; Hong, Seong Yul; Lee, Jin Hwan

2005-01-01

Because of circulating water filtration system(CFI) and essential service water system(SEC) of Ulchin unit 1 and 2 were designed by commonness water intake structure, circulating water filtration system is managed by quality grade Q class. In this study, circulating water filtration system (CFI) examined revision possibility from present quality grade Q class to R class. It is proving that the operation of essential service water system (SEC) is always available regardless CFI conditions

Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

Science.gov (United States)

Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

Perspective of patients, patients' families, and healthcare providers towards designing and delivering hospice care services in a middle income Country.

Science.gov (United States)

Azami-Aghdash, Saber; Ghojazadeh, Morteza; Aghaei, Mir Hossein; Naghavi-Behzad, Mohammad; Asgarlo, Zoleikha

2015-01-01

In view of the recent surge in chronic disease rates and elderly population in the developing countries, there is an urgent felt need for palliative and hospice care services. The present study investigates the views and attitudes of patients and their families, physicians, nurses, healthcare administrators, and insurers regarding designing and delivering hospice care service in a middle income country. In this qualitative study, the required data was collected using semi structured interviews and was analyzed using thematic analysis. Totally 65 participants from hospitals and Tabriz University of Medical Sciences were selected purposively to achieve data saturation. Analyzing the data, five main themes (barriers, facilitators, strategies, attitudes, and service provider) were extracted. Barriers included financial issues, cultural-religious beliefs, patient and family-related obstacles, and barriers related to healthcare system. Facilitators included family-related issues, cultural-religious beliefs, as well as facilitators associated with patients, healthcare status, and benefits of hospice service. Most participants (79%) had positive attitude towards hospice care service. Participant suggested 10 ways to design and deliver effective and efficient hospice care service. They thought the presence of physicians, nurses, and psychologists and other specialists and clergy were necessary in the hospice care team. Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.

Understanding the Limitations to the Right to Strike in Essential and Public Services in the SADC Region

Directory of Open Access Journals (Sweden)

Rochelle le Roux

2016-05-01

Full Text Available The nature of the limitations to the right to strike in essential and public services in the nine sub-regional countries of Southern Africa – South Africa, Botswana, Lesotho, Namibia, Swaziland, Malawi, Mozambique, Zambia and Zimbabwe – is examined in this contribution. While all of these countries share common influences and face common challenges, there appears to be a vast disparity in the approaches taken to the right to strike in public and essential services in the region. A brief overview of the demographics and labour markets in the countries under discussion is sketched, the salient features of the ILO's approach to strike in essential and public services is highlighted, and a broad overview of the contrasting and disparate approaches to essential and public services in the region is provided. The focus is, however, on the legislative approach taken to essential service employees in South Africa. It is concluded that – with the exception of South Africa and Namibia – the limitations to the right to strike of public sector employees exceed those endorsed by international conventions, and the broad definition of essential services generally relied upon effectively

Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study.

Science.gov (United States)

Yamashita, Tadashi; Reyes Tuliao, Maria Teresa; Concel Meana, Magdalena; Suplido, Sherri Ann; Llave, Cecilia L; Tanaka, Yuko; Matsuo, Hiroya

2017-01-01

A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher's exact test, and Mann-Whitney U test were used. There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility ( P Financial and environmental barriers might hinder the utilization of healthcare services by women who deliver at home in the Philippines. Low utilization of healthcare services in women who deliver at home might result in more frequent abnormal symptoms during postpartum.

Software-as-a-Service Vendors: Are They Ready to Successfully Deliver?

Science.gov (United States)

Heart, Tsipi; Tsur, Noa Shamir; Pliskin, Nava

Software as a service (SaaS) is a software sourcing option that allows organizations to remotely access enterprise applications, without having to install the application in-house. In this work we study vendors' readiness to deliver SaaS, a topic scarcely studied before. The innovation classification (evolutionary vs. revolutionary) and a new, Seven Fundamental Organizational Capabilities (FOCs) Model, are used as the theoretical frameworks. The Seven FOCs model suggests generic yet comprehensive set of capabilities that are required for organizational success: 1) sensing the stakeholders, 2) sensing the business environment, 3) sensing the knowledge environment, 4) process control, 5) process improvement, 6) new process development, and 7) appropriate resolution.

48 CFR 252.237-7023 - Continuation of Essential Contractor Services.

Science.gov (United States)

2010-10-01

... provide a written plan for continuing the performance of essential contractor services identified in...; and (v) The approach for communicating expectations to contractor employees regarding their roles and... or other designated representative as expeditiously as possible and use its best efforts to cooperate...

14 CFR 272.9 - Selection of a carrier to provide essential air service and payment of compensation.

Science.gov (United States)

2010-01-01

... SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.9 Selection of a carrier to provide essential air service and... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Selection of a carrier to provide essential...

A tiered approach for ecosystem services mapping

OpenAIRE

Grêt-Regamey, Adrienne; Weibel, Bettina; Rabe, Sven-Erik; Burkhard, Benjamin

2017-01-01

Mapping ecosystem services delivers essential insights into the spatial characteristics of various goods’ and services’ flows from nature to human society. It has become a central topic of science, policy, business and society – all belonging on functioning ecosystems. This textbook summarises the current state-of-the-art of ecosystem services mapping, related theory and methods, different ecosystem service quantification and modelling approaches as well as practical applications. The book...

Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

Science.gov (United States)

Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

2017-05-23

China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An

The Effect of Supply Disruptions on Customer Service Levels: a Case for Delivering Fertilizer Products using Maritime Transportation

Science.gov (United States)

Siswanto, N.; Kurniawati, U.; Wiratno, S. E.; Rusdiansyah, A.

2018-04-01

Delivering a product to customers can have a series of activities. It starts with the production of the product and then transporting it to the customers. However, uncontrollable and undesirable chance of disruption can occur during the delivery either at the production facility/supply side or in the process of transporting the product. Many researches has been conducting in the process of delivering the product. However not many considers these disruptions, although the disruptions has negative impacts on company such as reduce the profit, produce unbalanced inventory, and affect its reputation. This research will focus on the effect of supply disruption on customer service levels in the maritime transportation problem in order to maintain inventory level both in the supply and destination warehouses during predetermined planning horizon. The system considered consists of one loading port and two discharge ports for distributing one product. By using discrete event simulation, the result showed that supply disruption affects unbalanced inventory in the destination warehouses so that it will also influence company’s service level. The results show that there is a significant decreasing both in delivery service level, about 14%, and production service level, about 15% when the disruption occurs. A scenario to increase production rate is simulated to improved the service level.

Market-Oriented Cloud Computing: Vision, Hype, and Reality for Delivering IT Services as Computing Utilities

OpenAIRE

Buyya, Rajkumar; Yeo, Chee Shin; Venugopal, Srikumar

2008-01-01

This keynote paper: presents a 21st century vision of computing; identifies various computing paradigms promising to deliver the vision of computing utilities; defines Cloud computing and provides the architecture for creating market-oriented Clouds by leveraging technologies such as VMs; provides thoughts on market-based resource management strategies that encompass both customer-driven service management and computational risk management to sustain SLA-oriented resource allocation; presents...

Using technology to deliver mental health services to children and youth: a scoping review.

Science.gov (United States)

Boydell, Katherine M; Hodgins, Michael; Pignatiello, Antonio; Teshima, John; Edwards, Helen; Willis, David

2014-05-01

To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps. A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data. Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs. The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of findings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity.

e-Calibrations: using the Internet to deliver calibration services in real time at lower cost

International Nuclear Information System (INIS)

Desrosiers, Marc; Nagy, Vitaly; Puhl, James; Glenn, Robert; Densock, Robert; Stieren, David; Lang, Brian; Kamlowski, Andreas; Maier, Diether; Heiss, Arthur

2002-01-01

The National Institute of Standards and Technology (NIST) is expanding into a new frontier in the delivery of measurement services. The Internet will be employed to provide industry with electronic traceability to national standards. This is a radical departure from the traditional modes of traceability and presents many new challenges. The traditional mail-based calibration service relies on sending artifacts to the user, who then mails them back to NIST for evaluation. The new service will deliver calibration results to the industry customer on-demand, in real-time, at a lower cost. The calibration results can be incorporated rapidly into the production process to ensure the highest quality manufacturing. The service would provide the US radiation processing industry with a direct link to the NIST calibration facilities and its expertise, and provide an interactive feedback process between industrial processing and the national measurement standard. Moreover, an Internet calibration system should contribute to the removal of measurement-related trade barriers

Cost of delivering secondary-level health care services through public sector district hospitals in India

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

A cross-sectional survey of essential surgical capacity in Somalia.

Science.gov (United States)

Elkheir, Natalie; Sharma, Akshay; Cherian, Meena; Saleh, Omar Abdelrahman; Everard, Marthe; Popal, Ghulam Rabani; Ibrahim, Abdi Awad

2014-05-07

To assess life-saving and disability-preventing surgical services (including emergency, trauma, obstetrics, anaesthesia) of health facilities in Somalia and to assist in the planning of strategies for strengthening surgical care systems. Cross-sectional survey. Health facilities in all 3 administrative zones of Somalia; northwest Somalia (NWS), known as Somaliland; northeast Somalia (NES), known as Puntland; and south/central Somalia (SCS). 14 health facilities. The WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was employed to capture a health facility's capacity to deliver surgical and anaesthesia services by investigating four categories of data: infrastructure, human resources, interventions available and equipment. The 14 facilities surveyed in Somalia represent 10 of the 18 districts throughout the country. The facilities serve an average patient population of 331 250 people, and 12 of the 14 identify as hospitals. While major surgical procedures were provided at many facilities (caesarean section, laparotomy, appendicectomy, etc), only 22% had fully available oxygen access, 50% fully available electricity and less than 30% had any management guidelines for emergency and surgical care. Furthermore, only 36% were able to provide general anaesthesia inhalation due to lack of skills, supplies and equipment. Basic supplies for airway management and the prevention of infection transmission were severely lacking in most facilities. According to the results of the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care survey, there exist significant gaps in the capacity of emergency and essential surgical services in Somalia including inadequacies in essential equipment, service provision and infrastructure. The information provided by the WHO tool can serve as a basis for evidence-based decisions on country-level policy regarding the allocation of resources and provision of emergency and essential

Preparing pharmacists to deliver a targeted service in hypertension management: evaluation of an interprofessional training program.

Science.gov (United States)

Bajorek, Beata V; Lemay, Kate S; Magin, Parker J; Roberts, Christopher; Krass, Ines; Armour, Carol L

2015-09-28

Non-adherence to medicines by patients and suboptimal prescribing by clinicians underpin poor blood pressure (BP) control in hypertension. In this study, a training program was designed to enable community pharmacists to deliver a service in hypertension management targeting therapeutic adjustments and medication adherence. A comprehensive evaluation of the training program was undertaken. Tailored training comprising a self-directed pre-work manual, practical workshop (using real patients), and practice scenarios, was developed and delivered by an inter-professional team (pharmacists, GPs). Supported by practical and written assessment, the training focused on the principles of BP management, BP measurement skills, and adherence strategies. Pharmacists' experience of the training (expectations, content, format, relevance) was evaluated quantitatively and qualitatively. Immediate feedback was obtained via a questionnaire comprising Likert scales (1 = "very well" to 7 = "poor") and open-ended questions. Further in-depth qualitative evaluation was undertaken via semi-structured interviews several months post-training (and post service implementation). Seventeen pharmacists were recruited, trained and assessed as competent. All were highly satisfied with the training; other than the 'amount of information provided' (median score = 5, "just right"), all aspects of training attained the most positive score of '1'. Pharmacists most valued the integrated team-based approach, GP involvement, and inclusion of real patients, as well as the pre-reading manual, BP measurement workshop, and case studies (simulation). Post-implementation the interviews highlighted that comprehensive training increased pharmacists' confidence in providing the service, however, training of other pharmacy staff and patient recruitment strategies were highlighted as a need in future. Structured, multi-modal training involving simulated and inter-professional learning is effective in preparing

Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study

Directory of Open Access Journals (Sweden)

Yamashita T

2017-09-01

Full Text Available Tadashi Yamashita,1 Maria Teresa Reyes Tuliao,2 Magdalena Concel Meana,2 Sherri Ann Suplido,3 Cecilia L Llave,4 Yuko Tanaka,5 Hiroya Matsuo6 1Kobe City College of Nursing, Kobe, Japan; 2Health Department of Muntinlupa, Muntinlupa, Philippines; 3Department of Obstetrics and Gynecology, Philippine General Hospital, Manila, Philippines; 4College of Medicine (CM, University of the Philippine (UP, Manila, Philippines; 5Department of School of Health Sciences, Faculty of Medicine, Tokushima University Graduate School, Tokushima, Japan; 6Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan Background: A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. Methods: This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher’s exact test, and Mann–Whitney U test were used. Results: There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility (P<0.01. There was significant difference in the utilization of antenatal checkup (P<0.01 during pregnancy, whilst there was no

Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

Science.gov (United States)

Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

2016-04-01

Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

The GHG-CCI Project to Deliver the Essential Climate Variable Greenhouse Gases: Current status

Science.gov (United States)

Buchwitz, M.; Boesch, H.; Reuter, M.

2012-04-01

The GHG-CCI project (http://www.esa-ghg-cci.org) is one of several projects of ESA's Climate Change Initiative (CCI), which will deliver various Essential Climate Variables (ECVs). The goal of GHG-CCI is to deliver global satellite-derived data sets of the two most important anthropogenic greenhouse gases (GHGs) carbon dioxide (CO2) and methane (CH4) suitable to obtain information on regional CO2 and CH4 surface sources and sinks as needed for better climate prediction. The GHG-CCI core ECV data products are column-averaged mole fractions of CO2 and CH4, XCO2 and XCH4, retrieved from SCIAMACHY on ENVISAT and TANSO on GOSAT. Other satellite instruments will be used to provide constraints in upper layers such as IASI, MIPAS, and ACE-FTS. Which of the advanced algorithms, which are under development, will be the best for a given data product still needs to be determined. For each of the 4 GHG-CCI core data products - XCO2 and XCH4 from SCIAMACHY and GOSAT - several algorithms are bing further developed and the corresponding data products are inter-compared to identify which data product is the most appropriate. This includes comparisons with corresponding data products generated elsewhere, most notably with the operational data products of GOSAT generated at NIES and the NASA/ACOS GOSAT XCO2 product. This activity, the so-called "Round Robin exercise", will be performed in the first two years of this project. At the end of the 2 year Round Robin phase (end of August 2012) a decision will be made which of the algorithms performs best. The selected algorithms will be used to generate the first version of the ECV GHG. In the last six months of this 3 year project the resulting data products will be validated and made available to all interested users. In the presentation and overview about this project will be given focussing on the latest results.

Preparing pharmacists to deliver a targeted service in hypertension management: evaluation of an interprofessional training program

OpenAIRE

Bajorek, Beata V.; Lemay, Kate S.; Magin, Parker J.; Roberts, Christopher; Krass, Ines; Armour, Carol L.

2015-01-01

Background Non-adherence to medicines by patients and suboptimal prescribing by clinicians underpin poor blood pressure (BP) control in hypertension. In this study, a training program was designed to enable community pharmacists to deliver a service in hypertension management targeting therapeutic adjustments and medication adherence. A comprehensive evaluation of the training program was undertaken. Methods Tailored training comprising a self-directed pre-work manual, practical workshop (usi...

Trust - Essential Requirement and Basis for pHealth Services.

Science.gov (United States)

Ruotsalainen, Pekka; Blobel, Bernd

2017-01-01

Trust is a social code and glue between persons and organizations in any business domain including health. pHealth is a complex concept that is built around health service providers, individuals and artefacts such as sensors, mobile devices, networks, computers, and software applications. It has many stakeholders such as organizations, persons, patients, customers, and tele-operators. pHealth services are increasingly offered in insecure information space, and used over organizational, geographical and jurisdictional borders. This all means that trust is an essential requirement for successful pHealth services. To make pHealth a successful business, organizations offering pHealth services should establish inter-organizational trust and trusted relationship between their customers. Before starting to use services, the pHealth user should have a possibility to define how much it trusts on the service provider and on the surrounding information infrastructure. The authors' analysis show that trust models used in today's health care and e-commerce are insufficient for networked pHealth. Calculated trust as proposed by the authors is stronger than the predefined dispositional trust model currently used in health care, other's recommendations used in e-commerce and risk assessment. Until now, caused by the lack of business incentive, lack of regulatory and political pressure, pHealth providers have not demonstrated meaningful interest in moving from the current unsatisfactory situation to trust calculation by making information necessary for this methodology available. To make pHealth successful, a combination of legal, political, organizational, technological and educational efforts is needed to initiate the paradigm change and start the era of trust-based pHealth services.

A model to estimate the cost of the National Essential Public Health Services Package in Beijing, China.

Science.gov (United States)

Yin, Delu; Wong, Sabrina T; Chen, Wei; Xin, Qianqian; Wang, Lihong; Cui, Mingming; Yin, Tao; Li, Ruili; Zheng, Xiaoguo; Yang, Huiming; Yu, Juanjuan; Chen, Bowen; Yang, Weizhong

2015-06-06

In order to address several health challenges, the Chinese government issued the National Essential Public Health Services Package (NEPHSP) in 2009. In China's large cities, the lack of funding for community health centers and consequent lack of comprehensive services and high quality care has become a major challenge. However, no study has been carried out to estimate the cost of delivering the services in the package. This project was to develop a cost estimation approach appropriate to the context and use it to calculate the cost of the NEPHSP in Beijing in 2011. By adjusting models of cost analysis of primary health care and workload indicators of staffing need developed by the World Health Organization, a model was developed to estimate the cost of the services in the package through an intensive interactive process. A total of 17 community health centers from eight administrative districts in Beijing were selected. Their service volume and expenditure data in 2010 were used to evaluate the costs of providing the NEPHSP in Beijing based on the applied model. The total workload of all types of primary health care in 17 sample centers was equivalent to the workload requirement for 14,056,402 standard clinic visits. The total expenditure of the 17 sample centers was 26,329,357.62 USD in 2010. The cost of the workload requirement of one standard clinic visit was 1.87 USD. The workload of the NEPHSP was equivalent to 5,514,777 standard clinic visits (39.23 % of the total workload). The model suggests that the cost of the package in Beijing was 7.95 USD per capita in 2010. The cost of the NEPHSP in urban areas was lower than suburban areas: 7.31 and 8.65 USD respectively. The average investment of 3.97 USD per capita in NEPHSP was lower than the amount needed to meet its running costs. NEPHSP in Beijing is therefore underfunded. Additional investment is needed, and a dynamic cost estimate mechanism should be introduced to ensure services remain adequately funded.

Delivering Library Services to Remote Students.

Science.gov (United States)

Casado, Margaret

2001-01-01

Discusses library services at the University of Tennessee to reach off-campus and distance education students. Topics include online research; email; library instruction for faculty and students; Web interfaces; fax; telephone service; chat technology; the library's Web page; virtual classrooms; library links from a course management system; and…

NOAA's Regional Climate Services Program: Building Relationships with Partners and Customers to Deliver Trusted Climate Information at Usable Scales

Science.gov (United States)

Mecray, E. L.; Dissen, J.

2016-12-01

Federal agencies across multiple sectors from transportation to health, emergency management and agriculture, are now requiring their key stakeholders to identify and plan for climate-related impacts. Responding to the drumbeat for climate services at the regional and local scale, the National Oceanic and Atmospheric Administration (NOAA) formed its Regional Climate Services (RCS) program to include Regional Climate Services Directors (RCSD), Regional Climate Centers, and state climatologists in a partnership. Since 2010, the RCS program has engaged customers across the country and amongst many of the nation's key economic sectors to compile information requirements, deliver climate-related products and services, and build partnerships among federal agencies and their regional climate entities. The talk will include a sketch from the Eastern Region that may shed light on the interaction of the multiple entities working at the regional scale. Additionally, we will show examples of our interagency work with the Department of Interior, the Department of Agriculture, and others in NOAA to deliver usable and trusted climate information and resources. These include webinars, print material, and face-to-face customer engagements to gather and respond to information requirements. NOAA/National Centers for Environmental Information's RCSDs work on-the-ground to learn from customers about their information needs and their use of existing tools and resources. As regional leads, the RCSDs work within NOAA and with our regional partners to ensure the customer receives a broad picture of the tools and information from across the nation.

Motivating Customer Service Employees to Deliver Service Quality

National Research Council Canada - National Science Library

Whisnant, Andre

1999-01-01

.... With higher levels of customer service, greater customer satisfaction will follow. This increased customer satisfaction leads to increased customer loyalty and retention, producing higher sales...

Using latency as a QoS indicator for global cloud computing services

DEFF Research Database (Denmark)

Pedersen, Jens Myrup; Riaz, Tahir; Dubalski, Bozydar

2013-01-01

Many globally distributed cloud computing (CC) applications and services running over the Internet, between globally dispersed clients and servers, will require certain levels of QoS in order to deliver and give a sufficiently smooth user experience. This would be essential for real-time streaming...

Evaluation of a co-delivered training package for community mental health professionals on service user- and carer-involved care planning.

Science.gov (United States)

Grundy, A C; Walker, L; Meade, O; Fraser, C; Cree, L; Bee, P; Lovell, K; Callaghan, P

2017-08-01

WHAT IS KNOWN ON THE SUBJECT?: There is consistent evidence that service users and carers feel marginalized in the process of mental health care planning. Mental health professionals have identified ongoing training needs in relation to involving service users and carers in care planning. There is limited research on the acceptability of training packages for mental health professionals which involve service users and carers as co-facilitators. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A co-produced and co-delivered training package on service user- and carer-involved care planning was acceptable to mental health professionals. Aspects of the training that were particularly valued were the co-production model, small group discussion and the opportunity for reflective practice. The organizational context of care planning may need more consideration in future training models. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses using co-production models of delivering training to other mental health professionals can be confident that such initiatives will be warmly welcomed, acceptable and engaging. On the basis of the results reported here, we encourage mental health nurses to use co-production approaches more often. Further research will show how clinically effective this training is in improving outcomes for service users and carers. Background There is limited evidence for the acceptability of training for mental health professionals on service user- and carer-involved care planning. Aim To investigate the acceptability of a co-delivered, two-day training intervention on service user- and carer-involved care planning. Methods Community mental health professionals were invited to complete the Training Acceptability Rating Scale post-training. Responses to the quantitative items were summarized using descriptive statistics (Miles, ), and qualitative responses were coded using content analysis (Weber, ). Results Of 350 trainees, 310 completed the

Perspective of patients, patients' families, and healthcare providers towards designing and delivering hospice care services in a middle income Country

Directory of Open Access Journals (Sweden)

Saber Azami-Aghdash

2015-01-01

Conclusion: Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.

Feasibility of a clearing house for improved cooperation between telemedicine networks delivering humanitarian services: acceptability to network coordinators

Directory of Open Access Journals (Sweden)

Richard Wootton

2012-10-01

Full Text Available Background: Telemedicine networks, which deliver humanitarian services, sometimes need to share expertise to find particular experts in other networks. It has been suggested that a mechanism for sharing expertise between networks (a ‘clearing house’ might be useful. Objective: To propose a mechanism for implementing the clearing house concept for sharing expertise, and to confirm its feasibility in terms of acceptability to the relevant networks. Design: We conducted a needs analysis among eight telemedicine networks delivering humanitarian services. A small proportion of consultations (5–10% suggested that networks may experience difficulties in finding the right specialists from within their own resources. With the assistance of key stakeholders, many of whom were network coordinators, various methods of implementing a clearing house were considered. One simple solution is to establish a central database holding information about consultants who have agreed to provide help to other networks; this database could be made available to network coordinators who need a specialist when none was available in their own network. Results: The proposed solution was examined in a desktop simulation exercise, which confirmed its feasibility and probable value. Conclusions: This analysis informs full-scale implementation of a clearing house, and an associated examination of its costs and benefits.

IT service management - key to the quality of IT service delivering

International Nuclear Information System (INIS)

Recky, M.

2004-01-01

Objective of the contribution is to introduce IT service management (ITSM) as an approach to services quality improvement provided by IT departments of enterprises. As a result of massive application of information technologies in the past, the enterprises have become increasingly dependent on processes within IT of which many are critical for the business operations. Therefore it appears to be inevitable for IT organizations to become customer-oriented. ITSM's objective is to implement standardized and measurable IT services in every enterprise, to enable accurate service cost allocation and increase accuracy of planning of IT budget and investments. This method is based on processes definition, necessary technologies implementation and restructuralisation of human resources in IT organisations. It requires a change of attitude towards IT users who become IT department customers as well as cost-balanced utilization of in-sourcing and out-sourcing etc. Hewlett-Packard is a global leader offering its consulting and integration services in the area of IT service management together with an extensive portfolio of related technologies based on HP OpenView software platform. (author)

The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

Science.gov (United States)

Faye, M

2013-01-01

This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

The impact of employees' Motivation and Empowerment on Delivering Service Quality to Enhance Customer Satisfaction: Case Company X

OpenAIRE

Maria Amaanda, Nepwanga

2011-01-01

The main objective of this thesis is to assess the impact of employee motivation and empowerment on delivering quality service towards the enhancement of customer satisfaction for Company X of Namibia. The main purpose is to assist the management of Company X in finding the various measures that can be adopted to motivate and empower the employees. To analyse the current situation prevailing within the organization under review a qualitative research approach was used in this study. The r...

Ecosystem services delivered by weaver ants

DEFF Research Database (Denmark)

Offenberg, Joachim

Weaver ants (Oecopgylla spp.) are increasingly being utilized as efficient biocontrol agents in a number of tropical tree crops, as they prey on pest insects and increase yields. However, recent studies and a review of the literature reveal that a number of other services may derive from the pres......Weaver ants (Oecopgylla spp.) are increasingly being utilized as efficient biocontrol agents in a number of tropical tree crops, as they prey on pest insects and increase yields. However, recent studies and a review of the literature reveal that a number of other services may derive from...... the presence of these ants. First of all, the chemical footprint left by the high density of ants in managed host trees may results in additional benefits. (i) Ant deposits may lead to improved fruit quality, e.g. increased sugar content, (ii) ant deposits may deter important pests (chemical deterrence) from...... crops, and lastly, (iii) ant waste products deposited ias anal spots contain urea that may be taken up by plant leaves and in this way fertilize ant-plants. On top of chemical services, weaver ants have been shown to reduce plant disease incidence via competitive exclusion of other ant species because...

Enabling the maximum number of people to access essential services will not be possible without private sector involvement and appropriate pricing of the services concerned

Directory of Open Access Journals (Sweden)

Luc Rigouzzo

2012-06-01

Full Text Available Private sector provision of basic services (water, energy, financial services and housing for people in developing countries is a necessity if we really want to try to curb poverty. However, ‘traditional’ private funding is not spontaneously directed towards these sectors, largely as a result of rejecting the idea that poor population groups should ‘pay’ for essential services; an issue that has often been the subject of opposition campaigns mounted by social stakeholders. Nevertheless, there are many, many examples to show that given the impact of these services on their quality of life, consumers in these countries - and especially those at the ‘bottom of the pyramid’ - are prepared to pay for them as long as they have access to a high-quality service. In these sectors, the nominal cost of the service concerned matters much less than its opportunity cost and the impact it will have on the lives of those who benefit from it. Very often, this service may even be paid for in advance as a way of enabling families to gain greater control over the expenditure they can devote to obtaining it.It is, however, important to distinguish between the supply of essential services and those of consumer goods, and - of course - to avoid abuses. In any event, the possibility of building financially-balanced models is what governs the process of securing sufficient funding from local and international financial institutions. In this area, as in others, the way forward is probably the happy medium: avoiding the excesses of overpricing, but accepting the need to maintain profitable economic models. These should enable investors to receive a level of profit that encourages them to continue and increase their investment, thereby increasing the number of recipients as quickly as possible. Aspiring to build social models that reject the ambition to achieve a reasonable profit and rule out any distribution of dividends to shareholders is to condemn the

Climate Analytics-As-a-Service (CAaas), Advanced Information Systems, and Services to Accelerate the Climate Sciences.

Science.gov (United States)

McInerney, M.; Schnase, J. L.; Duffy, D.; Tamkin, G.; Nadeau, D.; Strong, S.; Thompson, J. H.; Sinno, S.; Lazar, D.

2014-12-01

The climate sciences represent a big data domain that is experiencing unprecedented growth. In our efforts to address the big data challenges of climate science, we are moving toward a notion of Climate Analytics-as-a-Service (CAaaS). We focus on analytics, because it is the knowledge gained from our interactions with big data that ultimately product societal benefits. We focus on CAaaS because we believe it provides a useful way of thinking about the problem: a specialization of the concept of business process-as-a-service, which is an evolving extension of IaaS, PaaS, and SaaS enabled by cloud computing. Within this framework, cloud computing plays an important role; however, we see it as only one element in a constellation of capabilities that are essential to delivering climate analytics-as-a-service. These elements are essential because in the aggregate they lead to generativity, a capacity for self-assembly that we feel is the key to solving many of the big data challenges in this domain. This poster will highlight specific examples of CAaaS using climate reanalysis data, high-performance cloud computing, map reduce, and the Climate Data Services API.

Successful healthcare programs and projects: organization portfolio management essentials.

Science.gov (United States)

Pickens, Scott; Solak, Jamie

2005-01-01

Many healthcare organization projects take more time and resources than planned and fail to deliver desired business outcomes. Healthcare IT is a major component of many projects and often undeservedly receives the blame for failure. Poor results are often not a result of faulty healthcare IT or poor project management or poor project execution alone. Many projects fail because of poor portfolio management--poor planning and management of the portfolio of initiatives designed to meet an organization's strategic goals. Because resources are limited, portfolio management enables organizations to more strategically allocate and manage their resources so care delivery, service delivery, and initiatives that advance organizations toward their strategic goals, including healthcare IT initiatives, can be accomplished at the levels of quality and service desired by an organization. Proper portfolio management is the essential foundation for program and project success and supports overall organization success. Without portfolio management, even programs and projects that execute flawlessly may not meet desired objectives. This article discusses the essential requirements for porfolio management. These include opportunity identification, return on investment (ROI) forecast, project prioritization, capacity planning (inclusive of human, financial, capital, and facilities resources), work scheduling, program and project management and execution, and project performance and value assessment. Portfolio management is essential to successful healthcare project execution. Theories are drawn from the Organizational Project Management Maturity Model (OPM3) work of the Project Management Institute and other leading strategy, planning, and organization change management research institutes.

Ecosystem services in European protected areas: Ambiguity in the views of scientists and managers?

NARCIS (Netherlands)

Hummel, C.; Provenzale, A.; Van der Meer, J.; Wijnhoven, S.; Nolte, A.; Poursanidis, D.; Janss, G.; Jurek, M.; Andresen, M.; Poulin, B.; Kobler, J.; Beierkuhnlein, C.; Honrado, J.; Razinkovas, A.; Stritih, A.; Bargmann, T.; Ziemba, A.; Bonet-García, F.; Adamescu, M.C.; Janssen, G.; Hummel, H.

2017-01-01

Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers,

Demonstration of Essential Reliability Services by a 300-MW Solar Photovoltaic Power Plant

Energy Technology Data Exchange (ETDEWEB)

Loutan, Clyde; Klauer, Peter; Chowdhury, Sirajul; Hall, Stephen; Morjaria, Mahesh; Chadliev, Vladimir; Milam, Nick; Milan, Christopher; Gevorgian, Vahan

2017-03-24

The California Independent System Operator (CAISO), First Solar, and the National Renewable Energy Laboratory (NREL) conducted a demonstration project on a large utility-scale photovoltaic (PV) power plant in California to test its ability to provide essential ancillary services to the electric grid. With increasing shares of solar- and wind-generated energy on the electric grid, traditional generation resources equipped with automatic governor control (AGC) and automatic voltage regulation controls -- specifically, fossil thermal -- are being displaced. The deployment of utility-scale, grid-friendly PV power plants that incorporate advanced capabilities to support grid stability and reliability is essential for the large-scale integration of PV generation into the electric power grid, among other technical requirements. A typical PV power plant consists of multiple power electronic inverters and can contribute to grid stability and reliability through sophisticated 'grid-friendly' controls. In this way, PV power plants can be used to mitigate the impact of variability on the grid, a role typically reserved for conventional generators. In August 2016, testing was completed on First Solar's 300-MW PV power plant, and a large amount of test data was produced and analyzed that demonstrates the ability of PV power plants to use grid-friendly controls to provide essential reliability services. These data showed how the development of advanced power controls can enable PV to become a provider of a wide range of grid services, including spinning reserves, load following, voltage support, ramping, frequency response, variability smoothing, and frequency regulation to power quality. Specifically, the tests conducted included various forms of active power control such as AGC and frequency regulation; droop response; and reactive power, voltage, and power factor controls. This project demonstrated that advanced power electronics and solar generation can be

Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

Directory of Open Access Journals (Sweden)

Peter Waiswa

2015-03-01

Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was

Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output

Science.gov (United States)

Geissbuhler, Antoine; Jethwani, Kamal; Kovarik, Carrie; Person, Donald A; Vladzymyrskyy, Anton; Zanaboni, Paolo; Zolfo, Maria

2012-01-01

Abstract Objective To summarize the experience, performance and scientific output of long-running telemedicine networks delivering humanitarian services. Methods Nine long-running networks – those operating for five years or more– were identified and seven provided detailed information about their activities, including performance and scientific output. Information was extracted from peer-reviewed papers describing the networks’ study design, effectiveness, quality, economics, provision of access to care and sustainability. The strength of the evidence was scored as none, poor, average or good. Findings The seven networks had been operating for a median of 11 years (range: 5–15). All networks provided clinical tele-consultations for humanitarian purposes using store-and-forward methods and five were also involved in some form of education. The smallest network had 15 experts and the largest had more than 500. The clinical caseload was 50 to 500 cases a year. A total of 59 papers had been published by the networks, and 44 were listed in Medline. Based on study design, the strength of the evidence was generally poor by conventional standards (e.g. 29 papers described non-controlled clinical series). Over half of the papers provided evidence of sustainability and improved access to care. Uncertain funding was a common risk factor. Conclusion Improved collaboration between networks could help attenuate the lack of resources reported by some networks and improve sustainability. Although the evidence base is weak, the networks appear to offer sustainable and clinically useful services. These findings may interest decision-makers in developing countries considering starting, supporting or joining similar telemedicine networks. PMID:22589567

Operations and quality management for public service delivery improvement.

Directory of Open Access Journals (Sweden)

Paulin Mbecke

2014-10-01

Full Text Available Public service management reforms have not yet contributed to poverty eradication and generally socio-economic development of many African countries. The reforms suggested and implemented to date still prove to be weak in addressing the many challenges faced by the public service in delivering goods and services to the population. The failure of the current public service management calls for a consideration of business-driven approaches and practices that facilitate effectiveness, efficiency, competitiveness and flexibility in goods and services provision. The critical social theory methodology and the literature review technique described and raised awareness on service delivery chaos in South Africa. A public service reform that focuses on operations and quality management is one of the ways of improving and sustaining service delivery in South Africa. Operations management is an essential tool for the planning, execution, control, monitoring and evaluation of production processes. Quality management, in the other hand, is essential to ensure best quality of goods and services produced by the public service within acceptable time and available resources to meet or exceed people’s expectations. The operations and quality management framework proposed in this article is a potential alternative to the current service delivery crisis in South Africa.

Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service.

Science.gov (United States)

Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec

2015-01-01

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

Service quality, satisfaction, and behavioral intention in home delivered meals program

Science.gov (United States)

Joung, Hyun-Woo; Yuan, Jingxue Jessica; Huffman, Lynn

2011-01-01

This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs. PMID:21556231

Service quality, satisfaction, and behavioral intention in home delivered meals program.

Science.gov (United States)

Joung, Hyun-Woo; Kim, Hak-Seon; Yuan, Jingxue Jessica; Huffman, Lynn

2011-04-01

This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs.

Delivering a quality-assured fracture liaison service in a UK teaching hospital-is it achievable?

Science.gov (United States)

Shipman, K E; Stammers, J; Doyle, A; Gittoes, N

2016-10-01

To determine whether new national guidance on the specifications of a fracture liaison service are realistically deliverable, 1 year of data on the performance of such a service were audited. Audit targets were mostly met. This audit demonstrates that these standards are deliverable in a real world setting. UK service specifications for a fracture liaison service (FLS) have been produced (National Osteoporosis Society, NOS) to promote effective commissioning and delivery of the highest quality care to patients with fragility fractures. How deliverable these standards are has not as yet been methodically reported. Our FLS was modelled on the ten NOS standards; performance was audited after 1 year to determine whether these standards could be delivered and to describe the lessons learnt. Performance was audited against the NOS FLS Service Standards, with management based on the Fracture Risk Assessment Tool (FRAX®), the four-item Falls Risk Assessment Tool (FRAT), National Institute for Health and Care Excellence (NICE) and the National Osteoporosis Guideline Groups (NOGG) guidance. Data were recorded prospectively on a database. The FLS commenced in May 2014, was fully operational in August 2014 and data were captured from 1 September 2014 to 1 September 2015. The FLS detected 1773 patients and standards were largely achieved. Most, 94 %, patients were seen within 6 weeks, 533 DXA requests were generated, 804 outpatient FRAT assessments were recorded (134 required falls intervention) and 773 patients had bone treatments started. On follow-up at 3 months, between 78-79 % were still taking medication. Preliminary evaluation of a FLS implemented according to UK NOS standards demonstrates that the model is practical to apply to a large teaching hospital population. Collection and review of outcome and cost effectiveness data is required to determine the performance of this model in comparison with existing models.

Online Services Management Support for an Intelligent Locality

Directory of Open Access Journals (Sweden)

Lorena BĂTĂGAN

2011-07-01

Full Text Available As the number of habitants of large cities is expanding, put greater pressure on city infrastructure delivering vital services, such as health, education, public safety and transport. These efforts are added to changing public demands for better information, better education, environmental programs, a more open government, lower maintenance costs and other housing options for older people. Therefore, to achieve these goals, it must take into account the quality of all services, but especially the quality of online services based on the use of modern information and communication technologies.The management of service quality on-line offers a performance evaluation and comparative analysis of indicators. He also works as a decision support to improve the quality of online services and increasing customer satisfaction, essential elements in an intelligent city.

An Automatic Web Service Composition Framework Using QoS-Based Web Service Ranking Algorithm.

Science.gov (United States)

Mallayya, Deivamani; Ramachandran, Baskaran; Viswanathan, Suganya

2015-01-01

Web service has become the technology of choice for service oriented computing to meet the interoperability demands in web applications. In the Internet era, the exponential addition of web services nominates the "quality of service" as essential parameter in discriminating the web services. In this paper, a user preference based web service ranking (UPWSR) algorithm is proposed to rank web services based on user preferences and QoS aspect of the web service. When the user's request cannot be fulfilled by a single atomic service, several existing services should be composed and delivered as a composition. The proposed framework allows the user to specify the local and global constraints for composite web services which improves flexibility. UPWSR algorithm identifies best fit services for each task in the user request and, by choosing the number of candidate services for each task, reduces the time to generate the composition plans. To tackle the problem of web service composition, QoS aware automatic web service composition (QAWSC) algorithm proposed in this paper is based on the QoS aspects of the web services and user preferences. The proposed framework allows user to provide feedback about the composite service which improves the reputation of the services.

Impact of peer delivered wellness coaching.

Science.gov (United States)

Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

2016-09-01

People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Grid Technology as a Cyberinfrastructure for Delivering High-End Services to the Earth and Space Science Community

Science.gov (United States)

Hinke, Thomas H.

2004-01-01

services discovered using semantic grid technology. As required, high-end computational resources could be drawn from available grid resource pools. Using grid technology, this confluence of data, services and computational resources could easily be harnessed to transform data from many different sources into a desired product that is delivered to a user's workstation or to a web portal though which it could be accessed by its intended audience.

Human Rights and Health Services

DEFF Research Database (Denmark)

Skitsou, Alexandra; Bekos, Christos; Charalambous, George

2016-01-01

Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions of the Ombuds......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...

A review of international pharmacy-based minor ailment services and proposed service design model.

Science.gov (United States)

Aly, Mariyam; García-Cárdenas, Victoria; Williams, Kylie; Benrimoj, Shalom I

2018-01-05

The need to consider sustainable healthcare solutions is essential. An innovative strategy used to promote minor ailment care is the utilisation of community pharmacists to deliver minor ailment services (MASs). Promoting higher levels of self-care can potentially reduce the strain on existing resources. To explore the features of international MASs, including their similarities and differences, and consider the essential elements to design a MAS model. A grey literature search strategy was completed in June 2017 to comply with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard. This included (1) Google/Yahoo! search engines, (2) targeted websites, and (3) contact with commissioning organisations. Executive summaries, table of contents and title pages of documents were reviewed. Key characteristics of MASs were extracted and a MAS model was developed. A total of 147 publications were included in the review. Key service elements identified included eligibility, accessibility, staff involvement, reimbursement systems. Several factors need to be considered when designing a MAS model; including contextualisation of MAS to the market. Stakeholder engagement, service planning, governance, implementation and review have emerged as key aspects involved with a design model. MASs differ in their structural parameters. Consideration of these parameters is necessary when devising MAS aims and assessing outcomes to promote sustainability and success of the service. Copyright © 2018 Elsevier Inc. All rights reserved.

Interdependence and dynamics of essential services in an extensive risk context: a case study in Montserrat, West Indies

Science.gov (United States)

Sword-Daniels, V. L.; Rossetto, T.; Wilson, T. M.; Sargeant, S.

2015-05-01

The essential services that support urban living are complex and interdependent, and their disruption in disasters directly affects society. Yet there are few empirical studies to inform our understanding of the vulnerabilities and resilience of complex infrastructure systems in disasters. This research takes a systems thinking approach to explore the dynamic behaviour of a network of essential services, in the presence and absence of volcanic ashfall hazards in Montserrat, West Indies. Adopting a case study methodology and qualitative methods to gather empirical data, we centre the study on the healthcare system and its interconnected network of essential services. We identify different types of relationship between sectors and develop a new interdependence classification system for analysis. Relationships are further categorised by hazard conditions, for use in extensive risk contexts. During heightened volcanic activity, relationships between systems transform in both number and type: connections increase across the network by 41%, and adapt to increase cooperation and information sharing. Interconnections add capacities to the network, increasing the resilience of prioritised sectors. This in-depth and context-specific approach provides a new methodology for studying the dynamics of infrastructure interdependence in an extensive risk context, and can be adapted for use in other hazard contexts.

MATURITY MODEL FOR IT SERVICE OUTSOURCING IN HIGHER EDUCATION INSTITUTIONS

OpenAIRE

Victoriano Valencia García; Dr. Eugenio J. Fernández Vicente; Dr. Luis Usero Aragonés

2013-01-01

The current success of organizations depends on the successful implementation of Information and Comunication Technologies (ICTs). Good governance and ICT management are essential for delivering value, managing technological risks, managing resources and performance measurement. In addition, outsourcing is a strategic option which complements IT services provided internally in organizations. This paper proposes the design of a new holistic maturity model based on standards ISO/IEC 20000 and I...

Controlling outsourced service delivery : Managing service quality in business service triads

NARCIS (Netherlands)

van Iwaarden, J.; van der Valk, W.

2013-01-01

Organisations are increasingly sourcing services that become part of their value proposition to their (business) customers from external providers. Often, these services are directly delivered by the service provider to the customer. The buying organisation, service provider and customer operate in

Regulatory analysis for the resolution of Generic Issue 130: Essential service water system failures at multi-unit sites

International Nuclear Information System (INIS)

Leung, V.; Basdekas, D.; Mazetis, G.

1991-06-01

The essential service water system (ESWS) is required to provide cooling in nuclear power plants during normal operation and accident conditions. The ESWS typically supports component cooling water heat exchangers, containment spray heat exchangers, high-pressure injection pump oil coolers, emergency diesel generators, and auxiliary building ventilation coolers. Failure of the ESWS function could lead to severe consequences. This report presents the regulatory analysis for GI-130, ''Essential Service Water System Failures at Multi-Unit Sites.'' The risk reduction estimates, cost/benefit analyses, and other insights gained during this effort have shown that implementation of the recommendations will significantly reduce risk and that these improvements are warranted in accordance with the backfit rule, 10 CFR 50.109(a)(3). 19 refs., 16 tabs

School Nurse-Delivered Adolescent Relationship Abuse Prevention

Science.gov (United States)

Raible, Claire A.; Dick, Rebecca; Gilkerson, Fern; Mattern, Cheryl S.; James, Lisa; Miller, Elizabeth

2017-01-01

Background: Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office…

An Examination of Peer-Delivered Parenting Skills Programs Across New York State.

Science.gov (United States)

Acri, Mary C; Craig, Nancy; Adler, Josh

2018-03-24

Peers are an important adjunct to the public mental health service system, and are being increasingly utilized across the country as a cost-effective solution to workforce shortages. Despite the tremendous growth of peer-delivered support over the past two decades, it has only been within the past few years that peer programs have been the subject of empirical inquiry. The purpose of this study was to examine the prevalence and characteristics of peer-delivered parenting programs across the New York State public mental health service system. We surveyed 46 family peer organizations across New York State regarding their delivery of structured peer-delivered parenting programs. Thirty-four (76%) completed the questionnaire, and of them, 18 (53%) delivered a parenting program. Subsequent interviews with seven of the 18 organizations revealed peer organizations had been delivering eight unique parenting programs for upwards of two decades. Additionally, organizations offered multiple supports to families to participate. Training, supervision, and issues around fidelity are discussed, as well as the implications of this study for states utilizing a peer workforce.

Delivering interventions to reduce the global burden of stillbirths: improving service supply and community demand

Science.gov (United States)

Bhutta, Zulfiqar A; Darmstadt, Gary L; Haws, Rachel A; Yakoob, Mohammad Yawar; Lawn, Joy E

2009-01-01

Background Although a number of antenatal and intrapartum interventions have shown some evidence of impact on stillbirth incidence, much confusion surrounds ideal strategies for delivering these interventions within health systems, particularly in low-/middle-income countries where 98% of the world's stillbirths occur. Improving the uptake of quality antenatal and intrapartum care is critical for evidence-based interventions to generate an impact at the population level. This concluding paper of a series of papers reviewing the evidence for stillbirth interventions examines the evidence for community and health systems approaches to improve uptake and quality of antenatal and intrapartum care, and synthesises programme and policy recommendations for how best to deliver evidence-based interventions at community and facility levels, across the continuum of care, to reduce stillbirths. Methods We systematically searched PubMed and the Cochrane Library for abstracts pertaining to community-based and health-systems strategies to increase uptake and quality of antenatal and intrapartum care services. We also sought abstracts which reported impact on stillbirths or perinatal mortality. Searches used multiple combinations of broad and specific search terms and prioritised rigorous randomised controlled trials and meta-analyses where available. Wherever eligible randomised controlled trials were identified after a Cochrane review had been published, we conducted new meta-analyses based on the original Cochrane criteria. Results In low-resource settings, cost, distance and the time needed to access care are major barriers for effective uptake of antenatal and particularly intrapartum services. A number of innovative strategies to surmount cost, distance, and time barriers to accessing care were identified and evaluated; of these, community financial incentives, loan/insurance schemes, and maternity waiting homes seem promising, but few studies have reported or evaluated the

Training radiographers to deliver an intervention to promote early presentation of breast cancer

International Nuclear Information System (INIS)

Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

2012-01-01

Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

Process Improvement Essentials

CERN Document Server

Persse, James R

2006-01-01

Process Improvement Essentials combines the foundation needed to understand process improvement theory with the best practices to help individuals implement process improvement initiatives in their organization. The three leading programs: ISO 9001:2000, CMMI, and Six Sigma--amidst the buzz and hype--tend to get lumped together under a common label. This book delivers a combined guide to all three programs, compares their applicability, and then sets the foundation for further exploration.

Are one-stop centres an appropriate model to deliver services to sexually abused children in urban Malawi?

Science.gov (United States)

Mulambia, Yabwile; Miller, Aaron J; MacDonald, Geraldine; Kennedy, Neil

2018-04-30

The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as 'Chikwanekwanes' - 'everything under one roof') to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country's first Chikwanekwane in the large, urban city of Blantyre. One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

Energy Technology Data Exchange (ETDEWEB)

Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [University of Crete, Interventional Radiology Unit, Department of Radiology, University Hospital Heraklion, Faculty of Medicine (Greece); Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliff Hospital, Radiology Department (United Kingdom); Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza – University of Rome, Interventional Radiology Unit, Department of Radiological Sciences (Italy); Roberston, Iain, E-mail: bsiriain@gmail.com [Gartnavel General Hospital, Interventional Radiology Unit (United Kingdom); Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology (United Kingdom); Delden, Otto van, E-mail: o.m.vandelden@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands); Radeleff, Boris, E-mail: boris.radeleff@med.uni-heidelberg.de [University Hospital of Heidelberg, Department for Diagnostic and Interventional Radiology (Germany); Müller-Hülsbeck, Stefan, E-mail: muehue@diako.de [Ev.-Luth. Diakonissenanstalt zu Flensburg – Zentrum für Gesundheit und Diakonie, Diagnostische u. Interventionelle Radiologie/Neuroradiologie (Germany); Szerbo-Trojanowska, Malgorzata, E-mail: m.trojanowska@umlub.pl [Medical University of Lublin, Interventional Radiology (Poland); Lee, Michael, E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland); Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom); Brountzos, Elias, E-mail: ebrountz@med.uoa.gr [National and Kapodistrian University of Athens (Greece); Belli, Anna Maria, E-mail: Anna.belli@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom)

2016-04-15

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

International Nuclear Information System (INIS)

Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; Delden, Otto van; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

2016-01-01

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

Controlling service delivery in service triads

NARCIS (Netherlands)

Iwaarden, van J.; Valk, van der W.; Aalders, L.; Virolainen, V.-M.

2010-01-01

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

The knowledge and skills gap of medical practitioners delivering ...

African Journals Online (AJOL)

The knowledge and skills gap of medical practitioners delivering district hospital ... and quality health services, and also for guiding appropriate undergraduate, ... The uneven skill and knowledge base in aspects of HIV/AIDS management ...

Anger management for people with mild to moderate learning disabilities: Study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff

Directory of Open Access Journals (Sweden)

Nuttall Jacqueline

2011-02-01

Full Text Available Abstract Background Cognitive behaviour therapy (CBT is the treatment of choice for common mental health problems, but this approach has only recently been adapted for people with learning disabilities, and there is a limited evidence base for the use of CBT with this client group. Anger treatment is the one area where there exists a reasonable number of small controlled trials. This study will evaluate the effectiveness of a manualized 12-week CBT intervention for anger. The intervention will be delivered by staff working in the day services that the participants attend, following training to act as 'lay therapists' by a Clinical Psychologist, who will also provide supervision. Methods/Design This is a multi-centre cluster randomized controlled trial of a group intervention versus a 'support as usual' waiting-list control group, with randomization at the level of the group. Outcomes will be assessed at the end of the intervention and again 6-months later. After completion of the 6-month follow-up assessments, the intervention will also be delivered to the waiting-list groups. The study will include a range of anger/aggression and mental health measures, some of which will be completed by service users and also by their day service key-workers and by home carers. Qualitative data will be collected to assess the impact of the intervention on participants, lay therapists, and services, and the study will also include a service-utilization cost and consequences analysis. Discussion This will be the first trial to investigate formally how effectively staff working in services providing day activities for people with learning disabilities are able to use a therapy manual to deliver a CBT based anger management intervention, following brief training by a Clinical Psychologist. The demonstration that service staff can successfully deliver anger management to people with learning disabilities, by widening the pool of potential therapists, would have

Using technology to deliver quality education in Asia | IDRC ...

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

2016-06-08

Jun 8, 2016 ... Using technology to deliver quality education in Asia ... Entrepreneurship has been a major driver of growth and job creation in Southeast Asia. ... to provide access to health services, especially to vulnerable populations.

Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence.

Science.gov (United States)

Sulaberidze, Lela; Green, Stuart; Chikovani, Ivdity; Uchaneishvili, Maia; Gotsadze, George

2018-02-13

Whilst there is recognition that the global burden of disease associated with mental health disorders is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce. Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing the opportunities for reform can support the development of strategies for change. A mixed methods study was developed, which engaged with a range of stakeholders from mental health services, including key informants, service managers, healthcare professional and patients and their care-takers. Data generated from interviews and focus groups were analysed using an existing framework that outlines a range of economic and financial barriers to improving mental health practice. In addition, the study utilised health financing and programmatic data. The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the mental health workforce and services due to inflexible resources; the variable and limited provision of services across the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial barriers identified were related to out-of pocket payments for purchasing high quality medications and transportation to access mental health services. Whilst scarcity of financial resources exists in Georgia, as in many other countries, there are clear opportunities to improve the effectiveness of the current mental health programme. Addressing system-wide barriers could enable the delivery of services that aim to meet the needs of patients. The use of existing data to assess the implementation of the mental health programme offers opportunities to benchmark and improve services and to support the appropriate commissioning and reconfiguration of services.

How Does PCSI Help Deliver Integrated Services?

Centers for Disease Control (CDC) Podcasts

This podcast describes how PCSI strengthens collaborative work across disease areas and integrates services that are provided by related programs, especially prevention activities related to HIV/AIDS, viral hepatitis, other sexually transmitted diseases (STDs), and tuberculosis (TB) at the client level.

Are doctors and nurses associated with coverage of essential health services in developing countries? A cross-sectional study

Directory of Open Access Journals (Sweden)

de Pinho Helen

2009-03-01

Full Text Available Abstract Background There is broad policy consensus that a shortage of doctors and nurses is a key constraint to increasing utilization of essential health services important for achieving the health Millennium Development Goals. However there is limited research on the quantitative links between health workers and service coverage rates. We examined the relationship between doctor and nurse concentrations and utilization rates of five essential health services in developing countries. Methods We performed cross-national analyses of low- and middle-income countries by means of ordinary least squares regression with coverage rates of antenatal care, attended delivery, caesarean section, measles immunization, tuberculosis case diagnosis and care for acute respiratory infection as outcomes. Doctor, nurse and aggregate health worker (sum of doctors and nurses concentrations were the main explanatory variables. Results Nurses were associated with utilization of skilled birth attendants (P = 0.02 and doctors were associated with measles immunization rates (P = 0.01 in separate adjusted analyses. Aggregate health workers were associated with the utilization of skilled birth attendants (P Conclusion A range of health system and population-level factors aside from health workers influences coverage of health services in developing countries. However, it is also plausible that health workers who are neither doctors nor nurses, such as clinical officers and community health workers, may be providing a substantial proportion of health services. The human resources for health research agenda should be expanded beyond doctors and nurses.

Analysis of risk-reduction measures for multiunit essential service water systems

International Nuclear Information System (INIS)

Kohut, P.; Musicki, Z.; Fitzpatrick, R.

1989-01-01

Many risk analyses have indicated the potentially significant contribution to core damage frequency (CDF) due to the loss of the essential service water (ESW) function. The ESW system serves as the ultimate heat sink, and its failure can affect numerous safety components and systems, although it does not directly perform a frontline safety function. As such, probabilistic risk assessment studies usually analyze its failures through support system modeling; however, the direct loss of the ESW as an initiator may or may not be explicitly treated. In addition, the actual analysis is made more complex due to the linked initiating event nature of these events, since the system fault trees are coupled to the initiator in these cases. Previously, a specific safety issue was identified concerning the increase in core-melt vulnerability caused by the failure of the ESW system in pressurized water reactor (PWR) multiplant units that have only two service water (SW) pumps per unit with a backup crosstie capability to the other unit. The main objective of the present study was to establish a realistic measure of the core damage vulnerability, to identify potential improvements for the ESW systems, and to obtain generic estimates of their risk-reduction potential and cost-effectiveness

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

Science.gov (United States)

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

2015-02-04

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

Delivering research data management services fundamentals of good practice

CERN Document Server

Jones, Sarah; Whyte, Angus

2014-01-01

The research landscape is changing, with key global research funders now requiring institutions to demonstrate how they will preserve and share research data. However, the practice of structured research data management is very new, and the construction of services remains experimental and in need of models and standards of approach. This groundbreaking guide will lead researchers, institutions and policy makers through the processes needed to set up and run effective institutional research data management services. This book will provide a step-by-step explanation of the components for an institutional service - effectively a 'how to guide'. Case studies from the newly emerging service infrastructures in the UK, USA and Australia will draw out the lessons learnt from working (or near to delivery) exemplars. Different approaches are highlighted and compared, for example, a case study of a researcher-focused strategy from Australia contrasted with a national, top-down approach. A chapter on the redeveloped UK ...

Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

Science.gov (United States)

Arifin, Nooranida; Hasbollah, Hasif Rafidee; Hanafi, Muhammad Hafiz; Ibrahim, Al Hafiz; Rahman, Wan Afezah Wan Abdul; Aziz, Roslizawati Che

2017-01-01

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved. PMID:29386978

A designerly approach to enable organizations to deliver product-service systems

NARCIS (Netherlands)

De Lille, C.S.H.; Roscam Abbing, E.; Kleinsmann, M.S.

2012-01-01

Design is not only just for products, logo’s or websites anymore. More and more companies are embracing design as a way to enable their organization to adapt to changes in society. One of the challenges many organizations face at the moment is how to create value for their customers by delivering

Can community care workers deliver a falls prevention exercise program? A feasibility study

Directory of Open Access Journals (Sweden)

Burton E

2018-03-01

Full Text Available Elissa Burton,1 Gill Lewin,2 Hilary O’Connell,3 Mark Petrich,4,5 Eileen Boyle,1 Keith D Hill1 1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; 2School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; 3Independent Living Centre Western Australia, Perth, Western Australia, Australia; 4Western Australian Department of Health, Perth, Western Australia, Australia; 5School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia Background: Almost half of older people receiving community care fall each year and this rate has not improved in the last decade. Falls prevention programs targeted at this group are uncommon, and expensively delivered by university trained allied health professionals. Purpose: To investigate the feasibility of community care workers delivering a falls prevention exercise program to older clients, at low or medium risk of falling, as part of an existing service provision. Patients and methods: Community care workers from 10 community care organizations participated in the training for, and delivery to their clients of, an 8-week evidence-based falls prevention exercise program. Community care workers included assessment staff (responsible for identifying the need for community care services through completing an assessment and support workers (responsible for providing support in the home. Clients were surveyed anonymously at the completion of the intervention and workers participated in a semi-structured interview. Results: Twenty-five community care workers participated in the study. The falls prevention program was delivered to 29 clients, with an average age of 82.7 (SD: 8.72 years and consisting of 65.5% female. The intervention was delivered safely with no adverse events recorded, and the eligibility and assessment tools

Information sharing for effective IT incident resolving in IT service provider networks: A financial service case study

NARCIS (Netherlands)

Vlietland, J.; Vliet, J.C.

2015-01-01

Information technology (IT)-enabled financial services are typically delivered by a network of interdependent IT service providers. Such networks need information to resolve IT incidents in their delivered IT services. The objective of this research is to identify the set of information that needs

Managing online service recovery : procedures, justice and customer satisfaction

OpenAIRE

Singh, Jaywant; Crisafulli, Benedetta

2016-01-01

Purpose The Internet has changed the way services are delivered and has created new forms of customer-firm interactions. Whilst online service failures remain inevitable, the Internet offers opportunities for delivering efficient service recovery through the online channel. Notwithstanding, research evidence on how firms can deliver online service recovery remains scarce. This study investigates the impact of two online service recovery strategies - online information and te...

A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake.

Science.gov (United States)

Grelotti, David J; Lee, Amy C; Fils-Aimé, Joseph Reginald; Jean, Jacques Solon; Therosmé, Tatiana; Petit-Homme, Handy; Oswald, Catherine M; Raviola, Giuseppe; Eustache, Eddy

2015-01-01

Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health and Zanmi Lasante worked to expand local mental health services in rural Haiti. The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based psychiatric services in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme ("mhGAP"), a tool developed by the World Health Organization to support mental health care delivery by nonspecialists in LMICs. The pilot was conducted in March 2011. A visiting psychiatrist traveled to rural Haiti and paired with local clinicians to evaluate patients and to support quality improvement practices in psychiatric care. Patients received a standard neuropsychiatric evaluation. mhGAP was an important clinical reference. To assess the experience, we conducted a retrospective chart review of outpatient encounters. Sixty-five patients presented with a wide range of common psychiatric, neurologic, and general medical conditions. Forty-nine of these patients (75%) reported primary problems subsumed by an mhGAP module. Fifteen patients (23%) reported headache as their chief complain, a condition that is not currently covered by mhGAP. Surprisingly, only 3 patients (5%), reported earthquake-related distress. Our clinical data reinforce the need for provision of standard psychiatric and neurologic services in LMICs. Such services ought to accompany interventions targeted specifically at disaster-related problems. Clinical situations falling outside existing mhGAP modules inspired the development of supplemental treatment protocols. These observations informed coordinated efforts at Zanmi Lasante to build a sustainable, integrated mental health system

The right tree for the job? perceptions of species suitability for the provision of ecosystem services.

Science.gov (United States)

Smaill, Simeon J; Bayne, Karen M; Coker, Graham W R; Paul, Thomas S H; Clinton, Peter W

2014-04-01

Stakeholders in plantation forestry are increasingly aware of the importance of the ecosystem services and non-market values associated with forests. In New Zealand, there is significant interest in establishing species other than Pinus radiata D. Don (the dominant plantation species) in the belief that alternative species are better suited to deliver these services. Significant risk is associated with this position as there is little objective data to support these views. To identify which species were likely to be planted to deliver ecosystem services, a survey was distributed to examine stakeholder perceptions. Stakeholders were asked which of 15 tree attributes contributed to the provision of five ecosystem services (amenity value, bioenergy production, carbon capture, the diversity of native habitat, and erosion control/water quality) and to identify which of 22 candidate tree species possessed those attributes. These data were combined to identify the species perceived most suitable for the delivery of each ecosystem service. Sequoia sempervirens (D.Don) Endl. closely matched the stakeholder derived ideotypes associated with all five ecosystem services. Comparisons to data from growth, physiological and ecological studies demonstrated that many of the opinions held by stakeholders were inaccurate, leading to erroneous assumptions regarding the suitability of most candidate species. Stakeholder perceptions substantially influence tree species selection, and plantations established on the basis of inaccurate opinions are unlikely to deliver the desired outcomes. Attitudinal surveys associated with engagement campaigns are essential to improve stakeholder knowledge, advancing the development of fit-for-purpose forest management that provides the required ecosystem services.

How Does PCSI Help Deliver Integrated Services?

Centers for Disease Control (CDC) Podcasts

2009-12-07

This podcast describes how PCSI strengthens collaborative work across disease areas and integrates services that are provided by related programs, especially prevention activities related to HIV/AIDS, viral hepatitis, other sexually transmitted diseases (STDs), and tuberculosis (TB) at the client level.  Created: 12/7/2009 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 12/7/2009.

A Preliminary Investigation of Maine Virtual Charter School Costs Relative to the Essential Programs and Services Funding Model

Science.gov (United States)

Johnson, Amy F.; Hopper, Fleur; Sloan, James E.

2016-01-01

In 2015, the Maine State Legislature's Joint Standing Committee on Education and Cultural Affairs commissioned the Maine Education Policy Research Institute (MEPRI) to study the state's Essential Program and Services (EPS) K-12 education funding model in relationship to the funding for Maine's two virtual charter schools. The study was initiated…

Modeling patients' acceptance of provider-delivered e-health.

Science.gov (United States)

Wilson, E Vance; Lankton, Nancy K

2004-01-01

Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

Science.gov (United States)

Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant

2017-08-03

The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P human resources in primary health facilities.

Public transportation systems: Comparative analysis of quality of service

Energy Technology Data Exchange (ETDEWEB)

Negri, L.; Florio, L. (Rome Univ. La Sapienza (Italy). Facolta' di Ingegneria, Dipt. di Idraulica, Trasporti e Strade)

The evaluation, choice and design of public transportation systems for urban areas requires, in addition to consolidated use parameters, other dimensions essential to supply-demand qualiflcative realignment, e.g.: 'door-to-door time' which allows system differentiation in terms of commercial velocity, frequency and length of route; technical productivity expressed as 'transport power' and 'specific transport power'; and 'system/service quality'. By the means of surveys, these factors can be incorporated into suitable mathematical models representing, in a complete and reliable way, all the functions which a given system actually delivers and those functions which it is expected to deliver by its users. This paper illustrates the application of these concepts in a comparative analysis of different public transportation options - light rail rapid transit, tram and bus networks.

SERVICE QUALITY IN THE PUBLIC SERVICE

OpenAIRE

Prabha Ramseook-Munhurrun; Soolakshna D. Lukea-Bhiwajee; Perunjodi Naidoo

2010-01-01

The purpose of this paper is to obtain a better understanding of the extent to which service quality is delivered within the Mauritian public service by drawing on front-line employees (FLE) and customer perceptions of service quality. The paper investigates how closely customer expectations of service and FLE perceptions of customer expectations match. SERVQUAL is used to measure service quality amongst FLE and customers in a major public sector department in Mauritius. The survey captures c...

Prospects of concentrating solar power to deliver key energy services in a developing country

Energy Technology Data Exchange (ETDEWEB)

Karakosta, Charikleia; Pappas, Charalampos; Psarras, John [National Technical University of Athens, School of Electrical and Computer Engineering, Management and Decision Support Systems Lab (NTUA-EPU), 9, Iroon Polytechniou str., 15780, Athens (Greece)

2011-07-01

One of today's greatest challenges is the response to the worldwide continuously increasing energy demand. The need for supply of electricity is getting greater year by year. In addition, climate change problems and the limited fossil resources require new sustainable electricity generation options, which utilize Renewable Energy Sources (RES) and are economical in the meantime. Concentrating Solar Power (CSP) generation is a proven renewable energy technology that has the potential to become cost-effective in the future. This analysis explores for Chile the potential of CSP to deliver key energy services for the country. The specific technology has a significant technical potential within Chile, but 'somehow' do not receive sufficient attention from relevant stakeholders, because of gaps either in stakeholders' awareness of the technology or in domestic research and development (R and D) and/or public/private investment. The aim of this paper is to establish a well-informed discussion on the feasibility and potential of the specific sustainable energy technology, namely the CSP technology, within a given country context and particularly Chile. It provides an overview of the fundamental (macro-economic) forces within an economy and identifies some of the blockages and barriers that can be expected when introducing a new technology.

Tropical and Highland Temperate Forest Plantations in Mexico: Pathways for Climate Change Mitigation and Ecosystem Services Delivery

Directory of Open Access Journals (Sweden)

Vidal Guerra-De la Cruz

2017-12-01

Full Text Available Forest plantations are a possible way of increasing forest productivity in temperate and tropical forests, and therefore also increasing above- and belowground carbon pools. In the context of climate change, monospecific plantations might become an alternative to mitigate global warming; however, their contribution to the structural complexity, complementarity, and biodiversity of forests has not been addressed. Mixed forest plantations can ensure that objectives of climate change mitigation are met through carbon sequestration, while also delivering anticipated ecosystem services (e.g., nutrient cycling, erosion control, and wildlife habitat. However, mixed forest plantations pose considerable operational challenges and research opportunities. For example, it is essential to know how many species or functional traits are necessary to deliver a set of benefits, or what mixture of species and densities are key to maintaining productive plantations and delivering multiple ecosystem services. At the same time, the establishment of forest plantations in Mexico should not be motivated solely by timber production. Forest plantations should also increase carbon sequestration, maintain biodiversity, and provide other ecosystem services. This article analyzes some matters that affect the development of planted forests in the Mexican national context, and presents alternatives for forest resources management through the recommendation of mixed forest plantations as a means of contributing to climate change mitigation and the delivery of ecosystem services.

Pre-test genetic counseling services for hereditary breast and ovarian cancer delivered by non-genetics professionals in the state of Florida.

Science.gov (United States)

Vadaparampil, S T; Scherr, C L; Cragun, D; Malo, T L; Pal, T

2015-05-01

Genetic counseling and testing for hereditary breast and ovarian cancer now includes practitioners from multiple healthcare professions, specialties, and settings. This study examined whether non-genetics professionals (NGPs) perform guideline-based patient intake and informed consent before genetic testing. NGPs offering BRCA testing services in Florida (n = 386) were surveyed about clinical practices. Among 81 respondents (response rate = 22%), approximately half reported: sometimes scheduling a separate session for pre-test counseling lasting 11-30 min prior to testing, discussing familial implications of testing, benefits and limitations of risk management options, and discussing the potential psychological impact and insurance-related issues. Few constructed a three-generation pedigree, discussed alternative hereditary cancer syndromes, or the meaning of a variant result. This lack of adherence to guideline-based practice may result in direct harm to patients and their family members. NGPs who are unable to deliver guideline adherent cancer genetics services should focus on identification and referral of at-risk patients to in person or telephone services provided by genetics professionals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Applying the International Classification of Functioning, Disability and Health to guide home health care services planning and delivery in Thailand.

Science.gov (United States)

Pimdee, Atipong; Nualnetr, Nomjit

2017-01-01

Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.

Announcement by the Logistics Service

CERN Document Server

GS Department

2011-01-01

Please note that CERN will dispatch or deliver only packages that relate to official orders or contracts. Individuals are not authorised to have private merchandise delivered to them at CERN and private deliveries will not be accepted by the Goods Reception services. Thank you for your co-operation. GS-IS-LS Service

Delivering care to oncology patients in the community: an innovative integrated approach.

LENUS (Irish Health Repository)

Hanan, Terry

2014-08-01

A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient\\'s home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.

Service Matters: Single Service Point as a Collaborative and Professional Learning Initiative for Service Excellence

Science.gov (United States)

Chauvet, Marianne; Bourbous, Vicki; Liston, Frances

2016-01-01

Changes and innovations in higher education learning and teaching acted as a catalyst for rethinking the way in which service was delivered to library clients at Australian Catholic University. The Single Service Point was piloted at one campus library in 2014 to develop a best practice approach to service delivery. The merging of cultures within…

Stakeholder views on the impact of nurse prescribing on dermatology services.

Science.gov (United States)

Carey, Nicola; Stenner, Karen; Courtenay, Molly

2010-02-01

To explore stakeholder views on the impact of nurse prescribing on dermatology services. Nurse led care enhances the services that dermatology patients receive. Research indicates that care delivered by nurse prescribers can improve efficiency and access to medicines. There is no evidence exploring the impact of nurse prescribing on the configuration of dermatology services. Case study. A collective case study of 10 practice settings across England where nurses prescribed medicines for dermatology patients. A thematic analysis of semi-structured interview data collected during 2006 and 2007. Participants were qualified nurse prescribers, administrative staff, doctors and non-nurse prescribers. Nurse prescribing was reported to support and facilitate the modernisation of dermatology services. It enabled nurses to make effective use of their knowledge and skills, overcome delays in treatment and provide faster access to medicines. However several organisational issues restricted the success of the initiative. Nurse prescribing is successfully being used to support and deliver a range of services to dermatology patients. Stakeholders reported that both patients and staff had benefited by the adoption of this role by nurses. However issues over support and access to CPD and capacity of the workforce were identified as potential barriers which could affect the contribution of nurse prescribing to dermatology patients. Nurse prescribing contributes to the services provided to dermatology patients; Nurse supplementary prescribing contributes to the ability of dermatology nurse specialists to work in teams and prescribe complex medicines; Provision of adequate support and strategic planning are essential if the impact of nurse prescribing is to be fully realised.

Collaboration between Government and Non-Governmental Organizations (NGOs) in Delivering Curative Health Services in North Darfur State, Sudan- a National Report.

Science.gov (United States)

I A Yagub, Abdallah

2014-05-01

North Darfur State has been affected by conflict since 2003 and the government has not been able to provide adequate curative health services to the people. The government has come to rely on Non-Governmental Organizations (NGOs) to provide curative health services. This study was conducted to examine the existing collaboration between government and NGOs in curative health service delivery in North Darfur State, and to identify the challenges that affect their collaboration. Documentary data were collected from government offices and medical organizations. Primary data were obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) and (2), health professionals and administrators working in the health sector (N= 45). The collaboration between the government and NGOs has been very weak because of security issues and lack of trust. The NGOs collaborate by providing human and financial resources, material and equipment, and communication facilities. The NGOs supply 70% of curative health services, and contribute 52.9% of the health budget in North Darfur State. The NGOs have employed 1 390 health personnel, established 44 health centres and manage and support 83 health facilities across the State. The NGOs have played a positive role in collaborating with the government in North Darfur State in delivering curative health services, while government's role has been negative. The problem that faces the government in future is how health facilities will be run should a peaceful settlement be reached and NGOs leave the region.

Programming WCF Services

CERN Document Server

Lowy, Juval

2008-01-01

Written by Microsoft software legend Juval Lowy, Programming WCF Services is the authoritative introduction to Microsoft's new, and some say revolutionary, unified platform for developing service-oriented applications (SOA) on Windows. Relentlessly practical, the book delivers insight, not documentation, to teach developers what they need to know to build the next generation of SOAs. Not only will this book make you a WCF expert, it will deliver techniques and guidance to become a better software engineer. It's the Rosetta Stone of WCF.

Assessing Measurements of QoS for global Cloud Computing Services

DEFF Research Database (Denmark)

Pedersen, Jens Myrup; Riaz, M. Tahir; Júnior, Joaquim Celestino

2011-01-01

Many global distributed cloud computing applications and services running over the Internet, between globally dispersed clients and servers, will require certain levels of Quality of Service (QoS) in order to deliver and give a sufficiently smooth user experience. This would be essential for real......-time streaming multimedia applications like online gaming and watching movies on a pay as you use basis hosted in a cloud computing environment. However, guaranteeing or even predicting QoS in global and diverse networks supporting complex hosting of application services is a very challenging issue that needs...... a stepwise refinement approach to be solved as the technology of cloud computing matures. In this paper, we investigate if latency in terms of simple Ping measurements can be used as an indicator for other QoS parameters such as jitter and throughput. The experiments were carried out on a global scale...

Power quality measurement service in the support of large customers

Energy Technology Data Exchange (ETDEWEB)

Levesque, F. [Hydro-Quebec, Montreal, PQ (Canada)

2006-07-01

Power quality and how it is measured among Hydro Quebec's major customers were the focus of this conference presentation. Background information on Hydro Quebec and its customers was provided with reference to information on clients, employees and how the organization is organized. The presentation also included a discussion of power quality and how it is delivered at Hydro Quebec. For example, characteristics and target values of the voltage supplied by Hydro Quebec for high, medium and low voltages were examined. Personnel responsible for the grid have created a system to document each event submitted by customers. Documenting the actual power quality at the point of common coupling allows benchmarking of real data against announced characteristics and target values. This approach quantifies disturbances and helps to find and focus on disturbances that really influence large customers, mainly industrials. Portable and permanent installations issues were discussed followed by a discussion of a new service offering power quality metering on a regular basis. This metering service includes a complete analysis and technical support with dedicated expertise since customers are rarely fully experienced in power quality. The metering service is presented from the perspective of preventive maintenance with continuous quantification of a large number of indicators to assess the quality of the delivered power. Essential tools that customers can benefit from with this new service include real time electronic mail notification, weekly reporting and ad hoc technical support. This combination of various levels of services allows Hydro-Quebec to address the needs of these large customers in a flexible way. figs.

A University of Greenwich Case Study of Cloud Computing – Education as a Service

OpenAIRE

Chang, Victor; Wills, Gary

2013-01-01

This chapter proposes a new Supply Chain Business Model in the Education domain and demonstrates how Education as a Service (EaaS) can be delivered. The implementation at the University of Greenwich (UoG) is used as a case study. Cloud computing business models are classified into eight Business Models; this classification is essential to the development of EaaS. A pair of the Hexagon Models are used to review Cloud projects against success criteria; one Hexagon Model focuses on Business Mode...

Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

Science.gov (United States)

Resnick, Sheilagh M.; Griffiths, Mark D.

2012-01-01

In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

Pharmacists in humanitarian crisis settings: Assessing the impact of pharmacist-delivered home medication management review service to Syrian refugees in Jordan.

Science.gov (United States)

Al Alawneh, Majdoleen; Nuaimi, Nabeel; Basheti, Iman A

2018-04-10

Refugees all over the world are facing several health-related problems. Chronic diseases among Syrian refugees in Jordan are high. The Home Medication Management Review (HMMR) service could be ideal to optimize refugees' health management. To assess the impact of the HMMR service on the type and frequency of Treatment Related Problems (TRPs) among Syrian refugees living in Jordan. This prospective randomized single blinded intervention-control study was conducted in three main cities in Jordan, between May and October 2016. Syrian refugees with chronic conditions were recruited and randomized into intervention and control groups. The HMMR service was conducted for all patients to identify TRPs at baseline. Data were collected via two home visits for all study participants. Clinical pharmacist's recommendations were written in a letter format to the physicians managing the patients in the intervention group only. Physicians' approved recommendations were conveyed to the patients via the pharmacist. Interventions at the patient level were delivered by the pharmacist directly. Patients were reassessed for their TRPs and satisfaction 3 months after baseline. Syrian refugees (n = 106) were recruited with no significant differences between the intervention (n = 53) and control groups (n = 53). A total of 1141 TRPs were identified for both groups at baseline, with a mean number of 10.8 ± 4.2 TRPs per patient. At follow-up, there was a significant decrease in the number of TRPs among the intervention group (P service. Identified TRPs are high amongst Syrian refugees living in Jordan. The HMMR service significantly reduced the number of TRPs, and was highly accepted by the physicians. Refugees reported high satisfaction with this service. Copyright © 2018. Published by Elsevier Inc.

Complex Deployed Responsive Service

Science.gov (United States)

Parry, Glenn; McLening, Marc; Caldwell, Nigel; Thompson, Rob

A pizza restaurant must provide product, in the form of the food and drink, and service in the way this is delivered to the customer. Providing this has distinct operational challenges, but what if the restaurant also provides a home delivery service? The service becomes deployed as the customer is no-longer co-located with the production area. The business challenge is complicated as service needs to be delivered within a geographic region, to time or the pizza will be cold, and within a cost that is not ­prohibitive. It must also be responsive to short term demand; needing to balance the number of staff it has available to undertake deliveries against a forecast of demand.

North West Surrey's locality hubs - delivering integrated care

OpenAIRE

Compton, Lisa; Wilkinson, Peter; Lawn, Liz

2017-01-01

Introduction: North West Surrey CCG (NWSCCG) is establishing Locality Hubs – physical buildings offering a fully integrated GP-led, multi-disciplinary ‘one-stop-shop’ services in the community for a defined cohort of frail elderly patients with multiple core morbidities. Hubs will ultimately deliver proactive and reactive care, available 24 hours a day, 365 days a year.The key drivers are;Ageing population, people living longer & more people living with chronic conditionsCost & demand...

Differences in essential newborn care at birth between private and public health facilities in eastern Uganda.

Science.gov (United States)

Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C; Hanson, Claudia

2015-01-01

In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (pprivate facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both

Cisco Networking Essentials

CERN Document Server

McMillan, Troy

2011-01-01

An engaging approach for anyone beginning a career in networking As the world leader of networking products and services, Cisco products are constantly growing in demand. Yet, few books are aimed at those who are beginning a career in IT--until now. Cisco Networking Essentials provides a solid foundation on the Cisco networking products and services with thorough coverage of fundamental networking concepts. Author Troy McMillan applies his years of classroom instruction to effectively present high-level topics in easy-to-understand terms for beginners. With this indispensable full-color resour

Gap between the Expectations and Perceptions of Students regarding the Educational Services Offered in a School of Nursing and Midwifery.

Science.gov (United States)

Asefi, Fariba; Delaram, Masoumeh; Deris, Fatemeh

2017-04-01

Awareness of students' opinions about the various aspects of training provided is an essential factor to evaluate the quality of education. The aim of this study was to determine the gap between the students' expectations and perceptions from the educational services provided to them in the School of Nursing and Midwifery in Shahrekord University of Medical Sciences. In this cross-sectional study, 320 students were selected by stratified random sampling method and data were collected by SERVQUAL questionnaire to examine the areas of assurance, responsiveness, empathy, tangibles and confidence. Data analysis was conducted by descriptive (frequency, percentage, mean±SD) and analytical (paired t-test, independent t-test and One-Way ANOVA) statistics in SPSS 20. The mean scores of the students' expectations and perceptions of the educational services delivered to them were 4.34±0.63 and 3.56±0.68, respectively, with a significant, negative gap (-0.77±0.77, p<0.001). The lowest gap of quality was derived for assurance (-0.65) followed by reliability (-0.69), accountability (-0.74), and empathy (-0.81), and the greatest gap observed in tangibles (-0.96). A negative gap was observed between the students' expectations and perceptions of the quality of educational services delivered to them. This means that the quality of services delivered to students was less than what they expected. The highest gap was related to the tangibles. In order to improve the educational services, paying attention to different areas of quality of educational services, especially, the tangibles, is necessary.

Using mobile phones and short message service to deliver self-management interventions for chronic conditions: a meta-review.

Science.gov (United States)

Jones, Katherine R; Lekhak, Nirmala; Kaewluang, Napatsawan

2014-04-01

The worldwide burden of chronic disease is widespread and growing. This shift from acute to chronic care requires rethinking how resources are invested in managing these conditions. One response has been to create programs and interventions that have the goal of helping patients better manage their own conditions. Over time, these self-management interventions and strategies have increasingly relied on various technologies for their implementation, with the newest technology being mobile phones and short message service (SMS). The objective of this meta-review was to evaluate the current evidence on the use of mobile phones and SMS to deliver self-management interventions for chronic conditions. A meta-review was conducted of the 11 systematic reviews (SRs) that were identified and retrieved after an extensive search of electronic databases covering the years 2000-2012. Relevant information was abstracted from each systematic review and a quality assessment carried out using the AMSTAR ("A Measurement Tool to Assess Systematic Reviews") criteria. The number and types of included studies and total number of subjects varied significantly across the systematic reviews. Mobile phone text messaging was reported to significantly improve adherence to appointments and antiretroviral therapy, short-term smoking quit rates, and selected clinical and behavioral outcomes. AMSTAR scores ranged from 11 to 3, reflecting substantial variation in SR quality. Mobile phones and SMS show promise as a technology to deliver self-management interventions to improve outcomes of chronic care management. However, the quality of future studies and systematic reviews needs to be improved. There also are unresolved issues about the technology itself. © 2014 Sigma Theta Tau International.

75 FR 66680 - Defense Federal Acquisition Regulation Supplement (DFARS); Continuation of Essential Contractor...

Science.gov (United States)

2010-10-29

...-AG52 Defense Federal Acquisition Regulation Supplement (DFARS); Continuation of Essential Contractor... that contractors providing essential contractor services, as determined by the requiring activity..., implementing the requirements of DoDI 3020.37, Continuation of Essential DoD Contractor Services During Crises...

Depolarization in Delivering Public Services? Impacts of Minimum Service Standards (MSS on the Quality of Health Services in Indonesia

Directory of Open Access Journals (Sweden)

Mohammad Roudo

2016-03-01

Full Text Available Abstract. Some scholars argue that decentralization policy tends to create polarization, i.e. an increase of inequality/disparity among districts. To deal with this problem, Minimum Service Standards (MSS were introduced as a key strategy in decentralizing Indonesia. In this research, we tried to find out through MSS performance measurements whether imposing standards can be effective in a decentralized system by seeking its impacts on polarization/depolarization in the delivery of public services, specifically in the health sector. This question is basically a response to the common criticism that decentralization is good to create equality between central government and local governments but often does not work to achieve equality among local governments. Using self-assessment data from a sample of 54 districts from 534 districts in Indonesia, from 2010 to 2013, we found that the existence of depolarization in the delivery of public services could potentially occur among regions by reducing the gap between their public service performance and the targets of MSS. We acknowledge that there are weaknesses in the validity of the self-assessment data, caused by a lack of knowledge and skills to execute the self-assessment according to the official guidelines, by the overrating of target achievements, as well as the lack of data from independent sources to confirm the self-assessment outcomes. We also acknowledge that differences in financial capacity are still the main determinant why one district is more successful in achieving the MSS targets compared to other districts. Keywords. Decentralization, Public Service, Minimum Standard Service

Pan-London tuberculosis services: a service evaluation

Directory of Open Access Journals (Sweden)

Belling Ruth

2012-07-01

Full Text Available Abstract Background London has the largest proportion of tuberculosis (TB cases of any western European capital, with almost half of new cases drug-resistant. Prevalence varies considerably between and within boroughs with research suggesting inadequate control of TB transmission in London. Economic pressures may exacerbate the already considerable challenges for service organisation and delivery within this context. This paper presents selected findings from an evaluation of London’s TB services’ organisation, delivery, professional workforce and skill mix, intended to support development of a strategic framework for a pan-London TB service. These may also interest health service professionals and managers in TB services in the UK, other European cities and countries and in services currently delivered by multiple providers operating independently. Methods Objectives were: 1 To establish how London’s TB services are structured and delivered in relation to leadership, management, organisation and delivery, coordination, staffing and support; 2 To identify tools/models for calculating skill mix as a basis for identifying skill mix requirements in delivering TB services across London; 3 To inform a strategic framework for the delivery of a pan-London TB service, which may be applicable to other European cities. The multi-method service audit evaluation comprised documentary analysis, semi-structured interviews with TB service users (n = 10, lead TB health professionals and managers (n = 13 representing London’s five sectors and focus groups with TB nurses (n = 8 and non-London network professionals (n = 2. Results Findings showed TB services to be mainly hospital-based, with fewer community-based services. Documentary analysis and professionals’ interviews suggested difficulties with early access to services, low suspicion index amongst some GPs and restricted referral routes. Interviews indicated lack of managed

Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

Science.gov (United States)

Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

2018-06-01

Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric

76 FR 24339 - Streamlining Service Delivery and Improving Customer Service

Science.gov (United States)

2011-05-02

... accessed by the Internet or mobile phone and improved processes that deliver services faster and more... ``Conversations with America'' to Further Improve Customer Service). However, with advances in technology and... major initiative (signature initiative) that will use technology to improve the customer experience; (b...

A technician-delivered 'virtual clinic' for triaging low-risk glaucoma referrals.

Science.gov (United States)

Kotecha, A; Brookes, J; Foster, P J

2017-06-01

PurposeThe purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with 'virtual review' of resultant data by a consultant ophthalmologist.Patients and methodsThe Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service.ResultsBetween 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%.ConclusionsOur technician-delivered glaucoma referral triaging clinic incorporates consultant 'virtual review' to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.

The Essentials of Proper Wine Service.

Science.gov (United States)

Manago, Gary H.

This instructional unit was designed to assist the food services instructor and/or the restaurant manager in training students and/or staff in the proper procedure for serving wines to guests. The lesson plans included in this unit focus on: (1) the different types of wine glasses and their uses; (2) the parts of a wine glass; (3) the proper…

The effectiveness of nurse-delivered aromatherapy in an acute care setting.

Science.gov (United States)

Johnson, Jill R; Rivard, Rachael L; Griffin, Kristen H; Kolste, Alison K; Joswiak, Denise; Kinney, Mary Ellen; Dusek, Jeffery A

2016-04-01

To examine the use and effectiveness of essential oil therapeutic interventions on pain, nausea, and anxiety, when provided by nurses to patients in acute hospital settings across a large health system. This study expands upon the limited body of literature on aromatherapy use among inpatients. Retrospective, effectiveness study using data obtained from electronic health records. Ten Allina Health hospitals located in Minnesota and western Wisconsin. Nurse-delivered aromatherapy. Change in patient-reported pain, anxiety, and nausea, rated before and after receiving aromatherapy using a numeric rating scale (0-10). There were 10,262 hospital admissions during the study time frame in which nurse-delivered aromatherapy was part of patient care. The majority of admissions receiving aromatherapy were females (81.71%) and white (87.32%). Over 75% of all aromatherapy sessions were administered via inhalation. Lavender had the highest absolute frequency (49.5%) of use regardless of mode of administration, followed by ginger (21.2%), sweet marjoram (12.3%), mandarin (9.4%), and combination oils (7.6%). Sweet marjoram resulted in the largest single oil average pain change at -3.31 units (95% CI: -4.28, -2.33), while lavender and sweet marjoram had equivalent average anxiety changes at -2.73 units, and ginger had the largest single oil average change in nausea at -2.02 units (95% CI: -2.55, -1.49). Essential oils generally resulted in significant clinical improvements based on their intended use, although each oil also showed ancillary benefits for other symptoms. Future research should explore use of additional essential oils, modes of administration, and different patient populations. Copyright © 2016. Published by Elsevier Ltd.

Adoption of Lean Thinking and Service Improvement for Care Home Service

OpenAIRE

Chuang-Chun Chiou

2014-01-01

Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Sim...

The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities.

Science.gov (United States)

Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina

2018-01-01

People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. © 2017 John Wiley & Sons Ltd.

Employer Relations and Recruitment Services: An Essential Part of Postsecondary Career Services. Monograph Series

Science.gov (United States)

Hoover, Myrna P.; Lenz, Janet G.; Garis, Jeff

2013-01-01

This monograph is intended for any career services provider seeking a guide for developing employer relations and recruitment services at a postsecondary institution. It serves to inform readers about the changing meaning of "placement" over the years and the role it currently plays in career services. The publication describes…

Occupational Task Profiles: A Pan-Canadian Snapshot of the Canadian Literacy and Essential Skills Workforce--A Think Paper. Revised

Science.gov (United States)

Harwood, Chris

2012-01-01

Because Literacy and Essential Skills are so important to economic development, it is vital to know the competencies needed by the educators who deliver Literacy and Essential Skills programming. Likewise, Literacy and Essential Skills are crucial for labour market attachment. Low-skilled work has been most affected by technological change. There…

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

Science.gov (United States)

Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

2015-09-28

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

Service employees give as they get: internal service as a moderator of the service climate-service outcomes link.

Science.gov (United States)

Ehrhart, Karen Holcombe; Witt, L A; Schneider, Benjamin; Perry, Sara Jansen

2011-03-01

We lend theoretical insight to the service climate literature by exploring the joint effects of branch service climate and the internal service provided to the branch (the service received from corporate units to support external service delivery) on customer-rated service quality. We hypothesized that service climate is related to service quality most strongly when the internal service quality received is high, providing front-line employees with the capability to deliver what the service climate motivates them to do. We studied 619 employees and 1,973 customers in 36 retail branches of a bank. We aggregated employee perceptions of the internal service quality received from corporate units and the local service climate and external customer perceptions of service quality to the branch level of analysis. Findings were consistent with the hypothesis that high-quality internal service is necessary for branch service climate to yield superior external customer service quality. PsycINFO Database Record (c) 2011 APA, all rights reserved.

Delivering Sustainability Through Supply Chain Distribution Network Redesign

Directory of Open Access Journals (Sweden)

Denise Ravet

2013-09-01

Full Text Available Purpose - Companies could gain (cost, service, green/sustainable competitive advantage through the supply chain network. The goal of this article is to study how to deliver sustainability through the supply chain distribution network redesign.Design/methodology/approach - A literature review is conducted to examine research relating to sustainable supply chain strategies and supply chain distribution network redesign.Findings - A study of the supply chain literature reveals the importance to rethink the supply chain distribution network design and to treat sustainability as integral to operations.

Competency-based education: the essential basis of pre-service education for the professional midwifery workforce.

Science.gov (United States)

Fullerton, Judith T; Thompson, Joyce B; Johnson, Peter

2013-10-01

many articles published in the decade since promulgation of the Millennium Development Goals have acknowledged the distinct advantages to maternal and newborn health outcomes that can be achieved as a result of expanding access to skilled birth attendant (including midwifery) services. However, these advantages are often predicated on the assumption that the midwifery workforce shares a common definition and identity. Regrettably, a clear delineation of midwifery competencies is rarely addressed. A core set of midwifery competencies is essential to providing the high quality services that lead to the desirable health outcomes described in that body of research. Attribution of improved outcomes to access to midwifery cannot be made without a common understanding of a defined set of services provided to standard by the midwifery workforce across the inter-conceptional and childbearing time frame. The International Confederation of Midwives (ICM) has developed a clear list of competencies that delineate the domains of practice for the fully qualified, professional midwife. These domains frame the educational outcomes that must be conveyed within competency-based education programmes. this article explores the concept of competency-based education for midwives; first exploring the concept of competency itself, then providing examples of what is already known about competency-based approaches to curriculum design, teacher preparation, teacher support and assessment of student learning. These concepts are linked to the ICM competencies as the unifying construct for education of individuals who share a common definition and identity as midwives. © 2013 Elsevier Ltd. All rights reserved.

IT Service

Data.gov (United States)

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...

Antecedents and consequences of the service climate in boundary-spanning self-managing service teams

NARCIS (Netherlands)

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

2004-01-01

In this article, the authors examine antecedents and consequences of the service climate in boundary-spanning self-managing teams (SMTs) that deliver financial services. Using data from members of 61 SMTs and their customers, the authors show a differential impact of the SMT service climate on

Ecosystem Services : In Nordic Freshwater Management

DEFF Research Database (Denmark)

Magnussen, Kristin; Hasler, Berit; Zandersen, Marianne

Human wellbeing is dependent upon and benefit from ecosystem services which are delivered by well-functioning ecosystems. Ecosystem services can be mapped and assessed consistently within an ecosystem service framework. This project aims to explore the use and usefulness of the ecosystem service ...

Equity of the essential public health service in rural china: evidence from a nationwide survey of hypertensive patients.

Science.gov (United States)

Zhou, Donghua; Feng, Zhanchun; He, Shasha; Sun, Xi; Ma, Caihui; Lv, Benyan; Zou, Xiong

2013-07-01

To explore healthcare disparities in rural China two years after the implementation of the Essential Public Health Service (EPHS) reform in 2009. A cross-sectional study was conducted by surveying 930 hypertension patients (HPs) from different regions in rural China in 2011. The percentages of patients using recommended four or more follow-up visits in a year were calculated by patient socio-demographic characteristics and statistically examined using chi-square and logistic regression to uncover disparities and correlated factors in EPHS use. The rates were not significantly different by age, gender, education, insurance status or income, but significantly different by region and hypertension history (p<0.01). Higher rates were also observed on patients who sought actively follow-up service at clinics, making appointment for the next follow-up with doctors, awareness of the need of follow-up, more satisfied with the follow-up services, and better medication adherence (p<0.01). There were no disparities observed among HPs in the use of follow-up services, suggesting that the reform has to some extent achieved its goal in ensuring equal access to EPHS. In this regard, regional implementation of the national policies and improvement of EPHS management at local level should be further improved.

Libraries Prepare for an Information Age.

Science.gov (United States)

Breivik, Patricia Senn; Shaw, Ward

1989-01-01

Since funding levels will probably not change much, college libraries will need to shift emphasis from seeking more funding for current and new services to delivering more and better service for less, becoming leaner and more able to deliver adaptable services. Increased budget flexibility will be essential. (MSE)

基本医疗服务的界定思路和框架%Thoughts and framework on how to define essential medical services

Institute of Scientific and Technical Information of China (English)

王禄生; 朱兆芳; 崔斌; 王亚; 吴妮娜

2016-01-01

Boundaries definition plays a key role in defining the scope of essential medical coverage of the country and the governmental role positioning in medical service offerings.It is also a precondition of furthering the ongoing healthcare reform.This paper analyzed the data of health service demand,supply and financing using the priority setting and the integrated balance methods.It suggested that the definition of the essential medical services should embody Chinese characteristics and be consistent with the Party′s governing philosophy and social core values.It also should be fully considered that the administration system,the governing philosophy,the medical insurance system and the government duty in the healthcare system of China.This paper proposed a multiple-criteria defining of the essential medical services,which should focus on main healthcare issues in China,and be adapted to the current healthcare reform process.Three dimensions need to be considered in the defining,which are the demand,supply and financing of the healthcare services,along with the impact of the housing,equipment,personnel, technology,supplies,drugs and other medical service elements.This paper presented the overall framework of essential medical services in four levels,which is composed of the basic package,the core package,the priority package and the expansion package.%利用优先选择法和综合平衡法对卫生服务需求、供给和筹资数据进行分析，认为我国的基本医疗服务包应体现中国特色，与党的执政理念和社会核心价值观相一致，充分考虑中国的管理体制、执政理念、医疗保险制度以及政府在卫生事业发展中的责任等，从多维度进行界定，突出重点健康问题，并与我国当前的医药卫生体制改革进程相适应。基本医疗服务的界定需要考虑供给、需求和筹资3�

Does health facility service environment matter for the receipt of essential newborn care? Linking health facility and household survey data in Malawi.

Science.gov (United States)

Carvajal-Aguirre, Liliana; Mehra, Vrinda; Amouzou, Agbessi; Khan, Shane M; Vaz, Lara; Guenther, Tanya; Kalino, Maggie; Zaka, Nabila

2017-12-01

Health facility service environment is an important factor for newborns survival and well-being in general and in particular in high mortality settings such as Malawi where despite high coverage of essential interventions, neonatal mortality remains high. The aim of this study is to assess whether the quality of the health service environment at birth is associated with quality of care received by the newborn. We used data from the Malawi Millennium Development Goals Endline household survey conducted as part of MICS survey program and Service Provision Assessment Survey carried out in 2014. The analysis is based on 6218 facility births that occurred during the past 2 years. Descriptive statistics, bivariate and multivariate random effect models are used to assess the association of health facility service readiness score for normal deliveries and newborn care with newborns receiving appropriate newborn care, defined for this analysis as receiving 5 out of 6 recommended interventions during the first 2 days after birth. Newborns in districts with top facility service readiness score have 1.5 higher odds of receiving appropriate newborn care (adjusted odds ratio (aOR) = 1.52, 95% confidence interval CI = 1.19-1.95, P  = 0.001), as compared to newborns in districts with a lower facility score after adjusting for potential confounders. Newborns in the Northern region were two times more likely to receive 5 newborn care interventions as compared to newborns in the Southern region (aOR = 2.06, 95% CI = 1.50-2.83, P  < 0.001). Living in urban or rural areas did not have an impact on receiving appropriate newborn care. There is need to increase the level of service readiness across all facilities, so that all newborns irrespective of the health facility, district or region of delivery are able to receive all recommended essential interventions. Investments in health systems in Malawi should concentrate on increasing training and availability of

A call for differentiated approaches to delivering HIV services to key populations.

Science.gov (United States)

Macdonald, Virginia; Verster, Annette; Baggaley, Rachel

2017-07-21

Key populations (KPs) are disproportionally affected by HIV and have low rates of access to HIV testing and treatment services compared to the broader population. WHO promotes the use of differentiated approaches for reaching and recruiting KP into the HIV services continuum. These approaches may help increase access to KPs who are often criminalized or stigmatized. By catering to the specific needs of each KP individual, differentiated approaches may increase service acceptability, quality and coverage, reduce costs and support KP members in leading the HIV response among their communities. WHO recommends the implementation of community-based and lay provider administered HIV testing services. Together, these approaches reduce barriers and costs associated with other testing strategies, allow greater ownership in HIV programmes for KP members and reach more people than do facility-based services. Despite this evidence availability and support for them is limited. Peer-driven interventions have been shown to be effective in engaging, recruiting and supporting clients. Some programmes employ HIV-positive or non-PLHIV "peer navigators" and other staff to provide case management, enrolment and/or re-enrolment in care and treatment services. However, a better understanding of the impact, cost effectiveness and potential burden on peer volunteers is required. Task shifting and non-facility-based service locations for antiretroviral therapy (ART) initiation and maintenance and antiretroviral (ARV) distribution are recommended in both the consolidated HIV treatment and KP guidelines of WHO. These approaches are accepted in generalized epidemics and for the general population where successful models exist; however, few organizations provide or initiate ART at KP community-based services. The application of a differentiated service approach for KP could increase the number of people who know their status and receive effective and sustained prevention and treatment for HIV

Non-physician delivered intravitreal injection service is feasible and safe - a systematic review.

Science.gov (United States)

Rasul, Asrin; Subhi, Yousif; Sørensen, Torben Lykke; Munch, Inger Christine

2016-05-01

Non-physicians such as nurses are trained to give injections into the vitreous body of the eye to meet the increasing demand for intravitreal therapy with vascular endothelial growth factor inhibitors against common eye diseases, e.g. age-related macular degeneration and diabetic retinopathy. We systematically reviewed the existing literature to provide an overview of the experiences in this transformational process. We searched for literature on 22 September 2015 using PubMed, Embase, the Cochrane Library, CINAHL and the Web of Science. Eligible studies had to address any outcome based on non-physician delivered intravitreal therapy regardless of the study design. Being non-physician was defined as the injecting personnel not being a physician, but no further restrictions were made. Five studies were included with a total of 31,303 injections having been performed by 16 nurses. The studies found that having nurses perform the intravitreal injections produced to a short-term capacity improvement and liberated physicians for other clinical work. Training was provided through courses and direct supervision. The rates of endophthalmitis were 0-0.40‰, which is comparable to reported rates when the intravitreal therapy is given by physicians. Non-physician delivered intravitreal therapy seems feasible and safe.

The 4-H Club Meeting: An Essential Youth Development Strategy

Science.gov (United States)

Cassels, Alicia; Post, Liz; Nestor, Patrick I.

2015-01-01

The club meeting has served as a key delivery method for 4-H programming across the United States throughout its history. A survey of WV 4-H community club members reinforces the body of evidence that the 4-H club meeting is an effective vehicle for delivering positive youth learning opportunities within the umbrella of the Essential Elements of…

The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention

Science.gov (United States)

2013-01-01

Background The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. Methods The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants’ characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. Results A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Conclusions With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle

The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.

Science.gov (United States)

Schneider, Francine; Schulz, Daniela N; Pouwels, Loes H L; de Vries, Hein; van Osch, Liesbeth A D M

2013-08-05

The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive

Essays on the Microfoundations of Competition and Choice in Public Service Delivery

NARCIS (Netherlands)

S.R. Jilke (Sebastian)

2015-01-01

markdownabstract__Abstract__ The way how public services are delivered has changed fundamentally in past decades. While in the 1970s most public services such as energy, water or telecommunications were provided by state-owned monopolists, nowadays these services are delivered by a large array

Towards a framework for modular service design synthesis

DEFF Research Database (Denmark)

Løkkegaard, Martin; Mortensen, Niels Henrik; McAloone, Tim C.

2016-01-01

This paper seeks to improve the understanding of how service-based companies can benefit from developing and delivering service offerings from a standardised core of service modules, which are organised through a service architecture. Research within the field is relatively sparse, and there is s......This paper seeks to improve the understanding of how service-based companies can benefit from developing and delivering service offerings from a standardised core of service modules, which are organised through a service architecture. Research within the field is relatively sparse...... model for modular service design synthesis presented in this paper. The case study is based on internal documentation and a high level of interview data. Inductive research methods have been used for the analysis. The presented conceptual model defines three suggested dimensions (Market Segmentation...

The Copernicus programme and its Climate Change Service (C3S): a European answer to Climate Change

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Pinty, Bernard; Thepaut, Jean-Noel; Dee, Dick

2016-07-01

In November 2014, The European Centre for Medium-range Weather Forecasts (ECMWF) signed an agreement with the European Commission to deliver two of the Copernicus Earth Observation Programme Services on the Commission's behalf. The ECMWF delivered services - the Copernicus Climate Change Service (C3S) and Atmosphere Monitoring Service (CAMS) - will bring a consistent standard to how we measure and predict atmospheric conditions and climate change. They will maximise the potential of past, current and future earth observations - ground, ocean, airborne, satellite - and analyse these to monitor and predict atmospheric conditions and in the future, climate change. With the wealth of free and open data that the services provide, they will help business users to assess the impact of their business decisions and make informed choices, delivering a more energy efficient and climate aware economy. These sound investment decisions now will not only stimulate growth in the short term, but reduce the impact of climate change on the economy and society in the future. C3S is in its proof of concept phase and through its climate data store will provide global and regional climate data reanalyses; multi-model seasonal forecasts; customisable visual data to enable examination of wide range of scenarios and model the impact of changes; access to all the underlying data, including climate data records from various satellite and in-situ observations. In addition, C3S will provide key indicators on climate change drivers (such as carbon dioxide) and impacts (such as reducing glaciers). The aim of these indicators will be to support European adaptation and mitigation policies in a number of economic sectors. The presentation will provide an overview of this newly created Service, its various components and activities, and a roadmap towards achieving a fully operational European Climate Service at the horizon 2019-2020. It will focus on the requirements for quality-assured Observation

An integrative review and evidence-based conceptual model of the essential components of pre-service education.

Science.gov (United States)

Johnson, Peter; Fogarty, Linda; Fullerton, Judith; Bluestone, Julia; Drake, Mary

2013-08-28

With decreasing global resources, a pervasive critical shortage of skilled health workers, and a growing disease burden in many countries, the need to maximize the effectiveness and efficiency of pre-service education in low-and middle-income countries has never been greater. We performed an integrative review of the literature to analyse factors contributing to quality pre-service education and created a conceptual model that shows the links between essential elements of quality pre-service education and desired outcomes. The literature contains a rich discussion of factors that contribute to quality pre-service education, including the following: (1) targeted recruitment of qualified students from rural and low-resource settings appears to be a particularly effective strategy for retaining students in vulnerable communities after graduation; (2) evidence supports a competency-based curriculum, but there is no clear evidence supporting specific curricular models such as problem-based learning; (3) the health workforce must be well prepared to address national health priorities; (4) the role of the preceptor and preceptors' skills in clinical teaching, identifying student learning needs, assessing student learning, and prioritizing and time management are particularly important; (5) modern, Internet-enabled medical libraries, skills and simulation laboratories, and computer laboratories to support computer-aided instruction are elements of infrastructure meriting strong consideration; and (6) all students must receive sufficient clinical practice opportunities in high-quality clinical learning environments in order to graduate with the competencies required for effective practice. Few studies make a link between PSE and impact on the health system. Nevertheless, it is logical that the production of a trained and competent staff through high-quality pre-service education and continuing professional development activities is the foundation required to achieve the

Delivering Results for Peace and Development

International Nuclear Information System (INIS)

Pattison, Hazel

2013-01-01

The IAEA’s technical cooperation programme is the primary mechanism for delivering the IAEA’s capacity-building services to its Member States. The programme supports the safe and secure application of nuclear technology for sustainable socioeconomic development in Member States. The overall strategic framework of the TC programme is determined by pertinent provisions laid down in key documents of the IAEA. Strategic direction for the multi-annual TC programme is provided by the Agency’s Members States and, more specifically, by relevant advisory and governance entities. The programme concentrates on: improving human health; supporting agriculture, rural development and food security; advancing water resource management; addressing environmental challenges; helping sustainable energy development, including the use of nuclear power for electricity; and promoting safety and security

Delivering an Alternative Medicine Resource to the User's Desktop via World Wide Web.

Science.gov (United States)

Li, Jie; Wu, Gang; Marks, Ellen; Fan, Weiyu

1998-01-01

Discusses the design and implementation of a World Wide Web-based alternative medicine virtual resource. This homepage integrates regional, national, and international resources and delivers library services to the user's desktop. Goals, structure, and organizational schemes of the system are detailed, and design issues for building such a…

Coordinator, Translation Services | IDRC - International ...

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

The Coordinator, Translation Services coordinates the overall operations of the ... services in IDRC by acting as the main resource person for internal clients ... all operational issues in order to ensure good quality products delivered on time.

The role of learning and customer orientation for delivering service quality to patients.

Science.gov (United States)

Bellou, Victoria

2010-01-01

This study seeks to investigate the impact that learning orientation, internal and external customer orientation have on quality of care delivered to patients. Additionally, given the differences between managerial and non-managerial employees regarding organizational value perception and focus on the needs of internal customers and patients, the study aims to examine potential variations in these relationships. The study took place in ten out of 31 public hospitals operating in the five largest districts in continental Greece. Hospitals were chosen on a random basis. Out of 800 questionnaires that were personally administered, 499 usable responses were gathered. The extent to which employees create and use knowledge and focus on satisfying the needs of both internal customers and patients is indicative of the quality of care provided. In addition, only managerial employees believe that learning orientation reinforces quality of care. The fact that employees rated quality of care delivered to patients and that most employees had extended tenure should be taken into consideration when interpreting these findings. Top management needs to create a strong and clear culture that emphasizes learning, as well as internal customer and patient orientation, and infuse them among all organizational members. Moreover, human resource management policies should be aligned to meeting or exceeding patients' requests and expectations. The paper enhances existing knowledge with regard to the antecedents of offering medical care of high quality.

Technical Quality of Delivered Care for Patients with Inflammatory Bowel Disease in Tabriz Care Centers

Directory of Open Access Journals (Sweden)

Mohammad Hosein Somi

2015-08-01

Full Text Available ​Background and objectives : Inflammatory Bowel Disease (IBD is a chronic disease and requires complex treatment. Due to the various treatment options and gradual understanding of specialists about the risks and benefits of different treatments of IBD, delivering care according to the treatment protocols and guidelines is essential. This study was conducted to assess delivered care from the perspective of patients with inflammatory bowel disease. Material and Methods : This cross-sectional study was conducted with 94 participants with IBD selected randomly in Emam Reza hospital and Golgasht clinic in Tabriz. Data were collected by an approved researcher-made questionnaire via interviewing patients. Chi-Squared Test was used to evaluate the relationship between demographic variables and accordance of delivered care with standards. SPSS17 was used for data analysis. Results : The results indicated that "visit by specialist" and "providing dietary recommendation by nutritionist" aspects had highest and lowest degree of accordance with standards, respectively. Furthermore, the aspects of “delivered care in exacerbation status of disease” and “delivered care by other specialists” had only 20 percent compliance with standards. Also, there was a significant relationship between age, job, education status, smoking and compliance with related standards in some care aspects (p Conclusion : The study results indicated that there is a deep gap between delivered cares for patients with inflammatory bowel disease and related standards. These deficiencies showed the parts that need improvement and require healthcare managers and policy makers’ attention.

Inclusive Services Innovation Configuration

Science.gov (United States)

Holdheide, Lynn R.; Reschly, Daniel J.

2011-01-01

Teacher preparation to deliver inclusive services to students with disabilities is increasingly important because of changes in law and policy emphasizing student access to, and achievement in, the general education curriculum. This innovation configuration identifies the components of inclusive services that should be incorporated in teacher…

Logistics Services Communication

CERN Multimedia

2006-01-01

Members of the personnel are invited to take note that only parcels corresponding to official orders or contracts will be handled at CERN. Individuals are not authorisedto have private merchandise delivered to them at CERN and private deliveries will not be accepted by the Goods Reception services. Thank you for your understanding. Logistics Services - FI Department - 79947

Logistics Services Communication

CERN Document Server

2006-01-01

Members of the personnel are invited to take note that only parcels corresponding to official orders or contracts will be handled at CERN. Individuals are not authorised to have private merchandise delivered to them at CERN and private deliveries will not be accepted by the Goods Reception services. Thank you for your understanding. Logistics Services - FI Department - 79947

Consensus development on the essential competencies for Iranian public health nutritionists.

Science.gov (United States)

Sadeghi-Ghotbabadi, Farzaneh; Shakibazadeh, Elham; Omidvar, Nasrin; Mortazavi, Fathieh; Kolahdooz, Fariba

2015-03-01

To assess key experts' opinion regarding essential competencies required for effective public health nutrition practice within the health-care system of Iran. Qualitative study using the modified Delphi technique through an email-delivered questionnaire. Iran. Fifty-five experts were contacted through email. The inclusion criterion for the study panel was being in a relevant senior-level position in nutrition science or public health nutrition in Iran. In the first round, forty-two out of fifty-five experts responded to the questionnaire (response rate=76 %). A sixty-five-item questionnaire was designed with nine competency areas, including 'nutrition science', 'planning and implementing nutritional interventions', 'health and nutrition services', 'advocacy and communication', 'assessment and analysis', 'evaluation', 'cultural, social and political aspects', 'using technology' and 'leadership and management'. All experts who had participated in the first round completed a modified version of the questionnaire with seventy-seven items in the second round. The experts scored 'nutrition science' as the most essential competency area, while more applied areas such as 'management and leadership' were less emphasized. In both rounds, the mean difference between the opinions of the necessity of each area was 5.6 %. The Iranian experts had general agreement on most of the core competency areas of public health nutritionists. The results indicated the need for capacity building and revisions to educational curricula for public health nutritionist programmes, with more emphasis on skill-based competency development.

Fee-for-Service Is Dead. Long Live Fee for Service?

Science.gov (United States)

Greene, Jan

2017-09-01

The move to a value-based payment system was supposed to end perverse incentives that pay doctors more for delivering often unnecessary services. But things are changing slowly and the market is still 95% fee for service. There's talk of reworking the Medicare fee schedule so docs are paid more for the things that work, and less for those that don't.

Evaluation of publicly financed and privately delivered model of emergency referral services for maternal and child health care in India.

Directory of Open Access Journals (Sweden)

Shankar Prinja

Full Text Available BACKGROUND: Emergency referral services (ERS are being strengthened in India to improve access for institutional delivery. We evaluated a publicly financed and privately delivered model of ERS in Punjab state, India, to assess its extent and pattern of utilization, impact on institutional delivery, quality and unit cost. METHODS: Data for almost 0.4 million calls received from April 2012 to March 2013 was analysed to assess the extent and pattern of utilization. Segmented linear regression was used to analyse month-wise data on number of institutional deliveries in public sector health facilities from 2008 to 2013. We inspected ambulances in 2 districts against the Basic Life Support (BLS standards. Timeliness of ERS was assessed for determining quality. Finally, we computed economic cost of implementing ERS from a health system perspective. RESULTS: On an average, an ambulance transported 3-4 patients per day. Poor and those farther away from the health facility had a higher likelihood of using the ambulance. Although the ERS had an abrupt positive effect on increasing the institutional deliveries in the unadjusted model, there was no effect on institutional delivery after adjustment for autocorrelation. Cost of operating the ambulance service was INR 1361 (USD 22.7 per patient transported or INR 21 (USD 0.35 per km travelled. CONCLUSION: Emergency referral services in Punjab did not result in a significant change in public sector institutional deliveries. This could be due to high baseline coverage of institutional delivery and low barriers to physical access. Choice of interventions for reduction in Maternal Mortality Ratio (MMR should be context-specific to have high value for resources spent. The ERS in Punjab needs improvement in terms of quality and reduction of cost to health system.

The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

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Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

2016-06-07

In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

Facilitators and barriers of implementing and delivering social prescribing services: a systematic review.

Science.gov (United States)

Pescheny, Julia Vera; Pappas, Yannis; Randhawa, Gurch

2018-02-07

Social Prescribing is a service in primary care that involves the referral of patients with non-clinical needs to local services and activities provided by the third sector (community, voluntary, and social enterprise sector). Social Prescribing aims to promote partnership working between the health and the social sector to address the wider determinants of health. To date, there is a weak evidence base for Social Prescribing services. The objective of the review was to identify factors that facilitate and hinder the implementation and delivery of SP services based in general practice involving a navigator. We searched eleven databases, the grey literature, and the reference lists of relevant studies to identify the barriers and facilitators to the implementation and delivery of Social Prescribing services in June and July 2016. Searches were limited to literature written in English. No date restrictions were applied. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Eight studies were included in the review. The synthesis identified a range of factors that facilitate and hinder the implementation and delivery of SP services. Facilitators and barriers were related to: the implementation approach, legal agreements, leadership, management and organisation, staff turnover, staff engagement, relationships and communication between partners and stakeholders, characteristics of general practices, and the local infrastructure. The quality of most included studies was poor and the review identified a lack of published literature on factors that facilitate and hinder the implementation and delivery of Social Prescribing services. The review identified a range of factors that facilitate and hinder the implementation and delivery of Social Prescribing services. Findings of this review provide an insight for commissioners, managers, and providers

Exploring weight loss services in primary care and staff views on using a web-based programme.

Science.gov (United States)

Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy

2012-01-01

Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Exploring weight loss services in primary care and staff views on using a web-based programme

Directory of Open Access Journals (Sweden)

Lisa J Ware

2013-09-01

Full Text Available Background Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of ehealth into primary care may face challenges.Objectives To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery.Methods Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36 involved in delivering weight loss services. Data were analysed using inductive thematic analysis.Results Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation.Conclusions Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and ‘ad hoc’ services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Combining Technologies to Deliver Distance Education

Directory of Open Access Journals (Sweden)

Vicki Freeman

1999-01-01

Full Text Available In 1997 a Health Resources and Services Administration (HRSA grant was awarded to the Department of Clinical Laboratory Sciences (CLS at The University of Texas Medical Branch - Galveston (UTMB for support of the Laboratory Education and Advancement Project (LEAP. The project entailed three primary objectives, targeting laboratory practitioners in rural and medically underserved areas of Texas for delivering a bachelor's degree, laboratory-intensive course of study via distance education. Several delivery mechanisms were utilized and evaluated for their effectiveness and friendliness to both the faculty and students. The authors discuss and describe the mechanisms utilized for delivery of courses, the advantages and disadvantages encountered with each mechanism, and subjective evaluation of the effectiveness of the courses. Also discussed are the lessons learned and plans for future development.

78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

Science.gov (United States)

2013-01-30

... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

14 CFR 272.8 - Obligation to continue service.

Science.gov (United States)

2010-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.8 Obligation to... eligible Freely Associated State place below the level of essential air service to such place, whether or not the Department has previously determined the level of essential air service to such place, the...

14 CFR 272.7 - Notice of discontinuance of service.

Science.gov (United States)

2010-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.7 Notice of... of essential air service for such place, the level of service specified in Order 80-9-63; and (2) If the Department has made a determination of essential air service for such place, that level of...

A Comparison of Learning Outcomes for Adult Students in On-Site and Online Service-Learning

Science.gov (United States)

Schwehm, Jeremy S.; Lasker-Scott, Tennille; Elufiede, Oluwakemi

2017-01-01

As noted by Kolb's (1984) experiential learning theory, adults learn best through experiences. Typically delivered in a traditional, face-to-face classroom setting, service-learning integrates the knowledge learned in the classroom with real-world experience and community service. E-service-learning, service-learning delivered in part or entirely…

Collaborative Engagement Approaches For Delivering Sustainable Infrastructure Projects In The AEC Sector

Directory of Open Access Journals (Sweden)

Adetola, Alaba

2011-12-01

Full Text Available The public sector has traditionally financed and operated infrastructure projects using resources from taxes and various levies (e.g. fuel taxes, road user charges. However, the rapid increase in human population growth coupled with extended globalisation complexities and associated social/political/economic challenges have placed new demands on the purveyors and operators of infrastructure projects. The importance of delivering quality infrastructure has been underlined by the United Nations declaration of the Millennium Development Goals; as has the provision of ‘adequate’ basic structures and facilities necessary for the well-being of urban populations in developing countries. Thus, in an effort to finance developing countries’ infrastructure needs, most countries have adopted some form of public-private collaboration strategy. This paper critically reviews these collaborative engagement approaches, identifies and highlights 10 critical themes that need to be appropriately captured and aligned to existing business models in order to successfully deliver sustainable infrastructure projects. Research findings show that infrastructure services can be delivered in many ways, and through various routes. For example, a purely public approach can cause problems such as slow and ineffective decision-making, inefficient organisational and institutional augmentation, and lack of competition and inefficiency (collectively known as government failure. On the other hand, adopting a purely private approach can cause problems such as inequalities in the distribution of infrastructure services (known as market failure. Thus, to overcome both government and market failures, a collaborative approach is advocated which incorporates the strengths of both of these polarised positions.

Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service

OpenAIRE

Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee; Yoo, Sooyoung

2015-01-01

Objectives To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. Methods We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functi...

Logistics service management; differentiating the logistics service

NARCIS (Netherlands)

Veeken, van der D.J.M.; Rutten, W.G.M.M.

1998-01-01

In this article a model is described, which enables differentiation of the logistics service that a company offers to its customers. Differentiating this service is essential for businesses with a large variation within their customer and/or products portfolio. The model consists of four phases:

Mental health services commissioning and provision: Lessons from the UK?

Science.gov (United States)

Ikkos, G; Sugarman, Ph; Bouras, N

2015-01-01

The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes to the cost of service across the whole care pathway. Particularly in difficult times, it is essential to keep an open mind as to how this might be best achieved. National and regional policies will necessarily vary as they reflect diverse local histories, cultures, needs and preferences. As systems of commissioning and delivering mental health care vary from country to country, there is the opportunity to learn from others. In the future international comparisons may help identify policies and systems that can work across nations and regions. However a persistent problem is the lack of clear evidence over cost and quality delivered by different local or national models. The best informed economists, when asked about the international evidence do not provide clear answers, stating that it depends how you measure cost and quality, the national governance model and the level of resources. The UK has a centrally managed system funded by general taxation, known as the National Health Service (NHS). Since 2010, the UK's new Coalition* government has responded by further reforming the system of purchasing and providing NHS services - aiming to strengthen choice and competition between providers on the basis of quality and outcomes as well as price. Although the present coalition government's intention is to maintain a tax-funded system, free at the point of delivery, introducing market-style purchasing and provider-side reforms to encompass all of these bring new risks, whilst not pursuing reforms of a system in crisis is also seen to carry risks. Competition might bring efficiency, but may weaken cooperation between providers

Context-aware QoS provisioning for an M-health service platform

OpenAIRE

Wac, K.E.; Delgado Kloos, C.; Larrabeiti, D.; van Halteren, Aart; Bults, Richard G.A.; Lopez, A.M.; Broens, T.H.F.

2007-01-01

Inevitably, healthcare goes mobile. Recently developed mobile healthcare (i.e., m-health) services allow healthcare professionals to monitor mobile patient’s vital signs and provide feedback to this patient anywhere at any time. Due to the nature of current supporting mobile service platforms, m-health services are delivered with a best-effort, i.e., there are no guarantees on the delivered Quality of Service (QoS). In this paper, we argue that the use of context information in an m-health se...

DISTRIBUTION OF BANKING PRODUCTS AND SERVICES

Directory of Open Access Journals (Sweden)

BULGAREA CATALIN NICOLAE

2010-12-01

Full Text Available Starting with the 90s, retails banks have faced several challenges. One of them is how to efficiently deliver their products and services to the customers. In fact, the most important challenge of a bank is how to efficiently reach the customer, with the right product or service, at the right time. Today, they can choose between branches, contact centers, ATMs, online channels, portals and web banks. Multichannel banking is, therefore, more relevant than ever. Multichannel banking is more than just offering multiple channels, but offering integrated channels, with the optimal balance of services, prices and offer across channels. Banks should have the ability to deliver the right service at the right time in the right channel. The bank should define exactly how they are going to use each channels, which services and products in which channels, how to mix and integrate the channels and how to support the channels

AN ENVIRONMENT FOR EDUCATIONAL SERVICE COMMUNITIES

OpenAIRE

Spillner, Josef

2014-01-01

In most global economies, there is a strong trend from agriculture and manufacturing towards service-orientation and tertiarisation: Services, products with value-added service solutions and, more recently, automated Internet service offerings seamlessly delivered through on-demand elastic cloud computing resources. In the affected societies, education is recognised as a key factor for maintaining the competitiveness. Specialised education about services is widely available, but tool support ...

Global fund financing of tuberculosis services delivery in prisons.

Science.gov (United States)

Lee, Donna; Lal, S S; Komatsu, Ryuichi; Zumla, Alimuddin; Atun, Rifat

2012-05-15

Despite concerted efforts to scale up tuberculosis control with large amounts of international financing in the last 2 decades, tuberculosis continues to be a social issue affecting the world's most marginalized and disadvantaged communities. This includes prisoners, estimated at about 10 million globally, for whom tuberculosis is a leading cause of mortality and morbidity. The Global Fund to Fight AIDS, Tuberculosis and Malaria has emerged as the single largest international donor for tuberculosis control, including funding support in delivering tuberculosis treatment for the confined population. The Global Fund grants database, with an aggregate approved investment of $21.7 billion in 150 countries by the end of 2010, was reviewed to identify tuberculosis and human immunodeficiency virus/tuberculosis grants and activities that monitored the delivery of tuberculosis treatment and support activities in penitentiary settings. The distribution and trend of number of countries with tuberculosis prison support was mapped by year, geographic region, tuberculosis or multidrug-resistant tuberculosis burden, and prison population rate. We examined the types of grant recipients managing program delivery, their performance, and the nature and range of services provided. Fifty-three of the 105 countries (50%) with Global Fund-supported tuberculosis programs delivered services within prison settings. Thirty-two percent (73 of 228) of tuberculosis grants, representing $558 million of all disbursements of Global Fund tuberculosis support by the end of 2010, included output indicators related to tuberculosis services delivered in prisons. Nearly two-thirds (64%) of these grants were implemented by governments, with the remaining by civil society and other partners. In terms of services, half (36 of 73) of grants provided diagnosis and treatment and an additional 27% provided screening and monitoring of tuberculosis for prisoners. The range of services tracked was limited in scope

Making Boundaries Great Again: Essentialism and Support for Boundary-Enhancing Initiatives.

Science.gov (United States)

Roberts, Steven O; Ho, Arnold K; Rhodes, Marjorie; Gelman, Susan A

2017-12-01

Psychological essentialism entails a focus on category boundaries (e.g., categorizing people as men or women) and an increase in the conceptual distance between those boundaries (e.g., accentuating the differences between men and women). Across eight studies, we demonstrate that essentialism additionally entails an increase in support for boundary-enhancing legislation, policies, and social services, and that it does so under conditions that disadvantage social groups, as well as conditions that benefit them. First, individual differences in essentialism were associated with support for legislation mandating that transgender people use restrooms corresponding with their biological sex, and with support for the boundary-enhancing policies of the 2016 then-presumptive Republican presidential nominee (i.e., Donald Trump). Second, essentialism was associated with support for same-gender classrooms designed to promote student learning, as well as support for services designed to benefit LGBTQ (lesbian, gay, bisexual, transgender, queer) individuals. These findings demonstrate the boundary-enhancing implications of essentialism and their social significance.

Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

Science.gov (United States)

Stanley, Dara A.; Garratt, Michael P. D.; Wickens, Jennifer B.; Wickens, Victoria J.; Potts, Simon G.; Raine, Nigel E.

2015-12-01

Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sublethal effects on bees, affecting their foraging behaviour, homing ability and reproductive success. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants, but until now research on pesticide effects has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence to our knowledge that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Bumblebee colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly, these pesticide-exposed colonies produced apples containing fewer seeds, demonstrating a reduced delivery of pollination services. Our results also indicate that reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour, but most likely due to effects at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the functioning of natural ecosystems.

Productivity in Public Services

OpenAIRE

Helen Simpson

2007-01-01

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...

Afraid of delivering at the hospital or afraid of delivering at home : a qualitative study of Thai Hmong families' decision-making about maternity services

OpenAIRE

Culhane-Pera, K.A.; Sriphetcharawut, S.; Thawsirichuchai, Rasamee; Yangyuenkun, W.; Kunstader, P.

2015-01-01

Thailand has high rates of maternity services; both antenatal care (ANC) and hospital delivery are widely used by its citizens. A recent Northern Thailand survey showed that Hmong women used maternity services at lower rates. Our objectives were to identify Hmong families' socio-cultural reasons for using and not using maternity services, and suggest ways to improve Hmong women's use of maternity services. In one Hmong village, we classified all 98 pregnancies in the previous 5 years into fou...

The other invisible hand: delivering public services through choice and competition

National Research Council Canada - National Science Library

Le Grand, Julian

2007-01-01

... problems with public services and hence to an American audience. This has the additional benefit of showing how the book's arguments can be applied outside the British context and thereby enhancin...

Leadership styles of service professionals aiding women of abuse: enhancing service delivery.

Science.gov (United States)

Haeseler, Lisa Ann

2013-01-01

Leadership styles of service professionals--including social workers and teachers--in the area of family abuse were investigated. Leadership characteristics of the professionals were measured by their responses to a survey. Results indicated that the interviewed service professionals demonstrated productive leadership traits. Study findings are congruent with leadership styles described in the research. Holistic and collaborative services are required to enhance care for women of abuse, as their needs are multifaceted and complex. Specific leadership styles promote better care for women; leaders need to collaboratively initiate and deliver more interdisciplinary and unified service.

Data Modeling for Mobile Services in the Real World

DEFF Research Database (Denmark)

Jensen, Christian Søndergaard; Pedersen, Torben Bach; Speicys, L.

2003-01-01

Research contributions on data modeling, data structures, query processing, and indexing for mobile services may have an impact in the longer term, but each contribution typically offers an isolated solution to one small part of the practical problem of delivering mobile services in the real world....... In contrast, this paper describes holistic concepts and techniques for mobile data modeling that are readily applicable in practice. Focus is on services to be delivered to mobile users, such as route guidance, point-of-interest search, road pricing, parking payment, traffic monitoring, etc. While geo...

Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh.

Directory of Open Access Journals (Sweden)

Sk Masum Billah

Full Text Available In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC and management of sick children younger than five years.Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children.Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19% healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average.Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should

33 CFR 20.304 - Service of documents.

Science.gov (United States)

2010-07-01

... other filed document (i) Mail.(ii) Personal delivery. (iii) Express-courier service. (iv) Fax. (v) Other... representative. Is not represented The last known address of the residence or principal place of business of the...) Delivered to the person's office during business hours. (iii) Delivered to the person's residence and...

Tales from the Jungle: The Evolving Climate Services Ecosystem

Science.gov (United States)

Redmond, K. T.

2015-12-01

In 2001 the NRC Report "A Climate Services Vision: First Steps Toward the Future" examined the state and trends of climate services. That report included a definition of this term that has lost no relevance: "The timely production and delivery of useful climate data, information, and knowledge to decision makers." The original entities delivering such services, at the state level, are represented by the American Association of State Climatologists (AASC). In 1986 the NOAA Regional Climate Center program was initiated, followed in 1994 by the NOAA Regional Climate Sciences and Assessments. Since 2010 we have seen the establishment of the USDI Climate Science Centers and the Landscape Conservation Cooperatives, the NOAA Regional Climate Service Directors, and the USDA Regional Climate Hubs. The recent expansion of formal programs has essentially filled out the agency "niche space." Other non-governmental and private entities are also expanding into this space. The present profusion runs a risk of creating a perception of excessive duplication in some quarters, including those funding these enterprises. Collectively these activities form what can be thought of as an ecosystem of climate services. A certain amount of replication is desirable, healthy, and necessary, but beyond some point can be excessive unless the total capacity remains insufficient. Each component has come into existence for a different set of reasons. Since these components were invented by human beings, their subsequent evolution can in theory be guided by humans. The history and purpose of each component needs to be borne in mind, with capsule descriptions suitable for rapid delivery to the decision-makers who approve the support for the various components. Good communication among the components is therefore essential for a healthy and functional overall system. This in turn calls for the ability to adequately represent the role of each of those components, a purpose best informed through actual

Delivery of crop pollination services is an insufficient argument for wild pollinator conservation

NARCIS (Netherlands)

Kleijn, D.; Winfree, R.; Bartomeus, D.; Carvalheiro, L.G.; Bommarco, R.; Scheper, J.; Tscharntke, T.; Verhulst, J.; Potts, S.G.

2015-01-01

There is compelling evidence that more diverse ecosystems deliver greater benefits to people, and these ecosystem services have become a key argument for biodiversity conservation. However, it is unclear how much biodiversity is needed to deliver ecosystem services in a cost-effective way. Here we

Ecosystem services in European protected areas: Ambiguity in the views of scientists and managers?

Directory of Open Access Journals (Sweden)

Christiaan Hummel

Full Text Available Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.

Ecosystem services in European protected areas: Ambiguity in the views of scientists and managers?

Science.gov (United States)

Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman

2017-01-01

Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas. PMID:29140983

Ecosystem services in European protected areas: Ambiguity in the views of scientists and managers?

Science.gov (United States)

Hummel, Christiaan; Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman

2017-01-01

Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.

Wujiang's service-oriented family planning programme.

Science.gov (United States)

Zhu, H

1995-08-01

Wujiang City in south Jiangsu Province is a county-level city, well known for its economic development and effective family planning program. Family planning is practiced voluntarily by the people. The growth rate of the city's population has decreased to 5.47/1000; the proportion of planned births has increased to 98%; and the total fertility rate has declined to 1.5. There are 34 towns (and townships) and 883 administrative villages under the jurisdiction of the city. The living standard has improved significantly. The successful implementation of family planning is largely due to the quality services delivered to farmers, especially women of reproductive age. In an interview, Mme. Ji and Mme. Shen, chiefs of the Wujiang Family Planning Committee, describe the services they deliver. The information, education, and communication (IEC) program is focused on population schools (city, town, township, and village), which deliver information to middle school students, premarital youth, and women who are pregnant, lying-in, or menopausal. Pamphlets on marriage and reproductive health are published by the county population school. Family planning service centers, which deliver contraceptive and technical services, were established in every town and township in 1993. Ultrasound scans are available and have been used to diagnose diseases, including cancer. Over 3000 women have been helped. Misuse of fetal sex identification is banned. The Family Planning Committee and the technical service centers in the city provide counselling services on fewer, healthier births; maternal and child health care; reproductive health; and treatment of infertility. There are several kinds of insurance related to family planning; these include old age support for the parents of only-children, safety insurance for only-children, and old age insurance for newlyweds. The insurance premium is shared by the couple (100 yuan) and the township (400 yuan). Only-child couples, two-daughter families

CONSUMERS PRODUCTS AND SERVICES VALUE PERCEPTION

Directory of Open Access Journals (Sweden)

Bogdan Nichifor

2008-12-01

Full Text Available This article is a theoretical approach on products and services as value satisfiers. Consumers have knowledge about the personal, symbolic values that products, services and brands help them satisfy or achieve. Values are people’s broad life goals. Values often involve the emotional affect associated with such goals and needs (the strong feelings and emotions that accompany success. Recognizing when a value has been satisfied or a basic life goal has been achieved is an internal feeling that is somewhat intangible and subjective. In contrast, functional and psychosocial consequences are more tangible and are more obvious when they occur. Salespeople add value by identifying customer needs and devising or delivering a solution for those needs. Salespeople are able to adapt how products or/and services are presented or even to adapt products/services so that they meet the needs of the buyers. Such adaption powers professional selling, because customers often don’t know what they need or how to configure a solution to their needs. Satisfying a value usually elicits positive affect (happiness, joy, satisfaction, whereas blocking a value produces negative affect (frustration, anger, disappointment. Consumers can have products and services knowledge about products and services attributes, consequences of products or services use and personal values. Most marketing research focuses on one type of products and services knowledge – usually attributes or consequences, where the focus typically is on benefits rather than risks. Values are examined less frequently and usually in isolation. This paper objective is to show the importance of creating, delivering, and capturing buyer value. A company’s ability to deliver value to its customers is closely tied with its ability to create satisfaction for its employees and other stakeholders. Value ultimately depends on the perceiver. Smart companies not only offer purchase value but also offer use value

Accounting, charging and billing for dynamic service composition chains

NARCIS (Netherlands)

Rumph, F.J.; Kruithof, G.H.; Huitema, G.B.

2010-01-01

Services delivered to an end user can be composed of numerous subservices and form chains of composed services. These service composition chains traditionally consist of a static set of business entities. However, in order to increase business agility, dynamic service composition chains can be used

Student Services. A Handbook for the Profession. Second Edition.

Science.gov (United States)

Delworth, Ursula; And Others

Updated information is presented on various student services to provide student service professionals with ideas for successfully planning, coordinating, delivering, and evaluating student services programs. Six sections contain 24 chapters as follows: (1) professional roots and commitments--"Historical Foundations of Student Services (R. Fenske);…

The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

Science.gov (United States)

Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

2014-05-01

Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries.

The Evolution of the Shared Services Business Unit.

Science.gov (United States)

Forst, Leland

2000-01-01

Explains shared services, where common business practices are applied by a staff unit focused entirely on delivering needed services at the highest value and lowest cost to internal customers. Highlights include accountability; examples of pioneering shared services organizations; customer focus transition; relationship management; expertise…

Operational space weather service for GNSS precise positioning

Directory of Open Access Journals (Sweden)

N. Jakowski

2005-11-01

Full Text Available The ionospheric plasma can significantly influence the propagation of radio waves and the ionospheric disturbances are capable of causing range errors, rapid phase and amplitude fluctuations (radio scintillations of satellite signals that may lead to degradation of the system performance, its accuracy and reliability. The cause of such disturbances should be sought in the processes originating in the Sun. Numerous studies on these phenomena have been already carried out at a broad international level, in order to measure/estimate these space weather induced effects, to forecast them, and to understand and mitigate their impact on present-day technological systems. SWIPPA (Space Weather Impact on Precise Positioning Applications is a pilot project jointly supported by the German Aerospace Centre (DLR and the European Space Agency (ESA. The project aims at establishing, operating, and evaluating a specific space-weather monitoring service that can possibly lead to improving current positioning applications based on Global Navigation Satellite Systems (GNSS. This space weather service provides GNSS users with essential expert information delivered in the form of several products - maps of TEC values, TEC spatial and temporal gradients, alerts for ongoing/oncoming ionosphere disturbances, etc.

Operational space weather service for GNSS precise positioning

Directory of Open Access Journals (Sweden)

N. Jakowski

2005-11-01

Full Text Available The ionospheric plasma can significantly influence the propagation of radio waves and the ionospheric disturbances are capable of causing range errors, rapid phase and amplitude fluctuations (radio scintillations of satellite signals that may lead to degradation of the system performance, its accuracy and reliability. The cause of such disturbances should be sought in the processes originating in the Sun. Numerous studies on these phenomena have been already carried out at a broad international level, in order to measure/estimate these space weather induced effects, to forecast them, and to understand and mitigate their impact on present-day technological systems.

SWIPPA (Space Weather Impact on Precise Positioning Applications is a pilot project jointly supported by the German Aerospace Centre (DLR and the European Space Agency (ESA. The project aims at establishing, operating, and evaluating a specific space-weather monitoring service that can possibly lead to improving current positioning applications based on Global Navigation Satellite Systems (GNSS. This space weather service provides GNSS users with essential expert information delivered in the form of several products - maps of TEC values, TEC spatial and temporal gradients, alerts for ongoing/oncoming ionosphere disturbances, etc.

Who wants to deliver public service? Do institutional antecedents of public service motivation provide an answer?

NARCIS (Netherlands)

Vandenabeele, W.V.

2011-01-01

Public service motivation has rapidly become one of the important concepts in contemporary public administration research. However, until now, research has mainly focused on its measurement and its consequences, whereas relatively ignoring its origins. This study investigates where the antecedents

Transformation of Library Services in Nuclear Malaysia: e-SDI

International Nuclear Information System (INIS)

Mohd Hafizal Yusof; Nasaruddin Ahmad; Habibah Adnan

2015-01-01

In order to deliver its services to the public, library must have initiatives to attract the public on using their services. One of the services offered by the library is information packaging or Selective Dissemination of Information (SDI). SDI is services that enable the librarian to serve the user on upcoming information according to the users interest. Before this, librarian will package new publication or information regarding certain topics of the user need and deliver it to the target user frequently. Theorically, this service is connection between library and user and back to library again. Nuclear Malaysia Library has used Integrated Library Management Utilities (ILMU) since 2005. Through this system, there is one module known as Article Browsing where its function same with SDI. This paper will elaborate on transformation of SDI services from conventional to the electronic form. (author)

The Copernicus Climate Change Service (C3S): Open Access to a Climate Data Store

Science.gov (United States)

Thepaut, Jean-Noel; Dee, Dick

2016-04-01

In November 2014, The European Centre for Medium-range Weather Forecasts (ECMWF) signed an agreement with the European Commission to deliver two of the Copernicus Earth Observation Programme Services on the Commission's behalf. The ECMWF delivered services - the Copernicus Climate Change Service (C3S) and Atmosphere Monitoring Service (CAMS) - will bring a consistent standard to how we monitor and predict atmospheric conditions and climate change. They will maximise the potential of past, current and future earth observations - ground, ocean, airborne, satellite - and analyse these to monitor and predict atmospheric conditions and in the future, climate change. With the wealth of free and open data that the services provide, they will help business users to assess the impact of their business decisions and make informed choices, delivering a more energy efficient and climate aware economy. These sound investment decisions now will not only stimulate growth in the short term, but reduce the impact of climate change on the economy and society in the future. C3S is in its proof of concept phase and through its Climate Data Store will provide • global and regional climate data reanalyses; • multi-model seasonal forecasts; • customisable visual data to enable examination of wide range of scenarios and model the impact of changes; • access to all the underlying data, including climate data records from various satellite and in-situ observations. In addition, C3S will provide key indicators on climate change drivers (such as carbon dioxide) and impacts (such as reducing glaciers). The aim of these indicators will be to support European adaptation and mitigation policies in a number of economic sectors. At the heart of the Service is the provision of open access to a one stop shop (the Climate Data Store) of climate data and modelling, analysing more than 20 Essential Climate Variables to build a global picture of our past, present and future climate and developing

A Robust Optimization Approach for Improving Service Quality

OpenAIRE

Andreas C. Soteriou; Richard B. Chase

2000-01-01

Delivering high quality service during the service encounter is central to competitive advantage in service organizations. However, achieving such high quality while controlling for costs is a major challenge for service managers. The purpose of this paper is to present an approach for addressing this challenge. The approach entails developing a model linking service process operational variables to service quality metrics to provide guidelines for service resource allocation. The approach en...

Structural Features Reminiscent of ATP-Driven Protein Translocases Are Essential for the Function of a Type III Secretion-Associated ATPase.

Science.gov (United States)

Kato, Junya; Lefebre, Matthew; Galán, Jorge E

2015-09-01

Many bacterial pathogens and symbionts utilize type III secretion systems to interact with their hosts. These machines have evolved to deliver bacterial effector proteins into eukaryotic target cells to modulate a variety of cellular functions. One of the most conserved components of these systems is an ATPase, which plays an essential role in the recognition and unfolding of proteins destined for secretion by the type III pathway. Here we show that structural features reminiscent of other ATP-driven protein translocases are essential for the function of InvC, the ATPase associated with a Salmonella enterica serovar Typhimurium type III secretion system. Mutational and functional analyses showed that a two-helix-finger motif and a conserved loop located at the entrance of and within the predicted pore formed by the hexameric ATPase are essential for InvC function. These findings provide mechanistic insight into the function of this highly conserved component of type III secretion machines. Type III secretion machines are essential for the virulence or symbiotic relationships of many bacteria. These machines have evolved to deliver bacterial effector proteins into host cells to modulate cellular functions, thus facilitating bacterial colonization and replication. An essential component of these machines is a highly conserved ATPase, which is necessary for the recognition and secretion of proteins destined to be delivered by the type III secretion pathway. Using modeling and structure and function analyses, we have identified structural features of one of these ATPases from Salmonella enterica serovar Typhimurium that help to explain important aspects of its function. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

CONSIDERATIONS ABOUT THE ESSENTIAL FEATURES OF INNOVATION

Directory of Open Access Journals (Sweden)

Geanina S. BANU

2014-11-01

Full Text Available Defining and classifying innovation represents a complex approach both theoretical and practical. While comprising various views, the innovation concept is permanently redefined according to various criteria. Nevertheless, approaching innovation generic features should be always considered as defining the core of innovation as a concept. The aim of the present paper is to perform a literature review identifying the essential features of innovation with the aim of providing a comprehensive and holistic view of the concept. Furthermore, the present article aims at delivering a theoretical guide on innovation. To this end, the review comprises definition of concept, classification, risk factors, innovation systems and measuring indicators.

12 CFR 1703.51 - Service of process.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Service of process. 1703.51 Section 1703.51... OFHEO § 1703.51 Service of process. (a) Except as otherwise provided by OFHEO regulations, the Federal.... (b) Service of process upon the General Counsel may be effected by personally delivering a copy of...

Design guidelines for mobile information and entertainment services based on the Radio538 ringtunes i-mode service case study

NARCIS (Netherlands)

Kar, E. van de; Maitland, C.F.; Wehn de Montalvo, U.W.C.; Bouwman, H.

2003-01-01

The mobile telecommunications industry is undergoing rapid change, which is increasing the interdependency of firms in the sector. Mobile information and entertainment services will be delivered through inter-organizational networks of firms. This means the problems of service design must be

A Multi-organisational Approach to Service Delivery

Science.gov (United States)

Purchase, Valerie; Mills, John; Parry, Glenn

Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

Transformation to cloud services sourcing : Required it governance capabilities

NARCIS (Netherlands)

Joha, A.; Janssen, M.F.W.H.A.

2012-01-01

The sourcing of cloud services is a relatively new type of service delivery model in which an organization gets access to IT services via a cloud service provider that is delivering services over the web to many users on a pay per use or period basis. Even though the importance of IT governance is

Alternative perspectives of safety in home delivered health care: a sequential exploratory mixed method study.

Science.gov (United States)

Jones, Sarahjane

2016-10-01

The aim of this study was to discover and describe how patients, carers and case management nurses define safety and compare it to the traditional risk reduction and harm avoidance definition of safety. Care services are increasingly being delivered in the home for patients with complex long-term conditions. However, the concept of safety remains largely unexplored. A sequential, exploratory mixed method design. A qualitative case study of the UK National Health Service case management programme in the English UK National Health Service was deployed during 2012. Thirteen interviews were conducted with patients (n = 9) and carers (n = 6) and three focus groups with nurses (n = 17) from three community care providers. The qualitative element explored the definition of safety. Data were subjected to framework analysis and themes were identified by participant group. Sequentially, a cross-sectional survey was conducted during 2013 in a fourth community care provider (patient n = 35, carer n = 19, nurse n = 26) as a form of triangulation. Patients and carers describe safety differently to case management nurses, choosing to focus on meeting needs. They use more positive language and recognize the role they have in safety in home-delivered health care. In comparison, case management nurses described safety similarly to the definitions found in the literature. However, when offered the patient and carer definition of safety, they preferentially selected this definition to their own or the literature definition. Patients and carers offer an alternative perspective on patient safety in home-delivered health care that identifies their role in ensuring safety and is more closely aligned with the empowerment philosophy of case management. © 2016 John Wiley & Sons Ltd.

Relationships among providing maternal, child, and adolescent health services; implementing various financial strategy responses; and performance of local health departments.

Science.gov (United States)

Issel, L Michele; Olorunsaiye, Comfort; Snebold, Laura; Handler, Arden

2015-04-01

We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations. We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

Cloud essentials CompTIA authorized courseware for exam CLO-001

CERN Document Server

Hausman, Kirk; Sampaio, Telmo

2013-01-01

CompTIA-Authorized courseware for the Cloud Essentials Exam (CLO-001) What better way to get up to speed on cloud computing than with this new book in the popular Sybex Essentials series? Cloud Essentials covers the basics of cloud computing and its place in the modern enterprise. Explore public and private clouds; contrast the ""as a service"" models for PaaS, SaaS, IaaS, or XaaS platforms; plan security; and more. In addition, the book covers the exam objectives for the both the CompTIA Cloud Essentials (Exam CLO-001) exam and the EXIN Cloud Computing Foundation (EX0-1

Life saving or money wasting? Perceptions of caesarean sections among users of services in rural Bangladesh.

Science.gov (United States)

Parkhurst, Justin Oliver; Rahman, Syed Azizur

2007-03-01

Bangladesh has a high level of maternal mortality, corresponding to one of the world's lowest rates of use of skilled birth attendance (12.1%), and a similarly low rate of caesarean births (2.4%). While increasing the proportion of women who deliver with professional medical care is essential to prevent maternal deaths, past work has identified distrust of caesarean procedures in Bangladesh. The reasons behind this distrust can manifest itself in health seeking behaviour around maternal care. This paper presents findings from a qualitative study of 30 women in a rural district of Bangladesh who recently delivered in a health facility. It finds that the distrust in doctor's recommendations for surgery stemmed from high costs incurred and a belief that it was used when not medically justified. This could lead to women avoiding or leaving medical facilities in extreme cases. Some women's experiences further illustrated disagreement among medical staff as to whether or not a caesarean procedure should be done, with conflicting financial incentives for doctors to perform caesarean deliveries, and for nurses and midwives to conduct normal deliveries. Policy makers must recognise that the fears women hold of caesarean deliveries may not simply be rooted in ignorance and may, in fact, reflect legitimate concerns with medical practice. Ultimately, it will be essential to address problems in the health systems environment, which may promote improper service provision.

DESIGNS MATTER: Delivering Information Sources for Tourism

Directory of Open Access Journals (Sweden)

Margie A. Nolasco

2016-11-01

Full Text Available Tourism has benefits not just for travelers, but also to the local economy. Since, Bicol Region has natural and cultural attractions; it is a potential travel destination in the country. Technology in delivering information sources played vital role for the success of the tourism industry in the Region. This allows travel enthusiasts to get more information about various tourist attractions. This paper analyzes the effectiveness of delivering information sources such as web advertisement and desktop publishing for tourist promotion in the Bicol Region. Specifically, it determined the status of tourism, and identified common forms of promotions for tourism development. The study adopted mixed method of research. This method was utilized to confirm and validate findings. Interviews and focus group discussions were used to gather data from the respondents of the selected Local Government Units, Department of Tourism, Travel Agencies and Hotel Agents in the Region. Based on the findings, of the total foreign visitors in the country, only 9.14% visited Bicol Region in 2014. That is why, domestic tourist showed high percentage against foreign visitors with 25.7%. Brochures with EZ maps as most commonly used desktop publishing materials and websites and social media for web advertisement. Thus, there is a need to reevaluate promotional activities by the DOT and other agencies. Adoption suggestive features for creative desktop publishing materials and web services should be considered to increase tourist visitors in the Region.

Examining the cost of delivering routine immunization in Honduras.

Science.gov (United States)

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

Beefing up operations in service firms.

Science.gov (United States)

Chase, R B; Hayes, R H

1991-01-01

Many articles exhort service firm managers to empower workers and first-line supervisors, exploit technology, focus on the customer, and, above all, provide outstanding service. This article proposes a framework to help you evaluate your company's competitive standing in each of these areas. It discusses four types of companies on a continuum, from the company that is simply "available for service" to the firm that delivers world class service. The authors focus on operations, the function that controls the service encounter, and apply the manufacturing strategy paradigm to services as a means of implementing change.

Performance Monitoring Framework for Service Oriented System Lifecycle

OpenAIRE

Masood , Tehreem; Cherifi , Chantal; Moalla , Néjib

2016-01-01

International audience; Service oriented systems are highly dynamic systems composed of several web services. One of the most important challenges in service oriented systems is to deliver acceptable quality of service. For this purpose, it is required to monitor quality of service along different activities of service oriented system. Existing research focuses on specific activities but do not take into account all the activities of service oriented system together at the infrastructure leve...

Australian nursing and midwifery educators delivering evidence-based education in Tanzania: A qualitative study.

Science.gov (United States)

Gower, Shelley; van den Akker, Jose; Jones, Mark; Dantas, Jaya A R; Duggan, Ravani

2016-05-01

Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These findings are described using the conceptual framework of Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare Services. With appropriate levels of cultural competence, international health professionals can be effective at providing ongoing professional development to colleagues in developing country contexts, which may help address difficulties with retention and motivation of staff. It is essential that prior to departure cultural competence training is provided to educators to enhance their teaching capacity and effectiveness in international settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

DATA ANALYSIS TECHNIQUES IN SERVICE QUALITY LITERATURE: ESSENTIALS AND ADVANCES

Directory of Open Access Journals (Sweden)

Mohammed naved Khan

2013-05-01

Full Text Available Academic and business researchers have for long debated on the most appropriate data analysis techniques that can be employed in conducting empirical researches in the domain of services marketing. On the basis of an exhaustive review of literature, the present paper attempts to provide a concise and schematic portrayal of generally followed data analysis techniques in the field of services quality literature. Collectively, the extant literature suggests that there is a growing trend among researchers to rely on higher order multivariate techniques viz. confirmatory factor analysis, structural equation modeling etc. to generate and analyze complex models, while at times ignoring very basic and yet powerful procedures such as mean, t-Test, ANOVA and correlation. The marked shift in orientation of researchers towards using sophisticated analytical techniques can largely beattributed to the competition within the community of researchers in social sciences in general and those working in the area of service quality in particular as also growing demands of reviewers ofjournals. From a pragmatic viewpoint, it is expected that the paper will serve as a useful source of information and provide deeper insights to academic researchers, consultants, and practitionersinterested in modelling patterns of service quality and arriving at optimal solutions to increasingly complex management problems.

Why Training for Service Contract Management is Mission Essential

National Research Council Canada - National Science Library

Friar, Allen

2005-01-01

... Programs provide vital services and act as force multipliers for forward deployment units. Consequently, a transformation in contracting and acquisition leadership along with proper planning is necessary to manage contracts...

Essentials of cloud computing

CERN Document Server

Chandrasekaran, K

2014-01-01

ForewordPrefaceComputing ParadigmsLearning ObjectivesPreambleHigh-Performance ComputingParallel ComputingDistributed ComputingCluster ComputingGrid ComputingCloud ComputingBiocomputingMobile ComputingQuantum ComputingOptical ComputingNanocomputingNetwork ComputingSummaryReview PointsReview QuestionsFurther ReadingCloud Computing FundamentalsLearning ObjectivesPreambleMotivation for Cloud ComputingThe Need for Cloud ComputingDefining Cloud ComputingNIST Definition of Cloud ComputingCloud Computing Is a ServiceCloud Computing Is a Platform5-4-3 Principles of Cloud computingFive Essential Charact

"When are you seeing my patient?"--an analysis of the cardiology consultation service in a teaching hospital.

LENUS (Irish Health Repository)

Cronin, E

2010-05-01

The provision of an efficient consultation service is essential to the efficient functioning of any hospital. Surprisingly little is known about this activity. We present the first reported evaluation of a cardiology consultation service in an attempt to determine the characteristics, efficiency and workload implications of such a service. We performed an audit of the in-patient cardiology consultation service over a four week period. During this period, 125 consultations were seen, of which 85 (68%) were requested by medical specialties. Consultations were seen in a timely fashion, with 76 (61%) being seen on the same day that the request was received. The most common problem was chest pain, (49 patients; 38%) which was felt to be of cardiac origin in only a minority (20; 40%) of cases. Consultations had significant resource implications for our department, with 35 (28%) procedures being performed, 25 (20%) patients\\' care being taken over, and a further 27 (21.6%) new out-patient referrals generated. Our results indicate that the consultation service considered was efficiently delivered but contributed significantly to the department\\'s workload. The most frequent consultation request was for chest pain that was often non-cardiac in nature.

Sketching web services backends with SERPE

NARCIS (Netherlands)

Aprile, W.A.

2009-01-01

In the face of current strong commercial interest in services that, from an implementation point of view, consist of databases provided with a web API and/or a front end, there is a scarcity of tools that allow quickly sketching the service backend in order to deliver an interactive prototype. SERPE

Note from the Goods Reception services

CERN Multimedia

FI Department

2008-01-01

Members of the personnel are invited to take note that only parcels corresponding to official orders or contracts will be handled at CERN. Individuals are not authorised to have private merchandise delivered to them at CERN and private deliveries will not be accepted by the Goods Reception services. Goods Reception Services

They're Doing What? A Brief Paper on Service Use and Attitudes in ASD Community-Based Agencies

Science.gov (United States)

Pickard, Katherine; Meza, Rosemary; Drahota, Amy; Brikho, Brigitte

2018-01-01

This brief article examines the community services delivered to youth with autism spectrum disorder (ASD) in a Southern Californian city as a way to better understand ASD service provision and service attitudes. Specific goals of the study were to identify the services being delivered within the area, and how the use, perceived evidence, and value…

Web Services and Other Enhancements at the Northern California Earthquake Data Center

Science.gov (United States)

Neuhauser, D. S.; Zuzlewski, S.; Allen, R. M.

2012-12-01

The Northern California Earthquake Data Center (NCEDC) provides data archive and distribution services for seismological and geophysical data sets that encompass northern California. The NCEDC is enhancing its ability to deliver rapid information through Web Services. NCEDC Web Services use well-established web server and client protocols and REST software architecture to allow users to easily make queries using web browsers or simple program interfaces and to receive the requested data in real-time rather than through batch or email-based requests. Data are returned to the user in the appropriate format such as XML, RESP, or MiniSEED depending on the service, and are compatible with the equivalent IRIS DMC web services. The NCEDC is currently providing the following Web Services: (1) Station inventory and channel response information delivered in StationXML format, (2) Channel response information delivered in RESP format, (3) Time series availability delivered in text and XML formats, (4) Single channel and bulk data request delivered in MiniSEED format. The NCEDC is also developing a rich Earthquake Catalog Web Service to allow users to query earthquake catalogs based on selection parameters such as time, location or geographic region, magnitude, depth, azimuthal gap, and rms. It will return (in QuakeML format) user-specified results that can include simple earthquake parameters, as well as observations such as phase arrivals, codas, amplitudes, and computed parameters such as first motion mechanisms, moment tensors, and rupture length. The NCEDC will work with both IRIS and the International Federation of Digital Seismograph Networks (FDSN) to define a uniform set of web service specifications that can be implemented by multiple data centers to provide users with a common data interface across data centers. The NCEDC now hosts earthquake catalogs and waveforms from the US Department of Energy (DOE) Enhanced Geothermal Systems (EGS) monitoring networks. These

Telecommunications and Universal Service: International ...

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

The services delivered over telecommunications networks can provide ... livestock vaccine development and production to benefit farmers across the Global South. ... OECD's Development Co-Operation Report highlights critical role of data to ...

e3service: a critical reflection and future research

NARCIS (Netherlands)

Razo-Zapata, Ivan S.; Gordijn, Jaap; de Leenheer, Pieter; Wieringa, Roelf J.

2015-01-01

Commercial services are of utmost importance for the economy. Due to the widespread use of information and communication technologies, many of these services may be delivered online by means of service value networks. To automate this delivery, however, issues such as composition, integration, and

E3service: A critical reflection and future research

NARCIS (Netherlands)

Razo Zapata, I.S.; Gordijn, J.; De Leenheer, P.G.M.; Wieringa, R.

2015-01-01

Commercial services are of utmost importance for the economy. Due to the widespread use of information and communication technologies, many of these services may be delivered online by means of service value networks. To automate this delivery, however, issues such as composition, integration, and

Good to Great in IT Service Management: A Case Study

NARCIS (Netherlands)

Gilbert Gilbert Silvius; Eric Brugh, van der

2009-01-01

For IT services companies, delivering high quality IT services is of eminent importance. IT service quality drives customer satisfaction, which in its turn drives firm performance. It is this link that is addressed in this paper: How can the performance of customer service delivery teams be

Controlling the delivery of outsourced services in asymmetrical supply chains

NARCIS (Netherlands)

Iwaarden, van J.; Valk, van der W.; Aalders, L.; Brown, S.W.

2009-01-01

Services are increasingly outsourced. When outsourced services are directly delivered to the final customer by the supplier, the buying company lacks direct control over the delivery of the service. The purpose of this study is to expand theory on control over service delivery in supply chains. A

The Organizational Role of Web Services

Science.gov (United States)

Mitchell, Erik

2011-01-01

The workload of Web librarians is already split between Web-related and other library tasks. But today's technological environment has created new implications for existing services and new demands for staff time. It is time to reconsider how libraries can best allocate resources to provide effective Web services. Delivering high-quality services…

Healthcare service providers' and facility administrators' perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study.

Science.gov (United States)

Lang'at, Evaline; Mwanri, Lillian

2015-06-27

Globally, there are increasing efforts to improve maternal health outcomes including the reduction in maternal mortality rates. Improved access to skilled care utilisation during pregnancy and delivery has been one of the strategies employed to improve maternal health outcomes. In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Data were analysed using a thematic framework analysis. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. Free maternal healthcare services can be one of the strategies to improve a range of maternal health outcomes. However, the implementation of this policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitized on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and

Developments in Technology-Delivered Psychological Interventions / Desarrollos en Intervenciones Psicológicas utilizando la Tecnología

Directory of Open Access Journals (Sweden)

Derek Richards

2013-06-01

Full Text Available The worldwide penetration of the Internet and its related technologies, the rapid developments of new technologies and the pervasive use of technology in people’s lives, are indicators that we live in a technological age. New technologies and their potential for use in psychological interventions and mental health services have not gone unnoticed. The last 15 years or so have witnessed the employment of new technologies in developing and delivering a variety of psychological interventions, these include information WebPages, internet-based computer programs that are addressed to treatment of specific problems, the use of mobile phones and games to help psychological practice, among others. However, while a broad range of technology-delivered psychological interventions have demonstrated success in high-income countries, little is known of their potential for countries such as Colombia. The paper begins with a brief history, followed by an overview of the field of technology-delivered psychological interventions. Lastly, the paper seeks to present a justification for the potential use of technology delivered psychological interventions in Colombia.

Need assessment of staffs' welfare services at tehran university of medical sciences: a cross-sectional study.

Science.gov (United States)

Dehghan, Reza; Mafimoradi, Shiva; Hadi, Mohammad

2015-01-01

Reviewing the human resources management literature shows an absence of attention given to the employee's benefits. Taking a look at functions of the Tehran University of Medical Sciences' wellbeing services system, it uncovers a gap between employees' real needs and what is delivered to meet their needs. So it requires an improved comprehensive system for delivering wellbeing services (financial, insurance, health care services, educational and training services, etc). Wellbeing need assessment can helps planners to identify vital needs of employee and response to them effectively. Moreover it can be used to evaluate the effectiveness of the current services which are delivered. Thus, the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs which were not fulfilled by the organization. Being a cross-sectional and analytic-descriptive survey including 98 responding participants, it is conducted by a questionnaire collecting employees' demographic information, their satisfactory rate of the implemented services, and determines unfulfilled wellbeing needs which were not already covered. Results indicated that services related to financial, educational, non-financial, insurance, occupational health and tourism/recreational services were the most satisfactory services successively. 'Staff's unwillingness to receive services' and 'poor announcement' (unawareness on the wellbeing services),' were found to be the most frequent reasons for not receiving the existing wellbeing services. To increase the satisfaction rate and responsiveness to the real needs of the staff, the current delivery system of wellbeing services in the TUMS should be redesigned by defining new wellbeing packages.

Reducing barriers associated with delivering health care services to migratory agricultural workers.

Science.gov (United States)

Schmalzried, Hans D; Fallon, L Fleming

2012-01-01

Between one and two million migratory agricultural workers (MAWs), primarily from Mexico and Central America, leave their homes each year to plant, cultivate, harvest and pack fruits, vegetables, and nuts in the USA. While in the USA, most lack health insurance, a permanent residence, and a regular healthcare provider. Publications over the past two decades in the USA have reported that a majority of MAWs encounter barriers to receiving medical services. Migratory agricultural workers experience high rates of occupational illness and injury. Poor access to medical care continues to exacerbate health problems among members of this population related to their working environments. In most studies concerning healthcare access issues for this population, researchers collected their information from healthcare service providers; rarely have they included input from migratory agricultural workers. This study was different in that opinions about healthcare access issues were collected directly from MAWs. The primary purpose of this study was to describe issues related to barriers associated with the delivery of healthcare services to migratory agricultural workers. A secondary purpose was to suggest strategies for reducing these barriers. In this study, data from focus group sessions were used to develop a survey questionnaire. Four certified bilingual interpreters were trained to administer the questionnaire. A total of 157 usable questionnaires were returned from MAWs living in employer-provided camps in Northwest Ohio. The statistical analyses were primarily descriptive. The most significant barriers hampering access to medical services among the 157 respondents were cost (n=113; 72.0%), crop demands (n=102; 65.0%), the lack of an interpreter (n=98; 62.4%), travel distance (n=88; 56.1%) and transportation (n=82; 52.2%). Approximately half (n=82; 52.2%) said that they had access to transportation for traveling to a medical clinic. As a group, respondents were willing to

Moldicidal properties of seven essential oils

Science.gov (United States)

Vina W. Yang; Carol A. Clausen

2006-01-01

When wood and wood products are exposed to moisture during storage, construction or while in-service, mold growth can occur in 24 to 48 hours. Mold growth could be suppressed or prevented if wood was treated with an effective mold inhibitor. The objective of this study was to evaluate the mold inhibiting properties of natural plant extracts such as essential oils....

Voice Over the Internet Protocol as a Medium for Delivering Reading Intervention

Directory of Open Access Journals (Sweden)

Craig Wright

2011-10-01

Full Text Available Voice Over the Internet Protocol (VoIP holds promise as a platform by which services can be delivered to students in rural and remote regions who have reading difficulties. VoIP is an Internet-based protocol that allows two or more individuals to videoconference from remote locations. This study used a single-case research design to investigate whether VoIP would produce significant gains in reading ability in BM, a 10-year-old with long-standing word-level reading problems. BM was provided with a theoretically motivated reading intervention 4 times weekly. The intervention was delivered remotely using the Apple iChat software. Substantial growth in regular- and nonword reading covaried with onset and removal of treatment. Treatment gains were maintained at 10-week follow-up. Meaningful gains were also seen in text-reading accuracy and reading comprehension. VoIP-based instruction represents an important avenue for future research and is a teaching method that holds much promise for rural and remote students.

Public values as essential criteria for public service innovation

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

2017-01-01

Background: The importance of innovation management has traditionally been ascribed to private production companies, however, there is an increasing interest in public services innovation management. One of the major theoretical challenges arising from this situation is to understand public value...

Online by design the essentials of creating information literacy courses

CERN Document Server

Mery, Yvonne

2014-01-01

As online instruction becomes more popular, librarians will want to develop the knowledge and skills needed to create an effective online information literacy course. Online by Design: The Essentials of Creating Information Literacy Courses will guide librarians as they go through the process of designing, developing, and delivering online information literacy courses. Yvonne Mery & Jill Newby offer proven techniques and tips for creating quality online courses that are engaging and effective. This handbook is perfect for instruction librarians who are interesting in developing new courses or

Tuning of Essential Oil Properties by Enzymatic Treatment: Towards Sustainable Processes for the Generation of New Fragrance Ingredients

Directory of Open Access Journals (Sweden)

Sylvain Antoniotti

2014-07-01

Full Text Available In this review, several strategies of modification of essential oils by enzymatic treatment are presented. Being either applied before or after the production of the essential oil, enzymatic methods are shown to be particularly adapted to attain the required selectivity, specificity and efficiency in sustainable processes delivering products eligible for the natural grade. Examples dealing with the optimization of the properties of essential oils in terms of biological activity, odor and safety are provided, and it is likely that these strategies will address other type of properties in the future, such as the physico-chemical properties, for example.

Web Services and Data Enhancements at the Northern California Earthquake Data Center

Science.gov (United States)

Neuhauser, D. S.; Zuzlewski, S.; Lombard, P. N.; Allen, R. M.

2013-12-01

The Northern California Earthquake Data Center (NCEDC) provides data archive and distribution services for seismological and geophysical data sets that encompass northern California. The NCEDC is enhancing its ability to deliver rapid information through Web Services. NCEDC Web Services use well-established web server and client protocols and REST software architecture to allow users to easily make queries using web browsers or simple program interfaces and to receive the requested data in real-time rather than through batch or email-based requests. Data are returned to the user in the appropriate format such as XML, RESP, simple text, or MiniSEED depending on the service and selected output format. The NCEDC offers the following web services that are compliant with the International Federation of Digital Seismograph Networks (FDSN) web services specifications: (1) fdsn-dataselect: time series data delivered in MiniSEED format, (2) fdsn-station: station and channel metadata and time series availability delivered in StationXML format, (3) fdsn-event: earthquake event information delivered in QuakeML format. In addition, the NCEDC offers the the following IRIS-compatible web services: (1) sacpz: provide channel gains, poles, and zeros in SAC format, (2) resp: provide channel response information in RESP format, (3) dataless: provide station and channel metadata in Dataless SEED format. The NCEDC is also developing a web service to deliver timeseries from pre-assembled event waveform gathers. The NCEDC has waveform gathers for ~750,000 northern and central California events from 1984 to the present, many of which were created by the USGS NCSN prior to the establishment of the joint NCSS (Northern California Seismic System). We are currently adding waveforms to these older event gathers with time series from the UCB networks and other networks with waveforms archived at the NCEDC, and ensuring that the waveform for each channel in the event gathers have the highest

Developing Service Strategies in Support of Servitization in China

DEFF Research Database (Denmark)

Raja, Jawwad; Frandsen, Thomas

economies. This paper attempts to begin bridging this gap by exploring attempts by a European manufacturer to expand services in China. Particular attention is given to the role of the service partner network in attempting to grow and deliver services. Based on an exploratory case study, we examine how...

Library 2.0: Service for the Next-Generation Library

Science.gov (United States)

Casey, Michael E.; Savastinuk, Laura C.

2006-01-01

Libraries are changing. Funding limits and customer demands are transforming staffing levels, service models, access to resources, and services to the public. Administrators and taxpayers are seeking more efficient ways of delivering services to achieve greater returns on financial investments. In this article, the author discusses the benefits of…

Mobile Opportunities and Applications for E-service Innovations

DEFF Research Database (Denmark)

Scupola, Ada

Mobile technology continues to shape our society, delivering information and knowledge right to our finger tips. It is only fitting that these advancements and opportunities are applied to the area of electronic services. Mobile Opportunities and Applications for E-Service Innovations brings...

Technology-Enhanced Maintenance of Treatment Gains in Eating Disorders: Efficacy of an Intervention Delivered via Text Messaging

Science.gov (United States)

Bauer, Stephanie; Okon, Eberhard; Meermann, Rolf; Kordy, Hans

2012-01-01

Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on…

Adolescents perception of reproductive health care services in Sri Lanka

Science.gov (United States)

Agampodi, Suneth B; Agampodi, Thilini C; UKD, Piyaseeli

2008-01-01

Adolescent health services are inadequate and available services are not being delivered in an acceptable manner. Proper training of health care providers on youth friendly service provision is essential. A National level integrated health care program is needed for the adolescents. PMID:18454869

Adolescents perception of reproductive health care services in Sri Lanka

Directory of Open Access Journals (Sweden)

Agampodi Thilini C

2008-05-01

. Conclusions and recommendations Adolescent health services are inadequate and available services are not being delivered in an acceptable manner. Proper training of health care providers on youth friendly service provision is essential. A National level integrated health care program is needed for the adolescents.

Adolescents perception of reproductive health care services in Sri Lanka.

Science.gov (United States)

Agampodi, Suneth B; Agampodi, Thilini C; Ukd, Piyaseeli

2008-05-03

are not being delivered in an acceptable manner. Proper training of health care providers on youth friendly service provision is essential. A National level integrated health care program is needed for the adolescents.

Comparing the Cost-Effectiveness of Campaigns Delivered via Various Combinations of Television and Online Media.

Science.gov (United States)

Allom, Vanessa; Jongenelis, Michelle; Slevin, Terry; Keightley, Stacey; Phillips, Fiona; Beasley, Sarah; Pettigrew, Simone

2018-01-01

Reflecting the increasing prevalence of online media, many mass media health campaigns are now delivered using both television (TV) and online media formats. The aim of this study was to evaluate a smoking cessation mass media campaign according to the cost-effectiveness of the various combinations of TV and online media formats to inform future media buying decisions. A quasi-experimental interrupted time series approach was employed. The campaign was delivered in seven 1-week bursts using TV, online video (OV), or online display (OD) (e.g., banner ads) formats in isolation and in various combinations over a 13-week period. Campaign bursts were separated by "off-weeks" in which no campaign materials were delivered. Assessed outcomes were the number of campaign response "events" recorded (campaign web page views, calls to a smoking cessation telephone service, and registrations for smoking cessation services). The cost-effectiveness of each individual and combined media format condition in terms of these outcome variables was calculated using attributed production and broadcasting costs. Overall, OD alone was found to be the most cost-effective means of achieving the nominated campaign outcomes, followed by a combination of OV and OD and a combination of TV and OV. The use of TV in isolation was the least cost-effective. The results of this evaluation indicate that online media constitute a promising means of enhancing the cost-effectiveness of smoking cessation campaigns. Future research assessing a broader range of outcomes, especially smoking cessation, is needed to provide a more comprehensive account of the cost-effectiveness of various campaign media.

Lemongrass essential oil gel as a local drug delivery agent for the treatment of periodontitis

Science.gov (United States)

Warad, Shivaraj B.; Kolar, Sahana S.; Kalburgi, Veena; Kalburgi, Nagaraj B.

2013-01-01

Background: It has been long recognized that periodontal diseases are infections of the periodontium, comprising the bacterial etiology, an immune response, and tissue destruction. Treatment strategies aiming primarily at suppressing or eliminating specific periodontal pathogens include adjunct use of local and systemic antibiotics as part of nonsurgical periodontal therapy. Unwanted side effects and resistance of microorganisms toward antibiotics due to their widespread use have modified the general perception about their efficacy. Research in phytosciences has revealed various medicinal plants offering a new choice of optional antimicrobial therapy. Cymbopogon citratus, Stapf. (lemongrass) is a popular medicinal plant. At a concentration ≤2%, lemongrass essential oil inhibits the growth of several kinds of microorganisms including periodontal pathogens, especially the reference strains Actinomyces naeslundii and Porphyromonas gingivalis, which were resistant to tetracycline hydrochloride. Aims: To evaluate the efficacy of locally delivered 2% lemongrass essential oil in gel form as an adjunct to scaling and root planing, as compared to scaling and root planing alone for the treatment of chronic periodontitis. Materials and Methods: 2% Lemongrass essential oil gel was prepared and placed in moderate to deep periodontal pockets after scaling and root planing. Results: Statistically significant reduction in probing depth and gingival index and gain in relative attachment level were noted in the experimental group as compared to the control group at 1 and 3 months. Conclusion: Locally delivered 2% lemongrass essential oil gel offers a new choice of safe and effective adjunct to scaling and root planing in periodontal therapy. PMID:24991068

Lemongrass essential oil gel as a local drug delivery agent for the treatment of periodontitis

Directory of Open Access Journals (Sweden)

Shivaraj B Warad

2013-01-01

Full Text Available Background: It has been long recognized that periodontal diseases are infections of the periodontium, comprising the bacterial etiology, an immune response, and tissue destruction. Treatment strategies aiming primarily at suppressing or eliminating specific periodontal pathogens include adjunct use of local and systemic antibiotics as part of nonsurgical periodontal therapy. Unwanted side effects and resistance of microorganisms toward antibiotics due to their widespread use have modified the general perception about their efficacy. Research in phytosciences has revealed various medicinal plants offering a new choice of optional antimicrobial therapy. Cymbopogon citratus, Stapf. (lemongrass is a popular medicinal plant. At a concentration ≤2%, lemongrass essential oil inhibits the growth of several kinds of microorganisms including periodontal pathogens, especially the reference strains Actinomyces naeslundii and Porphyromonas gingivalis, which were resistant to tetracycline hydrochloride. Aims: To evaluate the efficacy of locally delivered 2% lemongrass essential oil in gel form as an adjunct to scaling and root planing, as compared to scaling and root planing alone for the treatment of chronic periodontitis. Materials and Methods: 2% Lemongrass essential oil gel was prepared and placed in moderate to deep periodontal pockets after scaling and root planing. Results: Statistically significant reduction in probing depth and gingival index and gain in relative attachment level were noted in the experimental group as compared to the control group at 1 and 3 months. Conclusion: Locally delivered 2% lemongrass essential oil gel offers a new choice of safe and effective adjunct to scaling and root planing in periodontal therapy.

Logistics Services Reminder

CERN Multimedia

Logistics Services

2016-01-01

Members of the personnel are invited to take note that only parcels corresponding to official orders or contracts will be handled at CERN. Individuals are not authorised to have private merchandise delivered to them at CERN and private deliveries will not be accepted by the Goods Reception services. Thank you for your understanding.

Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.

Science.gov (United States)

Thomas, Kali S; Allen, Susan M

2016-01-01

Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed. Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership, including frequent communication, training in VAMC billing procedures, having a designated VAMC staff person for the program, and active involvement of the VAMC from the onset of VD-HCBS program development. Findings have implications for other interagency partnerships formed to deliver services to vulnerable Veterans.

When servitization is not transforming the way we do business - analysis of two unsuccessful service offerings from the shipping industry

DEFF Research Database (Denmark)

Pagoropoulos, Aris; Kjær, Louise Laumann; McAloone, Tim C.

2016-01-01

company in the role of the customer that in the course of two years turned down two different servitized offerings from two manufacturers: one pooling and servicing agreement and one performance agreement. Findings: The customer disregarded the servitized offerings because they were not perceived...... as important sources of value. Based on the two cases, two motifs emerged. The first was the lack of synergy between customer and supplier capabilities and focus, since the manufacturers’ service offerings were either indirectly competing or not complementing the customer’s internal resources. Together...... with the higher initial cost of the offerings, the customer company essentially challenged the necessity and efficiency of the transformation. The second was the manufacturer’s inability to deliver to the customer’s expectations. Even in cases where the customer was able to communicate its own needs...

The 5x1 DAFNE study protocol: a cluster randomised trial comparing a standard 5 day DAFNE course delivered over 1 week against DAFNE training delivered over 1 day a week for 5 consecutive weeks

Directory of Open Access Journals (Sweden)

Elliott Jackie

2012-11-01

Full Text Available Abstract Background Structured education programmes are now established as an essential component to assist effective self-management of diabetes. In the case of Type 1 diabetes, the Dose Adjustment For Normal Eating (DAFNE programme improves both glycaemic control and quality of life. Traditionally delivered over five consecutive days, this format has been cited as a barrier to participation by some patients, such as those who work full-time. Some centres in the UK have organised structured education programmes to be delivered one day a week over several consecutive weeks. This type of format may add benefit by allowing more time in which to practice skills between sessions, but may suffer as a result of weaker peer support being generated compared to that formed over five consecutive days. Methods/design We aim to compare DAFNE delivered over five consecutive days (1 week course with DAFNE delivered one day a week over five weeks (5 week course in a randomised controlled trial. A total of 213 patients were randomised to attend either a 1 week or a 5 week course delivered in seven participating centres. Study outcomes (measured at baseline, 6 and 12 months post-course include HbA1c, weight, self-reported rates of severe hypoglycaemia, psychosocial measures of quality of life, and cost-effectiveness. Generalisability was optimised by recruiting patients from DAFNE waiting lists at each centre, and by mailing eligible patients from hospital clinic lists. The inclusion and exclusion criteria were identical to those used to recruit to a standard DAFNE course (e.g., HbA1c Discussion This trial has been designed to test the hypothesis that the benefits of delivering a structured education programme over 5 weeks are comparable to those observed after a 1 week course. The results of the trial and the qualitative sub-study will both inform the design and delivery of future DAFNE courses, and the development of structured education programmes in other

Delivering Online Examinations: A Case Study

Directory of Open Access Journals (Sweden)

John MESSING

2004-07-01

Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

Uncovering ecosystem service bundles through social preferences.

Directory of Open Access Journals (Sweden)

Berta Martín-López

Full Text Available Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem's capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem's capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis. We found a clear trade-off among provisioning services (and recreational hunting versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs.

Uncovering Ecosystem Service Bundles through Social Preferences

Science.gov (United States)

Martín-López, Berta; Iniesta-Arandia, Irene; García-Llorente, Marina; Palomo, Ignacio; Casado-Arzuaga, Izaskun; Amo, David García Del; Gómez-Baggethun, Erik; Oteros-Rozas, Elisa; Palacios-Agundez, Igone; Willaarts, Bárbara; González, José A.; Santos-Martín, Fernando; Onaindia, Miren; López-Santiago, Cesar; Montes, Carlos

2012-01-01

Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem’s capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem’s capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs. PMID:22720006

MERRA Analytic Services: Meeting the Big Data Challenges of Climate Science through Cloud-Enabled Climate Analytics-as-a-Service

Science.gov (United States)

Schnase, J. L.; Duffy, D.; Tamkin, G. S.; Nadeau, D.; Thompson, J. H.; Grieg, C. M.; McInerney, M.; Webster, W. P.

2013-12-01

Climate science is a Big Data domain that is experiencing unprecedented growth. In our efforts to address the Big Data challenges of climate science, we are moving toward a notion of Climate Analytics-as-a-Service (CAaaS). We focus on analytics, because it is the knowledge gained from our interactions with Big Data that ultimately produce societal benefits. We focus on CAaaS because we believe it provides a useful way of thinking about the problem: a specialization of the concept of business process-as-a-service, which is an evolving extension of IaaS, PaaS, and SaaS enabled by Cloud Computing. Within this framework, Cloud Computing plays an important role; however, we see it as only one element in a constellation of capabilities that are essential to delivering climate analytics as a service. These elements are essential because in the aggregate they lead to generativity, a capacity for self-assembly that we feel is the key to solving many of the Big Data challenges in this domain. MERRA Analytic Services (MERRA/AS) is an example of cloud-enabled CAaaS built on this principle. MERRA/AS enables MapReduce analytics over NASA's Modern-Era Retrospective Analysis for Research and Applications (MERRA) data collection. The MERRA reanalysis integrates observational data with numerical models to produce a global temporally and spatially consistent synthesis of 26 key climate variables. It represents a type of data product that is of growing importance to scientists doing climate change research and a wide range of decision support applications. MERRA/AS brings together the following generative elements in a full, end-to-end demonstration of CAaaS capabilities: (1) high-performance, data proximal analytics, (2) scalable data management, (3) software appliance virtualization, (4) adaptive analytics, and (5) a domain-harmonized API. The effectiveness of MERRA/AS has been demonstrated in several applications. In our experience, Cloud Computing lowers the barriers and risk to

MERRA Analytic Services: Meeting the Big Data Challenges of Climate Science Through Cloud-enabled Climate Analytics-as-a-service

Science.gov (United States)

Schnase, John L.; Duffy, Daniel Quinn; Tamkin, Glenn S.; Nadeau, Denis; Thompson, John H.; Grieg, Christina M.; McInerney, Mark A.; Webster, William P.

2014-01-01

Climate science is a Big Data domain that is experiencing unprecedented growth. In our efforts to address the Big Data challenges of climate science, we are moving toward a notion of Climate Analytics-as-a-Service (CAaaS). We focus on analytics, because it is the knowledge gained from our interactions with Big Data that ultimately produce societal benefits. We focus on CAaaS because we believe it provides a useful way of thinking about the problem: a specialization of the concept of business process-as-a-service, which is an evolving extension of IaaS, PaaS, and SaaS enabled by Cloud Computing. Within this framework, Cloud Computing plays an important role; however, we it see it as only one element in a constellation of capabilities that are essential to delivering climate analytics as a service. These elements are essential because in the aggregate they lead to generativity, a capacity for self-assembly that we feel is the key to solving many of the Big Data challenges in this domain. MERRA Analytic Services (MERRAAS) is an example of cloud-enabled CAaaS built on this principle. MERRAAS enables MapReduce analytics over NASAs Modern-Era Retrospective Analysis for Research and Applications (MERRA) data collection. The MERRA reanalysis integrates observational data with numerical models to produce a global temporally and spatially consistent synthesis of 26 key climate variables. It represents a type of data product that is of growing importance to scientists doing climate change research and a wide range of decision support applications. MERRAAS brings together the following generative elements in a full, end-to-end demonstration of CAaaS capabilities: (1) high-performance, data proximal analytics, (2) scalable data management, (3) software appliance virtualization, (4) adaptive analytics, and (5) a domain-harmonized API. The effectiveness of MERRAAS has been demonstrated in several applications. In our experience, Cloud Computing lowers the barriers and risk to

Design of an autonomous mobile robot for service applications

CSIR Research Space (South Africa)

De Villiers, M

2011-02-01

Full Text Available This research project proposes the development of an autonomous, omnidirectional vehicle that will be used for general indoor service applications. A suggested trial application for this service robot will be to deliver printouts to various network...

Standalone Mobile Application for Shipping Services Based on Geographic Information System and A-Star Algorithm

Science.gov (United States)

Gunawan, D.; Marzuki, I.; Candra, A.

2018-03-01

Geographic Information Systems (GIS) plays an essential role in shipping service related application. By utilizing GIS, the courier can find the route to deliver goods for its customer. This research proposes a standalone mobile application to provide the shortest route to the destinations by utilizing geographic information systems with A-Star algorithm. This application is intended to be used although the area has no Internet network available. The developed application can handle several drop off points then calculates the shortest route that passes through all the drop off points. According to the conducted testing, the number of drop off points that can be calculated is influenced by the specification of the smartphone. More destinations require more smartphone resources and time to process.

Video teleconsultation service: Who is needed to do what, to get it implemented in daily care?

NARCIS (Netherlands)

Visser, Jacqueline J.W.; Bloo, J.K.C.; Grobbe, F.A.; Vollenbroek-Hutten, Miriam Marie Rosé

2010-01-01

Introduction: In telemedicine, technology is used to deliver services. Because of this, it is expected that various actors other than those involved in traditional care are involved in and need to cooperate, to deliver these services. The aim of this study was to establish a clear understanding of

Beyond Civil Service: The Changing Face of Public Personnel Management.

Science.gov (United States)

Klingner, Donald E.; Lynn, Dahlia Bradshaw

1997-01-01

Today, public services are often delivered by purchase-of-service agreements, privatization, franchising, vouchers, or other alternatives to civil service. Public personnel managers must now deal with broader policy issues, relationships with external organizations, and tighter focus on cost control, requiring new knowledge, skills, and abilities.…

One stop shop versus collaborative integration: what is the best way of delivering sexual health services?

Science.gov (United States)

French, R S; Coope, C M; Graham, A; Gerressu, M; Salisbury, C; Stephenson, J M

2006-06-01

To examine various models of integrated and/or one stop shop (OSS) sexual health services (including general practice, mainstream specialist services, and designated young people's services) and explore their relative strengths and weaknesses. Literature review and interviews with key informants involved in developing the National Strategy for Sexual Health and HIV (n = 11). The paper focuses on five broad perspectives (logistics, public health, users, staff, and cost). Contraceptive and genitourinary medicine issues are closely related. However, there is no agreement about what is meant by having "integrated" services, about which services should be integrated, or where integration should happen. There are concerns that OSSs will result in over-centralisation, to the disadvantage of stand alone and satellite services. OSS models are potentially more user focused, but the stigma that surrounds sexual health services may create an access barrier. From staff perspectives, the advantages are greater career opportunities and increased responsibility, while the disadvantages are concern that OSSs will result in loss of expertise and professional status. Cost effectiveness data are contradictory. Although there is a policy commitment to look at how integrated services can be better developed, more evidence is required on the impact and appropriateness of this approach.

Service Dogs in the Perioperative Setting.

Science.gov (United States)

Levey, Janet A; Chappy, Sharon L

2017-04-01

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

Need Assessment of Staffs’ Welfare Services at Tehran University of Medical Sciences: A Cross-Sectional Study

Science.gov (United States)

Dehghan, Reza; Mafimoradi, Shiva; Hadi, Mohammad

2015-01-01

Background: Reviewing the human resources management literature shows an absence of attention given to the employee's benefits. Taking a look at functions of the Tehran University of Medical Sciences’ wellbeing services system, it uncovers a gap between employees’ real needs and what is delivered to meet their needs. So it requires an improved comprehensive system for delivering wellbeing services (financial, insurance, health care services, educational and training services, etc). Wellbeing need assessment can helps planners to identify vital needs of employee and response to them effectively. Moreover it can be used to evaluate the effectiveness of the current services which are delivered. Thus, the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs which were not fulfilled by the organization. Material and Methods: Being a cross-sectional and analytic-descriptive survey including 98 responding participants, it is conducted by a questionnaire collecting employees’ demographic information, their satisfactory rate of the implemented services, and determines unfulfilled wellbeing needs which were not already covered. Result: Results indicated that services related to financial, educational, non-financial, insurance, occupational health and tourism/recreational services were the most satisfactory services successively. ‘Staff's unwillingness to receive services’ and ‘poor announcement’ (unawareness on the wellbeing services),’ were found to be the most frequent reasons for not receiving the existing wellbeing services. Conclusion: To increase the satisfaction rate and responsiveness to the real needs of the staff, the current delivery system of wellbeing services in the TUMS should be redesigned by defining new wellbeing packages. PMID:25767818

Understanding the role of intersectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India: a qualitative study.

Science.gov (United States)

Kim, Sunny S; Avula, Rasmi; Ved, Rajani; Kohli, Neha; Singh, Kavita; van den Bold, Mara; Kadiyala, Suneetha; Menon, Purnima

2017-02-02

actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that facilitate a continuum of care approach, rather than sectorally-driven, service-specific delivery processes.

Understanding the role of intersectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India: a qualitative study

Directory of Open Access Journals (Sweden)

Sunny S. Kim

2017-02-01

. Conclusions Congruent or shared priorities and regularity of actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that facilitate a continuum of care approach, rather than sectorally-driven, service-specific delivery processes.

Satisfaction with services following voluntary and involuntary admission.

LENUS (Irish Health Repository)

Smith, Damian

2014-02-01

Service user perspectives are essential for the evaluation and development of mental health services. Service users expressing less satisfaction with services subsequently have poorer treatment outcomes.

3PAC: Enforcing Access Policies for Web Services

NARCIS (Netherlands)

van Bemmel, J.; Wegdam, M.; Lagerberg, K.

Web Services fail to deliver on the promise of ubiquitous deployment and seamless interoperability due to the lack of a uniform, standards-based approach to all aspects of security. In particular, the enforcement of access policies in a Service Oriented Architecture is not addressed adequately. We

Customer adoption of e-service : an experimental study

NARCIS (Netherlands)

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

2001-01-01

So far, the term e-commerce has been primarily associated with communicating the brand and/or enabling sales transactions. However, the next vista for companies operating in the virtual marketplace seems to be e-service or, delivering value-added, interactive services to customers. This e-business

Customer adoption of e-service : An experimental study

NARCIS (Netherlands)

De Ruyter, Ko; Wetzels, Martin; Kleijnen, M.H.P.

2001-01-01

So far, the term e-commerce has been primarily associated with communicating the brand and/or enabling sales transactions. However, the next vista for companies operating in the virtual marketplace seems to be e-service or, delivering value-added, interactive services to customers. This e-business

Essential elements of an early intervention service for psychosis: the opinions of expert clinicians

Directory of Open Access Journals (Sweden)

Lewis Shôn

2004-07-01

Full Text Available Abstract Background Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements. Methods A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function. Results Overall there was expert consensus on the importance of 136 (90% of these elements. Of the items on which there was consensus, 106 (70.2% were rated essential, meaning that in their absence the functioning of the team would be severely impaired. Conclusion This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.

State as a Service : Towards Stateful Cloud Services

OpenAIRE

Alnoor, Ahmadullah

2012-01-01

Cloud ERP or Enterprise Resource Planning (ERP) as a Cloud Service delivers value by reducing initial and long term operating costs since infrastructure, platform and (certain) application management tasks are delegated to a specialist provider. Questions present at intersection of the ERP challenge landscape and the Cloud Computing opportunity horizon include characterization of Cloud friendly ERP modules and adaptation of stateful (on-premises ERP) components to a stateless platform. Contri...

Do self-service technologies affect interfirm relationships? A B2B perspective

Directory of Open Access Journals (Sweden)

Raechel Johns

2014-11-01

Full Text Available While considerable literature examines business-to business (B2B relationships, the impact of technology on these relationships has lacked attention. IT has impacted the way businesses operate in a B2B context as well as influencing services by altering the way services are delivered. To understand the way in which Internet technology has impacted these B2B services, it is essential to examine its impact not only on business processes but on business relationships too. One technology, enabled by modern Internet technologies, which is changing the nature of business relationships is the increased use of self-service technologies (SSTs or technology-enabled services, however, there is a shortage of research in the area in a B2B context. The discussion in this paper provides an overview of the impact of IT on business relationships, using Relationship Marketing theory to provide a theoretical framework. A qualitative study in the Australian banking industry provides findings relating to the theory. The findings of this study provide evidence that while traditional Relationship Marketing theory is still applicable for some business customers, new theory is required for business customers who do not seek relationships. With both practical and theoretical implications, the research detailed in this paper makes a useful contribution to the literature and indicates the necessity for further research to be developed which explores business customers who prefer to remain transaction-oriented, rather than develop interpersonal relationships.

Enabling Routes as Context in Mobile Services

DEFF Research Database (Denmark)

Brilingaite, Agne; Jensen, Christian Søndergaard; Zokaite, Nora

2004-01-01

With the continuing advances in wireless communications, geo-positioning, and portable electronics, an infrastructure is emerging that enables the delivery of on-line, location-enabled services to very large numbers of mobile users. A typical usage situation for mobile services is one characterized...... by a small screen and no keyboard, and by the service being only a secondary focus of the user. It is therefore particularly important to deliver the "right" information and service at the right time, with as little user interaction as possible. This may be achieved by making services context aware.Mobile...

Indoor location-based services prerequisites and foundations

CERN Document Server

Werner, Martin

2014-01-01

This book delivers concise coverage of classical methods and new developments related to indoor location-based services. It collects results from isolated domains including geometry, artificial intelligence, statistics, cooperative algorithms, and distributed systems and thus provides an accessible overview of fundamental methods and technologies. This makes it an ideal starting point for researchers, students, and professionals in pervasive computing. Location-based services are services using the location of a mobile computing device as their primary input. While such services are fairly e

Introduction: The provision of animal health services in a changing world.

Science.gov (United States)

de Haan, C

2004-04-01

In the future, animal health services in developing countries will need to operate in a continuously changing policy, institutional and commercial environment. Firstly, the changing policies and priorities of national policy-makers regarding public and private sector roles, reinforced in Africa by the donors, have reduced funding and support for the large number of tasks that animal health services have traditionally performed, and there is continuing pressure from policy-makers to focus on what the public sector can do best. Secondly, poverty reduction has become one of the main criteria guiding the allocation of official development assistance, which has major implications for the main target clientele of veterinary services. Thirdly, population growth, increasing income and urbanisation are causing a marked increase in demand for livestock products in the developing world. As a result, the entire livestock commodity chain is undergoing major structural changes, which has significant implications for the definition and control of food safety standards. Fourthly, globalisation, and increasing trade and travel have greatly increased the risk of disease transmission between different countries and continents. Veterinary institutions in the developing world need to adapt to these challenges. They will have to be able to focus on the essential public sector roles. At the same time they must deliver those essential services to the poor, and provide the policy framework to ensure that the inevitable structural changes in the commodity chain take place in an equitable and sustainable fashion, with an acceptable level of health risk for the consumer. According to the weight given to these different objectives, changes in the institutional set-up need to be considered. This issue of the Scientific and Technical Review addresses these challenges. It begins by reviewing the basic economic characteristics underlying the provision of animal health services, and then examines

Partnerships for Urban Forestry and Green Infrastructure Delivering Services to People and the Environment: A Review on What They Are and Aim to Achieve

Directory of Open Access Journals (Sweden)

Ralph Hansmann

2016-06-01

Full Text Available Background and Purpose: Partnerships are a key mechanism in the planning, delivery and management of urban forestry (UF and green infrastructure (GI. They can facilitate locally rooted co-management and polycentric governance. They can also achieve synergies by combining the resources, commitment and expertise of diverse stakeholder groups in order to generate valuable outcomes and build social capital. Unfortunately, the term “partnerships” is not used consistently in literature and requires clarification. The characteristics which distinguish a partnership approach from other modes of co-operation are identified and described. The diversity of existing UF and GI oriented partnerships is outlined, with reference to their stakeholders, drivers, activities and goals, together with potential advantages of the partnership approach. Considerations to be made in their evaluation are derived from this background analysis and possible success factors are discussed. Materials and Methods: The diversity, aims and defining characteristics of a partnership approach are based on an extensive literature review. Results: Partnerships focus on diverse aspects and delivery phases of UF, ranging from the planning, design and creation of urban forests and GI to their management and use. Benefits delivered by such partnerships include environmental and economic services as well as social and cultural services such as environmental education, health, leisure and tourism. Generating valuable services whilst at the same time nurturing relationships between stakeholders helps to develop social capital and build capacity. In addition to environmental, economic and social benefits, the evaluation of partnerships may also address internal process variables such as social learning, the relationship between partners, and motivational outcomes that can influence future co-operation. Conclusions: Co-operative partnerships offer a promising approach for delivery in UF

Big data analytics as a service infrastructure: challenges, desired properties and solutions

CERN Document Server

Martín-Márquez, Manuel

2015-01-01

CERN's accelerator complex generates a very large amount of data. A large volumen of heterogeneous data is constantly generated from control equipment and monitoring agents. These data must be stored and analysed. Over the decades, CERN's researching and engineering teams have applied different approaches, techniques and technologies for this purpose. This situation has minimised the necessary collaboration and, more relevantly, the cross data analytics over different domains. These two factors are essential to unlock hidden insights and correlations between the underlying processes, which enable better and more efficient daily-based accelerator operations and more informed decisions. The proposed Big Data Analytics as a Service Infrastructure aims to: (1) integrate the existing developments, (2) centralise and standardise the complex data analytics needs for CERN's research and engineering community, (3) deliver real-time, batch data analytics and information discovery capabilities, and (4) provide transpare...

Beyond mere pill taking: SMS reminders for HIV treatment adherence delivered to mobile phones of clients in a community support network in Australia.

Science.gov (United States)

Mao, Limin; Buchanan, Andrew; Wong, Horas Tze Hoo; Persson, Asha

2018-01-15

SMS reminders sent to personal mobiles are increasingly used by clinical services to promote patient engagement, including adherence to antiretroviral treatment (ART) for HIV. From August to September 2015, a 6-week, randomised SMS reminder for ART adherence intervention was implemented among 98 HIV-positive clients of Australian's largest HIV charitable organisation located in Sydney. This was followed by a mixed-method evaluation, comprising a self-completed online survey and a one-to-one interview. Of the 62 survey participants, all being men, the majority were gay (85.5%) and living long-term with HIV (median year of HIV diagnosis = 1998). While everyone was on ART, a substantial proportion (n = 27, 43.5%) had interrupted treatment in the past. At the end of the intervention, based on the standard SMAQ measure, 82% had consistently adhered to ART in the previous week. While there was no statistically significant intervention effect, perceiving less stigma were independently associated with better ART adherence (adjusted odds ratio = 0.37; 95% CI 0.16-0.89; P = .026). Of the 11 interviewees, despite limited add-on effects on individual ART adherence, the campaign was well-received as a unique community support service. This study underscores the essential role of empowerment through enhancing disease self-management, increasing social support and reducing stigma, particularly for long-term HIV survivors. SMS messaging, part of mHealth, delivered by community services could have broader impacts on reducing health and social inequity. © 2018 John Wiley & Sons Ltd.

Innovative advisory services in the virtual world an empowerment perspective

CERN Document Server

Li, Manning

2014-01-01

Based on detailed analysis of applications in business and government sectors, this book discusses the current state and future trends of virtual advisory services in digital environments. Shows how to effectively design and deliver virtual advisory services.

Twisted network programming essentials

CERN Document Server

Fettig, Abe

2005-01-01

Twisted Network Programming Essentials from O'Reilly is a task-oriented look at this new open source, Python-based technology. The book begins with recommendations for various plug-ins and add-ons to enhance the basic package as installed. It then details Twisted's collection simple network protocols, and helper utilities. The book also includes projects that let you try out the Twisted framework for yourself. For example, you'll find examples of using Twisted to build web services applications using the REST architecture, using XML-RPC, and using SOAP. Written for developers who want to s

Facilitating a teleconference-delivered fatigue management program: perspectives of occupational therapists.

Science.gov (United States)

Dunleavy, Leah; Preissner, Katharine L; Finlayson, Marcia L

2013-12-01

Telehealth refers to the provision of health information and services across a geographical distance. Little is known about the experiences of occupational therapists using this method of service delivery. The study explored the process of facilitating a telehealth intervention from the perspective of occupational therapists. Occupational therapists completed SOAP (Subjective, Objective, Assessment, and Plan) notes after facilitating group-based, teleconference-delivered fatigue management groups to people with multiple sclerosis. Notes were also documented after therapist team meetings. All SOAP notes and field notes were subjected to thematic analysis. Five major themes were identified. "Managing time" was the central theme and was facilitated by professional foundation and challenged by logistics. Managing time contributed to challenging work, which led to the realization that it can work! Based on study findings, the theory and research on clinical reasoning, professional development, and adult learning are relevant to developing curricula that prepare occupational therapists for using telehealth approaches in practice.

Comparing the Cost-Effectiveness of Campaigns Delivered via Various Combinations of Television and Online Media

Directory of Open Access Journals (Sweden)

Vanessa Allom

2018-03-01

Full Text Available BackgroundReflecting the increasing prevalence of online media, many mass media health campaigns are now delivered using both television (TV and online media formats. The aim of this study was to evaluate a smoking cessation mass media campaign according to the cost-effectiveness of the various combinations of TV and online media formats to inform future media buying decisions.MethodsA quasi-experimental interrupted time series approach was employed. The campaign was delivered in seven 1-week bursts using TV, online video (OV, or online display (OD (e.g., banner ads formats in isolation and in various combinations over a 13-week period. Campaign bursts were separated by “off-weeks” in which no campaign materials were delivered. Assessed outcomes were the number of campaign response “events” recorded (campaign web page views, calls to a smoking cessation telephone service, and registrations for smoking cessation services. The cost-effectiveness of each individual and combined media format condition in terms of these outcome variables was calculated using attributed production and broadcasting costs.ResultsOverall, OD alone was found to be the most cost-effective means of achieving the nominated campaign outcomes, followed by a combination of OV and OD and a combination of TV and OV. The use of TV in isolation was the least cost-effective.ConclusionThe results of this evaluation indicate that online media constitute a promising means of enhancing the cost-effectiveness of smoking cessation campaigns. Future research assessing a broader range of outcomes, especially smoking cessation, is needed to provide a more comprehensive account of the cost-effectiveness of various campaign media.

Exercise of essential competencies for midwifery care by nurses in São Paulo, Brazil.

Science.gov (United States)

Narchi, Nadia Zanon

2011-02-01

GENERAL OBJECTIVE: to analyse the exercise of essential competencies for midwifery care by nurses and/or midwives in the public health system of São Paulo (eastern zone), Brazil. to develop a profile of the public health institutions and of the nurses and/or midwives who care for women before, during and following childbirth; to identify the activities performed in providing such care, as well as their frequency; and to specify the possible obstacles or difficulties encountered by them when exercising their competencies. a descriptive and exploratory research design, using a quantitative approach. the study was conducted in all public health services of São Paulo (eastern zone), Brazil, namely 59 basic health-care units and six hospitals, during the period of October 2006-December 2007. the study population consisted of 272 nurses and/or midwives who provide care for pregnant women and newborns at the primary health-care units and maternity hospitals of the public health system. Participants comprised 100% of hospital nurse coordinators (n=6), 61% of hospital maternity nursing and/or midwifery staff (n=62) and 64% (n=204) of nursing and/or midwifery staff working at primary health-care units. the data collection was based on a single form given to the coordinators and two questionnaires, one handed out to antenatal and postnatal nursing and/or midwifery staff and another handed out to labour and birth nursing and/or midwifery staff. The results showed that nurses and/or midwives providing care for women during pregnancy, labour, birth and the postnatal period did not put the essential competencies for midwifery care into practice, because they encountered institutional barriers and personal resistance, and lacked protocols based on best practice and on the exercise of essential competencies needed for effective midwifery care. the model of care in the public health services of São Paulo (eastern zone) is based much more on hierarchical positions than on

Is Private Production of Public Services Cheaper Than Public Production? A Meta-Regression Analysis of Solid Waste and Water Services

Science.gov (United States)

Bel, Germa; Fageda, Xavier; Warner, Mildred E.

2010-01-01

Privatization of local government services is assumed to deliver cost savings, but empirical evidence for this from around the world is mixed. We conduct a meta-regression analysis of all econometric studies examining privatization of water distribution and solid waste collection services and find no systematic support for lower costs with private…

Organizing innovation to deliver financial services to the base of the Pyramid

NARCIS (Netherlands)

Posthumus, B.; Homberg, M.J.C. van den; Boer, J. de; Klarsfeld, L.; Chevrollier, N.; Jaspert, T.

2013-01-01

Over the past twenty years, the number of mobile phone subscriptions has risen from 12 million to more than six billion. 75% of the world has access to a mobile phone and the developing world is now more mobile than the developed world. However, the growth of non-voice services on these mobiles for

Women's attitudes towards receiving family planning services from ...

African Journals Online (AJOL)

These are age, level of education, knowledge about family planning benefits and districts. Conclusion: Women's perception towards family planning services delivered by CHWs in Western region in Kenya is quite low. To improve the demand and supply for family planning services in this region, there is need to invest a ...

Cost-benefit study of school nursing services.

Science.gov (United States)

Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

2014-07-01

In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in

Utility communication networks and services specification, deployment and operation

CERN Document Server

2017-01-01

This CIGRE green book begins by addressing the specification and provision of communication services in the context of operational applications for electrical power utilities, before subsequently providing guidelines on the deployment or transformation of networks to deliver these specific communication services. Lastly, it demonstrates how these networks and their services can be monitored, operated, and maintained to ensure that the requisite high level of service quality is consistently achieved.

Towards an inter-domain billing system to support dynamic service provisioning

NARCIS (Netherlands)

Le, V.M.

2009-01-01

Today, billing is a big challenge for service providers. With a growing number of rich services such as music, mobile TV, Video-on-Demand and eHealth delivered to the mass market, service providers are missing business opportunities because current billing solutions are not fully capable. In

Delivering high performance BWR fuel reliably

International Nuclear Information System (INIS)

Schardt, J.F.

1998-01-01

Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

A Framework for Analysing Service Ecosystem Capabilities to Innovate

OpenAIRE

Riedl, Christoph;Böhmann, Tilo;Leimeister, Jan Marco;Krcmar, Helmut

2014-01-01

Electronic services delivered over the Internet are gaining importance in the business world. This area has seen an increase in scientific interest over the past years under the labels ?Internet of Services? and Web-service ecosystems. The paper develops a conceptual framework of actors and their roles in an open innovation system for a networked ecosystem of Web-services. The framework illustrates how open innovation can be implemented in a Web-service ecosystem to increase innovation perfor...

Strategies for the improvement of quality of life and service at the wellsite

International Nuclear Information System (INIS)

Lombardo, G.J.; McCants, K.J.; Klein, M.

1991-01-01

The oil industry, particularly exploration and production drilling has always had to contend with a remarkable set of conditions: complicated logistics, remote locations, twenty four hour daily operations, and long and uneven schedules, to mention only a few. Invariably, operations personnel particularly service company personnel are required to perform highly technical, often critical tasks for long periods of time without the benefit of sustained periods of restfulness. This condition is compounded by irregular days-off schedules and the offshore environment itself. Research in other industries has shown that scheduling conditions similar to those experienced in the E and P drilling industry have lowered the standard of life, general health, safety and performance of employees. With the move towards higher technology and even more critical tasks, more demanding employees and an essentially unchanged working environment, the problems are compounded even further. Work related stress and quality of life have become important factors in our employees' career decisions and their ability to work safely. This paper discusses the evaluation of the work schedule and work/living conditions of the wellsite measurement and services personnel of Anadrill Schlumberger, and concludes with methods to improve the safety, health and general quality of life of those personnel and the service quality they can deliver

Including customers in health service design.

Science.gov (United States)

Perrott, Bruce E

2013-01-01

This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

Delivering Technological Literacy to a Class for Elementary School Pre-Service Teachers in South Korea

Science.gov (United States)

Kwon, Hyuksoo

2017-01-01

This study was conducted with the aim of creating a new introductory course emphasizing the development of technological literacy for elementary school pre-service teachers. This study also aimed to investigate elementary school pre-service teachers' attitudinal transition toward elementary school technology education (ESTE) and its…

Understanding and Monitoring Cloud Services

NARCIS (Netherlands)

Drago, Idilio

2013-01-01

Cloud services have changed the way computing power is delivered to customers. The advantages of the cloud model have fast resulted in powerful providers. However, this success has not come without problems. Cloud providers have been related to major failures, including outages and performance

Personalized Boutique Service: Critical to Academic Library Success?

Science.gov (United States)

Tilley, Elizabeth

2013-01-01

An academic library that focuses on delivering a personalized service is examined within the context of the boutique library model. It is suggested that a critical success factor in adopting a personalized, boutique-style service is acquiring knowledge and insight of our users. This, together with appropriate evaluation, will assist with providing…

The Interface Between EU Competition Law and Standard Essential Patents

DEFF Research Database (Denmark)

Lundqvist, Björn

2015-01-01

In this paper the recent ECJ judgment in Huawei is discussed in light of the earlier case law from the EU and the US. The Huawei case has been long awaited and many in academia hoped that it would finally deliver answers to if, when and on what terms access to so-called Standard Essential Patents...... would be granted under EU antitrust law. However, the question is whether Huawei is that case. On the contrary, it seems that the ECJ ruling gives room for speculation even in reference to core issues, some of which are dealt with in this paper....

Computational inference and control of quality in multimedia services

NARCIS (Netherlands)

Menkovski, V.

2013-01-01

Quality is the degree of excellence we expect of a service or a product. It is also one of the key factors that determine its value. For multimedia services, understanding the experienced quality means understanding how the delivered delity, precision and reliability correspond to the users'

Enabling Real-time Water Decision Support Services Using Model as a Service

Science.gov (United States)

Zhao, T.; Minsker, B. S.; Lee, J. S.; Salas, F. R.; Maidment, D. R.; David, C. H.

2014-12-01

Through application of computational methods and an integrated information system, data and river modeling services can help researchers and decision makers more rapidly understand river conditions under alternative scenarios. To enable this capability, workflows (i.e., analysis and model steps) are created and published as Web services delivered through an internet browser, including model inputs, a published workflow service, and visualized outputs. The RAPID model, which is a river routing model developed at University of Texas Austin for parallel computation of river discharge, has been implemented as a workflow and published as a Web application. This allows non-technical users to remotely execute the model and visualize results as a service through a simple Web interface. The model service and Web application has been prototyped in the San Antonio and Guadalupe River Basin in Texas, with input from university and agency partners. In the future, optimization model workflows will be developed to link with the RAPID model workflow to provide real-time water allocation decision support services.

Delivering high performance BWR fuel reliably

Energy Technology Data Exchange (ETDEWEB)

Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

1998-07-01

Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

Servicing NPPs in Japan, Korea and Taiwan

International Nuclear Information System (INIS)

Bohmann, W.; Poetz, F.

1991-01-01

More than 45 comparable orders (for equipment or services ) have been carried out in Japan, Korea and Taiwan by ABB Reaktor since 1982. Recently contracts to deliver inspection and repair equipment for the core baffle former bolts of Japanese NPPs, and in 1990, a contract to clean two steam generators in Korea, together with Pacific Nuclear Services, USA, were won. 2 figs

The Western European Mobile Service Market

DEFF Research Database (Denmark)

Henten, Anders; Tadayoni, Reza; Hjarup, Søren

The aim of the paper is to analyse the development of the structure in the Western European mobile services market, based primarily on technological and economic parameters. The focus of the analysis is on the market consolidation process, taking place horizontally, i.e. among the mobile network...... operators, and on the new companies entering the mobile field vertically, delivering, e.g., content and portal services, as convergence with Internet develops....

Revenue sources for essential services in Florida: findings and implications for organizing and funding public health.

Science.gov (United States)

Livingood, William C; Morris, Michael; Sorensen, Bonita; Chapman, Karen; Rivera, Lillian; Beitsch, Les; Street, Phil; Coughlin, Susan; Smotherman, Carmen; Wood, David

2013-01-01

The Florida Public Health Practice-Based Research Network conducted the study of Florida county health departments (CHDs) to assess relationships between self-assessed performance on essential services (ESs) and sources of funding. Primary data were collected using an online survey based on Public Health Accreditation Board standards for ES. Bivariate and multivariate analyses were conducted to assess the relationship of sources and amounts of revenue obtained from the Florida Department of Health financial system to responses to the survey of CHD capacity for ESs. Self-assessed CHD performance for each ES varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (Investigating Problems and Hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research/Evidence). Medicaid revenue and fees were positively correlated with some ESs. Per capita revenue support varied extensively among the CHDs. Revenue for ES is decreasing and is heavily reliant on noncategorical (discretionary) revenue. This study has important implications for continued reliance on ES as an organizing construct for public health.

Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service

Directory of Open Access Journals (Sweden)

Devescovi R

2016-06-01

. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System. Keywords: early diagnosis, early intervention, autism spectrum disorder, Early Start Denver Model, Public Health System service

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

Science.gov (United States)

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

2018-01-18

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

Foundations for Survivable System Development: Service Traces, Intrusion Traces, and Evaluation Models

National Research Council Canada - National Science Library

Linger, Richard

2001-01-01

.... On the system side, survivability specifications can be defined by essential-service traces that map essential-service workflows, derived from user requirements, into system component dependencies...

Relational uncertainty in service dyads

DEFF Research Database (Denmark)

Kreye, Melanie

2017-01-01

in service dyads and how they resolve it through suitable organisational responses to increase the level of service quality. Design/methodology/approach: We apply the overall logic of Organisational Information-Processing Theory (OIPT) and present empirical insights from two industrial case studies collected...... the relational uncertainty increased the functional quality while resolving the partner’s organisational uncertainty increased the technical quality of the delivered service. Originality: We make two contributions. First, we introduce relational uncertainty to the OM literature as the inability to predict...... and explain the actions of a partnering organisation due to a lack of knowledge about their abilities and intentions. Second, we present suitable organisational responses to relational uncertainty and their effect on service quality....

Models of Reference Services in Australian Academic Libraries

Science.gov (United States)

Burke, Liz

2008-01-01

This article reports on a project which was undertaken in 2006 to investigate the current modes and methods for delivering reference services in Australian academic libraries. The project included a literature review to assist in providing a definition of reference services as well as a snapshot of statistics showing staff and patron numbers from…

Creation of the quality control service in radio diagnosis facilities

International Nuclear Information System (INIS)

Martinez, A.; Morales, J.A.; Jova, L.

1998-01-01

This paper shows tests and tolerance criteria employed by LSCD in delivering this service as well as all documents supporting it. Besides it also offers some results attained during the execution of this service in different hospital in the capital of the country

Product/Service-System Development

DEFF Research Database (Denmark)

Tan, Adrian; McAloone, Timothy Charles; Gall, Catherine

2007-01-01

‘Product/service-systems’ (PSS) are innovation strategies where instead of focusing on the value of selling physical products, one focuses on the value of the utility of products and services throughout the product’s life period. This approach enables companies to provide customers with offerings...... that continuously deliver value and create a strong competitive advantage. PSS attempts to transcend the old industrial credo that value is embedded in products and the consideration of ‘cost-quality-time’ relates to the physical artefact. While there is increasing interest in PSS, limited research has been done...

Materials Delivered by Member States

International Nuclear Information System (INIS)

1966-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1965-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1968-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

Service quality in contracted facilities.

Science.gov (United States)

Rabbani, Fauziah; Pradhan, Nousheen Akber; Zaidi, Shehla; Azam, Syed Iqbal; Yousuf, Farheen

2015-01-01

The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006). The study shows that contracting out initiatives have the potential to improve MNH care. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.

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

Science.gov (United States)

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

2015-01-01

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

Propagating Occupational Safety and Health Programmes among Small Scalefarmers and Entrepreneursin Essential Oils Industry

OpenAIRE

MADYA LT KOL (B) AZUDDIN BIN BAHARI; HANUM BINTI HASSAN; FARIDAH BINTI WAHAB

2014-01-01

The production of essential oils as the end product entails the phases of planting, harvesting, production and marketing. Small scale farmers engage herein the field of essential oils industry is concern with planting, marketing what they produce or agricultural services while entrepreneurs are concern in the production and marketing of essential oils. Workers at the workplace faced a variety of hazards for instance chemical hazards, biological hazards, ergonomic hazards, psychosocial hazards...

Delivering breast cancer care in urban India: Heterotopia, hospital ethnography and voluntarism.

Science.gov (United States)

Macdonald, Alison

2016-05-01

Despite substantial strides to improve cancer control in India, challenges to deliver oncology services persist. One major challenge is the provision and accessibility of adequate infrastructure. This paper offers ethnographic insight on the conceptual and material conditions that are currently shaping the delivery of oncology in Mumbai, focusing specifically on the way India's socio-economic context necessitates non-biomedical acts of voluntarism or 'seva' (selfless service). Developing the premise that hospitals are not identical clones of a biomedical model, detailed attention is paid to the way 'care' emerges through 'praxis of place' (Casey, 2003) within the cancer hospital as a multi-scalar 'heterotopic' (Street and Coleman, 2012) site. Such a perspective enables global/local tensions to come into view, together with the heterogeneous confluence of juxtaposing materialities, imaginations, social practices and values that both propels and constrains the everyday delivery of care. The paper reflects on the theoretical implications of hospital seva in Mumbai in light of social science studies of hospital ethnography and health activism and contributes important ethnographic insight into the current global health debates regarding effective implementation of cancer services in India. Copyright © 2016 Elsevier Ltd. All rights reserved.

Security for service oriented architectures

CERN Document Server

Williams, Walter

2014-01-01

Although integrating security into the design of applications has proven to deliver resilient products, there are few books available that provide guidance on how to incorporate security into the design of an application. Filling this need, Security for Service Oriented Architectures examines both application and security architectures and illustrates the relationship between the two. Supplying authoritative guidance on how to design distributed and resilient applications, the book provides an overview of the various standards that service oriented and distributed applications leverage, includ

Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

Science.gov (United States)

Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

[Marketing in health service].

Science.gov (United States)

Ameri, Cinzia; Fiorini, Fulvio

2014-01-01

The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.

Delivering a lifelong integrated electronic health record based on a service oriented architecture.

Science.gov (United States)

Katehakis, Dimitrios G; Sfakianakis, Stelios G; Kavlentakis, Georgios; Anthoulakis, Dimitrios N; Tsiknakis, Manolis

2007-11-01

Efficient access to a citizen's Integrated Electronic Health Record (I-EHR) is considered to be the cornerstone for the support of continuity of care, the reduction of avoidable mistakes, and the provision of tools and methods to support evidence-based medicine. For the past several years, a number of applications and services (including a lifelong I-EHR) have been installed, and enterprise and regional infrastructure has been developed, in HYGEIAnet, the Regional Health Information Network (RHIN) of the island of Crete, Greece. Through this paper, the technological effort toward the delivery of a lifelong I-EHR by means of World Wide Web Consortium (W3C) technologies, on top of a service-oriented architecture that reuses already existing middleware components is presented and critical issues are discussed. Certain design and development decisions are exposed and explained, laying this way the ground for coordinated, dynamic navigation to personalized healthcare delivery.

A framework for analysing service ecosystems capabilities to innovate

OpenAIRE

Riedl, Christoph; Böhmann, Tilo; Leimeister, Jan Marco; Krcmar, Helmut

2009-01-01

Electronic services delivered over the Internet are gaining importance in the business world. This area has seen an increase in scientific interest over the past years under the labels “Internet of Services” and Web-service ecosystems. The paper develops a conceptual framework of actors and their roles in an open innovation system for a networked ecosystem of Web-services. The framework illustrates how open innovation can be implemented in a Web-service ecosystem to increase innovation perfor...

[Management of chemical burns and inhalation poisonings in acute medical care procedures of the State Fire Service].

Science.gov (United States)

Chomoncik, Mariusz; Nitecki, Jacek; Ogonowska, Dorota; Cisoń-Apanasewicz, Urszula; Potok, Halina

2013-01-01

Emergency Medical Services (EMS) were founded by the government to perform tasks aimed at providing people with help in life-threatening conditions. The system comprises two constituent parts. The first one is public administrative bodies which are to organise, plan, coordinate and supervise the completion of the tasks. The other constituent is EMS units which keep people, resources and units in readiness. Supportive services, which include: the State Fire Service (SFS) and the National Firefighting and Rescue System (NFRS), are of great importance for EMS because they are eligible for providing acute medical care (professional first aid). Acute medical care covers actions performed by rescue workers to help people in life-threatening conditions. Rescue workers provide acute medical care in situations when EMS are not present on the spot and the injured party can be accessed only with the use of professional equipment by trained workers of NFRS. Whenever necessary, workers of supportive services can assist paramedics' actions. Cooperation of all units of EMS and NFRS is very important for rescue operations in the integrated rescue system. Time is a key aspect in delivering first aid to a person in life-threatening conditions. Fast and efficient first aid given by the accident's witness, as well as acute medical care performed by a rescue worker can prevent death and minimise negative effects of an injury or intoxication. It is essential that people delivering first aid and acute medical care should act according to acknowledged and standardised procedures because only in this way can the process of decision making be sped up and consequently, the number of possible complications following accidents decreased. The present paper presents an analysis of legal regulations concerning the management of chemical burn and inhalant intoxication in acute medical care procedures of the State Fire Service. It was observed that the procedures for rescue workers entitled to

Measurement framework for product service system performance of generator set distributors

Science.gov (United States)

Sofianti, Tanika D.

2017-11-01

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

Quality Indicators for Family Support Services and Their Relationship to Organizational Social Context

Science.gov (United States)

Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.

2013-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286

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

Science.gov (United States)

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

2011-01-01

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

Delivering low-bandwidth telemedicine services over hybrid networks in developing countries.

Science.gov (United States)

Amble, R; Comparini, A; Kumar, K R; Dahlgren, R; Lurie, Y M

2004-01-01

The results of medical specialist consultations sampled from several rural clinics located throughout India indicate that remote expert opinions can improve the speed and accuracy of diagnosis. Central to this presentation is a description of how real-time and store & forward telemedicine services can be provided to rural populations over hybrid networks made up of ISDN, POTS, VSAT, cellular, and Cable Internet connections. A model for meeting the specialized medical needs of developing countries will be highlighted. Descriptions, examples, and benefits of how Browser-based client-server architectures are being used in over 20 locations in India and Mexico for triaging real-time vital signs, DICOM images, audio & video, and clinical text information will be highlighted.

Enterasys Networks delivers 10-Gigabit ethernet for the enterprise with new matrix E1 switching family

CERN Multimedia

2001-01-01

Enterasys Networks Inc., today announced its new Matrix E1 family of 10-Gigabit and Gigabit Ethernet switches. The Matrix E1 Optical Access Switch (OAS) enables organizations to deliver applications at 10-Gb speeds across a single fibre optic pair. Jacques Altaber, deputy leader of IT at CERN said "High-bandwith solutions are essential to leveraging more computing power, so 10-Gb Ethernet is the next logical step for us...The Matrix E1 allows us to provide the networking support that our scientists need and gives us a certain future for bandwidth and computing expansion".

Essentially stronger - 1999 EPCOR annual report

International Nuclear Information System (INIS)

1999-01-01

The year 1999 has been a year of consolidation for EPCOR Utilities, uniting the the former brands of Edmonton Power, Aquaalta and Eltec under a new single brand, EPCOR, to provide Edmontonians with a safe, high quality and reliable essential service at competitive prices . The company is building for growth by augmenting its product line with natural gas and green power, accessing new capital, proceeding with new projects at various sites, creating EPCOR Power Development Corporation with an ambitious mandate to grow beyond the Utilities traditional service areas. In proof of that, EPCOR Water Services won a strategically important contract in Port Hardy, BC; EPCOR Technologies also has been involved in projects beyond Alberta. As a sign of confidence in the company, the City of Edmonton voted to retain ownership of the company in July. The Utility also managed to win national awards for both safety and environmental practices and is the first utility company to have all its generating plants meet ISO 14001 standards. During 2000 the company will tackle the evolution of industry restructuring , will explore more diverse financial structures to accommodate growth and the increase in demand for services to make sure that EPCOR will be a leading provider of electric power and natural gas services as the era of deregulated competitive electrical services in Alberta begins in 2001. This report provides details of the achievements of the company's business units in 1999, accompanied by a consolidated financial statement

Integrated Data Management for Mobile Services in the Real World

DEFF Research Database (Denmark)

Hage, C.; Jensen, Christian Søndergaard; Pedersen, Torben Bach

2003-01-01

Market research companies predict a huge market for services to be delivered to mobile users. Services in5 clude route guidance, point-of-interest search, metering services such as road pricing and parking payment, traffic monitoring, etc. We believe that no single such service will be the killer...... service, but that suites of integrated services are called for. Such integrated services reuse integrated content obtained from multiple content providers. This paper describes concepts and techniques underlying the data management system deployed by a Danish mobile content integrator. While geo...

Outsourcing HR Services: The Role of Human Resource Intermediaries

Science.gov (United States)

Kock, Henrik; Wallo, Andreas; Nilsson, Barbro; Hoglund, Cecilia

2012-01-01

Purpose: In this article, the area of interest is an emerging type of organisation called human resource intermediaries (HRIs), which focus on delivering human resource (HR) services to public sector organisations and private companies. The purpose of this article is, thus, to explore HRIs as deliverers of HR services. More specifically, the…

Employee assistance program services for intimate partner violence and client satisfaction with these services.

Science.gov (United States)

Pollack, Keshia M; McKay, Tasseli; Cumminskey, Chris; Clinton-Sherrod, A Monique; Lindquist, Christine H; Lasater, Beth M; Walters, Jennifer L Hardison; Krotki, Karol; Grisso, Jeane Ann

2010-08-01

To describe intimate partner violence (IPV) services available through employee assistance programs (EAPs) and determine women's satisfaction with these services. A mixed-methods study consisting of semistructured telephone interviews with 28 EAPs about IPV-related services and a national web-based survey of 1765 women regarding their interactions with EAPs when seeking IPV-related assistance. Data were collected in the fall of 2008. EAPs provide fairly extensive services to individuals experiencing IPV. Satisfaction with EAP services for IPV was significantly associated with annual income and the type of help received from the EAP, but not with type of IPV experienced. EAP representatives described challenges with accurately identifying IPV victims and women expressed concerns with confidentiality. Future efforts to enhance the ability of EAPs to respond effectively to IPV should address confidentially and strengthen how IPV-related assistance is delivered.

Towards an inter-domain billing system to support dynamic service provisioning

OpenAIRE

Le, V.M.

2009-01-01

Today, billing is a big challenge for service providers. With a growing number of rich services such as music, mobile TV, Video-on-Demand and eHealth delivered to the mass market, service providers are missing business opportunities because current billing solutions are not fully capable. In particular, the delivery of on-the-fly composite services, composed of many service components provided by different service providers causes many complexities. This book proposes a billing system that de...

A Taxonomy of Self-configuring Service Discovery Systems

NARCIS (Netherlands)

Sundramoorthy, V.; Hartel, Pieter H.; Scholten, Johan

2007-01-01

We analyze the fundamental concepts and issues in service discovery. This analysis places service discovery in the context of distributed systems by describing service discovery as a third generation naming system. We also describe the essential architectures and the functionalities in service

Delivering stepped care: an analysis of implementation in routine practice

Directory of Open Access Journals (Sweden)

Richards David A

2012-01-01

Full Text Available Abstract Background In the United Kingdom, clinical guidelines recommend that services for depression and anxiety should be structured around a stepped care model, where patients receive treatment at different 'steps,' with the intensity of treatment (i.e., the amount and type increasing at each step if they fail to benefit at previous steps. There are very limited data available on the implementation of this model, particularly on the intensity of psychological treatment at each step. Our objective was to describe patient pathways through stepped care services and the impact of this on patient flow and management. Methods We recorded service design features of four National Health Service sites implementing stepped care (e.g., the types of treatments available and their links with other treatments, together with the actual treatments received by individual patients and their transitions between different treatment steps. We computed the proportions of patients accessing, receiving, and transiting between the various steps and mapped these proportions visually to illustrate patient movement. Results We collected throughput data on 7,698 patients referred. Patient pathways were highly complex and very variable within and between sites. The ratio of low (e.g., self-help to high-intensity (e.g., cognitive behaviour therapy treatments delivered varied between sites from 22:1, through 2.1:1, 1.4:1 to 0.5:1. The numbers of patients allocated directly to high-intensity treatment varied from 3% to 45%. Rates of stepping up from low-intensity treatment to high-intensity treatment were less than 10%. Conclusions When services attempt to implement the recommendation for stepped care in the National Institute for Health and Clinical Excellence guidelines, there were significant differences in implementation and consequent high levels of variation in patient pathways. Evaluations driven by the principles of implementation science (such as targeted planning

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

Science.gov (United States)

Dixon, Decia Nicole

2009-01-01

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

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment.

Science.gov (United States)

Cunningham, Charles E; Zipursky, Robert B; Christensen, Bruce K; Bieling, Peter J; Madsen, Victoria; Rimas, Heather; Mielko, Stephanie; Wilson, Fiona; Furimsky, Ivana; Jeffs, Lisa; Munn, Catharine

2017-01-01

We modeled design factors influencing the intent to use a university mental health service. Between November 2012 and October 2014, 909 undergraduates participated. Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. E-Mental Health options could engage students who may not wait for standard services.

Software as a Service - Common Service Bus (SAAS-CSB)

OpenAIRE

Swaminathan, R.; Karnavel, K.

2013-01-01

Software-as-a-Service (SaaS) is a form of cloud computing that relieves the user from the concern of hardware, software installation and management. It is an emerging business model that delivers software applications to the users through Web-based technology. Software vendors have varying requirements and SaaS applications most typically support such requirements. The various applications used by unique customers in a single instance are known as Multi-Tenancy. There would be a delay in serv...

Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth Environment.

Directory of Open Access Journals (Sweden)

Giorgia Gon

Full Text Available Hygiene during childbirth is essential to the health of mothers and newborns, irrespective of where birth takes place. This paper investigates the status of water and sanitation in both the home and facility childbirth environments, and for whom and where this is a more significant problem.We used three datasets: a global dataset, with information on the home environment from 58 countries, and two datasets for each of four countries in Eastern Africa: a healthcare facility dataset, and a dataset that incorporated information on facilities and the home environment to create a comprehensive description of birth environments in those countries. We constructed indices of improved water, and improved water and sanitation combined (WATSAN, for the home and healthcare facilities. The Joint Monitoring Program was used to construct indices for household; we tailored them to the facility context-household and facility indices include different components. We described what proportion of women delivered in an environment with improved WATSAN. For those women who delivered at home, we calculated what proportion had improved WATSAN by socio-economic status, education and rural-urban status.Among women delivering at home (58 countries, coverage of improved WATSAN by region varied from 9% to 53%. Fewer than 15% of women who delivered at home in Sub-Saharan Africa, had access to water and sanitation infrastructure (range 0.1% to 37%. This was worse among the poorest, the less educated and those living in rural areas. In Eastern Africa, where we looked at both the home and facility childbirth environment, a third of women delivered in an environment with improved water in Uganda and Rwanda; whereas, 18% of women in Kenya and 7% in Tanzania delivered with improved water and sanitation. Across the four countries, less than half of the facility deliveries had improved water, or improved water and sanitation in the childbirth environment.Access to water and

Cutting corners and working overtime : quality erosion in the service industry

OpenAIRE

Oliva, Rogelio.; Sterman, John.

1999-01-01

The erosion of service quality throughout the economy is a frequent concern in the popular press. The American Customer Satisfaction Index for services fell in 2000 to 69.4%, down 5 percentage points from 1994. We hypothesize that the characteristics of services---inseparability, intangibility, and labor intensity---interact with management practices to bias service providers toward reducing the level of service they deliver, often locking entire industries into a vicious cycle of eroding ser...

HR customer service--FedEx.com or BUST!

Science.gov (United States)

Gerver, H M

2001-09-01

As the "customers" of the benefits department, employees, beneficiaries and retirees deserve best practice service delivery. This article describes a benefits administration operating model that can deliver high levels of customer service by furnishing accurate, consistent and timely information. Performance measurement is a key element in this type of customer satisfaction, particularly when outsourcing vendors are involved in the provision of benefits.

Evolution of Cloud Storage as Cloud Computing Infrastructure Service

OpenAIRE

Rajan, Arokia Paul; Shanmugapriyaa

2013-01-01

Enterprises are driving towards less cost, more availability, agility, managed risk - all of which is accelerated towards Cloud Computing. Cloud is not a particular product, but a way of delivering IT services that are consumable on demand, elastic to scale up and down as needed, and follow a pay-for-usage model. Out of the three common types of cloud computing service models, Infrastructure as a Service (IaaS) is a service model that provides servers, computing power, network bandwidth and S...

Process of technical performance: essential features and their economic view

OpenAIRE

Zhylinska, O.

2010-01-01

Essential features of technical performance have been defined in the context of similarity of its components such as research and development, training of technical/engineering personnel and providing technical services. Also peculiarities of economic view have been examined in terms of information model of managing.

TQM: the essential concepts.

Science.gov (United States)

Chambers, D W

1998-01-01

This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.

Challenges and Opportunities To Deliver Research Services to Parliamentarians in the Japanese Diet.

Science.gov (United States)

Takeda, Michiyo

This paper outlines the challenges and opportunities for the services of the Japanese National Diet Library (NDL), especially the Research and Legislative Reference Bureau by using a SWOT (Strength, Weaknesses, Opportunities, and Threats) analysis. The introduction lists the major goals of the NDL's reform. The second section discusses the NDL's…

Communication from Goods Reception services

CERN Multimedia

2007-01-01

Members of the personnel are invited to take note that only parcels corresponding to official orders or contracts will be handled at CERN. Individuals are not authorised to have private merchandise delivered to them at CERN and private deliveries will not be accepted by the Goods Reception services. Thank you for your understanding.

The determinants of essential newborn care for home births in Bangladesh.

Science.gov (United States)

Akter, T; Dawson, A; Sibbritt, D

2016-12-01

To examine the association of sociodemographic, antenatal and delivery care factors with the essential newborn care (ENC) practices of neonates born at home in Bangladesh. This study analyzed data of a cross-sectional survey-the Bangladesh Demographic and Health Survey, 2011. This analysis considered 3190 most recent live-born infants who were delivered at home within three years of the survey. Logistic regression models were used to identify the factors affecting the implementation of six ENC practices, namely using disinfected instruments to cut the umbilical cord, avoidance of application of any substances to the umbilical cord stump, immediate drying and wrapping of newborns, delayed bathing of newborns, and immediate initiation of breastfeeding. Factors affecting ENC practices in Bangladesh are low parental education, low utilization of antenatal care services, the absence of skilled birth attendants, smaller size at birth, higher birth order and mother's age at birth. Regional factors also seem to considerably affect ENC practices. There is ample scope to improve the coverage of ENC practices in Bangladesh. Health promotion programmes that target parents with low education and older mothers may help to build awareness of ENC practices. This investigation provides insight into the key determinants of ENC practices, which require consideration when scaling up ENC practices in low-income and lower middle-income countries. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Moral Literacy through Two Lenses: Pre-Service Teachers' Preparation for Character Education

Science.gov (United States)

Rizzo, Kelly; Bajovic, Mira

2016-01-01

In this paper, we explored how well prepared pre-service teacher candidates are to develop moral literacy. With the mandate in Ontario schools to deliver character education, we were intrigued by the question: How well prepared are teacher candidates to deliver on this requirement based on preservice preparation and the realities of classroom…

Evaluation of service quality of hospital outpatient department services.

Science.gov (United States)

Chakravarty, Abhijit

2011-07-01

It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.

Online information services in the social sciences

CERN Document Server

Jacobs, Neil

2004-01-01

Information professionals are increasingly responsible not only for running traditional information and library services but also for providing an online presence for their organisation. This book shows how best practice in delivering online information services should be based on actual user needs and behaviour. A series of case studies provide real life examples of how social science information is being used in the community. The book then draws on these case studies to outline the main issues facing service providers: such as usability, metadata and management. The book concludes with a lo

Linking the Observation of Essential Variables to Societal Benefits

Science.gov (United States)

Sylak-Glassman, E.

2017-12-01

Different scientific communities have established sets of commonly agreed upon essential variables to help coordinate data collection in a variety of Earth observation areas. As an example, the World Meteorological Organization Global Climate Observing System has identified 50 Essential Climate Variables (ECVs), such as sea-surface temperature and carbon dioxide, which are required to monitoring the climate and detect and attribute climate change. In addition to supporting climate science, measuring these ECVs deliver many types of societal benefits, ranging from disaster mitigation to agricultural productivity to human health. While communicating the value in maintaining and improving observational records for these variables has been a challenge, quantifying how the measurement of these ECVs results in the delivery of many different societal benefits may help support their continued measurement. The 2016 National Earth Observation Assessment (EOA 2016) quantified the impact of individual Earth observation systems, sensors, networks, and surveys (or Earth observation systems, for short) on the achievement of 217 Federal objectives in 13 societal benefit areas (SBAs). This study will demonstrate the use of the EOA 2016 dataset to show the different Federal objectives and SBAs that are impacted by the Earth observation systems used to measure ECVs. Describing how the measurements from these Earth observation systems are used not only to maintain the climate record but also to meet additional Federal objectives may help articulate the continued measurement of the ECVs. This study will act as a pilot for the use of the EOA 2016 dataset to map between the measurements required to observe additional sets of variables, such as the Essential Ocean Variables and Essential Biodiversity Variables, and the ability to achieve a variety of societal benefits.

Heterogeneous access and processing of EO-Data on a Cloud based Infrastructure delivering operational Products

Science.gov (United States)

Niggemann, F.; Appel, F.; Bach, H.; de la Mar, J.; Schirpke, B.; Dutting, K.; Rucker, G.; Leimbach, D.

2015-04-01

To address the challenges of effective data handling faced by Small and Medium Sized Enterprises (SMEs) a cloud-based infrastructure for accessing and processing of Earth Observation(EO)-data has been developed within the project APPS4GMES(www.apps4gmes.de). To gain homogenous multi mission data access an Input Data Portal (IDP) been implemented on this infrastructure. The IDP consists of an Open Geospatial Consortium (OGC) conformant catalogue, a consolidation module for format conversion and an OGC-conformant ordering framework. Metadata of various EO-sources and with different standards is harvested and transferred to an OGC conformant Earth Observation Product standard and inserted into the catalogue by a Metadata Harvester. The IDP can be accessed for search and ordering of the harvested datasets by the services implemented on the cloud infrastructure. Different land-surface services have been realised by the project partners, using the implemented IDP and cloud infrastructure. Results of these are customer ready products, as well as pre-products (e.g. atmospheric corrected EO data), serving as a basis for other services. Within the IDP an automated access to ESA's Sentinel-1 Scientific Data Hub has been implemented. Searching and downloading of the SAR data can be performed in an automated way. With the implementation of the Sentinel-1 Toolbox and own software, for processing of the datasets for further use, for example for Vista's snow monitoring, delivering input for the flood forecast services, can also be performed in an automated way. For performance tests of the cloud environment a sophisticated model based atmospheric correction and pre-classification service has been implemented. Tests conducted an automated synchronised processing of one entire Landsat 8 (LS-8) coverage for Germany and performance comparisons to standard desktop systems. Results of these tests, showing a performance improvement by the factor of six, proved the high flexibility and

INVESTIGATING A QUALITY OF SERVICES IN THE PUBLIC SECTOR: EVIDENCE FROM NORTHERN CYPRUS

Directory of Open Access Journals (Sweden)

Ovgu Cidar Iyikal

2016-09-01

Full Text Available The current study aims is to investigate the service quality delivered by public enterprises in Turkish Republic of Northern Cyprus (TRNC and level of customer satisfaction as well as word of mouth (WOM in return. A convenient sampling method has been employed by using the service quality (SERVQUAL instrument which is used to gather customers’ excellent public service and compared those with their perceptions of the service delivered by Public Sectors which are operating in TRNC. Results of the study revealed that dimensions of reliability and assurance exert positively significant effects on Customer Satisfaction in the public sector. Moreover, the level of Customer Satisfaction from public services exerts positively significant effect on positive word of mouth. Finally, with the light of findings, the current study will also attempt to provide some recommendations about possible quality reforms and rearrangements to the policy makers for the public enterprises in TRNC.

Service quality attributes affecting passengers' satisfaction with ...

African Journals Online (AJOL)

Service quality and customer satisfaction are the growing concerns for business organizations throughout the world, and customer satisfaction studies have been proven to be essential tools in trying to optimize services provided to users. For transit agencies, as in other service industries, increase in customer satisfaction ...

Using mobile electronic devices to deliver educational resources in developing countries.

Science.gov (United States)

Mazal, Jonathan Robert; Ludwig, Rebecca

2015-01-01

Developing countries have far fewer trained radiography professionals than developed countries, which exacerbates the limited access to imaging services. The lack of trained radiographers reflects, in part, limited availability of radiographer-specific educational resources. Historically, organizations that provided such resources in the developing world faced challenges related to the limited stock of current materials as well as expenses associated with shipping and delivery. Four mobile electronic devices (MEDs) were loaded with educational content (e-books, PDFs, and digital applications) spanning major radiography topics. The MEDs were distributed to 4 imaging departments in Ghana, India, Nepal, and Nigeria based on evidence of need for radiography-specific resources, as revealed by survey responses. A cost comparison of postal delivery vs digital delivery of educational content was performed. The effectiveness of delivering additional content via Wi-Fi transmission also was evaluated. Feedback was solicited on users' experience with the MEDs as a delivery tool for educational content. An initial average per e-book expense of $30.05, which included the cost of the device, was calculated for the MED delivery method compared with $15.56 for postal delivery of printed materials. The cost of the MED delivery method was reduced to an average of $10.05 for subsequent e-book deliveries. Additional content was successfully delivered via Wi-Fi transmission to all recipients during the 3-month follow-up period. Overall user feedback on the experience was positive, and ideas for enhancing the MED-based method were identified. Using MEDs to deliver radiography-specific educational content appears to be more cost effective than postal delivery of printed materials on a long-term basis. MEDs are more efficient for providing updates to educational materials. Customization of content to department needs, and using projector devices could enhance the usefulness of MEDs for

Ancillary Services for the European Grid with High Shares of Wind and Solar Power

DEFF Research Database (Denmark)

Van Hulle, Frans; Holttinen, Hannele; Kiviluoma, Juha

2012-01-01

to be better understood. This relates both to the technical capabilities of the plants for delivering specific services and to the quantification of the needs. The paper presents the approach of the European IEE project REserviceS, aiming at establishing reference guidance for the ongoing developments......With significantly increasing share of variable renewable power generation like wind and solar PV, the need in the power system for ancillary services supporting the network frequency, voltage, etc. changes. Turning this issue around, market opportunities will emerge for wind and solar PV...... technology to deliver such grid services. In the European power system, adequate market mechanisms need to be developed to ensure that there will be an efficient trading of these services. For that purpose a range of (economic) characteristics of wind (and solar) power as providers of grid services need...

From Product- to Service-Oriented Strategies in the Enterprise Software Market

Science.gov (United States)

Xin, Mingdi

2009-01-01

The enterprise software market is seeing the rise of a new business model--selling Software-as-a-Service (SaaS), in which a standard piece of software is owned and managed remotely by the vendor and delivered as a service over the Internet. Despite the hype, questions remain regarding the rise of this new service model and how it would impact the…

78 FR 12833 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

Science.gov (United States)

2013-02-25

... wellness services and chronic disease management; and pediatric services, including oral \\8\\ and vision... Act uses the terms ``dental'' and ``oral'' interchangeably when referring to the pediatric dental care... Parts 147, 155, and 156 Patient Protection and Affordable Care Act; Standards Related to Essential...

Essential competencies analysis of a training model development for non-formal vocational teachers under the office of the non-formal and informal education in Thailand

OpenAIRE

Chayanopparat Piyanan; Charungkaittikul Suwithida; Ratana-Ubol Archanya

2016-01-01

Non-formal vocational education provides practical experiences in a particular occupational field to non-formal semi-skilled learners. Non-formal vocational teachers are the key persons to deliver particular occupational knowledge. The essential competencies enhancement for non-sformal vocational teachers will improve teaching performance. The question of the research is what the essential competencies for the nonformal vocational teachers are. The research method was 1) to review related lit...

Developing World-Class Customer Service at Navy Field Contracting Activities: An Assessment of the FISC San Diego Regional Contracts Department

National Research Council Canada - National Science Library

Allen, Robert

1997-01-01

.... The thesis defines world-class customer service and then describes various aspects of service quality including the customer's perspective on service, how service is delivered, how to effectively...

Economic evaluation of a Child Health Days strategy to deliver multiple maternal and child health interventions in Somalia.

Science.gov (United States)

Vijayaraghavan, Maya; Wallace, Aaron; Mirza, Imran Raza; Kamadjeu, Raoul; Nandy, Robin; Durry, Elias; Everard, Marthe

2012-03-01

Child Health Days (CHDs) are increasingly used by countries to periodically deliver multiple maternal and child health interventions as time-limited events, particularly to populations not reached by routine health services. In countries with a weak health infrastructure, this strategy could be used to reach many underserved populations with an integrated package of services. In this study, we estimate the incremental costs, impact, cost-effectiveness, and return on investment of 2 rounds of CHDs that were conducted in Somalia in 2009 and 2010. We use program costs and population estimates reported by the World Health Organization and United Nations Children's Fund to estimate the average cost per beneficiary for each of 9 interventions delivered during 2 rounds of CHDs implemented during the periods of December 2008 to May 2009 and August 2009 to April 2010. Because unstable areas were unreachable, we calculated costs for targeted and accessible beneficiaries. We model the impact of the CHDs on child mortality using the Lives Saved Tool, convert these estimates of mortality reduction to life years saved, and derive the cost-effectiveness ratio and the return on investment. The estimated average incremental cost per intervention for each targeted beneficiary was $0.63, with the cost increasing to $0.77 per accessible beneficiary. The CHDs were estimated to save the lives of at least 10,000, or 500,000 life years for both rounds combined. The CHDs were cost-effective at $34.00/life year saved. For every $1 million invested in the strategy, an estimated 615 children's lives, or 29,500 life years, were saved. If the pentavalent vaccine had been delivered during the CHDs instead of diphtheria-pertussis-tetanus vaccine, an additional 5000 children's lives could have been saved. Despite high operational costs, CHDs are a very cost-effective service delivery strategy for addressing the leading causes of child mortality in a conflict setting like Somalia and compare

Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom

Science.gov (United States)

Devlin, Alison M; McGee-Lennon, Marilyn; O’Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O’Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan

2016-01-01

Objective To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. PMID:26254480

Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom.

Science.gov (United States)

Devlin, Alison M; McGee-Lennon, Marilyn; O'Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O'Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan; Mair, Frances S

2016-01-01

To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program-a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit-led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. © The Author 2015. Published by Oxford University Press on behalf of

Materials Delivered by Member States

International Nuclear Information System (INIS)

1962-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

Brazil's PROFORMAÇÃO Project: A Case Study of an Integrated Virtual System for Delivering In-Service Teacher Education

Science.gov (United States)

Moore, Michael G.

2016-01-01

A systems methodology was employed to design and deliver a highly successful demonstration of the effectiveness of distance education as a means of providing high quality training to tens of thousands of teachers in the most remote areas of Brazil. Key elements in the success of the program were significant funding, top political buy-in, and…

Long-Term Efficacy of Constant Current Deep Brain Stimulation in Essential Tremor.

Science.gov (United States)

Rezaei Haddad, Ali; Samuel, Michael; Hulse, Natasha; Lin, Hsin-Ying; Ashkan, Keyoumars

2017-07-01

Ventralis intermedius deep brain stimulation is an established intervention for medication-refractory essential tremor. Newer constant current stimulation technology offers theoretical advantage over the traditional constant voltage systems in terms of delivering a more biologically stable therapy. There are no previous reports on the outcomes of constant current deep brain stimulation in the treatment of essential tremor. This study aimed to evaluate the long-term efficacy of ventralis intermedius constant current deep brain stimulation in patients diagnosed with essential tremor. Essential tremor patients implanted with constant current deep brain stimulation for a minimum of three years were evaluated. Clinical outcomes were assessed using the Fahn-Tolosa-Marin tremor rating scale at baseline and postoperatively at the time of evaluation. The quality of life in the patients was assessed using the Quality of Life in Essential Tremor questionnaire. Ten patients were evaluated with a median age at evaluation of 74 years (range 66-79) and a mean follow up time of 49.7 (range 36-78) months since starting stimulation. Constant current ventralis intermedius deep brain stimulation was well tolerated and effective in all patients with a mean score improvement from 50.7 ± 5.9 to 17.4 ± 5.7 (p = 0.0020) in the total Fahn-Tolosa-Marin rating scale score (65.6%). Furthermore, the total combined mean Quality of Life in Essential Tremor score was improved from 56.2 ± 4.9 to 16.8 ± 3.5 (p value = 0.0059) (70.1%). This report shows that long-term constant current ventralis intermedius deep brain stimulation is a safe and effective intervention for essential tremor patients. © 2017 International Neuromodulation Society.

Service quality of cloud-based applications

CERN Document Server

Bauer, Eric

2014-01-01

This book explains why applications running on cloud might not deliver the same service reliability, availability, latency and overall quality to end users as they do when the applications are running on traditional (non-virtualized, non-cloud) configurations, and explains what can be done to mitigate that risk.

In vitro magnetic stimulation: a simple stimulation device to deliver defined low intensity electromagnetic fields

Directory of Open Access Journals (Sweden)

Stephanie Grehl

2016-11-01

modified according to the stimulation delivered. Thus we describe a simple magnetic stimulation device that delivers defined stimulation parameters to different neural systems in vitro. Such devices are essential to further understanding of the fundamental effects of magnetic stimulation on biological tissue and optimise therapeutic application of human NIBS.

Understanding the Service Quality Perception Gaps between Judicial Servants and Judiciary Users

OpenAIRE

Rodrigo Murillo

2014-01-01

Judiciary service user expectations are usually not the same as ideas harbored in the minds of civil servants delivering such services. This discrepancy matches the definition of the service delivery GAP 1, as identified and assessed by SERVQUAL (Service Quality), a tool that for almost three decades has been employed worldwide in measuring service quality in many different industries and countries, in both private and public organizations. Through participant observation, semi-structured int...

More green infrastructure is required to maintain ecosystem services under current trends in land-use change in Europe.

Science.gov (United States)

Maes, Joachim; Barbosa, Ana; Baranzelli, Claudia; Zulian, Grazia; Batista E Silva, Filipe; Vandecasteele, Ine; Hiederer, Roland; Liquete, Camino; Paracchini, Maria Luisa; Mubareka, Sarah; Jacobs-Crisioni, Chris; Castillo, Carolina Perpiña; Lavalle, Carlo

Green infrastructure (GI), a network of nature, semi-natural areas and green space, delivers essential ecosystem services which underpin human well-being and quality of life. Maintaining ecosystem services through the development of GI is therefore increasingly recognized by policies as a strategy to cope with potentially changing conditions in the future. This paper assessed how current trends of land-use change have an impact on the aggregated provision of eight ecosystem services at the regional scale of the European Union, measured by the Total Ecosystem Services Index (TESI8). Moreover, the paper reports how further implementation of GI across Europe can help maintain ecosystem services at baseline levels. Current demographic, economic and agricultural trends, which affect land use, were derived from the so called Reference Scenario. This scenario is established by the European Commission to assess the impact of energy and climate policy up to 2050. Under the Reference Scenario, economic growth, coupled with the total population, stimulates increasing urban and industrial expansion. TESI8 is expected to decrease across Europe between 0 and 5 % by 2020 and between 10 and 15 % by 2050 relative to the base year 2010. Based on regression analysis, we estimated that every additional percent increase of the proportion of artificial land needs to be compensated with an increase of 2.2 % of land that qualifies as green infrastructure in order to maintain ecosystem services at 2010 levels.

An overview of cloud services adoption challenges in higher education institutions

OpenAIRE

Alharthi, Abdulrahman; Yahya, Fara; Walters, Robert John; Wills, Gary

2015-01-01

Information Technology (IT) plays an important role in enabling education services be delivered to users. Most education online services in universities have been run on the cloud to provide services to support students, lecturers, researchers and administration staff. These are enabled with the emergence of cloud computing in the world of IT. Cloud computing offers on demand Internet-based computing services. This paper presents an overview of cloud computing adoption in higher education, ma...

Value co-creation through e-services:Driving servitisation and building relationships

OpenAIRE

Huck, Jana Lisa

2016-01-01

Manufacturing firms have begun to add services to their product portfolios for interacting with customers and accessing their value creation processes.Through the technological possibilities of delivering services, e-services have emerged as a new research field. So far, little is known to what extent e-services are applicable in driving servitisation and building relationships. Thus, the purpose is to identify and describe the enabling factors that link servitisation, value co-creation and e...

Telecommunications and Universal Service: International ...

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

Out of print. 104 pages. e-ISBN : 1552503216. Téléchargez le PDF · Téléchargez le cyberlivre. The services delivered over telecommunications networks can provide enormous ... Amnisties pour la paix dans le delta du Niger - évaluation critique de la contribution à une paix durable du pardon de crimes du passé.

Service users' experiences of participation in decision making in mental health services.

Science.gov (United States)

Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

2015-11-01

Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core

Redefining Requirements of Ancillary Services for Technology Agnostic Sources

DEFF Research Database (Denmark)

Bondy, Daniel Esteban Morales; MacDonald, Jason; Kara, Emre Can

2018-01-01

New sources for ancillary services are needed, yet the requirements for service provision in most countries are explicitly formulated for traditional generators. This leads to waste of the potential for new technologies to deliver ancillary services. In order to harness this potential, we propose...... to parameterize the requirements of ancillary services so that reserves can be built by combining the advantageous properties of different technologies. The proposal is exemplified through a laboratory test where it shown that the system needs can be covered through cheaper and smaller reserves....

School-Based Mental Health Services: Definitions and Models of Effective Practice

Science.gov (United States)

Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.

2017-01-01

School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…

24 CFR 901.40 - Indicator #7, resident services and community building.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Indicator #7, resident services and community building. 901.40 Section 901.40 Housing and Urban Development Regulations Relating to Housing and... services and community building. This indicator examines the PHA's efforts to deliver quality customer...

The User Interface as a Supplier of Intertwined e-Services

Science.gov (United States)

Hultgren, Göran; Eriksson, Owen

Today, much of the world economy is focused on the service sector (Stafford and Saunders 2004). One of the changes driving service economic growth has been the rapid development in computer technology, mobile technology and the Internet (ibid.). There are e.g. mobile positioning services, traffic information services and intermediary services such as banking services on the Internet. With the help of channels such as the Internet and mobile telecommunications, information and functionalities are delivered by service providers, and are used by customers with the help of information technology (IT) systems. Many of these services have a characteristic where customers can meet and communicate with each other.

Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia

Directory of Open Access Journals (Sweden)

Kendra Siekmans

2017-01-01

Full Text Available Abstract Background Trained community health workers (CHW enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. Methods A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16, government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Results Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. “No touch” integrated community case management (iCCM guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Conclusions Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea

Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia.

Science.gov (United States)

Siekmans, Kendra; Sohani, Salim; Boima, Tamba; Koffa, Florence; Basil, Luay; Laaziz, Saïd

2017-01-17

Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. "No touch" integrated community case management (iCCM) guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea during the Ebola outbreak, making communities more resilient when

Delivering social work services in collaboration with the legal representation for individual clients: An effective, ethical and economical approach to supporting families in child abuse and neglect legal proceedings.

Science.gov (United States)

Pott, Robbin

2017-11-01

This article discusses the need to improve the quality of helping relationships between families and social workers in the child protection system and the growing body of evidence that teams of social workers and lawyers are effective at improving outcomes in child protection legal proceedings. The author presents an alternative structure of delivering social work services within the child protection systems once a court gets involved with a family, proposing that social workers should focus on individual clients in collaboration with their legal representation, rather than the traditional model of a governmental agency social worker serving the family as a unit as it also determines placement of the children. Pairing the social worker to an individual client in tandem with their legal representative would help resolve the widely observed relationship problems between service users and governmental agency social workers that include the power imbalance created by the agency's authority to determine placement of children, the conflicts of interest that agency workers face when required to manage differing family members' needs, and the lack of protection of the due process right of confidentiality for parties involved in legal proceedings. This alternative structure also impacts the need to use resources more efficiently and has been demonstrated to result in substantial returns on investment. This article concludes that when a family becomes involved in child abuse and neglect legal proceedings, the child welfare agency should shift the delivery of social work services to the individual parties, away from the governmental agency and in conjunction with their legal representation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Public preferences for ecosystem services on exurban landscapes: A case study from the Mid-Atlantic, USA

Directory of Open Access Journals (Sweden)

Joshua M. Duke

2016-07-01

Full Text Available This paper reports data from a residential landscape preference study conducted in Delaware, USA. The researchers constructed an ecologically designed exurban residential landscape, which delivered 20 new environmental and human-related impacts, including 7 that delivered ecosystem services. Ecosystem services included impacts such as improved flood control and enhanced plant diversity. Using pictures before and after the intervention, an intercept survey of 105 non-neighboring residents estimated whether the 20 impacts positively, negatively, or did not affect the respondents’ household wellbeing. The public found that most landscape-intervention impacts had a positive effect on their quality of life, especially those impacts involving ecosystem services. All but one ecosystem service were found to be strong amenities and the other (moving indoor activities outside was an amenity. However, the landscape intervention delivered one clear disamenity: increased undesirable wildlife. Respondents also identified what impacts were the most important in affecting their welfare: undesirable wildlife (negative; flood control (positive; and water quality (positive. Ecosystem services accounted for 41.6% of the public’s importance rating, while undesirable wildlife was 12.9%. A planning process seeking more ecosystem services from residential landscapes should focus on all the most important drivers of preference, if it is to be accepted by residents.

Socio-cultural and economic valuation of ecosystem services provided by Mediterranean mountain agroecosystems.

Science.gov (United States)

Bernués, Alberto; Rodríguez-Ortega, Tamara; Ripoll-Bosch, Raimon; Alfnes, Frode

2014-01-01

The aim of this work was to elucidate the socio-cultural and economic value of a number of ecosystem services delivered by mountain agroecosystems (mostly grazing systems) in Euro-Mediterranean regions. We combined deliberative (focus groups) and survey-based stated-preference methods (choice modelling) to, first, identify the perceptions of farmers and other citizens on the most important ecosystem services and, second, to value these in economic terms according to the willingness to pay of the local (residents of the study area) and general (region where the study area is located) populations. Cultural services (particularly the aesthetic and recreational values of the landscape), supporting services (biodiversity maintenance) and some regulating services (particularly fire risk prevention) were clearly recognized by both farmers and citizens, with different degrees of importance according to their particular interests and objectives. The prevention of forest fires (≈50% of total willingness to pay) was valued by the general population as a key ecosystem service delivered by these agroecosystems, followed by the production of specific quality products linked to the territory (≈20%), biodiversity (≈20%) and cultural landscapes (≈10%). The value given by local residents to the last two ecosystem services differed considerably (≈10 and 25% for biodiversity and cultural landscape, respectively). The Total Economic Value of mountain agroecosystems was ≈120 € person(-1) year(-1), three times the current level of support of agro-environmental policies. By targeting and quantifying the environmental objectives of the European agri-environmental policy and compensating farmers for the public goods they deliver, the so-called "green" subsidies may become true Payments for Ecosystems Services.

Socio-cultural and economic valuation of ecosystem services provided by Mediterranean mountain agroecosystems.

Directory of Open Access Journals (Sweden)

Alberto Bernués

Full Text Available The aim of this work was to elucidate the socio-cultural and economic value of a number of ecosystem services delivered by mountain agroecosystems (mostly grazing systems in Euro-Mediterranean regions. We combined deliberative (focus groups and survey-based stated-preference methods (choice modelling to, first, identify the perceptions of farmers and other citizens on the most important ecosystem services and, second, to value these in economic terms according to the willingness to pay of the local (residents of the study area and general (region where the study area is located populations. Cultural services (particularly the aesthetic and recreational values of the landscape, supporting services (biodiversity maintenance and some regulating services (particularly fire risk prevention were clearly recognized by both farmers and citizens, with different degrees of importance according to their particular interests and objectives. The prevention of forest fires (≈50% of total willingness to pay was valued by the general population as a key ecosystem service delivered by these agroecosystems, followed by the production of specific quality products linked to the territory (≈20%, biodiversity (≈20% and cultural landscapes (≈10%. The value given by local residents to the last two ecosystem services differed considerably (≈10 and 25% for biodiversity and cultural landscape, respectively. The Total Economic Value of mountain agroecosystems was ≈120 € person(-1 year(-1, three times the current level of support of agro-environmental policies. By targeting and quantifying the environmental objectives of the European agri-environmental policy and compensating farmers for the public goods they deliver, the so-called "green" subsidies may become true Payments for Ecosystems Services.

Measuring cloud service health using NetFlow/IPFIX: the WikiLeaks case

NARCIS (Netherlands)

Drago, Idilio; Hofstede, R.J.; Sadre, R.; Sperotto, Anna; Pras, Aiko

The increasing trend of outsourcing services to cloud providers is changing the way computing power is delivered to enterprises and end users. Although cloud services offer several advantages, they also make cloud consumers strongly dependent on providers. Hence, consumers have a vital interest to

Quality of service management framework for dynamic chaining of geographic information services

Science.gov (United States)

Onchaga, Richard

2006-06-01

Dynamic chaining of geographic information services (geo-services) is gaining popularity as a new paradigm for evolving flexible geo-information systems and for providing on-demand access to geo-information. In dynamic chaining, disparate geo-services are discovered and composed at run time to yield more elaborate functionality and create value-added geo-information. Common approaches to service chaining discover and compose disparate geo-services based on the functional capability of individual geo-services. The primary concern of common approaches is thus the emergent behavior of the resulting composite geo-service. However, as geo-services become mundane and take on a greater and more strategic role in mission critical processes, deliverable quality of service (QoS) becomes an important concern. QoS concerns operational characteristics of a service that determine its utility in an application context. To address pertinent QoS requirements, a new approach to service chaining becomes necessary. In this paper we propose a QoS-aware chaining approach in which geo-services are discovered, composed and executed considering both functional and QoS requirements. We prescribe a QoS management framework that defines fundamental principles, concepts and mechanisms which can be applied to evolve an effective distributed computing platform for QoS-aware chaining of geo-services - the so-called geo-service infrastructure. The paper also defines an extensible QoS model for services delivered by dynamic compositions of geo-services. The process of orthophoto generation is used to demonstrate the applicability of the prescribed framework to service-oriented geographic information processing.

SOA and Web services interface design principles, techniques, and standards

CERN Document Server

Bean, James

2009-01-01

SOA offers solutions to the most intractable business problems faced by every enterprise, but getting the SOA service interface right requires the practical design knowledge this book uniquely delivers

A Multilevel Approach to Breastfeeding Promotion: Using Healthy Start to Deliver Individual Support and Drive Collective Impact.

Science.gov (United States)

Leruth, Chelsey; Goodman, Jacqueline; Bragg, Brian; Gray, Dara

2017-12-01

Purpose Breastfeeding has been linked to a host of positive health effects for women and children. However, disparities in breastfeeding initiation and duration prevent many low-income and African-American women from realizing these benefits. Existing breastfeeding promotion efforts often do not reach women who need support the most. In response, the Westside Healthy Start program (WHS), located in Chicago, Illinois, developed an ongoing multilevel approach to breastfeeding promotion. Description Key elements of our WHS breastfeeding model include individual education and counseling from pregnancy to 6 months postpartum and partnership with a local safety-net hospital to implement the Baby-Friendly Hospital Initiative and provide lactation support to delivering patients. Assessment In the year our model was implemented, 44.6% (49/110) of prenatal WHS participants reported that they planned to breastfeed, and 67.0% (183/273) of delivered participants initiated. Among participants reaching 6 months postpartum, 10.5% (9/86) were breastfeeding. WHS also had 2667 encounters with women delivering at our partner hospital during breastfeeding rounds, with 65.1% of contacts initiating. Community data was not available to assess the efficacy of our model at the local level. However, WHS participants fared better than all delivering patients at our partner hospital, where 65.0% initiated in 2015. Conclusion Healthy Start programs are a promising vehicle to improve breastfeeding initiation at the individual and community level. Additional evaluation is necessary to understand barriers to duration and services needed for this population.

Towards effective telephone-based delivery of government services

CSIR Research Space (South Africa)

Barnard, E

2003-09-01

Full Text Available Government regulations have combined with a tremendous growth in prepaid cellular telephony to bring telephone connectivity to an unprecedented number of South African citizens – thus creating an ideal platform for delivering services to a wide...

Rethinking Customer Service Training: A Curricular Solution to a Familiar Problem

Science.gov (United States)

Epps, Sharon K.; Kidd, Judith; Negro, Toni; Sayles, Sheridan L.

2016-01-01

High-quality customer service is an important aim of the library experience. Its importance is evidenced by attention given to the topic in scholarly literature and academic conference proceedings. This article describes the challenging process of creating and delivering a blended customer service training curriculum to all library staff working…

Delivering Satisfaction

Institute of Scientific and Technical Information of China (English)

Liu Xinlian

2012-01-01

With more Chinese customers abandoning bricks-and-mortar department stores n favor of onine alternatives,express delivery services have sprouted up in recent years,riding the heels of the online shopping craze.Unfortunately for customers,delivery companies are renowned for providing unreliable service,sparking consumer ire and quickly becoming the bane of most netizens' online shopping experiences.

[Effect of implementation of essential medicine system in the primary health care institution in China].

Science.gov (United States)

Huang, Donghong; Ren, Xiaohua; Hu, Jingxuan; Shi, Jingcheng; Xia, Da; Sun, Zhenqiu

2015-02-01

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.

Pricing, subsidies, and the poor : demand for improved water services in Central America

OpenAIRE

Walker, Ian; Ordonez, Fidel; Serrano, Pedro; Halpern, Jonathan

2000-01-01

Reformulating tariff and subsidy policies is central to improving water and sanitation services in developing countries. The traditional model of state enterprise service provision, coupled with residential tariffs set well below the cost of service, has generally delivered unsatisfactory results. Low internal generation of funds has impeded expansion of networks into poor communities and ...

A Discrete-Events Simulation Approach for Evaluation of Service-Based Applications

OpenAIRE

Driss , Maha; Jamoussi , Yassine; Jézéquel , Jean-Marc; Ben Ghézala , Henda Hajjami

2008-01-01

International audience; One of the promises of the service-oriented architecture(SOA) is to build complex added-value services in order to enhance and extend existing ones. service-based applications(SBAs) are asked not only to perform required functionalities,but also to deliver expected level of Quality of Service (QoS). Dealing with QoS management of such distributed applications, which are executed in dynamic environments,raises the need to consider context characteristics.This paper prop...

A Multiple-Item Scale for Assessing E-Government Service Quality

Science.gov (United States)

Papadomichelaki, Xenia; Mentzas, Gregoris

A critical element in the evolution of e-governmental services is the development of sites that better serve the citizens’ needs. To deliver superior service quality, we must first understand how citizens perceive and evaluate online citizen service. This involves defining what e-government service quality is, identifying its underlying dimensions, and determining how it can be conceptualized and measured. In this article we conceptualise an e-government service quality model (e-GovQual) and then we develop, refine, validate, confirm and test a multiple-item scale for measuring e-government service quality for public administration sites where citizens seek either information or services.

General Practitioners' Attitudes Toward a Web-Based Mental Health Service for Adolescents: Implications for Service Design and Delivery.

Science.gov (United States)

Subotic-Kerry, Mirjana; King, Catherine; O'Moore, Kathleen; Achilles, Melinda; O'Dea, Bridianne

2018-03-23

Anxiety disorders and depression are prevalent among youth. General practitioners (GPs) are often the first point of professional contact for treating health problems in young people. A Web-based mental health service delivered in partnership with schools may facilitate increased access to psychological care among adolescents. However, for such a model to be implemented successfully, GPs' views need to be measured. This study aimed to examine the needs and attitudes of GPs toward a Web-based mental health service for adolescents, and to identify the factors that may affect the provision of this type of service and likelihood of integration. Findings will inform the content and overall service design. GPs were interviewed individually about the proposed Web-based service. Qualitative analysis of transcripts was performed using thematic coding. A short follow-up questionnaire was delivered to assess background characteristics, level of acceptability, and likelihood of integration of the Web-based mental health service. A total of 13 GPs participated in the interview and 11 completed a follow-up online questionnaire. Findings suggest strong support for the proposed Web-based mental health service. A wide range of factors were found to influence the likelihood of GPs integrating a Web-based service into their clinical practice. Coordinated collaboration with parents, students, school counselors, and other mental health care professionals were considered important by nearly all GPs. Confidence in Web-based care, noncompliance of adolescents and GPs, accessibility, privacy, and confidentiality were identified as potential barriers to adopting the proposed Web-based service. GPs were open to a proposed Web-based service for the monitoring and management of anxiety and depression in adolescents, provided that a collaborative approach to care is used, the feedback regarding the client is clear, and privacy and security provisions are assured. ©Mirjana Subotic

FUEL SERVICES: Customer focused on Product Support during the whole Life Time

Energy Technology Data Exchange (ETDEWEB)

Langenberger, J.; Hummel, W.

2015-07-01

For more than 40 years, Fuel Services of AREVA has been delivering devices and providing on-site services primary at LWR worldwide. We support our worldwide customers in achieving safe and economic operation of the fuel assemblies (FA) and core components (CC) and have received excellent feedback from them. But the Fuel Services support goes beyond on-site activities. (Author)

The Impact of Services on Economic Complexity: Service Sophistication as Route for Economic Growth.

Science.gov (United States)

Stojkoski, Viktor; Utkovski, Zoran; Kocarev, Ljupco

2016-01-01

Economic complexity reflects the amount of knowledge that is embedded in the productive structure of an economy. By combining tools from network science and econometrics, a robust and stable relationship between a country's productive structure and its economic growth has been established. Here we report that not only goods but also services are important for predicting the rate at which countries will grow. By adopting a terminology which classifies manufactured goods and delivered services as products, we investigate the influence of services on the country's productive structure. In particular, we provide evidence that complexity indices for services are in general higher than those for goods, which is reflected in a general tendency to rank countries with developed service sector higher than countries with economy centred on manufacturing of goods. By focusing on country dynamics based on experimental data, we investigate the impact of services on the economic complexity of countries measured in the product space (consisting of both goods and services). Importantly, we show that diversification of service exports and its sophistication can provide an additional route for economic growth in both developing and developed countries.

Service Users' Involvement and Engagement in Interprofessional Care.

Science.gov (United States)

Kaini, B K

2016-01-01

Interprofessional care is joint working between health care professionals by pooling their skills, knowledge and expertise, to make joint decisions and learn from each other for the benefits of service users and healthcare professionals. Service users involvement is considered as one of the important aspects of planning, management and decision making process in the delivery of health care to service users. Service users' involvement is not the same as public involvement and partnership arrangements in health care. The active involvement and engagement of service users in health care positively contributes to improve quality of care, to promote better health and to shape the future of health services. Service users are always at the centre of health care professionals' values, work ethics and roles. Moreover, service users centred interprofessional team collaboration is very important to deliver effective health services.

Oral microflora in infants delivered vaginally and by caesarean section

DEFF Research Database (Denmark)

Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

2011-01-01

International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

Utility Energy Services Contracts: Enabling Documents, May 2009 (Book)

Energy Technology Data Exchange (ETDEWEB)

2009-05-01

Enabling Documents, delivered by the U.S. Department of Energy's Federal Energy Management Program (FEMP) to provide materials that clarify the authority for federal agencies to enter into utility energy services contracts (UESCs).

Posters as assessment strategies: focusing on service users.

Science.gov (United States)

Crawley, Loretta; Frazer, Kate

This article debates whether posters as an assessment strategy in health professionals' education programmes can benefit learners, academics, and service users. Evidence suggests that service-user involvement benefits learning by developing students' communication, partnership and advocacy skills. The authors debate the value of posters as an assessment strategy in postgraduate diploma nursing programmes delivered in an Irish School of Nursing, Midwifery and Health Systems. It is argued that assessment strategies should not only examine programme theory and practice but should also benefit the people that will be using the service. Although the assessment strategy used in these programmes aimed to benefit service users, additional work is required for assessment to be truly inclusive of service users.

[Beliefs - Misbeliefs, answering essential questions about hand hygiene from the view of the evidences].

Science.gov (United States)

Szél, Borbála; Nagy, Kamilla; Milassin, Márta; Tálosi, Gyula

2017-02-01

Contaminated hands can play pivotal role in the development and spread of healthcare-associated infections. Consequently hand hygiene practice performed with adequate technique and with adequate timing is an essential implement for patient safety. Inhibition of the practice of high level hand hygiene by the misconceptions or deficient knowledge of healthcare workers may lead to negative influence on the quality of patient care. Erroneous beliefs or "rumourous knowledge" acquired from colleagues can not only influence the attitude of healthcare workers, but can also give rise to insufficient hand hygiene compliance. Finding, interpreting and imparting the related evidence by delivering continuing education and lectures, highlighting the theoretical and practical know-how on hand hygiene could help to understand and imprint the evidence-based practice and adequate technique in the essential issue of hand hygiene. Orv. Hetil., 2017., 158(6), 212-219.

Disparities in availability of essential medicines to treat non-communicable diseases in Uganda: A Poisson analysis using the Service Availability and Readiness Assessment.

Science.gov (United States)

Armstrong-Hough, Mari; Kishore, Sandeep P; Byakika, Sarah; Mutungi, Gerald; Nunez-Smith, Marcella; Schwartz, Jeremy I

2018-01-01

Although the WHO-developed Service Availability and Readiness Assessment (SARA) tool is a comprehensive and widely applied survey of health facility preparedness, SARA data have not previously been used to model predictors of readiness. We sought to demonstrate that SARA data can be used to model availability of essential medicines for treating non-communicable diseases (EM-NCD). We fit a Poisson regression model using 2013 SARA data from 196 Ugandan health facilities. The outcome was total number of different EM-NCD available. Basic amenities, equipment, region, health facility type, managing authority, NCD diagnostic capacity, and range of HIV services were tested as predictor variables. In multivariate models, we found significant associations between EM-NCD availability and region, managing authority, facility type, and range of HIV services. For-profit facilities' EM-NCD counts were 98% higher than public facilities (p < .001). General hospitals and referral health centers had 98% (p = .004) and 105% (p = .002) higher counts compared to primary health centers. Facilities in the North and East had significantly lower counts than those in the capital region (p = 0.015; p = 0.003). Offering HIV care was associated with 35% lower EM-NCD counts (p = 0.006). Offering HIV counseling and testing was associated with 57% higher counts (p = 0.048). We identified multiple within-country disparities in availability of EM-NCD in Uganda. Our findings can be used to identify gaps and guide distribution of limited resources. While the primary purpose of SARA is to assess and monitor health services readiness, we show that it can also be an important resource for answering complex research and policy questions requiring multivariate analysis.

Customer service: the key to market differentiation.

Science.gov (United States)

Stahl, D A

1997-06-01

Fierce competition in the subacute care environment makes customer service orientation essential. Four steps help to achieve quality customer service are: (1) institute core values; (2) identify your customers; (3) understand human resources; and (4) establish an efficient system.

Reaching out to Ray: delivering palliative care services to a homeless person in Melbourne, Australia.

Science.gov (United States)

MacWilliams, Judy; Bramwell, Michael; Brown, Sally; O'Connor, Margaret

2014-02-01

Most terminally ill people express a preference for dying at home. Within established models of palliative care, achieving death at home is a particular challenge for homeless people. This paper describes a quality-improvement project undertaken by a community-based palliative care service in Melbourne, Australia, to understand homeless people's palliative care needs and the challenges that workers face. Six semi-structured interviews with workers in hospital and community-based settings were undertaken and a case study documented. The results were used to initiate discussion about how policy and protocols for the community-based palliative care service might serve this population more effectively. The findings confirmed that homeless people have complex psychosocial and medical needs. They may be periodically uncontactable or living in unsafe settings, experience isolation from social support networks, and have issues of compliance with treatment protocols exacerbated by mental health problems and/or substance abuse. Service providers had particular challenges in meeting the palliative care needs of homeless people. A flexible, compassionate, and coordinated response is required, and more work is needed to explore how the needs of this particular group can be met.

Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?

Science.gov (United States)

Yeboah-Antwi, Kojo; Hamer, Davidson H; Semrau, Katherine; Waltensperger, Karen Z; Snetro-Plewman, Gail; Kambikambi, Chilobe; Sakala, Amon; Filumba, Stephen; Sichamba, Bias; Marsh, David R

2014-10-27

Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0-59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns. We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming. We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored "high", twelve scored "low," and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour's walking distance were more likely to score high. It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.

Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

Directory of Open Access Journals (Sweden)

Rajmohan Panda

2013-03-01

Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

Request for information related to the resolution of generic issue 130, ''Essential service water system failures at multi-unit sites,'' pursuant to 10 CFR 50.54(f) - Generic Letter 91-13

International Nuclear Information System (INIS)

Partlow, J.G.

1993-01-01

The essential service water system (ESWS) is important in maintaining plant safety during power operation, shutdown, and accident conditions. As part of the Nuclear Regulatory Commission's (NRC) evaluation of loss of essential service water (LOSW), extensive analyses of this issue were performed at the Brookhaven National Laboratory (BNL). In addition, the NRC staff performed a regulatory analysis to evaluate the safety benefits and implementation costs associated with various equipment and the administrative-type improvements that were considered. These analyses assume that the flushing and flow testing provisions of Generic Letter (GL) 89-13, ''Service Water System Problems Affecting Safety-Related Equipment,'' will be applied to the crosstie lines as part of addressees' implementation of the resolution of GI-51, ''Improving the Reliability of Open-Cycle Service Water Systems'' (GL 89-13 and Supplement 1). On the basis of results of these evaluations of this generic safety issue, the NRC staff has concluded that the following administrative-type improvements would significantly enhance the availability of the ESWS in affected plants, and their implementation is warranted in view of the safety benefit to be derived and the cost of implementation: technical specification (TS) changes contained in Enclosure 1 to enhance the availability of the ESWS as applied to the design configuration of affected plants; and improvement of emergency procedures for a LOSW using existing design features, specifically: (a) operating and maintaining high-pressure injection (HPI) pump integrity in the event of loss of reactor coolant pump (RCP) seals as a result of ESWS failure, and (b) testing and manipulating the ESWS crosstie between the units during a LOSW accident

The rare and undiagnosed diseases diagnostic service - application of massively parallel sequencing in a state-wide clinical service.

Science.gov (United States)

Baynam, Gareth; Pachter, Nicholas; McKenzie, Fiona; Townshend, Sharon; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Broley, Stephanie; Schofield, Lyn; Verhoef, Hedwig; Walker, Caroline E; Molster, Caron; Blackwell, Jenefer M; Jamieson, Sarra; Tang, Dave; Lassmann, Timo; Mina, Kym; Beilby, John; Davis, Mark; Laing, Nigel; Murphy, Lesley; Weeramanthri, Tarun; Dawkins, Hugh; Goldblatt, Jack

2016-06-11

The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km(2). Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care. Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care. The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.