WorldWideScience

Sample records for deliver essential services

  1. Denying or Delivering Services?

    Science.gov (United States)

    Kirk, Stuart A.; Greenley, James R.

    1974-01-01

    Many who apply to agencies for service do not receive it. To make service more accessible, changing the behavior patterns of organizations may be as important as changing organizational structure. (Author)

  2. Moving People to Deliver Services

    OpenAIRE

    Mattoo, Aaditya; Carzaniga, Antonia

    2003-01-01

    The World Trade Organization (WTO) is today dealing with an issue that lies at the interface of two major challenges the world faces, trade liberalization and international migration. Greater freedom for the "temporary movement of individual service suppliers" is being negotiated under the General Agreement on Trade in Services (GATS). Conditions in many developed economies - ranging from ...

  3. Delay Efficient Method for Delivering IPTV Services

    Directory of Open Access Journals (Sweden)

    Sangamesh

    2014-07-01

    Full Text Available Internet Protocol Television (IPTV is a system through which Internet television services are delivered using the architecture and networking methods of the Internet Protocol Suite over a packet-switched network infrastructure, e.g., the Internet and broadband Internet access networks, instead of being delivered through traditional radio frequency broadcast, satellite signal, and cable television (CATV formats. IPTV provides mainly three services: live TV, catch up TV, and video on demand (VoD.This paper focuses on delivering the live TV services by exploiting the virtualised cloud architecture of the IPTV and statistical multiplexing. The VoD tasks are prescheduled so that there will be less Instant Channel Change (ICC delay. We select a proper scheduling algorithm for rescheduling the VoD tasks. We then implement the scheduling algorithm for preshifting the VoD tasks.

  4. ISES Experience in Delivering Space Weather Services

    Science.gov (United States)

    Boteler, David

    The International Space Environment Service has over eighty years experience in providing space weather services to meet a wide variety of user needs. This started with broadcast on December 1, 2008 from the Eiffel Tower about radio conditions. The delivery of information about ionospheric effects on high frequency (HF) radio propagation continue to be a major concern in many parts of the world. The movement into space brought requirements for a new set of space weather services, ranging from radiation dangers to man in space, damage to satellites and effects on satellite communication and navigation systems. On the ground magnetic survey, power system and pipeline operators require information about magnetic disturbances that can affect their operations. In the past these services have been delivered by individual Regional Warning Centres. However, the needs of new trans-national users are stimulating the development of new collaborative international space weather services.

  5. Delivering cervical cancer prevention services in low-resource settings.

    Science.gov (United States)

    Bradley, J; Barone, M; Mahé, C; Lewis, R; Luciani, S

    2005-05-01

    The goals of any cervical cancer prevention program should be threefold: to achieve high coverage of the population at risk, to screen women with an accurate test as part of high-quality services, and to ensure that women with positive test results are properly managed. This article focuses on the experiences of the Alliance for Cervical Cancer Prevention (ACCP) in delivery of screening and treatment services as part of cervical cancer prevention projects in Africa, Latin America, and Asia. Research and experience show that cervical cancer can be prevented when strategies and services are well planned and well managed and when attention is paid to program monitoring and evaluation. Coordination of program components, reduction of the number of visits, improvement of service quality, and flexibility in how services are delivered are all essential features of an effective service.

  6. 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...... 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...

  7. 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.

  8. 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...

  9. Delivering Collaborative Web Labs as a Service for Engineering Education

    OpenAIRE

    Bochicchio, Mario A.; Antonella Longo

    2012-01-01

    As Internet speed grows up and academic networks reach more users, engineering schools take interest in online laboratories as a mean to increase the spectrum of offered services and to reduce costs by sharing expensive lab equipments. In this perspective, online labs must comply both with the scientific and pedagogic requirements coming from the lab users (students, researchers, …) and with the requirements coming from the administrative and technical staff in charge to manage and deliver th...

  10. A service model for delivering care closer to home.

    Science.gov (United States)

    Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

    2011-04-01

    Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

  11. Engineering a plant community to deliver multiple ecosystem services.

    Science.gov (United States)

    Storkey, Jonathan; Döring, Thomas; Baddeley, John; Collins, Rosemary; Roderick, Stephen; Jones, Hannah; Watson, Christine

    2015-06-01

    The sustainable delivery of multiple ecosystem services requires the management of functionally diverse biological communities. In an agricultural context, an emphasis on food production has often led to a loss of biodiversity to the detriment of other ecosystem services such as the maintenance of soil health and pest regulation. In scenarios where multiple species can be grown together, it may be possible to better balance environmental and agronomic services through the targeted selection of companion species. We used the case study of legume-based cover crops to engineer a plant community that delivered the optimal balance of six ecosystem services: early productivity, regrowth following mowing, weed suppression, support of invertebrates, soil fertility building (measured as yield of following crop), and conservation of nutrients in the soil. An experimental species pool of 12 cultivated legume species was screened for a range of functional traits and ecosystem services at five sites across a geographical gradient in the United Kingdom. All possible species combinations were then analyzed, using a process-based model of plant competition, to identify the community that delivered the best balance of services at each site. In our system, low to intermediate levels of species richness (one to four species) that exploited functional contrasts in growth habit and phenology were identified as being optimal. The optimal solution was determined largely by the number of species and functional diversity represented by the starting species pool, emphasizing the importance of the initial selection of species for the screening experiments. The approach of using relationships between functional traits and ecosystem services to design multifunctional biological communities has the potential to inform the design of agricultural systems that better balance agronomic and environmental services and meet the current objective of European agricultural policy to maintain viable food

  12. ServiceDesk Plus 8.x essentials

    CERN Document Server

    Agarwal, Ankush

    2013-01-01

    This is a practical, hands-on guide that assists you in setting up and efficiently managing ITSM.ServiceDesk Plus 8.x Essentials is for IT helpdesk managers, administrators, and staff, serving as a compendium for service management concepts useful for them.

  13. 20 CFR 669.330 - How are services delivered to the customer?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are services delivered to the customer... Farmworker Jobs Program Customers and Available Program Services § 669.330 How are services delivered to the customer? To ensure that all services are focused on the customer's needs, services are provided through a...

  14. BUSINESS PROCESS RE-ENGINEERING: THE TECHNIQUE TO IMPROVE DELIVERING SPEED OF SERVICE INDUSTRY IN TANZANIA

    OpenAIRE

    Joseph Joseph Sungau; Philibert C. Ndunguru; Joseph Kimeme

    2013-01-01

    Problem statement: Delivering speed is very critical in today’s business environment. In most cases, service organizations and customers are sensitive to time spent at delivering or receiving a service. Therefore, service organizations must change in order to meet this challenge. Overtime, service organizations have worked hard to identify techniques that enhance service delivering speed for improved performance. Business process re-engineering is one of such techniques that improves busines...

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

    National Research Council Canada - National Science Library

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

    2015-01-01

    ...) 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...

  16. 45 CFR 1321.45 - Transfer between congregate and home-delivered nutrition service allotments.

    Science.gov (United States)

    2010-10-01

    ... nutrition service allotments. 1321.45 Section 1321.45 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION... Responsibilities § 1321.45 Transfer between congregate and home-delivered nutrition service allotments. (a) A...

  17. 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 ...

  18. Delivering Interactive Multimedia Services in Dynamic Pervasive Computing Environments

    NARCIS (Netherlands)

    Hesselman, C.; Cesar Garcia, P.S.; Vaishnavi, I.; Boussard, M.; Kernchen, R.; Meissner, S.; Spedalieri, A.; Sinfreu, A.; Raeck, C.

    2008-01-01

    This paper introduces a distributed system for next generation multimedia support in dynamically changing pervasive computing environments. The overall goal is to enhance the experience of mobile users by intelligently adapting the way a service is presented, in particular by adapting the way the us

  19. Research data services in academic libraries: the essential list

    OpenAIRE

    Doñate-Cifuentes, Ana; Peset, Fernanda; Ferrer-Sapena, Antonia; García, Consol

    2016-01-01

    Study about research data services in academic library settings (America and Europe). The aim of our work is to build a list with the essential data services for the small libraries with a little budget, and describe the European situation.

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

    CSIR Research Space (South Africa)

    Smith, AC

    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...

  1. TRENDS IN DELIVERING EDUCATIONAL SERVICES WITHIN THE KNOWLEDGE-BASED SOCIETY

    Directory of Open Access Journals (Sweden)

    ZAMFIR Andreea

    2010-12-01

    Full Text Available Education and implicitly educational services become extremely important in the context of the knowledge-based society. Therefore, this study investigates the trends in delivering services identified through research of literature, as well as based on personal experience in providing educational services. It has been concluded that information and communication technology creates a vast opportunity to improve the way of delivering educational services within the knowledge-based society, to develop (educate peoples awareness of the need for knowledge, as well as their skills for the knowledge-based society.

  2. 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…

  3. Non-Dam Alternatives for Delivering Water Services at Least Cost and Risk

    Directory of Open Access Journals (Sweden)

    Michael P. Totten

    2010-06-01

    We present evidence that a value-adding and risk-minimising water planning process can be achieved by shifting from the conventional focus on supply expansion to one that concentrates on efficiently delivering services at and near the point of use. The State of California has two decades of experience with this approach, demonstrating that market-based policy and regulatory innovations can unleash efficiency gains resulting in more utility water services and energy services delivered with less supply expansion at lower costs, while minimising climate-change risk, pollution and the social cost that accompany large infrastructural projects. Efficiency in delivered water services could be accomplished with investments in the range of US$10-25 billion annually, while obviating the need for spending hundreds of billions of dollars on more expensive hydropower and related infrastructural expansion projects. The shift to a regulatory system that encompasses cost-effective end-use efficiency improvements in delivering water and energy services could eliminate the need for an estimated half of all proposed dams globally, thus allowing for the maintenance of other ecosystem service benefits and offer the best hopes of meeting basic human needs for water at a more achievable level of investment.

  4. Essential Concepts in Modern Health Services

    Directory of Open Access Journals (Sweden)

    El Taguri A

    2008-01-01

    Full Text Available Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints.

  5. It Takes a Village to Deliver and Test Child and Family-Focused Services.

    Science.gov (United States)

    McKay, Mary M; Gopalan, Geetha; Franco, Lydia M; Kalogerogiannis, Kosta; Umpierre, Mari; Olshtain-Mann, Orly; Bannon, William; Elwyn, Laura; Goldstein, Leah

    2010-01-01

    OBJECTIVES: The purpose of this article is to highlight the benefits of collaboration in child focused mental health services research. METHOD: Three unique research projects are described. These projects address the mental health needs of vulnerable, urban, minority children and their families. In each one, service delivery was codesigned, interventions were co-delivered and a team of stakeholders collaboratively tested the impact of each one. RESULTS: The results indicate that the three interventions designed, delivered, and tested are associated with reductions in youth mental health symptoms. CONCLUSION: These interventions are feasible alternatives to traditional individualized outpatient treatment.

  6. 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…

  7. 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…

  8. 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...

  9. Teacher Preparation to Deliver Inclusive Services to Students with Disabilities: TQ Connection Issue Paper

    Science.gov (United States)

    Holdheide, Lynn R.; Reschly, Daniel J.

    2008-01-01

    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. Inclusion of students with disabilities in general education environments has a long history in special education law;…

  10. Key Questions in Career Counseling. Techniques To Deliver Effective Career Counseling Services.

    Science.gov (United States)

    Guerriero, Janice M.; Allen, Robert Glenn

    This book, which was written for people responsible for career advising, employee development, performance improvement, organizational planning, and outplacement, explains techniques to deliver effective career counseling services. The book begins with an introductory examination of the factors driving the need for effective career counseling…

  11. Key Questions in Career Counseling. Techniques To Deliver Effective Career Counseling Services.

    Science.gov (United States)

    Guerriero, Janice M.; Allen, Robert Glenn

    This book, which was written for people responsible for career advising, employee development, performance improvement, organizational planning, and outplacement, explains techniques to deliver effective career counseling services. The book begins with an introductory examination of the factors driving the need for effective career counseling…

  12. Partnering with women collectives for delivering essential women's nutrition interventions in tribal areas of eastern India: a scoping study.

    Science.gov (United States)

    Sethi, Vani; Bhanot, Arti; Bhalla, Surbhi; Bhattacharjee, Sourav; Daniel, Abner; Sharma, Deepika Mehrish; Gope, Rajkumar; Mebrahtu, Saba

    2017-05-22

    We examined the feasibility of engaging women collectives in delivering a package of women's nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach. Conducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women's nutrition services. A capacity assessment tool was developed to map all types of community collectives and assess their awareness, institutional and programme capacity as a funded stakeholder for delivering women's nutrition services/behaviour promotion. Limited targeting of pre-pregnancy period, delays in first trimester registration of pregnant women, and low micronutrient supplementation supply and awareness issues emerged as key bottlenecks in improving women's nutrition in these districts. Amongst the 18 different types of community collectives mapped, Self Help Groups (SHGs) and their federations (tier 2 and tier 3), with total membership of over 650,000, emerged as the most promising community collective due to their vast network, governance structure, bank linkage, and regular interface. Nearly 400,000 (or 20% of women) in these districts can be reached through the mapped 31,919 SHGs. SHGs with organisational readiness for receiving and managing grants for income generation and community development activities varied from 41 to 94% across study districts. Stakeholders perceived that SHGs federations managing grants from government and be engaged for nutrition promotion and service delivery and SHG weekly meetings can serve as community interface for discussing/resolving local issues impeding access to services. Women SHGs (with tier 2 and tier 3) can become direct

  13. 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. 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.

  15. 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.

  16. Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

    Science.gov (United States)

    Bassuk, Ellen L; Hanson, Justine; Greene, R Neil; Richard, Molly; Laudet, Alexandre

    2016-04-01

    This systematic review identifies, appraises, and summarizes the evidence on the effectiveness of peer-delivered recovery support services for people in recovery from alcohol and drug addiction. Nine studies met criteria for inclusion in the review. They were assessed for quality and outcomes including substance use and recovery-related factors. Despite significant methodological limitations found in the included studies, the body of evidence suggests salutary effects on participants. Current limitations and recommendations for future research are discussed.

  17. Exploring New Ways to Deliver Value to Healthcare Organizations: Algorithmic Testing, Data Integration, and Diagnostic E-consult Service.

    Science.gov (United States)

    Risin, Semyon A; Chang, Brian N; Welsh, Kerry J; Kidd, Laura R; Moreno, Vanessa; Chen, Lei; Tholpady, Ashok; Wahed, Amer; Nguyen, Nghia; Kott, Marylee; Hunter, Robert L

    2015-01-01

    As the USA Health Care System undergoes transformation and transitions to value-based models it is critical for laboratory medicine/clinical pathology physicians to explore opportunities and find new ways to deliver value, become an integral part of the healthcare team. This is also essential for ensuring financial health and stability of the profession when the payment paradigm changes from fee-for-service to fee-for-performance. About 5 years ago we started searching for ways to achieve this goal. Among other approaches, the search included addressing the laboratory work-ups for specialists' referrals in the HarrisHealth System, a major safety net health care organization serving mostly indigent and underserved population of Harris County, TX. We present here our experience in improving the efficiency of laboratory testing for the referral process and in building a prototype of a diagnostic e-consult service using rheumatologic diseases as a starting point. The service incorporates algorithmic testing, integration of clinical, laboratory and imaging data, issuing structured comprehensive consultation reports, incorporating all the relevant information, and maintaining personal contacts and an e-line of communications with the primary providers and referral center personnel. Ongoing survey of providers affords testimony of service value in terms of facilitating their work and increasing productivity. Analysis of the cost effectiveness and of other value indicators is currently underway. We also discuss our pioneering experience in building pathology residents and fellows training in integrated diagnostic consulting service.

  18. Exploring operational barriers encountered by community midwives when delivering services in two provinces of Pakistan: a qualitative study.

    Science.gov (United States)

    Ur Rehman, Shafiq; Ahmed, Jamil; Bahadur, Sher; Ferdoos, Amber; Shahab, Muhammad; Masud, Nazish

    2015-01-01

    to explore barriers experienced by community midwives (CMWs) when delivering services, from their own and their managers׳ perspectives, at provincial and district level in the context of organisational factors, and to determine other factors linked with the poor performance of CMWs in the delivery of maternal, neonatal and child health (MNCH)-related services within their communities. qualitative study design using in-depth interviews (IDIs) and focus group discussions (FGDs). two districts in Khyber Pakhtunkhwa and Punjab provinces in Pakistan. 41 participants were interviewed in depth; they included CMWs, lady health supervisors and managerial staff of the MNCH programme. participants were interviewed about administrative issues including financial and policy areas, training and deployment in the community, functioning in the community, and supervision and referral for emergency cases. CMWs reported financial constraints, training needs and difficulty with building relationships in the community. They required support in terms of logistics, essential supplies, and mechanisms for referral of complicated cases to higher-level health facilities. CMWs working in developing countries face many challenges; starting from their training, deployment in the field and delivery of services in their respective communities. Facilitating their work and efforts through improved programming of the CMW's services can overcome these challenges. the MNCH programme, provincial government and other stakeholders need to take ownership of the CMW programme and implement it comprehensively. Long-term adequate resource allocation is needed to sustain the programme so that improvements in maternal and child health are visible. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    CERN Document Server

    Buyya, Rajkumar; 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 some representative Cloud platforms especially those developed in industries along with our current work towards realising market-oriented resource allocation of Clouds by leveraging the 3rd generation Aneka enterprise Grid technology; reveals our early thoughts on interconnecting Clouds for dynamically creating an atmospheric computing environment along with pointers to future community research; and concludes with the need for convergence of competing IT paradigms for delivering our 21st century vision.

  20. Delivering healthcare services to children with cerebral palsy and their families: a narrative review.

    Science.gov (United States)

    Hayles, Emily; Jones, Anne; Harvey, Desley; Plummer, David; Ruston, Sally

    2015-05-01

    Children with cerebral palsy have complex healthcare needs and often require complex multidisciplinary care. It is important for clinicians to understand which approaches to healthcare service delivery for this population are supported in the literature and how these should be applied in clinical practice. This narrative review aims to identify and review the evidence for current approaches to healthcare service delivery for children with cerebral palsy. Databases were searched using key terms to identify relevant research articles and grey literature from December 2011 to September 2013. Search results were screened and sorted according to inclusion and exclusion criteria. Thirty-two documents were included for evaluation and their content was analysed thematically. Three current approaches to healthcare service delivery for children with cerebral palsy identified in this narrative review were family-centred care, the World Health Organisation's International Classification of Functioning, Disability and Health, and collaborative community-based primary care. However, healthcare services for children with cerebral palsy and their families are inconsistently delivered according to these approaches and the identified guidelines or standards of care for children with cerebral palsy have limited incorporation of these approaches. Future research is required to investigate how these approaches to healthcare service delivery can be integrated into clinical practices to enable clinicians to improve services for this population.

  1. 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 o

  2. 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.

  3. Mobile Web 2.0 Developing and Delivering Services to Mobile Devices

    CERN Document Server

    Ahson, Syed A

    2010-01-01

    From basic concepts to research grade material, Mobile Web 2.0: Developing and Delivering Services to Mobile Devices provides complete and up-to-date coverage of the range of technical topics related to Mobile Web 2.0. It brings together the work of 51 pioneering experts from around the world who identify the major challenges in Mobile Web 2.0 applications and provide authoritative insight into many of their own innovations and advances in the field. To help you address contemporary challenges, the text details a conceptual framework that provides modeling facilities for context-aware, multi-c

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. INFORMATION AND COMMUNICATION TECHNOLOGIES TO DELIVER FINANCIAL SERVICES FOR THE LOW-INCOME POPULATION: CORRESPONDENT BANKING AT BANCO LEMON

    Directory of Open Access Journals (Sweden)

    Cesar Akira Yokomizo

    2010-12-01

    Full Text Available Brazilian banks have developed innovative initiatives to deliver financial services for the lowincome population through correspondent banking (CB. Banco Lemon is such an interesting case to be studied because it has implemented a business model based exclusively on CB outlets and its focus was on low-income clients. This paper describes Banco Lemon’s adoption process of the CB technology to deliver financial services for the low-income population, promoting a historical description of the bank’s activities, since its creation and up to the year 2009. Eventually, this paper concludes that bill payment initiatives were successful while credit initiatives led to unexpressive outcomes.

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

    Directory of Open Access Journals (Sweden)

    Charikleia Karakosta, Charalampos Pappas, John Psarras

    2011-09-01

    Full Text Available 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 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.

  12. Systematic Review and Narrative Synthesis of the Effectiveness of Contraceptive Service Interventions for Young People, Delivered in Health Care Settings

    Science.gov (United States)

    Blank, Lindsay; Baxter, Susan K.; Payne, Nick; Guillaume, Louise R.; Squires, Hazel

    2012-01-01

    A systematic review and narrative synthesis to determine the effectiveness of contraception service interventions for young people delivered in health care premises was undertaken. We searched 12 key health and medical databases, reference lists of included papers and systematic reviews and cited reference searches on included articles. All…

  13. DELIVERING GIS TRAINING USING GEOSPATIAL WEB SERVICE – A CASE STUDY OF LANDSLIDE RISK MAPPING IN HONG KONG

    OpenAIRE

    2015-01-01

    This paper sketches a prototype of web-based landslide prediction service for delivering web-based training. The results show that the proposed landslide GWSC model can effectively compute the landslide risk level in different location, and consequently allow for early-warning, which starts with the sensor in the field and ending with user-opitmized warning messages and action advice.

  14. Delivering high-quality family planning services in crisis-affected settings II: results.

    Science.gov (United States)

    Curry, Dora Ward; Rattan, Jesse; Huang, Shuyuan; Noznesky, Elizabeth

    2015-02-04

    An estimated 43 million women of reproductive age experienced the effects of conflict in 2012. Already vulnerable from the insecurity of the emergency, women must also face the continuing risk of unwanted pregnancy but often are unable to obtain family planning services. The ongoing Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) initiative, led by CARE, has provided contraceptives, including long-acting reversible contraceptives (LARCs), to refugees, internally displaced persons, and conflict-affected resident populations in Chad, the Democratic Republic of the Congo (DRC), Djibouti, Mali, and Pakistan. The project works through the Ministry of Health in 4 key areas: (1) competency-based training, (2) supply chain management, (3) systematic supervision, and (4) community mobilization to raise awareness and shift norms related to family planning. This article presents data on program results from July 2011 to December 2013 from the 5 countries. Project staff summarized monthly data from client registers using hard-copy forms and recorded the data electronically in Microsoft Excel for compilation and analysis. The initiative reached 52,616 new users of modern contraceptive methods across the 5 countries, ranging from 575 in Djibouti to 21,191 in Chad. LARCs have predominated overall, representing 61% of new modern method users. The percentage of new users choosing LARCs varied by country: 78% in the DRC, 72% in Chad, and 51% in Mali, but only 29% in Pakistan. In Djibouti, those methods were not offered in the country through SAFPAC during the period discussed here. In Chad, the DRC, and Mali, implants have been the most popular LARC method, while in Pakistan the IUD has been more popular. Use of IUDs, however, has comprised a larger share of the method mix over time in all 4 of these countries. These results to date suggest that it is feasible to work with the public sector in fragile, crisis-affected states to deliver a wide range of quality

  15. Social and Ecological Drivers of the Economic Value of Pollination Services Delivered to Coffee in Central Uganda

    Directory of Open Access Journals (Sweden)

    Bin Mushambanyi Théodore Munyuli

    2014-01-01

    Full Text Available On-farm pollination experiments were conducted in 30 different small-scale coffee fields to determine monetary value attributable to pollination services in coffee production and to identify the degree of influences of various socio-ecological drivers in Uganda. Ecological-economic approaches were applied to determine the economic value of pollinating services. Economic value of bees increased significantly with increase in coffee farm size, bee diversity, and cover of seminatural habitats. The value of bees declined sharply (P<0.05 with forest distance and cultivation intensity. Economic values of pollinating services associated with coffee fields established in regions with low intensity were found to be high. Organically managed small-scale coffee fields were 2 times more profitable than commercially managed farms. The annual value of pollinating services delivered by wild bees oscillated between US$67.18 and US$1431.36. Central Uganda produces in total 0.401 million tons of coffee beans for an approximate economic value of US$214 million from which US$149.42 million are attributable to pollination services. Policy makers should strengthen environmental/agricultural extension service systems to better serve farmers. Farmers are recommended to protect/increase the cover of natural and semi-natural habitats in the vicinity of their coffee fields to receive high economic benefits from pollinating services delivered by bees.

  16. Behavioral health providers' perspectives of delivering behavioral health services in primary care: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Beehler Gregory P

    2012-09-01

    Full Text Available Abstract Background Co-located, collaborative care (CCC is one component of VA’s model of Integrated Primary Care that embeds behavioral health providers (BHPs into primary care clinics to treat commonly occurring mental health concerns among Veterans. Key features of the CCC model include time-limited, brief treatments (up to 6 encounters of 30 minutes each and emphasis on multi-dimensional functional assessment. Although CCC is a mandated model of care, the barriers and facilitators to implementing this approach as identified from the perspective of BHPs have not been previously identified. Methods This secondary data analysis used interview data captured as part of a quality improvement project in 2008. Fourteen BHPs (48% of providers in a regional VA network agreed to participate in a 30-minute, semi-structured phone interview. The interview included questions about their perceived role as a CCC provider, depiction of usual practice styles and behaviors, and perceptions of typical barriers and facilitators to providing behavioral healthcare to Veterans in CCC. Interviews were transcribed verbatim into a text database and analyzed using grounded theory. Results Six main categories emerged from the analysis: (a Working in the VA Context, (b Managing Access to Care on the Front Line, (c Assessing a Care Trajectory, (d Developing a Local Integrated Model, (e Working in Collaborative Teams, and (f Being a Behavioral Health Generalist. These categories pointed to system, clinic, and provider level factors that impacted BHP’s role and ability to implement CCC. Across categories, participants identified ways in which they provided Veteran-centered care within variable environments. Conclusions This study provided a contextualized account of the experiences of BHP’s in CCC. Results suggest that these providers play a multifaceted role in delivering clinical services to Veterans while also acting as an interdependent component of the larger VA

  17. Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals.

    Science.gov (United States)

    Michie, Lucy; Cameron, Sharon T; Glasier, Anna

    2013-10-01

    Abortion services should provide high-quality contraceptive care. The community sexual and reproductive health (SRH) services may be well placed to deliver more abortion care in the UK. We wished to determine the views of health professionals working in SRH regarding their attitudes towards providing more abortion services and also the views of staff within one community SRH centre in Scotland where a service providing early medical abortion (EMA) was due to commence. An anonymous questionnaire distributed to attendees at a UK SRH scientific meeting collected data on demographics, current practice of and attitude to abortion, and views on delivery of abortion services. An internet questionnaire distributed by e-mail to staff at a community SRH clinic in Scotland sought demographics, views regarding the planned introduction of an EMA service and willingness to participate in it. 165 questionnaires were completed out of 200 distributed at the scientific meeting (an 82% response rate). 128 (78%) respondents felt that abortion services were suited to community clinics and 115 (70%) stated that they would be willing to participate in them. 62/90 (69%) staff from the SRH clinic responded to the internet questionnaire. 44 (71%) felt the plan to introduce abortion services was a natural extension to services already offered and the same number would be willing to be involved in such a service. There is clear support amongst health professionals in community SRH in the UK towards greater participation in the provision of abortion care services.

  18. 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.

  19. 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 ex

  20. Essential case management services for young children in foster care.

    Science.gov (United States)

    Zlotnick, C; Kronstadt, D; Klee, L

    1999-10-01

    A growing number of children in the United States are being placed into foster care. Past studies indicate that effective case manager interventions have helped foster families with a variety of different problems. This study enrolled a randomly selected sample of 130 children under age four who had been newly placed into foster care. The purpose of this study was to identify the services needed by foster care families and determine which services require the most case manager effort. Consistent with other research, many foster care children in this study exhibited developmental, medical and psychosocial concerns. Nevertheless, we found that it was services aimed at the foster care parents, rather than the foster care children, that required the most labor-intensive case management services.

  1. ASSESSING THE RISKS IN THE PRIVATE PROVISION OF ESSENTIAL SERVICES

    OpenAIRE

    Kessler, Tim; Nancy ALEXANDER

    2004-01-01

    The paper argues that private provision of water and electricity services requires a higher burden of proof than policies reforming existing state services. These utilities are public goods that must be universally affordable and accessible in order to achieve the Millennium Development Goals. In addition to considering productivity, policy-makers should assess social and "off-budget" fiscal impacts, as well as the feasibility of implementation in weak institutional environments. Benefits of ...

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

    Science.gov (United States)

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

    2016-01-01

    Background 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. Methods 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. Results 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

  3. 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.

  4. 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.

  5. Students Delivering Health Care to a Vulnerable Appalachian Population through Interprofessional Service-Learning

    Science.gov (United States)

    Lee, Michelle L.; Hayes, Patricia A.; McConnell, Peggy; Henry, Robin M.

    2013-01-01

    Interprofessional student service-learning experiences are integrated into the preventive care of older adult residents of public housing in Appalachia. Receiving a Health Resources and Services Administration grant provided the College of Nursing at East Tennessee State University the opportunity to expand interprofessional clinical experiences…

  6. The Psychology of Delivering a Psychological Service: Self-Organised Learning as a Model for Consultation

    Science.gov (United States)

    Clarke, Steve; Jenner, Simon

    2006-01-01

    The article describes how one Educational Psychology Service in the UK developed a service delivery based on self-organised learning (SOL). This model is linked to the paradigms and discourses within which educational psychology and special educational needs work. The work described here is dedicated to the memory of Brian Roberts, academic, close…

  7. Non-physician delivered intravitreal injection service is feasible and safe

    DEFF Research Database (Denmark)

    Rasul, Asrin; Subhi, Yousif; Sørensen, Torben Lykke

    2016-01-01

    retinopathy. We systematically reviewed the existing literature to provide an overview of the experiences in this transformational process. METHODS: 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. RESULTS: Five studies were included with a total of 31,303 injections having been performed...

  8. 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.

  9. Systematic review and narrative synthesis of the effectiveness of contraceptive service interventions for young people, delivered in educational settings.

    Science.gov (United States)

    Blank, Lindsay; Baxter, Susan K; Payne, Nick; Guillaume, Louise R; Pilgrim, Hazel

    2010-12-01

    This review was undertaken to determine the effectiveness of contraception service interventions for young people that were delivered in educational settings. We conducted a systematic review and narrative synthesis. Interventions were included where they were delivered in educational institutions, including schools, colleges, and pupil referral units. Young people aged 19 and under. Studies of wider age groups were included if the majority of participants were aged under 19 years. We included interventions which consisted of contraceptive service provision, and also interventions to encourage young people to use existing contraceptive services. The main outcome measures used in the studies were: rate of teenage pregnancy, rate of contraceptive use, and sexual behavior. Many outcome measures were self reported. Twenty-nine papers were included which reported on interventions to prevent adolescent pregnancy (and repeat pregnancy), school-based health centers, contraceptive use in college students, and multicomponent interventions. Intensive case management intervention conducted by a culturally matched school-based social worker (along with other components including peer education) were shown to be effective in preventing repeat adolescent pregnancy, at least for the duration of the intervention. Also, school-based health centers appear to be most effective when contraception provision is made available on site. The evidence from these papers is limited, in terms of both quality and quantity, along with consistency of findings, but some recommendations in relation to effective interventions can be made. Copyright © 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  10. Identifying future models for delivering genetic services: a nominal group study in primary care

    Directory of Open Access Journals (Sweden)

    Davies Peter

    2005-04-01

    Full Text Available Background To enable primary care medical practitioners to generate a range of possible service delivery models for genetic counselling services and critically assess their suitability. Methods Modified nominal group technique using in primary care professional development workshops. Results 37 general practitioners in Wales, United Kingdom too part in the nominal group process. The practitioners who attended did not believe current systems were sufficient to meet anticipated demand for genetic services. A wide range of different service models was proposed, although no single option emerged as a clear preference. No argument was put forward for genetic assessment and counselling being central to family practice, neither was there a voice for the view that the family doctor should become skilled at advising patients about predictive genetic testing and be able to counsel patients about the wider implications of genetic testing for patients and their family members, even for areas such as common cancers. Nevertheless, all the preferred models put a high priority on providing the service in the community, and often co-located in primary care, by clinicians who had developed expertise. Conclusion There is a need for a wider debate about how healthcare systems address individual concerns about genetic concerns and risk, especially given the increasing commercial marketing of genetic tests.

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

    Science.gov (United States)

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

    2015-06-01

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

  12. Cancer patients' questions and concerns expressed in an online nurse-delivered mail service: preliminary results.

    Science.gov (United States)

    Andersen, Trine; Ruland, Cornelia M

    2009-01-01

    Internet-based online patient-nurse communication (OPNC) services can constitute an important opportunity to support patients to manage their illness between treatment and rehabilitation while being at home. We explored the content of messages sent by prostate and breast cancer patients to an OPNC service to identify symptoms, problems, concerns and information needs expressed in these messages. Using qualitative content analyses we examined 276 messages sent from 38 breast and 22 prostate cancer patients during 15 months. Two main themes emerged: Concerns about physical symptoms and treatment side effects; and worries and questions about treatment and follow up. Analyses showed that cancer patients have many serious unanswered questions and concerns that can create considerable uncertainty and anxiety. An OPNC service can to a great extent meet patients' need for advice and information and thus be an important health care supplement that can improve quality of care.

  13. Cloud based intelligent system for delivering health care as a service.

    Science.gov (United States)

    Kaur, Pankaj Deep; Chana, Inderveer

    2014-01-01

    The promising potential of cloud computing and its convergence with technologies such as mobile computing, wireless networks, sensor technologies allows for creation and delivery of newer type of cloud services. In this paper, we advocate the use of cloud computing for the creation and management of cloud based health care services. As a representative case study, we design a Cloud Based Intelligent Health Care Service (CBIHCS) that performs real time monitoring of user health data for diagnosis of chronic illness such as diabetes. Advance body sensor components are utilized to gather user specific health data and store in cloud based storage repositories for subsequent analysis and classification. In addition, infrastructure level mechanisms are proposed to provide dynamic resource elasticity for CBIHCS. Experimental results demonstrate that classification accuracy of 92.59% is achieved with our prototype system and the predicted patterns of CPU usage offer better opportunities for adaptive resource elasticity.

  14. 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.

  15. Using ecosystem services in community-based landscape planning: science is not ready to deliver

    NARCIS (Netherlands)

    Opdam, P.F.M.

    2013-01-01

    Community-based landscape governance is considered as conditional to achieving sustainable landscape. I consider landscape governance from the point of view of adapting landscapes to create value out of ecosystem services, using the social–ecological system model as a theoretical framework. I advoca

  16. Distance Career Counseling: A Technology-Assisted Model for Delivering Career Counseling Services.

    Science.gov (United States)

    Djadali, Yas; Malone, James F.

    The purpose of the present article is to demonstrate the need for distance career counseling services, and to present an evolving counseling model that combines the best practices of face-to-face career counseling with technology. The article begins by tracing the historical development of distance career counseling models, and then illustrates…

  17. 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…

  18. 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

  19. The Use of Telecommunication to Deliver Services to Rural and Urban Vocational Rehabilitation Clients

    Science.gov (United States)

    Ipsen, Catherine; Rigles, Bethany; Arnold, Nancy; Seekins, Tom

    2012-01-01

    Telecommunication offers a cost-saving alternative to face-to-face vocational rehabilitation (VR) service delivery, yet little is known about the current use. This article describes findings from an exploratory survey of 1,187 counselors, representing 13 VR agencies across the United States. The online survey explored agency, counselor, and client…

  20. The Use of Telecommunication to Deliver Services to Rural and Urban Vocational Rehabilitation Clients

    Science.gov (United States)

    Ipsen, Catherine; Rigles, Bethany; Arnold, Nancy; Seekins, Tom

    2012-01-01

    Telecommunication offers a cost-saving alternative to face-to-face vocational rehabilitation (VR) service delivery, yet little is known about the current use. This article describes findings from an exploratory survey of 1,187 counselors, representing 13 VR agencies across the United States. The online survey explored agency, counselor, and client…

  1. Delivering Clinical Services to Vietnamese Americans: Implications for Speech-Language Pathologists.

    Science.gov (United States)

    Saenz, Terry Irvine; Huer, Mary Blake; Doan, Julie Huong Diem; Heise, Melinda; Fulford, Lana

    2001-01-01

    This article summarizes what is known about: (1) Vietnamese history and immigration patterns; (2) probable demographics of consumers within the Vietnamese American community who would need speech-language services; (3) the culture and structure of the Vietnamese-American family; and (4) traditional Vietnamese medical practices. Six principles for…

  2. Comparative performance of seven long-running telemedicine networks delivering humanitarian services.

    Science.gov (United States)

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

    2012-09-01

    Seven long-running telemedicine networks were surveyed. The networks provided humanitarian services (clinical and educational) in developing countries, and had been in operation for periods of 5-15 years. The number of experts serving each network ranged from 15 to 513. The smallest network had a total of 10 requesters and the largest one had more than 500 requesters. The networks operated in nearly 60 countries. The seven networks managed a total of 1857 cases in 2011, i.e. an average of 265 cases per year per network. There was a significant growth in total activity, amounting to 100.3 cases per year during the 15 year study period. In 2011, network activity was 50-700 teleconsultations per network. There were clear differences in the patterns of activity, with some networks managing an increasing caseload, and others managing a slowly reducing caseload. The seven networks had published a total of 44 papers listed in Medline which summarized the evidence resulting from the delivery of services by telemedicine. There was a dearth of information about clinical and cost-effectiveness. Nevertheless, the services were widely appreciated by referring doctors, considered to be clinically useful, and there were indications that clinical outcomes for telemedicine patients were often improved. Despite a lack of formal evidence, the present study suggests that telemedicine can provide clinically useful services in developing countries.

  3. Tobacco industry manipulation messages in anti-smoking public service announcements: the effect of explicitly versus implicitly delivering messages.

    Science.gov (United States)

    Shadel, William G; Fryer, Craig S; Tharp-Taylor, Shannah

    2010-05-01

    Message content in anti-smoking public service announcements (PSAs) can be delivered explicitly (directly with concrete statements) or implicitly (indirectly via metaphor), and the method of delivery may affect the efficacy of those PSAs. The purpose of this study was to conduct an initial test of this idea using tobacco industry manipulation PSAs in adolescents. A 2 (age: 11-14 years old; 15-17 years old)x2 (message delivery: implicit, explicit) mixed model design was used. There was a significant main effect of message delivery: Tobacco industry manipulation PSAs that delivered their messages explicitly were associated with stronger levels of smoking resistance self-efficacy compared to tobacco industry manipulation PSAs that delivered their messages implicitly. No significant main effects of age were found nor were any interactions between age and message delivery. These results suggest that message delivery factors should be taken into account when designing anti-smoking PSAs. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  4. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: Utility, technical performance and service provider perspective

    Directory of Open Access Journals (Sweden)

    Breen Patricia

    2010-09-01

    Full Text Available Abstract Background Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions. Methods A teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted. Results Over the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG. Conclusion Observations suggest that when traditional organisational boundaries are crossed challenges associated with the

  5. Delivering health information services and technologies to urban community health centers: the Chicago AIDS Outreach Project.

    Science.gov (United States)

    Martin, E R; McDaniels, C; Crespo, J; Lanier, D

    1997-10-01

    Health professionals cannot address public health issues effectively unless they have immediate access to current biomedical information. This paper reports on one mode of access, the Chicago AIDS Outreach Project, which was supported by the National Library of Medicine through outreach awards in 1995 and 1996. The three-year project is an effort to link the programs and services of the University of Illinois at Chicago Library of the Health Sciences and the Midwest AIDS Training and Education Center with the clinic services of community-based organizations in Chicago. The project was designed to provide electronic access to AIDS-related information for AIDS patients, the affected community, and their care givers. The project also provided Internet access and training and continued access to library resources. The successful initiative suggests a working model for outreach to health professionals in an urban setting.

  6. ENRICHED ETOM FRAMEWORK IN SERVICE DELIVER OPERATION THROUGH ALIGNMENT WITH SOME OF COBIT5 STRATEGIC OBJECTIVES

    OpenAIRE

    Faride Latifi; Ramin Nasiri; Mehran Mohsenzadeh

    2014-01-01

    eTOM is a standard framework that is defined in telecommunication business processes area. It contains of three phases, 1. Operations 2. Infrastructure, Strategy and Product 3. Enterprise Management. The goal of this paper is to enrich the processes in operations phase included of service assurance and fulfillment and to increase customer retention and loyalty and SLA fulfillment. For this purpose some processes in DSS domain of COBIT5 is introduced and mapped in different area of eTOM operat...

  7. Economic analysis of delivering primary health care services through community health workers in 3 North Indian states.

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    Full Text Available We assessed overall annual and unit cost of delivering package of services and specific services at sub-centre level by CHWs and cost effectiveness of Government of India's policy of introducing a second auxiliary nurse midwife (ANM at the sub-centre compared to scenario of single ANM sub-centre.We undertook an economic costing of health services delivered by CHWs, from a health system perspective. Bottom-up costing method was used to collect data on resources spent in 50 randomly selected sub-centres selected from 4 districts. Mean unit cost along with its 95% confidence intervals were estimated using bootstrap method. Multiple linear regression model was used to standardize cost and assess its determinants.Annually it costs INR 1.03 million (USD 19,381, or INR 187 (USD 3.5 per capita per year, to provide a package of preventive, curative and promotive services through community health workers. Unit costs for antenatal care, postnatal care, DOTS treatment and immunization were INR 525 (USD 10 per full ANC care, INR 767 (USD 14 per PNC case registered, INR 974 (USD 18 per DOTS treatment completed and INR 97 (USD 1.8 per child immunized in routine immunization respectively. A 10% increase in human resource costs results in 6% rise in per capita cost. Similarly, 10% increment in the ANC case registered per provider through-put results in a decline in unit cost ranging from 2% in the event of current capacity utilization to 3% reduction in case of full capacity utilization. Incremental cost of introducing 2nd ANM at sub-centre level per unit percent increase ANC coverage was INR 23,058 (USD 432.Our estimates would be useful in undertaking full economic evaluations or equity analysis of CHW programs. Government of India's policy of hiring 2nd ANM at sub-centre level is very cost effective from Indian health system perspective.

  8. Delivering Mental Health Services to OEF/OIF Veterans: A VHA Qualitative Study.

    Science.gov (United States)

    Signoracci, Gina M; Bahraini, Nazanin H; Matarazzo, Bridget B; Olson-Madden, Jennifer H; Brenner, Lisa A

    2014-09-01

    Veterans Health Administration (VHA) mental health (MH) professionals are providing care to increasing numbers of veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). This study aimed to describe MH clinicians' views of OEF/OIF veteran needs and how providers meet those needs within a large system of care. Qualitative research methodology, specifically qualitative description, was used to explore VHA MH clinicians' experiences providing MH services to OEF/OIF veterans. Thirteen VA MH providers participated in semistructured interviews, which included questions regarding the following areas: psychiatric needs of OEF/OIF veterans; collaboration and referral; needs and resources; and the personal/professional impact of providing services to this cohort. Themes emerged which highlighted complex challenges faced by OEF/OIF veterans, barriers associated with matching the unique needs of these veterans with existing treatments, and the challenges and rewards associated with providing care to members of this population. Capturing provider perspectives within MH services suggest potential areas for innovation aimed at providing patient-centered care to this cohort of veterans. Results may also inform future work aimed at meeting the needs of both OEF/OIF veterans and MH providers. © The Author(s) 2014.

  9. 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.

  10. Estimated expenditures for essential public health services--selected states, fiscal year 1995.

    Science.gov (United States)

    1997-02-21

    Essential public health services are activities that public health departments and other partners undertake to protect and ensure the health of the public. To characterize expenditures for those services and to distinguish within them expenditures for personal health-care services from community-based health services directed toward populations, the Public Health Service (PHS) and the Public Health Foundation surveyed senior health officials in eight states (Arizona, Iowa, Louisiana, New York, Oregon, Rhode Island, Texas and Washington [combined 1995 population: 57.8 million]). This report summarizes the results of that survey, which indicate that spending on community-based health services is a small proportion of spending on essential services and an even smaller proportion of total health-care expenditures.

  11. Using community partners to deliver low-cost and effective emergency management and business continuity services.

    Science.gov (United States)

    Thomas, Joan; Roggiero, Jean Paul; Silva, Brian

    2010-11-01

    Small to medium-sized organisations enhance their business mission as well as their communities by continuing to offer services in extreme circumstances. Developing emergency preparedness and business continuity plans that are cost-effective, comprehensive and operational for small to medium-sized organisations with limited resources requires a consistent, supportive, hands-on approach over time with professionals to create appropriate and sustainable strategies. Using a unique, multi-layered and applied approach to emergency preparedness training, organisations have successfully created plans that are effective and sustainable.

  12. Using e-health applications to deliver new mental health services.

    Science.gov (United States)

    Christensen, Helen; Hickie, Ian B

    2010-06-07

    Traditional clinic-based service delivery systems remain inaccessible to many Australians with mental health problems. If we are to substantially reduce the burden of mental illness, we need to develop more accessible, empowering and sustainable models of mental health care. E-health technologies have specific efficiencies and advantages in the domains of health promotion, prevention, early intervention and prolonged treatment. It is timely to use the best features of these technologies to start to build a more responsive and efficient mental health care system.

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

    Directory of Open Access Journals (Sweden)

    Virginia Macdonald

    2017-07-01

    Conclusions: 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. However, while community-based and lay provider testing are effective and affordable, they are not implemented to scale. Furthermore regulatory barriers to legitimizing lay and peer providers as part of healthcare delivery systems need to be overcome in many settings. WHO recommendations on task shifting and decentralization of ART treatment and care are often not applied to KP settings.

  14. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective.

    LENUS (Irish Health Repository)

    Breen, Patricia

    2010-01-01

    Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions.

  15. University Branding. An Analysis of University Services Delivered via the Internet

    Directory of Open Access Journals (Sweden)

    Catalin Vrabie

    2015-05-01

    Full Text Available The purpose of this article is to assess how the information can be more easily disseminated on the Web sites of higher education institutions. Marshall McLuhan saw the language developed in a book as a proof in favor of knowledge. “When information comes in contact with another information, the results are sensational and effective”. In terms of talent and how fast they adapt, the youth of today, Generation Net as Don Tapscott calls them, have the power to transform the present. They come up with new approaches on collaboration, sharing information and innovation in business and governance from around the world. There is strong evidence that organizations that embrace these new ways of working are more efficient registering a growth and greater success. We selected for this purpose a number of foreign students on master programs (based on the experience they have already from two prestigious universities Hacettepe in Ankara, Turkey and NUPSPA in Bucharest, Romania, and based on some questions and interviews we set up a strategy for how to improve quality management for university - Web services for students based on their perceptions. We started with the assumption that better e-integration, infrastructure, and Web-services will go to better quality management and from here to better results on intake of international students (with more successful students, research and education of high quality - assuming that internationalization yield increase higher education quality, public benefit, better competition, better access to funds etc. The SWOT analysis will be the centerpiece of our discussions with the students from those two groups – one from Hacettepe and the second one from NUPSPA.

  16. Quality of health care: the responsibility of health care professionals in delivering high quality services.

    Science.gov (United States)

    Giangrande, A

    1998-11-01

    According to a recent definition, quality of care consists of the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge; a definition that introduces both requirements of outcomes and the appropriateness of the process used. Clearly many different figures are interested in quality assessment initiatives in the health care field and these include patients, administrators and doctors each having different perspective. Doctors obviously pay greater attention to technical quality and results, giving greater emphasis to the health of the individual patient, tending to give priority to technical excellence and interaction between patient and doctor. Although the perspective of health care professionals is widely acknowledged to be important and useful, other perspectives on quality have been emphasised in recent years. The most important of these is the recognition that care must be responsive to the preferences and values of the consumers of health care services. In complete harmony with one's own professional commitment, the attention to the perspectives of patients must give physician the chance to identify methods of measuring and verifying quality which take account of the expectations of the many groups with an interest in improving the functioning of the health system. A global approach in the health field is needed the more specialization advances. The quality of medicine lies in its capacity to integrate what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator.

  17. CHARACTERISTICS OF MARKETING IN PROFESIONAL SERVICES DELIVERED BY THE HEALTHCARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Carmen Gabriela SECARA

    2013-09-01

    Full Text Available Equilibrium position of a competitive market must necessarily be an „pareto optimal”: with every transaction made, people get rich without anyone else to deplete. If there is no increasing income - economies of scale or proportion - in the production system, then each „pareto optimal” condition is a competitive equilibrium position, depending on the distribution of purchasing power. Where there are concerns about income distribution and hence of goods and services between individuals, the state can interfere by changing this algorithm of purchasing power distribution, within the economy. On the other hand, if some individuals are reluctant to risk (theory contradicted by the existence of gambling, then providing insurances is incumbent on mutually beneficial exchanges, because people are willing to pay for the convenience of not having to worry about the future events that may affect their existence. Another problem of the insurance field is that of ”moral hazard": since signing an insurance contract, the insured is no longer trying as hard to prevent accidents against which they have been insured, therefore the likelihood of occurrence for such accidents increases.

  18. Delivering good service: personal resources, job satisfaction and nurses' 'customer' (patient) orientation.

    Science.gov (United States)

    Gountas, Sandra; Gountas, John; Soutar, Geoffrey; Mavondo, Felix

    2014-07-01

    To explore the complex relationships between nurses' personal resources, job satisfaction and 'customer' (patient) orientation. Previous research has shown that nursing is highly intensive, emotionally charged work, which affects nurses' job performance and their customer orientation as well as patient or 'customer' satisfaction. This study contributes to the literature by examining how nurses' personal resources relate to their personal satisfaction and customer orientation and the relationships between them. Specifically, this study explores the effects of two facets of emotional labour (deep acting and surface acting), empathic concern, self-efficacy and emotional exhaustion on personal job satisfaction and customer orientation. We also test the moderating effects of inauthenticity and emotional contagion. A quantitative survey. Data were collected through a self-completion questionnaire administered to a sample of 159 Australian nurses, in a public teaching hospital, in 2010. The data were analysed using Partial Least Square analysis. Partial Least Square analysis indicates that the final model is a good fit to the data (Goodness of Fit = 0.51). Deep acting and surface acting have different effects (positive and negative) on job satisfaction and 'customer' orientation, self-efficacy has a positive effect on both and emotional exhaustion has a positive effect on customer orientation and a negative effect on job satisfaction. The moderating effects of emotional contagion and empathic concern, in the final model, are discussed. Understanding the complex interactions between personal resources, job satisfaction and customer orientation helps to increase service providers' (nurses in this study) personal satisfaction and 'customer' orientation particularly in difficult contexts. © 2013 John Wiley & Sons Ltd.

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. Measuring what matters in delivering services to remote-dwelling Indigenous mothers and infants in the Northern Territory, Australia.

    Science.gov (United States)

    Steenkamp, Malinda; Rumbold, Alice R; Kildea, Sue; Bar-Zeev, Sarah J; Kruske, Sue; Dunbar, Terry; Barclay, Lesley

    2012-08-01

    In the Northern Territory, 64% of Indigenous births are to remote-dwelling mothers. Delivering high-quality health care in remote areas is challenging, but service improvements, informed by participative action research, are under way. Evaluation of these initiatives requires appropriate indicators. Few of the many existing maternal and infant health indicators are specifically framed for the remote context or exemplify an Indigenous consumer perspective. We aimed to identify an indicator framework with appropriate indicators to demonstrate improvements in health outcomes, determinants of health and health system performance for remote-dwelling mothers and infants from pregnancy to first birthday. We reviewed existing indicators; invited input from experts; investigated existing administrative data collections and examined findings from a record audit, ethnographic work and the evaluation of the Darwin Midwifery Group Practice. Northern Territory. About 660 potentially relevant indicators were identified. We adapted the Aboriginal and Torres Strait Islander Health Performance Framework and populated the resulting framework with chosen indicators. We chose the indicators best able to monitor the impact of changes to remote service delivery by eliminating duplicated or irrelevant indicators using expert opinion, triangulating data and identifying key issues for remote maternal and infant health service improvements. We propose 31 indicators to monitor service delivery to remote-dwelling Indigenous mothers and infants. Our inclusive indicator framework covers the period from pregnancy to the first year of life and includes existing indicators, but also introduces novel ones. We also attempt to highlight an Indigenous consumer. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  4. 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

  5. Review and Analysis of Local Multipoint Distribution System (LMDS) to Deliver Voice, Data, Internet, and Video Services

    CERN Document Server

    Ahamed, S S Riaz

    2010-01-01

    Local multipoint distribution system (LMDS) uses cellular-like network architecture of microwave radios placed at the client's location and at the company's base station to deliver fixed services, mainly telephony, video and Internet access. The use of time-division multiple access (TDMA) and FDMA (frequency DMA) technology allows multiple customers within a 3-5 mile coverage radius to share the same radio channel. Customers can receive data rates between 64kbps to 155Mbps. LMDS was conceived as a broadband, fixed wireless, point-to-multipoint technology for utilization in the last mile. Throughput capacity and reliable distance of the link depends on common radio link constraints and the modulation method used - either phase-shift keying or amplitude modulation. In general deployment links of up to 5 miles (8 km) from the base station are possible, but distance is typically limited to about 1.5 miles due to rain fading attenuation constraints. Point-to-point systems are also capable of using the LMDS frequen...

  6. Data-as-a-Service Platform for Delivering Healthy Lifestyle and Preventive Medicine: Concept and Structure of the DAPHNE Project.

    Science.gov (United States)

    Gibbons, Catherine; Bailador Del Pozo, Gonzalo; Andrés, Javier; Lobstein, Tim; Manco, Melania; Lewy, Hadas; Bergman, Einat; O'Callaghan, David; Doherty, Gavin; Kudrautseva, Olga; Palomares, Angel; Ram, Roni; Olmo, Alberto

    2016-12-09

    Overweight and obesity is related to many health problems and diseases. The current obesity epidemic, which is a major health problem, is closely related to a lack of physical activity, high levels of sedentary behavior, and increased energy intake; with evidence to show increasing incidence of these issues in the younger population. Tackling obesity and its comorbid conditions requires a holistic approach encompassing attention on physical activity, healthy diet, and behavioral activation in order to enable and maintain meaningful and long-term weight loss and weight maintenance. The objective of the Data-as-a-Service Platform for Healthy Lifestyle and Preventive Medicine (DAPHNE) project is to develop a breakthrough information communications technology (ICT) platform for tracking health, weight, physical activity, diet, lifestyle, and psychological components within health care systems, whereby the platform and clinical support is linked. The DAPHNE platform aims to deliver personalized guidance services for lifestyle management to the citizen/patient by means of (1) advanced sensors and mobile phone apps to acquire and store continuous/real-time data on lifestyle aspects, behavior, and surrounding environment; (2) individual models to monitor their health and fitness status; (3) intelligent data processing for the recognition of behavioral trends; and (4) specific services for personalized guidance on healthy lifestyle and disease prevention. It is well known that weight loss and maintenance of weight loss are particularly difficult. This tool will address some of the issues found with conventional treatment/advice in that it will collect data in real time, thereby reducing reliability issues known with recalling events once they have passed and will also allow adjustment of behavior through timely support and recommendations sent through the platform without the necessity of formal one-to-one visits between patient and clinician. Patient motivation

  7. 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

  8. Development and Evaluation of Acceptance and Commitment Therapy Delivered by Psychologists and Non-Psychologists in an NHS Community Adult Mental Health Service: a Preliminary Analysis.

    Science.gov (United States)

    Richardson, Thomas; Bell, Lorraine; Bolderston, Helen; Clarke, Sue

    2017-05-11

    Previous studies have demonstrated that acceptance and commitment therapy (ACT) is effective for depression and may be useful for complex transdiagnostic clients. To conduct a preliminary evaluation of whether ACT is feasible and effective when delivered by psychologists and non-psychologists for complex clients in a National Health Service (NHS) community mental health service for adults. Staff were trained in ACT and conducted one-to-one therapy with clients. Measures on general mental health, depression, fusion and values were given pre-therapy, post-therapy and at 3-month follow-up. Standardized measures showed significant improvements post-therapy for global mental health, depression, cognitive fusion and values post-treatment. These were partially maintained at follow-up and remained after an intent-to-treat analysis. There were no differences in outcomes between psychologists and non-psychologists. ACT may be delivered effectively with limited training for complex cases in secondary care, though further research is needed.

  9. Improving access to essential health care services: the case of Israel.

    Science.gov (United States)

    van de Ven, Wynand P M M

    2016-01-01

    In a recent article in this journal Simon-Tuval, Horev and Kaplan argue that in order to improve the protection of consumers there might be a need to impose a threshold on the medical loss ratio (MLR) for voluntary health insurance (VHI) in Israel [1]. Their argument is that VHI in Israel covers several essential services that are not covered by the mandatory benefits package due to budget constraints, while there are market failures in the VHI market that justify regulation to assure consumer protection such as high accessibility to high quality coverage. In this commentary it will be argued that in addition to market failures there are also government failures. It is doubtful whether imposing a threshold on MLR is effective because of government failures. It can be even counter-productive. Therefore, alternative regulatory measures are discussed to promote the protection of the beneficiaries. If essential services covered by VHI are unaffordable for some low-income people, government can extend the current mandatory basic health insurance so that it covers all essential services. If there is a budget restriction, the amount of government funds could be increased, or the health plans could be allowed to request an additional flat rate premium, set by them and to be paid by the consumer directly to their health plan. Also, effective out-of-pocket payments could be introduced. Subsidies could be given to low-income people to compensate for their additional expenses under the mandatory health insurance. If these changes are adopted, then the government would no longer be held responsible for access to benefits outside the mandatory health insurance. Accordingly, all VHI could be sold on the normal free insurance market, just as other types of indemnity insurance. In addition, the Israeli health insurance and healthcare markets could be made more competitive by introducing procompetitive regulation. This would increase the efficiency and affordability of healthcare.

  10. Impact evaluation of a health promotion-focused organisational development strategy on a health service's capacity to deliver comprehensive primary health care.

    Science.gov (United States)

    Costello, Michelle; Taylor, Jane; O'Hara, Lily

    2015-01-01

    A comprehensive primary health care approach is required to address complex health issues and reduce inequities. However, there has been limited uptake of this approach by health services nationally or internationally. Reorienting health services towards becoming more health promoting provides a mechanism to support the delivery of comprehensive primary health care. The aim of this study was to determine the impact of a health promotion-focused organisational development strategy on the capacity of a primary health care service to deliver comprehensive primary health care. A questionnaire and semistructured individual interviews were used to collect quantitative and qualitative impact evaluation data, respectively, from 13 health service staff across three time points with regard to 37 indicators of organisational capacity. There were significant increases in mean scores for 31 indicators, with effect sizes ranging from moderate to nearly perfect. A range of key enablers and barriers to support the delivery of comprehensive primary health care was identified. In conclusion, an organisational development strategy to reorient health services towards becoming more health promoting may increase the capacity to deliver comprehensive primary health care.

  11. Aptamer-hybrid nanoparticle bioconjugate efficiently delivers miRNA-29b to non-small-cell lung cancer cells and inhibits growth by downregulating essential oncoproteins

    Directory of Open Access Journals (Sweden)

    Perepelyuk M

    2016-07-01

    Full Text Available Maryna Perepelyuk, Christina Maher, Ashakumary Lakshmikuttyamma, Sunday A Shoyele Department of Pharmaceutical Science, College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA Abstract: MicroRNAs (miRNAs are potentially attractive candidates for cancer therapy. However, their therapeutic application is limited by lack of availability of an efficient delivery system to stably deliver these potent molecules intracellularly to cancer cells while avoiding healthy cells. We developed a novel aptamer-hybrid nanoparticle bioconjugate delivery system to selectively deliver miRNA-29b to MUC1-expressing cancer cells. Significant downregulation of oncoproteins DNMT3b and MCL1 was demonstrated by these MUC1 aptamer-functionalized hybrid nanoparticles in A549 cells. Furthermore, downregulation of these oncoproteins led to antiproliferative effect and induction of apoptosis in a superior version when compared with Lipofectamine 2000. This novel aptamer-hybrid nanoparticle bioconjugate delivery system could potentially serve as a platform for intracellular delivery of miRNAs to cancer cells, hence improving the therapeutic outcome of lung cancer. Keywords: aptamer, nanoparticles, microRNA, lung cancer, targeted delivery

  12. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part II: the referring clinician and patient perspective.

    LENUS (Irish Health Repository)

    Breen, Patricia

    2010-01-01

    Feedback from service users will provide insight into opportunities for improvement so that performance can be optimised. In the context of a formative evaluation referring clinician and patient satisfaction with a teleneurophysiology service was examined during a 20 week pilot period.

  13. A Descriptive Analysis of Music Therapists' Perceptions of Delivering Services in Inclusive Settings: A Challenge to the Field.

    Science.gov (United States)

    Jones; Cardinal

    1999-01-01

    The purpose of this study was to examine the perceptions of music therapists toward inclusion (providing services within general education settings) and to determine their willingness to provide their services in these settings. A questionnaire was sent to 560 music therapists of which 373 responded (67%). A descriptive analysis indicated that although the vast majority of music therapists are providing their services in a segregated setting, they (a) overwhelmingly know about inclusion, (b) perceive benefits to clients with and without disabilities, and (c) are willing to provide their services within an inclusive setting. Why then do therapists so overwhelmingly provide their services in noninclusive settings? Possible answers to this question as well as the challenge this creates to the field of music therapy are discussed.

  14. Implementation of the essential elements of service learning in three nursing courses.

    Science.gov (United States)

    Bittle, Mary; Duggleby, Wendy; Ellison, Patty

    2002-03-01

    The students' creativity, enthusiasm, energy, and excellent planning skills made a tremendously positive impression on the community agencies that participated in this project. The students applied principles of: Epidemiology, including collecting meaningful descriptive data. Community and family intervention. Community partnerships. Leadership. Cultural competence. As students visited the homes of families of different ethnic and socioeconomic status than themselves, perhaps the most poignant outcome was the opportunity for students to experience cultural sensitivity, relativity, and accommodation-Implementing the essential elements of service learning provided the foundation for a successful service learning experience. It took the time, energy, and commitment of all involved, but the end result was an educational experience that benefited students, faculty, and the community. Service learning presents an effective, unique, and valuable means for nursing students to master the objectives of community health, leadership and management, and pediatrics courses, and to prepare to function in a health care environment that demands partnering with the community to use resources more effectively to promote public well-being.

  15. 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

  16. The real governance of disaster risk management in peri-urban Senegal: Delivering flood response services through co-production

    DEFF Research Database (Denmark)

    Schaer, Caroline; Hahonou, Eric Komlavi

    2017-01-01

    Disastrous and recurring floods have impacted West African urban centres over the last decade, accentuating already existing vulnerabilities in poor neighbourhoods. Climate change-induced changing weather patterns and more extreme weather events are only part of the explanation for this situation...... of public service delivery it also creates an environment favourable for brokers to take ownership of central processes of service delivery and for structural inequalities to be reinforced locally....

  17. 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.

  18. The real governance of disaster risk management in peri-urban Senegal: Delivering flood response services through co-production

    DEFF Research Database (Denmark)

    Schaer, Caroline; Hahonou, Eric Komlavi

    2016-01-01

    Disastrous and recurring floods have impacted West African urban centres over the last decade, accentuating already existing vulnerabilities in poor neighbourhoods. Climate change-induced changing weather patterns and more extreme weather events are only part of the explanation for this situation...... of the state in a poor peri-urban municipality of Pikine, Dakar. The authors show how the organization of collective services pertaining to flood response and climate change adaptation is maintained through co-production among service users and providers entailing a mixture of diverse governance modes...

  19. Key informant perspectives on policy- and service-level challenges and opportunities for delivering integrated sexual and reproductive health and HIV care in South Africa

    Directory of Open Access Journals (Sweden)

    Smit Jennifer A

    2012-02-01

    Full Text Available Abstract Background Integration of sexual and reproductive health (SRH and HIV services is a policy priority, both globally and in South Africa. Recent studies examining SRH/HIV integration in South Africa have focused primarily on the SRH needs of HIV patients, and less on the policy and service-delivery environment in which these programs operate. To fill this gap we undertook a qualitative study to elicit the views of key informants on policy-and service-level challenges and opportunities for improving integrated SRH and HIV care in South Africa. This study comprised formative research for the development of an integrated service delivery model in KwaZulu-Natal (KZN Province. Methods Semi-structured in-depth interviews were conducted with 21 expert key informants from the South African Department of Health, and local and international NGOs and universities. Thematic codes were generated from a subset of the transcripts, and these were modified, refined and organized during coding and analysis. Results While there was consensus among key informants on the need for more integrated systems of SRH and HIV care in South Africa, a range of inter-related systems factors at policy and service-delivery levels were identified as challenges to delivering integrated care. At the policy level these included vertical programming, lack of policy guidance on integrated care, under-funding of SRH, program territorialism, and weak referral systems; at the service level, factors included high client load, staff shortages and insufficient training and skills in SRH, resistance to change, and inadequate monitoring systems related to integration. Informants had varying views on the best way to achieve integration: while some favored a one-stop shop approach, others preferred retaining sub-specialisms while strengthening referral systems. The introduction of task-shifting policies and decentralization of HIV treatment to primary care provide opportunities for

  20. Policy-Focused Service-Learning as a Capstone: Teaching Essentials of Baccalaureate Nursing Education.

    Science.gov (United States)

    O'Neill, Moira

    2016-10-01

    The advancing accountability of nurses and nurse educators requires students to develop knowledge, skills, and judgment on a continuum of focus from individual patients to the broader context of care. A dynamic capstone policy course was developed by applying the American Association of Colleges of Nursing's Essentials of Baccalaureate Education for Professional Nursing Practice and capitalizing on related benefits of service-learning pedagogy. It shifts the approach from an intangible didactic lecture on policy and institutional structures to hands-on experiences in actual policy environment and patient health intersections. Acting as nurse consultants, students help clients address a system-based problem. Reflective assignments reinforce student learning as they take cumulative inventory of baccalaureate accomplishments. Competencies in professionalism, teamwork and collaboration, communication, problem solving, and quality assurance are assessed. Students have engaged at sophisticated levels of practice and advocacy. Situating capstone service-learning in a nursing policy course appears to sensitize students to perspectives of all ecological levels and desensitizes their discomfort in the policy arena. Implications for research include identifying and implementing measures of success in program outcomes. [J Nurs Educ. 2016;55(10):583-586.]. Copyright 2016, SLACK Incorporated.

  1. A Comparison of Speech Sound Intervention Delivered by Telepractice and Side-by-Side Service Delivery Models

    Science.gov (United States)

    Grogan-Johnson, Sue; Schmidt, Anna Marie; Schenker, Jason; Alvares, Robin; Rowan, Lynne E.; Taylor, Jacquelyn

    2013-01-01

    Telepractice has the potential to provide greater access to speech-language intervention services for children with communication impairments. Substantiation of this delivery model is necessary for telepractice to become an accepted alternative delivery model. This study investigated the progress made by school-age children with speech sound…

  2. Delivering Coordinated, Community-Based Services by Putting Networks into Action: New York City's Change Capital Fund. No. 3

    Science.gov (United States)

    Aceves, Aurelia De La Rosa; Greenberg, David M.; Schell, Sarah

    2016-01-01

    This brief is the third in a series documenting the implementation of an economic mobility initiative supported by New York City's Change Capital Fund (CCF). CCF is a consortium of New York City donors formed to invest in local nonprofits that undertake data-driven antipoverty strategies integrating housing, education, and employment services. CCF…

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Abdallah I A Yagub

    2014-05-01

    Full Text Available 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.

  5. [Essential medicines and the selection process in management practices of pharmaceutical services in Brazilian states and municipalities].

    Science.gov (United States)

    Magarinos-Torres, Rachel; Pepe, Vera Lucia Edais; Oliveira, Maria Auxiliadora; Osorio-de-Castro, Claudia Garcia Serpa

    2014-09-01

    The selection of medicines is a skilled process that produces an essential medicines list (EML) and substantiates rational management of pharmaceutical services. This paper presents the selection of essential medicines in Brazilian states and municipalities. It discusses the perception of pharmaceutical services managers regarding the concept of essential medicines and strategies adopted for their implementation, in addition to investigating how the National Essential Medicines List was adopted and is supporting local pharmaceutical services actions. A nationwide study was carried out adopting a qualitative methodological approach in health. State and municipal managers from the five Brazilian regions were interviewed. The findings point to weaknesses in local selection procedures and in the use of the National Essential Medicines List (Rename). Barriers such as lack of formalization of pharmaceutical services at regional levels, difficulties in drafting and maintaining a pharmacy and therapeutics committee and the acritical incorporation of drugs on the EML were identified. States and municipalities have distortions that exclude the EML form the concept of essential medicines.

  6. A cross-sectional study of the feasibility of pharmacy-delivered harm reduction services among people who inject drugs in Xichang, China.

    Science.gov (United States)

    Yang, Yi; Latkin, Carl A; Luan, Rongsheng; Yang, Cui

    2015-09-14

    HIV prevalence is high in Liangshan, China (1.1 %). In 2012, people who inject drugs (PWID) in Xichang, the capital city, contributed to 60.0 % of the HIV infections. The goal of the current study was to examine the feasibility of implementing pharmacy-delivered harm reduction services (PDHRS) for PWID. Face-to-face structured interviews with 403 PWID included questions on PWID's experiences of syringe services and their specific experiences, acceptance, and potential usage of PDHRS. There were some reports of harassment/bad treatment from pharmacists (12.2 %) and police (17.6 %). Non-prescription syringe sales (NPSS) from pharmacies in single piece were the main source (82.1 %) of syringes. 72.5 % of PWID reported visiting 31.5 % of the identified pharmacies. Most (74.7 %) PWID disposed of their used syringes by throwing them away. Only one PWID brought used syringes back to a pharmacy in the past 30 days. Half of the PDHRS, such as printed materials about HIV, Hepatitis C and STIs; risk reduction services; (16.9 %) and sharps container to dispose of syringes (0.2 %) were offered by a few pharmacies (pharmacies provided many PWID in Liangshan with new syringes. However, disposal of used syringes was problematic. At the time of investigation, half of 16 assessed PDHRS were already available in pharmacies in Xichang. PWID were ready to use all the potential PDHRS and14 of 16 PDHRS were feasible to provide. HIV testing kits may be available in pharmacies in the future. Many pharmacy-delivered harm reduction services are feasible and acceptable among PWID in Xichang, China.

  7. 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 facilities. There is a shortage of health promoters in urban primary health facilities (P facilities.

  8. The KwaZulu-Natal Child Eye Care Programme: Delivering refractive error services to primary school learners

    Directory of Open Access Journals (Sweden)

    Y. I. Mahraj

    2011-12-01

    Full Text Available Globally, over 300 million people are estimated to be visually impaired. Uncorrected refractive error is the primary cause of almost half of all visual impairment, resulting in the global economy losing $269 billion in productivity annually. There is a definitive level of urgency in the treatment of refractive error in children as uncorrected refractive error results in the failure of normal visual maturation, termed amblyopia, which cannot be corrected in adult life. In South Africa, the lack of appropriatechild eye care strategies has posed a serious problem to the visual health of children. In 2006, the International Centre for Eye Care Education (ICEE conducted a situational analysis of child eye care services in the province of KwaZulu-Natal (KZN. The findings of this analysis indicated a dire need for comprehensive services in the province. Stakeholders (the KwaZulu-Natal Department of Healthand the KwaZulu-Natal Department of Education were advised on the value of a short-term strategy as the underpinning of a long-term sustainable approach. This resulted in the formation of a trialliance to implement the KZN Child Eye Care Programme. Eighty (80 individuals who were previously volunteers for the KZN Department of Health were trained in vision screening. These vi-sion screeners screened 239 606 primary school children from February 2007 to May 2008. Seven percent (15 944 of the children failed the vision screening and were referred for optometric assessments. Of the 15 944 children that failed the vision screening, 10 707 children were examined by optometrists and 1083 were found to have a refractive error and were therefore supplied with spectacles. The study indicates that a short-term programme to address a backlog of services can reach many underserved children. This programme identified many challenges of implementing a vision screening programme such as poor uptake of refractive services by learners in the absence of an appropriate

  9. International VLBI Service for Geodesy and Astrometry - Delivering high-quality products and embarking on observations of the next generation

    Science.gov (United States)

    Nothnagel, A.; Artz, T.; Behrend, D.; Malkin, Z.

    2016-09-01

    The International VLBI Service for Geodesy and Astrometry (IVS) regularly produces high-quality Earth orientation parameters from observing sessions employing extensive networks or individual baselines. The master schedule is designed according to the telescope days committed by the stations and by the need for dense sampling of the Earth orientation parameters (EOP). In the pre-2011 era, the network constellations with their number of telescopes participating were limited by the playback and baseline capabilities of the hardware (Mark4) correlators. This limitation was overcome by the advent of software correlators, which can now accommodate many more playback units in a flexible configuration. In this paper, we describe the current operations of the IVS with special emphasis on the quality of the polar motion results since these are the only EOP components which can be validated against independent benchmarks. The polar motion results provided by the IVS have improved continuously over the years, now providing an agreement with IGS results at the level of 20-25 μ as in a WRMS sense. At the end of the paper, an outlook is given for the realization of the VLBI Global Observing System.

  10. International VLBI Service for Geodesy and Astrometry. Delivering high-quality products and embarking on observations of the next generation

    Science.gov (United States)

    Nothnagel, A.; Artz, T.; Behrend, D.; Malkin, Z.

    2017-07-01

    The International VLBI Service for Geodesy and Astrometry (IVS) regularly produces high-quality Earth orientation parameters from observing sessions employing extensive networks or individual baselines. The master schedule is designed according to the telescope days committed by the stations and by the need for dense sampling of the Earth orientation parameters (EOP). In the pre-2011 era, the network constellations with their number of telescopes participating were limited by the playback and baseline capabilities of the hardware (Mark4) correlators. This limitation was overcome by the advent of software correlators, which can now accommodate many more playback units in a flexible configuration. In this paper, we describe the current operations of the IVS with special emphasis on the quality of the polar motion results since these are the only EOP components which can be validated against independent benchmarks. The polar motion results provided by the IVS have improved continuously over the years, now providing an agreement with IGS results at the level of 20-25 μas in a WRMS sense. At the end of the paper, an outlook is given for the realization of the VLBI Global Observing System.

  11. 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.

  12. The purchasing of maintenance service delivery in the Dutch social housing sector: optimising commodity strategies for delivering maintenance services to tenants

    NARCIS (Netherlands)

    Van Mossel, J.H.

    2008-01-01

    For housing associations, maintenance is an opportunity for high quality interaction with their tenants, and thus an opportunity for effectively influencing the quality of service delivery to tenants. Dutch housing associations have a market share of about one third of the entire Dutch housing stock

  13. The purchasing of maintenance service delivery in the Dutch social housing sector: optimising commodity strategies for delivering maintenance services to tenants

    NARCIS (Netherlands)

    Van Mossel, J.H.

    2008-01-01

    For housing associations, maintenance is an opportunity for high quality interaction with their tenants, and thus an opportunity for effectively influencing the quality of service delivery to tenants. Dutch housing associations have a market share of about one third of the entire Dutch housing

  14. 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

  15. A comprehensive review of the barriers and promoters health workers experience in delivering prevention of vertical transmission of HIV services in sub-Saharan Africa.

    Science.gov (United States)

    Schuster, Roseanne C; McMahon, Devon E; Young, Sera L

    2016-01-01

    Despite significant biomedical and policy advances, 199,000 infants and young children in sub-Saharan Africa (SSA) became infected with HIV in 2013, indicating challenges to implementation of these advances. To understand the nature of these challenges, we sought to (1) characterize the barriers and facilitators that health workers encountered delivering prevention of vertical transmission of HIV (PVT) services in SSA and (2) evaluate the use of theory to guide PVT service delivery. The PubMed and CINAHL databases were searched using keywords barriers, facilitators, HIV, prevention of vertical transmission of HIV, health workers, and their synonyms to identify relevant studies. Barriers and facilitators were coded at ecological levels according to the Determinants of Performance framework. Factors in this framework were then classified as affecting motivation, opportunity, or ability, per the Motivation-Opportunity-Ability (MOA) framework in order to evaluate domains of health worker performance within each ecological level. We found that the most frequently reported challenges occurred within the health facility level and spanned all three MOA domains. Barriers reported in 30% or more of studies from most proximal to distal included those affecting health worker motivation (stress, burnout, depression), patient opportunity (stigma), work opportunity (poor referral systems), health facility opportunity (overburdened workload, lack of supplies), and health facility ability (inadequate PVT training, inconsistent breastfeeding messages). Facilitators were reported in lower frequencies than barriers and tended to be resolutions to challenges (e.g., quality supervision, consistent supplies) or responses to an intervention (e.g., record systems and infrastructure improvements). The majority of studies did not use theory to guide study design or implementation. Interventions addressing health workers' multiple ecological levels of interactions, particularly the health

  16. 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

  17. ‘Get Healthy, Stay Healthy’: protocol for evaluation of a lifestyle intervention delivered by text-message following the Get Healthy Information and Coaching Service®

    Science.gov (United States)

    2014-01-01

    Background Behavioural lifestyle interventions can be effective at promoting initial weight loss and supporting physical activity and dietary behaviour change, however maintaining improvements in these outcomes is often more difficult to achieve. Extending intervention contact to reinforce learnt behavioural skills has been shown to improve maintenance of behaviour change and weight loss. This trial aims to evaluate the feasibility, acceptability and efficacy of a text message-delivered extended contact intervention to enhance or maintain change in physical activity, dietary behaviour and weight loss among participants who have completed a six month Government-funded, population-based telephone coaching lifestyle program: the Get Healthy Information and Coaching Service (GHS). Methods/Design GHS completers will be randomised to the 6-month extended contact intervention (Get Healthy, Stay Healthy, GHSH) or a no contact control group (standard practice following GHS completion). GHSH participants determine the timing and frequency of the text messages (3–13 per fortnight) and content is tailored to their behavioural and weight goals and support preferences. Two telephone tailoring calls are made (baseline, 12-weeks) to facilitate message tailoring. Primary outcomes, anthropometric (body weight and waist circumference via self-report) and behavioural (moderate-vigorous physical activity via self-report and accelerometer, fruit and vegetable intake via self-report), will be assessed at baseline (at GHS completion), 6-months (end of extended contact intervention) and 12-months (6-months post intervention contact). Secondary aims include evaluation of: the feasibility of program delivery; the acceptability for participants; theoretically-guided, potential mediators and moderators of behaviour change; dose-responsiveness; and, costs of program delivery. Discussion Findings from this trial will inform the delivery of the GHS in relation to the maintenance of behaviour

  18. 'Get Healthy, Stay Healthy': protocol for evaluation of a lifestyle intervention delivered by text-message following the Get Healthy Information and Coaching Service®.

    Science.gov (United States)

    Fjeldsoe, Brianna; Phongsavan, Philayrath; Bauman, Adrian; Goode, Ana; Maher, Genevieve; Eakin, Elizabeth

    2014-02-04

    Behavioural lifestyle interventions can be effective at promoting initial weight loss and supporting physical activity and dietary behaviour change, however maintaining improvements in these outcomes is often more difficult to achieve. Extending intervention contact to reinforce learnt behavioural skills has been shown to improve maintenance of behaviour change and weight loss. This trial aims to evaluate the feasibility, acceptability and efficacy of a text message-delivered extended contact intervention to enhance or maintain change in physical activity, dietary behaviour and weight loss among participants who have completed a six month Government-funded, population-based telephone coaching lifestyle program: the Get Healthy Information and Coaching Service (GHS). GHS completers will be randomised to the 6-month extended contact intervention (Get Healthy, Stay Healthy, GHSH) or a no contact control group (standard practice following GHS completion). GHSH participants determine the timing and frequency of the text messages (3-13 per fortnight) and content is tailored to their behavioural and weight goals and support preferences. Two telephone tailoring calls are made (baseline, 12-weeks) to facilitate message tailoring. Primary outcomes, anthropometric (body weight and waist circumference via self-report) and behavioural (moderate-vigorous physical activity via self-report and accelerometer, fruit and vegetable intake via self-report), will be assessed at baseline (at GHS completion), 6-months (end of extended contact intervention) and 12-months (6-months post intervention contact). Secondary aims include evaluation of: the feasibility of program delivery; the acceptability for participants; theoretically-guided, potential mediators and moderators of behaviour change; dose-responsiveness; and, costs of program delivery. Findings from this trial will inform the delivery of the GHS in relation to the maintenance of behaviour change and weight loss, and will

  19. 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.

  20. 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

  1. 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.

  2. Nurse-led clinics: 10 essential steps to setting up a service.

    Science.gov (United States)

    Hatchett, Richard

    This article outlines 10 key steps for practitioners to consider when setting up and running a nurse-led clinic. It lays emphasis on careful planning, professional development and the need to audit and evaluate the service to ensure the clinic is measurably effective.

  3. Flow cytometry as the spearhead for delivering sustainable and versatile laboratory services to HIV-burdened health care systems of the developing world: a Caribbean model.

    Science.gov (United States)

    Abayomi, E Akinola; Landis, R Clive

    2008-01-01

    HIV is targeting the developing nations of the world, threatening their economic development, overwhelming public health systems, and depleting human capital. The Caribbean is no exception, with the second highest incidence of HIV/AIDS outside Sub-Saharan Africa, sharing similar mixed fortunes from a postcolonial heritage, limited resources, and an HIV population dispersed in small population centers. Here we share the experience of Barbados, an island state of 280,000 people, in mounting a holistic and sustainable program against HIV/AIDS. At the forefront of this response has been the growth in clinical flow cytometry used for CD4 monitoring, which has prompted a welcome expansion in diagnostic capacity even beyond HIV/AIDS. A pan-Caribbean extension to Barbados' program has been the founding of the Caribbean Cytometry & Analytical Society (CCAS), which acts as a regional forum to accelerate technology transfer and develop the human resources needed to mount an effective response against HIV/AIDS. The 4th CCAS workshop in 2007 produced a consensus statement on the desirable characteristics for a "diagnostic dream machine": a simple-to-use, rugged flow cytometer capable of carrying out multiple diagnostic functions at the point of patient care in rural or island settings of the developing world, including CD4 count, blood count, and opportunistic infections, without the need for a supply cold-chain or dependable power source. It is our ambitious vision that the spread of flow cytometry, primarily to monitor CD4 in HIV/AIDS, can act as a Trojan horse to deliver better general and specialized diagnostic services to the developing world.

  4. The digital Reference Service: an essential element of the virtual library

    OpenAIRE

    Gómez-Sánchez, Alicia-Fátima; Isabel-Gómez, Rebeca

    2012-01-01

    Introduction A key consideration in the successful implementation of a virtual library is the provision of quality user services appropriate to the resources available and to users’ levels of training and skills. Virtual health libraries have begun to facilitate access to collection contents and publications in a convenient and efficient manner for the user and at the lowest possible cost for the institution. In addition to access to collections, a library has to provide a support servi...

  5. Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys.

    Science.gov (United States)

    Kosec, Katrina; Avula, Rasmi; Holtemeyer, Brian; Tyagi, Parul; Hausladen, Stephanie; Menon, Purnima

    2015-06-17

    In Bihar, India, coverage of essential health and nutrition interventions is low. These interventions are provided by 2 national programs--the Integrated Child Development Services (ICDS) and Health/National Rural Health Mission (NRHM)--through Anganwadi workers (AWWs) and Accredited Social Health Activists (ASHAs), respectively. Little is known, however, about factors that predict effective service delivery by these frontline workers (FLWs) or receipt of services by households. This study examined the predictors of use of 4 services: (1) immunization information and services, (2) food supplements, (3) pregnancy care information, and (4) general nutrition information. Data are from a 2012 cross-sectional survey of 6,002 households in 400 randomly selected villages in 1 district of Bihar state, as well as an integrated survey of 377 AWWs and 382 ASHAs from the same villages. For each of the 4 service delivery outcomes, logistic regression models were specified using a combination of variables hypothesized to be supply- and demand-side drivers of service utilization. About 35% of households reported receiving any of the 4 services. Monetary immunization incentives for AWWs (OR = 1.55, CI = 1.02-2.36) and above-median household head education (OR = 1.39, CI = 1.05-1.82) were statistically significant predictors of household receipt of immunization services. Higher household socioeconomic status was associated with significantly lower odds of receiving food supplements (OR = 0.87, CI = 0.79-0.96). ASHAs receiving incentives for institutional delivery (OR = 1.52, CI = 0.99-2.33) was marginally associated with higher odds of receiving pregnancy care information, and ASHAs who maintained records of pregnant women was significantly associated with households receiving such information (OR = 2.25, CI = 1.07-4.74). AWWs receiving immunization incentives was associated with significantly higher odds of households receiving general

  6. Essential trauma management training: addressing service delivery needs in active conflict zones in eastern Myanmar

    Directory of Open Access Journals (Sweden)

    Richard Matthew G

    2009-03-01

    Full Text Available Abstract Introduction Access to governmental and international nongovernmental sources of health care within eastern Myanmar's conflict regions is virtually nonexistent. Historically, under these circumstances effective care for the victims of trauma, particularly landmine injuries, has been severely deficient. Recognizing this, community-based organizations (CBOs providing health care in these regions sought to scale up the capacity of indigenous health workers to provide trauma care. Case description The Trauma Management Program (TMP was developed by CBOs in cooperation with a United States-based health care NGO. The goal of the TMP is to improve the capacity of local health workers to deliver effective trauma care. From 2000 to the present, international and local health care educators have conducted regular workshops to train indigenous health workers in the management of landmine injuries, penetrating and blunt trauma, shock, wound and infection care, and orthopedics. Health workers have been regularly resupplied with the surgical instruments, supplies and medications needed to provide the care learnt through TMP training workshops. Discussion and Evaluation Since 2000, approximately 300 health workers have received training through the TMP, as part of a CBO-run health system providing care for approximately 250 000 internally displaced persons (IDPs and war-affected residents. Based on interviews with health workers, trauma registry inputs and photo/video documentation, protocols and procedures taught during training workshops have been implemented effectively in the field. Between June 2005 and June 2007, more than 200 patients were recorded in the trauma patient registry. The majority were victims of weapons-related trauma. Conclusion This report illustrates a method to increase the capacity of indigenous health workers to manage traumatic injuries. These health workers are able to provide trauma care for otherwise inaccessible

  7. Can shared care deliver better outcomes for patients undergoing total hip replacement? A prospective assessment of patient outcomes and associated service use

    NARCIS (Netherlands)

    Rosendal, H.; Beekum, W.T. van; Nijhof, P.; Witte, L.P. de; Schrijvers, A.J.P.

    2000-01-01

    Objectives: To assess whether shared care for patients undergoing total hip replacement delivers better outcomes compared to care as usual. Design: Prospective, observational cohort study. Setting: Two regions in the Netherlands where different organisational health care models have been

  8. Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989-2000.

    Science.gov (United States)

    De Vos, Pol; García-Fariñas, Anaí; Álvarez-Pérez, Adolfo; Rodríguez-Salvá, Armando; Bonet-Gorbea, Mariano; Van der Stuyft, Patrick

    2012-04-01

    During the 1990s, Cuba was able to overcome a severe crisis, almost without negative health impacts. This national retrospective study covering the years 1989-2000 analyses the country's strategy through essential social, demographic, health process and health outcome indicators. Gross domestic product (GDP) diminished by 34.76% between 1989 and 1993. In 1994 slow recuperation started. During the crisis, public health expenses increased. The number of family doctors rose from 9.22 to 27.03 per 104 inhabitants between 1989 and 2000. Infant mortality rate and life expectancy exemplify a series of health indicators that continued to improve during the crisis years, whereas low birth weight and tuberculosis incidence are among the few indicators that suffered deterioration. GDP is inversely related to tuberculosis incidence, whereas the average salary is inversely related to low birth weight. Infant mortality rate has a strong negative correlation with the health expenses per inhabitant, the number of maternal homes, the number of family doctors and the proportion of pregnant women receiving care in maternal homes. Life expectancy has a strong positive correlation with health expenses, the number of nursing personnel and the number of medical contacts per inhabitant. The Cuban strategy effectively resolved health risks during the crisis. In times of serious socio-economic constraints, a well conceptualized public health policy can play an important role in maintaining the overall well-being of a population.

  9. 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.

  10. 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

  11. Experiences and Engagement with the Design Features and Strategies of an Internet-Delivered Treatment Programme for Generalised Anxiety Disorder: A Service-Based Evaluation

    Science.gov (United States)

    Walsh, Amy; Richards, Derek

    2017-01-01

    Background: Outcome research has highlighted the efficacy of internet-based cognitive behavioural therapy (iCBT). Some process research has examined users experiences of iCBT. Understanding the user experience provides valuable feedback to developers of internet-delivered interventions. Aim: The present study aimed to evaluate user's experiences…

  12. Experiences and Engagement with the Design Features and Strategies of an Internet-Delivered Treatment Programme for Generalised Anxiety Disorder: A Service-Based Evaluation

    Science.gov (United States)

    Walsh, Amy; Richards, Derek

    2017-01-01

    Background: Outcome research has highlighted the efficacy of internet-based cognitive behavioural therapy (iCBT). Some process research has examined users experiences of iCBT. Understanding the user experience provides valuable feedback to developers of internet-delivered interventions. Aim: The present study aimed to evaluate user's experiences…

  13. 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,

  14. 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

  15. 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.

    Science.gov (United States)

    Willner, Paul; Jahoda, Andrew; Rose, John; Stenfert-Kroese, Biza; Hood, Kerenza; Townson, Julia K; Nuttall, Jacqueline; Gillespie, David; Felce, David

    2011-02-09

    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. 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. 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 very significant benefits in relation to the current policy of

  16. Utilization of Innovations and Techniques of Educational Technology in Delivering of Educational Practicum and Its Impact on Increasing Academic Achievement among Pre-Service Teachers

    Science.gov (United States)

    Ibrahim, Hatim G.

    2017-01-01

    The current study aims to identify the utilization of innovations and techniques of educational technology in teaching of educational practicum and its impact on increasing academic achievement among pre-service teachers. The study sample consisted of (60) pre-service teachers (student teachers) randomly selected from public middle and secondary…

  17. Defining and delivering appropriate technology for sustainable access to safe drinking water in un- and under-serviced rural South Africa

    CSIR Research Space (South Africa)

    Maposa, Sibonginkosi

    2012-05-01

    Full Text Available This paper presents the experiences and lessons from the Accelerating Sustainable Water Services Delivery (ASWSD) initiative that is currently being implemented in South Africa. The initiative is being spearheaded by the Department of Science...

  18. Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

    Institute of Scientific and Technical Information of China (English)

    Erhabor Osaro; Njemanze Chima

    2014-01-01

    The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5’s, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

  19. Turning Disaster into an Opportunity for Quality Improvement in Essential Intrapartum and Newborn Care Services in the Philippines: Pre- to Posttraining Assessments

    Directory of Open Access Journals (Sweden)

    M. S. Castillo

    2016-01-01

    Full Text Available Background. On 8 November 2013, supertyphoon Haiyan made landfall in the Philippines, severely disrupting health service delivery. Reestablishment of essential services for birthing mothers and their newborns became high priority. Methodology. Following a baseline assessment, an Essential Intrapartum and Newborn Care (EINC training package was implemented and posttraining assessments (1 and 3 months after training were undertaken. Results. Baseline assessments (n=56 facilities revealed gaps in provider’s skill and shortage of life-saving commodities. Facilities lacked newborn bags/masks (9%, towels (6%, and magnesium sulfate (39%. Service providers lacked skills in partograph use (54%, antenatal steroid (44% use, and breastfeeding initiation (50%. At 3 months after training (n=51 facilities, dramatic increases in correct partograph use (to 92%, antenatal steroid use (to 98%, breastfeeding initiation (to 86%, kangaroo mother care (to 94%, availability of magnesium sulfate (to 94%, and bag/masks (to 88% were documented. Gaps persisted for skills in assisted vaginal delivery and removal of placental fragments. Conclusion. Health services were severely disrupted after supertyphoon Haiyan. Our study demonstrates that essential birthing services and quality improvements to strengthen local health systems can be restored in a timely manner even in immediate postdisaster settings.

  20. Turning Disaster into an Opportunity for Quality Improvement in Essential Intrapartum and Newborn Care Services in the Philippines: Pre- to Posttraining Assessments

    Science.gov (United States)

    Castillo, M. S.; Corsino, M. A.; Calibo, A. P.; Zeck, W.; Capili, D. S.; Andrade, L. C.; Reyes, K. A.; Alfonso, R. C.; Ponferrada, M. B.; Silvestre, M. A.

    2016-01-01

    Background. On 8 November 2013, supertyphoon Haiyan made landfall in the Philippines, severely disrupting health service delivery. Reestablishment of essential services for birthing mothers and their newborns became high priority. Methodology. Following a baseline assessment, an Essential Intrapartum and Newborn Care (EINC) training package was implemented and posttraining assessments (1 and 3 months after training) were undertaken. Results. Baseline assessments (n = 56 facilities) revealed gaps in provider's skill and shortage of life-saving commodities. Facilities lacked newborn bags/masks (9%), towels (6%), and magnesium sulfate (39%). Service providers lacked skills in partograph use (54%), antenatal steroid (44%) use, and breastfeeding initiation (50%). At 3 months after training (n = 51 facilities), dramatic increases in correct partograph use (to 92%), antenatal steroid use (to 98%), breastfeeding initiation (to 86%), kangaroo mother care (to 94%), availability of magnesium sulfate (to 94%), and bag/masks (to 88%) were documented. Gaps persisted for skills in assisted vaginal delivery and removal of placental fragments. Conclusion. Health services were severely disrupted after supertyphoon Haiyan. Our study demonstrates that essential birthing services and quality improvements to strengthen local health systems can be restored in a timely manner even in immediate postdisaster settings. PMID:27403432

  1. Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

    Directory of Open Access Journals (Sweden)

    Erhabor Osaro

    2014-06-01

    There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

  2. Patient satisfaction- comparison of the comprehensive care model with traditional model of delivering dental services in Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Afsaneh Pakdaman

    2013-10-01

    Full Text Available   Background and Aims: One of the important aspects for evaluating an organization is assessing the level of satisfaction of the clients. This study was conducted to compare the level of satisfaction between traditional and new methods of delivering dental care in the clinic of Tehran University of Medical Sciences.   Materials and Methods: A cross-sectional study was conducted on 308 patients received dental care at the dental clinics of Tehran University of Medical Sciences in spring 2010. Data were collected from Comprehensive Care Unit (CCU in addition to 7 isolated clinics including restorative, periodontics, endodontics, radiology, and prosthodontics (fix and removable using translated version of the Dental Satisfaction Questionnaire (DSQ, consisted of 19 questions in three main domains in addition to demographic questions. Descriptive statistics was used as percentage of answers. In order to compare the mean score between domains ANOVA test was used.   Results: The standardized mean scores in each domain were: pain control 58±17, access 59±12, quality 68±11 and total Dental Satisfaction Index (DSI score of 62±10. 92.5% of the respondents reported that students were very careful when examining their patients. 96.8% reported that they treat their patients with respect . The most common reasons for dissatisfaction apart from waiting time and getting appointments were not providing preventive care and pain control.   Conclusion: The results of this study shows acceptable level of satisfaction with dental care in teaching clinics of this dental school, however efforts on implementing preventive care and pain control strategies are suggested.

  3. Critical incident stress: the role of hospital-based social work in developing a statewide intervention system for first-responders delivering emergency services.

    Science.gov (United States)

    Spitzer, W J; Neely, K

    1992-01-01

    Emotional, cognitive and behavioral stress can negatively affect the performance of fire, rescue and law enforcement personnel responding to emergency situations. Impaired professional performance in these crises not only endangers the incident victims, all involved responders and their families, but potentially the lives and property of entire communities. This article describes the major administrative and clinical leadership of a hospital-based Social Work department in implementing one of the few statewide critical incident stress debriefing teams for emergency service personnel in the United States. It represents a model for program development by other organizations.

  4. Delivering PrePex Medical Male Circumcision Services Through a Mobile Clinic: The Experience From a Pilot Project in North West Province, South Africa.

    Science.gov (United States)

    Kufa, Tendesayi; Chetty-Makkan, Candice; Maraisane, Mpho; Charalambous, Salome; Chihota, Violet; Toledo, Carlos

    2016-06-01

    We describe the implementation of a pilot project to demonstrate the safety and feasibility of providing PrePex circumcision from a mobile clinic. We analyzed available project diary entries and staff meeting minutes to identify challenges encountered. The main challenges identified were (1) daily time constraints because of setting up procedures, (2) transportation logistics for clients when the mobile clinic had moved to a different location, (3) integration and coordination of staff responsibilities, and (4) recruitment for PrePex services in the mobile clinic. The provision of PrePex device circumcision through a mobile clinic was feasible but careful planning and review of operational procedures were needed to resolve the implementation challenges.

  5. Distance to hospital and utilization of surgical services in Haiti: do children, delivering mothers, and patients with emergent surgical conditions experience greater geographical barriers to surgical care?

    Science.gov (United States)

    Friedman, James M; Hagander, Lars; Hughes, Christopher D; Nash, Katherine A; Linden, Allison F; Blossom, Jeff; Meara, John G

    2013-01-01

    An inverse relationship between healthcare utilization and distance to care has been previously described. The purpose of this study was to evaluate this effect related to emergency and essential surgical care in central Haiti. We conducted a retrospective review of operative logbooks from the Clinique Bon Sauveur in Cange, Haiti, from 2008 to 2010. We used Geographic Information Systems to map the home locations of all patients. Spearman's correlation was used to determine the relationship between surgical utilization and distance, and a multivariate linear regression model identified characteristics associated with differences in distances traveled to care. The highest annual surgical utilization rate was 184 operations/100,000 inhabitants. We found a significant inverse correlation between surgical utilization rate and distance from residence to hospital (rs = -0.68, p = 0.02). The median distance from residence to hospital was 55.9 km. Pediatric patients lived 10.1% closer to the hospital than adults (p Haiti. Children and patients receiving obstetric, gynecologic or emergent surgery lived significantly closer to the hospital, and these groups may need special attention to ensure adequate access to surgical care. Copyright © 2012 John Wiley & Sons, Ltd.

  6. Changes of the dental service delivered to patients with intellectual disability under general anaesthesia in Dental Polyclinic Split, Croatia, during the years 1985-2009.

    Science.gov (United States)

    Kovacić, Ivan; Tadin, Antonija; Petricević, Nikola; Mikelić, Branimira; Vidović, Neven; Palac, Antonija; Filipović-Zore, Irina; Celebić, Asja

    2012-09-01

    People with intellectual disability (ID) usually have a poor quality of oral health, which include poor oral hygiene, untreated caries and high proportion of missing teeth. Due to their fear and repulsive attitude towards medical staff general anesthesia is often a useful method for dental treatment. One thousand and fifty four intellectual disability patients for the period of 1985-2009 who received dental treatment under general anesthesia in Dental Polyclinic Split, were included in the study. Patients were divided into five groups based upon the period when a specific dental treatment had been received. Each period was analyzed for the number of ID patients treated and the type of dental treatment. The results showed that the most services provided were 4006 fillings, followed by 3225 extracted teeth and finally 274 endodontic treatments. Significantly the lowest number of fillings and endodontic treatments were found among patients in group II (1990-1994), with significantly the highest number of extracted teeth. In Conclusion, the types of dental treatment have changed during twenty five years. Number of extracted teeth decreased while the number of fillings and endodontic treatment increased. However, dental status of people with intellectual disability should be improved with more restorative treatments and with better oral health prevention program.

  7. Essentials of essential oils.

    Science.gov (United States)

    Manion, Chelsea R; Widder, Rebecca M

    2017-05-01

    Information to guide clinicians in educating and advising patients using or intending to use essential oils for self-administered aromatherapy or other medicinal purposes is presented. The term essential oils refers to highly concentrated, aromatic oils extracted from plants by steam distillation, hydrodiffusion, or pressure. Market reports indicate strong growth in the use of essential oils in the United States in recent decades. Therapeutic claims made in the marketing of essential oils have led the Food and Drug Administration to caution a number of suppliers. Along with rapid growth in sales of essential oils to consumers there has been an increase in the amount of published evidence regarding aromatherapy and essential oils; the annual number of relevant articles indexed using Medical Subject Headings terminology has doubled since 2004. In order to help ensure proper application and safe use of essential oils as a self-care modality, healthcare professionals can benefit from a general knowledge of the terminology and foundational concepts of medicinal use of essential oils, as well as resources to facilitate evaluations of appropriateness of use. Because of the increasing popularity of essential oils and the prevalence of essential oil-based self-care practices targeting a wide variety of ailments in the United States, healthcare professionals must be prepared to address concerns about the agents' safety and efficacy. Proper literature evaluation requires the ability to discern the quality of an oil, the safety of administration, and the validity of its use. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  8. Enhancing Pre-Service Elementary School Teachers' Understanding of Essential Science Concepts through a Reflective Conceptual Change Model

    Science.gov (United States)

    Aydeniz, Mehmet; Brown, Clara Lee

    2010-01-01

    This study explored the impact of a reflective teaching method on pre-service elementary teachers' conceptual understanding of the lunar phases, reasons for seasons, and simple electric circuits. Data were collected from 40 pre-service elementary teachers about their conceptual understanding of the lunar phases, reasons for seasons and day…

  9. [The telemedical service centre as an essential element of the conceptual approach for telemonitoring of cardiac patients : Requirements on the service, quality, and technical realization of telemonitoring].

    Science.gov (United States)

    Helms, T M; Müller, A; Perings, C; Köhler, F; Leonhardt, V; Rybak, K; Sack, S; Stockburger, M

    2017-08-24

    Telemonitoring as part of a treatment strategy supports and facilitates the monitoring, disease management and education of patients with heart failure and cardiac arrhythmias. Therefore, telemonitoring affects quality and success of the therapy. Thus, meeting the needs of the patients and of the involved health care professionals is important for the success of the telemonitoring service. Moreover, a high quality of the service has to be ensured. The following article describes several configuration options for telemonitoring services considering technical as well as quality- and service-related aspects.

  10. Challenges with couples, serodiscordance and HIV disclosure: healthcare provider perspectives on delivering safer conception services for HIV-affected couples, South Africa

    Directory of Open Access Journals (Sweden)

    Tamaryn L Crankshaw

    2014-03-01

    Full Text Available Introduction: Introduction Safer conception interventions should ideally involve both members of an HIV-affected couple. With serodiscordant couples, healthcare providers will need to manage periconception risk behaviour as well tailor safer conception strategies according to available resources and the HIV status of each partner. Prior to widespread implementation of safer conception services, it is crucial to better understand provider perspectives regarding provision of care since they will be pivotal to the successful delivery of safer conception. This paper reports on findings from a qualitative study exploring the viewpoints and experiences of doctors, nurses, and lay counsellors on safer conception care in a rural and in an urban setting in Durban, South Africa. Methods: We conducted six semistructured individual interviews per site (a total of 12 interviews as well as a focus group discussion at each clinic site (a total of 13 additional participants. All interviews were coded in Atlas.ti using a grounded theory approach to develop codes and to identify core themes and subthemes in the data. Results: Managing the clinical and relationship complexities related to serodiscordant couples wishing to conceive was flagged as a concern by all categories of health providers. Providers added that, in the HIV clinical setting, they often found it difficult to balance their professional priorities, to maintain the health of their clients, and to ensure that partners were not exposed to unnecessary risk, while still supporting their clients’ desires to have a child. Many providers expressed concern over issues related to disclosure of HIV status between partners, particularly when managing couples where one partner was not aware of the other's status and expressed the desire for a child. Provider experiences were that female clients most often sought out care, and it was difficult to reach the male partner to include him in the consultation

  11. Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population

    Institute of Scientific and Technical Information of China (English)

    Niu Hongli; Tian Miaomiao; Ma Anning; Wang Chunping; Zhang Liang

    2014-01-01

    Background Since 2009,health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility,and to achieve sustained population-wide health improvement.This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China,especially hypertension people and children aged 0-6 years.Methods A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children.Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients,and for children,public services provided were vaccination on schedule and regular physical check-up.Logistic regression was used to determine the predictors for effective management.Results A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range,and the rate in urban areas (43.61%) was higher than that in rural (31.88%).And 34.68% of them could receive more than 4 times follow-ups by the medical technician.Of 754 children,79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly.Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%).Overall,geographic location and education level were the determinants of people access to essential public health services.Conclusions Implementation of the health reform since 2009 has headed China's public health system in the right direction and promoted the improvement of public health system development.Our study highlights the growing needs for more public health services in China,and China's public health system needs to be greatly improved in

  12. 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…

  13. Regional drug user services in times of scarce financial resources: using a rapid assessment response approach to evaluate, plan, and prioritize essential services.

    Science.gov (United States)

    Comiskey, Catherine Maria; O'Sullivan, Karin; Milnes, Jennie

    2012-02-01

    The objective was to assess need, evaluate projects, and devise a roadmap for future provision given budget cuts. The analysis of 30 substance misuse services in towns and rural areas of Ireland was conducted in 2010. Analysis revealed that 24,315 (95% CI 12,928-40,629) individuals were using illegal drugs in 2006, 893 individuals were using opiates, opiate and cocaine use was increasing as was drug use amongst females. Evaluations demonstrated that not all services were meeting emerging needs, services lacked administrative support, and funding needed to be redirected. The RAR approach was useful for policy decisions and budget cuts in times of economic restraint.

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

    National Research Council Canada - National Science Library

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

    2014-01-01

    .... To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system...

  15. TC-2 Satellite Delivered

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    On April 18, 2005, TC-2, the second satellite of Double Star Program (DSP), which was jointly developed by CNSA and ESA, was approved to be delivered to the user after the on-board test and trial operation. The satellite is working well and the performance can meet the user's need. The satellite has collected large amount of valuable scientific data

  16. Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association--Nutrition services: an essential component of comprehensive school health programs.

    Science.gov (United States)

    Briggs, Marilyn; Safaii, SeAnne; Beall, Deborah Lane

    2003-04-01

    It is the position of the American Dietetic Association (ADA), the Society for Nutrition Education (SNE), and the American School Food Service Association (ASFSA) that comprehensive nutrition services must be provided to all of the nation's preschool through grade twelve students. These nutrition services shall be integrated with a coordinated, comprehensive school health program and implemented through a school nutrition policy. The policy should link comprehensive, sequential nutrition education; access to and promotion of child nutrition programs providing nutritious meals and snacks in the school environment; and family, community, and health services' partnerships supporting positive health outcomes for all children. Childhood obesity has reached epidemic proportions and is directly attributed to physical inactivity and diet. Schools can play a key role in reversing this trend through coordinated nutrition services that promote policies linking comprehensive, sequential nutrition education programs, access to and marketing of child nutrition programs, a school environment that models healthy food choices, and community partnerships. This position paper provides information and resources for nutrition professionals to use in developing and supporting comprehensive school health programs. J Am Diet Assoc. 2003;103:505-514.

  17. Delivering Better Health Services to Pakistan's Poor

    OpenAIRE

    World Bank

    2010-01-01

    Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan...

  18. Delivering Better Health Services to Pakistan's Poor

    OpenAIRE

    Belay, Tekabe; Couffinhal, Agnes; Haq, Inaam; Kazi, Shahnaz; Loevinsohn, Benjamin

    2010-01-01

    Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan will not achieve the MDG related to nutrition. The review aims to develop a limited set of practical opt...

  19. Application of prognostic score IPSET-thrombosis in patients with essential thrombocythemia of a Brazilian public service

    Directory of Open Access Journals (Sweden)

    Luana Magalhães Navarro

    Full Text Available Summary Introduction: In patients with essential thrombocythemia (ET, the vascular complications contribute to morbidity and mortality. To better predict the occurrence of thrombotic events, an International Prognostic Score for Thrombosis in Essential Thrombocythemia (IPSET-thrombosis has recently been proposed. We present the application of this score and compare its results with the usual classification system. Method: We retrospectively evaluated the characteristics and risk factors for thrombosis of 46 patients with a diagnosis of ET seen in the last 6 years at Faculdade de Medicina do ABC (FMABC. Results: Thrombosis in the arterial territory was more prevalent than in venous sites. We observed that cardiovascular risk factors (hypertension, hypercholesterolemia, diabetes mellitus, and smoking were also risk factors for thrombosis (p<0.001. Age over 60 years and presence of JAK2 V617F mutation were not associated with the occurrence of thrombotic events. No patient classified by IPSET-thrombosis as low risk had a thrombotic event. Furthermore, using the IPSET-thrombosis scale, we identified two patients who had thrombotic events during follow-up and were otherwise classified in the low-risk group of the traditional classification. Leukocytosis at diagnosis was significantly associated with arterial thrombosis (p=0.02, while splenomegaly was associated with venous thrombotic events (p=0.01. Conclusion: Cardiovascular risk factors and leukocytosis were directly associated with arterial thrombosis. IPSET-thrombosis appears to be better than the traditional classification at identifying lower risk patients who do not need specific therapy.

  20. 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个维度,并应注重房屋、设备、人员、技术、耗材和药品等医疗服务要素的影响。

  1. Effects of extreme natural events on the provision of ecosystem services in a mountain environment: The importance of trail design in delivering system resilience and ecosystem service co-benefits.

    Science.gov (United States)

    Tomczyk, Aleksandra M; White, Piran C L; Ewertowski, Marek W

    2016-01-15

    A continued supply of ecosystem services (ES) from a system depends on the resilience of that system to withstand shocks and perturbations. In many parts of the world, climate change is leading to an increased frequency of extreme weather events, potentially influencing ES provision. Our study of the effects of an intense rainfall event in Gorce National Park, Poland, shows: (1) the intense rainfall event impacted heavily on the supply of ES by limiting potential recreation opportunities and reducing erosion prevention; (2) these negative impacts were not only restricted to the period of the extreme event but persisted for up to several years, depending on the pre-event trail conditions and post-event management activities; (3) to restore the pre-event supply of ES, economic investments were required in the form of active repairs to trails, which, in Gorce National Park, were an order of magnitude higher than the costs of normal trail maintenance; and (4) when recreational trails were left to natural restoration, loss of biodiversity was observed, and recovery rates of ES (recreation opportunities and soil erosion prevention) were reduced in comparison to their pre-event state. We conclude that proper trail design and construction provides a good solution to avoid some of the negative impacts of extreme events on recreation, as well as offering co-benefits in terms of protecting biodiversity and enhancing the supply of regulating services such as erosion prevention.

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

    Science.gov (United States)

    2014-01-01

    Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban

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

    Science.gov (United States)

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

    2014-04-01

    Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a

  4. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35-tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which completed its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. 'The production is proceeding well and we expect to be complete in October as foreseen,' said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have already been delivered.

  5. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35 tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which finished its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. "The production is proceeding well and we expect to be complete in October as previously foreseen," said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have been delivered.

  6. A High Technology Military Postal Service.

    Science.gov (United States)

    Mail to military personnel overseas is delivered essentially in the same way it was during World War I. The use of electronic mail has been growing...in private industry and the United States Postal Service recently began an international application of electronic mail . The new technology offers

  7. Delivering SKA Science

    CERN Document Server

    Quinn, Peter; Bird, Ian; Dodson, Richard; Szalay, Alex; Wicenec, Andreas

    2015-01-01

    The SKA will be capable of producing a stream of science data products that are Exa-scale in terms of their storage and processing requirements. This Google-scale enterprise is attracting considerable international interest and excitement from within the industrial and academic communities. In this chapter we examine the data flow, storage and processing requirements of a number of key SKA survey science projects to be executed on the baseline SKA1 configuration. Based on a set of conservative assumptions about trends for HPC and storage costs, and the data flow process within the SKA Observatory, it is apparent that survey projects of the scale proposed will potentially drive construction and operations costs beyond the current anticipated SKA1 budget. This implies a sharing of the resources and costs to deliver SKA science between the community and what is contained within the SKA Observatory. A similar situation was apparent to the designers of the LHC more than 10 years ago. We propose that it is time for...

  8. 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........ This paper formulates performance measures and an index to evaluate in hind sight the quality of service delivery by an aggregator, both with respect to ancillary service and asset management service. The index is based on requirements formulated in service contracts and provides an overall assessment...

  9. Maximising the potential of social media to deliver academic library ...

    African Journals Online (AJOL)

    Maximising the potential of social media to deliver academic library services to ... that academic libraries in Kenya are currently using Facebook, WhatsApp, ... The Technical University of Kenya library, social media, social media marketing ...

  10. 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.

  11. Factors Affecting the Acceptance of Pandemic Influenza A H1N1 Vaccine amongst Essential Service Providers: A Cross Sectional Study

    Directory of Open Access Journals (Sweden)

    Charlotte Roberts

    2012-12-01

    Full Text Available Although mentioned in the UK pandemic plan, essential service providers were not among the priority groups. They may be important targets of future influenza pandemic vaccination campaigns. Therefore, we conducted a cross-sectional survey among 380 employees from West Midlands police headquarters and 15 operational command units in the West Midlands Area during December 2009–February 2010 to identify factors affecting intention to accept the pandemic influenza A (H1N1 vaccine. One hundred and ninety nine (52.4% employees completed the questionnaire. 39.7% were willing to accept the vaccine. The most common reasons for intention to accept were worry about catching Swine Flu (n = 42, 53.2% and about infecting others (n = 40, 50.6%. The most common reason for declination was worry about side effects (n = 45, 57.0%. The most important factor predicting vaccine uptake was previous receipt of seasonal vaccine (OR 7.9 (95% CI 3.4, 18.5. Employees aged <40 years, males, current smokers, and those who perceived a greater threat and severity of swine flu were also more likely to agree to the vaccine. The findings of this study could be used to improve future pandemic immunization strategies. Targeted education programs should be used to address misconceptions; the single most important factor which might lead to a large improvement in uptake is to allay concern about side effects.

  12. The Boston Safe Shops Project--preliminary findings of a case study in applying the 10 essential services of public health to building environmental health capacity.

    Science.gov (United States)

    Shoemaker, Paul A; Skogstrom, Tiffany; Shea, John; Bethune, Leon

    2007-01-01

    Boston's more than 500 automotive shops, located primarily in low-income communities of color, are a source both of well-paying jobs and of potential hazardous exposures to employees and residents. The Safe Shops Project works to reduce occupational and environmental health hazards without having to close these businesses. Combining inspections, in-shop trainings, outreach, and technical/financial assistance, it brings shops into compliance with laws and promotes use of safer practices and alternative products. After 18 months, 254 workers at 61 of 124 participating shops had received training. Surveys showed improved worker knowledge: Pre-training, 24.2 percent of the worker survey respondents stated that they knew what an MSDS was, and post-training, 75 percent stated that they knew. The surveys also found improvement in work practices: Pre-training, 48 percent of workers indicated that they used safety goggles in their work, while post-training, 70 percent indicated proper use of safety goggles. The results also showed shops investing in capital improvements such as replacement of PCE-based brake cleaners with aqueous cleaners. The Safe Shops Project has a successfully modeled application of the 10-essential-services framework to the building of public health capacity and community collaboration, and this model can be adapted to other locations and industries.

  13. KNIME essentials

    CERN Document Server

    Bakos, Gábor

    2013-01-01

    KNIME Essentials is a practical guide aimed at getting the results you want, as quickly as possible.""Knime Essentials"" is written for data analysts looking to quickly get up to speed using the market leader in data processing tools, KNIME. No knowledge of KNIME is required, but we will assume that you have some background in data processing.

  14. Astronomy essentials

    CERN Document Server

    Brass, Charles O

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Astronomy includes the historical perspective of astronomy, sky basics and the celestial coordinate systems, a model and the origin of the solar system, the sun, the planets, Kepler'

  15. Topology essentials

    CERN Document Server

    Milewski, Emil G

    2013-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Topology includes an overview of elementary set theory, relations and functions, ordinals and cardinals, topological spaces, continuous functions, metric spaces and normed spaces, co

  16. People deliver eye care: managing human resources

    Directory of Open Access Journals (Sweden)

    Kayode Odusote

    2005-12-01

    Full Text Available People deliver health. Effective health care needs an efficient and motivated health workforce, which is the totality of individuals who directly or indirectly contribute to the promotion, protection and improvement of the health of the population.Community eye health is about providing eye health care to the people as close as possible to where they live and as much as possible at a price they can afford. It promotes people-centred care rather than the traditional disease-centred eye care services. In order to provide effective and efficient eye care services, we need an adequate number of well-qualified, well-motivated and equitably distributed eye health workers (EHWs.

  17. 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...

  18. 高校图书馆服务社会之探索与实践——以深圳大学城图书馆为例%Study on Social Services Delivered by Academic Libraries A Case Study of University Town Library of Shenzhcn

    Institute of Scientific and Technical Information of China (English)

    陈园

    2012-01-01

    高校图书馆提升社会服务功能对社会、个人以及自身发展都具有积极的意义。但是现阶段国内高校图书馆面向社会服务的实践仍存在很多问题,文章以深圳大学城图书馆为例,对现存问题进行分析,提出一些可行性建议,以期为高校图书馆的社会服务进展提供借鉴。%The social service function of academic library has a positive effect on society, individual and its own development. But at present, the practice of social services delivered by academic library still has a lot of problems in China. So for providing some references for the progress of social services delivered by academic library, this paper takes Uni- versity Town Library of Shenzhen for example, analysis of existing problems and puts forward some feasible suggestions.

  19. Swift essentials

    CERN Document Server

    Blewitt, Alex

    2014-01-01

    Whether you are a seasoned Objective-C developer or new to the Xcode platform, Swift Essentials will provide you with all you need to know to get started with the language. Prior experience with iOS development is not necessary, but will be helpful to get the most out of the book.

  20. Essential AOP

    DEFF Research Database (Denmark)

    De Fraine, Bruno; Ernst, Erik; Südholt, Mario

    2010-01-01

    Aspect-oriented programming (AOP) has produced interesting language designs, but also ad hoc semantics that needs clarification. We contribute to this clarification with a calculus that models essential AOP, both simpler and more general than existing formalizations. In AOP, advice may intercept ...

  1. Highcharts essentials

    CERN Document Server

    Shahid, Bilal

    2014-01-01

    If you are a web developer with a basic knowledge of HTML, CSS, and JavaScript and want to quickly get started with this web charting technology, this is the book for you. This book will also serve as an essential guide to those who have probably used a similar library and are now looking at migrating to Highcharts.

  2. 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.

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

    OpenAIRE

    Raechel Johns

    2014-01-01

    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, enable...

  4. Strengthening of primary health care: Key to deliver inclusive health care

    Directory of Open Access Journals (Sweden)

    Rajiv Yeravdekar

    2013-01-01

    Full Text Available Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in ′Right to Life.′ It is imperative to define ′essential health care,′ which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of ′family physician′ in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery.

  5. Wireshark essentials

    CERN Document Server

    Baxter, James H

    2014-01-01

    This book is aimed at IT professionals who want to develop or enhance their packet analysis skills. Basic familiarity with common network and application services terms and technologies is assumed; however, expertise in advanced networking topics or protocols is not required. Readers in any IT field can develop the analysis skills specifically needed to complement and support their respective areas of responsibility and interest.

  6. Mockito essentials

    CERN Document Server

    Acharya, Sujoy

    2014-01-01

    This book is ideal for developers who have some experience in Java application development as well as some basic knowledge of test doubles and JUnit testing. This book also introduces you to the fundamentals of JUnit testing, test doubles, refactoring legacy code, and writing JUnit tests for GWT and web services.

  7. 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

  8. Essential SQLAlchemy

    CERN Document Server

    Copeland, Rick

    2008-01-01

    Essential SQLAlchemy introduces a high-level open-source code library that makes it easier for Python programmers to access relational databases such as Oracle, DB2, MySQL, PostgreSQL, and SQLite. SQLAlchemy has become increasingly popular since its release, but it still lacks good offline documentation. This practical book fills the gap, and because a developer wrote it, you get an objective look at SQLAlchemy's tools rather than an advocate's description of all the "cool" features. SQLAlchemy includes both a database server-independent SQL expression language and an object-relational mappe

  9. Linux Essentials

    CERN Document Server

    Smith, Roderick W

    2012-01-01

    A unique, full-color introduction to Linux fundamentals Serving as a low-cost, secure alternative to expensive operating systems, Linux is a UNIX-based, open source operating system. Full-color and concise, this beginner's guide takes a learning-by-doing approach to understanding the essentials of Linux. Each chapter begins by clearly identifying what you will learn in the chapter, followed by a straightforward discussion of concepts that leads you right into hands-on tutorials. Chapters conclude with additional exercises and review questions, allowing you to reinforce and measure your underst

  10. Prezi essentials

    CERN Document Server

    Sinclair, Domi

    2014-01-01

    If you want to learn Prezi, and specifically design within Prezi, this is the book for you. Perhaps you already know a bit about Prezi but have never used it, or perhaps you have used Prezi before but want to learn how to incorporate your own custom design elements. In either case, this book will get you up and running quickly. It would be helpful to have a bit of familiarity with basic design concepts and the use of Prezi, but prior experience is not essential.

  11. 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.

  12. Safety of Seasonal Malaria Chemoprevention (SMC) with Sulfadoxine-Pyrimethamine plus Amodiaquine when Delivered to Children under 10 Years of Age by District Health Services in Senegal: Results from a Stepped-Wedge Cluster Randomized Trial

    Science.gov (United States)

    NDiaye, J. L.; Cissé, B.; Ba, E. H.; Gomis, J. F.; Ndour, C. T.; Molez, J. F.; Fall, F. B.; Sokhna, C.; Faye, B.; Kouevijdin, E.; Niane, F. K.; Cairns, M.; Trape, J. F.; Rogier, C.; Gaye, O.; Greenwood, B. M.; Milligan, P. J. M.

    2016-01-01

    Background It is recommended that children aged 3 months to five years of age living in areas of seasonal transmission in the sub-Sahel should receive Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine (SPAQ) during the malaria transmission season. The purpose of this study was to evaluate the safety of SMC with SPAQ in children when delivered by community health workers in three districts in Senegal where SMC was introduced over three years, in children from 3 months of age to five years of age in the first year, then in children up to 10 years of age. Methods A surveillance system was established to record all deaths and all malaria cases diagnosed at health facilities and a pharmacovigilance system was established to detect adverse drug reactions. Health posts were randomized to introduce SMC in a stepped wedge design. SMC with SPAQ was administered once per month from September to November, by nine health-posts in 2008, by 27 in 2009 and by 45 in 2010. Results After three years, 780,000 documented courses of SMC had been administered. High coverage was achieved. No serious adverse events attributable to the intervention were detected, despite a high level of surveillance. Conclusions SMC is being implemented in countries of the sub-Sahel for children under 5 years of age, but in some areas the age distribution of cases of malaria may justify extending this age limit, as has been done in Senegal. Our results show that SMC is well tolerated in children under five and in older children. However, pharmacovigilance should be maintained where SMC is implemented and provision for strengthening national pharmacovigilance systems should be included in plans for SMC implementation. Trial Registration ClinicalTrials.gov NCT 00712374 PMID:27764102

  13. El impacto del sistema de aseguramiento de la calidad en el servicio entregado por las universidades privadas en Chile The impact of the quality assurance system in the service delivered by the private universities in Chile

    Directory of Open Access Journals (Sweden)

    Emilio Rodríguez-Ponce

    2011-12-01

    Full Text Available Esta investigación analiza la relación entre los sistemas de aseguramiento de la calidad de las universidades y el servicio entregado por éstas. Para este efecto se desarrolla un marco conceptual que vincula ambas variables, y posteriormente se analiza la pertinencia de la hipótesis planteada trabajando con una muestra de veinte universidades privadas que han participado de procesos de acreditación institucional. Los resultados muestran que el sistema de aseguramiento de la calidad, medido por los años de acreditación, tiene una capacidad explicativa del 41,5% de la calidad del servicio en las universidades analizadas. Por lo tanto, se concluye que los procesos de aseguramiento de la calidad de las instituciones de educación terciaria son un elemento constitutivo y determinante de la calidad del servicio de estas instituciones.This study examines the relationship between quality assurance systems of universities and the service provided by them. For this purpose, we develop a conceptual framework that links the two variables and then discusses the relevance of the hypothesis to work with a sample of twenty private universities that have participated in processes of institutional accreditation. The results show that the system of quality assurance, as measured by the years of accreditation, has explanatory power of 41.5% service quality in universities analyzed. Therefore, we conclude that the processes of quality assurance of tertiary education institutions, are a constituent and determinant of the quality of service of these institutions.

  14. 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...... together different perspectives on the understanding of e-service and mobile communication, as well as their effects on the fields of marketing, management, and information systems. The growth of e-services as it relates to business –to-business, business-to-consumer, consumer-to-consumer, are essential...

  15. 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.

  16. Essential astrophysics

    CERN Document Server

    Lang, Kenneth R

    2013-01-01

    Essential Astrophysics is a book to learn or teach from, as well as a fundamental reference volume for anyone interested in astronomy and astrophysics. It presents astrophysics from basic principles without requiring any previous study of astronomy or astrophysics. It serves as a comprehensive introductory text, which takes the student through the field of astrophysics in lecture-sized chapters of basic physical principles applied to the cosmos. This one-semester overview will be enjoyed by undergraduate students with an interest in the physical sciences, such as astronomy, chemistry, engineering or physics, as well as by any curious student interested in learning about our celestial science. The mathematics required for understanding the text is on the level of simple algebra, for that is all that is needed to describe the fundamental principles. The text is of sufficient breadth and depth to prepare the interested student for more advanced specialized courses in the future. Astronomical examples are provide...

  17. 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 streamin...

  18. Feasibility Analysis of Retread to Essential Service Water Pump Shaft Seal of Nuclear Power Plant%核电站重要厂用水泵的轴封改造

    Institute of Scientific and Technical Information of China (English)

    宋立; 林冲; 吴希曦; 李志山

    2014-01-01

    设计了一款适用于现有CPR1000堆型核电站重要厂用水泵的机械密封,并通过对重要厂用水泵的正常运行工况和事故工况进行分析,提出重要厂用水泵用机械密封替换填料密封后可能出现的事故运行工况,制定了正常运行使用Plan 32,轴封水中断事故时切换到Plan 14的综合机械密封冲洗方案。通过鉴定试验验证,在CRP1000堆型重要厂用水泵上换装机械密封用以替代现有的填料密封,是可以满足正常运行和事故条件下的使用要求的。%One mechanical seal was designed for the shaft sealing of essential service water pump of CPR1000 nuclear power plant.According to the normal and accidental condition analysis of the essential service water pump,the general flashing plan was established.The Plan32 is used during normal condition and Plan14 will be used during flashing water interrupted.This de-sign was validated by the qualification test.The test result approved that it is feasible to use the mechanical seal instead of pack-ing seal for the essential service water pump of CPR1000 nuclear power plant.

  19. 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.

  20. Study of transient hydraulic in the essential service water system in NPP. Cofrentes; Estudio de transitorios hidraulicos en el sistema de agua de servicio esencial en C. N. C

    Energy Technology Data Exchange (ETDEWEB)

    Molina, M. C.; Prieto, J.; Olmedo, J.; Mota, M.

    2013-07-01

    The present paper presents the study of the possible transient hydraulic that they could occur in the essential service water system due to changes in modes of operation, as well as replacement of components or failure of these within the same operating mode. For a complete analysis, it has created a computer model of the system through software EcosimPro, whereby different models have been corresponding to each division's system, making the check that in any mode of operation, and in any event, the values be exceeded the design for the system and its components.

  1. Pilot study of a program delivered within the regular service system in Germany: effect of a short-term attachment-based intervention on maternal sensitivity in mothers at risk for child abuse and neglect.

    Science.gov (United States)

    Pillhofer, Melanie; Spangler, Gottfried; Bovenschen, Ina; Kuenster, Anne K; Gabler, Sandra; Fallon, Barbara; Fegert, Joerg M; Ziegenhain, Ute

    2015-04-01

    This pilot study examined the effectiveness of a short-term attachment-based intervention, the Ulm Model, in a German population at risk for child abuse and neglect. The intervention used home visits and video feedback to promote maternal sensitivity, and was implemented by trained staff within the health care and youth welfare systems. Mothers in the control group (n=33) received standard services only, while those in the intervention group (n=63) additionally the Ulm Model intervention. The outcomes measured were maternal sensitivity, as assessed by the CARE-Index at pre-intervention, after the last session, and at about 6 and 12 months of age; and infant socio-emotional development, as assessed by the ET6-6 development test at about 6 and 12 months of age. The moderating effects on treatment outcomes of two variables were examined: risk for child abuse (moderate vs. high) and type of maternal attachment representation (secure vs. insecure). Among participants at moderate risk for child abuse, no differences were found between the intervention group and control group in either maternal sensitivity or infant development. Among those considered high risk, mothers in the intervention group showed a significant increase in maternal sensitivity from pre- to post-intervention; however, no group differences were seen at follow-up. There were some indications that infants of mothers in the intervention group showed better emotional development. The variable of maternal attachment representation was not a significant moderator for the intervention effect, but post hoc analysis indicated that the mean sensitivity of secure mothers was significant higher at the 6-month follow-up. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    Science.gov (United States)

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  3. Essential surgery: Integral to the right to health.

    Science.gov (United States)

    McQueen, K A Kelly; Ozgediz, Doruk; Riviello, Robert; Hsia, Renee Y; Jayaraman, Sudha; Sullivan, Stephen R; Meara, John G

    2010-06-15

    In a rights-based approach to health, the provision of essential surgical services is not a luxury, but a critical component of the "highest attainable standard of health." Yet while access to select basic health care interventions has increasingly been discussed as part of the human right to health, essential surgical services have generally not been part of this discussion. This is despite the substantial global burden of surgical conditions in low- and middle-income countries, extreme global disparities in access to surgical care, and the fact that relatively simple, cost-effective, and curative surgical procedures can avert disability and premature death from many life-threatening emergencies and other conditions. Many barriers, both supply and demand-related, such as constraints in human resources, infrastructure, and access to care, have limited the ability of health systems to deliver surgical services. In this paper, the authors share their experience - as a group of surgeons, anesthesiologists, emergency physicians, and public health experts working with colleagues in varied resource-constrained settings to provide basic surgical care - in addressing the challenge of realizing the right to surgery in resource-poor settings. We argue that essential surgical care should be included in the basic human right to health, and that the current emphasis on "vertical" disease-specific models of health service delivery should be broadened to include systems needed to provide surgical services. We outline the global burden of surgical conditions, discuss the public health importance of surgery, identify the most significant global disparities in access to surgical care, and provide economic arguments for surgical delivery.

  4. Delivering home-based case management to families with children with mental retardation and developmental disabilities.

    Science.gov (United States)

    Ardito, M; Botuck, S; Freeman, S E; Levy, J M

    1997-01-01

    To meet the needs of individuals with mental retardation and developmental disabilities (MR/DD) and their families living in urban setting, a noncenter-based model of case management was implemented. In contrast to traditional case management in which families and consumers come to the case manager and most service coordination is done by telephone or in meetings at the case manager/social worker's worksite, the case manager in a noncenter-based model is mobile and able to meet the consumer and family in their domains. In this model, case management is provided in conjunction with in-home residential habilitation and funded by Medicaid under the Home and Community Based Services Waiver. This funding stream provides monies for nontraditional services delivered in noncertified settings. Case managers used the Family Resource Scale to get an immediate indication of the resources and needs of each family. The scale highlights the adequacy of a person's basic and caregiving resources, as well as financial needs. The findings from this study suggest that an understanding of both disability and entitlements is essential for case managers who may have to help advocate for consumers around services and benefits. Moreover, to build and maintain an egalitarian and supportive relationship with families, the importance of caregiver-specified resources and needs must be recognized by case managers. Access to resource information and the ability to engage the family in problem-solving depends on a well-trained staff with the ability to respond to individuals with different needs and from a variety of circumstances. These essential skills prepare a case manager to assist families with their immediate requirements as well as to mobilize them to plan for future needs.

  5. 世界环境日:图书馆在行动%Delivering Services and Programs on the World Environment Day:Investigation into the Current Practice by China Libraries

    Institute of Scientific and Technical Information of China (English)

    崔秀艳; 亢琦; 郝倩; 郭兆红

    2015-01-01

    World Environment Day is celebrated every year on 5 June to raise global awareness to take positive environmental action to protect nature and the planet Earth. It is run by the United Nations Environment Programme . During a World Environment Day event, series of educational outreach programs among 35 libraries are well-established and expressed in broad and diverse ways to celebrate and enhance the environmental concerns. However, the network survey revealed several issues, including ongoing activities annually are lacking, programs types are not rich enough and not combined with self-work as well as media coverage pay less attention. The libraries acknowledged the importance and urgency of energy saving and environmental protection, a commitment to series activities and programs offered and conducted are proposed. The findings and implications for practice are applicable to the future environmental literacy education, and promotes the development of green, low-carbon library, and integrate the concept of ecological civilization into all aspects and the whole process of library operations and services.%世界环境日是联合国促进全球环境意识、提高各机构对环境问题的注意并采取行动的主要媒介之一。通过对国内各类型图书馆的网络调查发现,35所图书馆在世界环境日期间开展了丰富多彩的活动,反映了图书馆积极行动,努力提升用户的环境意识。对调查所得的数据进行分析,探究各图书馆在环境日开展的实践活动内容和存在的问题,发现图书馆存在没有根据环境日主题持续开展活动、活动内容形式单一且没有与图书馆工作结合起来以及对宣传报道不够重视等问题,提出图书馆要在思想上充分认识到节约能源和环境保护的重要性和紧迫性,环境纪念日宣传与环境素养教育活动要常态化、持续性、系统性地开展,以期推动图书馆绿色低碳发展和环境素养教

  6. Human Rights and Health Services

    DEFF Research Database (Denmark)

    Skitsou, Alexandra; Bekos, Christos; Charalambous, George

    2016-01-01

    , 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...... 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......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...

  7. 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.

  8. Using conditionality as a solution to the problem of low uptake of essential services among disadvantaged communities: a social determinants view.

    Science.gov (United States)

    Forde, Ian; Bell, Ruth; Marmot, Michael G

    2011-08-01

    Conditional cash transfer schemes, which use cash to incentivize uptake of basic health and educational services, are well established among social planners inlow- and middle-income countries and are now taking hold in high-income countries. We appraised these schemes within a social determinants framework and found some encouraging signs in their first decade of operation. Success, however, has been inconsistent, and it is unclear whether conditional cash transfer schemes can reliably secure meaningful improvements in participants' health and nutritional status or educational attainment. Conditional cash transfer schemes' objectives will not be met unless they are transformed in 3 ways: transferring power as well as resources, emphasizing entitlements alongside conditionality, and avoiding the trap of incoherent or residualized policy.

  9. 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

  10. Using mobile technology to deliver library services a handbook

    CERN Document Server

    Walsh, Andrew

    2012-01-01

    Packed with easy to implement ideas, practical examples and international case studies, this title provides you with a toolkit, exploring ideas as simple as renewals and reminders to the more complex such as access to e-books and virtual worlds.

  11. The role of accountable care organizations in delivering value.

    Science.gov (United States)

    O'Halloran, Kevin; Depalma, Andres; Joseph, Vilma; Cobelli, Neil; Sharan, Alok

    2012-12-01

    The goal of Accountable Care Organizations is to improve patient outcomes while maximizing the value of the services provided. This will be achieved through the use of performance and quality measures that facilitate efficient, cost-effective, evidence-based care. By creating a network connecting primary care physicians, specialists, rehabilitation facilities and hospitals, patient care should be maximized while at the same time delivering appropriate value for those services provided. The Medicare Shared Savings Program will financially reward ACOs that meet performance standards while at the same time lowering costs. The orthopaedic surgeon can only benefit by understanding how to participate in and negotiate the complexities of these organizations.

  12. Are Services Functions?

    OpenAIRE

    Sumita, Kouhei; Kitamura, Yoshinobu; Sasajima, Munehiko; Mizoguchi, Riichiro

    2012-01-01

    This paper proposes an ontological definition of services. Such a definition is one of the fundamentals of service research. The understanding of essentialities of the notion of services as its definition, which differentiates services from the other notions, contributes proper modeling and conceptualization of services in services design and knowledge management of services. The existing definitions and characteristics of services, however, cannot differentiate services from other concepts: ...

  13. 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.

  14. Analysis on the Equity of Essential Public Health Services among Different Regions in China%不同地区间基本公共卫生服务公平性分析

    Institute of Scientific and Technical Information of China (English)

    王芳; 刘利群; 朱晓丽; 周巍; 胡同宇

    2011-01-01

    Objectives This paper aimed to provide some basis and references for improving equalization and the evaluation of public health service by analyzing the equity of essential public health services among different regions or cities in China. Methods Results Conclusion. Methods The data of maternal and child health services was collected from China Health Statistical Yearbooks of 2006 to 2009, and data from 2008 and 2009 on establishment of health records, management of chronic diseases were collected by using questionnaire survey in six sample cities located in the east, central and western part of China . The Gini coefficient calculation was used to evaluate the equity of essential public health services. Results From 2006 to 2009, the quantity of maternal and child health services has been increasing, and the disparity is tiny, the Gini coefficients was lower than 0. 1 among different provinces! From 2008 to 2009, some of new essential public health services in community, such as the establishment of health records, management of chronic disease, made some progresses, while the disparity is apparent,the Gini coefficient was close to or higher than 0. 3, and for health management of elderly, it was higher than 0. 4 (reach the dangerous line), the eastern region did better than the central and western regions. Conclusions The traditional public health services (I. E. maternal and child health care) goes relatively well, and the equity among different regions are quite good. For the implementation of some of new services, the eastern is generally better than the central and western.%目的 通过分析我国不同地区间基本公共卫生服务的公平性,为促进基本公共卫生服务均等化及其评价提供参考和借鉴.方法 分析采取点面结合的方法.一是通过《中国卫生统计年鉴》收集2006~2009年妇幼保健服务提供方面的数据,二是通过自行设计调查表收集分布于东、中、西部的6个城市2008年和2009

  15. Delivering HPC Systems to 132 Dock

    Energy Technology Data Exchange (ETDEWEB)

    Kettering, Brett Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-23

    The intention of this document is to provide the subcontractor with information to enable trucks delivering HPC (High Performance Computing) systems to the 03-0132, computer rooms with the information they need to do so successfully.

  16. Time Outdoors May Deliver Better Sleep

    Science.gov (United States)

    ... fullstory_163389.html Time Outdoors May Deliver Better Sleep Camping and exposure to natural light helps prime ... Spending time in the outdoors may improve your sleep, a small study suggests. Researchers found that a ...

  17. Social Media–Delivered Sexual Health Intervention

    Science.gov (United States)

    Bull, Sheana S.; Levine, Deborah; Black, Sandra R.; Schmiege, Sarah; Santelli, John

    2012-01-01

    Background Youth are using social media regularly and represent a group facing substantial risk for sexually transmitted infection (STI). Although there is evidence that the Internet can be used effectively in supporting healthy sexual behavior, this hasn't yet extended to social networking sites. Purpose To determine whether STI prevention messages delivered via Facebook are efficacious in preventing increases in sexual risk behavior at 2 and 6 months. Design Cluster RCT, October 2010–May 2011. Setting/participants Individuals (seeds) recruited in multiple settings (online, via newspaper ads and face-to-face) were asked to recruit three friends, who in turn recruited additional friends, extending three waves from the seed. Seeds and waves of friends were considered networks and exposed to either the intervention or control condition. Intervention Exposure to Just/Us, a Facebook page developed with youth input, or to control content on 18–24 News, a Facebook page with current events for 2 months. Main outcome measures Condom use at last sex and proportion of sex acts protected by condoms. Repeated measures of nested data were used to model main effects of exposure to Just/Us and time by treatment interaction. Results 1578 participants enrolled, with 14% Latino and 35% African-American; 75% of participants completed at least one study follow-up. Time by treatment effects were observed at 2 months for condom use (intervention 68% vs control 56%, p=0.04) and proportion of sex acts protected by condoms (intervention 63% vs control 57%, p=0.03) where intervention participation reduced the tendency for condom use to decrease over time. No effects were seen at 6 months. Conclusions Social networking sites may be venues for efficacious health education interventions. More work is needed to understand what elements of social media are compelling, how network membership influences effects, and whether linking social media to clinical and social services can be beneficial

  18. 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.

  19. 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.

  20. Announcement by the Logistics Service

    CERN Multimedia

    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

  1. 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.

  2. Software as a Service, Platform as a Service, Infrastructure as a Service − A Review

    Directory of Open Access Journals (Sweden)

    Sumit Goyal

    2013-11-01

    Full Text Available Cloud services have revolutionized the dynamics of IT industry. Cloud computing provides scalable and virtualized resources as services over the Internet. Cloud offers three types of services: Software as a Service (SaaS, Platform as a Service (PaaS, and Infrastructure as a Service (IaaS. This investigation encapsulates all these services from industry’s point of view, identifies various cloud paradigms promising to deliver these services, and discusses pros & cons of these services. This write-up contributes to the knowledge of cloud services by reviewing the benefits and barriers in adopting cloud services, and also predicts the future of cloud services.

  3. Computing Services

    Science.gov (United States)

    2008-08-08

    Speed in delivering capacity to the datacenter floor – Managed services partnerships • ITIL -based processes 4 Virtualization & Application Stacking...House” Communications 129 450 1140 482 232 117 MAINFRAME ROUTERS SWITCHES SECURITY MANAGEMENT STORAGE Communication Devices by Function Terminal...to protect and enforce security boundaries • Managing content as an extension of the glass house (e.g., GCDS) Communication Provider(s) Value Added

  4. Strengthening informal healthcare deliver: gender perspectives

    CSIR Research Space (South Africa)

    Mashiri, M

    2008-07-01

    Full Text Available in rural areas in fighting disease, poverty, isolation and deprivation. It will profile the importance of transportation infrastructure and services as well as communication in facilitating informal healthcare service delivery. One strand of thought...

  5. Concentrations of selected essential and non-essential elements in adult male polar bears (Ursus maritimus) from Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Concentrations of selected essential and non-essential elements, including mercury, cadmium, lead, arsenic, selenium, copper, zinc, and vanadium were measured in...

  6. Electronic Mediated Administration and Public Service Delivery in Nigeria

    Directory of Open Access Journals (Sweden)

    Samuel Oni

    2015-12-01

    Full Text Available The public service of any country is a major pillar in determining the development and stability of such country. This is because the public service is the engine for the processing of the vastly acquired and expanded government responsibilities of executing public policies and projects and rendering essential services to the people. In Nigeria, various governmental regimes have attempted repositioning the public sector for effective and efficient service delivery through various reforms. In spite of all these efforts, the Nigeria Public Service remains inefficient and incapable of delivering its responsibility. This paper adopts descriptive and analytical approach with data collected from secondary sources. By interrogating the exponential growth, usage and acceptance of Information Communication Technology (ICT in Nigeria, it argues for a paradigm shift from the traditional approach to electronic administration to enhance the delivery of public goods and services which are considered necessary for the sustainable development of the country. ICT enabled administration has the potentials of revolutionizing the quality of services delivered to the citizens by ushering in transparency, accountability and efficiency which are the bane of the Nigeria’s public sector.

  7. Is International Accounting Education Delivering Pedagogical Value?

    Science.gov (United States)

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  8. TC-1 Satellite of DSP Delivered

    Institute of Scientific and Technical Information of China (English)

    SunQing

    2004-01-01

    TC-1 satellite of Double Star Program (DSP), a near-earth equatorial satellite, was delivered to the representative of the end user, the Research Center for Space Science and Application under the Chinese Academy of Sciences (CAS) on April 12, 2004, which symbolized that TC-1 satellite was put into operation formally.

  9. Interactivity in an Electronically Delivered Marketing Course.

    Science.gov (United States)

    Larson, Paul D.

    2002-01-01

    In a marketing course delivered using Lotus Notes, 32 students were randomly assigned to large or small groups with heavy or light coaching. No differences in interactivity appeared related to group size or gender. More coaching increased the quantity, not quality, of interactivity. Quality seemed to decrease as quantity increased. (Contains 35…

  10. Is International Accounting Education Delivering Pedagogical Value?

    Science.gov (United States)

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  11. Science Ⅲ marine research ship delivered

    Institute of Scientific and Technical Information of China (English)

    Gong Wei

    2006-01-01

    @@ On August 18, China's most advanced marine research ship Science Ⅲ was commissioned into operation at Qingdao and became an official member of China's marine research fleet. Designed and built by CSIC, the ship was delivered at Shanghai to the Institute of Oceanology, Chinese Academy of Sciences.

  12. 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.

  13. Delivering best care in war and peace.

    Science.gov (United States)

    Moore, Alison

    2014-06-24

    Col Alan Finnegan, the fi rst Ministry of Defence professor of nursing, is driving forward research into preparing nurses for deployment and ensuring they deliver the best care possible in war and peace. Research topics range from the role of autonomous practitioners to the effects on soldiers of injuries to their genitalia.

  14. Lessons Learned from 10 Years of Delivering Quality Microwave Data to Scientists

    Science.gov (United States)

    Smith, D. K.; Wentz, F. J.; Hilburn, K. A.; Gentemann, C. L.

    2009-12-01

    DISCOVER (Distributed Information Services: Climate/Ocean Products and Visualization for Earth Research) is a NASA MEaSUREs funded project that delivers ocean surface wind, water vapor, cloud, sea surface temperature and rain products to the scientific community. We have delivered these data to users via the Internet for over 10 years thanks to successive funding (Pathfinder, ESIP, REASoN and now MEaSUREs). Since we are a group of scientists who use the data ourselves in research, our approach to providing DISCOVER data to the user community is based on what we would want; that is, we provide simple file formats that are quick to download and easy to transfer between computer systems, with read routines and files to check whether the data are correct after transfer, and helpful, quick and accurate user support. Web and FTP user metrics collected since 1998 show a continual increase in activity and file downloads. Most importantly, the DISCOVER data are now essential building blocks to other value-added products created by scientists for the research community, such as the CCMP winds (another NASA MEaSUREs funded project). An extensive list of publications presenting results obtained through use of the DISCOVER data demonstrates the demand for and long-term use of the DISCOVER ocean data products by scientists. Our products are generated after extensive intercalibration, algorithm refinement, quality control checks, geolocation and satellite attitude adjustments, along-scan bias corrections, hot load or antenna emissivity corrections, sun glitter and RFI removal and independent validation. In this talk, we will summarize our methods and tools used in producing the various DISCOVER data products, describe the means by which we distribute the data to users and support them in their research, list the types of value-added products available, and present some of the ways in which the data are being used to answer important scientific and climate questions. In addition

  15. 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.

  16. 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.

  17. Delivering quality pain management: the challenge for nurses.

    Science.gov (United States)

    Hayes, Kim; Gordon, Debra B

    2015-03-01

    The delivery of high-quality pain management in the perioperative environment can be challenging and difficult to quantify. Commonly used tools in delivering care, such as pain intensity ratings, individual pain experience reporting, assessments of individual patients' expectations, and patient satisfaction scores, have limitations and are not always useful when addressing quality improvement measures. Despite clinical advances in pain management, patients continue to experience inadequate pain control and inconsistent pain management practices. In this article, we discuss the challenges in providing consistent quality pain management, the need for a coordinated plan of care with a goal of meeting desired pain outcomes, and the essential role that perianesthesia and perioperative nurses play throughout the transitions in perioperative care to promote optimal pain management interventions based on the patient's individual needs.

  18. TMS delivered for A-3 Test Stand

    Science.gov (United States)

    2010-01-01

    A state-of-the-art thrust measurement system for the A-3 Test Stand under construction at NASA's John C. Stennis Space Center was delivered March 17. Once completed, the A-3 stand (seen in background) will allow simulated high-altitude testing on the next generation of rocket engines for America's space program. Work on the stand began in 2007, with activation scheduled for 2012. The stand is the first major test structure to be built at Stennis since the 1960s. The recently delivered TMS was fabricated by Thrust Measurement Systems in Illinois. It is an advanced calibration system capable of measuring vertical and horizontal thrust loads with an accuracy within 0.15 percent at 225,000 pounds.

  19. Managing online service recovery: procedures, justice and customer satisfaction

    OpenAIRE

    Crisafulli, Benedetta; Singh, Jaywant

    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...

  20. 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 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

  1. 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

  2. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In

  3. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In 2003,

  4. 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…

  5. Privatization and emergency medical services.

    Science.gov (United States)

    Reissman, S G

    1997-01-01

    Osborne and Gaebler's Reinventing Government has sparked discussion amongst elected officials, civil servants, the media, and the general public regarding advantages of privatizing government services. Its support stems from an effort to provide services to municipalities while reducing taxpayer expenditure. Many echo the sentiment of former New York Governor Mario Cuomo, who said, "It is not government's obligation to provide services, but to see that they're provided." Even in the area of public safety, privatization has found a "market." In many localities, privatizing Emergency Medical Services (EMS) is a popular and successful method for providing ambulance services. Privately owned ambulance services staff and respond to medical emergencies in a given community as part of the 9-1-1 emergency response system. Regulations for acceptable response times, equipment, and other essential components of EMS systems are specified by contract. This allows the municipality oversight of the service provided, but it does not provide the service directly. As will be discussed, this "contracting-out" model has many benefits. Privatizing EMS services is a decision based not only on cost-savings, but on accountability. A thorough evaluation must be utilized in the selection process. Issues of efficiency, effectiveness, quality, customer service, responsiveness, and equity must be considered by the government, in addition to cost of service. The uncertain future of health care in the United States has led those in EMS to look beyond the field's internal market to explore additional opportunities for expanding and redefining its roles beyond emergency care. It is important, however, to consider how emergency medical care, the original role of EMS, can be best delivered. Responding to emergencies is not just one of the functions involved in this field, it is the principal function from which public perception of EMS is formed, and from which support for entering other markets can

  6. Heat transfer II essentials

    CERN Document Server

    REA, The Editors of

    1988-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Heat Transfer II reviews correlations for forced convection, free convection, heat exchangers, radiation heat transfer, and boiling and condensation.

  7. Numerical analysis II essentials

    CERN Document Server

    REA, The Editors of; Staff of Research Education Association

    1989-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Numerical Analysis II covers simultaneous linear systems and matrix methods, differential equations, Fourier transformations, partial differential equations, and Monte Carlo methods.

  8. Essentially slant Toeplitz operators

    OpenAIRE

    2009-01-01

    The notion of an essentially slant Toeplitz operator on the space $L^2$ is introduced and some of the properties of the set ${\\rm ESTO}(L^2)$, the set of all essentially slant Toeplitz operators on $L^2$, are investigated. In particular the conditions under which the product of two operators in ${\\rm ESTO}(L^2)$ is in ${\\rm ESTO}(L^2)$ are discussed. The notion is generalized to $k$th-order essentially slant Toeplitz operators.

  9. Transport phenomena II essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Transport Phenomena II covers forced convention, temperature distribution, free convection, diffusitivity and the mechanism of mass transfer, convective mass transfer, concentration

  10. Electric circuits essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Electric Circuits I includes units, notation, resistive circuits, experimental laws, transient circuits, network theorems, techniques of circuit analysis, sinusoidal analysis, polyph

  11. Pre-calculus essentials

    CERN Document Server

    Woodward, Ernest

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Pre-Calculus reviews sets, numbers, operations and properties, coordinate geometry, fundamental algebraic topics, solving equations and inequalities, functions, trigonometry, exponents

  12. Computer science I essentials

    CERN Document Server

    Raus, Randall

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Computer Science I includes fundamental computer concepts, number representations, Boolean algebra, switching circuits, and computer architecture.

  13. Modern algebra essentials

    CERN Document Server

    Lutfiyya, Lutfi A

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Modern Algebra includes set theory, operations, relations, basic properties of the integers, group theory, and ring theory.

  14. Business statistics I essentials

    CERN Document Server

    Clark, Louise

    2014-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Business Statistics I includes descriptive statistics, introduction to probability, probability distributions, sampling and sampling distributions, interval estimation, and hypothesis t

  15. Calculus III essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Calculus III includes vector analysis, real valued functions, partial differentiation, multiple integrations, vector fields, and infinite series.

  16. Differential equations I essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Differential Equations I covers first- and second-order equations, series solutions, higher-order linear equations, and the Laplace transform.

  17. Statistics I essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Statistics I covers include frequency distributions, numerical methods of describing data, measures of variability, parameters of distributions, probability theory, and distributions.

  18. Algebra & trigonometry II essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Algebra & Trigonometry II includes logarithms, sequences and series, permutations, combinations and probability, vectors, matrices, determinants and systems of equations, mathematica

  19. Calculus I essentials

    CERN Document Server

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Calculus I covers functions, limits, basic derivatives, and integrals.

  20. [Delivering bad news in a Swiss internal medicine ward: a medical and nurse partnership].

    Science.gov (United States)

    Castioni, J; Teike Lüthi, F; Boretti, S Moser; Vollenweider, P

    2015-11-01

    Delivering bad news to a patient has a major impact for patients, their relatives and caregivers. The way this information is delivered can affect the way the patient sees his disease and potentially how he adheres to its treatment. To improve this communication with the patient the service of internal medicine at the Swiss university hospital of Lausanne set up a process including the coordination between all involved caregivers, and to break the bad news in a setting including a medical and nurse partnership. It also underscores that the resident in charge of the patient remains the coordinator of delivering new information. Moreover, the service provides communication tools to the caregivers to improve the communication skills.

  1. Delivery of satellite based broadband services

    Science.gov (United States)

    Chandrasekhar, M. G.; Venugopal, D.

    2007-06-01

    Availability of speedy communication links to individuals and organizations is essential to keep pace with the business and social requirements of this modern age. While the PCs have been continuously growing in processing speed and memory capabilities, the availability of broadband communication links still has not been satisfactory in many parts of the world. Recognizing the need to give fillip to the growth of broadband services and improve the broadband penetration, the telecom policies of different counties have placed special emphasis on the same. While emphasis is on the use of fiber optic and copper in local loop, satellite communications systems will play an important role in quickly establishing these services in areas where fiber and other communication systems are not available and are not likely to be available for a long time to come. To make satellite communication systems attractive for the wide spread of these services in a cost effective way special emphasis has to be given on factors affecting the cost of the bandwidth and the equipment. As broadband services are bandwidth demanding, use of bandwidth efficient modulation technique and suitable system architecture are some of the important aspects that need to be examined. Further there is a need to re-look on how information services are provided keeping in view the user requirements and broadcast capability of satellite systems over wide areas. This paper addresses some of the aspects of delivering broadband services via satellite taking Indian requirement as an example.

  2. Living MedsCheck: Learning how to deliver MedsCheck in community practice in Ontario.

    Science.gov (United States)

    Grindrod, Kelly; Sanghera, Niki; Rahmaan, Israa; Roy, Meghna; Tritt, Michael

    2013-01-01

    To share the experiences of graduating students as they learn to deliver a new medication review service in community pharmacies in Ontario, Canada. Four graduating pharmacy students volunteered in different community pharmacies to learn how to navigate a new provincial program called MedsCheck, which pays pharmacists to do medication reviews. Each student selected his or her own practice site, including 2 independent community pharmacies, a grocery store chain pharmacy and a hospital outpatient pharmacy. To help the students learn to deliver the new MedsCheck services, a faculty mentor met with them on a weekly basis. To reflect on doing MedsChecks in the "real world" and to elicit feedback from the online community, each student blogged about his or her experiences. All 4 students felt that peer mentoring improved their ability to deliver MedsCheck services. They also identified a number of barriers to delivering the MedsChecks and helped each other try to overcome the barriers. MedsCheck is a new service in Ontario and is not easily implemented in the current pharmacy model of practice. Peer mentoring is a helpful way to share successes and overcome barriers to delivery. Can Pharm J 2013;146:33-38.

  3. Delivering IT and eBusiness value

    CERN Document Server

    Willcocks, Leslie

    2001-01-01

    Delivering Business Value from IT' is focused on the evaluation issue in IT and how IT evaluation can proceed across the life-cycle of any IT investment and be linked positively to improving business performance. .Chapters 1,2 and 3 detail an approach to IT evaluation whilst chapters 4 and 5 build on these by showing two distinctive approaches to linking IT to business performance. The remaining three chapters deal with a range of evaluation issues emerging as important - specifically Internet evaluation, Y2K and beyond, EMU, quality outsourcing, infrastructure, role of benchmarking, and cost

  4. Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana

    Directory of Open Access Journals (Sweden)

    Mahama Saaka

    2014-01-01

    Full Text Available Background. This study was designed to understand the patterns and determinants of three essential newborn care practices: safe cord care, optimal thermal care, and neonatal feeding practices. Methods. A community-based cross-sectional study was carried out on a sample of 404 lactating mothers who have delivered a live baby at home within the past one year prior to the study. Results. Overall, the prevalence of essential newborn practices on safe cord care and optimal thermal care was exceptionally low. Of the 404 newborns, only 0.2% (1 had safe cord care, 5.2% (21 optimal thermal care, and 50.2% (203 were considered to have had adequate neonatal feeding. In logistic regression analysis, the main predictors of good neonatal feeding were maternal age, timing of the first antenatal care (ANC, and maternal knowledge of newborn danger signs. Women who could mention at least 4 danger signs of the neonate were 4 times more likely to give good neonatal feeding to their babies (AOR = 4.7, Cl: 2.43–9.28, P<0.001. Conclusion. Evidence from this study strongly suggests that the expected essential newborn care practices are not available to a substantial number of the newborns. Efforts should therefore be made by the Ghana Health Service (GHS to expand essential newborn care interventions beyond institutional level into the communities.

  5. Learning to deliver education in fragile states

    Directory of Open Access Journals (Sweden)

    Martin Greeley

    2006-07-01

    Full Text Available The Fragile States Group within the Development AssistanceCommittee (DAC of the Organisation for EconomicCooperation and Development is working to advise donors onprovision of education (and other services in ‘fragile states’.

  6. Training Delivers Results to Federal Express.

    Science.gov (United States)

    Galagan, Patricia A.

    1991-01-01

    Federal Express uses Service Quality Indicators to measure customer satisfaction and innovative training methods such as an interactive video network, pay-for-performance/pay-for-knowledge, and a Leadership Evaluation and Awareness Process. (SK)

  7. Essential Bacillus subtilis genes

    DEFF Research Database (Denmark)

    Kobayashi, K.; Ehrlich, S.D.; Albertini, A.

    2003-01-01

    To estimate the minimal gene set required to sustain bacterial life in nutritious conditions, we carried out a systematic inactivation of Bacillus subtilis genes. Among approximate to4,100 genes of the organism, only 192 were shown to be indispensable by this or previous work. Another 79 genes were...... predicted to be essential. The vast majority of essential genes were categorized in relatively few domains of cell metabolism, with about half involved in information processing, one-fifth involved in the synthesis of cell envelope and the determination of cell shape and division, and one-tenth related...... to cell energetics. Only 4% of essential genes encode unknown functions. Most essential genes are present throughout a wide range of Bacteria, and almost 70% can also be found in Archaea and Eucarya. However, essential genes related to cell envelope, shape, division, and respiration tend to be lost from...

  8. Delivering the Promise: Developing New Graduates.

    Science.gov (United States)

    Graham, Colin; McKenzie, Alasdair

    1995-01-01

    Data from 15 United Kingdom organizations highlighted best practices in developing entry workers: direct managers play a key role, coaching in learning by doing is essential, and networking with peers is valuable. Development is influenced by a mix of factors: mentoring, personnel practices, attitude, organizational culture, peer group, and…

  9. Forest conservation delivers highly variable coral reef conservation outcomes.

    Science.gov (United States)

    Klein, Carissa J; Jupiter, Stacy D; Selig, Elizabeth R; Watts, Matthew E; Halpern, Benjamin S; Kamal, Muhammad; Roelfsema, Chris; Possingham, Hugh P

    2012-06-01

    Coral reefs are threatened by human activities on both the land (e.g., deforestation) and the sea (e.g., overfishing). Most conservation planning for coral reefs focuses on removing threats in the sea, neglecting management actions on the land. A more integrated approach to coral reef conservation, inclusive of land-sea connections, requires an understanding of how and where terrestrial conservation actions influence reefs. We address this by developing a land-sea planning approach to inform fine-scale spatial management decisions and test it in Fiji. Our aim is to determine where the protection of forest can deliver the greatest return on investment for coral reef ecosystems. To assess the benefits of conservation to coral reefs, we estimate their relative condition as influenced by watershed-based pollution and fishing. We calculate the cost-effectiveness of protecting forest and find that investments deliver rapidly diminishing returns for improvements to relative reef condition. For example, protecting 2% of forest in one area is almost 500 times more beneficial than protecting 2% in another area, making prioritization essential. For the scenarios evaluated, relative coral reef condition could be improved by 8-58% if all remnant forest in Fiji were protected rather than deforested. Finally, we determine the priority of each coral reef for implementing a marine protected area when all remnant forest is protected for conservation. The general results will support decisions made by the Fiji Protected Area Committee as they establish a national protected area network that aims to protect 20% of the land and 30% of the inshore waters by 2020. Although challenges remain, we can inform conservation decisions around the globe by tackling the complex issues relevant to integrated land-sea planning.

  10. Statistics Essentials For Dummies

    CERN Document Server

    Rumsey, Deborah

    2010-01-01

    Statistics Essentials For Dummies not only provides students enrolled in Statistics I with an excellent high-level overview of key concepts, but it also serves as a reference or refresher for students in upper-level statistics courses. Free of review and ramp-up material, Statistics Essentials For Dummies sticks to the point, with content focused on key course topics only. It provides discrete explanations of essential concepts taught in a typical first semester college-level statistics course, from odds and error margins to confidence intervals and conclusions. This guide is also a perfect re

  11. Statistics II essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Statistics II discusses sampling theory, statistical inference, independent and dependent variables, correlation theory, experimental design, count data, chi-square test, and time se

  12. Physics I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Physics I includes vectors and scalars, one-dimensional motion, plane motion, dynamics of a particle, work and energy, conservation of energy, dynamics of systems of particles, rotation

  13. C programming language essentials

    CERN Document Server

    Ackermann, Ernest C

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. C Programming Language discusses fundamental notions, data types and objects, expressions, statements, declarations, function and program structure, the preprocessor, and the standar

  14. Laplace transforms essentials

    CERN Document Server

    Shafii-Mousavi, Morteza

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Laplace Transforms includes the Laplace transform, the inverse Laplace transform, special functions and properties, applications to ordinary linear differential equations, Fourier tr

  15. Physical chemistry II essentials

    CERN Document Server

    REA, The Editors of

    1992-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Physical Chemistry II includes reaction mechanisms, theoretical approaches to chemical kinetics, gravitational work, electrical and magnetic work, surface work, kinetic theory, collisional and transport properties of gases, statistical mechanics, matter and waves, quantum mechanics, and rotations and vibrations of atoms and molecules.

  16. Thermodynamics II essentials

    CERN Document Server

    REA, The Editors of

    2013-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Thermodynamics II includes review of thermodynamic relations, power and refrigeration cycles, mixtures and solutions, chemical reactions, chemical equilibrium, and flow through nozzl

  17. Transport phenomena I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Transport Phenomena I includes viscosity, flow of Newtonian fluids, velocity distribution in laminar flow, velocity distributions with more than one independent variable, thermal con

  18. Thermodynamics I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Thermodynamics I includes review of properties and states of a pure substance, work and heat, energy and the first law of thermodynamics, entropy and the second law of thermodynamics

  19. Electronics I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Electronics I covers fundamentals of semiconductor devices, junction diodes, bipolar junction transistors, power supplies, multitransistor circuits, small signals, low-frequency anal

  20. Complex variables II essentials

    CERN Document Server

    Solomon, Alan D

    2013-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Complex Variables II includes elementary mappings and Mobius transformation, mappings by general functions, conformal mappings and harmonic functions, applying complex functions to a

  1. Electronics II essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Electronics II covers operational amplifiers, feedback and frequency compensation of OP amps, multivibrators, logic gates and families, Boolean algebra, registers, counters, arithmet

  2. Complex variables I essentials

    CERN Document Server

    Solomon, Alan D

    2013-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Complex Variables I includes functions of a complex variable, elementary complex functions, integrals of complex functions in the complex plane, sequences and series, and poles and r

  3. Algebra & trigonometry I essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Algebra & Trigonometry I includes sets and set operations, number systems and fundamental algebraic laws and operations, exponents and radicals, polynomials and rational expressions, eq

  4. Set theory essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Set Theory includes elementary logic, sets, relations, functions, denumerable and non-denumerable sets, cardinal numbers, Cantor's theorem, axiom of choice, and order relations.

  5. Data structures I essentials

    CERN Document Server

    Smolarski, Dennis C

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Data Structures I includes scalar variables, arrays and records, elementary sorting, searching, linked lists, queues, and appendices of binary notation and subprogram parameter passi

  6. Geometry I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Geometry I includes methods of proof, points, lines, planes, angles, congruent angles and line segments, triangles, parallelism, quadrilaterals, geometric inequalities, and geometric

  7. Group theory I essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Group Theory I includes sets and mapping, groupoids and semi-groups, groups, isomorphisms and homomorphisms, cyclic groups, the Sylow theorems, and finite p-groups.

  8. Boolean algebra essentials

    CERN Document Server

    Solomon, Alan D

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Boolean Algebra includes set theory, sentential calculus, fundamental ideas of Boolean algebras, lattices, rings and Boolean algebras, the structure of a Boolean algebra, and Boolean

  9. Computer science II essentials

    CERN Document Server

    Raus, Randall

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Computer Science II includes organization of a computer, memory and input/output, coding, data structures, and program development. Also included is an overview of the most commonly

  10. Data structures II essentials

    CERN Document Server

    Smolarski, Dennis C

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Data Structures II includes sets, trees, advanced sorting, elementary graph theory, hashing, memory management and garbage collection, and appendices on recursion vs. iteration, alge

  11. Delivering Hubble Discoveries to the Classroom

    Science.gov (United States)

    Eisenhamer, B.; Villard, R.; Weaver, D.; Cordes, K.; Knisely, L.

    2013-04-01

    Today's classrooms are significantly influenced by current news events, delivered instantly into the classroom via the Internet. Educators are challenged daily to transform these events into student learning opportunities. In the case of space science, current news events may be the only chance for educators and students to explore the marvels of the Universe. Inspired by these circumstances, the education and news teams developed the Star Witness News science content reading series. These online news stories (also available in downloadable PDF format) mirror the content of Hubble press releases and are designed for upper elementary and middle school level readers to enjoy. Educators can use Star Witness News stories to reinforce students' reading skills while exposing students to the latest Hubble discoveries.

  12. Empathic engineering: helping deliver dignity through design

    Science.gov (United States)

    Hosking, Ian; Cornish, Katie; Bradley, Mike; Clarkson, P. John

    2015-01-01

    Abstract Dignity is a key value within healthcare. Technology is also recognized as being a fundamental part of healthcare delivery, but also a potential cause of dehumanization of the patient. Therefore, understanding how medical devices can be designed to help deliver dignity is important. This paper explores the role of empathy tools as a way of engendering empathy in engineers and designers to enable them to design for dignity. A framework is proposed that makes the link between empathy tools and outcomes of feelings of dignity. It represents a broad systems view that provides a structure for reviewing the evidence for the efficacy of empathy tools and also how dignity can be systematically understood for particular medical devices. PMID:26453036

  13. Delivering advanced therapies: The big pharma approach.

    Science.gov (United States)

    Tarnowski, J; Krishna, D; Jespers, L; Ketkar, A; Haddock, R; Imrie, J; Kili, S

    2017-07-24

    After two decades of focused development and some recent clinical successes, cell and gene therapy (CGT) is emerging as a promising approach to personalized medicines. Genetically engineered cells as a medical modality are poised to stand alongside or in combination with small molecule and biopharmaceutical approaches to bring new therapies to patients globally. Big pharma can play a vital role in industrializing CGT by focusing on diseases with high un-met medical need and compelling genetic evidence. Pharma should invest in manufacturing and supply chain solutions that deliver reproducible, high quality therapies at a commercially viable cost. Due to the fast pace of innovation in this field proactive engagement with regulators is critical. It is also vital to understand the needs of patients all along the patient care pathway and to establish product pricing that is accepted by prescribers, payers, and patients.Gene Therapy accepted article preview online, 24 July 2017. doi:10.1038/gt.2017.65.

  14. Intranasal formulations: promising strategy to deliver vaccines.

    Science.gov (United States)

    Riese, Peggy; Sakthivel, Priya; Trittel, Stephanie; Guzmán, Carlos A

    2014-10-01

    The emergence of new diseases and the lack of efficient vaccines against numerous non-treatable pathogens require the development of novel vaccination strategies. To date, only a few mucosal vaccines have been approved for humans. This was in part due to i) the use of live attenuated vaccines, which are not suitable for certain groups of individuals, ii) safety concerns derived from implementation in humans of some mucosal vaccines, iii) the poor stability, absorption and immunogenicity of antigens delivered by the mucosal route and iv) the limited number of available technologies to overcome the bottlenecks associated with mucosal antigen delivery. Recent advances make feasible the development of efficacious mucosal vaccines with adequate safety profile. Thus, currently intranasal vaccines represent an attractive and valid alternative to conventional vaccines. The present review is focused on the potentials and limitations of market-approved intranasal vaccines and promising candidates undergoing clinical investigations. Furthermore, emerging strategies to overcome main bottlenecks including efficient breaching of the mucosal barrier and safety concerns by implementation of new adjuvants and delivery systems are discussed. The rational design of intranasal vaccines requires an in-depth understanding of the anatomic, physicochemical and barrier properties of the nasal mucosa, as well as the molecular mechanisms governing the activation of the local innate and adaptive immune system. This would provide the critical knowledge to establish effective approaches to deliver vaccine antigens across the mucosal barrier, supporting the stimulation of a long-lasting protective response at both mucosal and systemic levels. Current developments in the area of adjuvants, nanotechnologies and mucosal immunology, together with the identification of surface receptors that can be exploited for cell targeting and manipulating their physiological properties, will become instrumental

  15. Marketing management : De essentie

    NARCIS (Netherlands)

    Kotler, P.J.; Keller, K.; Robben, H.S.J.

    2010-01-01

    'Marketingmanagement, de essentie' biedt een volledige introductie in modern marketingmanagement. De nieuwste concepten en onderzoeksresultaten komen aan bod. Zo wordt veel aandacht besteed aan holistische marketing en is de impact van technologische ontwikkelingen op hedendaagse marketing in deze v

  16. Marketingmanagement : De essentie

    NARCIS (Netherlands)

    Kotler, P.J.; Keller, K.; Robben, H.S.J.

    2007-01-01

    'Marketingmanagement, de essentie' biedt een volledige introductie in modern marketingmanagement. De nieuwste concepten en onderzoeksresultaten komen aan bod. Zo wordt veel aandacht besteed aan holistische marketing en is de impact van technologische ontwikkelingen op hedendaagse marketing in deze v

  17. Marketingmanagement : De essentie

    NARCIS (Netherlands)

    Kotler, P.J.; Keller, K.; Robben, H.S.J.

    2007-01-01

    'Marketingmanagement, de essentie' biedt een volledige introductie in modern marketingmanagement. De nieuwste concepten en onderzoeksresultaten komen aan bod. Zo wordt veel aandacht besteed aan holistische marketing en is de impact van technologische ontwikkelingen op hedendaagse marketing in deze v

  18. Marketing management : De essentie

    NARCIS (Netherlands)

    Kotler, P.J.; Keller, K.; Robben, H.S.J.

    2010-01-01

    'Marketingmanagement, de essentie' biedt een volledige introductie in modern marketingmanagement. De nieuwste concepten en onderzoeksresultaten komen aan bod. Zo wordt veel aandacht besteed aan holistische marketing en is de impact van technologische ontwikkelingen op hedendaagse marketing in deze v

  19. 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

  20. 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…

  1. Essential software architecture

    CERN Document Server

    Gorton, Ian

    2011-01-01

    Job titles like ""Technical Architect"" and ""Chief Architect"" nowadays abound in software industry, yet many people suspect that ""architecture"" is one of the most overused and least understood terms in professional software development. Gorton's book tries to resolve this dilemma. It concisely describes the essential elements of knowledge and key skills required to be a software architect. The explanations encompass the essentials of architecture thinking, practices, and supporting technologies. They range from a general understanding of structure and quality attributes through technical i

  2. Artifacts and essentialism.

    Science.gov (United States)

    Gelman, Susan A

    2013-09-01

    Psychological essentialism is an intuitive folk belief positing that certain categories have a non-obvious inner "essence" that gives rise to observable features. Although this belief most commonly characterizes natural kind categories, I argue that psychological essentialism can also be extended in important ways to artifact concepts. Specifically, concepts of individual artifacts include the non-obvious feature of object history, which is evident when making judgments regarding authenticity and ownership. Classic examples include famous works of art (e.g., the Mona Lisa is authentic because of its provenance), but ordinary artifacts likewise receive value from their history (e.g., a worn and tattered blanket may have special value if it was one's childhood possession). Moreover, in some cases, object history may be thought to have causal effects on individual artifacts, much as an animal essence has causal effects. I review empirical support for these claims and consider the implications for both artifact concepts and essentialism. This perspective suggests that artifact concepts cannot be contained in a theoretical framework that focuses exclusively on similarity or even function. Furthermore, although there are significant differences between essentialism of natural kinds and essentialism of artifact individuals, the commonalities suggest that psychological essentialism may not derive from folk biology but instead may reflect more domain-general perspectives on the world.

  3. 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…

  4. 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…

  5. Design Environment for Novel Vertical Lift Vehicles: DELIVER

    Science.gov (United States)

    Theodore, Colin

    2016-01-01

    This is a 20 minute presentation discussing the DELIVER vision. DELIVER is part of the ARMD Transformative Aeronautics Concepts Program, particularly the Convergent Aeronautics Solutions Project. The presentation covers the DELIVER vision, transforming markets, conceptual design process, challenges addressed, technical content, and FY2016 key activities.

  6. 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

  7. Delivering enhanced testosterone replacement therapy through nanochannels.

    Science.gov (United States)

    Ferrati, Silvia; Nicolov, Eugenia; Bansal, Shyam; Zabre, Erika; Geninatti, Thomas; Ziemys, Arturas; Hudson, Lee; Ferrari, Mauro; Goodall, Randal; Khera, Mohit; Palapattu, Ganesh; Grattoni, Alessandro

    2015-02-18

    Primary or secondary hypogonadism results in a range of signs and symptoms that compromise quality of life and requires life-long testosterone replacement therapy. In this study, an implantable nanochannel system is investigated as an alternative delivery strategy for the long-term sustained and constant release of testosterone. In vitro release tests are performed using a dissolution set up, with testosterone and testosterone:2-hydroxypropyl-β-cyclodextrin (TES:HPCD) 1:1 and 1:2 molar ratio complexes release from the implantable nanochannel system and quantify by HPLC. 1:2 TES:HPCD complex stably achieve 10-15 times higher testosterone solubility with 25-30 times higher in vitro release. Bioactivity of delivered testosterone is verified by LNCaP/LUC cell luminescence. In vivo evaluation of testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels by liquid chromatography mass spectrometry (LC/MS) and multiplex assay is performed in castrated Sprague-Dawley rats over 30 d. Animals are treated with the nanochannel implants or degradable testosterone pellets. The 1:2 TES:HPCD nanochannel implant exhibits sustained and clinically relevant in vivo release kinetics and attains physiologically stable plasma levels of testosterone, LH, and FSH. In conclusion, it is demonstrated that by providing long-term steady release 1:2 TES:HPCD nanochannel implants may represent a major breakthrough for the treatment of male hypogonadism.

  8. Where should noninvasive ventilation be delivered?

    Science.gov (United States)

    Hill, Nicholas S

    2009-01-01

    Noninvasive ventilation (NIV) has assumed an important role in the management of certain types of respiratory failure in acute-care hospitals. However, the optimal location for NIV has been a matter of debate. Some have argued that all patients begun on NIV in the acute-care setting should go to an intensive care unit (ICU), but this is impractical because ICU beds are often unavailable, and it may not be a sensible use of resources. Also, relatively few studies have examined the question of location for NIV. One problem is that various units' capabilities to deliver NIV differ substantially, even in the same hospital. Choosing the appropriate environment for NIV requires consideration of the patient's need for monitoring, the monitoring capabilities of the unit, including both technical and personnel resources (nursing and respiratory therapy), and the staff's skill and experience. In some hospitals NIV is begun most often in the emergency department, but is most often managed in an ICU. Step-down units are often good locations for NIV, but many institutions do not have step-down units. With ICU beds at a premium, many hospitals are forced to manage some NIV patients on general wards, which can be safely done with more stable patients if the ward is suitably monitored and experienced. When deciding where to locate the patient, clinicians must be familiar with the capabilities of the units in their facility and try to match the patient's need for monitoring and the unit's capabilities.

  9. Delivering new physics at impressive speed

    CERN Multimedia

    2010-01-01

    The speed with which the heavy ion run at the LHC is delivering new physics is impressive not only for the insights it is bringing to the early Universe, but also for the clear demonstration it gives of the value of competition and complementarity between the experiments.   ALICE was the first off the mark to publish papers from the ion run, as you’d expect from the LHC’s dedicated ion experiment, but results emerging from ATLAS and CMS are bringing new understanding in their own right. Each collaboration’s result plays to the strengths of its detector, and it is by taking all the results together that our knowledge advances. The creation, observation and understanding of the hot dense matter that would have existed in the early Universe, normally known as Quark Gluon Plasma (QGP), is complex science and one of the ion programme’s key goals. Many signals for QGP exist, and like pieces of a puzzle, we must assemble all of them to get the full picture. At th...

  10. Changes in nurse education: delivering the curriculum.

    Science.gov (United States)

    Carr, Graham

    2008-01-01

    The aim of this study is to examine changes in pre-registration nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty. Each interview was subjected to a process of content analysis described by Miles and Huberman. The interviews took place between August 2003 and March 2004 and totalled 34.4 hours or 305,736 words. There were thirty female and seven male participants, who shared 1015 years of nursing experience, averaging at 27.4 years (min 7-max 42). These were supplemented by 552 years of teaching practice, the average being 15 years (min 0.5-max 29). This paper--delivering the nursing curriculum--identifies that the nature of nursing has changed as it has both expanded and contracted. Participants identified three major changes; the nature of nursing, selection of future nurses and the current impact that large cohorts have on our traditional model of person-centred education. The practice placements remain central to nursing education and it is the nursing role that should define the curriculum and the values of higher education should be supportive of this identity.

  11. Urban poverty: delivering babies in the slum.

    Science.gov (United States)

    Lloyd, M

    1998-01-01

    Government of India statistics indicate that about 3 million of New Delhi's 11 million people live in slums, while another 3 million people, most fleeing rural poverty, are expected to migrate to the capital by 2000. ASHA Community Health and Development Society is a nongovernmental organization currently working in 23 of India's slums, serving a population of about 150,000 people. The group has pioneered the use of community-based networks in New Delhi to improve health in the poorest communities. While ASHA has a small, full-time staff, most of the daily health care work is conducted by slum volunteers. Ekta Vihar is a slum community of 1800 residents. Community members' primary source of health care are Vimla Rana and Sobha, two illiterate women who reside in the community and are part of a team of community health workers trained by ASHA. Rana and Sobha deliver almost all of the babies born annually in the slum and care for community members when they become ill.

  12. VMware Horizon Workspace essentials

    CERN Document Server

    von Oven, Peter; Lindberg, Joel

    2014-01-01

    This book uses a step-by-step approach to teach you how to design, deploy, and manage a Horizon Workspace based on real world experience. Written in an easy-to-follow style, this book explains the terminology in a clear and concise manner. Each feature is explained starting at a high level and then drilling down into the technical detail, using diagrams and screenshots.This book is perfect for IT administrators who want to deploy a solution to centrally manage access to corporate applications, data, and virtual desktops using Horizon Workspace. You need to have some experience in delivering BY

  13. Essentials of Computational Electromagnetics

    CERN Document Server

    Sheng, Xin-Qing

    2012-01-01

    Essentials of Computational Electromagnetics provides an in-depth introduction of the three main full-wave numerical methods in computational electromagnetics (CEM); namely, the method of moment (MoM), the finite element method (FEM), and the finite-difference time-domain (FDTD) method. Numerous monographs can be found addressing one of the above three methods. However, few give a broad general overview of essentials embodied in these methods, or were published too early to include recent advances. Furthermore, many existing monographs only present the final numerical results without specifyin

  14. Physics Essentials For Dummies

    CERN Document Server

    Holzner, Steven

    2010-01-01

    For students who just need to know the vital concepts of physics, whether as a refresher, for exam prep, or as a reference, Physics Essentials For Dummies is a must-have guide. Free of ramp-up and ancillary material, Physics Essentials For Dummies contains content focused on key topics only. It provides discrete explanations of critical concepts taught in an introductory physics course, from force and motion to momentum and kinetics. This guide is also a perfect reference for parents who need to review critical physics concepts as they help high school students with homework assignments, as we

  15. Using essential oils in professional practice.

    Science.gov (United States)

    Price, S

    1998-10-01

    As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. Contraindications to certain oils, patients, or treatment have also to be thoroughly understood, and the dosage employed is related to some extent to the standard of training undertaken.

  16. Essential trichomegaly: case report

    Directory of Open Access Journals (Sweden)

    Julia Dutra Rossetto

    2013-02-01

    Full Text Available The present study reports two cases of symptomatic essential trichomegaly. Trichomegaly may develop in various diseases, including anorexia nervosa, hypothyroidism, pregnancy, pretibial myxedema, systemic lupus erythematosus, vernal keratoconjunctivitis, and uveitis. The exact incidence trichomegaly is unknown, and the condition remains sporadically reported. Two cases of symptomatic trichomegaly without any associated systemic disorder are presented in this paper.

  17. The Essential Leadership Model

    Science.gov (United States)

    Knuth, Richard K.; Banks, Patricia Anne

    2006-01-01

    This article introduces the reader to the Essential Leadership Model (ELM). The ELM provides a vocabulary and framework for clarifying and prioritizing the many complex and competing demands of the principalship. The ELM supports principals in identifying the critical needs of a school and the leadership knowledge, skills, and dispositions to meet…

  18. Physical Education: Essential Issues

    Science.gov (United States)

    Green, Ken, Ed.; Hardman, Ken, Ed.

    2005-01-01

    This book is aimed primarily at under and postgraduate students pursuing entire programmes or discrete courses and modules in the broad area of physical education and sport in schools. It consists of a collection of what is considered to be essential readings in the sense that they are contributions from eminent authors on a breadth of salient…

  19. Retrovirus-delivered siRNA

    Directory of Open Access Journals (Sweden)

    Devroe Eric

    2002-08-01

    Full Text Available Abstract Background The ability of transfected synthetic small interfering (si RNAs to suppress the expression of specific transcripts has proved a useful technique to probe gene function in mammalian cells. However, high production costs limit this technology's utility for many laboratories and experimental situations. Recently, several DNA-based plasmid vectors have been developed that direct transcription of small hairpin RNAs, which are processed into functional siRNAs by cellular enzymes. Although these vectors provide certain advantages over chemically synthesized siRNAs, numerous disadvantages remain including merely transient siRNA expression and low and variable transfection efficiency. Results To overcome several limitations of plasmid-based siRNA, a retroviral siRNA delivery system was developed based on commerically available vectors. As a pilot study, a vector was designed to target the human Nuclear Dbf2-Related (NDR kinase. Cells infected with the anti-NDR siRNA virus dramatically downregulate NDR expression, whereas control viruses have no effect on total NDR levels. To confirm and extend these findings, an additional virus was constructed to target a second gene, transcriptional coactivator p75. Conclusion The experiments presented here demonstrate that retroviruses are efficient vectors for delivery of siRNA into mammalian cells. Retrovirus-delivered siRNA provides significant advancement over previously available methods by providing efficient, uniform delivery and immediate selection of stable "knock-down" cells. This development should provide a method to rapidly assess gene function in established cell lines, primary cells, or animals.

  20. More Soil Delivered to Phoenix Lab

    Science.gov (United States)

    2008-01-01

    This image, taken by NASA's Phoenix Mars Lander's Surface Stereo Imager, documents the delivery of a soil sample from the 'Snow White' trench to the Wet Chemistry Laboratory. A small pile of soil is visible on the lower edge of the second cell from the top.This deck-mounted lab is part of Phoenix's Microscopy, Electrochemistry and Conductivity Analyzer (MECA). The delivery was made on Sept. 12, 2008, which was Sol 107 (the 107th Martian day) of the mission, which landed on May 25, 2008. The Wet Chemistry Laboratory mixes Martian soil with an aqueous solution from Earth as part of a process to identify soluble nutrients and other chemicals in the soil. Preliminary analysis of this soil confirms that it is alkaline, and composed of salts and other chemicals such as perchlorate, sodium, magnesium, chloride and potassium. This data validates prior results from that same location, said JPL's Michael Hecht, the lead scientist for MECA. In the coming days, the Phoenix team will also fill the final four of eight single-use ovens on another soil-analysis instrument, the Thermal and Evolved Gas Analyzer, or TEGA. The team's strategy is to deliver as many samples as possible before the power produced by Phoenix's solar panels declines due to the end of the Martian summer. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  1. Challenging the Service Cost Paradigm.

    Science.gov (United States)

    Seibert, Sandra

    2015-01-01

    Most healthcare organizations are looking to find more efficient and cost-effective ways of delivering service as they are challenged to assume more risk in order to provide timely and cost effective care. Alternative service with an independent service organization or third party may be an easy and rewarding solution. Serious consideration should be given purchase/service cycle and into a lower cost service paradigm designed to provide excellent service tailored to a facility's specific needs. In this article, an evaluation of all service model options is provided, as well as examples including a CT acquisition, pro formas, and program development.

  2. 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.

  3. A Research on the Demographic Reactions to the Usage of Essential Banking Services in Northern Cyprus(KKTC’de Temel Banka Hizmetlerine Yönelik Demografik Tepkiler Üzerine Bir Araştırma

    Directory of Open Access Journals (Sweden)

    Hüseyin ÖZDEŞER

    2007-01-01

    Full Text Available The nature and variety of financial services heavily influenced by information technology are rapidly changing. Because of the cost efficiency of new financial services commercial banks should pursue an appropriate marketing strategy for keeping present customers and attracting new ones in order to be competitive. In other words, the banker who wants to be successful must become more and more oriented to understanding customer behavior in the financial marketplace. However, demographic differences that can potentially constitute various market segments necessitating different marketing strategy should be considered when trying to understand customer behavior. In this respect, the demographic reactions of customers towards banking services in Northern Cyprus of which civil servants from Prime Ministry are chosen as the case study are researched. Basic findings of research can be summarized as: “Modern banking features are accepted by passage of time. Automated Teller Machine (ATM is the oldest method and has the most extend usage where internet banking is the newest way and its usage is the narrowest one. Beside this, women tend to use technology more than men. There is a negative relationship between the using new banking features and age. On the other hand, the new banking features and educational attainment has a positive relationship”.

  4. Public Private Partnership Benefits in Delivering Public Facilities in Malaysia

    Directory of Open Access Journals (Sweden)

    Sapri M.

    2016-01-01

    Full Text Available The development of infrastructure in developing country such as Malaysia was increasingly founded by the Public–Private Partnership (PPP scheme. Collaboration with private sector has become popular as a means to improve the delivery of public facilities. Yet, empirical evidence on how PPP initiative has benefits the delivery of public facilities within Malaysia context is lagging. The purpose of this paper is to identify and assess the perception of stakeholders on the benefits of adopting PPP in delivering public facilities in Malaysia. Literature review was carried out to identify PPP benefits, which were then incorporated into the questionnaire. The mean score and mean score ranking was conducted to assess the agreement level of stakeholders towards the PPP benefits. The overall findings show that the implementation of PPP has benefitted the delivery of public facilities in both financial and non-financial aspects. From the analysis, improvement in service quality is perceived as the top advantage followed by innovation in design and transfer of risk. The findings provide more informed basis on the rationale of PPP implementation and its potential in improving the delivery of public facilities within Malaysia context.

  5. [Treatment of essential thrombocythemia].

    Science.gov (United States)

    Alvarez-Larrán, Alberto; Cervantes, Francisco; Besses, Carlos

    2013-09-21

    Essential thrombocythemia is a chronic myeloproliferative neoplasm characterized by sustained thrombocytosis, bone marrow megakaryocytic hyperplasia and an increased risk of thrombosis and hemorrhage. The goal of treatment is to prevent the development of vascular complications without increasing the risk of transformation. Patients aged>60 years or a history of thrombosis have a high risk of thrombosis while those with a platelet count>1,500 x 10(9)/l have a higher risk of hemorrhage. Patients with low-risk essential thrombocythemia can be managed appropriately with low-dose of acetylsalicylic acid or even observation only, while patients with a high-risk disease are candidates to receive cytoreductive treatment, hydroxyurea being the first choice therapy. Anagrelide is the most suitable option for patients with resistance or intolerance to hydroxyurea. All patients must be submitted to a rigorous control of cardiovascular risk factors. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  6. Organization of rehabilitation services.

    Science.gov (United States)

    Graham, Laura A

    2013-01-01

    In the past 20 years there have been many changes in the way that neurological rehabilitation is delivered worldwide. This is in part a reflection of improved acute medical therapies and intensive care and also related to the development of a more holistic approach to recovery, embracing the principles of the WHO International Classification of Functioning as a model for rehabilitation. Traditionally, rehabilitation services have tended to develop piecemeal according to local resources and need. By definition such services should be driven by a patient-centered approach and thus there is wide variety in service provision nationally and internationally. This chapter describes the background to current service set-ups and provision, exploring models of rehabilitation delivery and common presentations in neurological rehabilitation. Relevant legislation and guidance documents are reviewed. The text provides an overview of different aspects of rehabilitation services including acute and inpatient provision, outpatient services, community-based rehabilitation, residential facilities, and vocational services.

  7. 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.

  8. Rake task management essentials

    CERN Document Server

    Koleshko, Andrey

    2014-01-01

    A step-by-step and interactive approach explaining the Rake essentials along with code examples and advanced features. If you are a developer who is acquainted with the Ruby language and want to speed up writing the code concerned with files, then this book is for you. To start reading this book, basic Ruby knowledge is required; however, a huge amount of experience with the language is not necessary.

  9. Essentials of artificial intelligence

    CERN Document Server

    Ginsberg, Matt

    1993-01-01

    Since its publication, Essentials of Artificial Intelligence has beenadopted at numerous universities and colleges offering introductory AIcourses at the graduate and undergraduate levels. Based on the author'scourse at Stanford University, the book is an integrated, cohesiveintroduction to the field. The author has a fresh, entertaining writingstyle that combines clear presentations with humor and AI anecdotes. At thesame time, as an active AI researcher, he presents the materialauthoritatively and with insight that reflects a contemporary, first hand

  10. Android application security essentials

    CERN Document Server

    Rai, Pragati

    2013-01-01

    Android Application Security Essentials is packed with examples, screenshots, illustrations, and real world use cases to secure your apps the right way.If you are looking for guidance and detailed instructions on how to secure app data, then this book is for you. Developers, architects, managers, and technologists who wish to enhance their knowledge of Android security will find this book interesting. Some prior knowledge of development on the Android stack is desirable but not required.

  11. Moodle administration essentials

    CERN Document Server

    Henrick, Gavin

    2015-01-01

    If you are an experienced system administrator and know how to manage servers and set up web environments but now want to explore Moodle, this book is perfect for you. You'll get to grips with the basics and learn to manage Moodle quickly, focusing on essential tasks. Having prior knowledge of virtual learning environments would be beneficial, but is not mandatory to make the most of this book.

  12. 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.

  13. AWS development essentials

    CERN Document Server

    Kuppusamy, Prabhakaran

    2014-01-01

    This book is intended for expert programmers and architects who want to learn how to migrate the existing infrastructure to AWS Cloud and start using AWS services in all application tiers. Basic knowledge of Java and competence in cloud computing will be needed to follow the examples in this book.

  14. The Essential Paralegal

    Science.gov (United States)

    Gibbs, Hope J.

    2007-01-01

    As the evidence will show, paralegals have become a vital part of today's law offices. More law offices are hiring paralegals to reduce costs and increase the availability and efficiency of legal services, thus placing these important legal-team players in high demand. There are a variety of paths to becoming a paralegal or legal assistant. The…

  15. Python requests essentials

    CERN Document Server

    Chandra, Rakesh Vidya

    2015-01-01

    If you are a Python administrator or developer interested in interacting with web APIs and have a passion for creating your own web applications, this is the book for you. Basic knowledge of Python programming, APIs, and web services will be an advantage.

  16. 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...

  17. Are Financial Variables Inputs in Delivered Production Functions? Are Financial Variables Inputs in Delivered Production Functions?

    Directory of Open Access Journals (Sweden)

    Miguel Kiguel

    1995-03-01

    Full Text Available Fischer's classic (1974 paper develops conditions under which it is appropriate to use money as an input in a 'delivered' production function. In this paper, we extend Fischer's model I (the Baumol-Tobin inventory approach by incorporating credit into the analysis. Our investigation of the extended model brings out a very restrictive but necessary implicit assumption employed by Fischer to treat money as an input. Namely. that there exists a binding constraint on the use of money! A similar result holds for our more general model. Fischer's classic (1974 paper develops conditions under which it is appropriate to use money as an input in a 'delivered' production function. In this paper, we extend Fischer's model I (the Baumol-Tobin inventory approach by incorporating credit into the analysis. Our investigation of the extended model brings out a very restrictive but necessary implicit assumption employed by Fischer to treat money as an input. Namely. that there exists a binding constraint on the use of money! A similar result holds for our more general model.

  18. Geometry essentials for dummies

    CERN Document Server

    Ryan, Mark

    2011-01-01

    Just the critical concepts you need to score high in geometry This practical, friendly guide focuses on critical concepts taught in a typical geometry course, from the properties of triangles, parallelograms, circles, and cylinders, to the skills and strategies you need to write geometry proofs. Geometry Essentials For Dummies is perfect for cramming or doing homework, or as a reference for parents helping kids study for exams. Get down to the basics - get a handle on the basics of geometry, from lines, segments, and angles, to vertices, altitudes, and diagonals Conque

  19. Surface chemistry essentials

    CERN Document Server

    Birdi, K S

    2013-01-01

    Surface chemistry plays an important role in everyday life, as the basis for many phenomena as well as technological applications. Common examples range from soap bubbles, foam, and raindrops to cosmetics, paint, adhesives, and pharmaceuticals. Additional areas that rely on surface chemistry include modern nanotechnology, medical diagnostics, and drug delivery. There is extensive literature on this subject, but most chemistry books only devote one or two chapters to it. Surface Chemistry Essentials fills a need for a reference that brings together the fundamental aspects of surface chemistry w

  20. Microsoft Windows networking essentials

    CERN Document Server

    Gibson, Darril

    2011-01-01

    The core concepts and technologies of Windows networking Networking can be a complex topic, especially for those new to the field of IT. This focused, full-color book takes a unique approach to teaching Windows networking to beginners by stripping down a network to its bare basics, thereby making each topic clear and easy to understand. Focusing on the new Microsoft Technology Associate (MTA) program, this book pares down to just the essentials, showing beginners how to gain a solid foundation for understanding networking concepts upon which more advanced topics and technologies can be built.

  1. RabbitMQ essentials

    CERN Document Server

    Dossot, David

    2014-01-01

    This book is a quick and concise introduction to RabbitMQ. Follow the unique case study of Clever Coney Media as they progressively discover how to fully utilize RabbitMQ, containing clever examples and detailed explanations.Whether you are someone who develops enterprise messaging products professionally or a hobbyist who is already familiar with open source Message Queuing software and you are looking for a new challenge, then this is the book for you. Although you should be familiar with Java, Ruby, and Python to get the most out of the examples, RabbitMQ Essentials will give you the push y

  2. Autodesk Maya 2014 essentials

    CERN Document Server

    Naas, Paul

    2013-01-01

    The premiere book on getting started with Maya 2014 Whether you're just beginning, or migrating from another 3D application, this step-by-step guide is what you need to get a good working knowledge of Autodesk Maya 2014. Beautifully illustrated with full-color examples and screenshots, Autodesk Maya 2014 Essentials explains the basics of Maya as well as modeling, texturing, animating, setting a scene, and creating visual effects. You'll absorb important concepts and techniques, and learn how to confidently use Maya tools the way professionals do. Each chapter includes fun and cha

  3. Microsoft Windows Security Essentials

    CERN Document Server

    Gibson, Darril

    2011-01-01

    Windows security concepts and technologies for IT beginners IT security can be a complex topic, especially for those new to the field of IT. This full-color book, with a focus on the Microsoft Technology Associate (MTA) program, offers a clear and easy-to-understand approach to Windows security risks and attacks for newcomers to the world of IT. By paring down to just the essentials, beginners gain a solid foundation of security concepts upon which more advanced topics and technologies can be built. This straightforward guide begins each chapter by laying out a list of topics to be discussed,

  4. Essential dynamics and relativity

    CERN Document Server

    O'Donnell, Peter J

    2014-01-01

    Essential Dynamics & Relativity provides students with an introduction to the core aspects of dynamics and special relativity. The author reiterates important ideas and terms throughout and covers concepts that are often missing from other textbooks at this level. He also places each topic within the wider constructs of the theory, without jumping from topic to topic to illustrate a point.The first section of the book focuses on dynamics, discussing the basic aspects of single particle motion and analyzing the motion of multi-particle systems. The book also explains the dynamical behavior of b

  5. 3D Animation Essentials

    CERN Document Server

    Beane, Andy

    2012-01-01

    The essential fundamentals of 3D animation for aspiring 3D artists 3D is everywhere--video games, movie and television special effects, mobile devices, etc. Many aspiring artists and animators have grown up with 3D and computers, and naturally gravitate to this field as their area of interest. Bringing a blend of studio and classroom experience to offer you thorough coverage of the 3D animation industry, this must-have book shows you what it takes to create compelling and realistic 3D imagery. Serves as the first step to understanding the language of 3D and computer graphics (CG)Covers 3D anim

  6. French essentials for dummies

    CERN Document Server

    Lawless, Laura K

    2011-01-01

    Just the core concepts you need to write and speak French correctly If you have some knowledge of French and want to polish your skills, French Essentials For Dummies focuses on just the core concepts you need to communicate effectively. From conjugating verbs to understanding tenses, this easy-to-follow guide lets you skip the suffering and score high at exam time. French 101 - get the lowdown on the basics, from expressing dates and times to identifying parts of speech Gender matters - see how a noun's gender determines the articles, adjectives, and pronouns y

  7. The essential David Bohm

    CERN Document Server

    Nichol, Lee

    2002-01-01

    There are few scientists of the twentieth century whose life's work has created more excitement and controversy than that of physicist David Bohm (1917-1992). For the first time in a single volume, The Essential David Bohm offers a comprehensive overview of Bohm's original works from a non-technical perspective. Including three chapters of previously unpublished material, and a forward by the Dalai Lama, each reading has been selected to highlight some aspect of the implicate order process, and to provide an introduction to one of the most provocative thinkers of our time.

  8. Cisco networking essentials

    CERN Document Server

    McMillan, Troy

    2015-01-01

    Start a career in networking Cisco Networking Essentials, 2nd Edition provides the latest for those beginning a career in networking. This book provides the fundamentals of networking and leads you through the concepts, processes, and skills you need to master fundamental networking concepts. Thinking of taking the CCENT Cisco Certified Entry Networking Technician ICND1 Exam 100-101? This book has you covered! With coverage of important topics and objectives, each chapter outlines main points and provides clear, engaging discussion that will give you a sound understanding of core topics and c

  9. 实施国家基本药物制度对上海市某社区卫生服务中心门诊用药的影响%Effect Analysis of the Implementation of National Essential Medicine System on the Drug Utilization of Outpa-tients in a Shanghai Community Health Service Center

    Institute of Scientific and Technical Information of China (English)

    刘艳; 朱福; 张蓉蓉; 毛士龙

    2016-01-01

    目的:为推动社区卫生服务中心进一步实施国家基本药物制度、促进合理用药提供参考。方法:采集2009年9月2日-2014年11月25日上海市徐汇区长桥街道社区卫生服务中心门诊处方用药数据,对国家基本药物制度实施前、实施后和非基本药物增补后各阶段的用药品种、处方张数、用药金额、用药频度(DDDs)进行统计和分析。结果:各阶段基本药物均占据用药主导,用药金额和处方张数呈大幅增长趋势;基本药物中中成药和心血管系统用药使用金额和处方量合计占比均超50%,且呈现较高的环比增长率;用药金额和DDDs排序前10位的品种均为基本药物,其中多数为《上海市基层医疗卫生机构增补药物目录(2010版)》品种,且部分品种与《国家基本药物目录》(2012年版)重叠;心脑血管疾病用药品种占据主导地位;头孢替安、阿托伐他汀用药金额环比增长率最高,碳酸钙D3、厄贝沙坦氢氯噻嗪DDDs环比增长率最高。结论:基本药物目录覆盖了基层用药的常用品种,但其中的中成药和抗菌药物的规范性使用问题值得关注。应加强基本药物的合理使用,并适时调整基本药物目录,地方按需增补非基本药物,以真正满足患者的用药需求,优化医疗资源配置。%OBJECTIVE:To provide reference for promoting the further implementation of national essential medicine system and rational use of drugs in community health service center. METHODS:Outpatients’information in Changqiao Street Communi-ty Health Service Center from Sept. 2,2009 to Nov. 25,2014 was collected to statistically analyze the drug variety,the number of prescriptions,the consumption sum and the DDDs before and after the implementation of essential medicine system and after the supplement of non essential medicines. RESULTS:Essential medicines occupied the main position of drug utilization

  10. Delivering Unidata Technology via the Cloud

    Science.gov (United States)

    Fisher, Ward; Oxelson Ganter, Jennifer

    2016-04-01

    Over the last two years, Docker has emerged as the clear leader in open-source containerization. Containerization technology provides a means by which software can be pre-configured and packaged into a single unit, i.e. a container. This container can then be easily deployed either on local or remote systems. Containerization is particularly advantageous when moving software into the cloud, as it simplifies the process. Unidata is adopting containerization as part of our commitment to migrate our technologies to the cloud. We are using a two-pronged approach in this endeavor. In addition to migrating our data-portal services to a cloud environment, we are also exploring new and novel ways to use cloud-specific technology to serve our community. This effort has resulted in several new cloud/Docker-specific projects at Unidata: "CloudStream," "CloudIDV," and "CloudControl." CloudStream is a docker-based technology stack for bringing legacy desktop software to new computing environments, without the need to invest significant engineering/development resources. CloudStream helps make it easier to run existing software in a cloud environment via a technology called "Application Streaming." CloudIDV is a CloudStream-based implementation of the Unidata Integrated Data Viewer (IDV). CloudIDV serves as a practical example of application streaming, and demonstrates how traditional software can be easily accessed and controlled via a web browser. Finally, CloudControl is a web-based dashboard which provides administrative controls for running docker-based technologies in the cloud, as well as providing user management. In this work we will give an overview of these three open-source technologies and the value they offer to our community.

  11. 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.

  12. Calcium, essential for health

    Science.gov (United States)

    Martínez de Victoria, Emilio

    2016-07-12

    Calcium (Ca) is the most abundant mineral element in our body. It accounts for about 2% of body weight. The functions of calcium are: a) functions skeletal and b) regulatory functions. Bone consists of a protein matrix that mineralizes mainly with calcium (the most abundant), phosphate and magnesium, for it is essential an adequate dietary intake of Ca, phosphorus and vitamin D. The ionic Ca (Ca2+) is essential to maintain and / or perform different specialized functions of, virtually, all body cells cellular. Because of its important functions Ca2+ must be closely regulated, keeping plasma concentrations within narrow ranges. For this reason there is an accurate response against hypocalcemia or hypercalcemia in which the parathormone, calcitriol, calcitonin and vitamin K are involved. Ca intakes in the Spanish population are low in a significant percentage of the older adult’s population, especially in women. The main source of Ca in the diet is milk and milk derivatives. Green leafy vegetables, fruits and legumes can be important sources of Ca in a Mediterranean dietary pattern. The bioavailability of dietary Ca depends on physiological and dietary factors. Physiological include age, physiological status (gestation and lactation) Ca and vitamin D status and disease. Several studies relate Ca intake in the diet and various diseases, such as osteoporosis, cancer, cardiovascular disease and obesity.

  13. Minimizing Carbon Emissions for Vehicle Routing and Scheduling in Picking up and Delivering Customers to Airport Service%面向最小碳排放量的接送机场服务的车辆路径与调度

    Institute of Scientific and Technical Information of China (English)

    杨培颖; 唐加福; 于洋; 裴金翔

    2013-01-01

    车辆路径与调度问题(Vehicle routing and scheduling problem,VRSP)是制造系统自动化和商业服务系统优化调度要解决的重要问题,常常以路径最短或成本(时间)最小为优化目标.在强制性碳排放政策的影响下,如何通过路径优化与调度实现系统的节能减排,已经成为管理者一个优化控制的目标.本文建立了针对接送机场服务中以最小碳排放量为目标的车次分配与调度问题的0-1混合整数规划模型,采用了改进的基于时间和地域划分的极线扫描算法.重点通过不同类型、规模测试实例,分别从测试实例的顾客点位置分布、顾客规模以及车辆容量大小、满意度水平分析了对人均碳排放的影响程度,对现实接送机场服务运作中车辆配置和设置服务水平提供了有价值的建议.%Vehicle routing and scheduling problem (VRSP) is the important problem in manufacturing systems automation and business services, which often aims at the shortest path or the minimal cost for the optimization and management objectives. Under the mandatory carbon emissions policy, there is another important objective for the managers to reduce carbon emissions by optimizing the transport paths of the logistics. In this paper, a 0-1 mixed integer programming model is proposed to minimize carbon emissions for the airport shuttle service. An improved NPFDS algorithm with the partition from both time and geographical is proposed. Using different type and size test cases, this paper analyzes the fuel consumption per person that is from four respective dimensions, which are the customer position distribution, the customer scale, the vehicle capacity and the customer satisfaction degree. Some conclusions and references for the airport shuttle service configuration and service degree setting are also obtained.

  14. E-Governance and Service Oriented Computing Architecture Model

    Science.gov (United States)

    Tejasvee, Sanjay; Sarangdevot, S. S.

    2010-11-01

    E-Governance is the effective application of information communication and technology (ICT) in the government processes to accomplish safe and reliable information lifecycle management. Lifecycle of the information involves various processes as capturing, preserving, manipulating and delivering information. E-Governance is meant to transform of governance in better manner to the citizens which is transparent, reliable, participatory, and accountable in point of view. The purpose of this paper is to attempt e-governance model, focus on the Service Oriented Computing Architecture (SOCA) that includes combination of information and services provided by the government, innovation, find out the way of optimal service delivery to citizens and implementation in transparent and liable practice. This paper also try to enhance focus on the E-government Service Manager as a essential or key factors service oriented and computing model that provides a dynamically extensible structural design in which all area or branch can bring in innovative services. The heart of this paper examine is an intangible model that enables E-government communication for trade and business, citizen and government and autonomous bodies.

  15. The Use of Freshmen Seminar Programs to Deliver Personalized Feedback

    Science.gov (United States)

    Henslee, Amber M.; Correia, Christopher J.

    2009-01-01

    The current study tested the effectiveness of delivering personalized feedback to first-semester college freshmen in a group lecture format. Participants enrolled in semester-long courses were randomly assigned to receive either personalized feedback or general information about alcohol. Both lecture conditions were delivered during a standard…

  16. Delivering value to multiple stakeholders: 2013 and beyond.

    Science.gov (United States)

    Nugent, Michael E

    2012-12-01

    To deliver greater value, top payers and providers should: Measure the value they deliver to their business partners and customers, Create value through continuous performance improvement, Package and price value to optimize their margin, mission, and market share, Organize for value through new legal entities, employed medical groups, or both.

  17. 76 FR 35295 - Delivering an Efficient, Effective, and Accountable Government

    Science.gov (United States)

    2011-06-16

    ... June 16, 2011 Part III The President Executive Order 13576--Delivering an Efficient, Effective, and... 13576 of June 13, 2011 Delivering an Efficient, Effective, and Accountable Government By the authority... frequently analyzed ] and reviewed by agency leadership. Agencies shall update these metrics quarterly,...

  18. Service level agreements.

    Science.gov (United States)

    Grimwood, A

    1998-02-01

    Service level agreements provide clearer descriptions of the services to be provided and the objectives to be met. In many instances it is the first time that services have been defined allowing their performance to be suitably measured. They should be output based and not too prescriptive on how the services are to be delivered. The emphasis should be on establishing outputs and the arrangements for monitoring achievement. Customer expectations can exceed available resources and arbitration may become necessary if agreement cannot be reached on internal service level agreements. The main requirements of customers for change through service level agreements is usually improved communications on job status that includes notification of any delays and that agreed response times will be met.

  19. Essentials of nonlinear optics

    CERN Document Server

    Murti, Y V G S

    2014-01-01

    Current literature on Nonlinear Optics varies widely in terms of content, style, and coverage of specific topics, relative emphasis of areas and the depth of treatment. While most of these books are excellent resources for the researchers, there is a strong need for books appropriate for presenting the subject at the undergraduate or postgraduate levels in Universities. The need for such a book to serve as a textbook at the level of the bachelors and masters courses was felt by the authors while teaching courses on nonlinear optics to students of both science and engineering during the past two decades. This book has emerged from an attempt to address the requirement of presenting the subject at college level. A one-semester course covering the essentials can effectively be designed based on this.

  20. Essential and Embattled Expertise

    DEFF Research Database (Denmark)

    Leander, Anna

    2014-01-01

    This article argues that expertise has continued to hold an absolutely assential and profoundly embattled position in the knowledge/expertise/policy nexus. More than this, it suggests that this duality of the and - (rather than the clarity of the either or) is to be welcomed. This argument is made...... with reference to the controversies surrounding the sarin gas attrack on Ghouta Damascus 21 August 2013. The article first argues that expertise continues to be essential in the sense that it is integral to contemporary policy-controversies. As the discussion around the sarin gas attack shows expertise is both...... constituted through controversies and at the same time constituting them. The article proceeds to suggest that precisely because this is the case, it is important that expertise also remains embattled. As shown with reference to the sarin gas attack controversies, it is only through contestation that the role...

  1. DSP Architecture Design Essentials

    CERN Document Server

    Marković, Dejan

    2012-01-01

    In DSP Architecture Design Essentials, authors Dejan Marković and Robert W. Brodersen cover a key subject for the successful realization of DSP algorithms for communications, multimedia, and healthcare applications. The book addresses the need for DSP architecture design that maps advanced DSP algorithms to hardware in the most power- and area-efficient way. The key feature of this text is a design methodology based on a high-level design model that leads to hardware implementation with minimum power and area. The methodology includes algorithm-level considerations such as automated word-length reduction and intrinsic data properties that can be leveraged to reduce hardware complexity. From a high-level data-flow graph model, an architecture exploration methodology based on linear programming is used to create an array of architectural solutions tailored to the underlying hardware technology. The book is supplemented with online material: bibliography, design examples, CAD tutorials and custom software.

  2. LEVELS OF ESSENTIAL AND NON-ESSENTIAL METALS IN ...

    African Journals Online (AJOL)

    Preferred Customer

    is responsible for bitterness in local alcoholic beverages [8, 9]. ... Levels of essential and non-essential metals in Rhamnus prinoides (Gesho) ..... digestion is not expected from the fermentation/metabolism and hence the metal content in the.

  3. The Essential Physics of Medical Imaging, Third Edition.

    Science.gov (United States)

    Mahesh, Mahadevappa

    2013-07-01

    The Essential Physics of Medical Imaging, Third Edition., Bushberg J. T., Seibert J. A., Leidholdt E. M. Jr., Boone J. M., Lippincott Williams & Wilkins, Philadelphia, PA, USA, 2012. 1048 pp. Price: $199.99. ISBN 9780781780575 (hardcover). © 2013 Doody's Review Service. Doody's Review Service. © 2013 American Association of Physicists in Medicine.

  4. 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".

  5. Jewish Family and Children's Services: a pioneering human service organization (1850-2008).

    Science.gov (United States)

    Schwartz, Sara L; Austin, Michael J

    2011-01-01

    Jewish Family and Children's Services of San Francisco, the Peninsula, Marin, and Sonoma Counties is a pioneering nonprofit human service organization that has delivered services for 157 years. Over the course of its history, the organization has transformed itself from an all-volunteer agency delivering aid to immigrant families during the Gold Rush era to a $30 million nonprofit human service organization offering a full-range of services to adults, children, and families. The history of Jewish Family and Children's Services sheds light on the importance of strong leadership, strategic planning, external relationships, and strong donor support.

  6. 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.

  7. Semi-Automated Creation of Converged iTV Services: From Macromedia Director Simulations to Services Ready for Broadcast

    Directory of Open Access Journals (Sweden)

    Emmanuel Tsekleves

    2007-07-01

    Full Text Available While sound and video may capture viewers′ attention, interaction can captivate them. This has not been available prior to the advent of Digital Television. In fact, what lies at the heart of the Digital Television revolution is this new type of interactive content, offered in the form of interactive Television (iTV services.On top of that, the new world of converged networks has created a demand for a new type of converged services on a range of mobile terminals (Tablet PCs, PDAs and mobile phones. This paper aims at presenting a new approach to service creation that allows for the semi-automatic translation of simulations and rapid prototypes created in the accessible desktop multimedia authoring package Macromedia Director into services ready for broadcast. This is achieved by a series of tools that de-skill and speed-up the process of creating digital TV user interfaces (UI and applications for mobile terminals.The benefits of rapid prototyping are essential for the production of these new types of services, and are therefore discussed in the first section of this paper. In the following sections, an overview of the operation of content, service, creation and management sub-systems is presented, which illustrates why these tools compose an important and integral part of a system responsible of creating, delivering and managing converged broadcast and telecommunications services. The next section examines a number of metadata languages candidates for describing the iTV services user interface and the schema language adopted in this project. A detailed description of the operation of the two tools is provided to offer an insight of how they can be used to de-skill and speed-up the process of creating digital TV user interfaces and applications for mobile terminals. Finally, representative broadcast oriented and telecommunication oriented converged service components are also introduced, demonstrating how these tools have been used to

  8. Service learning in final year

    OpenAIRE

    2015-01-01

    Service-learning, where senior students participate in delivering primary care within a community of animals and people, has attracted attention within veterinary educational literature because of the rich learning experiences it can deliver (Howe et al 1999; Freeman et al 2013). Most accounts describe high volume spay/neuter clinics operating within shelter medicine. This poster describes a similar approach applied to companion animal dentistry.Periodontal disease is the commonest condition ...

  9. 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 o

  10. 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

  11. Genetics Home Reference: essential thrombocythemia

    Science.gov (United States)

    ... Diagnosis and Management Resources (2 links) Cleveland Clinic: Thrombocytosis Merck Manual for Health Care Professionals: Essential Thrombocythemia ... my area? Other Names for This Condition essential thrombocytosis primary thrombocythemia primary thrombocytosis Related Information How are ...

  12. Better Collaborative Working is Likely to Increase Uptake of Library Resources in a University Setting. A review of: Hightower, Barbara, Carolyn Rawl, and Michelle Schutt. “Collaborations for Delivering the Library to Students Through WebCT.” Reference Services Review 35.4 (2007: 541-51.

    Directory of Open Access Journals (Sweden)

    John Loy

    2008-06-01

    Full Text Available Objectives – To ascertain the extent to which university faculty members are integrating library resources within the WebCT course management system / managed learning environment. Also, to identify the reasons why faculty members are not integrating library resources within WebCT, and to explore their willingness to do so in future. Design – Case study with survey questionnaire and selected interview follow up.Setting – Urban campus of Auburn University in Montgomery, Alabama, United States of America.Subjects – One hundred and two members of faculty received a questionnaire. Five follow-up interviews were conducted.Methods – One hundred and two members of faculty with WebCT-supported courses received a questionnaire. They were asked to indicate if they linked to library resources, and if so which specific ones (e.g. library homepage, online catalogue, etc.. If they did not link to library resources they were asked to indicate the reason why not, either by selecting one or more of five pre-selected reasons, or by detailing their own. Follow-up interviews were conducted with five respondents, two of whom (Education and Nursing linked to library resources, and three of whom (from Business, Education and Science did not. Server log reports were also examined to identify how many students were entering library resources from WebCT.Main Results – The survey response rate was 28% (29 individuals, and of these Nursing and Sciences were the highest users with 7 individuals in each faculty. Of the 29 respondents only 7 (24% currently linked to library resources. Nursing were the biggest group with 10 links (38% of the total, Science with 6 (23% and 5 each from Liberal Arts and Education (19%. The resources chosen to link to were• Article databases (6• Library homepage (5• Ask a Librarian e-mail service(3• Net library e-book collection (3Six other library resources scored lower and two were not linked to at all. While few respondents

  13. A new approach to automating services

    OpenAIRE

    2016-01-01

    While many white collar workers may feel threatened by service automation, companies that thoughtfully automate services are finding that the worries are overblown. By pairing humans and robots, companies can deliver better services for less, and jobs can become more interesting.

  14. Putative essential and core-essential genes in Mycoplasma genomes.

    Science.gov (United States)

    Lin, Yan; Zhang, Randy Ren

    2011-01-01

    Mycoplasma, which was used to create the first "synthetic life", has been an important species in the emerging field, synthetic biology. However, essential genes, an important concept of synthetic biology, for both M. mycoides and M. capricolum, as well as 14 other Mycoplasma with available genomes, are still unknown. We have developed a gene essentiality prediction algorithm that incorporates information of biased gene strand distribution, homologous search and codon adaptation index. The algorithm, which achieved an accuracy of 80.8% and 78.9% in self-consistence and cross-validation tests, respectively, predicted 5880 essential genes in the 16 Mycoplasma genomes. The intersection set of essential genes in available Mycoplasma genomes consists of 153 core essential genes. The predicted essential genes (available from pDEG, tubic.tju.edu.cn/pdeg) and the proposed algorithm can be helpful for studying minimal Mycoplasma genomes as well as essential genes in other genomes.

  15. 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.

  16. 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...

  17. US Forest Service Aerial Fire Retardant Avoidance Areas: Terrestrial

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service depicting aerial fire retardant avoidance areas delivered as part of the 2011 Nationwide Aerial Application of Fire Retardant on National Forest System...

  18. Essentially narrative explanations.

    Science.gov (United States)

    Roth, Paul A

    2017-04-01

    This essay argues that narrative explanations prove uniquely suited to answering certain explanatory questions, and offers reasons why recognizing a type of statement that requires narrative explanations crucially informs on their assessment. My explication of narrative explanation begins by identifying two interrelated sources of philosophical unhappiness with them. The first I term the problem of logical formlessness and the second the problem of evaluative intractability. With regard to the first, narratives simply do not appear to instantiate any logical form recognized as inference licensing. But absent a means of identifying inferential links, what justifies connecting explanans and explanandum? Evaluative intractability, the second problem, thus seems a direct consequence. This essay shows exactly why these complaints prove unfounded by explicating narrative explanations in the process of answering three interrelated questions. First, what determines that an explanation has in some critical or essential respect a narrative form? Second, how does a narrative in such cases come to constitute a plausible explanation? Third, how do the first two considerations yield a basis for evaluating an explanation offered as a narrative? Answers to each of these questions include illustrations of actual narrative explanations and also function to underline attendant dimensions of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Discover, Visualize, and Deliver Geospatial Data through OGC Standards-based WebGIS System

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Yaxing [ORNL; SanthanaVannan, Suresh K [ORNL; Cook, Robert B [ORNL

    2009-01-01

    Geospatial data are important to understand the Earth - ecosystem dynamics, land cover changes, resource management, and human interactions with the Earth to name a few. One of the biggest difficulties users face is to discover, access, and assemble distributed, large volume, heterogeneous geospatial data to conduct geo-analysis. Traditional methods of geospatial data discovery, visualization, and delivery lack the capabilities of resource sharing and automation across systems or organizational boundaries. They require users to download the data ldquoas-isrdquo in their original file format, projection, and extent. Also, discovering data served by traditional methods requires prior knowledge of data location, and processing requires specialized expertise. These drawbacks of traditional methods create additional burden to users, introduce too much overhead to research, and also reduce the potential usage of the data. At the Oak Ridge National Laboratory (ORNL), researchers working on NASA-sponsored projects: Distributed Active Archive Center (DAAC) and Modeling and Synthesis Thematic Data Center (MAST-DC) have tapped into the benefits of Open Geospatial Consortium (OGC) standards to overcome the drawbacks of traditional methods of geospatial data discovery, visualization, and delivery. The OGC standards-based approach facilitates data sharing and interoperability across network, organizational, and geopolitical boundaries. Tools and services based on OGC standards deliver the data in many user defined formats and allow users to visualize the data prior to download. This paper introduces an approach taken to visualize and deliver ORNL DAAC, MAST-DC, and other relevant geospatial data through OGC standards-based Web Services, including Web Map Service (WMS), Web Coverage Service (WCS), and Web Feature Service (WFS). It also introduces a WebGIS system built on top of OGC services that helps users discover, visualize, and access geospatial data.

  20. The ability of health promoters to deliver group diabetes education in South African primary care

    Directory of Open Access Journals (Sweden)

    Anna S. Botes

    2013-01-01

    Full Text Available Background: Diabetes makes a significant contribution to the burden of disease in South Africa.This study assesses a group diabetes education programme using motivational interviewingin public sector health centres serving low socio-economic communities in Cape Town.The programme was delivered by mid-level health promotion officers (HPOs.Objectives: The aim of the study was to explore the experience of the HPOs and to observetheir fidelity to the educational programme.Methods: Three focus group interviews were held with the 14 HPOs who delivered theeducational programme in 17 health centres. Thirty-three sessions were observed directly andthe audio tapes were analysed using the motivational interviewing (MI integrity code.Results: The HPOs felt confident in their ability to deliver group education after receiving thetraining. They reported a significant shift in their communication style and skills. They feltthe new approach was feasible and better than before. The resource material was found to berelevant, understandable and useful. The HPOs struggled with poor patient attendance and alack of suitable space at the facilities. They delivered the majority of the content and achievedbeginning-level proficiency in the MI guiding style of communication and the use of openquestions. The HPOs did not demonstrate proficiency in active listening and continued to offersome unsolicited advice.Conclusion: The HPOs demonstrated their potential to deliver group diabetes education despiteissues that should be addressed in future training and the district health services. Thefindings will help with the interpretation of results from a randomised controlled trial evaluatingthe effectiveness of the education.

  1. 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.

  2. Oral microflora in infants delivered vaginally and by caesarean section.

    Science.gov (United States)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron; Blomqvist, Susanne; Dahlén, Gunnar; Twetman, Svante

    2011-11-01

    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 Hospital in Halmstad, Sweden. Medically compromised and premature children (oral health need to be further investigated.

  3. Delivering Physical Education in selected schools in Soweto, South ...

    African Journals Online (AJOL)

    Delivering Physical Education in selected schools in Soweto, South Africa: ... Principals and sport masters of all five schools made up the 10 interviewees. ... preparedness of teachers, as well as the level of motivation and workload of teachers.

  4. Capacity to deliver pharmaceutical care by community pharmacies ...

    African Journals Online (AJOL)

    The capacity of community pharmacies to deliver pharmaceutical care was studied ... Ninety five percent (95%) of the respondents always educated customers on ... of the principles of Millennium Development Goals and pharmaceutical care ...

  5. 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.

  6. Return on Investment for Essential Obstetric Care Training in Ghana: Do Trained Public Sector Midwives Deliver Postabortion Care?

    NARCIS (Netherlands)

    K.A. Clark; E.H.M. Mitchell; P.K. Aboagye

    2010-01-01

    Introduction: In Ghana, the provision of postabortion care (PAC) by trained midwives is critical to the efficient and cost-effective reduction of unsafe abortion morbidity and mortality. Methods: We performed a secondary analysis of provider data from a representative sample of Ghanaian health facil

  7. Forecasting economic aspects of future wireless services

    DEFF Research Database (Denmark)

    Falch, Morten; Henten, Anders; Saugstrup, Dan

    based services may be delivered through collaboration between network operators and content providers. How can this market be expected to develop? Will the network operators act as system integrators connecting customers and content providers in a walled garden approach or will the market for wireless...... services be shaped like the Internet today with a large number of independent information providers offering their services directly to the customers? This deliverable will analyse economic models for delivery of ‘3G and beyond’ wireless Internet services, and assess the types of services that will drive......The topic for this deliverable is to assess the future economic setup and implications of wireless services. While provision of basic wireless communication services such as voice and messaging services usually are delivered as end-to-end services by the network operator, the market for content...

  8. A Legal Framework to Support Development and Assessment of Digital Health Services.

    Science.gov (United States)

    Garell, Cecilia; Svedberg, Petra; Nygren, Jens M

    2016-05-25

    Digital health services empower people to track, manage, and improve their own health and quality of life while delivering a more personalized and precise health care, at a lower cost and with higher efficiency and availability. Essential for the use of digital health services is that the treatment of any personal data is compatible with the Patient Data Act, Personal Data Act, and other applicable privacy laws. The aim of this study was to develop a framework for legal challenges to support designers in development and assessment of digital health services. A purposive sampling, together with snowball recruitment, was used to identify stakeholders and information sources for organizing, extending, and prioritizing the different concepts, actors, and regulations in relation to digital health and health-promoting digital systems. The data were collected through structured interviewing and iteration, and 3 different cases were used for face validation of the framework. A framework for assessing the legal challenges in developing digital health services (Legal Challenges in Digital Health [LCDH] Framework) was created and consists of 6 key questions to be used to evaluate a digital health service according to current legislation. Structured discussion about legal challenges in relation to health-promoting digital services can be enabled by a constructive framework to investigate, assess, and verify the digital service according to current legislation. The LCDH Framework developed in this study proposes such a framework and can be used in prospective evaluation of the relationship of a potential health-promoting digital service with the existing laws and regulations.

  9. 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.

  10. A review on how to better implement National Essential Public Health Services Program in China%国家基本公共卫生服务项目回顾及对“十三五”期间政策完善的思考

    Institute of Scientific and Technical Information of China (English)

    胡同宇

    2015-01-01

    国家基本公共卫生服务项目实施已经5年多,该项工作的成效、问题及如何深入推进受到各方关注。本文基于文献、文件及报告资料,对项目背景和进展进行了梳理,分析了项目实施过程中的重点问题,并对项目制度建设提出相应建议。项目进展和成效主要表现为,初步形成了制度安排、服务量稳步增加、健康和社会效益初步显现。但是,因项目涉及多部门、多领域及各类医疗卫生机构,需要处理好各种关系。“十三五”期间,建议进一步健全国家基本公共卫生服务有效供给机制,重点做好资金筹集和管理、服务内容决策、服务提供体系、服务模式、绩效考核和评价几方面工作。%Chinese government launched National Essential Public Health Services Program since 5 years ago;a program of which the progress, achievement, challenges and a knowhow for a better implementation are concerned by the related policy makers, implementers and researchers. Based on the years of experience in this area, combining literatures and reports relevant to this program, this paper summed up its background and progress, analyzed prob-lems and challenges as well as put forward the policy recommendations for a better implementation of the work. The results were mainly described in three different ways as follows:firstly, the public health service delivery system was formed;secondly, services types and target population were annually increased; and thirdly, there were remarkable health and social benefits. However, for such a big program that is related to multiple government departments and health institutions, contradictions may emerge during implementation. Therefore, it is important to deal with its dif-ferent relationships. Recommendations for further implementation of the work in the coming “Thirteenth-Five-Year”plan are enlightened to deepen a perfect essential public health service delivery

  11. On the performance of web services

    CERN Document Server

    Tari, Zahir; Jayasinghe, Malith

    2011-01-01

    Performance of Web Services provides innovative techniques to improve the performance of Web Services, as well as QoS (Quality of Service) requirements. This includes Qos performance, reliability and security. The author presents two levels of Web Services: the ""kernel"" (ithe SOAP engine which delivers messages from one point to another through various networks), and the ""server side"" (which processes heavy load / requests). The primary objective of this book is execution of applications delivered in a timely fashion. Case studies and examples are provided throughout this book.

  12. Essential Medicines: An Indian Perspective.

    Science.gov (United States)

    Maiti, Rituparna; Bhatia, Vikas; Padhy, Biswa Mohan; Hota, Debasish

    2015-01-01

    The concept of defining essential medicines and establishing a list of them was aimed to improve the availability of affordable medicines for the world's poor. Access to essential medicines is a major determinant of health outcomes. Several countries have made substantial progress towards increasing access to essential medicines, but access to essential medicines in developing countries like India is not adequate. In this review we have tried to present the Indian scenario in respect to availability and accessibility of essential medicines over last one decade. To enhance the credibility of Indian healthcare system, procurement and delivery systems of essential medicines have to be strengthened through government commitment, careful selection, adequate public sector financing, efficient distribution systems, control on taxes and duties, and inculcating a culture of rational use of medicines in current and future prescribers.

  13. Towards improving service delivery in screening and intervention services in community pharmacies: a case study of an alcohol IBA service.

    Science.gov (United States)

    Mackridge, A J; Krska, J; Stokes, E C; Heim, D

    2016-03-01

    Previous studies have demonstrated positive outcomes from a range of pharmacy public health services, but barriers to delivery remain. This paper explores the processes of delivering an alcohol screening and intervention service, with a view to improving service delivery. A mixed-methods, multi-perspective approach was used, comprising in-pharmacy observations and recording of service provision, follow-up interviews with service users and interactive feedback sessions with service providers. Observations and recordings indicate that staff missed opportunities to offer the service and that both availability and delivery of the service were inconsistent, partly owing to unavailability of trained staff and service restrictions. Most service users gave positive accounts of the service and considered pharmacies to be appropriate places for this service. Respondents also described positive impacts, ranging from thinking more about alcohol consumption generally to substantial reductions in consumption. Key facilitators to service provision included building staff confidence and service champions. Barriers included commissioning issues and staff perception of alcohol as a sensitive topic. Findings support expansion of pharmacies' role in delivering public health services and highlight benefits of providing feedback to pharmacy staff on their service provision as a possible avenue for service improvement. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. CUSTOMER IMPORTANCE RATING OF SERVICE QUALITY DIMENSIONS FOR AUTOMOBILE SERVICE

    Directory of Open Access Journals (Sweden)

    SATYENDRA SHARMA

    2014-12-01

    Full Text Available Customers are the center of an organization’s universe: they define quality. They expect performance, reliability, responsiveness, competitive prices, on-time delivery, service, clear and correct transaction processing and more. Customer satisfaction/Service quality management has become a strategic imperative for most firms. In the present circumstances, it is vital to measure customer perceptions and how well the company delivers on the critical factors/dimensions of the business. The main objective of this paper is to be acquainted with customer importance rating of service quality dimensions or Voice of Customers for an Automobile service centre. A questionnaire has been used for the purpose.

  15. Applying Fourth Generation Management to Access Services: Reinventing Customer Service and Process Management

    Science.gov (United States)

    Hasty, Douglas F.

    2004-01-01

    Are librarians doing all they can to ensure that customer services are delivered with the customer in mind? Librarians are great at helping, but we sometimes need help with identifying customers, defining their needs, developing services, and reviewing the processes behind the services. Fourth Generation Management provides new insight for…

  16. Services marketing for the enlightened manager.

    Science.gov (United States)

    Blumberg, M R

    1999-01-01

    A marketing focus emphasizes the customer's perspective rather than the supplier's internal perspective. The needs of the customer determine what services are brought to the market and how they are supplied, marketed, and sold. The marketing orientation differs drastically from the production orientation on a number of key sales and marketing criteria. For example, technical innovation is seen as a means of locating new opportunities for firms with a marketing orientation, whereas a firm with production orientation sees innovation as a mechanism for cutting costs. Biomedical equipment service managers who adopt these marketing principles understand the subtle differences between products and services, and in doing so have become enlightened marketers. Enlightened service marketers define and articulate their services to the customer and provide the customer with good knowledge of the service(s) to be delivered, before they are actually delivered. The customer is able to achieve a comfort level with the service provided before it is provided.

  17. 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.

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

    OpenAIRE

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

    2015-01-01

    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.\\ud \\ud Materials and Methods: Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolk...

  19. Consultation liaison psychiatry in Africa – essential service or ...

    African Journals Online (AJOL)

    the patient (longer hospital stays, delayed return to work or disability), as well as ... In Africa, many health professionals view mental illness as synonymous with ... expansion of successful medical-psychiatric care environments. In Africa, CL ...

  20. An assessment of essential maternal health services in Kwara state ...

    African Journals Online (AJOL)

    Frequency tables, percentages and charts were used for presenting the data. ... in reducing maternal mortality have a big challenge in the areas of availability, ... s'il existe des différences entre les établissements de santé publics et privés en ...

  1. ABC Article Essential Concepts in Modern Health Services

    African Journals Online (AJOL)

    102640

    Suitable legislations should be introduced including those that ensure coordination between .... part could make counteractive changes in .... matters to develop strategies for risk regulation ... A vivid example is the return of diphtheria .... develop an evidence base on HRs for health. [2]. The appropriate roles of the workforce,.

  2. Why Training for Service Contract Management is Mission Essential

    Science.gov (United States)

    2005-11-01

    The widely reported overcharging by Kellogg Brown & Root for gasoline during the Iraq invasion, the Abu Ghraib prisoner abuse scandal , and the Air...contracting adage says, Where there is no audit, there is no ethics. The recent Enron debacle provides an excellent example of just how true this adage can

  3. Understanding And Developing Innovative Products And Services: The Essential Elements

    DEFF Research Database (Denmark)

    Tan, Adrian; McAloone, Timothy Charles

    2006-01-01

    Innovation is synonymous with successful development and implementation, and therefore peculiar to innovation is that it has to prove itself on the market before we can deem it innovative. This paper suggests an approach for understanding the principles for innovative products which is based......, not on the product itself, but on the activity and the effect on stakeholders. Innovative products are products that contain a difference, with appropriate, valuable and desirable effects induced on the company, consumer and society. The approach is exemplified through a case on the Sony Walkman. When designing...

  4. Uncovering ecosystem service bundles through social preferences

    OpenAIRE

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

    2012-01-01

    11 p. 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 d...

  5. 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…

  6. Genetics Home Reference: essential tremor

    Science.gov (United States)

    ... tremor that results from other disorders or known causes, such as Parkinson disease or head trauma. Essential tremor usually occurs ... tremor occurs. Severe cases are often misdiagnosed as Parkinson disease . Related Information What information ... causes of essential tremor are unknown. Researchers are studying ...

  7. Relational uncertainty in service dyads

    DEFF Research Database (Denmark)

    Kreye, Melanie

    2016-01-01

    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...... via semi-structured interviews and secondary data. Findings: The findings suggest that relational uncertainty is caused by the partner’s unresolved organisational uncertainty, i.e. their lacking capabilities to deliver or receive (parts of) the service. Furthermore, we found that resolving...... 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...

  8. [Urban ecosystem services: A review].

    Science.gov (United States)

    Mao, Qi-zheng; Huang, Gan-lin; Wu, Jian-guo

    2015-04-01

    Maintaining and improving ecosystem services in urban areas and human well-being are essential for sustainable development and therefore constitute an important topic in urban ecology. Here we reviewed studies on ecosystem services in urban areas. Based on the concept and classification of urban ecosystem services, we summarized characteristics of urban ecosystem services, including the human domination, high demand of ecosystem services in urban areas, spatial heterogeneity and temporal dynamics of ecosystem services supply and demand in urban areas, multi-services of urban green infrastructures, the socio-economic dimension of ecosystem services supply and ecosystem disservices in urban areas. Among different urban ecosystem services, the regulating service and cultural service are particularly indispensable to benefit human health. We pointed out that tradeoffs among different types of ecosystem services mostly occur between supportive service and cultural service, as well as regulating service and cultural service. In particular, we emphasized the relationship between landscape design (i.e. green infrastructure) and ecosystem services supply. Finally, we discussed current gaps to link urban ecosystem services studies to landscape design and management and pointed out several directions for future research in urban ecosystem services.

  9. 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

  10. 77 FR 53233 - Renewable Energy and Related Services: Recent Developments

    Science.gov (United States)

    2012-08-31

    ... COMMISSION Renewable Energy and Related Services: Recent Developments AGENCY: United States International... (Commission) instituted investigation No. 332-534, Renewable Energy and Related Services: Recent Developments... services, and a second on renewable energy and related services, and deliver the reports in 8 and 11...

  11. 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

  12. Competencies for government veterinary services of the future: Summary of ISVEE 14 Yucatan 2015 roundtable discussion.

    Science.gov (United States)

    Stärk, Katharina D C; Goncalves, Vitor S P; McCluskey, Brian J; Pinto, Julio; Tsutsui, Toshiyuki; Gibbens, Jane

    2017-02-01

    This short communication summarizes the strengths and weaknesses of current organisational structures in government veterinary services, as well as future technical, financial and societal challenges and related necessary competencies for government veterinary services of the future as discussed by an expert panel at ISVEE2015. First, participating representatives of veterinary services of diverse geographical backgrounds and statements from the audience confirmed that non-technical skills such as ability to work in teams, adaptability to new environments and situations, social and communication skills are increasingly seen as important. The second challenge faced by veterinary services is related to capacity issues, i.e. to have enough manpower to plan and deliver according to legislation in a period of shrinking budgets. New and emerging diseases can result in sudden, massive increases in the workload of veterinary services. Technical complexity has also increased for some hazards. Staff skills in veterinary services therefore need to be continuously updated, and it is essential to establish cross technical collaboration with other sectors including food safety, public health and environment. ISVEE conferences were seen as an opportunity to provide a global platform to develop skills needed by veterinary services, now and in the future.

  13. 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…

  14. QoS Metrics for Cloud Computing Services Evaluation

    Directory of Open Access Journals (Sweden)

    Amid Khatibi Bardsiri

    2014-11-01

    Full Text Available Cloud systems are transforming the Information Technology trade by facultative the companies to provide admission to their structure and also software products to the membership foundation. Because of the vast range within the delivered Cloud solutions, from the customer’s perspective of an aspect, it's emerged as troublesome to decide whose providers they need to utilize and then what's the thought of his or her option. Especially, employing suitable metrics is vital in assessing practices. Nevertheless, to the most popular of our knowledge, there's no methodical explanation relating to metrics for estimating Cloud products and services. QoS (Quality of Service metrics playing an important role in selecting Cloud providers and also optimizing resource utilization efficiency. While many reports have got to devote to exploitation QoS metrics, relatively not much equipment supports the remark and investigation of QoS metrics of Cloud programs. To guarantee a specialized product is published, describing metrics for assessing the QoS might be an essential necessity. So, this text suggests various QoS metrics for service vendors, especially thinking about the consumer’s worry. This article provides the metrics list may stand to help the future study and also assessment within the field of Cloud service's evaluation.

  15. Ranking the technical dimensions of e-banking service quality evaluation models using Analytical Hierarchy Process

    Directory of Open Access Journals (Sweden)

    NoorMohammad Yaghubi

    Full Text Available With the expansion of internet, delivering e-services are rapidly growing in the bank industry. Therefore improving e-service quality for delivering better services is one of the most important areas of activity for banks. One of the most important aspect ...

  16. [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.

  17. 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

  18. DOD Service Acquisition: Improved Use of Available Data Needed to Better Manage and Forecast Service Contract Requirements

    Science.gov (United States)

    2016-02-01

    augmentation program Logistics support services Electronic and communication services Information technology services Telecom services Equipment...costs into their POM estimates. For example: • Air Force Minuteman Minimum Essential Emergency Communications Network Program Upgrade office developed...Minimum Essential Emergency Communications Network Program Upgrade office, which developed its fiscal year 2015-2019 POM input in accordance with

  19. 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.

  20. In vitro Magnetic Stimulation: A Simple Stimulation Device to Deliver Defined Low Intensity Electromagnetic Fields

    Science.gov (United States)

    Grehl, Stephanie; Martina, David; Goyenvalle, Catherine; Deng, Zhi-De; Rodger, Jennifer; Sherrard, Rachel M.

    2016-01-01

    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 optimize therapeutic application of human NIBS. PMID:27857683

  1. 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 degra

  2. 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.

  3. 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

  4. Effectiveness of an Electronic Booster Session Delivered to Mandated Students.

    Science.gov (United States)

    Linowski, Sally A; DiFulvio, Gloria T; Fedorchak, Diane; Puleo, Elaine

    2016-01-01

    College student drinking continues to be a problem in the United States. Students who have violated campus alcohol policy are at particularly high risk for dangerous drinking. While Brief Alcohol Screening and Intervention for College Students (BASICS) has been found to be an effective strategy in reducing high-risk drinking and associated consequences, questions remain about ways to further reduce risk or sustain changes associated with a face-to face intervention. The purpose of this study was to assess the effectiveness of a computer-delivered personalized feedback (electronic booster) delivered to policy violators who completed a mandated BASICS program. At 3-month post-intervention, 346 participants (60.4% male and 39.6% female) were randomized to one of two conditions: assessment only (n = 171) or electronic booster feedback (n = 175). Follow-up assessments were given to all participants at 3, 6, and 12-month post-initial intervention. Both groups showed reductions in drinking after the in-person BASICS intervention, but no additional reductions were seen with the addition of an electronic booster session. Findings suggest that although brief motivational interventions delivered in person to mandated students have been shown to be effective with mandated students, there is no additional benefit from an electronic booster session delivered 3-month post-intervention for this population.

  5. The Challenges of Globalisation: Delivering an MBA Programme in Eritrea.

    Science.gov (United States)

    Dence, Roger; O'Toole, John

    1999-01-01

    Describes the experiences of delivering an MBA (Master in Business Administration) program in Eritrea (North East Africa) through the United Kingdom's Open University. Discusses tutoring teams that travel to Eritrea, localizing case examples and assignments, sensitivity to local cultural contexts, writing assignments, student assessment, and…

  6. Lessons from VET Providers Delivering Degrees: Case Studies. Support Document

    Science.gov (United States)

    Callan, Victor J.; Bowman, Kaye

    2015-01-01

    The recent growth in the number of registered vocational education and training (VET) providers delivering associate degrees and bachelor degrees in their own right has been well publicized. However, little is known about why these VET providers have made this transition, what support is being provided to their staff and students, and how the…

  7. Justice Delivered Locally : Systems, Challenges, and Innovations in Solomon Islands

    OpenAIRE

    2013-01-01

    This report presents the research findings of the Justice Delivered Locally (JDL) initiative of Solomon Islands' Ministry of Justice and Legal Affairs, which was supported by the World Bank's Justice for the Poor (J4P) program. JDL supports the Solomon Islands Government (SIG) policy of reinvigorating local-level justice systems. This is based on an understanding that developmentally impor...

  8. Designing and Delivering Intensive Interventions: A Teacher's Toolkit

    Science.gov (United States)

    Murray, Christy S.; Coleman, Meghan A.; Vaughn, Sharon; Wanzek, Jeanne; Roberts, Greg

    2012-01-01

    This toolkit provides activities and resources to assist practitioners in designing and delivering intensive interventions in reading and mathematics for K-12 students with significant learning difficulties and disabilities. Grounded in research, this toolkit is based on the Center on Instruction's "Intensive Interventions for Students Struggling…

  9. Putative essential and core-essential genes in Mycoplasma genomes

    OpenAIRE

    Lin, Yan; Zhang, Randy Ren

    2011-01-01

    Mycoplasma, which was used to create the first “synthetic life”, has been an important species in the emerging field, synthetic biology. However, essential genes, an important concept of synthetic biology, for both M. mycoides and M. capricolum, as well as 14 other Mycoplasma with available genomes, are still unknown. We have developed a gene essentiality prediction algorithm that incorporates information of biased gene strand distribution, homologous search and codon adaptation index. The al...

  10. Neuroimaging essentials in essential tremor: a systematic review.

    Science.gov (United States)

    Sharifi, Sarvi; Nederveen, Aart J; Booij, Jan; van Rootselaar, Anne-Fleur

    2014-01-01

    Essential tremor is regarded to be a disease of the central nervous system. Neuroimaging is a rapidly growing field with potential benefits to both diagnostics and research. The exact role of imaging techniques with respect to essential tremor in research and clinical practice is not clear. A systematic review of the different imaging techniques in essential tremor is lacking in the literature. We performed a systematic literature search combining the terms essential tremor and familial tremor with the following keywords: imaging, mri, vbm, dwi, fmri, pet and spect, both in abbreviated form as well as in full form. We summarize and discuss the quality and the external validity of each study and place the results in the context of existing knowledge regarding the pathophysiology of essential tremor. A total of 48 neuroimaging studies met our search criteria, roughly divided into 19 structural and 29 functional and metabolic studies. The quality of the studies varied, especially concerning inclusion criteria. Functional imaging studies indicated cerebellar hyperactivity during rest and during tremor. The studies also pointed to the involvement of the thalamus, the inferior olive and the red nucleus. Structural studies showed less consistent results. Neuroimaging techniques in essential tremor give insight into the pathophysiology of essential tremor indicating the involvement of the cerebellum as the most consistent finding. GABAergic dysfunction might be a major premise in the pathophysiological hypotheses. Inconsistencies between studies can be partly explained by the inclusion of heterogeneous patient groups. Improvement of scientific research requires more stringent inclusion criteria and application of advanced analysis techniques. Also, the use of multimodal neuroimaging techniques is a promising development in movement disorders research. Currently, the role of imaging techniques in essential tremor in daily clinical practice is limited.

  11. Building the Case for Delivering Health Promotion Services within the Vocational Rehabilitation System

    Science.gov (United States)

    Ipsen, Catherine; Seekins, Tom; Ravesloot, Craig

    2010-01-01

    Research studies report a negative relationship between employment and secondary conditions. Access to health promotion programs to manage secondary conditions, however, is limited for people with disabilities due to employment, financial, and insurance barriers. Vocational rehabilitation (VR) is one possible delivery point to overcome these…

  12. THE IMPORTANCE OF MOTIVATION THEORIES IN DELIVERING THE PROMISED SERVICES TO CUSTOMERS

    OpenAIRE

    CONSTANTIN CÃRUNTU; ANDREEA LAURA CÃRUNTU

    2012-01-01

    Motivation represents an important factor in the achievement of revenues of a company and that is why the management should pay great attention to this subject. For many managers it is quite a challenge to find the best solution to motivate employees because human beings are different and are guided by different reasons in life. The paper focuses on the presentation of the most important types of motivation, to motivation theories and takes into consideration their importance in the delivery ...

  13. Metal casting industry of the future: An integrated approach to delivering energy efficiency products and services

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    The Industries of the Future process is driven by industry. Through technology roadmaps, industry participants set technology priorities, assess the progress of R and D, and ultimately lead the way in applying research results. This approach to private-public partnerships ensures the most strategic allocation possible of limited resources for the development of new technologies and the enhancement of industrial processes. Based on industry`s request, OIT`s role is to help facilitate the Industries of the Future strategy and to support the development and deployment of technologies that will shape the future of the metal casting industry. Part of this role is to encourage industry to undertake long-term, sector-wide technology planning and to selectively cost-share with OIT in collaborative R and D activities that match OIT`s mission. OIT metal casting research requires a dollar for dollar industry cost share.

  14. A New European distance training environment delivering VET services: In.Tra.Net system

    Directory of Open Access Journals (Sweden)

    Maria Riccio

    2009-10-01

    Full Text Available This contribution' main goal is to describe an innovative learning system and approach aimed to support professional training in using complex and last generation electric apparatus through distance laboratory reproducing real conditions and technical instruments The paper describes a comprehensive solution based on a distance learning environment to distribute theoretical and practical learning activities to control and manage remote real instrumentations via Internet and web solutions. This specific solution derives from the project IN.TRA.NET (Innovation Transfer Network, a Leonardo da Vinci’ transfer of innovation project funded under the 2008 call of Life Long Learning. The paper briefly presents the general framework for distance experimental learning environments, IN.TRA.NET' goals and features and the first project' evidences arising from preliminary need analysis.

  15. Killer web content make the sale, deliver the service, build the brand

    CERN Document Server

    McGovern, Gerry

    2009-01-01

    Written by an internationally-acclaimed specialist in this field, Killer Web Content givesyou the strategies and practical techniques you need to get the verybest out of your Web content. Accessible, concise and practical, itwill make your website really work for you.

  16. In the Wake of Hurricane Katrina: Delivering Crisis Mental Health Services to Host Communities

    Science.gov (United States)

    Marbley, Aretha Faye

    2007-01-01

    Throughout the country and especially in Texas, local communities opened their arms to hurricane Katrina evacuees. Like the federal government, emergency health and mental health entities were unprepared for the massive numbers of people needing assistance. Mental health professionals, though armed with a wealth of crisis intervention information,…

  17. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    . The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative...

  18. Information Selection and Delivery Algorithm for Delivering Advertisements Suitable for the Pedestrians Present at a Particular Site

    Directory of Open Access Journals (Sweden)

    Koichi MATSUOKA

    2011-02-01

    Full Text Available We consider a service that shows an advertisement suitable for the preferences of the pedestrians present at the site where the display is installed. In order to evaluate the effectiveness of this service by a simulation that reflects the reality well, we propose evaluation functions that take account of the line of sight of moving pedestrians. The evaluation functions incorporate two independent variables: Category and Producer. Based on this evaluation functions, we also propose an algorithm of multicasting an advertisement to different sites in order to deliver advertisements efficiently over a network while ensuring a high advertisement relevance rate. The evaluation results show that the proposed algorithm always scores a higher advertisement relevance rate than conventional advertising media. It is also shown that the proposed algorithm can reduce the delivery time by about 37%, and the volume of data delivered from the server by about 39% compared with unicast delivery.

  19. Mobile Cloud for Personalized Any-Media Services

    Institute of Scientific and Technical Information of China (English)

    Bhumip Khasnabish

    2012-01-01

    In this paper, we define mobile cloud computing and describe how it can be used for delivering advanced any-media services to both nomadic and mobile users. We focus on service delivery that is localized and personalized and suggest that virtualization and tighter cross-layer communication allows for convergence and seamless transition of services. These are also creating new and never-before seen ways of developing and delivering personalized any-media services. We discuss current paradigms for implementing cloud-based any-media services that generate revenue. Future research topics and requirements for evolving network and service elements are also discussed.

  20. Essential Math Skills for Engineers

    CERN Document Server

    Paul, Clayton R

    2011-01-01

    Just the math skills you need to excel in the study or practice of engineering Good math skills are indispensable for all engineers regardless of their specialty, yet only a relatively small portion of the math that engineering students study in college mathematics courses is used on a frequent basis in the study or practice of engineering. That's why Essential Math Skills for Engineers focuses on only these few critically essential math skills that students need in order to advance in their engineering studies and excel in engineering practice. Essential Math Skills for Engineers features con

  1. Intelligent Integration of Information and Services on the Web

    OpenAIRE

    Stroulia, Eleni

    2002-01-01

    The evolution of the World Wide Web from a repository of HTML data to a source of varied distributed services creates exciting opportunities for offering complex, integrated services over the web. The syntactic problems of such integration are being addressed by the advent of the web services stack of standards.1 However, the promise of service integration will not be delivered unless services can be integrated semantically as well. The 2002 AAAI workshop entitled "Intelligent Service Integra...

  2. Service discovery at home

    NARCIS (Netherlands)

    Sundramoorthy, V.; Scholten, Johan; Jansen, P.G.; Hartel, Pieter H.

    2003-01-01

    Service discovery is a fairly new field that kicked off since the advent of ubiquitous computing and has been found essential in the making of intelligent networks by implementing automated discovery and remote control between devices. This paper provides an overview and comparison of several promin

  3. Service Discovery At Home

    NARCIS (Netherlands)

    Sundramoorthy, V.; Scholten, Johan; Jansen, P.G.; Hartel, Pieter H.

    2003-01-01

    Service discovery is a fady new field that kicked off since the advent of ubiquitous computing and has been found essential in the making of intelligent networks by implementing automated discovery and remote control between deviies. This paper provides an ovewiew and comparison of several prominent

  4. Service discovery at home

    NARCIS (Netherlands)

    Sundramoorthy, V.; Scholten, Johan; Jansen, P.G.; Hartel, Pieter H.

    2003-01-01

    Service discovery is a fairly new field that kicked off since the advent of ubiquitous computing and has been found essential in the making of intelligent networks by implementing automated discovery and remote control between devices. This paper provides an overview and comparison of several

  5. Service Discovery At Home

    NARCIS (Netherlands)

    Sundramoorthy, V.; Scholten, Johan; Jansen, P.G.; Hartel, Pieter H.

    Service discovery is a fady new field that kicked off since the advent of ubiquitous computing and has been found essential in the making of intelligent networks by implementing automated discovery and remote control between deviies. This paper provides an ovewiew and comparison of several prominent

  6. Service discovery at home

    NARCIS (Netherlands)

    Sundramoorthy, Vasughi; Scholten, Hans; Jansen, Pierre; Hartel, Pieter

    2003-01-01

    Service discovery is a fairly new field that kicked off since the advent of ubiquitous computing and has been found essential in the making of intelligent networks by implementing automated discovery and remote control between devices. This paper provides an overview and comparison of several promin

  7. Essential tremor responsive to levetiracetam

    Directory of Open Access Journals (Sweden)

    Abdullah Yılgör

    2012-03-01

    Full Text Available Essential tremor is one of the most common movementdisorders with a prevalence of 0.4% to 3.9% in the generalpopulation and increases with age. The medical treatmentavailable for patients with essential tremor is ofteninadequate. Propranolol and primidone are the first-linetreatment options, improving in up to two thirds of cases.This article reports a satisfying response to levetiracetamwith disabling essential tremor in a 58-year-old man whompropranolol as well as primidone had to be discontinueddue to unresponsiveness and severe side effects. One ofthe antiepileptic drugs, levetiracetam, may be more usefulin the treatment of essential tremor. J Clin Exp Invest2012; 3(1: 108-110

  8. 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

  9. Essential Patents and Coordination Mechanisms

    OpenAIRE

    Justus Baron; Tim Pohlmann

    2010-01-01

    This article investigates the interplay between formal standards, essential patents and informal industry alliances such as consortia and patent pools. Building upon more than 6.200 declarations of essential patents to major international Standard Development Organizations (SDO), we investigate how informal standardization consortia and patent pools influence the number and timing of patent declarations to formal SDOs. This is the first thorough empirical investigation of the effectiveness of...

  10. 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…

  11. 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

  12. 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

  13. 77 FR 44306 - Service Delivery Plan

    Science.gov (United States)

    2012-07-27

    ...) Deliver quality disability decisions and services; (2) provide quality service to the public; (3) preserve... significantly to the Nation's economy. As we develop our plan, we are interested in hearing from you, our... responding to requests for verifying benefit amounts and assisting people with claims for other Federal...

  14. Mechanical Service; Service Mechanique

    Energy Technology Data Exchange (ETDEWEB)

    Alliaume, T.; Benoit, A.; Bonin, H.; Ducimetiere, D.; Essertaize, D.; Gelin, G.; Guillot, G.; Lemoine, C.; Mabo, J.C.; Mounier, F.; Tissot, S.; Verdier, G. [Inst. de Physique Nucleaire, Lyon-1 Univ., 69 - Villeurbanne (France)

    1998-12-31

    The service studies the mechanical part of the experiment or detectors used by the physics groups in collaboration with the physicists, engineers and the technicians of the experiment assistance group as well as with other technical groups. The mechanical service was implied in the following projects: CMS, VIRGO (the IGISOL ion guide chamber), PIAFE, NA50 (reaction chamber, metallic cluster source), ORION, SICANE, EDELWEISS II 2 figs.

  15. Middle managers service leadership

    Directory of Open Access Journals (Sweden)

    Lucio Roberto Lescano Duncan

    2011-12-01

    Full Text Available A big challenge in modern service organization is to focus on customers and to forge their satisfaction and loyalty. Innovation, information technology and value added are decisive factors, however the main aspect to consider is the human factor. It is necessary to focus on people in order to improve the service capability within the organization.Middle manager is the link between the strategy designed by top management and the execution to deliver services, that is realized by employees guided by leaders of middle level. Our study is focused on middle manager service orientation as the pillar to get a customer focus and to forge the service employees' performance.We consider that middle managers have to asume a service leadership in order to foster the productivity and employees' commitment. In that sense we focus especially on middle managers' main roles. Those are the key aspect to deploy a service culture, and at the same time to promote employees' satisfaction that drives their performance and development.

  16. Maintaining high-quality IP audio services in lossy IP network environments

    Science.gov (United States)

    Barton, Robert J., III; Chodura, Hartmut

    2000-07-01

    In this paper we present our research activities in the area of digital audio processing and transmission. Today's available teleconference audio solutions are lacking in flexibility, robustness and fidelity. There was a need for enhancing the quality of audio for IP-based applications to guarantee optimal services under varying conditions. Multiple tests and user evaluations have shown that a reliable audio communication toolkit is essential for any teleconference application. This paper summarizes our research activities and gives an overview of developed applications. In a first step the parameters, which influence the audio quality, were evaluated. All of these parameters have to be optimized in order to result into the best achievable quality. Therefore it was necessary to enhance existing schemes or develop new methods. Applications were developed for Internet-Telephony, broadcast of live music and spatial audio for Virtual Reality environments. This paper describes these applications and issues of delivering high quality digital audio services over lossy IP networks.

  17. 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.

  18. Out of pocket expenditure to deliver at public health facilities in India: a cross sectional analysis.

    Science.gov (United States)

    Issac, Anns; Chatterjee, Susmita; Srivastava, Aradhana; Bhattacharyya, Sanghita

    2016-08-24

    To expand access to safe deliveries, some developing countries have initiated demand-side financing schemes promoting institutional delivery. In the context of conditional cash incentive scheme and free maternity care in public health facilities in India, studies have highlighted high out of pocket expenditure (OOPE) of Indian families for delivery and maternity care. In this context the study assesses the components of OOPE that women incurred while accessing maternity care in public health facilities in Uttar Pradesh, India. It also assesses the determinants of OOPE and the level of maternal satisfaction while accessing care from these facilities. It is a cross-sectional analysis of 558 recently delivered women who have delivered at four public health facilities in Uttar Pradesh, India. All OOPE related information was collected through interviews using structured pre-tested questionnaires. Frequencies, Mann-Whitney test and categorical regression were used for data reduction. The analysis showed that the median OOPE was INR 700 (US$ 11.48) which varied between INR 680 (US$ 11.15) for normal delivery and INR 970 (US$ 15.9) for complicated cases. Tips for getting services (consisting of gifts and tips for services) with a median value of INR 320 (US$ 5.25) contributed to the major share in OOPE. Women from households with income more than INR 4000 (US$ 65.57) per month, general castes, primi-gravida, complicated delivery and those not accompanied by community health workers incurred higher OOPE. The significant predictors for high OOPE were caste (General Vs. OBC, SC/ST), type of delivery (Complicated Vs. Normal), and presence of ASHA (No Vs. Yes). OOPE while accessing care for delivery was one among the least satisfactory items and 76 % women expressed their dissatisfaction. Even though services at the public health facilities in India are supposed to be provided free of cost, it is actually not free, and the women in this study paid almost half of their mandated

  19. 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.

  20. 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....

  1. 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

  2. The Ten Essential Shared Capabilities: reflections on education in values based practice: a qualitative study.

    Science.gov (United States)

    McGonagle, Ian; Jackson, Christine S; Kane, Roslyn

    2015-02-01

    This paper presents the findings of a study exploring the impact of a values-based training initiative on the practice of mental health workers. This work is set within the context of increasing attention on the values of nurses and other health care workers as a response to national reports on care failure and negative media attention. To examine written response feedback from participants on a national training programme for values-based practice (VBP) in order to examine any intention to change practice. A national evaluation using quantitative and qualitative methodologies was conducted to gather data on reflections and self-report impact of the Ten Essential Shared Capabilities' training programme. The training was delivered in a range of hospital, community and third sector training programmes across eight regions in England. The participants were predominantly nurses but all sectors in the mental health community including service users as co-facilitators and participants were represented. This study presents the qualitative findings from a cross-sectional survey. Using NVIVO 10 software, data were analysed using the framework method of qualitative analysis. Four principal themes emerged from the data'Thinking differently''Changes to practice''Creating an effective learning environment and skills for practice development' and 'Increasing self-awareness'. The quality and safety drive in the NHS has an emphasis on delivery of evidence based practice. It was concluded that an active focus on values based practice merits equal attention and status. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. 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

  4. RESNA Wheelchair Service Provision Guide

    Science.gov (United States)

    Arledge, Stan; Armstrong, William; Babinec, Mike; Dicianno, Brad E.; Digiovine, Carmen; Dyson-Hudson, Trevor; Pederson, Jessica; Piriano, Julie; Plummer, Teresa; Rosen, Lauren; Schmeler, Mark; Shea, Mary; Stogner, Jody

    2011-01-01

    The purpose of the Wheelchair Service Provision Guide is to provide an appropriate framework for identifying the essential steps in the provision of a wheelchair. It is designed for use by all participants in the provision process including consumers, family members, caregivers, social service and health care professionals, suppliers,…

  5. FY-2E Delivered And FY-3A Performs Well

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ The FY-2E meteorological satellite was delivered to China Meteorological Administration (CMA) on May 19, 2009. Developed by Shanghai Academy of Spacefiight Technology (SAST), a subsidiary of CASC, the satellite was launched atop a LM-3A from Xichang Satellite Launch Center (XSLC). The satellite passed in-orbit testing on February 28,2009 and all the onboard systems performed well when the satellite was in the Earth's shadow.

  6. Delivering business analytics practical guidelines for best practice

    CERN Document Server

    Stubbs, Evan

    2013-01-01

    AVOID THE MISTAKES THAT OTHERS MAKE - LEARN WHAT LEADS TO BEST PRACTICE AND KICKSTART SUCCESS This groundbreaking resource provides comprehensive coverage across all aspects of business analytics, presenting proven management guidelines to drive sustainable differentiation. Through a rich set of case studies, author Evan Stubbs reviews solutions and examples to over twenty common problems spanning managing analytics assets and information, leveraging technology, nurturing skills, and defining processes. Delivering Business Analytics also outlines the Data Scientist's Code, fifteen principle

  7. Can service integration work for universal health coverage? Evidence from around the globe.

    Science.gov (United States)

    Lê, Gillian; Morgan, Rosemary; Bestall, Janine; Featherstone, Imogen; Veale, Thomas; Ensor, Tim

    2016-04-01

    Universal health coverage (UHC) is at the heart of the new 2030 Agenda for Sustainable Development. Health service integration is seen by World Health Organization as an essential requirement to achieve UHC. However, to date the debate on service integration has focused on perceived benefits rather than empirical impact. We conducted a global review in a systematic manner searching for empirical outcomes of service integration experiments in UHC countries and those on the path to UHC. Sixty-seven articles and reports were found. We grouped results into a unique integration typology with six categories - medical staff from different disciplines; patients and medical staff; care package for one medical condition; care package for two or more medical conditions; specialist stand-alone services with GP services; community locations. We showed that it is possible to integrate services in different human development contexts delivering positive outcomes for patients and clinicians without incurring additional costs. However, the improved outcomes shown were incremental rather than radical and suggest that integration is likely to enhance already well established systems rather than fundamentally changing the outcomes of care.

  8. 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

  9. [Antioxidant properties of essential oils].

    Science.gov (United States)

    Misharina, T A; Terenina, M B; Krikunova, N I

    2009-01-01

    By the method of capillary gas-liquid chromatography we studied antioxidant properties and stability during the storage of hexane solutions of 14 individual essential oils from black and white pepper (Piper nigrum L.), cardamom (Elettaria cardamomum L.), nutmeg (Myristica fragrans Houtt.), mace (Myristica fragrans Houtt), juniperberry (Juniperus communis L.), seed of fennel (Foeniculum vulgare Mill., var. dulce Thelling), caraway (Carvum carvi L.), dry leaves of cinnamon (Cinnamomum zeylanicum Bl.), marjoram (Origanum majorana L.), laurel (Laurus nobilis L.), ginger (Zingiber officinale L.), garlic (Allium sativum L.), and clove bud (Caryophyllus aromaticus L.). We assessed the antioxidant properties by the oxidation of aliphatic aldehyde (trans-2-hexenal) into the according carbon acid. We established that essential oils of garlic, clove bud, ginger and leaves of cinnamon have the maximal efficiency of inhibition of hexenal oxidation (80-93%), while black pepper oil has the minimal (49%). Antioxidant properties of essential oils with a high content of substituted phenols depended poorly on its concentration in model systems. We studied the changes in essential oils content during the storage of its hexane solutions for 40 days in the light and out of the light and compared it with the stability of essential oils stored for a year out of the light.

  10. Levels of Essential and Non-Essential Elements in Commercially ...

    African Journals Online (AJOL)

    Enebi Jasper

    elements in all samples ranged between 50.78 to 61.13 mg/kg K, 29.81 to 42.03 mg/kg Ca 5.62-9.23 ... essential elements detected were Sr, Sc, Rb and Zr, all had concentrations below 1mg/kg. ... toxicity and adverse effects linked to the use of.

  11. 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

  12. Service Gateway

    Institute of Scientific and Technical Information of China (English)

    WANG Guozhong; HOU Gang; HUANG Zeqing

    2003-01-01

    This article focuses on the service gateway which implements the Open Service gateway Initiative (OSGI), it manages voice, data, Internet, and multimedia communications to and from the home, office and other locations. This service gateway can also function as an application server for a range of high value services such as energy management and control, safety and security services, health care monitoring services, device control and maintenance, electronic commerce services and more.

  13. Regional Primary Care Team to Deliver Best-Practice Diabetes Care

    Science.gov (United States)

    Segal, Leonie; Leach, Matthew J.; May, Esther; Turnbull, Catherine

    2013-01-01

    OBJECTIVE Best-practice diabetes care can reduce the burden of diabetes and associated health care costs. But this requires access to a multidisciplinary team with the right skill mix. We applied a needs-driven evidence-based health workforce model to describe the primary care team required to support best-practice diabetes care, paying particular attention to diverse clinic populations. RESEARCH DESIGN AND METHODS Care protocols, by number and duration of consultations, were derived for twenty distinct competencies based on clinical practice guidelines and structured input from a multidisciplinary clinical panel. This was combined with a previously estimated population profile of persons across 26 patient attributes (i.e., type of diabetes, complications, and threats to self-care) to estimate clinician contact hours by competency required to deliver best-practice care in the study region. RESULTS A primary care team of 22.1 full-time-equivalent (FTE) positions was needed to deliver best-practice primary care to a catchment of 1,000 persons with diabetes with the attributes of the Australian population. Competencies requiring greatest contact time were psychosocial issues and dietary advice at 3.5 and 3.3 FTE, respectively (1 FTE/∼300 persons); home (district) nursing at 3.2 FTE; and diabetes education at 2.8 FTE. The annual cost of delivering care was estimated at just over 2,000 Australian dollars (∼2,090 USD) (2012) per person with diabetes. CONCLUSIONS A needs-driven approach to primary care service planning identified a wider range of competencies in the diabetes primary and community care team than typically described. Access to psychosocial competences as well as medical management is required if clinical targets are to be met, especially in disadvantaged groups. PMID:23393210

  14. 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

  15. SQL Server 2014 development essentials

    CERN Document Server

    Masood-Al-Farooq, Basit A

    2014-01-01

    This book is an easy-to-follow, comprehensive guide that is full of hands-on examples, which you can follow to successfully design, build, and deploy mission-critical database applications with SQL Server 2014. If you are a database developer, architect, or administrator who wants to learn how to design, implement, and deliver a successful database solution with SQL Server 2014, then this book is for you. Existing users of Microsoft SQL Server will also benefit from this book as they will learn what's new in the latest version.

  16. Models for Delivering School-Based Dental Care.

    Science.gov (United States)

    Albert, David A.; McManus, Joseph M.; Mitchell, Dennis A.

    2005-01-01

    School-based health centers (SBHCs) often are located in high-need schools and communities. Dental service is frequently an addition to existing comprehensive services, functioning in a variety of models, configurations, and locations. SBHCs are indicated when parents have limited financial resources or inadequate health insurance, limiting…

  17. Analgesic Potential of Essential Oils

    Directory of Open Access Journals (Sweden)

    José Ferreira Sarmento-Neto

    2015-12-01

    Full Text Available Pain is an unpleasant sensation associated with a wide range of injuries and diseases, and affects approximately 20% of adults in the world. The discovery of new and more effective drugs that can relieve pain is an important research goal in both the pharmaceutical industry and academia. This review describes studies involving antinociceptive activity of essential oils from 31 plant species. Botanical aspects of aromatic plants, mechanisms of action in pain models and chemical composition profiles of the essential oils are discussed. The data obtained in these studies demonstrate the analgesic potential of this group of natural products for therapeutic purposes.

  18. The checkerboard area health system: delivering comprehensive care in a remote region of New Mexico.

    Science.gov (United States)

    Reid, R A; Bartlett, E E; Kozoll, R

    1982-01-01

    A comprehensive health center is defined as the synergistic coupling of a medical and administrative structure designed to provide inpatient, outpatient, and public health services. While health centers have been widely established in other countries, only limited implementation has occurred in rural areas of the United States. The successful implementation of the health center concept in a sparsely populated area of northwestern New Mexico, which is predominately inhabited by Navajo Indians and Spanish Americans, is descriptively analyzed. The physical environment and the socioeconomic characteristics of the catchment area residents are related to dominant conditions in underdeveloped countries. The evolution of the delivery system with its network of satellite clinics staffed by mid-level primary care providers is documented. The funding and provision of a wide range of preventive and curative health services supported by communication, transportation, outreach, education, public health, and administration components are described. Several problems thought to impede the application of the health center concept to other regions in the United States are identified and discussed relative to this New Mexican experience. Innovative and persevering systems designers who are strongly committed to delivering a balance between preventive and curative services are considered to be absolutely necessary for successful implementation of the health center concept in the United States.

  19. MATURITY MODEL FOR IT SERVICE OUTSOURCING IN HIGHER EDUCATION INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Victoriano Valencia García

    2013-11-01

    Full Text Available 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 ISO/IEC 38500, the frameworks and best practices of ITIL and COBIT, with a specific focus on IT outsourcing. This model is validated by practices in the field of higher education, using a questionnaire and a metrics table among other measurement tools. Models, standards and guidelines are proposed in the model for facilitating adaptation to universities and achieving excellence in the outsourcing of IT services. The applicability of the model allows an effective transition to a model of good governance and management of outsourced IT services which, aligned with the core business of universities (teaching, research and innovation, affect the effectiveness and efficiency of its management, optimizes its value and minimizes risks.

  20. Quality of EIS support and maintenance services

    OpenAIRE

    Laakso, Tiina

    2015-01-01

    Company X delivers integrated information systems for enterprises operating in various business areas. In addition to planning, implementing and deploying these systems, the company provides continuous support and maintenance services to its customers. However these services have not been systematically developed and quality of service can vary greatly. The purpose of this thesis was to identify the problem areas causing low customer satisfaction and operational inefficiency. The objectiv...