WorldWideScience

Sample records for group facilitation services

  1. Mindfulness for group facilitation

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine; Krohn, Simon

    2014-01-01

    In this paper, we argue that mindfulness techniques can be used for enhancing the outcome of group performance. The word mindfulness has different connotations in the academic literature. Broadly speaking there is ‘mindfulness without meditation’ or ‘Western’ mindfulness which involves active...... thinking and ‘Eastern’ mindfulness which refers to an open, accepting state of mind, as intended with Buddhist-inspired techniques such as meditation. In this paper, we are interested in the latter type of mindfulness and demonstrate how Eastern mindfulness techniques can be used as a tool for facilitation....... A brief introduction to the physiology and philosophy of Eastern mindfulness constitutes the basis for the arguments of the effect of mindfulness techniques. The use of mindfulness techniques for group facilitation is novel as it changes the focus from individuals’ mindfulness practice...

  2. Facilitating Collaboration in Online Groups

    Directory of Open Access Journals (Sweden)

    Geralyn E Stephens

    2017-02-01

    Full Text Available Demonstrating the ability to collaborate effectively is essential for students moving into 21st century workplaces. Employers are expecting new hires to already possess group-work skills and will seek evidence of their ability to cooperate, collaborate, and complete projects with colleagues, including remotely or at a distance. Instructional activities and assignments that provide students with a variety of ways to engage each other have a direct and immediate effect on their academic performance. This paper shares the Facilitating Collaboration in Online Groups (FCOG instructional planning strategy. The strategy is designed for faculty use and familiarizes students with the process and technology necessary to collaborate effectively in online classroom groups. The strategy utilizes proven teaching techniques to maximize student-student and student-content relationships. Each of the four (4 sequential phases in the FCOG instructional planning strategy are discussed: 1 Creating Groups, 2 Establishing Expectations, 3 Communication Tools, and 4 Assignments and Activities. The discussion also contains implementation suggestions as well as examples of instructional assignments and activities that provide students with a variety of ways to collaborate to reach the learning outcomes.

  3. Entry Facilitation by Environmental Groups

    NARCIS (Netherlands)

    van der Made, Allard; Schoonbeek, Lambert

    We consider a model of vertical product differentiation where consumers care about the environmental damage their consumption causes. An environmental group is capable of increasing consumers' environmental concern via a costly campaign. We show that the prospect of such a campaign can induce entry

  4. Facilitating peer learning in study groups

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine; Madsen, Lene Møller

    2009-01-01

    In 2008 University of Aarhus, Denmark, issued a report concerning student experience with the study environment. Among the university's eight faculties, the Danish School of Education (DPU) held the sad record of having the lowest student well-being. This led to an action research project...... 'Facilitating study environment' at one of DPU's educations in spring 2009. The pilot project consisted of three elements: Facilitated study groups, a student bar with facilitated activities, and academic identity events. Subsequently, we have studied students' experiences with the project. This paper outlines...... the preliminary results from the facilitated study groups. After one term (February-May), student satisfaction with both the social and the disciplinary environment had increased. The project shows how academic and social integration can be achieved with minimum faculty member involvement. This is done by relying...

  5. Facilitating Group Decision-Making: Facilitator's Subjective Theories on Group Coordination

    Directory of Open Access Journals (Sweden)

    Michaela Kolbe

    2008-10-01

    Full Text Available A key feature of group facilitation is motivating and coordinating people to perform their joint work. This paper focuses on group coordination which is a prerequisite to group effectiveness, especially in complex tasks. Decision-making in groups is a complex task that consequently needs to be coordinated by explicit rather than implicit coordination mechanisms. Based on the embedded definition that explicit coordination does not just happen but is purposely executed by individuals, we argue that individual coordination intentions and mechanisms should be taken into account. Thus far, the subjective perspective of coordination has been neglected in coordination theory, which is understandable given the difficulties in defining and measuring subjective aspects of group facilitation. We therefore conducted focused interviews with eight experts who either worked as senior managers or as experienced group facilitators and analysed their approaches to group coordination using methods of content analysis. Results show that these experts possess sophisticated mental representations of their coordination behaviour. These subjective coordination theories can be organised in terms of coordination schemes in which coordination-releasing situations are facilitated by special coordination mechanisms that, in turn, lead to the perception of specific consequences. We discuss the importance of these subjective coordination theories for effectively facilitating group decision-making and minimising process losses. URN: urn:nbn:de:0114-fqs0901287

  6. Encountering Carl Rogers: His Views on Facilitating Groups.

    Science.gov (United States)

    Landreth, Garry L.

    1984-01-01

    Presents Carl Rogers' views on facilitating groups, as expressed in a telephone dialogue seminar with graduate students in counselor education at North Texas State University. Discusses extended group marathons, cocounseling, nonverbal group exercises and the future of group work. (JAC)

  7. Dynamics of group knowledge production in facilitated modelling workshops

    DEFF Research Database (Denmark)

    Tavella, Elena; Franco, L. Alberto

    2015-01-01

    by which models are jointly developed with group members interacting face-to-face, with or without computer support. The models produced are used to inform negotiations about the nature of the issues faced by the group, and how to address them. While the facilitated modelling literature is impressive......, the workshop. Drawing on the knowledge-perspective of group communication, we conducted a micro-level analysis of a transcript of a facilitated modelling workshop held with the management team of an Alternative Food Network in the UK. Our analysis suggests that facilitated modelling interactions can take...

  8. Facilitating small groups: how to encourage student learning.

    Science.gov (United States)

    Kitchen, Mark

    2012-02-01

    Many clinicians are involved in medical education, with small group teaching (SGT) forming a significant part of their work. Most facilitate these sessions by experience and common sense: less than one-third of them have received formal training in SGT. Evidence suggests small group productivity depends on good facilitation rather than on topic knowledge. Applying the fundamental concepts of SGT will lead to improvements in the quality of clinicians' teaching and in student learning. Good SGT creates the perfect environment for learning and discussion, without the need for didactic teaching. SGT emphasises the role of students in sharing and discussing their ideas in a safe learning environment, without domination by the tutor. This article provides clinicians with basic requirements for effective session design and planning, explains how to encourage student participation, how to manage students as a group, how to manage student learning, and how to recognise and deal with problems. Active facilitation and group management is the key to success in SGT, and consequently better learning outcomes. Improving the facilitation skills of clinical teachers makes teaching more effective, stimulating, and enjoyable for both tutors and students. © Blackwell Publishing Ltd 2012.

  9. Factors facilitating dementia case management : Results of online focus groups

    NARCIS (Netherlands)

    Dr. J. de Lange; E. Deusing; I.F.M. van Asch; J. Peeters; M. Zwaanswijk; A.M. Pot; A.L. Francke

    2016-01-01

    To obtain insight into facilitating factors for case management in dementia care, we conducted a qualitative study with 13 online focus groups (OFGs). Participants were professionals involved in dementia case management (N = 99). We used mind-maps and the method of constant comparison for analysis.

  10. Teacher’s action zone in facilitating group dynamics

    Directory of Open Access Journals (Sweden)

    Dagmara Gałajda

    2012-01-01

    Full Text Available As believed by many researchers (Dörnyei & Murphey 2003, Hadfield 1992, classroom climate is strongly determined by the dynamics of the learning group and its development over time. For this reason, the role of the teacher in facilitating group processes seems to be of primary importance since it is the teacher who has long been regarded as the group leader in both teacher-centred and learner-centred classrooms.The presentation focuses not only on positive but also on negative forms of classroom dynamics together with management techniques for dealing with conflicts, educational alienation and psychological defensiveness. This, in turn, leads to the concept of facilitator style based on Heron’s (2006 model of facilitation, which consists of six dimensions and three modes. In the paper particular emphasis is placed on the presentation and comparison of various theories of leadership, namely Heron’s system of facilitation, Hersey and Blanchard’s situational-leadership theory (1982 and Bass and Avolio’s transactional versus transformational leadership theory (1984.

  11. Facilitating mobile service provisioning in IP Multimedia Subsystem (IMS) using service oriented architecture

    NARCIS (Netherlands)

    Radovanovic, I.; Ray, A.; Lukkien, J.J.; Chaudron, M.R.V.; Krämer, B.J.; Lin, K.J.; Narasimhan, P.

    2007-01-01

    This paper presents an extension of the IMS software architecture using a service orientation, which provides flexibility of mobile service provisioning. The suggested extension facilitates composition of new mobile services in run-time based on the existing services and enables the end users to

  12. A Semantically Enabled Portal for Facilitating the Public Service Provision

    Science.gov (United States)

    Loutas, Nikolaos; Giantsiou, Lemonia; Peristeras, Vassilios; Tarabanis, Konstantinos

    During the past years, governments have made significant efforts to improve both their internal processes and the services that they provide to citizens and businesses. These led to several successful e-Government applications (e.g., see www.epractice.eu). One of the most popular tools that was used by governments in order to modernize their services and make them accessible is e-Government portals, e.g., (Drigas et al. 2005), (Fang 2002). The main goals of such portals are: To make available complete, easy to understand, and structured information about public services and public administration's modus operandi, which will assist citizens during the service provision process. To facilitate the electronic execution of public services. Nevertheless, most of such efforts did not succeed. Gartner argues that most e-Government strategies have not achieved their objectives and have failed to trigger sustainable government transformation to greater efficiency and citizen-centricity (DiMaio 2007).

  13. User's perspectives of barriers and facilitators to implementing quality colonoscopy services in Canada: a study protocol.

    Science.gov (United States)

    Jobin, Gilles; Gagnon, Marie Pierre; Candas, Bernard; Dubé, Catherine; Ben Abdeljelil, Anis; Grenier, Sonya

    2010-11-02

    Colorectal cancer (CRC) represents a serious and growing health problem in Canada. Colonoscopy is used for screening and diagnosis of symptomatic or high CRC risk individuals. Although a number of countries are now implementing quality colonoscopy services, knowledge synthesis of barriers and facilitators perceived by healthcare professionals and patients during implementation has not been carried out. In addition, the perspectives of various stakeholders towards the implementation of quality colonoscopy services and the need of an efficient organisation of such services have been reported in the literature but have not been synthesised yet. The present study aims to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators perceived by all stakeholders to the implementation of quality colonoscopy services in Canada. First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to implementing quality colonoscopy services. Standardised literature searches and data extraction methods will be used. The quality of the studies and their relevance to informing decisions on colonoscopy services implementation will be assessed. For each group of users identified, barriers and facilitators will be categorised and compiled using narrative synthesis and meta-analytical techniques. The principle factors identified for each group of users will then be validated for its applicability to various Canadian contexts using the Delphi study method. Following this study, a set of strategies will be identified to inform decision makers involved in the implementation of quality colonoscopy services across Canadian jurisdictions. This study will be the first to systematically summarise the barriers and facilitators to implementation of quality colonoscopy services perceived by different groups and to consider the local contexts in order to ensure the applicability of this

  14. Emotions facilitate the communication of ambiguous group memberships.

    Science.gov (United States)

    Tskhay, Konstantin O; Rule, Nicholas O

    2015-12-01

    It is well known that emotions intersect with obvious social categories (e.g., race), influencing both how targets are categorized and the emotions that are read from their faces. Here, we examined the influence of emotional expression on the perception of less obvious group memberships for which, in the absence of obvious and stable physical markers, emotion may serve as a major avenue for group categorization and identification. Specifically, we examined whether emotions are embedded in the mental representations of sexual orientation and political affiliation, and whether people may use emotional expressions to communicate these group memberships to others. Using reverse correlation methods, we found that mental representations of gay and liberal faces were characterized by more positive facial expressions than mental representations of straight and conservative faces (Study 1). Furthermore, participants were evaluated as expressing more positive emotions when enacting self-defined "gay" and "liberal" versus "straight" and "conservative" facial expressions in the lab (Study 2). In addition, neutral faces morphed with happiness were perceived as more gay than when morphed with anger, and when compared to unmorphed controls (Study 3). Finally, we found that affect facilitated perceptions of sexual orientation and political affiliation in naturalistic settings (Study 4). Together, these studies suggest that emotion is a defining characteristic of person construal that people tend to use both when signaling their group memberships and when receiving those signals to categorize others. (c) 2015 APA, all rights reserved).

  15. Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study.

    Science.gov (United States)

    Rose, Diana; Trevillion, Kylee; Woodall, Anna; Morgan, Craig; Feder, Gene; Howard, Louise

    2011-03-01

    Mental health service users are at high risk of domestic violence but this is often not detected by mental health services. To explore the facilitators and barriers to disclosure of domestic violence from a service user and professional perspective. A qualitative study in a socioeconomically deprived south London borough, UK, with 18 mental health service users and 20 mental health professionals. Purposive sampling of community mental health service users and mental healthcare professionals was used to recruit participants for individual interviews. Thematic analysis was used to determine dominant and subthemes. These were transformed into conceptual maps with accompanying illustrative quotations. Service users described barriers to disclosure of domestic violence to professionals including: fear of the consequences, including fear of Social Services involvement and consequent child protection proceedings, fear that disclosure would not be believed, and fear that disclosure would lead to further violence; the hidden nature of the violence; actions of the perpetrator; and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Service users and professionals reported that the medical diagnostic and treatment model with its emphasis on symptoms could act as a barrier to enquiry and disclosure. Both groups reported that enquiry and disclosure were facilitated by a supportive and trusting relationship between the individual and professional. Mental health services are not currently conducive to the disclosure of domestic violence. Training of professionals in how to address domestic violence to increase their confidence and expertise is recommended.

  16. Effectiveness of a nurse facilitated cognitive group intervention ...

    African Journals Online (AJOL)

    both genders.3. Empirical support for Cognitive Behaviour Therapy ... There was a statistically significant difference between the groups, with respect to the BDI scores. (p<0.001). ..... another study, group CBT, group counseling, and individual.

  17. "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups.

    Science.gov (United States)

    de Melo, Lucas Pereira; de Campos, Edemilson Antunes

    2014-01-01

    to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups. ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique. four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study. the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

  18. Ethics reflection groups in community health services: an evaluation study.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2015-04-17

    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

  19. Facilitating Support Groups for Professionals Working with People with AIDS.

    Science.gov (United States)

    Grossman, Arnold H.; Silverstein, Charles

    1993-01-01

    Describes support groups for health care professionals who work with people with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) and who are experiencing burnout from excessive demands on their energy, strength, and resources. Discusses group administration, effective intervention techniques, and issues of health…

  20. Using Computer Conferencing and Electronic Mail to Facilitate Group Projects.

    Science.gov (United States)

    Anderson, Margaret D.

    1996-01-01

    Reports on the use of electronic mail and an electronic conferencing system to conduct group projects in three educational psychology courses at the State University of New York College at Cortland. Course design is explained and group project design is described, including assignments and oral presentations during regular class sessions.…

  1. Beliefs About the Malleability of Immoral Groups Facilitate Collective Action

    NARCIS (Netherlands)

    Cohen-Chen, Smadar; Halperin, Eran; Saguy, Tamar; van Zomeren, Martijn

    Although negative out-group beliefs typically foster individuals' motivation for collective action, we propose that such beliefs may diminish this motivation when people believe that this out-group cannot change in its very essence. Specifically, we tested the idea that believing in the malleability

  2. Note from the radioprotection group's shipping service

    CERN Multimedia

    2006-01-01

    Le service SHIPPING du groupe de radioprotection souhaite vous rappeler qu'avant toute expédition de matériel susceptible d'être radioactif, une demande de transport doit être établie par EDH en cochant la case appropriée (danger radioactif). Merci de bien vouloir prendre note des informations figurant dans le site Web: http://cern.ch/service-rp-shipping Toute demande non conforme ne sera pas prise en compte. Radioactive Shipping Service http://cern.ch/service-rp-shippingTél: 73171Fax: 69200

  3. mCell: Facilitating Mobile Communication of Small Groups

    OpenAIRE

    Mikko T. Tarkiainen; Jonna Häkkilä; Jan Blom; Merja Haveri; Jyri Virtanen

    2008-01-01

    Mobile communication technology offers a potential platform for new types of communication applications. Here, we describe the development and experiences with a mobile group communication application, mCell, that runs on a mobile phone. We present the underlying design implications, the application implementation, and a user study, where three groups used the application for one month. The findings of the user study reveal general user experiences with the application and show different patt...

  4. Visual Grouping in Accordance With Utterance Planning Facilitates Speech Production

    Directory of Open Access Journals (Sweden)

    Liming Zhao

    2018-03-01

    Full Text Available Research on language production has focused on the process of utterance planning and involved studying the synchronization between visual gaze and the production of sentences that refer to objects in the immediate visual environment. However, it remains unclear how the visual grouping of these objects might influence this process. To shed light on this issue, the present research examined the effects of the visual grouping of objects in a visual display on utterance planning in two experiments. Participants produced utterances of the form “The snail and the necklace are above/below/on the left/right side of the toothbrush” for objects containing these referents (e.g., a snail, a necklace and a toothbrush. These objects were grouped using classic Gestalt principles of color similarity (Experiment 1 and common region (Experiment 2 so that the induced perceptual grouping was congruent or incongruent with the required phrasal organization. The results showed that speech onset latencies were shorter in congruent than incongruent conditions. The findings therefore reveal that the congruency between the visual grouping of referents and the required phrasal organization can influence speech production. Such findings suggest that, when language is produced in a visual context, speakers make use of both visual and linguistic cues to plan utterances.

  5. Visual Grouping in Accordance With Utterance Planning Facilitates Speech Production.

    Science.gov (United States)

    Zhao, Liming; Paterson, Kevin B; Bai, Xuejun

    2018-01-01

    Research on language production has focused on the process of utterance planning and involved studying the synchronization between visual gaze and the production of sentences that refer to objects in the immediate visual environment. However, it remains unclear how the visual grouping of these objects might influence this process. To shed light on this issue, the present research examined the effects of the visual grouping of objects in a visual display on utterance planning in two experiments. Participants produced utterances of the form "The snail and the necklace are above/below/on the left/right side of the toothbrush" for objects containing these referents (e.g., a snail, a necklace and a toothbrush). These objects were grouped using classic Gestalt principles of color similarity (Experiment 1) and common region (Experiment 2) so that the induced perceptual grouping was congruent or incongruent with the required phrasal organization. The results showed that speech onset latencies were shorter in congruent than incongruent conditions. The findings therefore reveal that the congruency between the visual grouping of referents and the required phrasal organization can influence speech production. Such findings suggest that, when language is produced in a visual context, speakers make use of both visual and linguistic cues to plan utterances.

  6. Active facilitation of focus groups: exploring the implementation of ...

    African Journals Online (AJOL)

    The focus group research reported in this article forms part of a broader inter- ..... “scientific research in education” should “refrain from writing [and acting] as if our ..... http://www.qualitative-research.net/index.php/fqs/article/view/338/737.

  7. Active facilitation of focus groups: exploring the implementation of ...

    African Journals Online (AJOL)

    In this article, we explain how we took an “active” approach to focus group discussions with teachers in three South African schools. The topic of discussion was their views on the implementation of inclusive education. We shall also show how we sought feedback from the participants on their experiences of these ...

  8. Mixed-Gender Co-Facilitation in Therapeutic Groups for Men Who Have Perpetrated Intimate Partner Violence: Group Members' Perspectives

    Science.gov (United States)

    Roy, Valerie; Lindsay, Jocelyn; Dallaire, Louis-Francois

    2013-01-01

    This article describes a study that explored the use of mixed-gender co-facilitation in intimate partner violence groups, especially regarding its potential for gender role socialization. Using an interpretive approach, interviews with men from different mixed-gender co-facilitated groups in Canada were analyzed, with a focus on the men's…

  9. Process factors facilitating and inhibiting medical ethics teaching in small groups.

    Science.gov (United States)

    Bentwich, Miriam Ethel; Bokek-Cohen, Ya'arit

    2017-11-01

    To examine process factors that either facilitate or inhibit learning medical ethics during case-based learning. A qualitative research approach using microanalysis of transcribed videotaped discussions of three consecutive small-group learning (SGL) sessions on medical ethics teaching (MET) for three groups, each with 10 students. This research effort revealed 12 themes of learning strategies, divided into 6 coping and 6 evasive strategies. Cognitive-based strategies were found to relate to Kamin's model of critical thinking in medical education, thereby supporting our distinction between the themes of coping and evasive strategies. The findings also showed that cognitive efforts as well as emotional strategies are involved in discussions of ethical dilemmas. Based on Kamin's model and the constructivist learning theory, an examination of the different themes within the two learning strategies-coping and evasive-revealed that these strategies may be understood as corresponding to process factors either facilitating or inhibiting MET in SGL, respectively. Our classification offers a more nuanced observation, specifically geared to pinpointing the desired and less desired process factors in the learning involved in MET in the SGL environment. Two key advantages of this observation are: (1) it brings to the forefront process factors that may inhibit and not merely facilitate MET in SGL and (2) it acknowledges the existence of emotional and not just cognitive process factors. Further enhancement of MET in SGL may thus be achieved based on these observations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Facilitating Service Learning in the Online Technical Communication Classroom

    Science.gov (United States)

    Nielsen, Danielle

    2016-01-01

    Drawing from the author's experience teaching online technical communication courses with an embedded service-learning component, this essay opens the discussion to the potential problems involved in designing online service-learning courses and provides practical approaches to integrating service learning into online coursework. The essay…

  11. Home care services for sick children: Healthcare professionals' conceptions of challenges and facilitators.

    Science.gov (United States)

    Castor, Charlotte; Hallström, Inger; Hansson, Helena; Landgren, Kajsa

    2017-09-01

    To explore healthcare professionals' conceptions of caring for sick children in home care services. Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. An inductive qualitative design. Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise using a phenomenographic analysis. Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges such as feelings of inadequacy and fear and professional growth such as increased competence and satisfaction. Conceptions of whether the home or the hospital was the best place for care differed. Adapting to the child's care was conceived as important. Cooperation with paediatric departments and a well-functioning team work were important organisational aspects. Providing home care for children was a challenging but rewarding task for healthcare professionals used to care for adults. To provide care with a child perspective was experienced as important even though there were conflicting conceptions of how this should be done. Close cooperation with paediatric departments and teamwork were prerequisites that make up for the low number of paediatric patients and facilitate confidence and competence. A sufficient number of referred children and enabling healthcare professionals to be part of the re-organising and implementation processes might facilitate the home care services for sick children. Enough time and good teamwork must be emphasised. Early referrals, continuous cooperation with paediatric clinics complemented with

  12. The facilitation of groups and networks: capabilities to shape creative cooperation

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard

    2003-01-01

    The facilitator, defined as a process guide of creative cooperation, is becoming more and more in focus to assist groups,teams and networks to meet these challenges. The author defines and exemplifies different levels of creative coorperation. Core capabilities of facilitation are defined...

  13. Mental Health Consultation: An Untapped Tool for Facilitating Volatile Intercultural Diversity Group Dialogs

    Science.gov (United States)

    marbley, aretha faye; Stevens, Hal; Taylor, Colette M.; Ritter, Rachelle Berg; Robinson, Petra A.; McGaha, Valerie; Bonner, Fred A., II; Li, Jiaqi

    2015-01-01

    There is an urgent need for leadership skills when facilitating communication and engendering acceptance and respect among people from culturally different backgrounds, opposing viewpoints, and vastly different experiences. Thus, when facilitating intercultural group dialogs, varying institutions, agencies, and businesses need culturally competent…

  14. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Science.gov (United States)

    2013-01-04

    ... Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial... Assistance (TAA) applicable to workers and former workers of Hartford Financial Services Group, Inc., Commercial/ Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford...

  15. A student-facilitated community-based support group initiative for ...

    African Journals Online (AJOL)

    A student-facilitated community-based support group initiative for Mental Health ... was a collaborative partnership between a local University Psychology Department ... users, Rehabilitation, Primary Health Care, Social support, Stigmatisation ...

  16. A student-facilitated community-based support group initiative for ...

    African Journals Online (AJOL)

    Leana Meiring

    supplement for offering support to service users in PHC settings. The group assisted ... training, as well as psychological and social support focussed on improving ... helping service users cope with their mental illness and improve their quality.

  17. Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

    Science.gov (United States)

    Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann

    2015-06-01

    The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. [Facilitators in the implantation of telemedicine services. Perspective of professionals involved in its design and implementation].

    Science.gov (United States)

    Loscertales, F Roig; Rubió, F Saigí

    2011-01-01

    Given the difficulties encountered by Telemedicine for final incorporation into clinical practice and given the lack of scientific evidence regarding the most appropriate implementation strategies, it is necessary to collect and disseminate lessons gained from experience in its introduction and diffusion in our health system. The aim of this study is to identify the facilitators perceived by professionals who actively participate in the design and implementation of telemedicine projects in the health care system. Qualitative study of data from semi-structured interviews with 17 key informants belonging to different Catalan health organizations. The identified facilitators are grouped in four broad areas: a TM service that meets a need clearly perceived by practitioners; a core leadership with a clinical profile, managing an open, participatory and flexible model that takes into account the needs of professionals; the ability to establish partnerships with different stakeholders beyond the customer-supplier relationship; and the inclusion in the initial design of a strategy for sustainability and normalization. Understanding the facilitators and barriers that appear in the process of implementing TM experiences in health care organizations becomes an item of high value for its final introduction. An approach combining the evidence on clinical effectiveness and cost-benefit with lessons learned about the dynamics of implementation and normalization will allow for a holistic understanding of the adoption of the TM and provide guidance for improving its organizational management.

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

    Science.gov (United States)

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

    2015-06-01

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

  20. Group Counseling with South Asian Immigrant High School Girls: Reflections and Commentary of a Group Facilitator

    Science.gov (United States)

    Thakore-Dunlap, Ulash; Van Velsor, Patricia

    2014-01-01

    The diversity of the U.S. school population speaks to a need to provide support for youth from various backgrounds. As a school-based mental health counselor, the first author observed that the South Asian immigrant students at her school did not utilize any of the counseling services provided. Because South Asians are typically collectivistic,…

  1. Using Group Drawings Activities to Facilitate the Understanding of Systemic Aspects of Projects

    DEFF Research Database (Denmark)

    Arantes do Amaral, João Alberto; Hess, Aurélio; Gonçalves, Paulo

    2017-01-01

    In this article, we present our findings regarding promoting group drawing activities in order to facilitate the learning of systemic aspects of projects. We discuss the approach we used to engage the students and foster learning in our classes. We used group drawing activities in two project...... technique, we followed the five-phased qualitative analysis method, combined with a systems analysis of the data obtained from observation. Five recurrent themes emerged: 1) Making drawings in groups helps content retention and facilitates connections between the concepts explained by the professor; 2...

  2. 76 FR 4726 - Avaya Global Services, AOS Service Delivery, Worldwide Services Group, Including Workers Whose...

    Science.gov (United States)

    2011-01-26

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,411] Avaya Global Services, AOS Service Delivery, Worldwide Services Group, Including Workers Whose Unemployment Insurance (UI) Wages Are Reported Through Diamondware, Ltd and Nortel Networks, Inc., Including Workers Working at...

  3. Comparing Facilitator Priorities of Suicide Survivor Support Groups: A Cross-Cultural Comparison Between Japanese and American Groups.

    Science.gov (United States)

    Feigelman, William; Feigelman, Beverly; Kawashima, Daisuke; Shiraga, Keisuke; Kawano, Kenji

    2017-08-01

    A total of 56 Japanese and 59 American survivor of suicide support group facilitators were asked to rank the mutual aid objectives of their groups following Shulman's scheme in terms of their frequency and importance. Both American and Japanese facilitators showed an emphasis on personal adaptation goals (such as helping bereaved feel less isolated in their grief or encouraging bereaved to share their coping with loss experiences) over collective goals (such as raising monies for more research on mental illness or trying to combat societal suicide stigma in their local communities). Differences were also noted with American facilitators evaluating helping with problem solving, sharing different ways of coping, viewing personal issues as societal problems, and advocating for promoting social change as significantly higher than the Japanese did. We believe some of these contrasts reflect differences in American and Japanese cultural values.

  4. Barriers and facilitators of HIV prevention with heterosexual Latino couples: beliefs of four stakeholder groups.

    Science.gov (United States)

    Pérez-Jiménez, David; Seal, David W; Serrano-García, Irma

    2009-01-01

    Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men's involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed.

  5. Barriers and Facilitators of HIV Prevention With Heterosexual Latino Couples: Beliefs of Four Stakeholder Groups

    Science.gov (United States)

    Pérez-Jiménez, David; Seal, David W.; Serrano-García, Irma

    2012-01-01

    Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men’s involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed. PMID:19209976

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

    Science.gov (United States)

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

    2018-02-07

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

  7. Note from the radioprotection group's shipping service

    CERN Multimedia

    2006-01-01

    The service for the import/export of radioactive materials reminds you that shipping requests for potentially radioactive materials must be made via the EDH request form by ticking the box 'radioactive material'. All the necessary information is given on the web site: http://cern.ch/service-rp-shipping Requests not complying with the above procedure will not be taken into account. Radioactive Shipping Service http://cern.ch/service-rp-shipping Tel. 73171 Fax: 69200

  8. Lessons learned in the trenches: facilitating exercise adherence among breast cancer survivors in a group setting.

    Science.gov (United States)

    Rogers, Laura Q; Vicari, Sandy; Courneya, Kerry S

    2010-01-01

    Improving effectiveness of group exercise counseling for breast cancer survivors is needed. The objective of this study was to describe clinical observations, with research and translation implications, derived during group exercise counseling for breast cancer survivors. While implementing group session components of an effective social cognitive theory-based exercise intervention, observations were made through verbal discussion with study staff, review of participant feedback, and prospective journaling by the group facilitator. The intervention has been implemented 11 times (ie, 63 survivors; 66 group sessions). Thematic consistency, application to intervention goals and design, and implications were reconciled between 2 investigators. Breast cancer diagnosis was a strong source of commonality among group participants. Participant age, time since diagnosis, and expectation for group sessions (eg, group support vs health education) hindered group commonality. Barriers unique to the breast cancer experience were infrequent, but people-pleasing behavior was often identified as a barrier to adherence. Feeling at risk for cancer recurrence was a major concern. Some participants required referral for mental health evaluation for preexisting conditions (eg, depression). Although participants easily understood time management, application of other behavioral modification techniques was more difficult. A breast cancer diagnosis alone is not sufficient for commonality among group members. Teaching time management and positive reframing is essential. Protocols for appropriate mental health referrals are needed. Our observations will assist group facilitators in enhancing group dynamics and addressing obstacles hindering counseling effectiveness. Moreover, our results suggest hypotheses related to enhancing behavior change in a group setting worthy of future study.

  9. Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

    Directory of Open Access Journals (Sweden)

    Annette F. Street

    2012-01-01

    Full Text Available This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

  10. Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review.

    Science.gov (United States)

    Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

    2016-02-01

    Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.

  11. Training Counseling Students to Develop Group Leadership Self-Efficacy and Multicultural Competence through Service Learning

    Science.gov (United States)

    Midgett, Aida; Hausheer, Robin; Doumas, Diana M.

    2016-01-01

    This article describes a service-learning project designed to increase student group leadership self-efficacy and multicultural competence. Students facilitated debriefing groups for campus and community members after they participated in a theater production aimed at increasing awareness of oppression, power, and privilege. Students completed…

  12. Peer Facilitated Writing Groups: A Programmatic Approach to Doctoral Student Writing

    Science.gov (United States)

    Kumar, Vijay; Aitchison, Claire

    2018-01-01

    Very few empirical studies have investigated programmes in which doctoral students act as peer facilitators in faculty writing groups. We report on the development of a centrally delivered doctoral student writing programme in which twenty student participants were mentored and provided with the resources to initiate their own faculty-based…

  13. Barriers to and facilitators of rehabilitation services for people with physical disabilities: A systematic review

    Directory of Open Access Journals (Sweden)

    Nondwe B. Mlenzana

    2013-09-01

    Objectives: This article aimed to review the relevant literature regarding barriers to and facilitators of rehabilitation services for people with disabilities. Method: Articles for the period 1990–2010 using descriptors related to rehabilitation services, barriers, facilitators and the physically disabled population were retrieved for this review. Results: A total of 19 article titles were identified from references of other articles but following application of the inclusion criteria selected for this review, only six articles were chosen. Five of these articles were qualitative studies and one was a quantitative study. Barriers and facilitators regarding rehabilitation services highlighted by participants in the studies included a perception that health professionals have a lack of understanding of rehabilitation for people with disabilities and there was a lack of information sharing from health professionals about the rehabilitation process. On the other hand some participants reported that health professionals demonstrated confidence in the disability and rehabilitation process during consultation and highlighted that their needs were met by the rehabilitation professionals. Conclusion: Even though there were few studies highlighting the barriers to and facilitators of rehabilitation services, they highlighted that there are gaps in the process of rehabilitation services provided. It would be advisable for health professionals to take cognisance of the issues highlighted in this study in order to make rehabilitation services more effective.

  14. 75 FR 28298 - Avaya Inc., Worldwide Services Group, Global Support Services (GSS) Organization, Including On...

    Science.gov (United States)

    2010-05-20

    ...., Worldwide Services Group, Global Support Services (GSS) Organization, Including On-Site Leased Workers From..., Highlands Ranch, CO; Including Employees in Support of Avaya Inc., Worldwide Services Group, Global Support... workers of Avaya Inc., Worldwide Services Group, Global Support Services (GSS) Organization, including on...

  15. Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Nsangou, Édith-Romy; Payne-Gagnon, Julie; Grenier, Sonya; Sicotte, Claude

    2014-01-01

    We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care. We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings. We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources. This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation. This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

  16. Key facilitators and best practices of hotel-style room service in hospitals.

    Science.gov (United States)

    Sheehan-Smith, Lisa

    2006-04-01

    This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages.

  17. Facilitation of self-transcendence in a breast cancer support group.

    Science.gov (United States)

    Coward, D D

    1998-01-01

    To examine the feasibility and patterns of effectiveness of a breast cancer support group intervention specifically designed to facilitate self-transcendence views and perspectives that would enhance emotional and physical well-being. Pre-experimental design pilot intervention study with a quantitative approach to data analysis. Survivor-established breast cancer resource center in Austin, TX. Women with recently diagnosed breast cancer (N = 16) participating in 90-minute support group sessions that met weekly for eight weeks. Theory-driven support group intervention facilitated by an oncology clinical nurse specialist, a psychotherapist, and a breast cancer survivor. Activities planned for individual sessions were based on self-transcendence theory, cancer support group literature, and the facilitators' extensive previous support group experience. Self-transcendence, emotional well-being, physical well-being. Good networking, coordination, and follow-up were essential for participant recruitment and retention throughout the intervention period. Although specific theory-driven activities were planned for group sessions, facilitators maintained flexibility in meeting immediate concerns of the participants. Relationships among participants' scores on study variables indicated an association between self-transcendence and emotional well-being. Scores on self-transcendence and well-being variables at the end of the intervention increased from baseline, but only functional performance status, mood state, and satisfaction with life reached statistical significance. The pilot study was invaluable in providing direction for the conduct of future experimental studies. Provides preliminary support for the use of theory-driven activities for promotion of self-transcendence views and behaviors within a cancer support group setting.

  18. Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies.

    Science.gov (United States)

    Kenning, Cassandra; Daker-White, Gavin; Blakemore, Amy; Panagioti, Maria; Waheed, Waquas

    2017-08-30

    It is estimated that there are about 25,000 people from UK ethnic minority groups with dementia. It is clear that there is an increasing need to improve access to dementia services for all ethnic groups to ensure that everyone has access to the same potential health benefits. The aim was to systematically review qualitative studies and to perform a meta-synthesis around barriers and facilitators to accessing care for dementia in ethnic minorities. Databases were searched to capture studies on barriers and facilitators to accessing care for dementia in ethnic minorities. Analysis followed the guidelines for meta-ethnography. All interpretations of data as presented by the authors of the included papers were extracted and grouped into new themes. Six hundred and eighty four papers were identified and screened. Twenty eight studies were included in the meta-synthesis. The analysis developed a number of themes and these were incorporated into two overarching themes: 'inadequacies' and 'cultural habitus'. The two overarching themes lend themselves to interventions at a service level and a community level which need to happen in synergy. The review was registered with PROSPERO: CRD42016049326 .

  19. Using Group Drawings Activities to Facilitate the Understanding of the Systemic Aspects of Projects

    Directory of Open Access Journals (Sweden)

    João Alberto Arantes do Amaral

    2017-04-01

    Full Text Available In this article, we present our findings regarding promoting group drawing activities in order to facilitate the learning of systemic aspects of projects. We discuss the approach we used to engage the students and foster learning in our classes. We used group drawing activities in two project management undergraduate courses. The courses, which involved 41 students, took place during the second semester of 2016 in a public university in Brazil. We conducted qualitative research, using qualitative observation and focus group interviews. In order to gauge the effects of the use of this educational technique, we followed the five-phased qualitative analysis method, combined with a systems analysis of the data obtained from observation. Five recurrent themes emerged: 1 Making drawings in groups helps content retention and facilitates connections between the concepts explained by the professor; 2 Making drawings in groups promotes knowledge sharing among team members; 3 Making drawings in group fosters creativity and communication between students; 4 Drawing in groups reduces the students’ boredom, makes the lecture more dynamic and interesting; 5 Drawing in groups reinforces bonds between students. Our systems analysis suggests that group drawing improves student participation in classroom activities, strengthens bonds between students, and enhances learning.

  20. Barriers and Facilitating Factors for Implementation of Genetic Services: A Public Health Perspective

    OpenAIRE

    Martina C. Cornel; Carla G. van El

    2017-01-01

    More than 15 years after the publication of the sequence of the human genome, the resulting changes in health care have been modest. At the same time, some promising examples in genetic services become visible, which contribute to the prevention of chronic disease such as cancer. These are discussed to identify barriers and facilitating factors for the implementation of genetic services. Examples from oncogenetics illustrate a high risk of serious disease where prevention is possible, especia...

  1. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  2. Older people's adoption of e-learning services: a qualitative study of facilitators and barriers.

    Science.gov (United States)

    Bai, Xue; He, Yiqin; Kohlbacher, Florian

    2018-05-14

    This research investigates the facilitators and barriers for older people to adopt e-learning services using qualitative data of older people in a Chinese city. A qualitative approach was applied to explore the perceived facilitators and obstacles toward e-learning adoption with 10 older Chinese aged over 50. The results indicate the following: (1a) Age-related changes and cohort effects were found to be the internal barriers for the adoption of e-learning. (1b) Equipment problems, lack of time, and the availability of alternatives were found to have negative effects on the acceptance of e-learning services. It is notable that alternatives including the University of the Third Age (U3A) were found to be more attractive for older Chinese. (2a) Work requirements and flexibility of e-learning services were found to have direct effects on the acceptance of services. (2b) User-friendly design and stimulation from family would facilitate older people to adopt. Practical implications of this research include that policymakers should consider investing more in education in later life and introducing e-learning services in public lectures and tutorials and that the age-related barrier should be taken into consideration in the design phase of e-learning services. U3As should consider integrating e-learning approaches and cooperating with the community.

  3. Using a Critical Service-Learning Approach to Facilitate Civic Identity Development

    Science.gov (United States)

    Mitchell, Tania D.

    2015-01-01

    This article highlights elements of civic engagement programs that have the rich potential to facilitate civic identity development. Focusing on research with alumni, the study examines 3 civic engagement programs, the approaches of which are guided by critical service-learning. It explores elements of the experiences that alumni name as…

  4. Using the Apple iPad to facilitate student-led group work and seminar presentation.

    Science.gov (United States)

    Davies, Mark

    2014-08-01

    Mobile technology has become progressively more visible within the Higher Education learning environment, and is, in the author's experience, often used casually by students to support their learning. The project outlined within this paper examines the efficacy of using such technology (Apple iPad) more formally in facilitating increased levels of interaction and group cohesion within a series of tutorial sessions involving undergraduate nursing students (n = 24). For the purposes of the project, a tutorial group was created and facilitated in which the students undertook and fed back upon a series of specific iPad supported activities. Data was collected at the mid point and cessation of the project. The outcomes were most encouraging, and indicated that mobile computing platforms of this type may indeed help students to engage more fully with learning activities and materials, and as a corollary, increase student confidence with peer presentation and feedback. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. 78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

    Science.gov (United States)

    2013-02-06

    ... Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial... workers and former workers of Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford, Connecticut (The Hartford-IDS...

  6. Systematic review: barriers and facilitators for minority ethnic groups accessing urgent and prehospital care

    OpenAIRE

    Phung, Viet-Hai; Windle, Karen; Asghar, Zahid; Ortega, Marishona; Essam, Nadya; Barot, Mukesh; Kai, Joe; Johnson, Mark; Siriwardena, A. Niroshan

    2014-01-01

    Background Research addressing inequalities has focussed predominantly on primary and acute care. We aimed to identify barriers or facilitators to people from minority ethnic groups accessing prehospital care and to explore the causes and consequences of any differences in delivery. Methodology We conducted a systematic literature review and narrative synthesis. Electronic searches from 2003 through to 2013 identified studies; systematic reviews, randomised controlled trials, quasi-...

  7. Barriers and facilitators of treatment for depression in a latino community: a focus group study.

    Science.gov (United States)

    Uebelacker, Lisa A; Marootian, Beth A; Pirraglia, Paul A; Primack, Jennifer; Tigue, Patrick M; Haggarty, Ryan; Velazquez, Lavinia; Bowdoin, Jennifer J; Kalibatseva, Zornitsa; Miller, Ivan W

    2012-02-01

    We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.

  8. Structured Play Therapy Groups for Preschoolers: facilitating the emergence of social competence.

    Science.gov (United States)

    Stone, Susan; Stark, Martha

    2013-01-01

    Over the years, we have developed a working model of Structured Play Therapy Groups for Preschoolers, an innovative treatment approach designed to address the needs of young children ages 3 to 5 struggling to adjust to the social demands of their preschool classrooms. These short-term therapy groups facilitate development of the young child's social competence and capacity to participate effectively in a classroom environment. Although the literature on therapy groups for children suggests that preschoolers are not yet evolved enough developmentally to engage actively in a group process, our experience indicates otherwise. The model of treatment presented here will therefore challenge that contention with the claim that not only can preschoolers participate in a structured therapy group of peers but they can, by virtue of that very participation, benefit in ways that will prepare them (as they transition from preschool to kindergarten) for the ever-increasing demands of their ever-expanding social milieus.

  9. Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups.

    Science.gov (United States)

    Reddy, Shalini T; Zegarek, Matthew H; Fromme, H Barrett; Ryan, Michael S; Schumann, Sarah-Anne; Harris, Ilene B

    2015-06-01

    Despite the importance of feedback, the literature suggests that there is inadequate feedback in graduate medical education. We explored barriers and facilitators that residents in anesthesiology, emergency medicine, obstetrics and gynecology, and surgery experience with giving and receiving feedback during their clinical training. Residents from 3 geographically diverse teaching institutions were recruited to participate in focus groups in 2012. Open-ended questions prompted residents to describe their experiences with giving and receiving feedback, and discuss facilitators and barriers. Data were transcribed and analyzed using the constant comparative method associated with a grounded theory approach. A total of 19 residents participated in 1 of 3 focus groups. Five major themes related to feedback were identified: teacher factors, learner factors, feedback process, feedback content, and educational context. Unapproachable attendings, time pressures due to clinical work, and discomfort with giving negative feedback were cited as major barriers in the feedback process. Learner engagement in the process was a major facilitator in the feedback process. Residents provided insights for improving the feedback process based on their dual roles as teachers and learners. Time pressures in the learning environment may be mitigated by efforts to improve the quality of teacher-learner relationships. Forms for collecting written feedback should be augmented by faculty development to ensure meaningful use. Efforts to improve residents' comfort with giving feedback and encouraging learners to engage in the feedback process may foster an environment conducive to increasing feedback.

  10. Barriers and facilitators to cultural competence in rehabilitation services: a scoping review.

    Science.gov (United States)

    Grandpierre, Viviane; Milloy, Victoria; Sikora, Lindsey; Fitzpatrick, Elizabeth; Thomas, Roanne; Potter, Beth

    2018-01-15

    There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer. After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems. To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner

  11. Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

    Science.gov (United States)

    Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

    2014-10-01

    The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

  12. Testing a model of facilitated reflection on network feedback: a mixed method study on integration of rural mental healthcare services for older people.

    Science.gov (United States)

    Fuller, Jeffrey; Oster, Candice; Muir Cochrane, Eimear; Dawson, Suzanne; Lawn, Sharon; Henderson, Julie; O'Kane, Deb; Gerace, Adam; McPhail, Ruth; Sparkes, Deb; Fuller, Michelle; Reed, Richard L

    2015-11-11

    To test a management model of facilitated reflection on network feedback as a means to engage services in problem solving the delivery of integrated primary mental healthcare to older people. Participatory mixed methods case study evaluating the impact of a network management model using organisational network feedback (through social network analysis, key informant interviews and policy review). A model of facilitated network reflection using network theory and methods. A rural community in South Australia. 32 staff from 24 services and 12 senior service managers from mental health, primary care and social care services. Health and social care organisations identified that they operated in clustered self-managed networks within sectors, with no overarching purposive older people's mental healthcare network. The model of facilitated reflection revealed service goal and role conflicts. These discussions helped local services to identify as a network, and begin the problem-solving communication and referral links. A Governance Group assisted this process. Barriers to integrated servicing through a network included service funding tied to performance of direct care tasks and the lack of a clear lead network administration organisation. A model of facilitated reflection helped organisations to identify as a network, but revealed sensitivity about organisational roles and goals, which demonstrated that conflict should be expected. Networked servicing needed a neutral network administration organisation with cross-sectoral credibility, a mandate and the resources to monitor the network, to deal with conflict, negotiate commitment among the service managers, and provide opportunities for different sectors to meet and problem solve. This requires consistency and sustained intersectoral policies that include strategies and funding to facilitate and maintain health and social care networks in rural communities. Published by the BMJ Publishing Group Limited. For permission to

  13. Identification of Strategies to Facilitate Organ Donation among African Americans using the Nominal Group Technique

    Science.gov (United States)

    Qu, Haiyan; Shewchuk, Richard; Mannon, Roslyn B.; Gaston, Robert; Segev, Dorry L.; Mannon, Elinor C.; Martin, Michelle Y.

    2015-01-01

    Background and objectives African Americans are disproportionately affected by ESRD, but few receive a living donor kidney transplant. Surveys assessing attitudes toward donation have shown that African Americans are less likely to express a willingness to donate their own organs. Studies aimed at understanding factors that may facilitate the willingness of African Americans to become organ donors are needed. Design, setting, participants, & measurements A novel formative research method was used (the nominal group technique) to identify and prioritize strategies for facilitating increases in organ donation among church-attending African Americans. Four nominal group technique panel interviews were convened (three community and one clergy). Each community panel represented a distinct local church; the clergy panel represented five distinct faith-based denominations. Before nominal group technique interviews, participants completed a questionnaire that assessed willingness to become a donor; 28 African-American adults (≥19 years old) participated in the study. Results In total, 66.7% of participants identified knowledge- or education-related strategies as most important strategies in facilitating willingness to become an organ donor, a view that was even more pronounced among clergy. Three of four nominal group technique panels rated a knowledge-based strategy as the most important and included strategies, such as information on donor involvement and donation-related risks; 29.6% of participants indicated that they disagreed with deceased donation, and 37% of participants disagreed with living donation. Community participants’ reservations about becoming an organ donor were similar for living (38.1%) and deceased (33.4%) donation; in contrast, clergy participants were more likely to express reservations about living donation (33.3% versus 16.7%). Conclusions These data indicate a greater opposition to living donation compared with donation after one’s death

  14. 75 FR 47631 - Swets Information Services, Operations Department, Information Technology Group, Marketing Group...

    Science.gov (United States)

    2010-08-06

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,668] Swets Information Services, Operations Department, Information Technology Group, Marketing Group, Finance Group, Runnemede..., Information Technology (IT) Group, Marketing Group and the Finance Group into one entity instead of...

  15. SOFTWARE ARCHITECTURE DESIGN OF GIS WEB SERVICE AGGREGATION BASED ON SERVICE GROUP

    Directory of Open Access Journals (Sweden)

    J.-C. Liu

    2012-08-01

    Full Text Available Based on the analysis of research status of domestic and international GIS web service aggregation and development tendency of public platform of GIS web service, the paper designed software architecture of GIS web service aggregation based on GIS web service group. Firstly, using heterogeneous GIS services model, the software architecture converted a variety of heterogeneous services to a unified interface of GIS services, and divided different types of GIS services into different service groups referring to description of GIS services. Secondly, a service aggregation process model was designed. This model completed the task of specific service aggregation instance, by automatically selecting member GIS Web services in the same service group. Dynamic capabilities and automatic adaptation of GIS Web services aggregation process were achieved. Thirdly, this paper designed a service evaluation model of GIS web service aggregation based on service group from three aspects, i.e. GIS Web Service itself, networking conditions and service consumer. This model implemented effective quality evaluation and performance monitoring of GIS web service aggregation. It could be used to guide the execution, monitor and service selection of aggregation process. Therefore, robustness of aggregated GIS web service was improved. Finally, the software architecture has been widely used in public platform of GIS web service and a number of geo-spatial framework constructions for digital city in Sichuan Province, and aggregated various GIS web services such as World Map(National Public Platform of Geo-spatial Service, ArcGIS, SuperMap, MapGIS, NewMap etc. Applications of items showed that this software architecture was practicability.

  16. Web-Browsing Competencies of Pre-Service Adult Facilitators: Implications for Curriculum Transformation and Distance Learning

    Science.gov (United States)

    Theresa, Ofoegbu; Ugwu, Agboeze Matthias; Ihebuzoaju, Anyanwu Joy; Uche, Asogwa

    2013-01-01

    The study investigated the Web-browsing competencies of pre-service adult facilitators in the southeast geopolitical zone of Nigeria. Survey design was adopted for the study. The population consists of all pre-service adult facilitators in all the federal universities in the southeast geopolitical zone of Nigeria. Accidental sampling technique was…

  17. Supervisors’ Strategies to Facilitate Work Functioning among Employees with Musculoskeletal Complaints: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Tove Ask

    2015-01-01

    Full Text Available Aim. To explore what strategies the supervisors found beneficial to prevent or reduce sickness absence among employees with musculoskeletal complaints. Methods. Five focus groups were conducted and 26 supervisors from health and social sector participated. Commonly used strategies to prevent sickness absence and interdisciplinary cooperation in this work were discussed in the focus groups. Systematic text condensation was used to analyse the data. Results. The supervisors described five strategies for sick leave management: (1 promoting well-being and a healthy working environment, (2 providing early support and adjustments, (3 making employees more responsible, (4 using confrontational strategies in relation to employees on long-term sick leave, and (5 cooperation with general practitioners (GPs. Conclusions. Strategies of promoting a healthy working environment and facilitating early return to work were utilised in the follow-up of employees with musculoskeletal complaints. Supportive strategies were found most useful especially in the early phases, while finding a balance between being supportive, on one side, and confronting the employee, on the other, was endeavoured in cases of recurrent or long-term sick leave. Further, the supervisors requested a closer cooperation with the GPs, which they believed would facilitate return to work.

  18. A student-facilitated community-based support group initiative for Mental Health Care users in a Primary Health Care setting

    Directory of Open Access Journals (Sweden)

    Leana Meiring

    2017-12-01

    Methods: Qualitative research methods were applied. Data were collected using semistructured interviews and a collage-making and storytelling method. Thematic analysis highlighted the main themes representing the meaning the five participants ascribed to the group. Results: The findings suggest that the group offered the participants a sense of belonging and a means of social and emotional support. The group also created opportunity for learning, encouraged mental and physical mobilisation and stimulation, and served as an additional link to professional services. Conclusion: The findings suggest that student-facilitated support groups could offer a viable supplement for offering support to service users in PHC settings. The group assisted MHC users to cope with symptoms, social integration, and participating in meaningful activities as part of rehabilitation services.

  19. Facilitation of the Estuary/Ocean Subgroup and the Expert Regional Technical Group, Fiscal Year 2013 Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Gary E.; Sather, Nichole K.

    2013-10-30

    This project covers facilitation of the Estuary/Ocean Subgroup (EOS) for federal research, monitoring, and evaluation (RME) and the Expert Regional Technical Group (ERTG) for estuary habitat restoration. The EOS is part of the research, monitoring, and evaluation effort that the Action Agencies (Bonneville Power Administration [BPA], U.S. Army Corps of Engineers [Corps], U.S. Bureau of Reclamation) developed in response to obligations arising from the Endangered Species Act as applied to operation of the Federal Columbia River Power System (FCRPS). The EOS is tasked by National Marine Fisheries Service (NMFS) and the Action Agencies (AAs) to design and coordinate implementation of the federal RME plan for the lower Columbia River and estuary, including the river’s plume in the ocean. Initiated in 2002, the EOS is composed of members from BPA, the Corps, NMFS, and Pacific Northwest National Laboratory’s (PNNL’s) Marine Sciences Laboratory, and other agencies as necessary.

  20. Exploring Forms of Triangulation to Facilitate Collaborative Research Practice: Reflections From a Multidisciplinary Research Group

    Directory of Open Access Journals (Sweden)

    Tarja Tiainen

    2006-10-01

    Full Text Available This article contains critical reflections of a multidisciplinary research group studying the human and technological dynamics around some newly offered electronic services in a specific rural area of Finland. For their research, the group adopted ethnography. On facing the challenges of doing ethnographic research in a multidisciplinary setting, the group evolved its own breed of research practice based on multiple forms of triangulation. This implied the use of multiple data sources, methods, theories, and researchers, in different combinations. One of the outcomes of the work is a model for collaborative research. It highlights, among others, the importance of creating a climate for collaboration within the research group and following a process of individual and collaborative writing to achieve the potential benefits of such research. The article also identifies a set of remaining challenges relevant to collaborative research.

  1. Genetic risks and healthy choices: creating citizen-consumers of genetic services through empowerment and facilitation.

    Science.gov (United States)

    Harvey, Alison

    2010-03-01

    Genetic testing to identify susceptibility to a variety of common complex diseases is increasingly becoming available. In this article, focusing on the development of genetic susceptibility testing for diet-related disease, I examine the emergence of direct-to-the-consumer genetic testing services and the (re)configuration of healthcare provision, both within and outside the specialist genetics service, in the UK. I identify two key techniques within these practices: empowerment and facilitation. Using Foucauldian social theory, I show that empowerment and facilitation are being positioned as tools for the creation of citizen-consumers who will make appropriate dietary choices, based on the results of their genetic analysis. Through these techniques, individuals are transformed into properly entrepreneurial citizens who will, through judicious choices, act to maximise their 'vital capital' (their health) and the capital of the social body. I argue that the user of these services is not purely an economic figure, making rational choices as a consumer, but that her configuration as a citizen-consumer who avails herself of genetic information and services in a proper manner ensures that she is fit to contribute to the economic life of our present.

  2. Service Learning in Undergraduate Nursing Education: Strategies to Facilitate Meaningful Reflection.

    Science.gov (United States)

    Schmidt, Nola A; Brown, Janet M

    2016-01-01

    Service learning is recognized as a valuable pedagogy involving experiential learning, reflection, and reciprocal learning. Students develop critical thinking and social awareness by using the crucial activity of reflecting upon their experiential learning with community partners. The purpose of this paper is to demystify the process of reflection by identifying best practices to enhance reflection and offering suggestions for grading. By understanding "the what" and "the how" of reflection, educators can implement service learning experiences designed to include the essential component of reflection. Strategies for facilitating meaningful reflection are described including descriptions of what students should reflect upon and how to initiate reflection through writing, reading, doing, and telling. Grading rubrics are suggested to facilitate evaluation of student reflection. When properly implemented, service learning encourages students to be good citizens of the world. By using best practices associated with reflection, students can be challenged to think critically about the world and how their service can achieve community goals. Copyright © 2016. Published by Elsevier Inc.

  3. Facilitating reintegration for military service personnel, veterans, and their families: An introduction to the special issue.

    Science.gov (United States)

    Elnitsky, Christine A; Kilmer, Ryan P

    2017-01-01

    As service members return from active duty and, in some cases, exit the military, they face a process of reintegration (also referred to as community reintegration) as they seek to resume participation in their life roles as civilians. Facilitating this dynamic process of reintegration for service members, veterans, and their families-including outlining potential strategies for supporting this return to civilian life and its demands, roles, and responsibilities-is the focus of this Special Issue. Reintegration has been framed as a national priority (U.S. Department of Veterans Affairs, 2015) and has been a point of emphasis of efforts at federal, state, and local levels. As the articles in this issue suggest, multiple public, private, and voluntary systems and the communities to which service members, veterans, and their families return can help influence their health outcomes and, ultimately, their reintegration. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Histo-blood group carbohydrates as facilitators for infection by Helicobacter pylori.

    Science.gov (United States)

    Brandão de Mattos, Cinara Cássia; de Mattos, Luiz Carlos

    2017-09-01

    Helicobacter pylori infect millions of people around the world. It occupies a niche in the human gastrointestinal tract characterized by high expression of a repertoire of carbohydrates. ABO and Lewis histo-blood group systems are controlled by genes coding for functional glycosyltransferases which synthesize great diversity of related fucosylated carbohydrate in different tissues, including gastrointestinal mucosa, and exocrine secretions. The structural diversity of histo-blood group carbohydrates is highly complex and depends on epistatic interactions among gene-encoding glycosyltransferases. The histo-blood group glycosyltransferases act in the glycosylation of proteins and lipids in the human gastrointestinal tract allowing the expression of a variety of potential receptors in which H. pylori can adhere. These oligosaccharide molecules are part of the gastrointestinal repertoire of carbohydrates which act as potential receptors for microorganisms, including H. pylori. This Gram-negative bacillus is one of the main causes of the gastrointestinal diseases such as chronic active gastritis, peptic ulcer, and cancer of stomach. Previous reports showed that some H. pylori strains use carbohydrates as receptors to adhere to the gastric and duodenal mucosa. Since some histo-blood group carbohydrates are highly expressed in one but not in others histo-blood group phenotypes it has pointed out that quantitative differences among them influence the susceptibility to diseases caused by H. pylori. Additionally, some experiments using animal model are helping us to understand how this bacillus explore histo-blood group carbohydrates as potential receptors, offering possibility to explore new strategies of management of infection, disease treatment, and prevention. This text highlights the importance of structural diversity of ABO and Lewis histo-blood group carbohydrates as facilitators for H. pylori infection. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services.

    Science.gov (United States)

    Rodda, S N; Manning, V; Dowling, N A; Lee, S J; Lubman, D I

    2018-03-01

    Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured interviews were undertaken with 30 clinicians and managers from 11 mental health services in Victoria, Australia. Major themes and subthemes were identified using qualitative content analysis. Six themes emerged including competing priorities, importance of routine screening, access to appropriate screening tools, resources, patient responsiveness and workforce development. Barriers to screening included a focus on immediate risk as well as gambling being often considered as a longer-term concern. Clinicians perceived problem gambling as a relatively rare condition, but did acknowledge the need for brief screening. Facilitators to screening were changes to system processes, such as identification of an appropriate brief screening instrument, mandating its use as part of routine screening, as well as funded workforce development activities in the identification and management of problem gambling.

  6. Barriers and Facilitating Factors for Implementation of Genetic Services: A Public Health Perspective

    Directory of Open Access Journals (Sweden)

    Martina C. Cornel

    2017-08-01

    Full Text Available More than 15 years after the publication of the sequence of the human genome, the resulting changes in health care have been modest. At the same time, some promising examples in genetic services become visible, which contribute to the prevention of chronic disease such as cancer. These are discussed to identify barriers and facilitating factors for the implementation of genetic services. Examples from oncogenetics illustrate a high risk of serious disease where prevention is possible, especially in relatives. Some 5% of breast cancers and colorectal cancers are attributable to an inherited predisposition. These cancers occur at a relatively young age. DNA testing of relatives of affected patients may facilitate primary and secondary prevention. Training of non-genetic health care workers and health technology assessment are needed, as is translational research in terms of bringing genomics to health care practice while monitoring and evaluating. Stratified screening programs could include cascade screening and risk assessment based on family history. New roles and responsibilities will emerge. A clear assessment of the values implied is needed allowing to balance the pros and cons of interventions to further the responsible innovation of genetic services.

  7. Barriers and Facilitating Factors for Implementation of Genetic Services: A Public Health Perspective.

    Science.gov (United States)

    Cornel, Martina C; van El, Carla G

    2017-01-01

    More than 15 years after the publication of the sequence of the human genome, the resulting changes in health care have been modest. At the same time, some promising examples in genetic services become visible, which contribute to the prevention of chronic disease such as cancer. These are discussed to identify barriers and facilitating factors for the implementation of genetic services. Examples from oncogenetics illustrate a high risk of serious disease where prevention is possible, especially in relatives. Some 5% of breast cancers and colorectal cancers are attributable to an inherited predisposition. These cancers occur at a relatively young age. DNA testing of relatives of affected patients may facilitate primary and secondary prevention. Training of non-genetic health care workers and health technology assessment are needed, as is translational research in terms of bringing genomics to health care practice while monitoring and evaluating. Stratified screening programs could include cascade screening and risk assessment based on family history. New roles and responsibilities will emerge. A clear assessment of the values implied is needed allowing to balance the pros and cons of interventions to further the responsible innovation of genetic services.

  8. Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

    2017-03-10

    This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

  9. What influences buying leisure services coupons on online group buying?

    OpenAIRE

    Langvinienė, Neringa; Zemblytė, Jurgita; Sližienė, Gelminė

    2016-01-01

    Growing use of IT, laptops, tablets, PC in individuals' life shaped an opportunity to create online group buying (OGB) as a new online business model. Several of surveys show that OGB is rather popular for selling recreational activities and leisure services, such as restaurant coupons, cinema, spa, concert, flight tickets, museum visits, etc. Therefore, the paper aims to identify and estimate the influences that affect the customers to purchase the leisure services coupons on online group bu...

  10. Barriers and facilitators of access to maternal services for women with disabilities: scoping review protocol.

    Science.gov (United States)

    Mheta, Doreen; Mashamba-Thompson, Tivani P

    2017-05-16

    The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.

  11. Exploiting peer group concept for adaptive and highly available services

    CERN Document Server

    Jan, M A; Fraz, M M; Ali, A; Ali, Arshad; Fraz, Mohammad Moazam; Jan, Muhammad Asif; Zahid, Fahd Ali

    2003-01-01

    This paper presents a prototype for redundant, highly available and fault tolerant peer to peer framework for data management. Peer to peer computing is gaining importance due to its flexible organization, lack of central authority, distribution of functionality to participating nodes and ability to utilize unused computational resources. Emergence of GRID computing has provided much needed infrastructure and administrative domain for peer to peer computing. The components of this framework exploit peer group concept to scope service and information search, arrange services and information in a coherent manner, provide selective redundancy and ensure availability in face of failure and high load conditions. A prototype system has been implemented using JXTA peer to peer technology and XML is used for service description and interfaces, allowing peers to communicate with services implemented in various platforms including web services and JINI services. It utilizes code mobility to achieve role interchange amo...

  12. Student perceptions of independent versus facilitated small group learning approaches to compressed medical anatomy education.

    Science.gov (United States)

    Whelan, Alexander; Leddy, John J; Mindra, Sean; Matthew Hughes, J D; El-Bialy, Safaa; Ramnanan, Christopher J

    2016-01-01

    The purpose of this study was to compare student perceptions regarding two, small group learning approaches to compressed (46.5 prosection-based laboratory hours), integrated anatomy education at the University of Ottawa medical program. In the facilitated active learning (FAL) approach, tutors engage students and are expected to enable and balance both active learning and progression through laboratory objectives. In contrast, the emphasized independent learning (EIL) approach stresses elements from the "flipped classroom" educational model: prelaboratory preparation, independent laboratory learning, and limited tutor involvement. Quantitative (Likert-style questions) and qualitative data (independent thematic analysis of open-ended commentary) from a survey of students who had completed the preclerkship curriculum identified strengths from the EIL (promoting student collaboration and communication) and FAL (successful progression through objectives) approaches. However, EIL led to student frustration related to a lack of direction and impaired completion of objectives, whereas active learning opportunities in FAL were highly variable and dependent on tutor teaching style. A "hidden curriculum" was also identified, where students (particularly EIL and clerkship students) commonly compared their compressed anatomy education or their anatomy learning environment with other approaches. Finally, while both groups highly regarded the efficiency of prosection-based learning and expressed value for cadaveric-based learning, student commentary noted that the lack of grade value dedicated to anatomy assessment limited student accountability. This study revealed critical insights into small group learning in compressed anatomy education, including the need to balance student active learning opportunities with appropriate direction and feedback (including assessment). © 2015 American Association of Anatomists.

  13. Interactive, open source, travel time scenario modelling: tools to facilitate participation in health service access analysis.

    Science.gov (United States)

    Fisher, Rohan; Lassa, Jonatan

    2017-04-18

    Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and

  14. Noninvasive brain stimulation can induce paradoxical facilitation . Are these neuroenhancements transferable and meaningful to security services?

    Directory of Open Access Journals (Sweden)

    Jean eLevasseur-Moreau

    2013-08-01

    Full Text Available For ages, we have been looking for ways to enhance our physical and cognitive capacities in order to augment our security. One potential way to achieve this goal may be to externally stimulate the brain. Methods of noninvasive brain stimulation (NIBS, such as repetitive transcranial magnetic stimulation and transcranial electrical stimulation, have been recently developed to modulate brain activity. Both techniques are relatively safe and can transiently modify motor and cognitive functions outlasting the stimulation period. The purpose of this paper is to review data suggesting that NIBS can enhance motor and cognitive performance in healthy volunteers. We frame these findings in the context of whether they may serve security purposes. Specifically, we review studies reporting that NIBS induces paradoxical facilitation in motor (precision, speed, strength, acceleration endurance, and execution of daily motor task and cognitive functions (attention, impulsive behaviour, risk-taking, working memory, planning, and deceptive capacities. Although transferability and meaningfulness of these NIBS-induced paradoxical facilitations into real life situations are not clear yet, NIBS may contribute at improving training of motor and cognitive functions relevant for military, civil and forensic security services. This is an enthusiastic perspective that also calls for fair and open debates on the ethics of using NIBS in healthy individuals to enhance normal functions.

  15. Software architecture and design of the web services facilitating climate model diagnostic analysis

    Science.gov (United States)

    Pan, L.; Lee, S.; Zhang, J.; Tang, B.; Zhai, C.; Jiang, J. H.; Wang, W.; Bao, Q.; Qi, M.; Kubar, T. L.; Teixeira, J.

    2015-12-01

    Climate model diagnostic analysis is a computationally- and data-intensive task because it involves multiple numerical model outputs and satellite observation data that can both be high resolution. We have built an online tool that facilitates this process. The tool is called Climate Model Diagnostic Analyzer (CMDA). It employs the web service technology and provides a web-based user interface. The benefits of these choices include: (1) No installation of any software other than a browser, hence it is platform compatable; (2) Co-location of computation and big data on the server side, and small results and plots to be downloaded on the client side, hence high data efficiency; (3) multi-threaded implementation to achieve parallel performance on multi-core servers; and (4) cloud deployment so each user has a dedicated virtual machine. In this presentation, we will focus on the computer science aspects of this tool, namely the architectural design, the infrastructure of the web services, the implementation of the web-based user interface, the mechanism of provenance collection, the approach to virtualization, and the Amazon Cloud deployment. As an example, We will describe our methodology to transform an existing science application code into a web service using a Python wrapper interface and Python web service frameworks (i.e., Flask, Gunicorn, and Tornado). Another example is the use of Docker, a light-weight virtualization container, to distribute and deploy CMDA onto an Amazon EC2 instance. Our tool of CMDA has been successfully used in the 2014 Summer School hosted by the JPL Center for Climate Science. Students had positive feedbacks in general and we will report their comments. An enhanced version of CMDA with several new features, some requested by the 2014 students, will be used in the 2015 Summer School soon.

  16. Guide to Savannah River Laboratory Analytical Services Group

    International Nuclear Information System (INIS)

    1990-04-01

    The mission of the Analytical Services Group (ASG) is to provide analytical support for Savannah River Laboratory Research and Development Programs using onsite and offsite analytical labs as resources. A second mission is to provide Savannah River Site (SRS) operations with analytical support for nonroutine material characterization or special chemical analyses. The ASG provides backup support for the SRS process control labs as necessary

  17. Guide to Savannah River Laboratory Analytical Services Group

    Energy Technology Data Exchange (ETDEWEB)

    1990-04-01

    The mission of the Analytical Services Group (ASG) is to provide analytical support for Savannah River Laboratory Research and Development Programs using onsite and offsite analytical labs as resources. A second mission is to provide Savannah River Site (SRS) operations with analytical support for nonroutine material characterization or special chemical analyses. The ASG provides backup support for the SRS process control labs as necessary.

  18. Group guidance services to improved creativity for teachers

    Directory of Open Access Journals (Sweden)

    Solihatun Solihatun

    2017-11-01

    Full Text Available Creativity in the learning process by teachers is very important in order to support the task at school. Teacher creativity allows teachers to apply various learning methods that encourage students' interest to learn from the classroom. Besides, creativity for teachers is needed to support student development. This study aims to determine the level of creativity of teachers through group guidance services. Subjects in this study involved 10 teachers at Gemma Insani Indonesia Depok. Data analysis used a quantitative approach with pre-test and post-test control group of one design. The results show effective group guidance to improve teacher creativity at Gemma Insani Indonesia Depok.

  19. Engineering and service activities in the Cogema group

    International Nuclear Information System (INIS)

    1998-03-01

    This short document presents the engineering and service daughter companies of the Cogema group: SGN (nuclear engineering, fuel cycle, wastes and spent fuels management, decontamination and dismantling); Euriware group (advice, expertise and information systems in nuclear, pharmacy, petroleum, automotive and steel making industries); Game group (industrial maintenance in nuclear, chemistry, petroleum, automotive and steel making industries); Eurisys Mesures (nuclear measurements, instrumentation, radiation protection and nuclear imaging); SICN (mechanics); STMI and Socodei (nuclear cleansing and management of low level radioactive wastes); Krebs/Speichim (chemical engineering, divisions of SGN and Technip). (J.S.)

  20. Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

    Science.gov (United States)

    Jenaro, C; Vega, V; Flores, N; Cruz, M

    2013-06-01

    Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  1. Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services.

    Science.gov (United States)

    Howard, Brittni N; Van Dorn, Richard; Myers, Bronwyn J; Zule, William A; Browne, Felicia A; Carney, Tara; Wechsberg, Wendee M

    2017-11-21

    Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women's Health CoOp (WHC) in clinics and substance abuse rehab settings in Cape Town, South Africa. We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women's risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to implementing the WHC successfully must be addressed before the program can be

  2. Tackling fuel poverty through facilitating energy tariff switching: a participatory action research study in vulnerable groups.

    Science.gov (United States)

    Lorenc, A; Pedro, L; Badesha, B; Dize, C; Fernow, I; Dias, L

    2013-10-01

    A fifth of UK households live in fuel poverty, with significant health risks. Recent government strategy integrates public health with local government. This study examined barriers to switching energy tariffs and the impact of an energy tariff switching 'intervention' on vulnerable peoples' likelihood to, success in, switching tariffs. Participatory Action Research (PAR), conducted in West London. Community researchers from three voluntary/community organisations (VCOs) collaborated in recruitment, study design, data collection and analysis. VCOs recruited 151 participants from existing service users in three groups: Black and Minority Ethnic (BME) communities, older people (>75 yrs) and families with young children. Researchers conducted two semi-structured interviews with each participant, a week apart. The first interview asked about demographics, current energy supplier, financial situation, previous experience of tariff-switching and barriers to switching. Researchers then provided the 'intervention' - advice on tariff-switching, printed materials, access to websites. The second interview explored usefulness of the 'intervention', other information used, remaining barriers and information needs. Researchers kept case notes and a reflective log. Data was analysed thematically and collaboratively between the research coordinator and researchers. Quantitative data was analysed using SPSS, with descriptive statistics and Chi-squared tests. A total of 151 people were interviewed: 47 older people over 75 years, 51 families with young children, 51 BME (two were missing demographics). The majority were not White British or UK-born. Average household weekly income was £230. Around half described 'difficult' financial situations, 94% were receiving state benefits and 62% were in debt. Less than a third had tried to find a better energy deal; knowledge was the main barrier. After the intervention 19 people tried to switch, 13 did. Young families were most likely to

  3. The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis.

    Science.gov (United States)

    Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine

    2017-12-01

    Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Collegiate athletes'mental health services utilization:A systematic review of conceptualizations,operationalizations,facilitators,and barriers

    Institute of Scientific and Technical Information of China (English)

    Jennifer J.Moreland; Kathryn A.Coxe; Jingzhen Yang

    2018-01-01

    Background: While mental health among collegiate athletes is receiving increased attention,research on factors surrounding collegiate athletes' decision to seek mental health services is limited.The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes'utilization of mental health services,including the facilitators of and barriers to use of these services. Methods: The analysis was guided and organized using a socio-ecological framework,which considered the unique context in which collegiate athletes study and perform.A total of 21 articles,published between 2005 and 2016,which concern U.S.collegiate athletes'mental health services utilization(MHSU)were selected and included for the final analysis.Conceptualizations and operationalizations of MHSU were compared and contrasted.Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor(facilitator or barrier)to the athletes. Results: Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed,which made interpretation and cross comparison difficult.Collegiate athletes are willing to utilize mental health services,but gender,perceived stigma,peer norms—for athletes and coaches—plus service availability impact their MHSU. Conclusion: Key stakeholders,administrators,and public health officials should partner to eliminate MHSU barriers,support facilitators,and generally empower collegiate athletes to actively manage their mental health.

  5. [THE FAILURE MODES AND EFFECTS ANALYSIS FACILITATES A SAFE, TIME AND MONEY SAVING OPEN ACCESS COLONOSCOPY SERVICE].

    Science.gov (United States)

    Gingold-Belfer, Rachel; Niv, Yaron; Horev, Nehama; Gross, Shuli; Sahar, Nadav; Dickman, Ram

    2017-04-01

    Failure modes and effects analysis (FMEA) is used for the identification of potential risks in health care processes. We used a specific FMEA - based form for direct referral for colonoscopy and assessed it for procedurerelated perforations. Ten experts in endoscopy evaluated and computed the entire referral process, modes of preparation for the endoscopic procedure, the endoscopic procedure itself and the discharge process. We used FMEA assessing for likelihood of occurrence, detection and severity and calculated the risk profile number (RPN) for each of the above points. According to the highest RPN results we designed a specific open access referral form and then compared the occurrence of colonic perforations (between 2010 and 2013) in patients who were referred through the open access arm (Group 1) to those who had a prior clinical consultation (non-open access, Group 2). Our experts in endoscopy (5 physicians and 5 nurses) identified 3 categories of failure modes that, on average, reached the highest RPNs. We identified 9,558 colonoscopies in group 1, and 12,567 in group 2. Perforations were identified in three patients from the open access group (1:3186, 0.03%) and in 10 from group 2 (1:1256, 0.07%) (p = 0.024). Direct referral for colonoscopy saved 9,558 pre-procedure consultations and the sum of $850,000. The FMEA tool-based specific referral form facilitates a safe, time and money saving open access colonoscopy service. Our form may be adopted by other gastroenterological clinics in Israel.

  6. The Use of Group Therapy as a Means of Facilitating Cognitive-Behavioural Instruction for Adolescents with Disruptive Behaviour

    Science.gov (United States)

    Larmar, Stephen

    2006-01-01

    This article reports on the findings of an action research enquiry examining the efficacy of group therapy as a means of facilitating cognitive-behavioural instruction for students who exhibit disruptive behaviours. A curriculum comprising the key tenets of cognitive-behaviour modification was developed and taught over a 9-week period to a group…

  7. Going beyond the identification of change facilitators to effectively implement a new model of services: lessons learned from a case example in paediatric rehabilitation.

    Science.gov (United States)

    Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Carrière, Monique

    2011-01-01

    To identify facilitators and barriers to service reorganization, how they evolved and interacted to influence change during the implementation of a new service delivery model of paediatric rehabilitation. Over 3 years, different stakeholders responded to SWOT questionnaires (n = 139) and participated in focus groups (n = 19) and telephone interviews (n = 13). A framework based on socio constructivist theories made sense of the data. Facilitators related to the programme's structure (e.g. funding), the actors (e.g. willingness to test the new service model) and the change management process (e.g. participative approach). Some initial facilitators became barriers (e.g. leadership lacked at the end), while other barriers emerged (e.g. lack of tools). Understanding factor interactions requires examining the multiple actors' intentions, actions and consequences and their relations with structural elements. Analysing facilitators and barriers helped better understand the change processes, but this must be followed by concrete actions to successfully implement new paediatric rehabilitation models.

  8. Systematic review: the barriers and facilitators for minority ethnic groups in accessing urgent and prehospital care

    OpenAIRE

    Phung, Viet-Hai; Windle, Karen; Asghar, Zahid; Ortega, Marishona; Essam, Nadya; Barot, Mukesh; Kai, Joe; Johnson, Mark; Siriwardena, A. Niroshan

    2014-01-01

    Introduction Research addressing inequalities has focused predominantly on primary and community care; few initiatives relate to the prehospital environment. We aimed to identify in the literature barriers or facilitators experienced by patients from black and minority ethnic (BME) communities in accessing prehospital care and to explore the causes and consequences of any differences in delivery. Methods We conducted a systematic literature review and narrative synthesis. Electronic...

  9. An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education

    DEFF Research Database (Denmark)

    Stenov, Vibeke; Hempler, Nana Folmann; Reventlow, Susanne

    2017-01-01

    AIM: To investigate approaches among healthcare providers (HCPs) that support or hinder person-centredness in group-based diabetes education programmes targeting persons with type 2 diabetes. METHODS: Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes....... Applying person-centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person-centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person...

  10. EnviroAtlas - Austin, TX - Ecosystem Services by Block Group

    Science.gov (United States)

    This EnviroAtlas dataset presents environmental benefits of the urban forest in 750 block groups in Austin, Texas. Carbon attributes, temperature reduction, pollution removal and value, and runoff effects are calculated for each block group using i-Tree models (www.itreetools.org), local weather data, pollution data, EPA provided city boundary and land cover data, and U.S. Census derived block group boundary data. This dataset was produced by the US Forest Service to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

  11. Facilitation of self-transcendence in a breast cancer support group: II.

    Science.gov (United States)

    Coward, Doris Dickerson

    2003-01-01

    To pilot a second support group intervention study promoting self-transcendence perspectives and activities and to document changes over time in well-being in support group participants compared with nonparticipants. Quasiexperimental, partial randomization, preference trial design. An urban breast cancer resource center established by survivors. 41 women with newly diagnosed breast cancer were recruited, and 39 completed the study. 22 women participated in three intervention support groups; 17 were in a comparison group. The intervention was an eight-week, closed support group based on self-transcendence theory. Data were collected three times during 14 months. Support group intervention, self-transcendence, and emotional and physical well-being. The intervention group had lower scores than the comparison group on self-transcendence and well-being variables at baseline (time [T] 1). Scores were higher for both groups postintervention (T2), with no differences between groups. One year postintervention (T3), intervention group scores again were lower than comparison group scores. Intervention group T3 scores were unchanged from T2. Most potential participants were unwilling to risk being randomized into a nonpreferred group. Activities based on self-transcendence theory were associated with expanded perspectives and activities and an improved sense of well-being in support group participants at the end of the intervention, but not one year later. Findings from the pilot studies informed a study currently in progress. Nurses should maintain awareness of local resources for support and make that information available to women when they are newly diagnosed with breast cancer, during their treatment, and later.

  12. The Influence of Collaborative Group Work on Students' Development of Critical Thinking: The Teacher's Role in Facilitating Group Discussions

    Science.gov (United States)

    Fung, Dennis Chun-Lok; To, Helen; Leung, Kit

    2016-01-01

    The objective of this study was to determine whether the incorporation of group work in a teaching intervention can effectively foster students' critical thinking skills. Building upon Kuhn's critical thinking model, the research involved comparison of pretest and post-test results for 140 secondary four (10th grade) students in Hong Kong on two…

  13. Social networks improve leaderless group navigation by facilitating long-distance communication

    Directory of Open Access Journals (Sweden)

    Nikolai W. F. BODE, A. Jamie WOOD, Daniel W. FRANKS

    2012-04-01

    Full Text Available Group navigation is of great importance for many animals, such as migrating flocks of birds or shoals of fish. One theory states that group membership can improve navigational accuracy compared to limited or less accurate individual navigational ability in groups without leaders (“Many-wrongs principle”. Here, we simulate leaderless group navigation that includes social connections as preferential interactions between individuals. Our results suggest that underlying social networks can reduce navigational errors of groups and increase group cohesion. We use network summary statistics, in particular network motifs, to study which characteristics of networks lead to these improvements. It is networks in which preferences between individuals are not clustered, but spread evenly across the group that are advantageous in group navigation by effectively enhancing long-distance information exchange within groups. We suggest that our work predicts a base-line for the type of social structure we might expect to find in group-living animals that navigate without leaders [Current Zoology 58 (2: 329-341, 2012].

  14. Perspectives on Research Participation and Facilitation Among Dialysis Patients, Clinic Personnel, and Medical Providers: A Focus Group Study.

    Science.gov (United States)

    Flythe, Jennifer E; Narendra, Julia H; Dorough, Adeline; Oberlander, Jonathan; Ordish, Antoinette; Wilkie, Caroline; Dember, Laura M

    2017-12-19

    Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers. We also sought to elucidate stakeholder preferences for research communication. Qualitative study. 7 focus groups (59 participants: 8 clinic managers, 14 nurses/patient care technicians, 8 social workers/dietitians, 11 nephrologists/advanced practice providers, and 18 patients/care partners) from 7 North Carolina dialysis clinics. Clinics and participants were purposively sampled. Focus groups were recorded and transcribed. Thematic analysis. We identified 11 themes that captured barriers to and facilitators of research participation by patients and research facilitation by clinic personnel and medical providers. We collapsed these themes into 4 categories to create an organizational framework for considering stakeholder (narrow research understanding, competing personal priorities, and low patient literacy and education levels), relationship (trust, buy-in, and altruistic motivations), research design (convenience, follow-up, and patient incentives), and dialysis clinic (professional demands, teamwork, and communication) aspects that may affect stakeholder interest in participating in or facilitating research. These themes appear to shape the degree of research readiness of a dialysis clinic environment. Participants preferred short research communications delivered in multiple formats. Potential selection bias and inclusion of English-speaking participants only. Our findings

  15. Collegiate athletes' mental health services utilization: A systematic review of conceptualizations, operationalizations, facilitators, and barriers

    Directory of Open Access Journals (Sweden)

    Jennifer J. Moreland

    2018-01-01

    Conclusion: Key stakeholders, administrators, and public health officials should partner to eliminate MHSU barriers, support facilitators, and generally empower collegiate athletes to actively manage their mental health.

  16. Nurses of the psychiatric service as the specific occupational group

    Directory of Open Access Journals (Sweden)

    Klimentova I.V.

    2016-06-01

    Full Text Available The demand for psychiatric services in modern health care system will increase due to the growth in number of mental diseases. The role of nurses in prevention, treatment and rehabilitation of mental illness has a number of features. These features are related to care of patients with high level of aggressiveness, behavioral deviations, and problems in self-service. Differences in procedure practice and communicative space specialize and make narrower the nurses' professional practice in psychiatry and determine appearance of specific mechanisms and norms bound up with the necessity of supervision of patients while respecting their rights. Personnel's oversight functions, deviant behavior of patients, high degree of closure of psychiatric medical institutions — are the reasons for specialization of nurses' professional group in psychiatry, forming special mechanisms of maintaining tolerance to patients in professional sphere of this community.

  17. The Service Programme of the Isaac Newton Group of Telescopes

    Science.gov (United States)

    Méndez, J.

    2013-05-01

    The Service Programme of the Isaac Newton Group of Telescopes (Roque de los Muchachos Observatory, La Palma, Spain) aims at providing astronomers with a rapid and flexible tool for obtaining small sets of observations on the William Herschel Telescope up to 8 hours. This can be used to try new ideas or complement a regular observing programme allocated on the ING telescopes, for instance. Proposals are accepted from principal investigators working in an institution located in the United Kingdom, the Netherlands or Spain, but also regardless the nationality of the host institution. A monthly deadline for application submission takes place at midnight on the last day of each month but urgent requests submitted at any time can also be accepted. Proposals are generally withdrawn from the scheme after a one year period. In this poster we provide an overview of the programme and some statistics. More information can be obtained at http://www.ing.iac.es/astronomy/service/.

  18. Professional Development of Mathematics Teachers toward the Facilitation of Small-Group Collaboration

    Science.gov (United States)

    Tabach, Michal; Schwarz, Baruch B.

    2018-01-01

    Collaborative work in small groups is often a suitable context for yielding substantial individual learning outcomes. Indeed, small-group collaboration has recently become an educational goal rather than a means. Yet, this goal is difficult to attain, and students must be taught how to learn together. In this paper, we focus on how to prepare…

  19. Perceptions of northeast Thai breastfeeding mothers regarding facilitators and barriers to six-month exclusive breastfeeding: focus group discussions.

    Science.gov (United States)

    Thepha, Thiwawan; Marais, Debbie; Bell, Jacqueline; Muangpin, Somjit

    2018-01-01

    The 6-month exclusive breastfeeding rate in the Northeast region of Thailand has recently significantly decreased in contrast to all other regions in Thailand. The factors that have influenced this decrease remain unknown. Hence, it is suggested that an investigation into factors that could improve or hinder EBF for 6 months in Northeast Thailand may be required to inform the development of relevant interventions to improve this situation. This study aimed to identify perceived facilitators and barriers to providing exclusive breastfeeding for 6 months in Northeast Thailand among breastfeeding mothers. Six focus group discussions were conducted with a total of 30 mothers aged 20 to 40 years who had children aged between 4 and 6 months and were currently breastfeeding or had breastfeeding experience. Participants were recruited through self-selection sampling from Khonkaen hospital (urban), Numphong hospital (peri-urban) and private hospitals (urban) in Khonkaen, Thailand. Thematic analysis was employed to analyse the data. Five main themes, with 10 sub-themes, were identified as either facilitators (+) or barriers (-), or in some cases, as both (+/-). Breastfeeding knowledge, perceptions, maternal circumstances, support, and traditional food were the main identified themes. Mother's breastfeeding knowledge, intention to breastfeed, and social media were perceived as facilitators. Perceptions, employment, and formula milk promotion were perceived as barriers. Family, healthcare, and traditional food were perceived as both facilitators and barriers. The perception that social media was a way to access breastfeeding knowledge and support mothers in Northeast Thailand emerged as a new facilitating factor that had not previously been identified in Thai literature relating to facilitators and barriers to exclusive breastfeeding. Intention to breastfeed, family support, healthcare support and traditional food were mentioned by all groups, whereas mothers from urban

  20. Improving service innovation in Aker Solutions – How clients’ knowledge, management and organisational structure can facilitate service innovation

    OpenAIRE

    Hreinsdóttir, Sign! Jóna; Dhali-Lund, Faysal Ahmed

    2014-01-01

    Services have long been perceived as non-innovative or technologically backward. It is only recently that innovation in services has attracted greater interest. However, service innovation is important for organisational competitive advantage and is of ever greater importance in the economic development through creating new business opportunities and employment. In our study we look into how application of service innovation theories can benefit Aker Solutions by investigati...

  1. Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services

    Directory of Open Access Journals (Sweden)

    Brittni N. Howard

    2017-11-01

    Full Text Available Abstract Background Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women’s Health CoOp (WHC in clinics and substance abuse rehab settings in Cape Town, South Africa. Methods We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. Results All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. Conclusions In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women’s risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to

  2. Cloud Manufacturing Service Paradigm for Group Manufacturing Companies

    Directory of Open Access Journals (Sweden)

    Jingtao Zhou

    2014-07-01

    Full Text Available The continuous refinement of specialization requires that the group manufacturing company must be constantly focused on how to concentrate its core resources in special sphere to form its core competitive advantage. However, the resources in enterprise group are usually distributed in different subsidiary companies, which means they cannot be fully used, constraining the competition and development of the enterprise. Conducted as a response to a need for cloud manufacturing studies, systematic and detailed studies on cloud manufacturing schema for group companies are carried out in this paper. A new hybrid private clouds paradigm is proposed to meet the requirements of aggregation and centralized use of heterogeneous resources and business units distributed in different subsidiary companies. After the introduction of the cloud manufacturing paradigm for enterprise group and its architecture, this paper presents a derivation from the abstraction of paradigm and framework to the application of a practical evaluative working mechanism. In short, the paradigm establishes an effective working mechanism to translate collaborative business process composed by the activities into cloud manufacturing process composed by services so as to create a foundation resulting in mature traditional project monitoring and scheduling technologies being able to be used in cloud manufacturing project management.

  3. Facilitating Group Analysis of Two Case Studies Utilising Peer Tutoring: Comparison of Tasks and Outcomes

    Science.gov (United States)

    Fong, Lin Siew

    2016-01-01

    Peer-tutoring sessions of two groups of advanced diploma in financial accounting students with mixed proficiency were analysed thoroughly in this study. Numerous studies in peer tutoring have produced favourable results to both tutors and tutees due to the scaffolding process which promotes effective learning. However, there is a lack of studies…

  4. Crossing the Communication Barrier: Facilitating Communication in Mixed Groups of Deaf and Hearing Students

    Science.gov (United States)

    Marchetti, Carol; Foster, Susan; Long, Gary; Stinson, Michael

    2012-01-01

    Teachers of introductory technical courses such as statistics face numerous challenges in the classroom, including student motivation and mathematical background, and difficulties in interpreting numerical results in context. Cooperative learning through small groups addresses many such challenges, but students for whom spoken English is not their…

  5. Integrating Identities: Facilitating a Support Group for LGBTQ Students on a Christian College Campus

    Science.gov (United States)

    Vespone, Brianna M.

    2016-01-01

    College can be a challenging time for young adults, as many are experiencing life on their own for the first time, adjusting to new lifestyles, new social groups, and new ways to express themselves. For lesbian, gay, bisexual, transgender, and queer (LGBTQ) college students, the challenges are increased as they face harassment, discrimination, and…

  6. Facilitating and supporting HIV+ parenthood: Lessons for developing the advocate role of voluntary HIV support services workers.

    Science.gov (United States)

    Cane, Tam Pheona Chipawe

    2018-06-01

    Increasingly as people living with HIV (PLWHIV) aim to become parents, they engage with HIV voluntary services for support through either fertility or adoption services. Yet, little is known about the role of HIV support services workers in facilitating access to fertility treatment or child adoption. The purpose of this study was to explore the role of HIV support workers based in HIV voluntary organisations who have a key role helping PLWHIV in navigating relevant fertility and adoption processes. This was an exploratory qualitative study which involved interviewing six HIV support workers, from across the UK. Interviews were conducted using face to face interviews, recorded and transcribed. Findings revealed that HIV services support workers provide practical support in advocating service provision, and emotional and social support along the journey. They also face challenges in their role from health care professionals including information sharing and gatekeeping. The role of HIV support workers is important in facilitating access to resources and complex systems. HIV support workers should be recognised and as they are often a trusted professional to address stigma, discrimination and barriers to services. The study contributes to research seeking to understand the emerging needs and support requirements for people living with HIV seeking fertility and adoption. Further work in this area is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Group I metabotropic glutamate receptors reduce excitotoxic injury and may facilitate neurogenesis

    DEFF Research Database (Denmark)

    Baskys, Andrius; Bayazitov, Ildar; Fang, Liwei

    2005-01-01

    neuroprotective activation of group I metabotropic glutamate receptors. Brain Research, Molecular Brain Research 117, 196-205.]. In the present study, we used organotypic hippocampal culture preparation to examine specific phospholipase C (PLC) inhibitor U73122 effects on DHPG-induced neuroprotection, changes......-CA1 pathway. The fEPSP depression was not affected by the PLC inhibitor U73122. In contrast, prolonged (2-h) treatment of cultures with DHPG induced a significant protective effect that was blocked by a PLC inhibitor U73122 but not by its inactive analog U73343. Voltage-clamp measurements...... a PLC involvement. Since activation of PLC is thought to be associated with cell proliferation, we investigated whether group I mGluR agonist DHPG or subtype antagonists LY367385 and MPEP have an effect on dentate granule cells expressing immature neuronal marker TOAD-64. DHPG (100 microM, 72 h...

  8. Exploring reforms while learning to teach science: Facilitating exploration of theory-practice relationships in a teacher education study group

    Science.gov (United States)

    Foster, Jacob G.

    This dissertation inserts a new view into an old problem in teacher education. The study explores the theory-practice gap, the large distance between what preservice science teachers experience in schools, are able to enact, and are told they should hold themselves to in their practice. It does so by narrowing the focus of analysis to a secondary science study group and examining how the facilitator uses sociocultural constructivism to promote discussion. The analysis surfaces key communicative moves made by the facilitator and preservice teachers that yield fruitful discussion of theory-practice relationships. Additionally, the study's use of discourse analysis as a methodology and intertextuality as a conceptual framework opens new directions for applied sociolinguistic research and scholarship in science teacher education. Findings from the study focus on what was discussed and how explorations of theory-practice relationships were facilitated. Preservice teachers in the study group engaged in meaningful conversations about constructivist theory and its application to their students and teaching of science. They discussed many science education topics such as planning science lessons that actively engage students, assessment of content understanding, and management of content-based activities. Discussions of broader science education goals, including implementation of inquiry or development of collaborative communities, were not promoted. Examination of the facilitation illuminates a number of strategies found to be helpful in supporting these explorations. This study shows that facilitation can successfully support preservice teachers to construct understanding of social constructivist assumptions underlying the National Science Education Standards (NSES), as well as a few components of the Standards themselves. The focus on the underlying assumptions suggests that science teacher education should focus on these so that preservice teachers can build a strong

  9. Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review

    Directory of Open Access Journals (Sweden)

    Leduc Yvan

    2011-04-01

    Full Text Available Abstract Background Electronic health record (EHR implementation is currently underway in Canada, as in many other countries. These ambitious projects involve many stakeholders with unique perceptions of the implementation process. EHR users have an important role to play as they must integrate the EHR system into their work environments and use it in their everyday activities. Users hold valuable, first-hand knowledge of what can limit or contribute to the success of EHR implementation projects. A comprehensive synthesis of EHR users' perceptions is key to successful future implementation. This systematic literature review was aimed to synthesize current knowledge of the barriers and facilitators influencing shared EHR implementation among its various users. Methods Covering a period from 1999 to 2009, a literature search was conducted on nine electronic databases. Studies were included if they reported on users' perceived barriers and facilitators to shared EHR implementation, in healthcare settings comparable to Canada. Studies in all languages with an empirical study design were included. Quality and relevance of the studies were assessed. Four EHR user groups were targeted: physicians, other health care professionals, managers, and patients/public. Content analysis was performed independently by two authors using a validated extraction grid with pre-established categorization of barriers and facilitators for each group of EHR users. Results Of a total of 5,695 potentially relevant publications identified, 117 full text publications were obtained after screening titles and abstracts. After review of the full articles, 60 publications, corresponding to 52 studies, met the inclusion criteria. The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health

  10. Creating neighbourhood groupings based on built environment features to facilitate health promotion activities.

    Science.gov (United States)

    Schopflocher, Donald; VanSpronsen, Eric; Spence, John C; Vallianatos, Helen; Raine, Kim D; Plotnikoff, Ronald C; Nykiforuk, Candace I J

    2012-07-26

    Detailed assessments of the built environment often resist data reduction and summarization. This project sought to develop a method of reducing built environment data to an extent that they can be effectively communicated to researchers and community stakeholders. We aim to help in an understanding of how these data can be used to create neighbourhood groupings based on built environment characteristics and how the process of discussing these neighbourhoods with community stakeholders can result in the development of community-informed health promotion interventions. We used the Irvine Minnesota Inventory (IMI) to assess 296 segments of a semi-rural community in Alberta. Expert raters "created" neighbourhoods by examining the data. Then, a consensus grouping was developed using cluster analysis, and the number of IMI variables to characterize the neighbourhoods was reduced by multiple discriminant function analysis. The 296 segments were reduced to a consensus set of 10 neighbourhoods, which could be separated from each other by 9 functions constructed from 24 IMI variables. Biplots of these functions were an effective means of summarizing and presenting the results of the community assessment, and stimulated community action. It is possible to use principled quantitative methods to reduce large amounts of information about the built environment into meaningful summaries. These summaries, or built environment neighbourhoods, were useful in catalyzing action with community stakeholders and led to the development of health-promoting built environment interventions.

  11. Nitrogen-Containing Functional Groups-Facilitated Acetone Adsorption by ZIF-8-Derived Porous Carbon

    Directory of Open Access Journals (Sweden)

    Liqing Li

    2018-01-01

    Full Text Available Nitrogen-doped porous carbon (ZC is prepared by modification with ammonia for increasing the specific surface area and surface polarity after carbonization of zeolite imidazole framework-8 (ZIF-8. The structure and properties of these ZCs were characterized by Transmission electron microscopy, X-ray diffraction, N2 sorption, X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy. Through static adsorption tests of these carbons, the sample obtained at 600 °C was selected as an excellent adsorbent, which exhibited an excellent acetone capacity of 417.2 mg g−1 (25 °C with a very large surface area and high-level nitrogen doping (13.55%. The microporosity, surface area and N-containing groups of the materials, pyrrolic-N, pyridinic-N, and oxidized-N groups in particular, were found to be the determining factors for acetone adsorption by means of molecular simulation with density functional theory. These findings indicate that N-doped microporous carbon materials are potential promising adsorbents for acetone.

  12. Disclosing Sex Trading Histories to Providers: Barriers and Facilitators to Navigation of Social Services Among Women Impacted by Commercial Sexual Exploitation.

    Science.gov (United States)

    Gerassi, Lara; Edmond, Tonya E; Fabbre, Vanessa; Howard, Abby; Nichols, Andrea J

    2017-12-01

    Sex trafficking and commercial sexual exploitation (CSE) can lead to devastating health and mental health consequences for women, such as elevated rates of substance use, trauma, posttraumatic stress disorder, depression, sexually transmitted infections (STIs), and HIV. Consequently, engagement with services that address addiction, mental health, and housing, and provide general advocacy is critically important to women's increased safety, stabilization, and quality of life. The purpose of this study is to identify perceived barriers and facilitators to service access and engagement with social services among women involved in CSE. Drawing from a larger grounded theory study that partnered with an anti-trafficking coalition and a substance use treatment center for women, in-depth, semistructured interviews were conducted with 30 adult women who traded sex as adults and 20 service providers who come into contact with this population. Women engaging in services were sampled through maximum variation sampling ( n = 24) and women not engaged with services ( n = 6) were recruited through snowball sampling. Providers were recruited through purposive sampling through the coalition ( n = 10) and nominations sampling ( n = 10). Open and focused coding were conducted. Multiple enhancements to methodological and analytic rigor were taken, including collaboration with multiple key stakeholders, use of nonstigmatizing language, self-reflexivity processes, analytic memo-writing, and member checking. Findings suggest that women experienced judgment when disclosing sex trading in social service intakes, and individual and group sessions from providers and other women in the groups. Although some women saw disclosure as helpful in addressing the complex feelings stemming from sex trading, as well as the desire to help or relate to other women in similar situations, they also identified risk of harm and multiple barriers to disclosing during intake meetings and individual sessions

  13. Barriers and Facilitators for implementing programmes and services to address hyperglycaemia in pregnancy in low and middle income countries

    DEFF Research Database (Denmark)

    Nielsen, Karoline Kragelund; Damm, Peter; Bygbjerg, Ib C

    2018-01-01

    AIMS: An estimated 87.6% of hyperglycaemia in pregnancy cases is in low and middle income countries (LMICs). The aim of this study is to review the evidence on barriers and facilitators to programmes and services addressing hyperglycaemia in pregnancy in LMICs. METHODS: A systematic review...... they relate to capacity in terms of human and material resources; availability of feasible and appropriate guidelines; organizational management and referral pathways. Individual level barriers and facilitators include knowledge; risk perception; illness beliefs; financial condition; work obligations......; concerns for the baby and hardship associated with services. At the social and societal level, perceptions and norms related to women's roles, mobility and health; the knowledge and support of the women's social network; and structural aspects are important influencing factors. CONCLUSIONS: Numerous...

  14. The Power and Promise of Group Work: Consumer Evaluation of Group Work Services in Gauteng, South Africa

    Science.gov (United States)

    Rasool, Shahana; Ross, Eleanor

    2017-01-01

    Purpose: In light of the limited research into consumers' experiences of group work services in South Africa, the study evaluated groups offered by a range of social service agencies in Gauteng to determine whether group interventions were perceived by users as developmental and empowering. Methods: Program evaluation was employed to evaluate 47…

  15. Barriers and facilitators to the dissemination and implementation of cognitive services in Spanish community pharmacies / Barreras y facilitadores para la diseminación e implantación de servicios cognitivos de la farmacia comunitaria española

    Directory of Open Access Journals (Sweden)

    Faus MJ

    2005-07-01

    Full Text Available The implementation of cognitive services in the community pharmacy is proving to be slower than expected. A number of authors have described barriers to implementation, and facilitators that might contribute to accelerating the process. This paper reviews the literature on these two groups of elements in Spain. Descriptions of the barriers show no common pattern, and some of the studies contain important omissions. Moreover, we have been unable to find any papers specifically dealing with the search for facilitators.

  16. Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services.

    Science.gov (United States)

    Cree, Lindsey; Brooks, Helen L; Berzins, Kathryn; Fraser, Claire; Lovell, Karina; Bee, Penny

    2015-08-29

    Formal recognition and involvement of carers in mental health services has been the focus of recent policy and practice initiatives as well as being supported by carers themselves. However, carers still report feeling marginalised and distanced from services. A prominent theme is that that they are not listened to and their concerns are not taken seriously. Compared to service user views, the reasons underpinning carers' dissatisfaction with care-planning procedures have been relatively neglected in the research literature, despite the substantial and significant contribution that they make to mental health services. The aim of the study was to explore carers' experiences of the care planning process for people with severe mental illness. Qualitative interviews and focus groups were undertaken with carers. Data were combined and analysed using framework analysis. Whilst identifying a shared desire for involvement and confirming a potential role for carers within services, our data highlighted that many carers perceive a lack of involvement in care planning and a lack of recognition and appreciation of their role from health professionals. Barriers to involvement included structural barriers, such as the timing and location of meetings, cultural barriers relating to power imbalances within the system and specific barriers relating to confidentiality. This qualitative study led by a researcher who was a carer herself has developed the understanding of the potential role of carers within the care planning process within mental health services, along with the facilitators and barriers to achieving optimal involvement.

  17. EnviroAtlas Community Block Group Metrics Web Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This web service includes...

  18. "From resistance to challenge": child health service nurses experiences of how a course in group leadership affected their management of parental groups.

    Science.gov (United States)

    Lefèvre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger

    2017-01-01

    All parents in Sweden are invited to child health service (CHS) parental groups, however only 49% of the families participate. The way the parental groups are managed has been shown to be of importance for how parents experience the support and CHS nurses describe feeling insecure when running the groups. Lack of facilitation, structure and leadership might jeopardise the potential benefit of such support groups. This study describes CHS nurses' experiences of how a course in group leadership affected the way they ran their parental groups. A course in group leadership given to 56 CHS nurses was evaluated in focus group interviews 5-8 months after the course. The nurses felt strengthened in their group leader role and changed their leadership methods. The management of parental groups was after the course perceived as an important work task and the nurses included time for planning, preparation and evaluation, which they felt improved their parental groups. Parental participation in the activities in the group had become a key issue and they used their new exercises and tools to increase this. They expressed feeling more confident and relaxed in their role as group leaders and felt that they could adapt their leadership to the needs of the parents. Specific training might strengthen the CHS nurses in their group leader role and give them new motivation to fulfil their work with parental groups.  Clinical Trials.gov ID: NCT02494128.

  19. Barriers and Facilitators for Utilization of Genetic Counseling and Risk Assessment Services in Young Female Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Beth Anderson

    2012-01-01

    Full Text Available Introduction. Women diagnosed with breast cancer at a young age are more likely to carry a cancer predisposing genetic mutation. Per the current NCCN recommendations, women diagnosed under age 50 should be referred to cancer genetic counseling for further risk evaluation. This study seeks to assess patient-reported barriers and facilitators to receiving genetic counseling and risk assessment among a community-based population of young breast cancer survivors (YBCS. Methods. Through the Michigan Cancer Surveillance Program, a state-based cancer registry, 488 women diagnosed with breast cancer before age 50 in 2006-2007 were identified. They received a mail survey regarding family history and facilitators and barriers to receiving genetic counseling and risk assessment. Results. Responses were received from 289 women (59.2%. One hundred twenty-two (42.2% reported having received cancer genetic counseling. The most frequent reason identified for receiving services was to benefit their family's future. The top reasons for not attending were “no one recommended it” and “medical insurance coverage issues.” Discussion. This study is the first published report using a state cancer registry to determine facilitators and barriers to receiving genetic counseling and risk assessment among YBCS. These findings demonstrate the need for additional awareness and education about appropriate indications for genetic services.

  20. Barriers and Facilitators for Utilization of Genetic Counseling and Risk Assessment Services in Young Female Breast Cancer Survivors

    International Nuclear Information System (INIS)

    Anderson, B.; McLosky, J.; Wasilevich, E.; Callo, S. L.; Duquette, D.; Copeland, G.

    2012-01-01

    Introduction. Women diagnosed with breast cancer at a young age are more likely to carry a cancer predisposing genetic mutation. Per the current NCCN recommendations, women diagnosed under age 50 should be referred to cancer genetic counseling for further risk evaluation. This study seeks to assess patient-reported barriers and facilitators to receiving genetic counseling and risk assessment among a community-based population of young breast cancer survivors (YBCS). Methods. Through the Michigan Cancer Surveillance Program, a state-based cancer registry, 488 women diagnosed with breast cancer before age 50 in 2006-2007 were identified. They received a mail survey regarding family history and facilitators and barriers to receiving genetic counseling and risk assessment. Results. Responses were received from 289 women (59.2%). One hundred twenty-two (42.2%) reported having received cancer genetic counseling. The most frequent reason identified for receiving services was to benefit their family's future. The top reasons for not attending were “no one recommended it” and “medical insurance coverage issues.” Discussion. This study is the first published report using a state cancer registry to determine facilitators and barriers to receiving genetic counseling and risk assessment among YBCS. These findings demonstrate the need for additional awareness and education about appropriate indications for genetic services.

  1. Facilitating and securing offline e-medicine service through image steganography.

    Science.gov (United States)

    Kamal, A H M; Islam, M Mahfuzul

    2014-06-01

    E-medicine is a process to provide health care services to people using the Internet or any networking technology. In this Letter, a new idea is proposed to model the physical structure of the e-medicine system to better provide offline health care services. Smart cards are used to authenticate the user singly. A very unique technique is also suggested to verify the card owner's identity and to embed secret data to the card while providing patients' reports either at booths or at the e-medicine server system. The simulation results of card authentication and embedding procedure justify the proposed implementation.

  2. Facilitating and securing offline e-medicine service through image steganography

    Science.gov (United States)

    Islam, M. Mahfuzul

    2014-01-01

    E-medicine is a process to provide health care services to people using the Internet or any networking technology. In this Letter, a new idea is proposed to model the physical structure of the e-medicine system to better provide offline health care services. Smart cards are used to authenticate the user singly. A very unique technique is also suggested to verify the card owner's identity and to embed secret data to the card while providing patients' reports either at booths or at the e-medicine server system. The simulation results of card authentication and embedding procedure justify the proposed implementation. PMID:26609382

  3. Stabilization of Transfected Cells Expressing Low-Incidence Blood Group Antigens: Novel Methods Facilitating Their Use as Reagent-Cells.

    Directory of Open Access Journals (Sweden)

    Cecilia González

    Full Text Available The identification of erythrocyte antibodies in the serum of patients rely on panels of human red blood cells (RBCs, which coexpress many antigens and are not easily available for low-incidence blood group phenotypes. These problems have been addressed by generating cell lines expressing unique blood group antigens, which may be used as an alternative to human RBCs. However, the use of cell lines implies several drawbacks, like the requirement of cell culture facilities and the high cost of cryopreservation. The application of cell stabilization methods could facilitate their use as reagent cells in clinical laboratories.We generated stably-transfected cells expressing low-incidence blood group antigens (Dia and Lua. High-expresser clones were used to assess the effect of TransFix® treatment and lyophilization as cell preservation methods. Cells were kept at 4°C and cell morphology, membrane permeability and antigenic properties were evaluated at several time-points after treatment.TransFix® addition to cell suspensions allows cell stabilization and proper antigen detection for at least 120 days, despite an increase in membrane permeability and a reduction in antigen expression levels. Lyophilized cells showed minor morphological changes and antigen expression levels were rather conserved at days 1, 15 and 120, indicating a high stability of the freeze-dried product. These stabilized cells have been proved to react specifically with human sera containing alloantibodies.Both stabilization methods allow long-term preservation of the transfected cells antigenic properties and may facilitate their distribution and use as reagent-cells expressing low-incidence antigens, overcoming the limited availability of such rare RBCs.

  4. Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review.

    Science.gov (United States)

    Watt, Nicola; Sigfrid, Louise; Legido-Quigley, Helena; Hogarth, Sue; Maimaris, Will; Otero-García, Laura; Perel, Pablo; Buse, Kent; McKee, Martin; Piot, Peter; Balabanova, Dina

    2017-11-01

    Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps. Of the 150 articles included, 67% (n = 102) were from high-income countries. The articles explored integration with services for one or several chronic disorders, the most studied being alcohol or substance use disorders (47.7%), and mental health issues (29.5%). Four cross-cutting themes related to the health system were identified. The first and most common theme was the requirement for effective collaboration and coordination: formal and informal productive relationships throughout the system between providers and within teams, and between staff and patients. The second was the need for adequate and appropriately skilled and incentivized health workers-with the right expertise, training and operational support for the programme. The third was the need for supportive institutional structures and dedicated resources. The fourth was leadership in terms of political will, effective managerial oversight and organizational culture, indicating that actual implementation is as important as programme design. A fifth theme, outside the health system, but underpinning all aspects of the system operation, was that placing the patient at the centre of service delivery and responding holistically to their diverse needs. This was an important facilitator of integration. These findings confirm that integration processes in service delivery depend substantially for their success on characteristics of

  5. Home Care Pharmacy Practice in Canada: A Cross-Sectional Survey of Services Provided, Remuneration, Barriers, and Facilitators.

    Science.gov (United States)

    Houle, Sherilyn; MacKeigan, Linda

    2017-01-01

    As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care. A link to a web-based survey was posted in e-newsletters of provincial, territorial, and national pharmacy associations in Canada. In addition, pharmacists known to the researchers as providing in-home clinical services were contacted directly. The survey was open from October to December 2015. Practices or organizations that performed at least one home visit per week for clinical purposes, with documentation of the services provided, were eligible to participate. One response per practice or organization was allowed. Seventeen practices meeting the inclusion criteria were identified, representing community, hospital, and clinic settings. Home visits were most commonly performed for individuals with complex medication regimens or nonadherence to medication therapy. The most common services were conducting medication reconciliation and reviews and counselling patients about medication adherence. No practices or organizations billed patients for these services, yet lack of remuneration was an important barrier identified by many respondents. Although 12 (71%) of the respondents collected data for evaluative purposes, collection of clinical or health system outcome data was rare. Few Canadian pharmacy practices that provide in-home patient care at least once a week could be identified. Data collection suitable to establish an evidence base for this service was infrequently performed by practices and organizations providing

  6. Queensland Youth Cancer Service: A Partnership Model to Facilitate Access to Quality Care for Young People Diagnosed with Cancer.

    Science.gov (United States)

    Bradford, Natalie K; Henney, Roslyn; Walker, Rick; Walpole, Euan; Kennedy, Glen; Nicholls, Wayne; Pinkerton, Ross

    2018-06-01

    Global recognition of the need to improve outcomes for adolescents and young adults (AYA) with cancer has led to the development of specific oncology programs and services. In Australia, Youth Cancer Services (YCS) are now established across the country. While each service has been shaped by nationally agreed principles, program development has been influenced by local policy and geographic differences. Queensland is a vast state with a widely dispersed population; coordination of cancer services for young people across this landscape presents unique challenges. The Queensland YCS (QYCS) work in a consultative partnership model with primary treating teams, across both pediatric and adult tertiary cancer services. Understanding how cancer services approach challenges and service development can provide guidance for other developing services. In this article, we describe the goals and development of QYCS and review the outcomes achieved in the service to date. We reviewed referral data and retrieved statewide clinical activity from the web-based data system. We compared these data with cancer registry data to identify disparities and areas for service development. While the service has achieved notable outcomes, challenges remain. These include recruitment of appropriately skilled and trained health professionals for this newly developing area of oncology. In addition, there is an ongoing need to advocate for this relatively small patient group, and to promote awareness and understanding of the need for AYA-specific services. With the dispersed population and concentration of services in metropolitan Brisbane, identifying and testing new innovative models, including telehealth, to reach all AYA diagnosed with cancer regardless of location of care are priorities.

  7. Using Excel's Solver Function to Facilitate Reciprocal Service Department Cost Allocations

    Science.gov (United States)

    Leese, Wallace R.

    2013-01-01

    The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated and theoretically incorrect direct or step-down methods. This article illustrates how Excel's Solver…

  8. A SIMULATION-AS-A-SERVICE FRAMEWORK FACILITATING WEBGIS BASED INSTALLATION PLANNING

    Directory of Open Access Journals (Sweden)

    Z. Zheng

    2017-09-01

    Full Text Available Installation Planning is constrained by both natural and social conditions, especially for spatially sparse but functionally connected facilities. Simulation is important for proper deploy in space and configuration in function of facilities to make them a cohesive and supportive system to meet users’ operation needs. Based on requirement analysis, we propose a framework to combine GIS and Agent simulation to overcome the shortness in temporal analysis and task simulation of traditional GIS. In this framework, Agent based simulation runs as a service on the server, exposes basic simulation functions, such as scenario configuration, simulation control, and simulation data retrieval to installation planners. At the same time, the simulation service is able to utilize various kinds of geoprocessing services in Agents’ process logic to make sophisticated spatial inferences and analysis. This simulation-as-a-service framework has many potential benefits, such as easy-to-use, on-demand, shared understanding, and boosted performances. At the end, we present a preliminary implement of this concept using ArcGIS javascript api 4.0 and ArcGIS for server, showing how trip planning and driving can be carried out by agents.

  9. Reusing Information Management Services for Recommended Decadal Study Missions to Facilitate Aerosol and Cloud Studies

    Science.gov (United States)

    Kempler, Steve; Alcott, Gary; Lynnes, Chris; Leptoukh, Greg; Vollmer, Bruce; Berrick, Steve

    2008-01-01

    NASA Earth Sciences Division (ESD) has made great investments in the development and maintenance of data management systems and information technologies, to maximize the use of NASA generated Earth science data. With information management system infrastructure in place, mature and operational, very small delta costs are required to fully support data archival, processing, and data support services required by the recommended Decadal Study missions. This presentation describes the services and capabilities of the Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) and the reusability for these future missions. The GES DISC has developed a series of modular, reusable data management components currently in use. They include data archive and distribution (Simple, Scalable, Script-based, Science [S4] Product Archive aka S4PA), data processing (S4 Processor for Measurements aka S4PM), data search (Mirador), data browse, visualization, and analysis (Giovanni), and data mining services. Information management system components are based on atmospheric scientist inputs. Large development and maintenance cost savings can be realized through their reuse in future missions.

  10. 75 FR 66796 - Pricewaterhousecoopers LLP (“PwC”), Internal Firm Services Client Account Administrators Group...

    Science.gov (United States)

    2010-10-29

    ... LLP (``PwC''), Internal Firm Services Client Account Administrators Group Atlanta, GA; Amended...''), Internal Firm Services Client Account Administrators Group. Accordingly, the Department is amending this... Firm Services Client Account Administrators Group. The amended notice applicable to TA-W-73,630 is...

  11. 76 FR 66327 - Iron Mountain Information Management, Inc., Corporate Service Group, Information Technology (IT...

    Science.gov (United States)

    2011-10-26

    ... Management, Inc., Corporate Service Group, Information Technology (IT) Division, Including On-Site Leased... Information Management, Inc., Corporate Service Group, Information Technology (IT) Division, including on-site... location of Iron Mountain Information Management, Inc., Corporate Service Group, Information Technology (IT...

  12. Facilitating improved road safety based on increased knowledge about driving behaviour and profiling sub-groups of drivers

    DEFF Research Database (Denmark)

    Martinussen, Laila Marianne

    The aim of the Ph.D. study presented in this thesis was to facilitate improved road safety through increased understanding of methods used to measure driving behaviour, and through increased knowledge about driving behaviour in sub-groups of drivers. More specifically, the usefulness of the Driver...... with underlying mechanisms of lack of focus, emotional stress, recklessness and confusion, and hence it is highly important to further explore means to making drivers become more focused or attentive when driving, and to deal with emotional responses in traffic like impatience and frustration (Article 1). 2......, indicating that the problem lies in the drivers’ attitudes towards safety (Article 3). 6. It is indicated that rather than viewing safety and risk as two ends of a continuum, safety and risk should be understood as two separate constructs, with different underlying motives. Therefore it is suggested...

  13. The Copernicus Atmosphere Monitoring Service: facilitating the prediction of air quality from global to local scales

    Science.gov (United States)

    Engelen, R. J.; Peuch, V. H.

    2017-12-01

    The European Copernicus Atmosphere Monitoring Service (CAMS) operationally provides daily forecasts of global atmospheric composition and regional air quality. The global forecasting system is using ECMWF's Integrated Forecasting System (IFS), which is used for numerical weather prediction and which has been extended with modules for atmospheric chemistry, aerosols and greenhouse gases. The regional forecasts are produced by an ensemble of seven operational European air quality models that take their boundary conditions from the global system and provide an ensemble median with ensemble spread as their main output. Both the global and regional forecasting systems are feeding their output into air quality models on a variety of scales in various parts of the world. We will introduce the CAMS service chain and provide illustrations of its use in downstream applications. Both the usage of the daily forecasts and the usage of global and regional reanalyses will be addressed.

  14. The facilitation of adoption and use of text intensive mobile services by low-literate users

    CSIR Research Space (South Africa)

    Matyila, M

    2016-11-01

    Full Text Available ., Leinert, S., Fleck, M., & Liebrich, A. (2012). Mobile Tourism Services and Technology Acceptance in a Mature Domestie Tourism Market: The Case of Switzerland: na. Bagozzi, R. (2007). The legacy of the technology acceptance model and a proposal for a... and dissemination in the developing world (Donner & Gitau, 2009; infoDev, 2012) including South Africa (Mphidi, 2008). In fact mobile phones are in a new era by moving beyond being sources of information and communication to enabling knowledge sharing...

  15. Attitudes, barriers and facilitators for health promotion in the elderly in primary care. A qualitative focus group study.

    Science.gov (United States)

    Badertscher, Nina; Rossi, Pascal Olivier; Rieder, Arabelle; Herter-Clavel, Catherine; Rosemann, Thomas; Zoller, Marco

    2012-07-11

    Effective health promotion is of great importance from clinical as well as from public health perspectives and therefore should be encouraged. Especially regarding health promotion in the elderly, general practitioners (GPs) have a key role. Nevertheless, evidence suggests a lack of health promotion by GPs, especially in this age group. The aim of our study was to assess self-perceived attitudes, barriers and facilitators of GPs to provide health promotion in the elderly. We performed a qualitative focus group study with 37 general practitioners. The focus group interviews were recorded digitally, transcribed literally and analysed with ATLAS.ti, a software program for qualitative text analysis. Among the participating GPs, definitions of health promotion varied widely and the opinions regarding its effectiveness were very heterogeneous. The two most important self-perceived barriers for GPs to provide health promotion in the elderly were lack of time and insufficient reimbursement for preventive and health promotion advice. As intervention to increase health promotion in the elderly, GPs suggested, for example, integration of health promotion into under and postgraduate training. Changes at the practice level such as involving the practice nurse in health promotion and counselling were discussed very controversially. Health promotion, especially in the elderly, is crucial but in the opinion of the GPs we involved in our study, there is a gap between public health requirements and the reimbursement system. Integration of health promotion in medical education may be needed to increase knowledge as well as attitudes of GPs regarding this issue.

  16. An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education.

    Science.gov (United States)

    Stenov, Vibeke; Hempler, Nana Folmann; Reventlow, Susanne; Wind, Gitte

    2017-08-22

    To investigate approaches among healthcare providers (HCPs) that support or hinder person-centredness in group-based diabetes education programmes targeting persons with type 2 diabetes. Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes included 21 participants and 10 HCPs and were observed over 5 weeks. Additionally, 10 in-depth semi-structured interviews were conducted with patients (n = 7) and HCPs (n = 3). Data were analysed using systematic text condensation. Hindering approaches included a teacher-centred focus on delivering disease-specific information. Communication was dialog based, but HCPs primarily asked closed-ended questions with one correct answer. Additional hindering approaches included ignoring participants with suboptimal health behaviours and a tendency to moralize that resulted in feelings of guilt among participants. Supporting approaches included letting participants set the agenda using broad, open-ended questions. Healthcare providers are often socialized into a biomedical approach and trained to be experts. However, person-centredness involves redefined roles and responsibilities. Applying person-centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person-centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person-centred approaches in a group context. Teacher-centredness undermined person-centredness because HCPs primarily delivered disease-specific recommendations, leading to biomedical information overload for participants. © 2017 Nordic College of Caring Science.

  17. The eClassroom used as a Teacher's Training Laboratory to Measure the Impact of Group Facilitation on Attending, Participation, Interaction, and Involvement

    Directory of Open Access Journals (Sweden)

    Mia Lobel

    2002-10-01

    Full Text Available This paper describes and quantifies the role of group facilitation in an experiential, real-time, online, university level credit course entitled eAHSC/ 230 Interpersonal Communications and Relations. A new and unique group interaction pattern called parallel communication, as well as classical elements of group interaction are described and quantified. New measures of online group facilitation attributes with analogous face-to-face (F2F counterparts are presented. Specifically, the impact of effective group facilitation on Attentiveness, on Interaction, on Involvement, and on Participation is explored. The paper also examines the eClassrom’s potential effectiveness as a real time teaching and training laboratory which also functions as a process observation tool that collects and feeds back interaction data, providing teachers and trainers immediate and ongoing measures of facilitation effectiveness.

  18. 2015 Service Academy Gender Relations Focus Groups: Overview Report

    Science.gov (United States)

    2015-11-30

    Assault—general discussion of alcohol involvement in sexual assault and specific use alcohol to facilitate having sex with someone. 11. Additional... kids who are from the ages of 18 to 24 and good decisions aren’t always made.” (Male)  Some cadets indicated that the increased discussion of the...regulations for the class of 2016, 2017, 2018 because they had a kid , completely unrelated to this, die of heat stroke. So they changed everything. So

  19. 76 FR 41411 - Group E Post Office Box Service

    Science.gov (United States)

    2011-07-14

    ... conforming with local practice, driving conditions, driver expectations, etc. Further, postmasters already... carrier's line of travel and to which the Postal Service makes delivery. c. A customer must pay the...

  20. Can intravenous conscious sedation with midazolam be effective at facilitating surgical dentistry in adolescent orthodontic patients? A service evaluation.

    Science.gov (United States)

    Stamp, A J; Dorman, M L; Vernazza, C R; Deeming, G; Reid, C; Wilson, K E; Girdler, N M

    2017-01-27

    Background Surgical dentistry during orthodontic care often occurs in adolescence and may involve surgical removal or exposure of teeth. The invasive nature of treatment, combined with dental anxiety, means care can often be provided under general anaesthesia (GA). Best-practice guidelines however endorse conscious sedation as an alternative, where appropriate. Although a limited number of studies have shown safe and effective use of intravenous conscious sedation (IVCS) with midazolam in this cohort, robust evidence to support routine use is lacking. Aim To assess whether IVCS with midazolam can effectively facilitate surgical dentistry in adolescent orthodontic patients in primary care.Method A retrospective service evaluation was undertaken reviewing clinical records of adolescents (aged 12-15 years) undergoing surgical exposure and/or surgical removal of teeth under IVCS with midazolam.Results A total of 174 adolescents (mean age 14.2 years) attended for treatment between 2009 and 2015. Of these adolescents, 98.9% (N = 172) allowed cannulation, with all surgical dentistry completed during a single visit. Midazolam dose ranged from 2-7 mg with 79.1% of patients having good or excellent cooperation and three minor adverse events occurring.Conclusion This service evaluation shows IVCS with midazolam can effectively facilitate surgical orthodontics in carefully selected adolescents. There is however a distinct need to further explore potential for this technique to provide a viable alternative to GA.

  1. Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study

    Science.gov (United States)

    Seubert, Liza J; Boeni, Fabienne; Hattingh, Laetitia; Clifford, Rhonda M

    2017-01-01

    Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so. PMID:29211054

  2. Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Liza J Seubert

    2017-12-01

    Full Text Available Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so.

  3. Computer-Based Training in Eating and Nutrition Facilitates Person-Centered Hospital Care: A Group Concept Mapping Study.

    Science.gov (United States)

    Westergren, Albert; Edfors, Ellinor; Norberg, Erika; Stubbendorff, Anna; Hedin, Gita; Wetterstrand, Martin; Rosas, Scott R; Hagell, Peter

    2018-04-01

    Studies have shown that computer-based training in eating and nutrition for hospital nursing staff increased the likelihood that patients at risk of undernutrition would receive nutritional interventions. This article seeks to provide understanding from the perspective of nursing staff of conceptually important areas for computer-based nutritional training, and their relative importance to nutritional care, following completion of the training. Group concept mapping, an integrated qualitative and quantitative methodology, was used to conceptualize important factors relating to the training experiences through four focus groups (n = 43), statement sorting (n = 38), and importance rating (n = 32), followed by multidimensional scaling and cluster analysis. Sorting of 38 statements yielded four clusters. These clusters (number of statements) were as follows: personal competence and development (10), practice close care development (10), patient safety (9), and awareness about the nutrition care process (9). First and second clusters represented "the learning organization," and third and fourth represented "quality improvement." These findings provide a conceptual basis for understanding the importance of training in eating and nutrition, which contributes to a learning organization and quality improvement, and can be linked to and facilitates person-centered nutritional care and patient safety.

  4. Facilitation of the Estuary/Ocean Subgroup and the Expert Regional Technical Group, Annual Report for 2015

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Gary E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-08-01

    This document is the annual report for the period September 1, 2014 through August 31, 2015 for the project—Facilitation of the Estuary/Ocean Subgroup (EOS) and the Expert Regional Technical Group (ERTG). Pacific Northwest National Laboratory (PNNL) conducted the project for the Bonneville Power Administration (BPA). The EOS and ERTG are part of the research, monitoring, and evaluation (RME) and habitat restoration efforts, respectively, developed by the Action Agencies (BPA, U.S. Army Corps of Engineers [Corps or USACE], and U.S. Bureau of Reclamation) in response to obligations arising from the Endangered Species Act as a result of operation of the Federal Columbia River Power System (FCRPS) and implemented under the Columbia Estuary Ecosystem Restoration Program (CEERP). BPA/Corps (2015) explain the CEERP and the role of RME and the ERTG. For the purposes of this report, the lower Columbia River and estuary (LCRE) includes the floodplain from Bonneville Dam down through the lower river and estuary into the river’s plume in the ocean. The main purpose of this project is to facilitate EOS and ERTG meetings and work products. Other purposes are to provide technical support for CEERP adaptive management, CEERP restoration design challenges, and tributary RME. From 2002 through 2008, the EOS worked to design the federal RME program for the estuary/ocean (Johnson et al. 2008). From 2009 to the present day, EOS activities have involved RME implementation; however, EOS activities were minimal during the current reporting period. PNNL provided technical support to CEERP’s adaptive management process by convening 1.2 meetings of the Action Agencies (AAs) and drafting material for the “CEERP 2015 Restoration and Monitoring Plan” (BPA/Corps 2015).

  5. Developing resources to facilitate culturally-sensitive service planning and delivery - doing research inclusively with people with learning disabilities.

    Science.gov (United States)

    Unwin, Gemma; Larkin, Michael; Rose, John; Kroese, Biza Stenfert; Malcolm, Stephen

    2016-01-01

    (Please see www.Toolsfortalking.co.uk for an easy read summary of the project.) The Tools for Talking are a set of resources that were developed through collaboration between Black, Asian and minority ethnic people with learning disabilities and researchers at the University of Birmingham. The resources were designed to be used by people with learning disabilities and service providers to facilitate culturally-sensitive communication and information sharing, service planning and delivery. They comprise illustrative videos and exploratory activities relating to five topics, namely, culture, activities, support from staff, important people, choices and independence. These topics emerged as important to people with learning disabilities during the 'Access to Social Care-Learning Disabilities' (ASC-LD) study which involved interviews with 32 adults with learning disabilities from Black, Asian and minority ethnic communities. The results of the ASC-LD study were used to develop a set of draft resources which were then co-developed through collaboration with people with learning disabilities and service providers. A 'Partnership event' was convened to involve stakeholders in the development of the resources. This paper describes the refinement of these materials by people with learning disabilities from Black, Asian and minority ethnic backgrounds in cooperation with a range of other stakeholders. Background Black, Asian and minority ethnic people with learning disabilities face inequities in health and social care provision. Lower levels of service uptake and satisfaction with services have been reported, however, this is largely based on the views of carers. The 'Access to Social Care: Learning Disabilities (ASC-LD)' study sought to explore the views and experiences of social support services among adults with learning disabilities from Black, Asian and minority ethnic communities. Interviews with 32 Black, Asian and minority ethnic adults with learning disabilities

  6. Joint Cross-Service Group for Laboratories 1995 Defense Base Realignment and Closure Process

    National Research Council Canada - National Science Library

    Reed, Donald

    1995-01-01

    This report is one in a series of reports that discusses the Joint Cross-Service Group implementation of the internal control plan developed by the 1995 Defense Base Closure and Realignment Steering Group (the Steering Group...

  7. Challenges faced by engineering services group in meeting nuclear power project targets

    International Nuclear Information System (INIS)

    Phanse, N.R.

    2001-01-01

    Nuclear Power Corporation of India Ltd. (NPCIL) is an organisation building and operating nuclear power stations for which a number of different types of engineering services/activities are necessary. All these services are provided by Engineering Services Group of NPCIL. The activities and responsibilities of the group are discussed

  8. Perceptions of telecare training needs in home healthcare services: a focus group study.

    Science.gov (United States)

    Guise, Veslemøy; Wiig, Siri

    2017-02-23

    The implementation and use of telecare requires significant changes to healthcare service organisation and delivery, including new ways of working for staff. Competency development and training for healthcare professionals is therefore required to enable necessary adaptation of clinical practice and ensure competent provision of telecare services. It is however unclear what skills healthcare staff need when providing care at a distance and there is little empirical evidence on effective training strategies for telecare practice. Training should however emphasise the experiences and preferences of prospective trainees to ensure its relevance to their educational needs. The aim of this study was to explore healthcare professionals' perceptions of training related to the general use of telecare, and to identify specific training needs associated with the use of virtual visits in the home healthcare services. Six focus group interviews were held with a total of 26 participants working in the home healthcare services in Norway, including registered nurses, enrolled nurses, physiotherapists, occupational therapists, social workers, health workers, and healthcare assistants. The data material was analysed by way of systematic text condensation. The analysis resulted in five categories relevant to telecare training for healthcare professionals: Purposeful training creates confidence and changes attitudes; Training needs depend on ability to cope with telecare; The timing of training; Training must facilitate practical insight into the patients' perspective; and Training content must focus on the telecare process. Findings are discussed in light of implications for the form and content of a training program for healthcare professionals on how to undertake virtual home healthcare visits. Appropriate preparation and training for telecare use is important for healthcare professionals and must be taken seriously by healthcare organisations. To facilitate the knowledge, skills

  9. Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study.

    Science.gov (United States)

    Barnett, Julie; Vasileiou, Konstantina; Djemil, Fayika; Brooks, Laurence; Young, Terry

    2011-12-16

    Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse

  10. Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study

    Directory of Open Access Journals (Sweden)

    Barnett Julie

    2011-12-01

    Full Text Available Abstract Background Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations

  11. "There isn't an easy way of finding the help that's available." Barriers and facilitators of service use among dementia family caregivers: a qualitative study.

    Science.gov (United States)

    Macleod, Ashley; Tatangelo, Gemma; McCabe, Marita; You, Emily

    2017-05-01

    Family caregivers of people with dementia have significant unmet needs in regard to their caregiving role. Despite this, they are reluctant to utilize services to reduce their burden. The aim of this study was to examine the barriers and facilitators of service use among family caregivers of people with dementia. Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analyzed using thematic analysis. Six main barriers and three facilitators were identified. These barriers and facilitators were relevant across many types of services and supports. The barriers were: the inability to find information about relevant services or support, the poor quality or mistrust of the services, the inflexibility of services, caregivers' beliefs about their obligations to the caregiving role and resistance by the care recipient. Key facilitators were: having good communication with the care recipient, having an "expert" point of contact, and having beliefs about the caregiving role that enabled the use of services. Given the significant changes in the aged care service-system, it is important to discuss the barriers faced by family caregivers of people with dementia. This will inform the development of targeted strategies to address the lack of service use among these family caregivers.

  12. Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

    Science.gov (United States)

    Wright, Heathcote R; Diamond, Jeremy P

    2015-03-01

    To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Xeroderma Pigmentosum Group A Promotes Autophagy to Facilitate Cisplatin Resistance in Melanoma Cells through the Activation of PARP1.

    Science.gov (United States)

    Ge, Rui; Liu, Lin; Dai, Wei; Zhang, Weigang; Yang, Yuqi; Wang, Huina; Shi, Qiong; Guo, Sen; Yi, Xiuli; Wang, Gang; Gao, Tianwen; Luan, Qi; Li, Chunying

    2016-06-01

    Xeroderma pigmentosum group A (XPA), a key protein in the nucleotide excision repair pathway, has been shown to promote the resistance of tumor cells to chemotherapeutic drugs by facilitating the DNA repair process. However, the role of XPA in the resistance of melanoma to platinum-based drugs like cisplatin is largely unknown. In this study, we initially found that XPA was expressed at higher levels in cisplatin-resistant melanoma cells than in cisplatin-sensitive ones. Furthermore, the knockdown of XPA not only increased cellular apoptosis but also inhibited cisplatin-induced autophagy, which rendered the melanoma cells more sensitive to cisplatin. Moreover, we discovered that the increased XPA in resistant melanoma cells promoted poly(adenosine diphosphate-ribose) polymerase 1 (PARP1) activation and that the inhibition of PARP1 could attenuate the cisplatin-induced autophagy. Finally, we proved that the inhibition of PARP1 and the autophagy process made resistant melanoma cells more susceptible to cisplatin treatment. Our study shows that XPA can promote cell-protective autophagy in a DNA repair-independent manner by enhancing the activation of PARP1 in melanoma cells resistant to cisplatin and that the XPA-PARP1-mediated autophagy process can be targeted to overcome cisplatin resistance in melanoma chemotherapy. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. EnviroAtlas - Milwaukee, WI - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,175 block groups in Milwaukee, Wisconsin. Carbon attributes, temperature reduction,...

  15. EnviroAtlas - Portland, ME - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 146 block groups in Portland, Maine. Carbon attributes, temperature reduction,...

  16. EnviroAtlas - Austin, TX - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 750 block groups in Austin, Texas. Carbon attributes, temperature reduction,...

  17. EnviroAtlas - Memphis, TN - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 703 block groups in Memphis, Tennessee. Carbon attributes, temperature reduction,...

  18. EnviroAtlas - Paterson, NJ - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 107 block groups in Paterson, New Jersey. Carbon attributes, temperature reduction,...

  19. EnviroAtlas - Woodbine, IA - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1 block group in Woodbine, Iowa. Carbon attributes, temperature reduction, pollution...

  20. EnviroAtlas - Durham, NC - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 193 block groups in Durham, North Carolina. Carbon attributes, temperature reduction,...

  1. EnviroAtlas - Pittsburgh, PA - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,089 block groups in Pittsburgh, Pennsylvania. Carbon attributes, temperature...

  2. EnviroAtlas - Tampa, FL - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,833 block groups in Tampa Bay, Florida. Carbon attributes, temperature reduction,...

  3. EnviroAtlas - Portland, OR - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1176 block groups in Portland, Oregon. Carbon attributes, temperature reduction,...

  4. EnviroAtlas - Fresno, CA - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 405 block groups in Fresno, California. Carbon attributes, temperature reduction,...

  5. EnviroAtlas - Cleveland, OH - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,442 block groups in Cleveland, Ohio. Carbon attributes, temperature reduction,...

  6. EnviroAtlas - Phoenix, AZ - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset presents environmental benefits of the urban forest in 2,434 block groups in Phoenix, Arizona. Carbon attributes, pollution removal and value, and...

  7. 2017 Military Services Gender Relations Focus Groups: Active Duty

    Science.gov (United States)

    2018-04-30

    Office of People Analytics Office of People Analytics (OPA) Defense Research, Surveys, and Statistics Center 4800 Mark Center Drive, Suite 06E22...Relations (2017 MSGR) Focus Groups among active duty members. This is the third6 administration of gender relations focus groups. This introductory ...Enlisted, Male “It is true statistically , a majority of sexual assaults there is alcohol or drugs. In the military, it’s into the alcohol more than

  8. Quality of Services and Quality of Life from Service Providers' Perspectives: Analysis with Focus Groups

    Science.gov (United States)

    Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.

    2013-01-01

    Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…

  9. Perception of using group buying sites to acquire tourist services cou-pons

    OpenAIRE

    Luiz Mendes Filho; Vanessa Araújo Jorge; Otávio Bezerra de Sena Júnior

    2016-01-01

    Technologies brought new forms of business as in the case of group buying sites, which are basically a way to sell on the Internet that allows consumers to buy goods and services at lower prices. This study analyzed the travelers’ perception of the use of group buying sites to acquire tourist services coupons. The research presents a quantitative-exploratory approach using the Technology Acceptance Model to investigate the use of group buying sites to acquire tourist services coupons during a...

  10. [Study on the occupational stress norm and it's application for the marketing group, public service/safety group and production laborer group].

    Science.gov (United States)

    Yang, Xin-Wei; Wang, Zhi-Ming; Jin, Tai-Yi; Lan, Ya-Jia

    2006-09-01

    A study of the occupational stress norm and it's application for the marketing group, public service/safety group and production laborer group. In this study, cross-sectional study method is used, and a synthetic way of sorting and randomized sampling is adopted to deal with research targets (36 marketing group, 331 public service/safety group, 903 production laborer group). Descriptive statistics for OSI-R scale scores for the marketing group, public service/safety group and production laborer group were modulated. Scale raw score to T-score conversion tables derived from the OSI-R normative sample for marketing group public service/safety group and production laborer group were established. OSI-R profile from for marketing group, public service/safety group and production laborer group were established. For the ORQ and PSQ scales, scores at or above 70 indicate a strong levels of maladaptive stress and strain. Score in the range of 60 to 69 suggest middle levels of maladaptive stress and strain. Score in the range of 40 to 59 indicate normal levels of stress and strain. Score below 40 indicate a relative absence of occupational stress and strain. For the PRQ scales, score below 30 indicate a significant lack of coping resources. Score in the range of 30 to 39 suggest middle deficits in coping resources. Score in the range of 40 to 59 indicate average coping resources. Scores at or above 60 indicate a strong levels of coping resources. The authors combined subjective and objective environment match model of occupational stress. Different intervention measure should be take to reduce the occupational stress so as to improve the work ability.

  11. Placement of the Services with the help of Perception Maps presented by the GSM Operators Facilitating in Turkey

    Directory of Open Access Journals (Sweden)

    Aykut Ekiyor

    2014-03-01

    Full Text Available Product placement comes into prominence as a wide and de tailed topic reaching the basis to the differentiation in the market. The product placement facilities are to form a specific product perception on the target consumer’s minds. In giving these services, a good marketing communication with the consumers has an important role. In the frame of product placement, the perception maps are used as a visual vehicle. In this study: the aim was to put forth the positioning of the service given by the cell phone operators facilitating in Turkey by the help of percepti on maps with the data gained by the consumers. Also, another aim was to visually show the different and similar variables of the cell phone operators in the minds of the consumers. In the scope of a literature review a questionnaire has been prepared to id entify the similarities and differences between the cell phone operators. The questionnaire has been applied to 521 consumers. As each consumer evaluated the three operators 1563 data has been gained. The evaluation of the data gained after the study was done by discriminant analysis

  12. The facilitative orientation of the teacher as a base condition for the organization of group work with the elementary school students

    Directory of Open Access Journals (Sweden)

    Maslova E. A.

    2017-12-01

    Full Text Available the questions connected with the organization of group work with the elementary school students are revised in this article as well as its object, objectives, advantages and difficulties which may occur during the preparation work. The author reveals the essence and meaning of the pedagogical facilitation and draws attention that one of the conditions for its effective organization is the pedagogical facilitation of the teacher and the safe educational environment. The pedagogical facilitation is being reviewed though the following components: emotionally-cognitive, praxeologically-behavioural, reflexive ones.

  13. Social facilitation of eating novel food in tufted capuchin monkeys (Cebus apella): input provided by group members and responses affected in the observer.

    Science.gov (United States)

    Addessi, E; Visalberghi, E

    2001-11-01

    Learning about food palatability from watching what conspecifics eat might be one of the advantages of group living. A previous study investigated whether group members' presence or eating activity account for social facilitation of eating of foods never previously tasted. Capuchins encountered novel colored foods when (1) alone (Alone condition) or (2) with group members visible in the nearby cage (Group-present condition) or (3) with group members present and eating a familiar food that had not been colored (Group+food condition). Social facilitation of eating occurred when group members were eating, despite the difference in color between the familiar food eaten by them and the novel food presented to the experimental subject. To clarify what subjects learnt from group members when social facilitation occurred, we further analyze here the data from the previous study. The number of visual exposures to the colored novel food (as a group member) correlated with increased consumption of that novel food when encountered later (as experimental subject). In contrast, the number of times that an individual fed on the familiar food (as a group member) did not decrease its consumption of novel food (as experimental subject). Therefore, capuchins (1) habituated to the colors of the novel foods, and (2) did not take into account that seeing group members eating a food does not provide information about the palatability of a differently colored food. Since social facilitation of eating occurs when foods do not match in color, at least in capuchins, social facilitation of eating should not be considered as a way of learning about a safe diet, but rather as a way of overcoming neophobia.

  14. ‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

    Science.gov (United States)

    2013-01-01

    Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of

  15. Service-learning from the views of university teachers: a qualitative study based on focus groups.

    Science.gov (United States)

    Shek, Daniel T L; Chan, Stephen C F

    2013-01-01

    Under the New Undergraduate Curriculum at The Hong Kong Polytechnic University (PolyU), students are required to take a 3-credit subject to fulfill service-learning requirements. To understand the views of teachers regarding service-learning, five focus group interviews (n=33) are conducted to examine the perceived characteristics and myths of service-learning as well as colleagues' views on the policy at PolyU. Results showed that most informants are aware of service-learning and have seen its benefits to both students and teachers. Most informants also possess positive views about service-learning. Nevertheless, in terms of service-learning at PolyU, three different groups of views on service-learning are observed, namely, positive, negative, and mixed views. This paper also discusses teachers' views on the anticipated difficulties of service-learning implementation and the ways, by which to promote the subject in the PolyU context.

  16. What are the barriers and facilitators for third sector organisations (non-profits) to evaluate their services? A systematic review.

    Science.gov (United States)

    Bach-Mortensen, Anders Malthe; Montgomery, Paul

    2018-01-22

    The third sector is becoming a more common provider of social and health services, but little is known about how third sector organisations (TSOs) evaluate their activities. Past research has reported that the third sector is under increasing pressure to evaluate its impact and performance by government and other commissioning bodies. However, in responding to this increased pressure to undertake evaluation, research suggests that many TSOs struggle to evaluate their activities following the principles of evidence-based practice (EBP). Yet, there has been no systematic effort to investigate why the third sector is struggling to provide good quality evidence of its effects. This systematic review is reported following the PRISMA guidelines. Ten interdisciplinary databases were searched using a search string developed following best practice and in consultation with an information systems expert. Included studies were primary research of any research design investigating barriers to and facilitators of the evaluation process of TSOs as identified by practitioners. All studies were quality appraised, and the results were synthesised as a thematic summary. Twenty-four studies were included, which mainly investigated TSOs working within health and social services. The thematic summary identified the main barriers for TSOs to undertake evaluation to be related to the (1) lack of financial resources, (2) lack of technical capability and evaluation literacy and (3) challenges around identifying relevant evaluation systems and outcome indicators. Key facilitating factors involved (1) getting the appropriate support, (2) having an organisational culture that supports evaluation and (3) the motivation to be accountable to stakeholders. These findings were robust to study quality. This review constitutes the first systematic effort to synthesise existing literature on factors supporting and preventing evaluation by TSOs. The prevalence of factors revolving around the lack of

  17. Participatory design facilitates Person Centred Nursing in service improvement with older people: a secondary directed content analysis.

    Science.gov (United States)

    Wolstenholme, Daniel; Ross, Helen; Cobb, Mark; Bowen, Simon

    2017-05-01

    To explore, using the example of a project working with older people in an outpatient setting in a large UK NHS Teaching hospital, how the constructs of Person Centred Nursing are reflected in interviews from participants in a Co-design led service improvement project. Person Centred Care and Person Centred Nursing are recognised terms in healthcare. Co-design (sometimes called participatory design) is an approach that seeks to involve all stakeholders in a creative process to deliver the best result, be this a product, technology or in this case a service. Co-design practice shares some of the underpinning philosophy of Person Centred Nursing and potentially has methods to aid in Person Centred Nursing implementation. The research design was a qualitative secondary Directed analysis. Seven interview transcripts from nurses and older people who had participated in a Co-design led improvement project in a large teaching hospital were transcribed and analysed. Two researchers analysed the transcripts for codes derived from McCormack & McCance's Person Centred Nursing Framework. The four most expressed codes were as follows: from the pre-requisites: knowing self; from care processes, engagement, working with patient's beliefs and values and shared Decision-making; and from Expected outcomes, involvement in care. This study describes the Co-design theory and practice that the participants responded to in the interviews and look at how the co-design activity facilitated elements of the Person Centred Nursing framework. This study adds to the rich literature about using emancipatory and transformational approaches to Person Centred Nursing development, and is the first study exploring explicitly the potential contribution of Co-design to this area. Methods from Co-design allow older people to contribute as equals in a practice development project, co-design methods can facilitate nursing staff to engage meaningfully with older participants and develop a shared

  18. Linking HIV-Negative Youth to Prevention Services in 12 U.S. Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum.

    Science.gov (United States)

    Doll, Mimi; Fortenberry, J Dennis; Roseland, Denise; McAuliff, Kathleen; Wilson, Craig M; Boyer, Cherrie B

    2018-04-01

    Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth. Thematic analysis of structured interviews with staff implementing linkage to prevention services programs for youth aged 12-24 years. Twelve adolescent medicine HIV primary care programs as part of larger testing research program focused on young sexual minority men of color. The study included staff implementing linkage to prevention services programs along with community-based HIV testing programs. The main outcomes of the study were key barriers/facilitators to linkage to prevention services. Eight themes summarized perspectives on linkage to prevention services: (1) relationships with community partners, (2) trust between providers and youth, (3) youth capacity to navigate prevention services, (4) pre-exposure prophylaxis specific issues, (5) privacy issues, (6) gaps in health records preventing tailored services, (7) confidentiality of care for youth accessing services through parents'/caretakers' insurance, and (8) need for health-care institutions to keep pace with models that prioritize HIV prevention among at-risk youth. Themes are discussed in the context of factors that facilitated/challenged linkage to prevention services. Several evidence-based HIV prevention tools are available; infrastructures for coordinated service delivery to high-risk youth have not been developed. Implementation of such infrastructures requires attention to community-, provider-, and youth-related issues. Copyright

  19. 76 FR 70520 - Rovac Corp., RS Group of Companies, Inc., Rymer Foods, Inc. Stratus Services Group, Inc., Sun Cal...

    Science.gov (United States)

    2011-11-14

    ...., Rymer Foods, Inc. Stratus Services Group, Inc., Sun Cal Energy, Inc., Sun Motor International, Inc... current and accurate information concerning the securities of Sun Cal Energy, Inc. because it has not... Sun Motor International, Inc. because it has not filed any periodic reports since the period ended...

  20. Barriers and facilitators to recruitment of physicians and practices for primary care health services research at one centre

    Directory of Open Access Journals (Sweden)

    Hogg William

    2010-12-01

    Full Text Available Abstract Background While some research has been conducted examining recruitment methods to engage physicians and practices in primary care research, further research is needed on recruitment methodology as it remains a recurrent challenge and plays a crucial role in primary care research. This paper reviews recruitment strategies, common challenges, and innovative practices from five recent primary care health services research studies in Ontario, Canada. Methods We used mixed qualitative and quantitative methods to gather data from investigators and/or project staff from five research teams. Team members were interviewed and asked to fill out a brief survey on recruitment methods, results, and challenges encountered during a recent or ongoing project involving primary care practices or physicians. Data analysis included qualitative analysis of interview notes and descriptive statistics generated for each study. Results Recruitment rates varied markedly across the projects despite similar initial strategies. Common challenges and creative solutions were reported by many of the research teams, including building a sampling frame, developing front-office rapport, adapting recruitment strategies, promoting buy-in and interest in the research question, and training a staff recruiter. Conclusions Investigators must continue to find effective ways of reaching and involving diverse and representative samples of primary care providers and practices by building personal connections with, and buy-in from, potential participants. Flexible recruitment strategies and an understanding of the needs and interests of potential participants may also facilitate recruitment.

  1. Barriers and facilitators to recruitment of physicians and practices for primary care health services research at one centre.

    Science.gov (United States)

    Johnston, Sharon; Liddy, Clare; Hogg, William; Donskov, Melissa; Russell, Grant; Gyorfi-Dyke, Elizabeth

    2010-12-13

    While some research has been conducted examining recruitment methods to engage physicians and practices in primary care research, further research is needed on recruitment methodology as it remains a recurrent challenge and plays a crucial role in primary care research. This paper reviews recruitment strategies, common challenges, and innovative practices from five recent primary care health services research studies in Ontario, Canada. We used mixed qualitative and quantitative methods to gather data from investigators and/or project staff from five research teams. Team members were interviewed and asked to fill out a brief survey on recruitment methods, results, and challenges encountered during a recent or ongoing project involving primary care practices or physicians. Data analysis included qualitative analysis of interview notes and descriptive statistics generated for each study. Recruitment rates varied markedly across the projects despite similar initial strategies. Common challenges and creative solutions were reported by many of the research teams, including building a sampling frame, developing front-office rapport, adapting recruitment strategies, promoting buy-in and interest in the research question, and training a staff recruiter. Investigators must continue to find effective ways of reaching and involving diverse and representative samples of primary care providers and practices by building personal connections with, and buy-in from, potential participants. Flexible recruitment strategies and an understanding of the needs and interests of potential participants may also facilitate recruitment.

  2. The Turn the Tables Technique (T[cube]): A Program Activity to Provide Group Facilitators Insight into Teen Sexual Behaviors and Beliefs

    Science.gov (United States)

    Sclafane, Jamie Heather; Merves, Marni Loiacono; Rivera, Angelic; Long, Laura; Wilson, Ken; Bauman, Laurie J.

    2012-01-01

    The Turn the Tables Technique (T[cube]) is an activity designed to provide group facilitators who lead HIV/STI prevention and sexual health promotion programs with detailed and current information on teenagers' sexual behaviors and beliefs. This information can be used throughout a program to tailor content. Included is a detailed lesson plan of…

  3. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Heidi Schultz

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN. Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient's belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.   Type: Original Research

  4. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Amanda Brummel, PharmD

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.

  5. Using Group Communication to Implement a Fault-Tolerant Directory Service

    NARCIS (Netherlands)

    Kaashoek, M.F.; Tanenbaum, A.S.; Verstoep, C.

    1993-01-01

    Group communication is an important paradigm for building distributed applications. This paper discusses a fault-tolerant distributed directory service based on group communication, and compares it with the previous design and implementation based on remote procedure call. The group directory

  6. Use of participant focus groups to identify barriers and facilitators to worksite exercise therapy adherence in randomized controlled trials involving firefighters

    Directory of Open Access Journals (Sweden)

    Mayer JM

    2013-03-01

    Full Text Available John M Mayer,1 James L Nuzzo,1 Simon Dagenais2 1School of Physical Therapy and Rehabilitation Sciences, College of Medicine, University of South Florida, Tampa, FL, 2Palladian Health, West Seneca, NY, USA Background: Firefighters are at increased risk for back injuries, which may be mitigated through exercise therapy to increase trunk muscle endurance. However, long-term adherence to exercise therapy is generally poor, limiting its potential benefits. Focus groups can be used to identify key barriers and facilitators to exercise adherence among study participants. Objective: To explore barriers and facilitators to worksite exercise therapy adherence among firefighters to inform future randomized controlled trials (RCTs. Methods: Participants enrolled in a previous RCT requiring twice-weekly worksite exercise therapy for 24 weeks were asked to take part in moderated focus group discussions centered on eight open-ended questions related to exercise adherence. Responses were analyzed qualitatively using a social ecological framework to identify key intrapersonal, interpersonal, and institutional barriers and potential facilitators to exercise adherence. Results: A total of 27 participants were included in the four focus group discussions, representing 50% of those assigned to a worksite exercise therapy group in the previous RCT, in which only 67% of scheduled exercise therapy sessions were completed. Lack of self-motivation was cited as the key intrapersonal barrier to adherence, while lack of peer support was the key interpersonal barrier reported, and lack of time to exercise during work shifts was the key institutional barrier identified. Conclusion: Focus group discussions identified both key barriers and potential facilitators to increase worksite exercise therapy adherence among firefighters. Future studies should consider educating and reminding participants about the benefits of exercise, providing individual and group incentives based on

  7. User satisfaction with public and private dental services for different age groups in Brazil

    Directory of Open Access Journals (Sweden)

    Aline Macarevich

    2018-02-01

    Full Text Available Abstract: This article aimed to describe the levels of user satisfaction in different age groups and to study the association between user satisfaction and different types of dental services in a representative sample of Brazilians. This study is based on the Brazilian Oral Health Survey, which evaluated the dental health of adolescents, adults and older adults in 177 Brazilian cities. The outcome variable was user satisfaction, related to the last dental visit, evaluated in a five-level Likert-type scale. The main exposure variable was the type of dental service (public service, private service, health plan or insurance. The independent variables were DMFT (decay, missing and filled teeth; pain intensity in the past six months; reason for the last dental visit; perceived need for treatment; frequency of use of dental services; sex; equivalent income; and educational level. An ordered logistic regression analysis was performed separately for each age group. Few participants evaluated the services as bad or very bad (4.3% of adolescents, 6.1% of adults and 4.1% of older adults. In the crude model, the use of public services was associated with lower satisfaction than the use of private services and health plans between all groups. However, after adjusting by covariates, this association remained only in adolescents, who showed lower satisfaction with the public service compared to the private service and health plans. In general, Brazilians are satisfied with dental services, but, among adolescents, the use of public services was associated with lower satisfaction. Public services may be focused on issues related to children, adults and older adults, and not to the adolescent audience, which has specific demands.

  8. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    Science.gov (United States)

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

  9. SOCIAL SERVICE USE GOOGLE-GROUPS INTO THE CURRICULUM AND EDUCATIONAL ACTIVITIES

    Directory of Open Access Journals (Sweden)

    T. Nosenko

    2010-06-01

    Full Text Available The article considers the use of Web2.0 services for organizing training activities high school teachers, formulated and analyzed the benefits of using social services issues in educational purposes. Determined that united in groups, students of pedagogical universities, thus preparing for the profession, enhancing professional knowledge.

  10. 77 FR 43071 - MPS Customer Group v. Maine Public Service Company; Notice of Complaint

    Science.gov (United States)

    2012-07-23

    ..., MPS Customer Group (Complainant) filed a formal complaint against Maine Public Service Company (MPS or... document is added to a subscribed docket(s). For assistance with any FERC Online service, please email... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-84-000] MPS Customer...

  11. Across Racial/Ethnic Groups in Effects of Racial Incidents on Satisfaction with Military Service

    National Research Council Canada - National Science Library

    Stewart, James

    2001-01-01

    This study compares the effects of racial incidents on reported levels of satisfaction with military service across racial/ethnic groups by analyzing responses to the Armed Forces Equal Opportunity Survey (AFEOS...

  12. Variation Across Racial/Ethnic Groups in Effects of Racial Incidents on Satisfaction with Military Service

    National Research Council Canada - National Science Library

    Stewart, James

    2001-01-01

    This study compares the effects of racial incidents on reported levels of satisfaction with military service across racial/ethnic groups by analyzing responses to the Armed Forces Equal Opportunity Survey (AFEOS...

  13. 07051 Working Group Outcomes -- Programming Paradigms for the Web: Web Programming and Web Services

    OpenAIRE

    Hull, Richard; Thiemann, Peter; Wadler, Philip

    2007-01-01

    Participants in the seminar broke into groups on ``Patterns and Paradigms'' for web programming, ``Web Services,'' ``Data on the Web,'' ``Software Engineering'' and ``Security.'' Here we give the raw notes recorded during these sessions.

  14. Some Practical Issues in the Design and Implementation of Group Communication Services

    National Research Council Canada - National Science Library

    Mishra, Shivakant

    2000-01-01

    The main objective of the proposed research was to investigate four important practical issues in the understanding, design, and implementation of group communication services. These issues were (1) Performance...

  15. Academic status of deaf and hard-of-hearing students in public schools: student, home, and service facilitators and detractors.

    Science.gov (United States)

    Reed, Susanne; Antia, Shirin D; Kreimeyer, Kathryn H

    2008-01-01

    We examined facilitators and detractors of academic success of 25 deaf or hard-of-hearing (DHH) students selected from a pool of 187 students attending general education classes and enrolled in a study of academic progress. Interviews with their teachers of DHH, general education teachers, principals, parents, interpreters, and students themselves were analyzed for child, family, and school facilitators and detractors of academic status. Facilitators included student self-advocacy and motivation, high family and school expectations, families' ability to help with homework, and good communication between professionals. Detractors included additional disabilities and poor family-school communication. A comparison of above- and below-average students revealed no single distinguishing facilitator or detractor. Each above-average student had many facilitators, whereas each below-average student had several significant detractors.

  16. ‘The Remembering Group’; facilitating a cognitive stimulation group in an inpatient health and rehabilitation setting.

    OpenAIRE

    Peacock-Brennan, Sinead; Jamal, S.; O’Sullivan, G.

    2016-01-01

    A trainee clinical psychologist and two occupational therapists reflect upon the\\ud experience of adapting a cognitive stimulation therapy group for an inpatient health\\ud and rehabilitation setting. The adaptations, benefits and challenges of implementing\\ud the group are discussed.

  17. Cyberinfrastructure Initiatives of the Committee on Earth Observation Satellites (CEOS) Working Group on Information Systems and Services (WGISS)

    Science.gov (United States)

    McDonald, K. R.; Faundeen, J. L.; Petiteville, I.

    2005-12-01

    The Committee on Earth Observation Satellites (CEOS) was established in 1984 in response to a recommendation from the Economic Summit of Industrialized Nations Working Group on Growth, Technology, and Employment's Panel of Experts on Satellite Remote Sensing. CEOS participants are Members, who are national or international governmental organizations who operate civil spaceborne Earth observation satellites, and Associates who are governmental organizations with civil space programs in development or international scientific or governmental bodies who have an interest in and support CEOS objectives. The primary objective of CEOS is to optimize benefits of satellite Earth observations through cooperation of its participants in mission planning and in development of compatible data products, formats, services, applications and policies. To pursue its objectives, CEOS establishes working groups and associated subgroups that focus on relevant areas of interest. While the structure of CEOS has evolved over its lifetime, today there are three permanent working groups. One is the Working Group on Calibration and Validation that addresses sensor-specific calibration and validation and geophysical parameter validation. A second is the Working Group on Education, Training, and Capacity Building that facilitates activities that enhance international education and training in Earth observation techniques, data analysis, interpretation and applications, with a particular focus on developing countries. The third permanent working group is the Working Group on Information Systems and Services (WGISS). The purpose of WGISS is to promote collaboration in the development of the systems and services based on international standards that manage and supply the Earth observation data and information from participating agencies' missions. WGISS places great emphasis on the use of demonstration projects involving user groups to solve the critical interoperability issues associated with the

  18. Antecendents and consequences of group potency : a study of self-managing teams in customer services

    NARCIS (Netherlands)

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

    2005-01-01

    This paper proposes and tests a model of antecedents and consequences of group potency in self-managing teams in retail banking. Based on data collected from boundary-spanning service employees organized in 60 teams and their customers, our findings reveal a significant positive impact of group

  19. A Dialogue with Carl Rogers: Cross-Cultural Challenges of Facilitating Person-Centered Groups in Africa.

    Science.gov (United States)

    Hain-Hill, Alicia; Rogers, Carl R.

    1988-01-01

    Presents brainstorming dialogue with Carl Rogers which was held in January of 1987, shortly before Rogers's death. Explores basic challenges involved in a large-scale, cross-cultural application of person-centered group work in South Africa. (Author)

  20. Using computer-assisted process facilitation techniques in government sponsored public meetings and working sessions - a paper addressing the East Fork Poplar Creek Working Group Experience

    International Nuclear Information System (INIS)

    Armstrong, L.D.; Rymer, G.; Perkins, S.

    1994-01-01

    This paper addresses a process facilitation technique using computer hardware and software that assists its users in group decision-making, consensus building, surveying and polling, and strategic planning. The process and equipment has been successfully used by the Department of Energy and Martin Marietta Energy Systems, Inc., Environmental Restoration and Waste Management Community Relations program. The technology is used to solicit and encourage qualitative and documented public feedback in government mandated or sponsored public meetings in Oak Ridge, Tennessee

  1. An unreliable group arrival queue with k stages of service, retrial under variant vacation policy

    Science.gov (United States)

    Radha, J.; Indhira, K.; Chandrasekaran, V. M.

    2017-11-01

    In this research work we considered repairable retrial queue with group arrival and the server utilize the variant vacations. A server gives service in k stages. Any arriving group of units finds the server free, one from the group entering the first stage of service and the rest are joining into the orbit. After completion of the i th stage of service, the customer may have the option to choose (i+1)th stage of service with probability θi , with probability pi may join into orbit as feedback customer or may leave the system with probability {q}i=≤ft\\{\\begin{array}{l}1-{p}i-{θ }i,i=1,2,\\cdots k-1\\ 1-{p}i,i=k\\end{array}\\right\\}. If the orbit is empty at the service completion of each stage service, the server takes modified vacation until at least one customer appears in the orbit on the server returns from a vacation. Busy server may get to breakdown and the service channel will fail for a short interval of time. By using the supplementary variable method, steady state probability generating function for system size, some system performance measures are discussed.

  2. Treating first episode psychosis--the service users' perspective: a focus group evaluation.

    Science.gov (United States)

    O'Toole, M S; Ohlsen, R I; Taylor, T M; Purvis, R; Walters, J; Pilowsky, L S

    2004-06-01

    UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users' experiences of a first episode intervention designed along evidence-based 'best practice' guidelines and to establish specific elements seen as effective to help inform future service planning and provision. Twelve users of a specialist first episode service participated in focus groups. These were then analyzed using Interpretative Phenomenological Analysis, a specialized form of content analysis. Key elements identified by the service users included the 'human' approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users' experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users' and caregivers' perspective.

  3. The Cultivation of a Prosocial Value Orientation through Community Service: An Examination of Organizational Context, Social Facilitation, and Duration

    Science.gov (United States)

    Horn, Aaron S.

    2012-01-01

    Community service is widely regarded as a fundamental experience in preparation for good citizenship, but it remains unclear whether common variants of service are consequential for civic outcomes. This study examines changes in the relative importance assigned to prosocial and egoistic values associated with service through different types of…

  4. Perception of using group buying sites to acquire tourist services cou-pons

    Directory of Open Access Journals (Sweden)

    Luiz Mendes Filho

    2016-08-01

    Full Text Available Technologies brought new forms of business as in the case of group buying sites, which are basically a way to sell on the Internet that allows consumers to buy goods and services at lower prices. This study analyzed the travelers’ perception of the use of group buying sites to acquire tourist services coupons. The research presents a quantitative-exploratory approach using the Technology Acceptance Model to investigate the use of group buying sites to acquire tourist services coupons during a trip. They were collected 60 valid questionnaires with students from a public university in northeastern of Brazil. It was used a data collection survey type, with a non-probabilistic convenience sample. Since this is a pilot study with a small sample, the results were verified by the structural equation modeling (SEM, using the technique Partial Least Squares (PLS. From the analysis, it was found that most people who responded to the questionnaires are using group buying sites to acquire tourist services coupons. However, according to the results, the group buying sites may not be easy tools to help in decision making in purchasing tourism services.

  5. Facilitating practitioner research into strategies for improving communication in classroom groups: Action research and interaction analysis — A reconciliation?

    Science.gov (United States)

    Sadler, Jo; Fawns, Rod

    1993-12-01

    This study involved collaborative classroom-based observation of student communication and cognition in small groups after the implementation of two management strategies in science departments in several schools. The paper presents the data and provides insights into the conduct of research and teacher development in the midst of educational change.

  6. Evaluation of a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care: the role of Primary Care Mental Health Specialists.

    Science.gov (United States)

    Hamilton-West, Kate; Hotham, Sarah; Yang, Wei; Hedayioglu, Julie; Brigden, Charlotte

    2017-07-01

    Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013. Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Findings Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a 'safety net' they could fall back on in case of difficulties, whereas staff used the analogy of a 'bridge' to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient's care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient.

  7. ATR-FTIR Spectroscopic Evidence for Biomolecular Phosphorus and Carboxyl Groups Facilitating Bacterial Adhesion to Iron Oxides

    Science.gov (United States)

    Parikh, Sanjai J.; Mukome, Fungai N.D.; Zhang, Xiaoming

    2014-01-01

    Attenuated total reflectance (ATR) Fourier transform infrared (FTIR) spectroscopy has been used to probe the binding of bacteria to hematite (α-Fe2O3) and goethite (α-FeOOH). In situ ATR-FTIR experiments with bacteria (Pseudomonas putida, P. aeruginosa, Escherichia coli), mixed amino acids, polypeptide extracts, deoxyribonucleic acid (DNA), and a suite of model compounds were conducted. These compounds represent carboxyl, catecholate, amide, and phosphate groups present in siderophores, amino acids, polysaccharides, phospholipids, and DNA. Due in part to the ubiquitous presence of carboxyl groups in biomolecules, numerous IR peaks corresponding to outer-sphere or unbound (1400 cm−1) and inner-sphere (1310-1320 cm−1) coordinated carboxyl groups are noted following reaction of bacteria and biomolecules with α-Fe2O3 and α-FeOOH. However, the data also reveal that the presence of low-level amounts (i.e., 0.45-0.79%) of biomolecular phosphorous groups result in strong IR bands at ~1043 cm−1, corresponding to inner-sphere Fe-O-P bonds, underscoring the importance of bacteria associated P-containing groups in biomolecule and cell adhesion. Spectral comparisons also reveal slightly greater P-O-Fe contributions for bacteria (Pseudomonad, E. coli) deposited on α-FeOOH, as compared to α-Fe2O3. This data demonstrates that slight differences in bacterial adhesion to Fe oxides can be attributed to bacterial species and Fe-oxide minerals. However, more importantly, the strong binding affinity of phosphate in all bacteria samples to both Fe-oxides results in the formation of inner-sphere Fe-O-P bonds, signifying the critical role of biomolecular P in the initiation of bacterial adhesion. PMID:24859052

  8. The impact of patient participation direct enhanced service on patient reference groups in primary care: a qualitative study.

    Science.gov (United States)

    Pollard, Lorraine; Agarwal, Shona; Harrad, Fawn; Lester, Louise; Cross, Ainsley; Wray, Paula; Smith, Gordon; Locke, Anthony; Sinfield, Paul

    2014-01-01

    NHS policy documents continue to make a wide-ranging commitment to patient involvement. The Patient Participation Direct Enhanced Service (PP-DES), launched in 2011, aimed to ensure patients are involved in decisions about the range and quality of services provided and commissioned by their practice through patient reference groups (PRGs). The aim of this exploratory study is to review the impact of the PP-DES (2011-13) on a sample of PRGs and assess how far it has facilitated their involvement in decisions about the services of their general practices. A qualitative methods design, using semi- structured interviews and focus groups, was employed to explore the experiences and views of GP practice staff (n = 24), PRG members (n = 80) at 12 GP practices, and other stakeholders (n = 4). Wide variation in the role and remit of the participating PRGs was found, which broadly ranged from activities to improve practice resources to supporting health promotion activities. The majority of PRG members were unfamiliar with the PP-DES scheme and its aims and purpose. Stakeholders and practice staff felt strongly that the main success of the PP-DES was that it had led to an increase in the number of PRGs being established in the locality. The PP-DES scheme has been a catalyst to establish PRGs. However, the picture was mixed in terms of the PRGs involvement in decisions about the services provided at their general practice as there was wide variation in the PRGs role and remit. The financial incentive alone, provided via the DES scheme, did not secure greater depth of PRG activity and power, however, as social factors were identified as playing an important role in PRGs' level of participation in decision making. Many PRGs have to become more firmly established before they are involved as partners in commissioning decisions at their practice.

  9. VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

    Science.gov (United States)

    Trafton, Jodie A; Greenberg, Greg; Harris, Alex H S; Tavakoli, Sara; Kearney, Lisa; McCarthy, John; Blow, Fredric; Hoff, Rani; Schohn, Mary

    2013-03-01

    To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations. To support these programs, tailored site-specific reports were generated. Metric development required close collaboration between program evaluators, policy makers and clinical leadership, and consideration of policy language and intent. Electronic reports supporting different purposes required distinct formatting and presentation features, despite their having similar general goals and using the same metrics. Health information technology can facilitate mental health policy implementation but must be integrated into a process of consensus building and close collaboration with policy makers, evaluators, and practitioners.

  10. 75 FR 66797 - PricewaterhouseCoopers LLP (“PwC”) Internal Firm Services Client Account Administrators Group...

    Science.gov (United States)

    2010-10-29

    ... LLP (``PwC'') Internal Firm Services Client Account Administrators Group, Charlotte, NC; Amended... Firm Services Client Account Administrators Group. Accordingly, the Department is amending this... Firm Services Client Account Administrators Group. The amended notice applicable to TA-W-73,608 is...

  11. 75 FR 43557 - TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical Bill Processing and...

    Science.gov (United States)

    2010-07-26

    ... Leased Workers From Beeline: Aurora, IL; TA-W-73,682A, Hartford Financial Services Group, Incorporated..., applicable to workers of Hartford Financial Services Group, Incorporated, Medical Bill Processing and Production Center Support, Aurora, Illinois and Hartford Financial Services Group, Incorporated, Medical Bill...

  12. Group-Oriented Services: A Shift towards Consumer-Managed Relationships in the Telecom Industry

    Science.gov (United States)

    Vrdoljak, Luka; Bojic, Iva; Podobnik, Vedran; Jezic, Gordan; Kusek, Mario

    Today, telecom operators face a threefold challenge: a social challenge dealing with the evolution of the consumer lifestyle, a technological challenge dealing with ever changing ICT trends and a business challenge dealing with the need for innovative business models. This paper introduces an idea of group-oriented services, a special type of personalized telecom services, as a possible solution for all three of these challenges. A proof-of-concept service, called Agent-Based Mobile Content Brokerage, is presented and elaborated with the aim to demonstrate a shift towards consumer-managed relationships, a novel provisioning paradigm within the telecom industry.

  13. Building and evaluating an informatics tool to facilitate analysis of a biomedical literature search service in an academic medical center library.

    Science.gov (United States)

    Hinton, Elizabeth G; Oelschlegel, Sandra; Vaughn, Cynthia J; Lindsay, J Michael; Hurst, Sachiko M; Earl, Martha

    2013-01-01

    This study utilizes an informatics tool to analyze a robust literature search service in an academic medical center library. Structured interviews with librarians were conducted focusing on the benefits of such a tool, expectations for performance, and visual layout preferences. The resulting application utilizes Microsoft SQL Server and .Net Framework 3.5 technologies, allowing for the use of a web interface. Customer tables and MeSH terms are included. The National Library of Medicine MeSH database and entry terms for each heading are incorporated, resulting in functionality similar to searching the MeSH database through PubMed. Data reports will facilitate analysis of the search service.

  14. Barriers and facilitators for implementing programmes and services to address hyperglycaemia in pregnancy in low and middle income countries: A systematic review.

    Science.gov (United States)

    Kragelund Nielsen, Karoline; Damm, Peter; Bygbjerg, Ib C; Kapur, Anil

    2018-04-21

    An estimated 87.6% of hyperglycaemia in pregnancy cases are in low and middle income countries (LMICs). The aim of this study is to review the evidence on barriers and facilitators to programmes and services addressing hyperglycaemia in pregnancy in LMICs. A systematic review and narrative synthesis was conducted based on searches in PubMed. A total of 23 qualitative and quantitative studies were included. Barriers and facilitators exist at the health system level, individual level and social and societal levels and are often interacting. At the health system level they relate to capacity in terms of human and material resources; availability of feasible and appropriate guidelines; organisational management and referral pathways. Individual level barriers and facilitators include knowledge; risk perception; illness beliefs; financial condition; work obligations; concerns for the baby and hardship associated with services. At the social and societal level important factors are: perceptions and norms related to women's roles, mobility and health; the knowledge and support of women's social network; and structural aspects. Numerous factors influence programmes and services addressing hyperglycaemia in pregnancy in LMICs. Thus, several components are needed to ensure detection, treatment and follow-up of women with hyperglycaemia in pregnancy. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Urology Group Compensation and Ancillary Service Models in an Era of Value-based Care.

    Science.gov (United States)

    Shore, Neal D; Jacoby, Dana

    2016-01-01

    Changes involving the health care economic landscape have affected physicians' workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non-physician- owned multispecialty enterprises, for both outpatient and inpatient services. The looming and dramatic shift from volume- to value-based health care compensation will assuredly affect urology group compensation arrangements and productivity formulae. For groups that can implement change rapidly, efficiently, and harmoniously, there will be opportunities to achieve the Triple Aim goals of the Patient Protection and Affordable Care Act, while maintaining a successful medical-financial practice. In summary, implementing new payment algorithms alongside comprehensive care coordination will assist urology groups in addressing the health economic cost and quality challenges that have been historically encountered with fee-for-service systems. Urology group leadership and stakeholders will need to adjust internal processes, methods of care coordination, cultural dependency, and organizational structures in order to create better systems of care and management. In response, ancillary services and patient throughput will need to evolve in order to adequately align quality measurement and reporting systems across provider footprints and patient populations.

  16. How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation

    NARCIS (Netherlands)

    Leemans, K.; Block, L.; van der Stichele, R.; Francke, A.L.; Deliens, L.; Cohen, J.

    2015-01-01

    Purpose: There is an increasing demand for the use of quality indicators in palliative care. With previous research about implementation in this field lacking, we aimed to evaluate the barriers to and facilitators of implementation. Methods: Three focus group interviews were organized with 21

  17. How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation.

    NARCIS (Netherlands)

    Leemans, K.; Block, L. van den; Stichele, R. Vander; Francke, A.L.; Deliens, L.; Cohen, J.

    2015-01-01

    Purpose: There is an increasing demand for the use of quality indicators in palliative care.With previous research about implementation in this field lacking, we aimed to evaluate the barriers to and facilitators of implementation. Methods: Three focus group interviews were organized with 21

  18. Improving Indigenous access to cancer screening and treatment services: descriptive findings and a preliminary report on the Midwest Indigenous Women’s Cancer Support Group

    Directory of Open Access Journals (Sweden)

    Lisabeth D Finn

    2008-01-01

    Full Text Available BackgroundHigher cancer morbidity and mortality rates for the Indigenous population comparedto the overall Australian population has underlined the critical need to improve accessfor Aboriginal people to cancer treatment services. This paper describes anIndigenous Women’s Cancer Support Group (IWCSG established to supportIndigenous people with cancer and their carers/relatives and to facilitate Aboriginalaccess to cancer screening and treatment. Preliminary findings from an evaluation ofthe group are presented.MethodsThe study employed qualitative research methods to describe IWCSG operations andinvestigate the group’s effectiveness. It included one-on-one interviews with 11Geraldton-based health service providers, the IWCSG coordinator, and 10 womenwho have been linked to IWCSG support, as well as observation of group meetings.ResultsDescriptive outcomes relate to group operations, group effectiveness, group benefitsand future development of the group. A cultural strength of IWCSG is its ability tooperate confidentially behind the scenes, providing emotional support and practicalhelp directly to Indigenous people concerned about privacy and shame issues. Theimportant cultural role IWCSG plays in overcoming communication and othercultural barriers to accessing cancer treatment was unanimously recognised by healthservice providers. Aboriginal women supported by IWCSG spoke about an increasedsense of safety, trust and support in accessing and navigating mainstream cancerservices. A critical issue emerging from the research is the need for further development of effective collaborative working relationships between IWCSGmembers and health service providers.ConclusionsThe IWCSG has the potential to inform an effective model for facilitating Indigenousaccess both to cancer treatment and to mainstream treatment for a variety of healthproblems. Future research is required to explore the applicability of Indigenoussupport groups and to focus on the

  19. Mental Health Facilitator (MHF) Service Implementation in Schools in Malawi, Africa: A Strategy for Increasing Community Human Resources

    Science.gov (United States)

    Luke, Melissa; Hinkle, J. Scott; Schweiger, Wendi; Henderson, Donna

    2016-01-01

    The Mental Health Facilitator (MHF) program utilizes a population-based curriculum and has been implemented in Malawi for the past seven years. This article reports findings from an ethnographic study that explored how 40 MHF stakeholders have experienced the MHF program. This transdisciplinary program is a 30-hour training in community mental…

  20. Impact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa.

    Science.gov (United States)

    Kompala, T; Moll, A P; Mtungwa, N; Brooks, R P; Friedland, G H; Shenoi, S V

    2016-08-11

    HIV testing, diagnosis and treatment programs have expanded globally, particularly in resource-limited settings. Diagnosis must be followed by determination of treatment eligibility and referral to care prior to initiation of antiretroviral treatment (ART). However, barriers and delays along these early steps in the treatment cascade may impede successful ART initiation. New strategies are needed to facilitate the treatment cascade. We evaluated the role of on site CD4+ T cell count phlebotomy services by nurses in facilitating pre-ART care in a community-based voluntary counseling and testing program (CBVCT) in rural South Africa. We retrospectively evaluated CBVCT services during five continuous time periods over three years: three periods when a nurse was present on site, and two periods when the nurse was absent. When a nurse was present, CD4 count phlebotomy was performed immediately after HIV testing to determine ART eligibility. When a nurse was absent, patients were referred to their local primary care clinic for CD4 testing. For each period, we determined the proportion of HIV-positive community members who completed CD4 testing, received notification of CD4 count results, as well as the time to test completion and result notification. Between 2010 and 2013, 7213 individuals accessed CBVCT services; of these, 620 (8.6 %) individuals were HIV-positive, 205 (33.1 %) were eligible for ART according to South African national CD4 count criteria, and 78 (38.0 % of those eligible) initiated ART. During the periods when a professional nurse was available to provide CD4 phlebotomy services, HIV-positive clients were significantly more likely to complete CD4 testing than during periods when these services were not available (85.5 % vs. 37.3 %, p ART care cascade and facilitate timely entry into HIV care.

  1. Issues in educating health professionals to meet the diverse needs of patients and other service users from ethnic minority groups.

    Science.gov (United States)

    Chevannes, Mel

    2002-08-01

    The main aim of the study was to undertake training needs analysis among a multi-professional group for the purpose of improving care for ethnic minority patients and other service users. Evidence from the literature identifies that some of the explanations advanced for the failure of health professionals to meet the needs of ethnic minorities include lack of understanding of cultural diversities, racism, racial stereotyping, lack of knowledge, exclusivity, and ethnocentrism. While these issues have been addressed in different countries, little work has been carried out to examine these from the perspective of health professionals caring for ethnic minorities. This study is therefore an attempt to find out what health professionals know about caring for patients and other service users from minority ethnic groups and their perception of training needs in this area of work. A pre- and post-training design phase structured the qualitative approach. A purposive sample of individuals working across five health service organizations located in a multi-racial city yielded a multi-professional group of participants. Views of 22 participants were obtained by semi-structured interviews at a pretraining phase. Training needs of health professionals drew on Walklin's (1992) six stages used to structure data collection, data analysis and delivery of training. The post-training phase used questionnaires to evaluate immediate learning that based on a 4-week period of reflection and applied to practice. The questionnaires were complemented by a facilitator-lead focus group. The majority of the participants confirmed that no attention was given in their initial education to the health care needs of minority ethnic groups. Instead, participants engaged in self-initiated learning to improve their knowledge and understanding. The issue of communication was viewed with dissatisfaction and seen as affecting the sufficiency of caring for these patients. All participants rated meeting

  2. A discrete single server queue with Markovian arrivals and phase type group services

    Directory of Open Access Journals (Sweden)

    Attahiru Sule Alfa

    1995-01-01

    Full Text Available We consider a single-server discrete queueing system in which arrivals occur according to a Markovian arrival process. Service is provided in groups of size no more than M customers. The service times are assumed to follow a discrete phase type distribution, whose representation may depend on the group size. Under a probabilistic service rule, which depends on the number of customers waiting in the queue, this system is studied as a Markov process. This type of queueing system is encountered in the operations of an automatic storage retrieval system. The steady-state probability vector is shown to be of (modified matrix-geometric type. Efficient algorithmic procedures for the computation of the rate matrix, steady-state probability vector, and some important system performance measures are developed. The steady-state waiting time distribution is derived explicitly. Some numerical examples are presented.

  3. 78 FR 70579 - Deluxe Laboratories, Inc., a Division of Deluxe Entertainment Services Group, Inc. Hollywood...

    Science.gov (United States)

    2013-11-26

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-82,442] Deluxe Laboratories, Inc., a Division of Deluxe Entertainment Services Group, Inc. Hollywood, California; Notice of Revised Determination on Reconsideration On July 23, 2013, the Department of Labor (Department) issued a Notice of Affirmative Determination Regarding...

  4. Foster Youth Evaluate the Performance of Group Home Services in California

    Science.gov (United States)

    Green, Rex S.; Ellis, Peter T.

    2008-01-01

    In 2003 foster youth employed by a foster youth advocacy organization suggested that an evaluation of group home services to foster youth be conducted in Alameda County, California. This report presents the development and conduct of this evaluation study; how funding was obtained; and how foster youth were hired, trained, and employed to produce…

  5. 75 FR 26945 - International Education Programs Service-Fulbright-Hays Group Projects Abroad Program

    Science.gov (United States)

    2010-05-13

    .... Schools and/or departments of education have a role to play in creating greater exposure since they are... DEPARTMENT OF EDUCATION International Education Programs Service--Fulbright-Hays Group Projects... Postsecondary Education, Department of Education. ACTION: Notice of proposed priorities. SUMMARY: The Assistant...

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

    Science.gov (United States)

    Ross, Andrew L.

    2007-01-01

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

  7. 77 FR 22622 - AP Henderson Group, BPO Management Services, Inc., Capital Mineral Investors, Inc...

    Science.gov (United States)

    2012-04-16

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] AP Henderson Group, BPO Management Services, Inc., Capital Mineral Investors, Inc., CardioVascular BioTherapeutics, Inc., and 1st Centennial... that there is a lack of current and accurate information concerning the securities of 1st Centennial...

  8. Massage therapy services for healthcare: a telephone focus group study of drivers for clients' continued use of services.

    Science.gov (United States)

    Smith, Joanna M; Sullivan, S John; Baxter, G David

    2009-01-01

    To explore opinions of why clients use, value and continue to seek massage therapy as a healthcare option. Telephone focus group methodology was used. Current and repeat users (n = 19) of either relaxation, remedial or sports massage therapy services participated in three telephone focus groups. Audiotaped semi-structured interviews were conducted. Telephone focus group with massage clients from provincial and urban localities in New Zealand. Summary of reported themes of the massage experience and suggested drivers for return to, or continuing with massage therapy. Data were transcribed, categorised (NVivo7) and thematically analysed using the general inductive approach. Key drivers for return to, or continuing with, massage therapy were: positive outcomes, expectations of goals being met, a regular appointment and the massage therapy culture. Massage therapy is perceived and valued as a personalised, holistic and hands-on approach to health management, which focuses on enhancing relaxation in conjunction with effective touch, within a positive client-therapist relationship and a pleasant non-rushed environment. Massage therapy as a health service is result and client driven but is reinforced by the culture of the experience.

  9. Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands

    NARCIS (Netherlands)

    Sijpkens, M.K. (Meertien K.); E.A.P. Steegers (Eric); Rosman, A.N. (Ageeth N.)

    2016-01-01

    textabstractObjectives Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in

  10. ClimateQUAL® and Thinklets: Using ClimateQUAL® with Group Support Systems to Facilitate Discussion and Set Priorities for Organizational Change at Criss Library

    Directory of Open Access Journals (Sweden)

    Nora Hillyer

    2013-06-01

    Full Text Available Objective – This article discusses a series of actions taken by the Criss Library at the University of Nebraska at Omaha to implement organizational change, using the ClimateQUAL® survey and facilitated discussions with ThinkTank™ group decision software. The library had experienced significant changes over a five-year period, with a renovation of the facility and three reorganizations resulting in a 50% staff turnover. Recognizing the strain that years of construction and personnel changes had placed on the organization, there was a desire to uncover the mood of the employees and reveal the issues behind low morale, uneasiness, and fear.Methods – In November 2009, the library conducted a ClimateQUAL® survey to develop a baseline to assess the effectiveness of any changes. After the results were distributed to library faculty and staff, a series of two-hour facilitated discussions was held to gather opinions and ideas for solutions using thinkLets, a pattern language for reasoning toward a goal. The group support system ThinkTank™ software was loaded onto computers, and employees were able to add their ideas anonymously during the sessions. Finally, 12 employees (29% completed a four-question survey on their perceptions of the facilitated discussions.Results – The facilitated discussions returned 76 sub-themes in 12 categories: staffing and scheduling issues, staff unity/teamwork, communication, goodwill/morale, accountability, decision-making, policy issues, skills and training, leadership, ergonomics/physical work environment, respect, and bullying. An advisory team culled the 76 sub-themes into 40 improvement strategies. Five were implemented immediately, and the remaining 35 were scheduled to be presented to the faculty and staff via an online survey. Participants’ perceptions of the facilitated discussions were mixed. Eighty-three percent of respondents reported that they did not feel safe speaking out about issues, most

  11. fMRI correlates of object-based attentional facilitation versus suppression of irrelevant stimuli, dependent on global grouping and endogenous cueing.

    Directory of Open Access Journals (Sweden)

    Elliot D Freeman

    2014-02-01

    Full Text Available Theories of object-based attention often make two assumptions: that attentional resources are facilitatory, and that they spread automatically within grouped objects. Consistent with this, ignored visual stimuli can be easier to process, or more distracting, when perceptually grouped with an attended target stimulus. But in past studies, the ignored stimuli often shared potentially relevant features or locations with the target. In this fMRI study, we measured the effects of attention and grouping on Blood Oxygenation Level Dependent (BOLD responses in the human brain to entirely task-irrelevant events.Two checkerboards were displayed each in opposite hemifields, while participants responded to check-size changes in one pre-cued hemifield, which varied between blocks. Grouping (or segmentation between hemifields was manipulated between blocks, using common (versus distinct motion cues. Task-irrelevant transient events were introduced by randomly changing the colour of either checkerboard, attended or ignored, at unpredictable intervals. The above assumptions predict heightened BOLD signals for irrelevant events in attended versus ignored hemifields for ungrouped contexts, but less such attentional modulation under grouping, due to automatic spreading of facilitation across hemifields. We found the opposite pattern, in primary visual cortex. For ungrouped stimuli, BOLD signals associated with task-irrelevant changes were lower, not higher, in the attended versus ignored hemifield; furthermore, attentional modulation was not reduced but actually inverted under grouping, with higher signals for events in the attended versus ignored hemifield.

  12. Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors.

    Science.gov (United States)

    Greenwood, Nan; Holley, Jess; Ellmers, Theresa; Mein, Gill; Cloud, Geoffrey

    2016-01-29

    Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers' part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Technical Note: Harmonizing met-ocean model data via standard web services within small research groups

    Science.gov (United States)

    Signell, Richard; Camossi, E.

    2016-01-01

    Work over the last decade has resulted in standardised web services and tools that can significantly improve the efficiency and effectiveness of working with meteorological and ocean model data. While many operational modelling centres have enabled query and access to data via common web services, most small research groups have not. The penetration of this approach into the research community, where IT resources are limited, can be dramatically improved by (1) making it simple for providers to enable web service access to existing output files; (2) using free technologies that are easy to deploy and configure; and (3) providing standardised, service-based tools that work in existing research environments. We present a simple, local brokering approach that lets modellers continue to use their existing files and tools, while serving virtual data sets that can be used with standardised tools. The goal of this paper is to convince modellers that a standardised framework is not only useful but can be implemented with modest effort using free software components. We use NetCDF Markup language for data aggregation and standardisation, the THREDDS Data Server for data delivery, pycsw for data search, NCTOOLBOX (MATLAB®) and Iris (Python) for data access, and Open Geospatial Consortium Web Map Service for data preview. We illustrate the effectiveness of this approach with two use cases involving small research modelling groups at NATO and USGS.

  14. Stakeholders' perspectives on facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea: a qualitative study.

    Science.gov (United States)

    Chol, Chol; Hunter, Cynthia; Debru, Berhane; Haile, Berhana; Negin, Joel; Cumming, Robert G

    2018-01-19

    Wars affect maternal health services by destroying health systems. Eritrea experienced two wars with neighbouring Ethiopia. Despite this, the maternal mortality ratio (MMR) in Eritrea fell by 69% from 1590 per 100,000 live births in 1990 to 501 in 2015. This study aimed to examine facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea. Using in-depth interviews and field observations for data collection, this qualitative study was conducted in five healthcare facilities in Asmara, the capital of Eritrea, in February and March 2016. The participants were: women (n = 40), husbands (n = 5), healthcare providers (n = 10), and decision makers (n = 5). There were two perceived facilitators of utilisation of and access to maternal health services: health education (related to the WHO health service delivery building blocks) and improvement in gender equality driven by the role played by Eritrean women as combatants during the War of Independence (1961-1991). The only perceived barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and shortage of healthcare workers (related to the WHO health workforce building block). This study assessed women and their husbands/partners' perceptions and the possible effects of contemporary Eritrean culture and the history of war on the utilisation of and access to maternal health services in the country. As well, we examined healthcare providers' and decision makers' perspectives. The two key facilitators of women's utilisation of and access to maternal health services were health education and women's empowerment driven by their role as combatants during the War of Independence. One main barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and a shortage of healthcare workers. As only a limited number of qualitative studies have been published about maternal health services in war

  15. Barriers and facilitators to uptake of the school-based HPV vaccination programme in an ethnically diverse group of young women.

    Science.gov (United States)

    Batista Ferrer, Harriet; Trotter, Caroline L; Hickman, Matthew; Audrey, Suzanne

    2016-09-01

    To identify the barriers and facilitators to uptake of the HPV vaccine in an ethnically diverse group of young women in the south west of England. Three school-based vaccination sessions were observed. Twenty-three young women aged 12 to 13 years, and six key informants, were interviewed between October 2012 and July 2013. Data were analysed using thematic analysis and the Framework method for data management. The priority given to preventing cervical cancer in this age group influenced whether young women received the HPV vaccine. Access could be affected by differing levels of commitment by school staff, school nurses, parents and young women to ensure parental consent forms were returned. Beliefs and values, particularly relevant to minority ethnic groups, in relation to adolescent sexual activity may affect uptake. Literacy and language difficulties undermine informed consent and may prevent vaccination. The school-based HPV vaccination programme successfully reaches the majority of young women. However, responsibility for key aspects remain unresolved which can affect delivery and prevent uptake for some groups. A multi-faceted approach, targeting appropriate levels of the socio-ecological model, is required to address procedures for consent and cultural and literacy barriers faced by minority ethnic groups, increase uptake and reduce inequalities. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  16. Evaluation of Public E-Services and Information Technology Accessibility in Different Social Groups

    Directory of Open Access Journals (Sweden)

    Ramutė Naujikienė

    2012-12-01

    Full Text Available The purpose of this study is to develop an approach based on the social quality evaluation square model for evaluation of information technology usage in different social groups. Componential view to the accessibility of e-services including IT means providing the possibility to research the influences of different life conditions to usage of the public e-services. The task of this empirical study is directed towards revealing the differences of e-inclusion and e-services accessibility for social groups of citizens of Lithuania, and to compare this accessibility data with other EU countries.Design/methodology/approach—the approach is based on the square model of social quality evaluation of information technology usage in different social groups. The social division square model includes an assessment of quality according to the evaluation of socioeconomic security, social inclusion, social cohesion, and empowerment. Empowerment can be defined as consisting of individual or collective decisions to act on one’s own life.Findings—the results are demonstrated by the accessibility of public e-services data, which are evaluated by the quality of social group development according to IT applications. The hypothesis was confirmed that the e-government activities can be realized by properly selecting and installing technologies, and using technology facilities. E-services influence the capabilities of state officials to apply modern technology and increase the availability of e-services for social groups. Results consist of individual or collective decisions to act on one’s own life, to implementation of effective information technologies in the e-government activities and using of e-services. An important indicator is the implementation of e-services in the activity of citizens. It is submitted as the index of e-participation in dealing with the activities of citizens and the possibilities of authorities directly related with providing services

  17. Evaluation of Public E-Services and Information Technology Accessibility in Different Social Groups

    Directory of Open Access Journals (Sweden)

    Ramutė Naujikienė

    2013-02-01

    Full Text Available The purpose of this study is to develop an approach based on the social quality evaluation square model for evaluation of information technology usage in different social groups. Componential view to the accessibility of e-services including IT means providing the possibility to research the influences of different life conditions to usage of the public e-services. The task of this empirical study is directed towards revealing the differences of e-inclusion and e-services accessibility for social groups of citizens of Lithuania, and to compare this accessibility data with other EU countries. Design/methodology/approach—the approach is based on the square model of social quality evaluation of information technology usage in different social groups. The social division square model includes an assessment of quality according to the evaluation of socioeconomic security, social inclusion, social cohesion, and empowerment. Empowerment can be defined as consisting of individual or collective decisions to act on one’s own life. Findings—the results are demonstrated by the accessibility of public e-services data, which are evaluated by the quality of social group development according to IT applications. The hypothesis was confirmed that the e-government activities can be realized by properly selecting and installing technologies, and using technology facilities. E-services influence the capabilities of state officials to apply modern technology and increase the availability of e-services for social groups. Results consist of individual or collective decisions to act on one’s own life, to implementation of effective information technologies in the e-government activities and using of e-services. An important indicator is the implementation of e-services in the activity of citizens. It is submitted as the index of e-participation in dealing with the activities of citizens and the possibilities of authorities directly related with providing

  18. Simulating the service life performance of an inspected group of jacket-type structures

    DEFF Research Database (Denmark)

    Schneider, Ronald; Thöns, Sebastian; Rogge, Andreas

    2017-01-01

    and risk. We intend to adopt this approach to optimize inspection, monitoring and repair activities for offshore wind park support structures. As a first step, we simulate – in analogy to an offshore wind park – the service life performance of an inspected group of jacket-type frames. The performance......A novel method for risk-based optimization of inspection and repair strategies for deteriorating structural systems has recently been proposed. The method defines heuristics at the system level to reduce the number of possible strategies. For each defined strategy, it computes the updated system...... failure probability conditional on simulated inspection and repair histories, and evaluates the associated costs and risk. The expected total service life costs and risk for a strategy are finally determined using Monte Carlo simulation. The optimal strategy minimizes the expected total service life costs...

  19. A finite capacity queue with Markovian arrivals and two servers with group services

    Directory of Open Access Journals (Sweden)

    S. Chakravarthy

    1994-01-01

    Full Text Available In this paper we consider a finite capacity queuing system in which arrivals are governed by a Markovian arrival process. The system is attended by two exponential servers, who offer services in groups of varying sizes. The service rates may depend on the number of customers in service. Using Markov theory, we study this finite capacity queuing model in detail by obtaining numerically stable expressions for (a the steady-state queue length densities at arrivals and at arbitrary time points; (b the Laplace-Stieltjes transform of the stationary waiting time distribution of an admitted customer at points of arrivals. The stationary waiting time distribution is shown to be of phase type when the interarrival times are of phase type. Efficient algorithmic procedures for computing the steady-state queue length densities and other system performance measures are discussed. A conjecture on the nature of the mean waiting time is proposed. Some illustrative numerical examples are presented.

  20. Facilitating Fresh: State Laws Supporting School Gardens Are Associated With Use of Garden-Grown Produce in School Nutrition Services Programs.

    Science.gov (United States)

    Turner, Lindsey; Leider, Julien; Piekarz, Elizabeth; Schermbeck, Rebecca M; Merlo, Caitlin; Brener, Nancy; Chriqui, Jamie F

    2017-06-01

    To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs. Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens. Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program. Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals. State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law. State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

  1. Differential in Utilization of Maternal Care Services in Empowered Action Group States, India (1990-2006

    Directory of Open Access Journals (Sweden)

    Jeetendra Yadav

    2016-03-01

    Full Text Available Background: Low use of maternal care services is one of the reasons why child mortality and maternal mortality is still considerably high in India. Most maternal deaths are preventable if mothers receive essential health care before, during, and after childbirth. In India, the eight socioeconomically backward states referred to as the Empowered Action Group (EAG states; lag behind in the demographic transition and low utilization of maternal health care services. Addressing the maternity care needs of women may have considerable ramifications for achieving the Millennium Development Goal (MDG – 5.Aims & Objectives:  To explore the prevalence, trends and factors associated with the utilization of maternal care services in Empowered Action Group States, India (1990-2006.Material Methods: Data from three rounds of the round of the Demographic and Health Survey (DHS, known as the National Family Health Survey (NFHS of India were analyzed. Bivariate and multivariate-pooled logistic regression model were applied to examine the utilization of the maternal and child health care trends over time.Result: The results from analysis indicate that the full ANC and skilled birth attendant (SBA has increased from 17% and 20% to 25% and35% respectively during the last one and half decade (1990-2006.Conclusion: Various socioeconomic and demographic factors are associated with the utilization of maternal care services in EAG states, India. Promoting the use of family planning, female education, targeting vulnerable groups such as poor, illiterate, high parity women, involving media and grass root level workers and collaboration between community leaders and health care system could be some important policy level interventions to address the unmet need of maternal and child health care services among women. The study concludes that much of these differentials are social constructs that can be reduced by prioritizing the needs of the disadvantaged and adopting

  2. Differential in Utilization of Maternal Care Services in Empowered Action Group States, India (1990-2006

    Directory of Open Access Journals (Sweden)

    Jeetendra Yadav

    2016-03-01

    Full Text Available Background: Low use of maternal care services is one of the reasons why child mortality and maternal mortality is still considerably high in India. Most maternal deaths are preventable if mothers receive essential health care before, during, and after childbirth. In India, the eight socioeconomically backward states referred to as the Empowered Action Group (EAG states; lag behind in the demographic transition and low utilization of maternal health care services. Addressing the maternity care needs of women may have considerable ramifications for achieving the Millennium Development Goal (MDG – 5. Aims & Objectives:  To explore the prevalence, trends and factors associated with the utilization of maternal care services in Empowered Action Group States, India (1990-2006. Material Methods: Data from three rounds of the round of the Demographic and Health Survey (DHS, known as the National Family Health Survey (NFHS of India were analyzed. Bivariate and multivariate-pooled logistic regression model were applied to examine the utilization of the maternal and child health care trends over time. Result: The results from analysis indicate that the full ANC and skilled birth attendant (SBA has increased from 17% and 20% to 25% and35% respectively during the last one and half decade (1990-2006. Conclusion: Various socioeconomic and demographic factors are associated with the utilization of maternal care services in EAG states, India. Promoting the use of family planning, female education, targeting vulnerable groups such as poor, illiterate, high parity women, involving media and grass root level workers and collaboration between community leaders and health care system could be some important policy level interventions to address the unmet need of maternal and child health care services among women. The study concludes that much of these differentials are social constructs that can be reduced by prioritizing the needs of the disadvantaged and

  3. Interdisciplinary Service-Learning: Building Student Competencies through the Cross-Cultural Parent Groups Project

    Directory of Open Access Journals (Sweden)

    Michele Belliveau

    2011-03-01

    Full Text Available Changing demographics and an emphasis on competency-based social work education call for innovative approaches to the delivery of curricular content. In an effort to introduce BSW students to the socio-political issues facing the local Latino immigrant community, a service-learning project was developed in collaboration with the Spanish Language Department and a local middle school. An analysis of outcomes from social work student evaluations showed that students engaged with the community and issues in new and unexpected ways. Through their engagement in a cross-cultural group project, students developed greater cultural competency, honed their group practice skills in an unfamiliar context, provided a needed service to the community, and raised their awareness about the working conditions of new immigrants as part of a developing framework for social action. Details and implications of the project as a means to build student competencies are described.

  4. Feasibility of a Video-Based Advance Care Planning Website to Facilitate Group Visits among Diverse Adults from a Safety-Net Health System.

    Science.gov (United States)

    Zapata, Carly; Lum, Hillary D; Wistar, Emily; Horton, Claire; Sudore, Rebecca L

    2018-02-20

    Primary care providers in safety-net settings often do not have time to discuss advance care planning (ACP). Group visits (GV) may be an efficient means to provide ACP education. To assess the feasibility and impact of a video-based website to facilitate GVs to engage diverse adults in ACP. Feasibility pilot among patients who were ≥55 years of age from two primary care clinics in a Northern California safety-net setting. Participants attended two 90-minute GVs and viewed the five steps of the movie version of the PREPARE website ( www.prepareforyourcare.org ) concerning surrogates, values, and discussing wishes in video format. Two clinician facilitators were available to encourage participation. We assessed pre-to-post ACP knowledge, whether participants designated a surrogate or completed an advance directive (AD), and acceptability of GVs and PREPARE materials. We conducted two GVs with 22 participants. Mean age was 64 years (±7), 55% were women, 73% nonwhite, and 55% had limited literacy. Knowledge improved about surrogate designation (46% correct pre vs. 85% post, p = 0.01) and discussing decisions with others (59% vs. 90%, p = 0.01). Surrogate designation increased (48% vs. 85%, p = 0.01) and there was a trend toward AD completion (9% vs. 24%, p = 0.21). Participants rated the GVs and PREPARE materials a mean of 8 (±3.1) on a 10-point acceptability scale. Using the PREPARE movie to facilitate ACP GVs for diverse adults in safety net, primary care settings is feasible and shows potential for increasing ACP engagement.

  5. Internet Group Management Protocol for IPTV Services in Passive Optical Network

    Science.gov (United States)

    Lee, Eunjo; Park, Sungkwon

    We propose a new Internet group management protocol (IGMP) which can be used in passive optical network (PON) especially for IPTV services which dramatically reduces the channel change response time caused by traditional IGMP. In this paper, the newly proposed IGMP is introduced in detail and performance analysis is also included. Simulation results demonstrated the performance of the newly proposed IGMP, whereby, viewers can watch the shared IPTV channels without the channel change response time when channel request reaches a threshold.

  6. Evaluation of Cloud Services: A Fuzzy Multi-Criteria Group Decision Making Method

    Directory of Open Access Journals (Sweden)

    Santoso Wibowo

    2016-12-01

    Full Text Available This paper presents a fuzzy multi-criteria group decision making method for evaluating the performance of Cloud services in an uncertain environment. Intuitionistic fuzzy numbers are used to better model the subjectivity and imprecision in the performance evaluation process. An effective algorithm is developed based on the technique for order preference by similarity to the ideal solution and the Choquet integral operator for adequately solving the performance evaluation problem. An example is presented for demonstrating the applicability of the proposed method for solving the multi-criteria group decision making problem in real situations.

  7. The benefits of Outsourcing facility services when selecting right service provider for a hotel:Case Kämp Group Oy

    OpenAIRE

    Paudyal, Manoj; Acharya, Saroj

    2015-01-01

    This research paper examines about the outsourcing of facility services in the Kämp group of hotels. The scope of the study includes Facility Management, outsourcing facilities services, and the selection process of the service providers for a hotel. The research was carried at the hotels of Kämp group Oy in the Metropolitan Area of Helsinki. Facility management includes wide ranges of non-core functions such as Property management, real estates, design and technology. Activities such as secu...

  8. Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study

    Science.gov (United States)

    Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

    2017-01-01

    Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of

  9. Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

    Science.gov (United States)

    Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

    2017-06-22

    Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public

  10. Wellness works: community service health promotion groups led by occupational therapy students.

    Science.gov (United States)

    Scott, A H

    1999-01-01

    In the context of a group process course, occupational therapy students learned health promotion skills through working on personal wellness goals and leading community-based health promotion groups. The groups targeted topics such as smoking cessation, improving diet, reducing stress through yoga, meditation, tai chi chuan, ROM (Range of Motion) Dance, aerobics, and a variety of other activities. After identifying a personal wellness goal and developing it in a Wellness Awareness Learning Contract, each student used a Goal Attainment Scale (GAS) to predict an expected outcome for achieving the goal and to measure his or her progress toward attaining the goal. Students also used the GAS to measure progress in attaining group leadership skills within the community groups, which they outlined in a separate Group Skills Contract. Students kept weekly logs to foster reflective thinking, and the logs were used for interactive dialogue with the instructor. To further evaluate lifestyle change, students compared pretest and posttest scores on a Self-Assessment Scorecard, which surveyed six areas of health and human potential in body, mind, and spirit. Students monitored their own change process on both their personal health lifestyle goals and their group leadership skills while developing a richer appreciation of the dynamics of working for change with clients in community and traditional settings. Differences on the Self-Assessment Scorecard indicated improvement on two of the six scales for physical health and choices. Students experienced firsthand the challenges of developing healthier lifestyles on the basis of their personal goals as well as through fostering group changes. The two GAS learning contracts provided them with concrete evidence of their growth and learning. This experience--embedded in the context of a group process course with a community service learning group practicum--provided most students with a positive initial experience with group leadership

  11. Barriers and facilitators to the integration of mental health services into primary health care: a systematic review protocol.

    Science.gov (United States)

    Wakida, Edith K; Akena, Dickens; Okello, Elialilia S; Kinengyere, Alison; Kamoga, Ronald; Mindra, Arnold; Obua, Celestino; Talib, Zohray M

    2017-08-25

    Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works. This review will use the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework approach to identify experiences of mental health integration into PHC; the findings will be reported using the "Best fit" framework synthesis. PubMed, EMBASE, PsycINFO, and Cochrane Central Register of Controlled trials (CENTRAL) will be searched including other sources like the WHO website and OpenGrey database. Assessment of bias and quality will be done at study level using two separate tools to check for the quality of evidence presented. Data synthesis will take on two synergistic approaches (qualitative and quantitative studies). Synthesizing evidence from countries across the globe will provide useful insights into the experiences of integrating mental health services into PHC and how the barriers and challenges have been handled. The findings will be useful to a wide array of stakeholders involved in the implementation of the mental health integration into PHC. The SPIDER framework has been chosen for this review because of its suitable application to qualitative and mixed methods research and will be used as a guide when selecting articles for inclusion. Data extracted will be synthesized using the "Best fit" framework because it has been used before and proved its suitability in producing new conceptual models for explaining decision-making and possible behaviors. Synthesizing evidence from countries across the globe

  12. Comparing group deliberation to other forms of preference aggregation in valuing ecosystem services

    Directory of Open Access Journals (Sweden)

    Mackenzie B. Murphy

    2017-12-01

    Full Text Available Deliberative methods for valuing ecosystem services are hypothesized to yield group preferences that differ systematically from those that would be obtained through calculative aggregation of the preferences of participating individuals. We tested this hypothesis by comparing the group consensus results of structured deliberations against a variety of aggregation methods applied to individual participant preferences that were elicited both before and after the deliberations. Participants were also asked about their perceptions of the deliberative process, which we used to assess their ability to detect preference changes and identify the causes of any changes. For five of the seven groups tested, the group consensus results could not have been predicted from individual predeliberation preferences using any of the aggregation rules. However, individual postdeliberation preferences could be used to reconstruct the group preferences using consensual and rank-based aggregation rules. These results imply that the preferences of participants changed over the course of the deliberation and that the group preferences reflected a broad consensus on overall rankings rather than simply the pairwise preferences of the majority. Changes in individual preferences seem to have gone largely unnoticed by participants, as most stated that they did not believe their preferences had substantially changed. Most participants were satisfied with the outcome of the deliberation, and their degree of satisfaction was correlated with the feeling that their opinion was heard and that they had an influence on the outcome. Based on our results, group deliberation shows promise as a means of generating ecosystem service valuations that reflect a consensus opinion rather than simply a collection of personal preferences.

  13. Facilitators and barriers to implementation of the AIDES initiative, a social innovation for participative assessment of children in need and for coordination of services.

    Science.gov (United States)

    Dufour, Sarah; Lessard, Danielle; Chamberland, Claire

    2014-12-01

    As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. [Priorization of facilitators for the implementation of medication review with follow-up service in Spanish community pharmacies through exploratory factor analysis].

    Science.gov (United States)

    Gil, Modesta Inmaculada; Benrimoj, Shalom Isaac; Martínez-Martínez, Fernando; Cardero, Manuel; Gastelurrutia, Miguel Ángel

    2013-01-01

    to prioritize previously identified in Spain facilitators for the implementation of new Pharmaceutical Services that allow designing strategies for the implementation of Medication Review with follow-up (MRFup) service. Exploratory factor analysis (EFA). A draft of a questionnaire was performed based on a previous literature review and following the RAND/UCLA methodology. An expert panel worked with it and generated a definitive questionnaire which, after piloting, was used with a representative sample of pharmacists, owners or staff members, who were working in community pharmacy, using computer-assisted telephone interviewing (CATI) methodology. To understand underlying constructs in the questionnaire an EFA was performed. Different approaches were tested such as principal components factor analysis and principal axis factoring method. The best interpretability was achieved using the Factorization of Principal axis method with Direct Oblimin rotation, which explained the 40.0% of total variance. This produced four factors defined as: «Incentives», «External campaigns», «Expert in MRFup» and «Professionalism of the pharmacist». It can be stated that for implementation and sustainability of MRFup Service it is necessary being paid; also it must be explained to health professional and society in general. Practice of MRFup service demands pharmacists receiving a more clinical education and assuming more responsibilities as health professionals. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. Globus Nexus: A Platform-as-a-Service Provider of Research Identity, Profile, and Group Management.

    Science.gov (United States)

    Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

    2016-03-01

    Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

  16. Globus Nexus: A Platform-as-a-Service provider of research identity, profile, and group management

    Energy Technology Data Exchange (ETDEWEB)

    Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

    2016-03-01

    Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

  17. Easing reintegration: telephone support groups for spouses of returning Iraq and Afghanistan service members.

    Science.gov (United States)

    Nichols, Linda Olivia; Martindale-Adams, Jennifer; Graney, Marshall J; Zuber, Jeffrey; Burns, Robert

    2013-01-01

    Spouses of returning Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) military service members report increased depression and anxiety post deployment as they work to reintegrate the family and service member. Reconnecting the family, renegotiating roles that have shifted, reestablishing communication patterns, and dealing with mental health concerns are all tasks that spouses must undertake as part of reintegration. We tested telephone support groups focusing on helping spouses with these basic reintegration tasks. Year-long telephone support groups focused on education, skills building (communication skills, problem solving training, cognitive behavioral techniques, stress management), and support. Spouse depression and anxiety were decreased and perceived social support was increased during the course of the study. In subgroup analyses, spouses with husbands whose injuries caused care difficulties had a positive response to the intervention. However, they were more likely to be depressed, be anxious, and have less social support compared to participants who had husbands who had no injury or whose injury did not cause care difficulty. Study findings suggest that this well-established, high-access intervention can help improve quality of life for military spouses who are struggling with reintegration of the service member and family.

  18. 78 FR 53194 - Advisory Group to the Internal Revenue Service Tax Exempt and Government Entities Division (TE/GE...

    Science.gov (United States)

    2013-08-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Advisory Group to the Internal Revenue Service Tax Exempt and Government Entities Division (TE/GE); Meeting AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice. SUMMARY: The Advisory Committee on Tax Exempt and Government Entities (ACT) will...

  19. Several Factors of Library Publishing Services Facilitate Scholarly Communication Functions. A Review of: Park, J.-H., & Shim, J. (2011. Exploring how library publishing services facilitate scholarly communication. Journal of Scholarly Publishing, 43(1, 76-89. doi: 10.1353/scp.2011.0038

    Directory of Open Access Journals (Sweden)

    Leslie Bussert

    2012-12-01

    Full Text Available Objective – To identify and examine thefactors of library publishing services thatfacilitate scholarly communication.Design – Analysis of library publishing serviceprograms.Setting – North American research libraries.Subjects – Eight research libraries selectedfrom the signatories for the Compact for Open-Access Publishing Equity (COPE CornellUniversity Library’s Center for InnovativePublishing; Dartmouth College Library’sDigital Publishing Program and ScholarsPortal Project; MIT Libraries’ Office ofScholarly Publishing and Licensing; ColumbiaUniversity Libraries’ Center for DigitalResearch and Scholarship; University ofMichigan Library’s Scholarly PublishingOffice; Duke University Library’s Office ofScholarly Communications; University ofCalgary Libraries and Cultural Resources’Centre for Scholarly Communication; andSimon Fraser University Library’s ScholarlyPublishing.Methods – The authors used Roosendaal andGeurt’s (1997 four functions of scholarlycommunication to analyze and categorizelibrary publishing services provided bylibraries included in the study. The fourfunctions of scholarly communication includeregistration, certification, awareness, andarchiving.Main Results – Analysis of the registration functions provided by library publishing services in this study revealed three types of facilitating factors: intellectual property, licensing, and publishing. These include services such as repositories for digital scholarly work and research, ISBN/ISSN registration, and digital publishing. Analysis of archiving functions demonstrated that most programs in the study focus on repository-related services in support of digital content preservation of papers, datasets, technical reports, etc. Analysis of certification functions provided by these services exposed a focus on expert review and research support. These include services like professional assessment of information sources, consultation on appropriate

  20. A Lightweight Web of Things Open Platform to Facilitate Context Data Management and Personalized Healthcare Services Creation

    Directory of Open Access Journals (Sweden)

    Iván Corredor

    2014-04-01

    Full Text Available In the last few years, many health monitoring systems have been designed to fullfil the needs of a large range of scenarios. Although many of those systems provide good ad hoc solutions, most of them lack of mechanisms that allow them to be easily reused. This paper is focused on describing an open platform, the micro Web of Things Open Platform (µWoTOP, which has been conceived to improve the connectivity and reusability of context data to deliver different kinds of health, wellness and ambient home care services. µWoTOP is based on a resource-oriented architecture which may be embedded in mobile and resource constrained devices enabling access to biometric, ambient or activity sensors and actuator resources through uniform interfaces defined according to a RESTful fashion. Additionally, µWoTOP manages two communication modes which allow delivering user context information according to different methods, depending on the requirements of the consumer application. It also generates alert messages based on standards related to health care and risk management, such as the Common Alerting Protocol, in order to make its outputs compatible with existing systems.

  1. How do occupational rehabilitation clinicians approach participants on long-term sick leave in order to facilitate return to work? A focus group study

    Directory of Open Access Journals (Sweden)

    M. Eftedal

    2017-11-01

    Full Text Available Abstract Background The objective of this study was to explore occupational rehabilitation clinicians’ experiences on how to approach their participants on long-term sick leave in order to facilitate return to work (RTW. Methods An exploratory qualitative design was used. Four focus groups were conducted with 29 clinicians working on interdisciplinary inpatient and outpatient occupational rehabilitation teams in Norway. The clinicians shared narratives from clinical practice. Transcripts were analysed, and results were reported by use of systematic text condensation. Results The clinicians used several approaches to facilitate RTW among individuals on sick leave. Three themes emerged as especially important in order to succeed: 1 To get a basic understanding of the participant’s life-world through a mapping process; 2 To build a therapeutic alliance through communication characterised by sensitivity to the participants’ needs and emotional concerns; and 3 To initiate processes of change that increase the possibilities for RTW. Four main areas targetable for change were identified, three directed at the individual and one encompassing the participants’ surroundings. These approaches were: a To increase feelings of confidence and coping; b To increase the participants’ awareness of their own limits; c To challenge inefficient and negative attitudes and thoughts related to the sick-role; and d Close and immediate dialogue with key stakeholders. Conclusions To increase the possibilities for RTW among individuals on long-term sick leave, a thorough mapping process and the construction of a therapeutic alliance are seen as crucial elements in approaches by occupational rehabilitation clinicians. By gaining the participants’ trust and identifying their barriers and possibilities for work, the clinicians can target modifiable factors, especially at the individual level, and obstacles for RTW in their individual surroundings. This study

  2. Effects of compensation methods and physician group structure on physicians' perceived incentives to alter services to patients.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Landon, Bruce E

    2006-08-01

    To examine how health plan payment, group ownership, compensation methods, and other practice management tools affect physician perceptions of whether their overall financial incentives tilt toward increasing or decreasing services to patients. Nationally representative data on physicians are from the 2000-2001 Community Tracking Study Physician Survey (N=12,406). Ordered and multinomial logistic regression were used to explore how physician, group, and market characteristics are associated with physician reports of whether overall financial incentives are to increase services, decrease services, or neither. Seven percent of physicians report financial incentives are to reduce services to patients, whereas 23 percent report incentives to increase services. Reported incentives to reduce services were associated with reports of lower ability to provide quality care. Group revenue in the form of capitation was associated with incentives to reduce services whereas practice ownership and variable compensation and bonuses for employee physicians were mostly associated with incentives to increase services to patients. Full ownership of groups, productivity incentives, and perceived competitive markets for patients were associated with incentives to both increase and reduce services. Practice ownership and the ways physicians are compensated affect their perceived incentives to increase or decrease services to patients. In the latter case, this adversely affects perceived quality of care and satisfaction, although incentives to increase services may also have adverse implications for quality, cost, and insurance coverage.

  3. Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users

    OpenAIRE

    Fancourt, Daisy; Perkins, Rosie; Ascenso, Sara; Carvalho, Livia A.; Steptoe, Andrew; Williamon, Aaron

    2016-01-01

    Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location.) Significant improvements ...

  4. Development of Quality Management System Under ISO 9001:2015 and Joint Inspection Group (JIG for Aviation Fuelling Service

    Directory of Open Access Journals (Sweden)

    Ruamchat Kanon

    2017-09-01

    Full Text Available The Joint Inspection Group (JIG standard for aviation fuel quality management assists in the operational process and maintenance of aviation fuel from its point of origin and through distribution systems to airports. Currently, problems arise as the JIG standard and quality management in aviation fuel are isolated and have independent procedures. Merging the JIG standards with ISO 9001:2015 can override original JIG’s philosophy by connecting all quality assessment, and management parties involved, throughout the supply chain. This integration can harmonize auditing tasks, focusing on risk/opportunity, and continue quality improvement focus. This paper proposes a development of quality management system (QMS under ISO 9001:2015 for aviation fuelling service in a systematic way. The content and critical success factors of ISO 9001:2015 and JIG standards were studied. The beneficial synergies, similarities, and logical linkages between both standards are identified. This QMS was developed in the largest petroleum company in Thailand and 60 selected experts were surveyed, with a response rate of 88.3%, for their agreement on integrated criteria. Two external quality auditors, who have ISO 9001 and JIG expertise, were interviewed to modify our initial proposed QMS. The final QMS was implemented in the into-plane fuelling services as the first phase of this implementation. Results of framework implementation are discussed in a case study. There are mutual benefits resulting from the integration of JIG and ISO 9001:2015 standards. This QMS provides a unified process for quality management practices, and enhances the effectiveness of risk evaluation as well as the opportunity for continued quality improvement. It facilitates the identification of ISO 9001:2015 requirements and establishes relationships between the roles of JIG standard and the clauses of ISO 9001:2015. The first experience from five airports as the pilot study of proposed QMS

  5. How does a servant leader fuel the service fire? A multilevel model of servant leadership, individual self identity, group competition climate, and customer service performance.

    Science.gov (United States)

    Chen, Zhijun; Zhu, Jing; Zhou, Mingjian

    2015-03-01

    Building on a social identity framework, our cross-level process model explains how a manager's servant leadership affects frontline employees' service performance, measured as service quality, customer-focused citizenship behavior, and customer-oriented prosocial behavior. Among a sample of 238 hairstylists in 30 salons and 470 of their customers, we found that hair stylists' self-identity embedded in the group, namely, self-efficacy and group identification, partially mediated the positive effect of salon managers' servant leadership on stylists' service performance as rated by the customers, after taking into account the positive influence of transformational leadership. Moreover, group competition climate strengthened the positive relationship between self-efficacy and service performance. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  6. TEACHER TRAINING IN COMMUNITIES OF PRACTICE: THE CASE OF A GROUP OF PRE-SERVICE CHEMISTRY TEACHERS

    OpenAIRE

    Santos, Valéria C.; Arroio, Agnaldo

    2015-01-01

    This work deals with communities of practice and their contribution to pre-service teacher training. A group of eight pre-service chemistry teachers was accompanied during their participation in the PIBID program. Based on their interaction in planning teaching activities, the group was characterized as a community of practice. For this characterization the three dimensions of communities of practice were observed: mutual engagement, joint enterprise and shared repertoire. The results showed ...

  7. Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City.

    Science.gov (United States)

    Boyce, Sabrina; Barrington, Clare; Bolaños, Herbert; Arandi, Cesar Galindo; Paz-Bailey, Gabriela

    2012-01-01

    The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services. In-depth, semi-structured interviews were conducted with 29 purposively sampled individuals, including 8 transgender, 16 gay/bisexual and 5 heterosexual-identifying participants. Topical codes were applied to the data using software Atlas.ti™ to compare data between sub-groups. Analysis revealed that public clinics were most commonly used due to their lower cost and greater accessibility, but many participants experienced discrimination, violation of confidentiality and distrust of these services. Transgender and gay/bisexual-identifying participants preferred clinics where they felt a sense of belonging, while heterosexual-identifying participants preferred clinics unassociated with the men who have sex with men community. The most prominent barriers to sexual health services included fear of discrimination, fear of having HIV, cost and lack of social support. Findings highlight the need to strengthen existing public sexually transmitted infection clinics so that they address the multiple layers of stigma and discrimination that men who have sex with men and transgender persons experience.

  8. A group arrival retrial G - queue with multi optional stages of service, orbital search and server breakdown

    Science.gov (United States)

    Radha, J.; Indhira, K.; Chandrasekaran, V. M.

    2017-11-01

    A group arrival feedback retrial queue with k optional stages of service and orbital search policy is studied. Any arriving group of customer finds the server free, one from the group enters into the first stage of service and the rest of the group join into the orbit. After completion of the i th stage of service, the customer under service may have the option to choose (i+1)th stage of service with θi probability, with pI probability may join into orbit as feedback customer or may leave the system with {q}i=≤ft\\{\\begin{array}{l}1-{p}i-{θ }i,i=1,2,\\cdots k-1\\ 1-{p}i,i=k\\end{array}\\right\\} probability. Busy server may get to breakdown due to the arrival of negative customers and the service channel will fail for a short interval of time. At the completion of service or repair, the server searches for the customer in the orbit (if any) with probability α or remains idle with probability 1-α. By using the supplementary variable method, steady state probability generating function for system size, some system performance measures are discussed.

  9. The "take a nurse to lunch" program. A unique focus group improves and promotes food services.

    Science.gov (United States)

    1998-10-01

    Dan Booth is the director of hospitality services for MaineGeneral Health. For this 450-bed health care organization, he directs six departments, which include environmental services, food and nutrition, security, laundry services, telecommunications, and transportation. In this article he describes how his Take a Nurse to Lunch program operates, what its benefits are, and how it was implemented.

  10. Predicting User Acceptance and Continuance Behaviour Towards Location-based Services: The Moderating Effect of Facilitating Conditions on Behavioural Intention and Actual Use

    Directory of Open Access Journals (Sweden)

    Mohamamd Alamgir Hossain

    2017-06-01

    Full Text Available The purpose of this study is to establish and examine the significance of a consumer acceptance and continuance model for location-based services (LBSs through the integration of perceived entertainment gratification (PEG and perceived application quality (PAQ with the technology acceptance model (TAM. By arguing that behavioural intention (BI does not automatically lead to actual use (AU, we investigated the moderating effect of facilitating conditions (FC on the relationship between BI and AU. A quantitative study was conducted in Australia and Bangladesh; data were obtained from multiple sources by systematic sampling of the distribution of questionnaires. For data analysis we applied the partial least square (PLS method. The results indicate that, in both Australia and Bangladesh, perceived usefulness (PU, PEG and PAQ have significant influence on user attitude (UA, which has a subsequent effect on BI. Interestingly, perceived ease of use (PEoU does not have a direct effect on UA but indirectly influences it through PU—confirming the mediating effect of PU. Further, FC has a moderating effect between BI and AU. The implications of these findings and directions for future research directions are also discussed.

  11. Apparatus for facilitating the servicing of inverted canned pump motors having limited access space and restricted access time especially in nuclear power plants

    International Nuclear Information System (INIS)

    Matusz, J.M.

    1991-01-01

    This patent describes a service apparatus for one or more inverted canned motor pumps installed above a floor and beneath a steam generator in a nuclear or fossil power plant with limited access space and limited access time at least in the case of nuclear power plants, each of the canned motor pumps having a pump casing and a depending motor having a flange secured to a pump casing flange by tensioned studs with tightened nuts. It comprises a maintenance cart having a height greater than the height of the motor beneath the motor flange and further having a generally U-shaped frame means with an open vertical side that permits the cart to be moved horizontally such that the cart frame means can be moved under the pump casing to surround the depending motor; actuator means supported by the cart frame means and having translating arm means engageable with support means on the motor; means for operating the translating arm means to support, raise and lower the motor; means supported by the frame means to support the motor flange prior to raising the motor to its installed position and after the motor has been released from its installed position and lowered to the cart; work platform means provided on the cart frame means at an elevation beneath the motor flange elevation; and roller means provided on the bottom of the cart frame means to facilitate horizontal cart movement along the floor

  12. Configuring the HYSPLIT Model for National Weather Service Forecast Office and Spaceflight Meteorology Group Applications

    Science.gov (United States)

    Dreher, Joseph; Blottman, Peter F.; Sharp, David W.; Hoeth, Brian; Van Speybroeck, Kurt

    2009-01-01

    The National Weather Service Forecast Office in Melbourne, FL (NWS MLB) is responsible for providing meteorological support to state and county emergency management agencies across East Central Florida in the event of incidents involving the significant release of harmful chemicals, radiation, and smoke from fires and/or toxic plumes into the atmosphere. NWS MLB uses the National Oceanic and Atmospheric Administration Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model to provide trajectory, concentration, and deposition guidance during such events. Accurate and timely guidance is critical for decision makers charged with protecting the health and well-being of populations at risk. Information that can describe the geographic extent of areas possibly affected by a hazardous release, as well as to indicate locations of primary concern, offer better opportunity for prompt and decisive action. In addition, forecasters at the NWS Spaceflight Meteorology Group (SMG) have expressed interest in using the HYSPLIT model to assist with Weather Flight Rules during Space Shuttle landing operations. In particular, SMG would provide low and mid-level HYSPLIT trajectory forecasts for cumulus clouds associated with smoke plumes, and high-level trajectory forecasts for thunderstorm anvils. Another potential benefit for both NWS MLB and SMG is using the HYSPLIT model concentration and deposition guidance in fog situations.

  13. Configuring the HYSPLIT Model for National Weather Service Forecast Office and Spaceflight Meteorology Group Applications

    Science.gov (United States)

    Dreher, Joseph G.

    2009-01-01

    For expedience in delivering dispersion guidance in the diversity of operational situations, National Weather Service Melbourne (MLB) and Spaceflight Meteorology Group (SMG) are becoming increasingly reliant on the PC-based version of the HYSPLIT model run through a graphical user interface (GUI). While the GUI offers unique advantages when compared to traditional methods, it is difficult for forecasters to run and manage in an operational environment. To alleviate the difficulty in providing scheduled real-time trajectory and concentration guidance, the Applied Meteorology Unit (AMU) configured a Linux version of the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) (HYSPLIT) model that ingests the National Centers for Environmental Prediction (NCEP) guidance, such as the North American Mesoscale (NAM) and the Rapid Update Cycle (RUC) models. The AMU configured the HYSPLIT system to automatically download the NCEP model products, convert the meteorological grids into HYSPLIT binary format, run the model from several pre-selected latitude/longitude sites, and post-process the data to create output graphics. In addition, the AMU configured several software programs to convert local Weather Research and Forecast (WRF) model output into HYSPLIT format.

  14. Comparing hospital staff and patient perceptions of customer service: a pilot study utilizing survey and focus group data.

    Science.gov (United States)

    Fottler, Myron D; Dickson, Duncan; Ford, Robert C; Bradley, Kenneth; Johnson, Lee

    2006-02-01

    The measurement of patient satisfaction is crucial to enhancing customer service and competitive advantage in the health-care industry. While there are numerous approaches to such measurement, this paper provides a case study which compares and contrasts patient and staff perceptions of customer service using both survey and focus group data. Results indicate that there is a high degree of correlation between staff and patient perceptions of customer service based on both survey and focus group data. However, the staff and patient subgroups also provided complementary information regarding patient perceptions of their service experience. Staff members tended to have more negative perceptions of service attributes than did the patients themselves. The focus group results provide complementary information to survey results in terms of greater detail and more managerially relevant information. While these results are derived from a pilot study, they suggest that diversification of data sources beyond patient surveys may enhance the utility of customer service information. If further research can affirm these findings, they create exciting possibilities for gathering valid, reliable and cost-effective customer service information.

  15. Nominal group technique-elicited barriers and facilitators to following the Dietary Guidelines for solid fats and added sugars in children: The HEALTH Study

    Science.gov (United States)

    The US population has a high intake of discretionary solid fats and added sugars (SoFAS) which currently exceeds federal dietary recommendations. The goal of this study was to identify barriers and facilitators to following the DGA. Thirty-eight 5th grade children across six Human Nutrition Resear...

  16. Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.

    Science.gov (United States)

    Goenka, N; Turner, B; Vora, J

    2011-12-01

    The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  17. Unit-level voluntary turnover rates and customer service quality: implications of group cohesiveness, newcomer concentration, and size.

    Science.gov (United States)

    Hausknecht, John P; Trevor, Charlie O; Howard, Michael J

    2009-07-01

    Despite substantial growth in the service industry and emerging work on turnover consequences, little research examines how unit-level turnover rates affect essential customer-related outcomes. The authors propose an operational disruption framework to explain why voluntary turnover impairs customers' service quality perceptions. On the basis of a sample of 75 work units and data from 5,631 employee surveys, 59,602 customer surveys, and organizational records, results indicate that unit-level voluntary turnover rates are negatively related to service quality perceptions. The authors also examine potential boundary conditions related to the disruption framework. Of 3 moderators studied (group cohesiveness, group size, and newcomer concentration), results show that turnover's negative effects on service quality are more pronounced in larger units and in those with a greater concentration of newcomers.

  18. Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

    Science.gov (United States)

    Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

    2012-01-01

    Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

  19. Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services.

    Science.gov (United States)

    Alleyne, Jo; Jumaa, Mansour Olawale

    2007-03-01

    The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and

  20. 42 CFR 418.56 - Condition of participation: Interdisciplinary group, care planning, and coordination of services.

    Science.gov (United States)

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE... level of understanding, involvement, and agreement with the plan of care, in accordance with the hospice... communication and integration, in accordance with the hospice's own policies and procedures, to— (1) Ensure that...

  1. Attitudes Toward Mental Health Services Among American Indians by Two Age Groups.

    Science.gov (United States)

    Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Yee-Melichar, Darlene; Talbot, Elizabeth P

    2015-11-01

    This study examined determinants of attitudes toward mental health services with a sample of American Indian younger-old-adults (aged 50-64, n = 158) and American Indian older-old adults (aged 65 and older, n = 69). Adapting Andersen's behavioral model of healthcare utilization, predisposing factors, mental health needs, and enabling factors were considered as potential predictors. Female and those with higher levels of social support tend to report more positive attitudes toward mental health services. Culture-influenced personal belief was associated with negative attitudes toward mental health services among American Indian younger-old -adults. Age and higher chronic medical conditions were significantly related to negative attitudes toward mental health services. Health insurance was positively associated with positive attitudes toward mental health services in the American Indian older-old adults. Findings indicate that practitioners should engage how culture, social support, and chronic conditions influence the response to mental health needs when working with older American Indians.

  2. Laboratory services series: a safety program for service groups in a national research and development laboratory (1965--1974)

    International Nuclear Information System (INIS)

    Winget, R.H.

    1975-11-01

    The experiences of a ten-year period of developing a safety program for craft and labor groups supporting a major laboratory are summarized with tabulations of types of injuries or accidents, improvements noted over the decade, and educational and safety recognition efforts

  3. Facilitators for practice change in Spanish community pharmacy.

    Science.gov (United States)

    Gastelurrutia, Miguel A; Benrimoj, S I Charlie; Castrillon, Carla C; de Amezua, María J Casado; Fernandez-Llimos, Fernando; Faus, Maria J

    2009-02-01

    To identify and prioritise facilitators for practice change in Spanish community pharmacy. Spanish community pharmacies. Qualitative study. Thirty-three semi-structured interviews were conducted with community pharmacists (n = 15) and pharmacy strategists (n = 18), and the results were examined using the content analysis method. In addition, two nominal groups (seven community pharmacists and seven strategists) were formed to identify and prioritise facilitators. Results of both techniques were then triangulated. Facilitators for practice change. Twelve facilitators were identified and grouped into four domains (D1: Pharmacist; D2: Pharmacy as an organisation; D3: Pharmaceutical profession; D4: Miscellaneous). Facilitators identified in D1 include: the need for more clinical education at both pre- and post-graduate levels; the need for clearer and unequivocal messages from professional leaders about the future of the professional practice; and the need for a change in pharmacists' attitudes. Facilitators in D2 are: the need to change the reimbursement system to accommodate cognitive service delivery as well as dispensing; and the need to change the front office of pharmacies. Facilitators identified in D3 are: the need for the Spanish National Professional Association to take a leadership role in the implementation of cognitive services; the need to reduce administrative workload; and the need for universities to reduce the gap between education and research. Other facilitators identified in this study include: the need to increase patients' demand for cognitive services at pharmacies; the need to improve pharmacist-physician relationships; the need for support from health care authorities; and the need for improved marketing of cognitive services and their benefits to society, including physicians and health care authorities. Twelve facilitators were identified. Strategists considered clinical education and pharmacists' attitude as the most important, and

  4. How can web-based training facilitate a more carer friendly practice in community-based health and social care services in Norway? Staff experiences and implementation challenges.

    Science.gov (United States)

    Hanssen, Helene; Norheim, Anne; Hanson, Elizabeth

    2017-03-01

    It is a central feature of current Norwegian health and social care policy to see informal carers as active partners. However, research has revealed that carers often experience a lack of recognition by professionals. In 2010, the Norwegian Directorate of Health initiated a web-based competence-building programme (CBP) for health and social care practitioners aimed at facilitating collaboration with carers. The programme comprised case presentations, e-lectures, exercises and topics for discussion, and was introduced in 2012. It was flexible and free of charge. This article is based on a study (2012-2013) that followed the piloting of this CBP in four settings. The study aimed to explore factors that influenced the implementation of the programme and whether or not using it affected health and social care practitioners' attitudes and perceived capacity for collaboration with carers. The study employed a mixed-methods design. A questionnaire was distributed to all staff before and 5 months after the CBP was introduced, followed by focus group interviews with a sample of staff members and individual interviews with the leadership in the involved settings and those who introduced the programme. The quantitative data were analysed using descriptive statistics, which subsequently formed the basis for the focus group interviews. The qualitative data were analysed by means of content analysis. The programme's introduction was similar across all research settings. Nevertheless, whether or not it was adopted depended to a large extent on leadership commitment and engagement. In settings where the programme's use was monitored, supported by management and formed part of on-the-job training, there seemed to be a positive impact on staff attitudes concerning collaboration with carers. Participant staff reported that their awareness of, motivation for and confidence in collaboration with carers were all strengthened. In contrast, the programme was of minimal benefit in

  5. Analysis of an MAP/PH/1 Queue with Flexible Group Service

    Directory of Open Access Journals (Sweden)

    Brugno Arianna

    2017-03-01

    Full Text Available A novel customer batch service discipline for a single server queue is introduced and analyzed. Service to customers is offered in batches of a certain size. If the number of customers in the system at the service completion moment is less than this size, the server does not start the next service until the number of customers in the system reaches this size or a random limitation of the idle time of the server expires, whichever occurs first. Customers arrive according to a Markovian arrival process. An individual customer’s service time has a phase-type distribution. The service time of a batch is defined as the maximum of the individual service times of the customers which form the batch. The dynamics of such a system are described by a multi-dimensional Markov chain. An ergodicity condition for this Markov chain is derived, a stationary probability distribution of the states is computed, and formulas for the main performance measures of the system are provided. The Laplace–Stieltjes transform of the waiting time is obtained. Results are numerically illustrated.

  6. Facilitating Transfers

    DEFF Research Database (Denmark)

    Kjær, Poul F.

    to specific logics of temporalisation and spatial expansion of a diverse set of social processes in relation to, for example, the economy, politics, science and the mass media. On this background, the paper will more concretely develop a conceptual framework for classifying different contextual orders...... that the essential functional and normative purpose of regulatory governance is to facilitate, stabilise and justify the transfer of condensed social components (such as economic capital and products, political decisions, legal judgements, religious beliefs and scientific knowledge) from one social contexts...

  7. 34 CFR 361.49 - Scope of vocational rehabilitation services for groups of individuals with disabilities.

    Science.gov (United States)

    2010-07-01

    ... seeking to employ individuals with disabilities. (5) In the case of any small business enterprise operated..., including enterprises established under the Randolph-Sheppard program, management services and supervision... and improve small business enterprises operated by individuals with significant disabilities...

  8. Traveler information services in rural tourism areas : appendix B, qualitative interviews and focus groups

    Science.gov (United States)

    2000-06-30

    This report documents results from surveys which were conducted for qualitatively assessing the use of traveler information services in rural areas. The focus of the surveys was to identify those factors which influence travel planning and thus impro...

  9. An Emotional Awareness Based Parenting Group for Parents with Mental Illness: A Mixed Methods Feasibility Study of Community Mental Health Nurse Facilitation.

    Science.gov (United States)

    Isobel, Sophie; Meehan, Felicity; Pretty, Danielle

    2016-02-01

    There has been limited examination of the use of relationship based structured parenting programs that focus on emotional interactions in the parent-child dyad in families where a parent has a mental illness. There is also a lack of awareness of the practicalities of providing such interventions within adult mental health services. This study explores the process and outcomes of a nurse led emotional awareness based parenting program for adult clients of a mental health service. Participants demonstrated a significant reduction in difficult parenting moments and associated stress and distress as well as promising improvements in overall distress and emotional awareness. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  10. Facilitation as a teaching strategy : experiences of facilitators

    Directory of Open Access Journals (Sweden)

    E Lekalakala-Mokgele

    2006-09-01

    Full Text Available Changes in nursing education involve the move from traditional teaching approaches that are teacher-centred to facilitation, a student centred approach. The studentcentred approach is based on a philosophy of teaching and learning that puts the learner on centre-stage. The aim of this study was to identify the challenges of facilitators of learning using facilitation as a teaching method and recommend strategies for their (facilitators development and support. A qualitative, explorative and contextual design was used. Four (4 universities in South Africa which utilize facilitation as a teaching/ learning process were identified and the facilitators were selected to be the sample of the study. The main question posed during in-depth group interviews was: How do you experience facilitation as a teaching/learning method?. Facilitators indicated different experiences and emotions when they first had to facilitate learning. All of them indicated that it was difficult to facilitate at the beginning as they were trained to lecture and that no format for facilitation was available. They experienced frustrations and anxieties as a result. The lack of knowledge of facilitation instilled fear in them. However they indicated that facilitation had many benefits for them and for the students. Amongst the ones mentioned were personal and professional growth. Challenges mentioned were the fear that they waste time and that they do not cover the content. It is therefore important that facilitation be included in the training of nurse educators.

  11. 77 FR 46346 - Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services

    Science.gov (United States)

    2012-08-03

    ... DEPARTMENT OF COMMERCE Minority Business Development Agency 15 CFR Part 1400 [Docket No. 120517080-2284-03] Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services AGENCY: Minority Business Development Agency, Commerce. ACTION: Notice of proposed rulemaking and request...

  12. 77 FR 34883 - Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services

    Science.gov (United States)

    2012-06-12

    ... DEPARTMENT OF COMMERCE Minority Business Development Agency 15 CFR Part 1400 [Docket No. 120517080-2132-02] Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services AGENCY: Minority Business Development Agency, Commerce. [[Page 34884

  13. 77 FR 31765 - Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services

    Science.gov (United States)

    2012-05-30

    ... DEPARTMENT OF COMMERCE Minority Business Development Agency 15 CFR Part 1400 [Docket No. 120517080-2080-01] Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services AGENCY: Minority Business Development Agency, Commerce. ACTION: Notice of proposed rulemaking and request...

  14. 77 FR 53780 - Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services

    Science.gov (United States)

    2012-09-04

    ... DEPARTMENT OF COMMERCE Minority Business Development Agency 15 CFR Part 1400 [Docket No. 120517080-2402-04] Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services AGENCY: Minority Business Development Agency, Commerce. ACTION: Notice of proposed rulemaking and request...

  15. 77 FR 72254 - Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services

    Science.gov (United States)

    2012-12-05

    ... DEPARTMENT OF COMMERCE Minority Business Development Agency 15 CFR Part 1400 [Docket No. 121130667-2667-01] Petition for Inclusion of the Arab-American Community in the Groups Eligible for MBDA Services AGENCY: Minority Business Development Agency, Commerce. ACTION: Notice of proposed rulemaking and request...

  16. Facilitating participation

    DEFF Research Database (Denmark)

    Skøtt, Bo

    2018-01-01

    the resulting need for a redefinition of library competence. In doing this, I primarily address the first two questions from Chapter 1 and how they relate to the public’s informal, leisure-time activities in a networked society. In particular, I focus on the skills of reflexive self-perception and informed...... opinion formation. Further, I point out the significance which these informal leisure-time activities have for public library staff’s cultural dissemination skills. In this way, I take on the question of the skills required for facilitating the learning of a participatory public (cf. Chapter 1......), exemplifying with the competence required of library staff. My discussion will proceed by way of a literature review. In the next section, I shall explain how and what sources were chosen and section three and four present the theoretical framework and how the applied theories are related. In the fifth section...

  17. Facilitating Transfers

    DEFF Research Database (Denmark)

    Kjær, Poul F.

    2018-01-01

    Departing from the paradox that globalisation has implied an increase, rather than a decrease, in contextual diversity, this paper re-assesses the function, normative purpose and location of Regulatory Governance Frameworks in world society. Drawing on insights from sociology of law and world...... society studies, the argument advanced is that Regulatory Governance Frameworks are oriented towards facilitating transfers of condensed social components, such as economic capital and products, legal acts, political decisions and scientific knowledge, from one legally-constituted normative order, i.......e. contextual setting, to another. Against this background, it is suggested that Regulatory Governance Frameworks can be understood as schemes which act as ‘rites of passage’ aimed at providing legal stabilisation to social processes characterised by liminality, i.e ambiguity, hybridity and in-betweenness....

  18. The potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education.

    Science.gov (United States)

    Stenov, Vibeke; Wind, Gitte; Skinner, Timothy; Reventlow, Susanne; Hempler, Nana Folmann

    2017-09-18

    Healthcare professionals' person-centered communication skills are pivotal for successful group-based diabetes education. However, healthcare professionals are often insufficiently equipped to facilitate person-centeredness and many have never received post-graduate training. Currently, assessing professionals' skills in conducting group-based, person-centered diabetes education primarily focus on experts measuring and coding skills on various scales. However, learner-centered approaches such as adequate self-reflective tools have been shown to emphasize professional autonomy and promote engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. The study entails of two components: 1) Field observations of five different educational settings including 49 persons with diabetes and 13 healthcare professionals, followed by interviews with 5 healthcare professionals and 28 persons with type 2 diabetes. 2) One professional development workshop involving 14 healthcare professionals. Healthcare professionals were asked to assess their person-centered communication skills using a self-assessment tool based on challenges and skills related to four educator roles: Embracer, Facilitator, Translator, and Initiator. Data were analyzed by hermeneutic analysis. Theories derived from theoretical model 'The Health Education Juggler' and techniques from 'Motivational Interviewing in Groups' were used as a framework to analyze data. Subsequently, the analysis from the field notes and interview transcript were compared with healthcare professionals' self-assessments of strengths and areas in need to effectively facilitate group-based, person-centered diabetes education. Healthcare professionals self-assessed the Translator and the Embracer to be the two most skilled roles whereas

  19. Participatory Public Service Design by Gov.3.0 Design Group

    Directory of Open Access Journals (Sweden)

    Suhyun Baek

    2018-01-01

    Full Text Available Citizen satisfaction levels with public service have become a key indicator in evaluating a nation’s policy capability; as such, it has become important to realize citizen-centered public service that enhances the satisfaction of citizens. Governments need to adopt new and creative methods to respond to changes and redefine the conditions of their policy processes. This study reviews the effectiveness of utilizing open innovation by design thinking for policy processes, and aims to detail the conditions for a policy process geared towards citizen-centered public service. The study reviews open innovation as a means of overcoming the insular tendencies of organizations, and also reviews the advantages of design thinking in identifying the diversified needs of citizens and coordinating their interests. Based on those, we conducted a case study and applied open innovation by design thinking for policy processes. The results revealed that key conditions include cooperation among designers, the diversification of communication channels between internal and external organizations, the joining of citizen experiences, repeated verification of citizen needs, and visualization of the whole progression. Such conditions are principal factors that contribute to citizen orientation and participation, and are expected to play a conducive role in the realization of citizen-centered public service in the future.

  20. Analyzing Lifestyle and Consumption Pattern of Hire Groups under Product Service Systems in Taiwan

    Directory of Open Access Journals (Sweden)

    Jui-Che Tu

    2013-01-01

    Full Text Available This study explores the characteristics of rental goods, integrates the green concept in the design and development, and introduces the concept of product service into the rental consumption trend in Taiwan. This study takes the questionnaire survey to collect various opinions of the consumers to rental consumption and also classifies the Taiwanese consumers into five clusters based on the life styles, and the names of clusters are simple financial management cluster, environment and taste cluster, fashionable and flexible cluster, careful purchase cluster, and smart consumption cluster. Finally, conclusions are as follows. (1 The green consumption cognition and attitude of the consumers to the environmental goods can help to master the factor of green consumption property for developing the rental commodities. (2 The market segmentation of the rental consumption market can be enhanced by the variables of available life styles. (3 The applications with product service rental characteristics should take the opinion feedback of the consumers into the sustainable product development conditions and expand the service property of the product. (4 As the cost of cradle-to-cradle recycling pattern is high, the support and promotion of the government can help to construct the business model of product service rental consumption and develop the rental economy.

  1. Improving the United States airline industry's capacity to provide safe and dignified services to travelers with disabilities: focus group findings.

    Science.gov (United States)

    McCarthy, Michael J

    2011-01-01

    As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.

  2. Multiple Family Group Service Model for Children With Disruptive Behavior Disorders: Child Outcomes at Post-Treatment.

    Science.gov (United States)

    Chacko, Anil; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Jackson, Jerrold; Marcus, Sue; Hoagwood, Kimberly; McKay, Mary

    2015-06-01

    The purpose of this study was to determine the benefits of a multiple family group (MFG) service delivery model compared with services as usual (SAU) in improving the functioning of youth with oppositional defiant/conduct disorder in families residing in socioeconomically disadvantaged communities. Participants included 320 youth aged 7 to 11 and their families who were referred to participating outpatient clinics. Participants were assigned to the MFG or the SAU condition, with parent report of child oppositional behavior, social competence, and level of youth impairment as primary outcomes at post-treatment. Family engagement to MFG was measured by attendance to each group session. Caregivers of youth in the MFG service delivery model condition reported significant improvement in youth oppositional behavior and social competence compared with youth in the SAU condition. Impairment improved over time for both groups with no difference between treatment conditions. The MFG led to greater percentage of youth with clinically significant improvements in oppositional behavior. Attendance to the MFG was high, given the high-risk nature of the study population. The MFG service delivery model offers an efficient and engaging format to implement evidence-based approaches to improving functioning of youth with oppositional defiant and/or conduct disorder in families from socioeconomically disadvantaged communities.

  3. [Local groups as a tool for quality assurance of community health services].

    Science.gov (United States)

    Mjell, J; Hjortdahl, P

    2001-05-30

    The aim of this study was to assess the use of local interprofessional or audit groups as a tool of quality enhancement. Fifty-six doctors, physiotherapists and nurses attended nine local interprofessional groups. The aim was to improve the quality of each professional's practice and to improve communication between the professions. The groups had a total of 62 meetings with each professional attending on average 5.7 meetings. All groups initiated quality enhancement projects. Initially the groups were very active and showed great initiative, but there were few final results. However, many groups reported improved communication and cooperation between the participating professionals. The experience from this project may be summarised as follows: The professionals within one and the same group should have more or less the same background and specialty. We recommend caution with organising interprofessional groups unless their participants work in the same practice. Interprofessional groups should spend adequate time for the members to get to know each other, and they should be guided by an experienced leader.

  4. The influence of stakeholder groups in operation and maintenance services of offshore wind farms

    DEFF Research Database (Denmark)

    Ahsan, Dewan; Pedersen, Søren

    2018-01-01

    One of the prime challenges in offshore wind is to manage and coordinate with the various stakeholders involved in the operation and maintenance (O&M) phase. Therefore the aims of this paper are: i) to map the stakeholder groups involved in O&M of Offshore Wind Farm (OWF), ii) to assess...... the identified stakeholder group's interest and power to influence O&M, iii) to evaluate the relationship between different stakeholder groups and iv) to highlight potential strategies to manage the stakeholder groups. In this article, the stakeholder analysis approach is used. The results reveal that eleven key...

  5. From Teaching to Facilitation

    DEFF Research Database (Denmark)

    de Graaff, Erik

    2013-01-01

    A shift from teaching to learning is characteristic of the introduction of Problem Based Learning (PBL) in an existing school. As a consequence the teaching staff has to be trained in skills like facilitating group work and writing cases. Most importantly a change in thinking about teaching...

  6. Linking Structure, Process, and Outcome to Improve Group Home Services for Foster Youth in California

    Science.gov (United States)

    Green, Rex S.; Ellis, Peter T.

    2007-01-01

    The California Youth Connection obtained funding from two foundations to evaluate the performance of group homes serving foster youth in Alameda County, California, in order to inform state policy-making. The evaluation team initially included 14 foster youth that personally experienced group home living. Three inter-related aspects of service…

  7. Persistent problems of access to appropriate, affordable TB services in rural China: experiences of different socio-economic groups.

    Science.gov (United States)

    Zhang, Tuohong; Tang, Shenglan; Jun, Gao; Whitehead, Margaret

    2007-02-08

    Large-scale Tuberculosis (TB) control programmes in China have been hailed a success. Concerns remain, however, about whether the programme is reaching all sections of the population, particularly poorer groups within rural communities, and whether there are hidden costs. This study takes a household perspective to investigate receipt of appropriate care and affordability of services for different socio-economic groups with TB symptoms in rural China. Secondary analysis of Chinese National Household Health Survey for 2003: 40,000 rural households containing 143,991 individuals, 2,308 identified as TB suspects. use of services and expenditure of TB suspects, by gender and socio-economic position, indicated by household income, education, material assets, and insurance status. 37% of TB suspects did not seek any professional care, with low-income groups less likely to seek care than more affluent counterparts. Of those seeking care, only 35% received any of the recommended diagnostic tests. Of the 182 patients with a confirmed TB diagnosis, 104 (57%) received treatment at the recommended level, less likely if lacking health insurance or material assets. The burden of payment for services amounted to 45% of annual household income for the low-income group, 16% for the high-income group. Access to appropriate, affordable TB services is still problematic in some rural areas of China, and receipt of care and affordability declines with declining socio-economic position. These findings highlight the current shortcomings of the national TB control programme in China and the formidable challenge it faces if it is to reach all sections of the population, including the poor with the highest burden of disease.

  8. Experience within the CERN Civil Engineering Group with Outsourced Design Services

    CERN Document Server

    Watson, T

    1998-01-01

    In April 1996, CERN awarded three contracts for civil engineering design services associated with the LHC project. The three contracts were awarded to three different joint ventures of firms from five member states. The total bid price for these services was in excess of 35 MCHF and the contracts will run for up to seven years. This paper aims to discuss and analyze the experience gained to date in the management of these contracts. In particular, the paper will address the issues of conditions of contract and specification for this form of contract. Current experience with each of the three consultants will be presented with the areas of difficulty highlighted. Conclusions will be made regarding future use of such contracts and in particular the way in which CERN must change in order to work efficiently with external designers.

  9. Diagnosis Related Groups System - Managerial Tool for Estimating the Cost of Hospital Services (Empirical Study

    Directory of Open Access Journals (Sweden)

    Carmen-Mihaela Creţu

    2012-05-01

    Full Text Available Public health services in Romania are in a complex and continuous process of reform, a majorpriority of government. In the light of future trends of development of health care, we can say that healthcareis becoming more and more a "market" operating on the principle of supply and demand. The patientbecomes a consumer; he is interested in health care and wants to be adept at maintaining and improving hishealth. Therefore, the Romanian health sector must intensify efforts to develop management because successand even its existence depend exclusively on an appropriate management system that continuously improvesto the needs of the patient (customer and to the market economy. Thus, we considered it necessary forcosting approach in the health sector in Romania due to the high complexity of health services and the highconsumption of resources.

  10. Using focus groups to investigate service quality determinants for customer satisfaction in selected university libraries in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Chaminda Jayasundara

    2010-01-01

    Full Text Available This study aimed at establishing service quality determinants which may affect customer satisfaction in university libraries in Sri Lanka. Using the literature, 113 service quality determinants were identified. These were then reviewed by eight focus groups in four different universities. Forty of the determinants were perceived to be applicable to their context. The participants also added 14 quality requirements which they thought were not provided for in the list. Finally, the content and face validity of the 54 determinants were evaluated by a panel of experts who ultimately reduced them to 50. This study recommends the use of the identified quality determinants by library administrators and policymakers in the higher education sector in Sri Lanka to gauge the levels of customer satisfaction and assure quality of service.

  11. Main Group Element Chemistry in Service of Hydrogen Storage and Activation. Final report

    International Nuclear Information System (INIS)

    Dixon, David A.; Arduengo, Anthony J. III

    2010-01-01

    Replacing combustion of carbon-based fuels with alternative energy sources that have minimal environmental impact is one of the grand scientific and technological challenges of the early 21st century. Not only is it critical to capture energy from new, renewable sources, it is also necessary to store the captured energy efficiently and effectively for use at the point of service when and where it is needed, which may not be collocated with the collection site. There are many potential storage media but we focus on the storage of energy in chemical bonds. It is more efficient to store energy on a per weight basis in chemical bonds. This is because it is hard to pack electrons into small volumes with low weight without the use of chemical bonds. The focus of the project was the development of new chemistries to enable DOE to meet its technical objectives for hydrogen storage using chemical hydrogen storage systems. We provided computational chemistry support in terms of thermodynamics, kinetics, and properties prediction in support of the experimental efforts of the DOE Center of Excellence for Chemical Hydrogen Storage. The goal of the Center is to store energy in chemical bonds involving hydrogen atoms. Once the hydrogen is stored in a set of X-H/Y-H bonds, the hydrogen has to be easily released and the depleted fuel regenerated very efficiently. This differs substantially from our current use of fossil fuel energy sources where the reactant is converted to energy plus CO 2 (coal) or CO 2 and H 2 O (gasoline, natural gas), which are released into the atmosphere. In future energy storage scenarios, the spent fuel will be captured and the energy storage medium regenerated. This places substantial additional constraints on the chemistry. The goal of the computational chemistry work was to reduce the time to design new materials and develop materials that meet the 2010 and 2015 DOE objectives in terms of weight percent, volume, release time, and regeneration ability

  12. Final Report: Main Group Element Chemistry in Service of Hydrogen Storage and Activation

    Energy Technology Data Exchange (ETDEWEB)

    David A. Dixon; Anthony J. Arduengo, III

    2010-09-30

    Replacing combustion of carbon-based fuels with alternative energy sources that have minimal environmental impact is one of the grand scientific and technological challenges of the early 21st century. Not only is it critical to capture energy from new, renewable sources, it is also necessary to store the captured energy efficiently and effectively for use at the point of service when and where it is needed, which may not be collocated with the collection site. There are many potential storage media but we focus on the storage of energy in chemical bonds. It is more efficient to store energy on a per weight basis in chemical bonds. This is because it is hard to pack electrons into small volumes with low weight without the use of chemical bonds. The focus of the project was the development of new chemistries to enable DOE to meet its technical objectives for hydrogen storage using chemical hydrogen storage systems. We provided computational chemistry support in terms of thermodynamics, kinetics, and properties prediction in support of the experimental efforts of the DOE Center of Excellence for Chemical Hydrogen Storage. The goal of the Center is to store energy in chemical bonds involving hydrogen atoms. Once the hydrogen is stored in a set of X-H/Y-H bonds, the hydrogen has to be easily released and the depleted fuel regenerated very efficiently. This differs substantially from our current use of fossil fuel energy sources where the reactant is converted to energy plus CO2 (coal) or CO2 and H2O (gasoline, natural gas), which are released into the atmosphere. In future energy storage scenarios, the spent fuel will be captured and the energy storage medium regenerated. This places substantial additional constraints on the chemistry. The goal of the computational chemistry work was to reduce the time to design new materials and develop materials that meet the 2010 and 2015 DOE objectives in terms of weight percent, volume, release time, and regeneration ability. This

  13. EnviroAtlas - New York, NY - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 6,378 block groups in New York City, New York. Carbon attributes, temperature...

  14. EnviroAtlas - Green Bay, WI - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 155 block groups in Green Bay, Wisconsin. Carbon attributes, temperature reduction,...

  15. EnviroAtlas - Des Moines, IA - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 312 block groups in Des Moines, IA. Carbon attributes, temperature reduction,...

  16. EnviroAtlas - Minneapolis/St. Paul, MN - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,772 block groups in Minneapolis/St. Paul, Minnesota. Carbon attributes, temperature...

  17. EnviroAtlas - New Bedford, MA - Ecosystem Services by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 128 block group in New Bedford, Massachusetts. Carbon attributes, temperature...

  18. Playing facilitator

    DEFF Research Database (Denmark)

    Houmøller, Ellen; Marchetti, Emanuela

    2015-01-01

    event called InnoEvent, addressed to students in the fields of multimedia and healthcare. Being interested in studying games and role-play as tools to support independent learning in the field of design thinking and team-building, following Dewey’s (1938) theory of learning experience, we ran two...... workshops based on two classic role-play games: The Silent Game (Brandt, 2006) and The Six Thinking Hats (de Bono, 1985). These games were created to support students in learning design thinking in groups and are assigned positive values in literature, hence we expected a smooth process. However, our...... experience was rather characterized by conflictual negotiations with the students. Data from our observations and from interviews with group representatives show that the students took a discontinuous learning path, characterised by a false start, failure, and a thorough reconsideration of their work...

  19. Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services.

    OpenAIRE

    Cree, Lindsey; Brooks, Helen L; Berzins, Kathryn; Fraser, Claire; Lovell, Karina; Bee, Penny

    2015-01-01

    BACKGROUND: Formal recognition and involvement of carers in mental health services has been the focus of recent policy and practice initiatives as well as being supported by carers themselves. However, carers still report feeling marginalised and distanced from services. A prominent theme is that that they are not listened to and their concerns are not taken seriously. Compared to service user views, the reasons underpinning carers' dissatisfaction with care-planning procedures have been rela...

  20. A Tutorial on Interfacing the Object Management Group (OMG) Data Distribution Service (DDS) with LabView

    Science.gov (United States)

    Smith, Kevin

    2011-01-01

    This tutorial will explain the concepts and steps for interfacing a National Instruments LabView virtual instrument (VI) running on a Windows platform with another computer via the Object Management Group (OMG) Data Distribution Service (DDS) as implemented by the Twin Oaks Computing CoreDX. This paper is for educational purposes only and therefore, the referenced source code will be simplistic and void of all error checking. Implementation will be accomplished using the C programming language.

  1. The Problem Analysis of Existing FSES of Higher Education for the Enlarged Group of Specialties"the Service and Tourism"

    OpenAIRE

    Marina A. Maznichenko; Nataliya I. Neskoromnykh

    2016-01-01

    The article presents the results of aspect analysis of the current federal state educational standards of higher education for the enlarged group of specialties"Service and tourism". There are analyzed the conformity of educational standards of higher education to the requirements of employers, the requirements for development results, to the structure and terms of realization of educational programs of undergraduate/graduate. The authors outline the key problems for each aspect, also identif...

  2. [An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group].

    Science.gov (United States)

    Kim, Dasom; Lee, Insook

    2017-10-01

    This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements. © 2017 Korean Society of Nursing Science

  3. Grid enablement of OpenGeospatial Web Services: the G-OWS Working Group

    Science.gov (United States)

    Mazzetti, Paolo

    2010-05-01

    In last decades two main paradigms for resource sharing emerged and reached maturity: the Web and the Grid. They both demonstrate suitable for building Distributed Computing Infrastructures (DCIs) supporting the coordinated sharing of resources (i.e. data, information, services, etc) on the Internet. Grid and Web DCIs have much in common as a result of their underlying Internet technology (protocols, models and specifications). However, being based on different requirements and architectural approaches, they show some differences as well. The Web's "major goal was to be a shared information space through which people and machines could communicate" [Berners-Lee 1996]. The success of the Web, and its consequent pervasiveness, made it appealing for building specialized systems like the Spatial Data Infrastructures (SDIs). In this systems the introduction of Web-based geo-information technologies enables specialized services for geospatial data sharing and processing. The Grid was born to achieve "flexible, secure, coordinated resource sharing among dynamic collections of individuals, institutions, and resources" [Foster 2001]. It specifically focuses on large-scale resource sharing, innovative applications, and, in some cases, high-performance orientation. In the Earth and Space Sciences (ESS) the most part of handled information is geo-referred (geo-information) since spatial and temporal meta-information is of primary importance in many application domains: Earth Sciences, Disasters Management, Environmental Sciences, etc. On the other hand, in several application areas there is the need of running complex models which require the large processing and storage capabilities that the Grids are able to provide. Therefore the integration of geo-information and Grid technologies might be a valuable approach in order to enable advanced ESS applications. Currently both geo-information and Grid technologies have reached a high level of maturity, allowing to build such an

  4. Perceptions and acceptability of short message services technology to improve treatment adherence amongst tuberculosis patients in Peru: a Focus Group Study.

    Directory of Open Access Journals (Sweden)

    Sandra Albino

    Full Text Available Tuberculosis (TB is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru.We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data.Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants.The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to increase treatment adherence

  5. Perceptions and acceptability of short message services technology to improve treatment adherence amongst tuberculosis patients in Peru: a Focus Group Study.

    Science.gov (United States)

    Albino, Sandra; Tabb, Karen M; Requena, David; Egoavil, Miguel; Pineros-Leano, Maria F; Zunt, Joseph R; García, Patricia J

    2014-01-01

    Tuberculosis (TB) is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru. We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS) reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data. Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants. The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to increase treatment adherence for low

  6. Service station requirements for safe use of hydrogen based fuels: NHA work group update

    Energy Technology Data Exchange (ETDEWEB)

    Coutts, D.A. [Westinghouse Savannah River Co., Aiken, SC (United States)

    1997-12-31

    This paper consists of viewgraphs which summarize the results of the meeting of the working group on safety standards. A standard for an odorant for hydrogen leak detection is set forth. Recent activities with the National Fire Protection Association and the International Standard Organization are enumerated. The path forward is also summarized.

  7. Promoting Pre-Service Elementary Students' Understanding of Chemical Equilibrium through Discussions in Small Groups

    Science.gov (United States)

    Bilgin, Ibrahim

    2006-01-01

    The purpose of this study was to investigate the effectiveness of small group discussion on students' conceptual understanding of chemical equilibrium. Students' understanding of chemical equilibrium concepts was measured using the Misconception Identification Test. The test consisted of 30 items and administered as pre-posttests to a total of 81…

  8. Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users.

    Directory of Open Access Journals (Sweden)

    Daisy Fancourt

    Full Text Available Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location. Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11 and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78, and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24 alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19 and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04. All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL 4, IL6, IL17, tumour necrosis factor alpha (TNFα, and monocyte chemoattractant protein (MCP 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health.ClinicalTrials.gov NCT01906892.

  9. IT services in a completely digitized radiological department: value and benefit of an in-house departmental IT group

    International Nuclear Information System (INIS)

    Treitl, M.; Wirth, S.; Lucke, A.; Rieger, J.; Pfeifer, K.J.; Reiser, M.; Villain, S.

    2005-01-01

    To analyze the benefit of a departmental IT group in comparison to support by hospital IT groups or system manufacturers in a completely digitized radiological department. The departmental IT group comprises a fulltime IT specialist, two student assistants and four clinical employees participating 1 day/week. For 18 months IT problems were quantified and specified according to urgency, responsibility and affected system by use of an intranet-based reporting system. For each IT service provider the performance and duration of problem solution was evaluated. In 18 months 3,234 IT problems emerged. 88.7% were solved by the departmental IT group. In 474 cases (14.7%) a solution within 2 h was required. The departmental IT group solved 35.8% within 30 min, system manufacturers needed 18 h 38 min in mean. The departmental IT group solved 90.2% of the problems within a time limit. System manufacturers met the limit in 60.1% with a mean duration of 7 days 21 h. In 6.7% of the cases, support by system manufacturers was indispensable. A considerable proportion of IT problems in completely digitized radiological departments can be solved by a departmental IT group, providing a fast and cost-efficient first-level IT support with effective prevention of major breaks in the workflow. In a small number of cases support by system manufacturers remains necessary. (orig.)

  10. "Conversation" group in the Psychiatric service for the diagnosis and treatment of Caltagirone (Italy

    Directory of Open Access Journals (Sweden)

    Raffaele Barone

    2014-09-01

    Full Text Available The clinical device, introduced in clinical psychiatric hospital of Caltagirone, wants to be a crisis intervention for the patient and the entire family system. The "conversation group" with the participation of family members and professionals who want to make contact with their patients. Knowing the discomfort that the users bring in hospital, enables the development, comparison with others and with their stories, comments and different perspectives. In the space of the group the patient can admit the possibility of expressing content and see all the thoughts and feelings more destructive, to find a meaning to their crisis, their discomfort, in order to start a process of recovery. Within this space processes are activated mutual aid, sharing and reflections that mobilize resources for individual and family awareness and the development of transformative movements. A resonance in terms transformative is perceived by the whole micro-community of the department, influencing the climate, the processes of socialization among patients and between patients and their personal health, combating loneliness admission and burnout of health personnel. Keywords:Multifamily group; Mutual aid; Sharing and reflection; Multiple transfert; narrative medicine 

  11. Do action learning sets facilitate collaborative, deliberative learning?: A focus group evaluation of Graduate Entry Pre-registration Nursing (GEN) students' experience.

    Science.gov (United States)

    Maddison, Charlotte; Strang, Gus

    2018-01-01

    The aim of this study was to investigate if by participating in action learning sets, Graduate Entry Pre-registration Nursing (GEN) students were able to engage in collaborative and deliberative learning. A single focus group interview involving eleven participants was used to collect data. Data analysis identified five themes; collaborative learning; reflection; learning through case study and problem-solving; communication, and rejection of codified learning. The themes are discussed and further analysed in the context of collaborative and deliberative learning. The evidence from this small scale study suggests that action learning sets do provide an environment where collaborative and deliberative learning can occur. However, students perceived some of them, particularly during year one, to be too 'teacher lead', which stifled learning. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Comparison between group and personal rehabilitation for dementia in a geriatric health service facility: single-blinded randomized controlled study.

    Science.gov (United States)

    Tanaka, Shigeya; Honda, Shin; Nakano, Hajime; Sato, Yuko; Araya, Kazufumi; Yamaguchi, Haruyasu

    2017-05-01

    The aim of this study was to compare the effects of rehabilitation involving group and personal sessions on demented participants. This single-blinded randomized controlled trial included 60 elderly participants with dementia in a geriatric health service facility, or R oken. Staff members, who did not participate in the intervention, examined cognitive function, mood, communication ability, severity of dementia, objective quality of life, vitality, and daily behaviour. After a baseline assessment, participants were randomly divided into three groups: (i) group intervention; (ii) personal intervention; and (iii) control. The 1-h group intervention (3-5 subjects) and 20-min personal intervention (one staff member per participant) were performed twice a week for 12 weeks (24 total sessions). The cognitive rehabilitation programme consisted of reminiscence, reality orientation, and physical exercise, and it was based on five principles of brain-activating rehabilitation; (i) pleasant atmosphere; (ii) communication; (iii) social roles; (iv) praising; and (v) errorless support. Data were analyzed after the second assessment. Outcome measures were analyzed in 43 participants-14 in the control group, 13 in group intervention, and 16 in personal intervention. Repeated measure ancova showed a significant interaction for cognitive function score (Mini-Mental State Examination) between group intervention and controls ( F  = 5.535, P = 0.029). In the post-hoc analysis, group intervention showed significant improvement (P = 0.016). Global severity of dementia tended to improve (P = 0.094) in group intervention compared to control (Mann-Whitney U -test). There were no significant interactions or improvements for other measurements. Group rehabilitation for dementia is more effective for improving cognitive function and global severity of dementia than personal rehabilitation in Roken. © 2016 Japanese Psychogeriatric Society.

  13. 76 FR 20045 - The Ubs Group, a Division Of Ubs Ag, Also Known as Ubs Financial Services, Inc. and/or Ubs-Glb...

    Science.gov (United States)

    2011-04-11

    ... Division Of Ubs Ag, Also Known as Ubs Financial Services, Inc. and/or Ubs-Glb (Americas), Inc., Formerly... UBS AG, also known as UBS Financial Services, Inc., and/or UBS-GLB (Americas), Inc., Corporate Center... The UBS Group, a division of UBS AG, also known as UBS Financial Services, Inc., and/or UBS-GLB...

  14. Focus groups for allied health professionals and professions allied to technical services in the NHS--marketing opportunities, lessons learnt and recommendations.

    Science.gov (United States)

    Chamberlain, David; Brook, Richard

    2011-09-01

    Worcestershire Health Libraries provides services to all NHS and social care staff in Worcestershire. Despite intensive marketing, statistics showed low usage of the library service for professions allied to technical services and allied health professionals. To discover why there was low usage of the library services using qualitative techniques and to use focus groups as a marketing opportunity. This article also aims to outline the processes involved in delivering focus groups, the results gained, and the actions taken in response to the results. Focus groups were conducted in two departments, Pathology and Occupational Therapy. The Biochemistry department (part of Pathology) had two focus groups. An additional focus group was conducted for all the Pathology education leads. Occupational Therapy had two meetings, one for hospital based staff, and the other for community staff. Issues centred on registration, inductions, time, library ambience, multi-disciplinary service and resources. The findings raised marketing opportunities and the process identified potential candidates for the role of team knowledge officer, to act as library champions within departments. It also identified areas in which the library service was not meeting user needs and expectations, and helped focus service development. Focus groups allowed an opportunity to speak to non-users face to face and to discover, and where appropriate challenge both their, and library staff's pre-conceived ideas about the service. The information revealed gave an opportunity to market services based on user needs. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  15. Facilitating organisational development using a group-based formative assessment and benchmarking method: design and implementation of the International Family Practice Maturity Matrix.

    Science.gov (United States)

    Elwyn, Glyn; Bekkers, Marie-Jet; Tapp, Laura; Edwards, Adrian; Newcombe, Robert; Eriksson, Tina; Braspenning, Jozé; Kuch, Christine; Adzic, Zlata Ozvacic; Ayankogbe, Olayinka; Cvetko, Tatjana; In 't Veld, Kees; Karotsis, Antonis; Kersnik, Janko; Lefebvre, Luc; Mecini, Ilir; Petricek, Goranka; Pisco, Luis; Thesen, Janecke; Turón, José María; van Rossen, Edward; Grol, Richard

    2010-12-01

    Well-organised practices deliver higher-quality care. Yet there has been very little effort so far to help primary care organisations achieve higher levels of team performance and to help them identify and prioritise areas where quality improvement efforts should be concentrated. No attempt at all has been made to achieve a method which would be capable of providing comparisons--and the stimulus for further improvement--at an international level. The development of the International Family Practice Maturity Matrix took place in three phases: (1) selection and refinement of organisational dimensions; (2) development of incremental scales based on a recognised theoretical framework; and (3) testing the feasibility of the approach on an international basis, including generation of an automated web-based benchmarking system. This work has demonstrated the feasibility of developing an organisational assessment tool for primary care organisations that is sufficiently generic to cross international borders and is applicable across a diverse range of health settings, from state-organised systems to insurer-based health economies. It proved possible to introduce this assessment method in 11 countries in Europe and one in Africa, and to generate comparison benchmarks based on the data collected. The evaluation of the assessment process was uniformly positive with the view that the approach efficiently enables the identification of priorities for organisational development and quality improvement at the same time as motivating change by virtue of the group dynamics. We are not aware of any other organisational assessment method for primary care which has been 'born international,' and that has involved attention to theory, dimension selection and item refinement. The principal aims were to achieve an organisational assessment which gains added value by using interaction, engagement comparative benchmarks: aims which have been achieved. The next step is to achieve wider

  16. Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups.

    Science.gov (United States)

    Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

    2009-04-30

    The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to

  17. The potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education

    DEFF Research Database (Denmark)

    Stenov, Vibeke; Wind, Gitte; Skinner, Timothy

    2017-01-01

    engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals’ strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. Methods: The study entails of two components......: 1) Field observations of five different educational settings including 49 persons with diabetes and 13 healthcare professionals, followed by interviews with 5 healthcare professionals and 28 persons with type 2 diabetes. 2) One professional development workshop involving 14 healthcare professionals...

  18. Cogema and the environment. Environmental policy. The Cogema group in the environment service

    International Nuclear Information System (INIS)

    1997-01-01

    This document presents the organization of the environmental policy at Cogema facilities. The first part presents the environmental policy of the group: integration of environment management at all levels, reduction of effluents and control of their environmental impact, integrating environment protection at the design stage of facilities, quality and improvement policy, expenses devoted to environment protection (investments, R and D, funds), public information. The second part concerns the transfer of Cogema's know-how in environmental engineering towards other industrial sectors: radioactivity measurements, mine and quarry sites rehabilitation, industrial wastes and effluents processing, decontamination and rehabilitation of ancient polluted industrial sites, foreign activities (rehabilitation of US-DOE military sites, aid to Eastern countries. (J.S.)

  19. Evaluation of a multiple-encounter in situ simulation for orientation of staff to a new paediatric emergency service: a single-group pretest/post-test study.

    Science.gov (United States)

    Davison, Michelle; Kinnear, Frances B; Fulbrook, Paul

    2017-10-01

    To assess the utility of a multiple-encounter in-situ (MEIS) simulation as an orientation tool for multidisciplinary staff prior to opening a new paediatric emergency service. A single-group pretest/post-test study was conducted. During the MEIS simulation, multidisciplinary staff with participant or observer roles managed eight children (mannequins) who attended triage with their parent/guardians (clinical facilitators) for a range of emergency presentations (structured scenarios designed to represent the expected range of presentations plus test various clinical pathways/systems). Participants were debriefed to explore clinical, systems and crisis-resource management issues. Participants also completed a pre-intervention and post-intervention questionnaire comprising statements about role confidence and orientation adequacy. Pre-test and post-test results were analysed using t-test and Wilcoxon signed rank test. Eighty-nine staff participated in the MEIS simulation, with the majority completing the pre-simulation and post-simulation questionnaire. There was a significant improvement in post-intervention versus pre-intervention Likert scores for role confidence and orientation adequacy (p=0.001 and orientation adequacy. Nearly all scenarios resulted in significant increases in participants' confidence levels. The MEIS simulation was of utility in orientation of staff, at least with respect to self-reported role confidence and orientation adequacy. Its effectiveness in practice or compared with other orientation techniques was not assessed, but it did identify several flaws in planned systems allowing remediation prior to opening.

  20. Role enactment of facilitation in primary care

    DEFF Research Database (Denmark)

    Due, Tina Drud; Thorsen, Thorkil; Waldorff, Frans Boch

    2017-01-01

    facilitation visits in 13 practice settings and had interviews and focus groups with facilitators. We applied an explorative approach in data collection and analysis, and conducted an inductive thematic analysis. RESULTS: The facilitators mainly enacted four facilitator roles: teacher, super user, peer...

  1. Role enactment of facilitation in primary care

    DEFF Research Database (Denmark)

    Due, Tina Drud; Thorsen, Thorkil; Waldorff, Frans Boch

    2017-01-01

    facilitation visits in 13 practice settings and had interviews and focus groups with facilitators. We applied an explorative approach in data collection and analysis, and conducted an inductive thematic analysis. Results: The facilitators mainly enacted four facilitator roles: teacher, super user, peer...

  2. Dynamics and Structure of Dispute in Open Group of Facebook Social Networking Service in Terms of Teenagers’ Homosexual Relations Education

    Directory of Open Access Journals (Sweden)

    Sergei V. Kharitonov

    2014-05-01

    Full Text Available The article considers the results of discussions in the group of Facebook social networking service, dealing with the problem of teenagers’ homosexual relations education. The goal of the research is to study the dynamics of the dispute in Facebook social networking service on the example of the closed group “Teenagers’ Sexual Orientation”. As a whole, 72 people participated in the discussion, involving both representatives, sharing the views of the LGBT community, concerning homosexual relations and teenagers’ heterosexual parents. As a result of the dispute, conducted within Facebook website 230 comments were left. Resulting from the content analysis of the message texts, the estimation of a number of parameters was made. The estimation showed that the parties of the virtual discussion are in deficit of decisions in terms of virtual disputes conduct. The declared wish to argue out doesn’t lead to the real activity, relevant to evidence-based disputes. Thus, we can consider that the participants of the virtual discussion are in deficit of the decisions in terms of virtual disputes conduct.

  3. Costing for long-term care: the development of Scottish health service resource utilization groups as a casemix instrument.

    Science.gov (United States)

    Urquhart, J; Kennie, D C; Murdoch, P S; Smith, R G; Lennox, I

    1999-03-01

    to create a casemix measure with a limited number of categories which discriminate in terms of resource use and will assist in the development of a currency for contracting for the provision of health care. nursing staff completed a questionnaire providing clinical data and also gave estimates of relative patient resource use; ward-based costs were collected from appropriate unit managers. National Health Service continuing-care wards in 50 Scottish hospitals. 2783 long-stay patients aged 65 years and over. inter-rater reliability was assessed using 1402 patients; percentage agreement between raters for individual variables varied from 68% for feeding to 97% for clinically complex treatments. Nursing costs gave 62% agreement given categories of high, medium and low. The Scottish health service resource utilization groups (SHRUG) measure was developed using 606 cases, and 67% consistency was achieved for the five categories. The relative weights for the SHRUG categories ranged from 0.56 to 1.41. The five categories explain 35% of variance in costs. the five SHRUG casemix categories show good discrimination in terms of costs. The SHRUG measure compares favourably with diagnosis-related groups in the acute sector and with other casemix instruments for long-term care previously piloted in the UK. SHRUG is a useful measurement instrument in assessing the resource needs of elderly people in long-term care.

  4. Facilitation Skills for Library Professionals

    OpenAIRE

    O'Shea, Anne; Matheson, Laura

    2010-01-01

    Session summary: Brainstorming, problem-solving, team-building and group communication – all of these things can be made easier through facilitation! Come to this fun, interactive workshop to learn techniques and exercises to boost your group meetings. Taught by two information professionals with formal facilitation training and experience, this workshop will give you theory, hands-on practice time and feedback. What participants will learn: Participants will learn techniques to he...

  5. Power to the people : how sustainable energy services and development can be facilitated through grass root development- a case study from the Bondo district in Kenya

    OpenAIRE

    Thoresen, Marius Halkinrud

    2010-01-01

    Masteroppgave i development management- Universitetet i Agder 2010 Serious international actors like the IPCC, the UNFCCC and the WEO, highlight the need to implement sustainable energy resources as fossil fuels has contributed to increase the global CO2 emission, which again has contributed to climate change. In many parts of the developing world there is currently no access to energy services. WEO predicts that developing countries will be responsible for much of ...

  6. Group facilitation: building that winning team.

    Science.gov (United States)

    Krumberger, J M

    1992-12-01

    Team building does not occur by chance; it involves using techniques to make it easier for members to contribute their expertise while working with others to achieve quality results. Evaluation of team effectiveness involves assessing both the processes (team interactions and work processes) and accomplishment of goals (out-comes; see box). Productivity and quality that could not be accomplished by individual efforts may be enhanced by effectively working teams.

  7. If a Student Takes Control: Facilitator's Tasks and Responsibilities

    Science.gov (United States)

    Väljataga, Terje

    This paper presents initial research results of an intervention into higher educational teaching and studying practices from facilitators‘ point of view. The intervention was implemented into an international Master’s level online course mediated by landscapes of social media tools and services. In this course more emphasis was put on a shift of control from a facilitator to a student or a group of students in the following aspects: setting up one’s study goals, choosing activities, selecting appropriate resources, including technology and defining one’s evaluation criteria. The initial analysis showed that the facilitators gained a lot in terms of understanding the benefits of exploiting social media tools and services for their teaching practices, perceiving a need of having a different role as well as the shortages and problems while being a facilitator in such a course.

  8. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  9. Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups.

    Science.gov (United States)

    Ruy, Hosihn; Young, Wendy B; Kwak, Hoil

    2002-01-01

    The purpose of this study is to outline a method to identify the characteristics of socioeconomic variables in determining the differences in health insurance coverage and health services utilization patterns for different ethnic groups, using the behavioural model of health service utilization. A sample drawn from Asian American adult respondents to the 1992, 1993, and 1994 National Health Interview Surveys (NHIS) in the USA formed the data set. The results showed Asian Americans as not being homogeneous. There were distinctly different demographic and socioeconomic characteristics between six Asian American ethnic groups that affect health insurance coverage and health service utilization. The study method is useful for constructing health policy and services to address the general public need without adversely affecting smaller minority groups. Secondary analysis of well-constructed national data sets such as the specific Asian ethnic groups in NHIS, offers a rich method for predicting the differential impact of specific health policies on various ethnic groups.

  10. Facilitating a stakeholder-led approach to the development of Mediterranean climate services: co-ordinating the CLIM-RUN case studies

    Science.gov (United States)

    Goodess, C. M.

    2012-04-01

    The CLIM-RUN case studies provide a real-world context for bringing together experts on the demand and supply side of climate services. They are essential to the CLIM-RUN objective of using iterative and bottom-up (i.e., stakeholder led) approaches for optimizing the two-way information transfer between climate experts and stakeholders. The region of interest for CLIM-RUN is the Mediterranean, which is a recognised climate change hotspot (i.e., a region particularly sensitive and vulnerable to global warming) and which does not currently have developed climate service networks such as exist in a number of Central and Northern European countries. The case studies focus on the energy and tourism sectors, but also include a cross-cutting study on wild fires (an issue of increasing concern in the Mediterranean) as well as a cross-sectorial integrated case study for the Venice lagoon. They span coastal (e.g., Tunisia and Croatia), island (e.g., Cyprus) and mountain (e.g., Savoie) environments, the eastern (e.g., Greece) to western (e.g., Spain, Morocco) Mediterranean regions, and regional to local foci. Stakeholder involvement has been critical from the start of the project in March 2011, with a series of targeted workshops helping to define the framework for each case study. Two specific workshop objectives were to (i) better understand who are the climate services stakeholders and (ii) what they need/want from climate services (both in terms of data products and broader knowledge). Many of the workshops were held in local languages to maximise stakeholder participation, with expert knowledge provided by the CLIM-RUN climate and stakeholder expert teams (the CET and SET). Following the workshops, CET members are 'translating' the user needs into specific requirements from climate observations and models and identifying areas where additional modelling and analysis are required. As part of the central co-ordination of the case studies, a perception and data needs

  11. A creative analysis of the role of practice development facilitators in a critical care environment

    Directory of Open Access Journals (Sweden)

    Tanya Heyns

    2017-10-01

    Full Text Available Practice development focuses on methods to address the quality of care and advance healthcare practices. The role of practice development facilitators to address challenges of delivering evidence-based person-centred care in the critical care environment was determined by using a nominal group technique. Eleven participants from public and private healthcare services reached consensus on seven clusters: theory-practice application, facilitation of learning, increasing collaboration, effective communication, facilitation of change, time management and role modelling. The clusters were visually represented as a hot air balloon. Competence as facilitators is of vital importance to ensure knowledge translation with the aim to improve quality.

  12. Facilitating quality control for spectra assignments of small organic molecules: nmrshiftdb2--a free in-house NMR database with integrated LIMS for academic service laboratories.

    Science.gov (United States)

    Kuhn, Stefan; Schlörer, Nils E

    2015-08-01

    nmrshiftdb2 supports with its laboratory information management system the integration of an electronic lab administration and management into academic NMR facilities. Also, it offers the setup of a local database, while full access to nmrshiftdb2's World Wide Web database is granted. This freely available system allows on the one hand the submission of orders for measurement, transfers recorded data automatically or manually, and enables download of spectra via web interface, as well as the integrated access to prediction, search, and assignment tools of the NMR database for lab users. On the other hand, for the staff and lab administration, flow of all orders can be supervised; administrative tools also include user and hardware management, a statistic functionality for accounting purposes, and a 'QuickCheck' function for assignment control, to facilitate quality control of assignments submitted to the (local) database. Laboratory information management system and database are based on a web interface as front end and are therefore independent of the operating system in use. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City.

    Science.gov (United States)

    Kupprat, Sandra A; Dayton, Alex; Guschlbauer, Andrea; Halkitis, Perry N

    2009-07-01

    A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

  14. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers.

    Science.gov (United States)

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age of the participants was 21-57 years (M=35.27; SD=8.13). Polish versions of the Impact of Event Scale--Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive--social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance.

  15. Facilitating value co-creation in networks

    DEFF Research Database (Denmark)

    Rasmussen, Mette Apollo

    participants in varied ways come to grasp the meaning of networking. The dissertation draws on insights from the Service-Dominant (S-D) Logic to explain how networks can be seen as spheres for value co-creation. Co-creation as a theoretical construct has evolved from varied streams of service marketing...... of networking. The concept of “imaginative value” (Beckert, 2011) is used to explain the oscillating behaviors observed in the two networks. Imaginative value can be defined as symbolic value that actors ascribe to an object, in this case the network. I argue that the group practices in the networks led......The dissertation investigates through two ethnographic case studies how value co-creation takes place in inter-organizational networks that have been facilitated by a municipality. The contribution of the study to business network research is the emphasis on development phases of networks...

  16. 75 FR 22853 - D-11456, PNC Financial Services Group, Inc.; and D-11602, State Street Bank and Trust Company, et...

    Science.gov (United States)

    2010-04-30

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration D-11456, PNC Financial Services... certain secondary services, as defined below, (Secondary Services) to such Funds in which a Client Plan... fees charged to the Funds by PNC for investment advisory or similar services, on a date which is no...

  17. What Should Dental Services for People with Disabilities in Ireland Be Like? Agreed Priorities from a Focus Group of People with Learning Disabilities

    Science.gov (United States)

    Mac Giolla Phadraig, Caoimhin; Dougall, Alison; Stapleton, Siobhan; McGeown, Danielle; Nunn, June; Guerin, Suzanne

    2016-01-01

    Background: In Ireland, people with learning disabilities have poor oral health. This is in part due to inappropriate oral health services. Recognising the value of inclusive approaches to research and healthcare planning, this study sought to include a group of people with learning disabilities in priority setting for oral health services in…

  18. Exposing Underrepresented Groups to Climate Change and Atmospheric Science Through Service Learning and Community-Based Participatory Research

    Science.gov (United States)

    Padgett, D.

    2016-12-01

    Tennessee State University (TSU) is among seven partner institutions in the NASA-funded project "Mission Earth: Fusing Global Learning and Observations to Benefit the Environment (GLOBE) with NASA Assets to Build Systemic Innovation in STEM Education." The primary objective at the TSU site is to expose high school students from racial and ethnic groups traditionally underrepresented in STEM to atmospheric science and physical systems associated with climate change. Currently, undergraduate students enrolled in TSU's urban and physical courses develop lessons for high school students focused upon the analysis of global warming phenomena and related extreme weather events. The GLOBE Atmosphere Protocols are emphasized in exercises focused upon the urban heat island (UHI) phenomenon and air quality measurements. Pre-service teachers at TSU, and in-service teachers at four local high schools are being certified in the Atmosphere Protocols. Precipitation, ambient air temperature, surface temperature and other data are collected at the schools through a collaborative learning effort among the high school students, TSU undergraduates, and high school teachers. Data collected and recorded manually in the field are compared to each school's automated Weatherbug station measurements. Students and teachers engage in analysis of NASA imagery as part of the GLOBE Surface Temperature Protocol. At off-campus locations, US Clean Air Act (CAA) criteria air pollutant and Toxic Release Inventory (TRI) air pollutant sampling is being conducted in community-based participatory research (CBPR) format. Students partner with non-profit environmental organizations. Data collected using low-cost air sampling devices is being compared with readings from government air monitors. The GLOBE Aerosols Protocol is used in comparative assessments with air sampling results. Project deliverables include four new GLOBE schools, the enrollment of which is nearly entirely comprised of students

  19. Epilepsy and Pregnancy: For healthy pregnancies and happy outcomes. Suggestions for service improvements from the Multispecialty UK Epilepsy Mortality Group.

    Science.gov (United States)

    Leach, J P; Smith, P E; Craig, J; Bagary, M; Cavanagh, D; Duncan, S; Kelso, A R C; Marson, A G; McCorry, D; Nashef, L; Nelson-Piercy, C; Northridge, R; Sieradzan, K; Thangaratinam, S; Walker, M; Winterbottom, J; Reuber, M

    2017-08-01

    Between 2009 and 2012 there were 26 epilepsy-related deaths in the UK of women who were pregnant or in the first post-partum year. The number of pregnancy-related deaths in women with epilepsy (WWE) has been increasing. Expert assessment suggests that most epilepsy-related deaths in pregnancy were preventable and attributable to poor seizure control. While prevention of seizures during pregnancy is important, a balance must be struck between seizure control and the teratogenic potential of antiepileptic drugs (AEDs). A range of professional guidance on the management of epilepsy in pregnancy has previously been issued, but little attention has been paid to how optimal care can be delivered to WWE by a range of healthcare professionals. We summarise the findings of a multidisciplinary meeting with representation from a wide group of professional bodies. This focussed on the implementation of optimal pregnancy epilepsy care aiming to reduce mortality of epilepsy in mothers and reduce morbidity in babies exposed to AEDs in utero. We identify in particular -What stage to intervene - Golden Moments of opportunities for improving outcomes -Which Key Groups have a role in making change -When - 2020 vision of what these improvements aim to achieve. -How to monitor the success in this field We believe that the service improvement ideas developed for the UK may provide a template for similar initiatives in other countries. Copyright © 2017 British Epilepsy Association. All rights reserved.

  20. Impacts of online and group perinatal education: a mixed methods study protocol for the optimization of perinatal health services.

    Science.gov (United States)

    Roch, Geneviève; Borgès Da Silva, Roxane; de Montigny, Francine; Witteman, Holly O; Pierce, Tamarha; Semenic, Sonia; Poissant, Julie; Parent, André-Anne; White, Deena; Chaillet, Nils; Dubois, Carl-Ardy; Ouimet, Mathieu; Lapointe, Geneviève; Turcotte, Stéphane; Prud'homme, Alexandre; Painchaud Guérard, Geneviève; Gagnon, Marie-Pierre

    2018-05-29

    Prenatal education is a core component of perinatal care and services provided by health institutions. Whereas group prenatal education is the most common educational model, some health institutions have opted to implement online prenatal education to address accessibility issues as well as the evolving needs of future parents. Various studies have shown that prenatal education can be effective in acquisition of knowledge on labour and delivery, reducing psychological distress and maximising father's involvement. However, these results may depend on educational material, organization, format and content. Furthermore, the effectiveness of online prenatal education compared to group prenatal education remains unclear in the literature. This project aims to evaluate the impacts of group prenatal education and online prenatal education on health determinants and users' health status, as well as on networks of perinatal educational services maintained with community-based partners. This multipronged mixed methods study uses a collaborative research approach to integrate and mobilize knowledge throughout the process. It consists of: 1) a prospective cohort study with quantitative data collection and qualitative interviews with future and new parents; and 2) a multiple case study integrating documentary sources and interviews with stakeholders involved in the implementation of perinatal information service networks and collaborations with community partners. Perinatal health indicators and determinants will be compared between prenatal education groups (group prenatal education and online prenatal education) and standard care without these prenatal education services (control group). This study will provide knowledge about the impact of online prenatal education as a new technological service delivery model compared to traditional group prenatal education. Indicators related to the complementarity of these interventions and those available in community settings will

  1. Facilitating Sustainable Waste Management Behaviors Within the Health Sector: A Case Study of the National Health Service (NHS in Southwest England, UK

    Directory of Open Access Journals (Sweden)

    Janet Richardson

    2012-04-01

    Full Text Available Waste costs the National Health Service (NHS £71.2 million in 2007/2008; recycling all papers, newspapers and cardboard produced by the NHS in England and Wales could save up to 42,000 tonnes of CO2. As the largest employer in the UK, the NHS is in a prime position to both lead the way towards a sustainable future, but also act as a test bed for organizational change and provide evidence of what works at an individual level to change attitudes and behavior. However these require changes in mindset, including values, attitudes, norms and behaviors which are required along with clear definitions of the problems faced in terms of economics, society and culture. Initial investigations of the literature indicate that behavior change theory may provide a feasible means of achieving constructive changes in clinical waste management; such approaches require further investigation. This paper describes a feasibility study designed to examine issues that might affect the introduction of a behavior change strategy and improve waste management in a healthcare setting. Guided by the evidence gained from our systematic review, 20 interviews were carried out with senior managers, clinicians and support staff involved in the management of healthcare waste from a broad range of agencies in South West England. Interviews were audio-recorded and transcribed for analysis. Thematic content analysis was conducted in order to identify key issues and actions. Data extraction, coding and analysis were cross checked independently by the four members of the research team. Initial findings suggest tensions, between Government and local policies, between packaging and storage space at ward level and, and between the operational requirements of infection control and maintaining appropriate and ethical patient care. These tensions increase pressures on staff already trying to maintain high quality care in a resource restricted and changing environment.

  2. The impact of team-based primary care on health care services utilization and costs: Quebec's family medicine groups.

    Science.gov (United States)

    Strumpf, Erin; Ammi, Mehdi; Diop, Mamadou; Fiset-Laniel, Julie; Tousignant, Pierre

    2017-09-01

    We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not. Participation in FMGs is voluntary and we address potential selection bias by matching on GP propensity scores, using inverse probability of treatment weights at the patient level, and then estimating difference-in-differences models. We also use appropriate modelling strategies to account for the distributions of health care cost and utilization data. We find that FMGs significantly decrease patients' health care services utilization and costs in outpatient settings relative to patients not in FMGs. The number of primary care visits decreased by 11% per patient per year among FMG enrolees and specialist visits declined by 6%. The declines in costs were of roughly equal magnitude. We found no evidence of an effect on hospitalizations, their associated costs, or the costs of ED visits. These results provide support for the idea that primary care organizational reforms can have impacts on the health care system in the absence of changes to physician payment mechanisms. The extent to which the decline in GP visits represents substitution with other primary care providers warrants further investigation. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  3. Cost justification of clinical pharmacy services on a general surgery team: focus on diagnosis-related group cases.

    Science.gov (United States)

    Bertch, K E; Hatoum, H T; Willett, M S; Witte, K W

    1988-11-01

    We used a novel approach to cost-justify clinical pharmacy services on a general surgery team in nine diagnosis-related group cases. The clinical pharmacist monitored nine patients longitudinally on a general surgery team from admission to discharge and intervened in their therapeutic management. Each recommendation was analyzed for rationale, acceptance, perceived impact on quality and/or cost of patient care, whether self-initiated or solicited, and impact on patient outcome. Types of recommendations and outcomes were categorized by process and outcome measurement criteria. Total cost avoidance per patient was calculated using costs of drug therapy, laboratory tests, and length of stay. Accounting for cost of clinical pharmacy services, net cost avoidance per patient was calculated. The clinical pharmacist made 101 recommendations on nine patients. Physicians accepted 82 percent of the recommendations; 77 percent of the recommendations were self-initiated and 23 percent were solicited. Recommendations had a perceived impact on cost, quality, or both at 13, 31, and 56 percent, respectively. Most recommendations (79 percent) brought patient therapy to a level of conformance with current standards of practice as documented in the medical literature. Recommendations that potentially preserved a major organ function by preventing drug-induced toxicity or the exacerbation of existing problems constituted 16 percent of the total. None of the accepted recommendations adversely affected patient outcome and 23 percent directly resulted in a measurable positive outcome in patient care. A total of four hospital days was potentially saved for two cases. Based on objective outcome criteria, a 1.9-day increase in therapeutic control was documented per patient.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.

    Science.gov (United States)

    Jay, Melanie; Chintapalli, Sumana; Squires, Allison; Mateo, Katrina F; Sherman, Scott E; Kalet, Adina L

    2015-11-14

    Obesity is highly prevalent among Veterans. In the United States, the Veterans Health Administration (VHA) offers a comprehensive weight management program called MOVE!. Yet, fewer than 10 % of eligible patients ever attend one MOVE! visit. The VHA has a patient-centered medical home (PCMH) model of primary care (PC) called Patient-Aligned Care Teams (PACT) at all Veterans Affairs (VA) Medical Centers. PACT teamlets conduct obesity screening, weight management counseling, and refer to MOVE!. As part of a needs assessment to improve delivery of weight management services, the purpose of this study was to assess PACT teamlet and MOVE! staff: 1) current attitudes and perceptions regarding obesity care; 2) obesity-related counseling practices 3) experiences with the MOVE! program; and 4) targets for interventions to improve implementation of obesity care in the PC setting. We recruited 25 PACT teamlet members from a single VA study site-11 PC physicians, 5 registered nurses, 5 licensed practical nurses, 1 clerical assistant, and 3 MOVE! staff (2 dietitians, 1 psychologist)-for individual interviews using a combination of convenience and snowball sampling. Audio recorded interviews were professionally transcribed and iteratively coded by two independent reviewers. The analytic process was guided by discourse analysis in order to discover how the participants perceived and provided weight management care and what specific attitudes affected their practices, all as bounded within the organization. Emerging themes included: 1) role perceptions, 2) anticipated outcomes of weight management counseling and programs, and 3) communication and information dissemination. Perceived role among PCPs was influenced by training, whereas personal experience with their own weight management impacted role perception among LPNs/RNs. Attitudes about whether or not they could impact patients' weight outcomes via counseling or referral to MOVE! varied. System-level communication about VHA

  5. An evaluation of the telehealth facilitation of diabetes and cardiovascular care in remote Australian Indigenous communities: - protocol for the telehealth eye and associated medical services network [TEAMSnet] project, a pre-post study design.

    Science.gov (United States)

    Brazionis, Laima; Jenkins, Alicia; Keech, Anthony; Ryan, Chris; Bursell, Sven-Erik

    2017-01-05

    Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia. Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from three primary-care health-services in the Northern Territory. Diabetes status will be based on clinical records. There will be four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and telehealth screening strategy]. 2. A lifestyle survey tool administered at ≈ 6-months. 3. At ≈ 6- and 18-months, an electronic cardiovascular disease and diabetes decision-support tool based on current guidelines in the Standard Treatment Manual of the Central Australian Rural Practitioner's Association to generate clinical recommendations. 4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will include: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and survey data/opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence to clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed. Remoteness is a major barrier to provision and uptake of best-practice chronic disease management. Telehealth, beyond videoconferencing of consultations, could facilitate evidence-based management of diabetes and cardiovascular disease in Indigenous Australians and serve as a model for other conditions. Australia

  6. [Emergency contraception in Brazil: facilitators and barriers].

    Science.gov (United States)

    Hardy, E; Duarte, G A; Osis, M J; Arce, X E; Possan, M

    2001-01-01

    A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.

  7. Intelligence in the power grid and services to the consumers. Issue paper - working group 4; Denmark. Smart Grid Network; Intelligens i el-nettet og serviceydelser til forbrugerne. Issue paper, arbejdsgruppe 4

    Energy Technology Data Exchange (ETDEWEB)

    Jonsen, B.O. (Solar Danmark A/S, Vejen (Denmark)); Hauge, B. (IT-Branchen, Copenhagen (Denmark)); Strunge, C. (Energinet.dk, Fredericia (Denmark)) (and others)

    2011-07-01

    The Smart Grid Network was established in 2010 by the Danish climate and energy minister tasked with developing recommendations for future actions and initiatives that make it possible to handle up to 50% electricity from wind energy in the power system in 2020. The task of working group 4 was to investigate what it takes to involve consumers in smart grid and how to create good conditions for new services related to smart grid. Against this background, the working group agreed the following recommendations: 1) Enhance consumer engagement. A prerequisite for electricity customers becoming involved in smart grid is that they have awareness and knowledge about the smart grid and their own possibilities for action in relation thereto. Therefore it is important that concepts such as smart grid and flexible electricity consumption gradually become popular among electric customers; 2) Minimize the risk. In order to promote electric customers' and other stakeholders' participation in the smart grid, the risk of this participation must be minimized. It is therefore recommended to enhance the skills of the professionals and to establish a common framework for security; 3) Make it easier to create new services. Part of the potential of smart grid can be realized through new services such as delivery of flexible electricity consumption for electric cars and heat pumps and the resale of local power generation at the customer. To facilitate the conditions for these services, the working group recommends that better access to relevant data is created, that the interoperability of smart grid solutions is strengthened, that requirements for buildings are made, that it is made easier to be an aggregator, and that test and inspiration laboratories for small and medium enterprises in the smart grid area are established. (LN)

  8. Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study.

    Science.gov (United States)

    Byrne, Eamonn; Bury, Gerard

    2018-02-08

    Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring. Even though reporting systems are in place, the levels appear to be well below what might be expected. Little data is available to explain this apparent discrepancy. To identify, investigate and document the barriers to medication error reporting within the NAS. An independent moderator led four focus groups in March of 2016. A convenience sample of 18 frontline Paramedics and Advanced Paramedics from Cork City and County discussed medication errors and the medication error reporting process. The sessions were recorded and anonymised, and the data was analysed using a process of thematic analysis. Practitioners understood the value of reporting errors. Barriers to reporting included fear of consequences and ridicule, procedural ambiguity, lack of feedback and a perceived lack of both consistency and confidentiality. The perceived consequences for making an error included professional, financial, litigious and psychological. Staff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted.

  9. Assessing the Relationship between Physical Illness and Mental Health Service Use and Expenditures among Older Adults from Racial/Ethnic Minority Groups

    Science.gov (United States)

    Jimenez, Daniel E; Cook, Benjamin; Kim, Giyeon; Reynolds, Charles F.; Alegria, Margarita; Coe-Odess, Sarah; Bartels, Stephen J.

    2015-01-01

    Objective The association of physical illness and mental health service use in older adults from racial/ethnic minority groups is an important area of study given the mental and physical health disparities and the low use of mental health services in this population. The purpose of this study is to describe the impact of comorbid physical illness on mental health service use and expenditures in older adults; and to evaluate disparities in mental health service use and expenditures among a racially/ethnically diverse sample of older adults with and without comorbid physical illness. Methods Data were obtained from the Medical Expenditure Panel Survey (years 2004–2011). The sample included 1563 whites, 519 African-Americans, and 642 Latinos and (N=2,724) aged 65+ with probable mental illness. Using two-part generalized linear models, we estimated and compared mental health service use among those with and without a comorbid physical illness. Results Mental health service use was greater for older adults with comorbid physical illness compared to those without a comorbid physical illness. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid physical illness increased the likelihood of mental health service use in older whites and Latinos. However, the presence of a comorbidity did not impact racial/ethnic disparities in mental health service use. Conclusions This study highlighted the important role of comorbid physical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial/ethnic minority groups. PMID:25772763

  10. Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of 'Living Life to the Full Interactive', 'Sleepio' and 'Breaking Free Online' at 'Self Help Services'.

    Science.gov (United States)

    Elison, Sarah; Ward, Jonathan; Williams, Chris; Espie, Colin; Davies, Glyn; Dugdale, Stephanie; Ragan, Kathryn; Chisnall, Leanne; Lidbetter, Nicky; Smith, Keith

    2017-07-20

    There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. 'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. 1068 service users referred to the service for secondary care for their mental health difficulties. Participants were triaged into one of three eTherapy programmes: 'Living Life to the Full Interactive' for low mood, stress and anxiety; 'Sleepio' for insomnia; and 'Breaking Free Online' for substance misuse, depending on clinical need. Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, pmental health scores were found within all three groups (all pmental health difficulties (pmental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Trauma quality improvement: The Pietermaritzburg Metropolitan Trauma Service experience with the development of a comprehensive structure to facilitate quality improvement in rural trauma and acute care in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Clarke, Damian Luiz

    2015-01-03

    Improving the delivery of efficient and effective surgical care in rural South Africa is a mammoth task bedevilled by conflict between the stakeholders, who include rural doctors, surgeons, ancillary staff, researchers, educators and administrators. Management training is not part of most medical school curricula, yet as they progress in their careers, many clinicians are required to manage a health system and find the shift from caring for individual patients to managing a complex system difficult. Conflict arises when management-type interventions are imposed in a top-down manner on surgical staff suspicious of an unfamiliar field of study. Another area of conflict concerns the place of surgical research. Researchers are often accused of not being sufficiently focused on or concerned about the tasks of service delivery. This article provides an overview of management theory and describes a comprehensive management structure that integrates a model for health systems with a strategic planning process, strategic planning tools and appropriate quality metrics, and shows how the Pietermaritzburg Metropolitan Trauma Service in KwaZulu-Natal Province, South Africa, successfully used this structure to facilitate and contextualise a diverse number of quality improvement programmes and research initiatives in the realm of rural acute surgery and trauma. We have found this structure to be useful, and hope that it may be applied to other acute healthcare systems.

  12. British Asian families and the use of child and adolescent mental health services: a qualitative study of a hard to reach group \\ud \\ud

    OpenAIRE

    Bradby, Hannah; Varyani, Maya; Oglethorpe, Rachel; Raine, Wendy; White, Ishbel; Helen, Minnis

    2007-01-01

    We explored attitudes to and experiences of Child and Adolescent Mental Health Services (CAMHS) among families of South Asian origin who are underrepresented as service-users in an area of a Scottish city with a high concentration of people of South Asian origin. Six community focus groups were conducted, followed by semi-structured interviews with families who had used CAMHS and with CAMHS professionals involved in those families’ cases. Lastly, parents of children who had problems usually r...

  13. Synergies between veterinarians and para-professionals in the public and private sectors: organisational and institutional relationships that facilitate the process of privatising animal health services in developing countries.

    Science.gov (United States)

    Woodford, J D

    2004-04-01

    and livestock products. An informal delivery system has gained a foothold in many developing countries in the absence of a well-planned strategy for the privatisation of animal health services. Most governments would now acknowledge that this presents a greater risk than the deployment of well-regulated and effectively supervised para-professionals. This paper explores some of the principal challenges facing policy-makers in their efforts to bridge the transition from full state provision of animal health services to the formation of a partnership with the private sector. Governments and donors need to take active steps to facilitate the process of privatisation of animal health services, especially those targeting the poorer rural subsistence and pastoralist farming systems. This would entail an initial investment in developing the necessary management skills at all levels in the delivery system. Thereafter, further investment would be required to allow the changes to be managed using tools such as the strategic planning cycle. Should sufficient resources be made available to allow the full participation of all stakeholders in the delivery of animal health services, appropriate institutions and effective organisational relationships addressing all the more important issues will have to be identified. The paper then proceeds to describe how different livestock production systems determine the level of demand for animal health services. If these services are to be provided on a financially sustainable basis, they must be tailored to meet actual rather than perceived demand. Identifying an appropriate model for animal health service delivery thus requires careful analysis of the production system to be targeted. Governments and donors can play a useful role in providing resources for this type of study as well as for appropriate market studies, business planning, training and access to soft loans. Finally, as regards regulation, as the law stands today, many activities

  14. "Recovery" in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study.

    Science.gov (United States)

    Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

    2012-04-01

    Bipolar disorder (BD) is a chronic and recurrent affective disorder. Recovery is defined as the process by which people can live fulfilling lives despite experiencing symptoms. To explore how an opportunistically recruited group of service users with BD experience recovery and self-management to understand more about how a service users' recovery may be supported. Twelve service users with BD took part in a series of focus groups. Service users' responses to questions about their personal experiences of self-management and recovery were analysed. Focus groups were transcribed verbatim and thematic analysis ([ Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101]) was employed to identify common themes in the data. Four key themes were identified: (1) Recovery is not about being symptom free; (2) Recovery requires taking responsibility for your own wellness; (3) Self-management: building on existing techniques; (4) Overcoming barriers to recovery: negativity, stigma and taboo. Service users with BD have provided further support for the concept of recovery and have suggested a number of ways recovery can be supported. A self-management approach informed by the recovery literature has been proposed as a way to support service users' recovery.

  15. Barriers and facilitators of the HIV care continuum in Southern New England for people with drug or alcohol use and living with HIV/AIDS: perspectives of HIV surveillance experts and service providers.

    Science.gov (United States)

    Grau, Lauretta E; Griffiths-Kundishora, Abbie; Heimer, Robert; Hutcheson, Marguerite; Nunn, Amy; Towey, Caitlin; Stopka, Thomas J

    2017-10-02

    Contemporary studies about HIV care continuum (HCC) outcomes within substance using populations primarily focus on individual risk factors rather than provider- or systems-level influences. Over 25% of people living with HIV (PLWH) have substance use disorders that can alter their path through the HCC. As part of a study of HCC outcomes in nine small cities in Southern New England (population 100,000-200,000 and relatively high HIV prevalence particularly among substance users), this qualitative analysis sought to understand public health staff and HIV service providers' perspectives on how substance use may influence HCC outcomes. Interviews with 49 participants, collected between November 2015 and June 2016, were analyzed thematically using a modified social ecological model as the conceptual framework and codes for substance use, HCC barriers and facilitators, successes and failures of initiatives targeting the HCC, and criminal justice issues. Eight themes were identified concerning the impact of substance use on HCC outcomes. At the individual level, these included coping and satisfying basic needs and could influence all HCC steps (i.e., testing, treatment linkage, adherence, and retention, and viral load suppression). The interpersonal level themes included stigma issues and providers' cultural competence and treatment attitudes and primarily influenced treatment linkage, retention, and viral load suppression. These same HCC steps were influenced at the health care systems level by organizations' physical environment and resources as well as intra-/inter-agency communication. Testing and retention were the most likely steps to affect at the policy/society level, and the themes included opposition within an organization or community, and activities with unintended consequences. The most substantial HCC challenges for PLWH with substance use problems included linking and retaining in treatment those with multiple co-morbidities and meeting their basic living

  16. The Combination Design of Enabling Technologies in Group Learning: New Study Support Service for Visually Impaired University Students

    Science.gov (United States)

    Tangsri, Chatcai; Na-Takuatoong, Onjaree; Sophatsathit, Peraphon

    2013-01-01

    This article aims to show how the process of new service technology-based development improves the current study support service for visually impaired university students. Numerous studies have contributed to improving assisted aid technology such as screen readers, the development and the use of audiobooks, and technology that supports individual…

  17. Facilitating community information service for national development ...

    African Journals Online (AJOL)

    Many rural communities have continued to be underserved; hence, information becomes necessary in integrating the needs of the people for sustainable development. Librarians and libraries are charged with providing the information resources and outreaches to the communities to help build the bridge between the ...

  18. Welfare Lobby Groups responding to Globalisation: A Comparison of the Australian Council of Social Service (ACOSS and the UK Child Poverty Action Group (CPAG

    Directory of Open Access Journals (Sweden)

    2004-05-01

    Full Text Available The past decade has witnessed a period of intense economic globalisation. The growing significance of international trade, investment, production and financial flows appears to be curtailing the autonomy of individual nation states. In particular, globalisation appears to be encouraging, if not demanding, a decline in social spending and standards. However, many authors believe that this thesis ignores the continued impact of national political and ideological pressures and lobby groups on policy outcomes. In particular, it has been argued that national welfare consumer and provider groups remain influential defenders of the welfare state. For example, US aged care groups are considered to be particularly effective defenders of social security pensions. According to this argument, governments engaged in welfare retrenchment may experience considerable electoral backlash (Pierson 1996; Mishra 1999. Yet, it is also noted that governments can take action to reduce the impact of such groups by reducing their funding, and their access to policy-making and consultation processes. These actions are then justified on the basis of removing potential obstacles to economic competitiveness (Pierson 1994; Melville 1999.

  19. Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sinha Rajesh

    2011-07-01

    Full Text Available Abstract Background Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting. The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa. Methods/design The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional

  20. Family group interventions in an early psychosis program: A re-evaluation of practice after 10 years of service delivery.

    Science.gov (United States)

    Day, Kate; Starbuck, Rachael; Petrakis, Melissa

    2017-08-01

    The role of family in supporting service users in coping with illness and engaging in relapse prevention in early psychosis is important. Taking on this caring though is stressful and challenging, and it has been found that support and information for carers assists in their coping and reduces isolation. To evaluate the current utility of a psychoeducation group program in a public adult mental health service, for the families of people experiencing early psychosis. A purpose-designed pre- and post-intervention questionnaire was administered to quantitatively measure group participants' changes in perceptions of their understanding of mental illness and its treatment through attending the group. Additional qualitative items were used to determine other knowledge, benefits and any critical feedback. The group program continues to result in highly significant improvements in family members' understanding of psychosis, recovery, medications, relapse prevention and substance co-morbidities. Additional feedback reaffirmed previous findings that family members find group peer support valuable and that this reduces isolation and the experience of stigma. The current evaluation, conducted following 10 years of early psychosis group work, found there to be efficacy in family peer support groups and that it is important to provide family interventions in public early psychosis mental health services.

  1. Behavior change techniques used in group-based behavioral support by the English stop-smoking services and preliminary assessment of association with short-term quit outcomes.

    Science.gov (United States)

    West, Robert; Evans, Adam; Michie, Susan

    2011-12-01

    To develop a reliable coding scheme for components of group-based behavioral support for smoking cessation, to establish the frequency of inclusion in English Stop-Smoking Service (SSS) treatment manuals of specific components, and to investigate the associations between inclusion of behavior change techniques (BCTs) and service success rates. A taxonomy of BCTs specific to group-based behavioral support was developed and reliability of use assessed. All English SSSs (n = 145) were contacted to request their group-support treatment manuals. BCTs included in the manuals were identified using this taxonomy. Associations between inclusion of specific BCTs and short-term (4-week) self-reported quit outcomes were assessed. Fourteen group-support BCTs were identified with >90% agreement between coders. One hundred and seven services responded to the request for group-support manuals of which 30 had suitable documents. On average, 7 BCTs were included in each manual. Two were positively associated with 4-week quit rates: "communicate group member identities" and a "betting game" (a financial deposit that is lost if a stop-smoking "buddy" relapses). It is possible to reliably code group-specific BCTs for smoking cessation. Fourteen such techniques are present in guideline documents of which 2 appear to be associated with higher short-term self-reported quit rates when included in treatment manuals of English SSSs.

  2. Using the Consolidated Framework for Implementation Research to Identify Barriers and Facilitators for the Implementation of an Internet-Based Patient-Provider Communication Service in Five Settings: A Qualitative Study.

    Science.gov (United States)

    Varsi, Cecilie; Ekstedt, Mirjam; Gammon, Deede; Ruland, Cornelia M

    2015-11-18

    Although there is growing evidence of the positive effects of Internet-based patient-provider communication (IPPC) services for both patients and health care providers, their implementation into clinical practice continues to be a challenge. The 3 aims of this study were to (1) identify and compare barriers and facilitators influencing the implementation of an IPPC service in 5 hospital units using the Consolidated Framework for Implementation Research (CFIR), (2) assess the ability of the different constructs of CFIR to distinguish between high and low implementation success, and (3) compare our findings with those from other studies that used the CFIR to discriminate between high and low implementation success. This study was based on individual interviews with 10 nurses, 6 physicians, and 1 nutritionist who had used the IPPC to answer messages from patients. Of the 36 CFIR constructs, 28 were addressed in the interviews, of which 12 distinguished between high and low implementation units. Most of the distinguishing constructs were related to the inner setting domain of CFIR, indicating that institutional factors were particularly important for successful implementation. Health care providers' beliefs in the intervention as useful for themselves and their patients as well as the implementation process itself were also important. A comparison of constructs across ours and 2 other studies that also used the CFIR to discriminate between high and low implementation success showed that 24 CFIR constructs distinguished between high and low implementation units in at least 1 study; 11 constructs distinguished in 2 studies. However, only 2 constructs (patient need and resources and available resources) distinguished consistently between high and low implementation units in all 3 studies. The CFIR is a helpful framework for illuminating barriers and facilitators influencing IPPC implementation. However, CFIR's strength of being broad and comprehensive also limits its

  3. The lay user perspective on the quality of pharmaceuticals, drug therapy and pharmacy services--results of focus group discussions

    DEFF Research Database (Denmark)

    Traulsen, Janine Marie; Almarsdóttir, Anna Birna; Björnsdóttir, Ingunn

    2002-01-01

    This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland.......This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland....

  4. Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

    OpenAIRE

    Young-Shin Lee

    2017-01-01

    Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD) tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women com...

  5. A comparison of the efficacy of three intervention trial types: postal, group, and one-to-one facilitation, prior management and the impact of message framing and repeat messages on the flock prevalence of lameness in sheep.

    Science.gov (United States)

    Grant, Claire; Kaler, Jasmeet; Ferguson, Eamonn; O'Kane, Holly; Green, Laura Elizabeth

    2018-01-01

    sheep pre-trial than those not using Six steps at all. There was no significant effect of message framing. The greatest behavioural change was a reduction in therapeutic and routine foot trimming and the greatest attitude change was an increase in negative attitudes towards foot trimming. We conclude that all three intervention trial approaches were effective to promote best practice to treat sheep with footrot with one-to-one facilitation more effective than group and postal intervention trials. Results suggest that farmers' behaviour change was greater among those practising aspects of the intervention message before the trial began than those not practising any aspect. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Genitourinary medicine/HIV services for persons with insecure immigration or seeking asylum in the United Kingdom: a British Co-operative Clinical Group survey.

    Science.gov (United States)

    Rajamanoharan, Sasikala; Monteiro, Eric F; Maw, Raymond; Carne, Christopher A; Robinson, Angela

    2004-08-01

    Over the past three years many genitourinary medicine (GUM) clinics have anecdotally reported large numbers of persons with insecure immigration or seeking asylum (PIISA) attending their facilities. We conducted a national survey to assess the prevalence and demographic background of PIISA who were attending GUM clinics in the UK during 2001 and 2002 and the effect on service provision. A questionnaire was circulated in April 2003 to 182 consultants in the UK of whom 128 (70%) responded. Amongst those centres that responded, 89 (69%) had provided GUM/HIV services for PIISA in 2002. One-third of clinics had accurate data collection systems and less than a quarter used computerized databases in order to identify the associated workload. Of the HIV-positive patients attending these clinics during 2002, 1140 (42%) were identified as PIISA. Eighty-two (95.3%) and 62 (48.8%) clinics had cared for PIISA from Africa and Europe respectively. Co-infection with HIV and tuberculosis was higher in patients from the PIISA group compared with the non-PIISA group (85% vs 15%, P = 0.001) for both 2001 and 2002. Clinics reported many problems associated with the service for PIISA. Forty-five percent of the clinics reported difficulties with funding for the increased workload associated with PIISA. The survey shows that GUM services have an important role in the management of PIISA and that the programme of dispersal is having a significant impact on the workload of clinics outside London. Services report that they are significantly overstretched and underfunded. An immediate investment in GUM services is necessary to improve the health of this client group. Any delay in diagnosis of sexually transmitted infections and HIV will have implications for public health and acute services.

  7. Perceived needs and experiences with healthcare services of women with spinal cord injury during pregnancy and childbirth - a qualitative content analysis of focus groups and individual interviews.

    Science.gov (United States)

    Bertschy, Sue; Geyh, Szilvia; Pannek, Jürgen; Meyer, Thorsten

    2015-06-16

    Women after a spinal cord injury (SCI), who decide to get pregnant and to become mothers, have special health care service needs. This study aims to identify the perceived service needs of woman with SCI during pregnancy and childbirth in Switzerland and to reconstruct their experiences of healthcare service utilization based on their accounts. A qualitative content analysis based on focus groups and individual interviews was conducted. 17 mothers with SCI who had given birth following SCI within the past 15 years participated. The data were transcribed verbatim before content analyses were carried out. Primary data was collected from August 2012 to September 2013 at the Swiss Paraplegic Research Centre, Nottwil; the University of Lausanne and at the homes of the participants. Mothers reported a broad spectrum of medical needs, including the need for access to improved integrated care. They also reported difficulties finding providers with knowledge of both paraplegiology (i.e. spinal cord medicine) and gynaecology. Mothers preferred using local health care services and regular birth hospitals, and reported receiving no additional benefit from the services of specialised SCI centres during pregnancy. A pre-existing provider-patient relationship was helpful for optimizing care processes. This study showed that pregnant women with SCI have various perceived healthcare needs and health care service use. Effective programs to improve these women's access to integrated care during pregnancy and childbirth and policies requiring the provision of specific pregnancy information and pre-birth services are necessary.

  8. Calculation of demands for nuclear fuels and fuel cycle services. Description of computer model and strategies developed by Working Group 1

    International Nuclear Information System (INIS)

    Working Group 1 examined a range of reactor deployment strategies and fuel cycle options, in oder to estimate the range of nuclear fuel requirements and fuel cycle service needs which would result. The computer model, its verification in comparison with other models, the strategies to be examined through use of the model, and the range of results obtained are described

  9. Group Guidance Services with Self-Regulation Technique to Improve Student Learning Motivation in Junior High School (JHS)

    Science.gov (United States)

    Pranoto, Hadi; Atieka, Nurul; Wihardjo, Sihadi Darmo; Wibowo, Agus; Nurlaila, Siti; Sudarmaji

    2016-01-01

    This study aims at: determining students motivation before being given a group guidance with self-regulation technique, determining students' motivation after being given a group counseling with self-regulation technique, generating a model of group counseling with self-regulation technique to improve motivation of learning, determining the…

  10. 77 FR 8725 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2012-02-15

    ... regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by... plans and group health insurance issuers on April 16, 2012. FOR FURTHER INFORMATION CONTACT: Amy Turner... addition, information from HHS on private health insurance for consumers can be found on the CMS Web site...

  11. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ... to the interim final regulations implementing the rules for group health plans and health insurance... dates. These interim final regulations generally apply to group health plans and group health insurance... from HHS on private health insurance for consumers can be found on the Centers for Medicare & Medicaid...

  12. 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...

  13. COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

    Science.gov (United States)

    Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei

    2016-09-01

    The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

  14. Visual explorer facilitator's guide

    CERN Document Server

    Palus, Charles J

    2010-01-01

    Grounded in research and practice, the Visual Explorer™ Facilitator's Guide provides a method for supporting collaborative, creative conversations about complex issues through the power of images. The guide is available as a component in the Visual Explorer Facilitator's Letter-sized Set, Visual Explorer Facilitator's Post card-sized Set, Visual Explorer Playing Card-sized Set, and is also available as a stand-alone title for purchase to assist multiple tool users in an organization.

  15. Learning facilitating leadership

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard; Hansen, Mette Sanne

    2016-01-01

    This paper explains how engineering students at a Danish university acquired the necessary skills to become emergent facilitators of organisational development. The implications of this approach are discussed and related to relevant viewpoints and findings in the literature. The methodology deplo....... By connecting the literature, the authors’ and engineering students’ reflections on facilitator skills, this paper adds value to existing academic and practical discussions on learning facilitating leadership....

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

    Science.gov (United States)

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

    2013-12-01

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

  17. Impact of Structured Group Activities on Pre-Service Teachers' Beliefs about Classroom Motivation: An Exploratory Study

    Science.gov (United States)

    Mansfield, Caroline F.; Volet, Simone E.

    2014-01-01

    Pre-service teachers' beliefs about classroom motivation, and how these beliefs may be developed during initial teacher preparation, is a relatively new aspect of enquiry in the fields of motivation and teacher education. An empirical study, grounded in a social constructivist perspective, was designed to examine the impact of providing…

  18. Group Training of Applied Behavior Analysis (ABA) Knowledge Competencies to Community-Based Service Providers for Adults with Developmental Disabilities

    Science.gov (United States)

    Luiselli, James K.; St. Amand, CarrieAnne; MaGee, Christine; Sperry, James M.

    2008-01-01

    We describe a training program to teach applied behavior analysis (ABA) knowledge competencies to paraprofessional staff (N = 47) at a habilitation services agency for adults with developmental disabilities. Before and following training, staff completed assessment of knowledge tests for three content areas: basic learning principles,…

  19. British Asian families and the use of child and adolescent mental health services: a qualitative study of a hard to reach group.

    Science.gov (United States)

    Bradby, Hannah; Varyani, Maya; Oglethorpe, Rachel; Raine, Wendy; White, Ishbel; Helen, Minnis

    2007-12-01

    We explored attitudes to and experiences of Child and Adolescent Mental Health Services (CAMHS) among families of South Asian origin who are underrepresented as service-users in an area of a Scottish city with a high concentration of people of South Asian origin. Six community focus groups were conducted, followed by semi-structured interviews with families who had used CAMHS and with CAMHS professionals involved in those families' cases. Lastly, parents of children who had problems usually referred to CAMHS but who had not used the service were interviewed. Qualitative analysis of transcripts and notes was undertaken using thematic and logical methods. Participants consisted of 35 adults who identified themselves as Asian and had children; 7 parents and/or the young service users him-herself; 7 health care professionals involved in the young person's care plus 5 carers of 6 young people who had not been referred to CAMHS, despite having suitable problems. Focus groups identified the stigma of mental illness and the fear of gossip as strong disincentives to use CAMHS. Families who had been in contact with CAMHS sought to minimise the stigma they suffered by emphasising that mental illness was not madness and could be cured. Families whose children had complex emotional and behavioural problems said that discrimination by health, education and social care professionals exacerbated their child's difficulties. Families of children with severe and enduring mental illness described tolerating culturally inappropriate services. Fear of gossip about children's 'madness' constituted a major barrier to service use for Asian families in this city. Given the widespread nature of the concern over the stigma of children's mental illness, it should be considered in designing culturally competent services for children's mental health.

  20. Stories of People Who Have Attended a Lesbian, Gay, Bisexual and Trans Support Group in a Secure Intellectual Disability Service.

    Science.gov (United States)

    Tallentire, Liz; Smith, Matthew; David, Lee; Roberts, Adam; Bruce; Morrow, Sarah; Withers, Paul; Smith, Ian

    2016-08-31

    This research is about people who have intellectual disabilities and live in a secure hospital. It is about a group of people who meet at a support group. The support group is for people who are lesbian, gay, bisexual or transgender. These people with intellectual disabilities helped with planning, doing, and telling other people about the research. They told their stories about going to the support group. Their stories were joined together into a group story. The story said that the group helped people in lots of different ways. For some people going to the group was difficult at first because it was ?coming out'. This means telling other people you are lesbian, gay, bisexual, or transgender. Then it got easier and people started to feel better about themselves. Then they wanted to help others and this was important in their lives. This group seemed to help people get better. We have given some ideas for setting up other groups and doing more research. © 2016 John Wiley & Sons Ltd.

  1. What do service users with bipolar disorder want from a web-based self-management intervention? A qualitative focus group study.

    Science.gov (United States)

    Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

    2013-01-01

    Bipolar disorder (BD) is a chronic and recurrent severe mental health problem. A web-based self-management intervention provides the opportunity to widen access to psychological interventions. This qualitative study aims to identify what an ideal web-based intervention would look like for service users with BD. Twelve service users with BD were recruited in the UK and took part in a series of focus groups to inform and refine the development of a web-based self-management intervention. Reported here is a subset analysis of data gathered with the primary aim of identifying the needs and desires of service users for such an intervention for BD. We analysed service users' responses to questions about content, outcomes, format, barriers and support. Focus groups were transcribed verbatim, and thematic analysis was employed. The data were ordered into four key themes: (1) gaining an awareness of and managing mood swings; (2) not just about managing mood swings: the importance of practical and interpersonal issues; (3) managing living within mood swings without losing the experience; (4) internet is the only format: freely accessible, instant and interactive; (5) professional and peer support to overcome low motivation and procrastination difficulties. The small group of participants are not representative of those living with BD. These findings have significantly enhanced our understanding of what service users with BD want from a web-based self-management intervention and have clear implications for the future development of such approaches. Service users desire a web-based self-management approach that gives them the techniques they need to not only manage their moods but also manage their lives alongside the disorder, including interpersonal and practical issues. Service users describe their primary outcome, not as a cure or reduction in their symptoms, but instead being able to live a fulfilling life alongside their condition. Service users see the internet as their

  2. Containers, facilitators, innovators?

    DEFF Research Database (Denmark)

    Makkonen, Teemu; Merisalo, Maria; Inkinen, Tommi

    2018-01-01

    : are they containers, facilitators or innovators? This is investigated here through empirical material derived from 27 interviews with top departmental management in three Finnish cities (Helsinki, Espoo and Vantaa). The results show that local city governments (LCGs) consider cities as facilitators of innovation...

  3. Training facilitators and supervisors

    DEFF Research Database (Denmark)

    Kjær, Louise Binow; O Connor, Maja; Krogh, Kristian

    At the Master’s program in Medicine at Aarhus University, Denmark, we have developed a faculty development program for facilitators and supervisors in 4 progressing student modules in communication, cooperation, and leadership. 1) A course for module 1 and 3 facilitators inspired by the apprentic...

  4. Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the Elderly Receiving Home Care Service.

    Science.gov (United States)

    Jeon, MiYang; Gu, Mee Ock; Yim, JongEun

    2017-12-01

    The purpose of this study was to provide information to develop a program to prevent repeated falls by analyzing the difference in gait, muscle strength, balance, and fear of falling according to their fall experience. The study subjects were 110 elderly individuals aged over 60 years who agreed to their participation in this research. The study participants were categorized into a repeated fall group (n = 40), a one-time fall group (n = 15), and a nonfall group (n = 46) of the elderly. Measurements of gait, muscle strength, balance, and fear of falling were taken in each group. With regard to gait, there were significant differences among three groups in gait cycle (F = 3.50, p = .034), speed (F = 13.06, p balance, the nonfall group had significantly greater results than the one-time fall group and repeated fall group in dynamic balance (F = 10.80, p balance (F = 8.20, p = .001). In the case of the fear of falling, the repeated fall group had significantly higher score than other two groups (F = 20.62, p fall risk factors to enhance gait and balance and lower body muscle strength and reduce the fear of falling to prevent repeated incidences of falls in this population. Copyright © 2017. Published by Elsevier B.V.

  5. A Case Study of Student Engagement in Collaborative Group Learning in a Blended Community Based (Service) Learning Module

    OpenAIRE

    McGarrigle, John G.

    2009-01-01

    Abstract: A participatory action research case study employed mixed methods to examine student collaboration and engagement in a Community Based (Service) learning module. A quasi experimental testing of Coates (2007) typology of student engagement found low agreement between students and lecturers in assigning the terms, passive, intense, independent or collaborative to student postings to discussion fora. Evidence from this case study found greater student collaboration in discussion fora w...

  6. Evaluation of the influence of economic groups on the efficiency and quality of service of water companies: an empirical approach for Chile.

    Science.gov (United States)

    Molinos-Senante, María; Farías, Rodrigo

    2018-06-04

    The privatization of water and sewerage services (WSS) has led to the foundation of water economic groups, which integrate several water companies and have gained notable importance at the global level. In the framework of benchmarking studies, there are no prior studies exploring the impact that economic groups have on the efficiency and quality of service provided by water companies. This study investigates, for the first time, whether the membership of water companies in an economic group influences their performance. Quantity- and quality-adjusted efficiency scores were computed using data envelopment analysis models. An empirical application was developed for the Chilean water industry since most of their water companies are private and belong to an economic group. The results show that independent water companies provide WSS with better quality than do water companies that belong to an economic group. From a statistical point of view, it was evident that membership in an economic group impacts both the quantity- and quality-adjusted efficiency scores of water companies. The results of this study illustrate that applying the model-firm regulation to the Chilean water industry has significant drawbacks that should be addressed by the water regulator to promote the long-term sustainability of the water industry.

  7. Woc 5 distribution. Report of study group 5.1 ''service pipes''; Rapport du groupe de travail 5.1 ''branchements''

    Energy Technology Data Exchange (ETDEWEB)

    Sircar, A.; Hec, D.

    2000-07-01

    Service pipes are constitute an important link in the gas distribution chain. By their numbers, their relative weakness against third party aggressions and due to the fact that they constitute in most cases the limit of responsibility between the gas company network and customers' installations, service pipes have been identified as a technical and economical key issue for the gas industry development. This document analyses technical and economical data dealing with domestic service pipes having a maximum flow rate of 10 m3/h collected from 42 gas companies spread over 22 countries. All service pipes elements, from the connection with the distribution network up to the delivery point, are analysed emphasizing their layouts and design, the materials used, the construction techniques, the operating and maintenance policies and a few rehabilitation techniques. The main different technical solutions given by the gas companies have been compared in order for the study group to draw up some recommendations regarding the best practices in terms of safety, ease of maintenance and economical savings. (author)

  8. Group elicitations yield more consistent, yet more uncertain experts in understanding risks to ecosystem services in New Zealand bays

    KAUST Repository

    Singh, Gerald G.; Sinner, Jim; Ellis, Joanne; Kandlikar, Milind; Halpern, Benjamin S.; Satterfield, Terre; Chan, Kai

    2017-01-01

    The elicitation of expert judgment is an important tool for assessment of risks and impacts in environmental management contexts, and especially important as decision-makers face novel challenges where prior empirical research is lacking or insufficient. Evidence-driven elicitation approaches typically involve techniques to derive more accurate probability distributions under fairly specific contexts. Experts are, however, prone to overconfidence in their judgements. Group elicitations with diverse experts can reduce expert overconfidence by allowing cross-examination and reassessment of prior judgements, but groups are also prone to uncritical

  9. Group elicitations yield more consistent, yet more uncertain experts in understanding risks to ecosystem services in New Zealand bays

    KAUST Repository

    Singh, Gerald G.

    2017-08-02

    The elicitation of expert judgment is an important tool for assessment of risks and impacts in environmental management contexts, and especially important as decision-makers face novel challenges where prior empirical research is lacking or insufficient. Evidence-driven elicitation approaches typically involve techniques to derive more accurate probability distributions under fairly specific contexts. Experts are, however, prone to overconfidence in their judgements. Group elicitations with diverse experts can reduce expert overconfidence by allowing cross-examination and reassessment of prior judgements, but groups are also prone to uncritical

  10. Interagency Working Group on Ocean Social Science: Incorporating ecosystem services approaches into ocean and coastal decision-making and governance

    Science.gov (United States)

    The application of social science has been recognized as a priority for effective ocean and coastal management, driving much discussion and fostering emerging efforts in several areas. The Interagency Working Group on Ocean Social Science (IWG-OSS) is tasked with assisting the Su...

  11. Operation and maintenance service provision in uncertain times – the case of the FLSmidth Group during the Arab Spring

    DEFF Research Database (Denmark)

    Kreye, Melanie

    2016-01-01

    This case was written by Melanie E. Kreye. It was compiled based on primary data collection by the author such as interviews and observations and published secondary data by the case companies. The case was made possible through the generous co-operation of the FLSmidth Group. It is intended to b...

  12. The Future of Digital Music Services in Three Stereotypes; How Focus Groups of End Users See the New Business Models

    NARCIS (Netherlands)

    Bookholt, Erik; Spil, Antonius A.M.; Katsma, Christiaan

    2013-01-01

    “I am just a stereotype” sang Terry Hall in 1980. Ariola records took them in and made the band The Specials a world success. How will that process go in 2014? Will they put it on You Tube for free? Do they need a record company? Will they have less or more fans, earn less or more money? Focus group

  13. Large-scale STI services in Avahan improve utilization and treatment seeking behaviour amongst high-risk groups in India: an analysis of clinical records from six states

    Directory of Open Access Journals (Sweden)

    Gurung Anup

    2011-12-01

    Full Text Available Abstract Background Avahan, the India AIDS Initiative, implemented a large HIV prevention programme across six high HIV prevalence states amongst high risk groups consisting of female sex workers, high risk men who have sex with men, transgenders and injecting drug users in India. Utilization of the clinical services, health seeking behaviour and trends in syndromic diagnosis of sexually transmitted infections amongst these populations were measured using the individual tracking data. Methods The Avahan clinical monitoring system included individual tracking data pertaining to clinical services amongst high risk groups. All clinic visits were recorded in the routine clinical monitoring system using unique identification numbers at the NGO-level. Visits by individual clinic attendees were tracked from January 2005 to December 2009. An analysis examining the limited variables over time, stratified by risk group, was performed. Results A total of 431,434 individuals including 331,533 female sex workers, 10,280 injecting drug users, 82,293 men who have sex with men, and 7,328 transgenders visited the clinics with a total of 2,700,192 visits. Individuals made an average of 6.2 visits to the clinics during the study period. The number of visits per person increased annually from 1.2 in 2005 to 8.3 in 2009. The proportion of attendees visiting clinics more than four times a year increased from 4% in 2005 to 26% in 2009 (p Conclusions The programme demonstrated that acceptable and accessible services with marginalised and often difficult–to-reach populations can be brought to a very large scale using standardized approaches. Utilization of these services can dramatically improve health seeking behaviour and reduce STI prevalence.

  14. Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

    Directory of Open Access Journals (Sweden)

    Dukers-Muijrers Nicole HTM

    2012-12-01

    Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

  15. The association of personal importance of religion and religious service attendance with suicidal ideation by age group in the National Survey on Drug Use and Health.

    Science.gov (United States)

    Nishi, Daisuke; Susukida, Ryoko; Kuroda, Naoaki; Wilcox, Holly C

    2017-09-01

    Religiosity has been shown to be inversely associated with suicidal ideation, but few studies have examined associations by age group. This study aimed to examine the association between religiosity with suicidal ideation by age group. This study used a large nationally representative sample of 260,816 study participants from the National Survey on Drug Use and Health. Religiosity was defined as self-reported importance of religious beliefs and frequency of religious service attendance. The association between religiosity and suicidal ideation was assessed by multivariable logistic regression analysis stratified by age group (18-25, 26-34, 35-49, 50-64, 65 or older). The importance of religious beliefs was inversely associated with suicidal ideation in all age groups. The association was the strongest in people aged 65 or older, followed by people aged 18-25. Religious service attendance was also inversely associated with suicidal ideation in people aged 65 or more when attendance was more than 25 times per year. These findings may be helpful to understand age in relation to the relationship between religiosity and suicidal ideation. Particular attention to religiosity among older adults as a protective factor for suicidal ideation may be helpful in clinical settings. Copyright © 2017. Published by Elsevier B.V.

  16. Becoming Reflective Practitioners: A Case Study of Three Beginning Pre-Service Teachers

    Science.gov (United States)

    Tiainen, Outi; Korkeamäki, Riitta-Liisa; Dreher, Mariam Jean

    2018-01-01

    This case study examined three pre-service teachers' reflection processes during their first teaching practicum. During the six-week practicum, the pre-service teachers reflected on their own as well as their peers' teaching in group mentoring meetings several times a week. Unstructured stimulated recall facilitated pre-service teacher-initiated…

  17. The Future of Digital Music Services in Three Stereotypes; How Focus Groups of End Users See the New Business Models

    OpenAIRE

    Bookholt, Erik; Spil, Antonius A.M.; Katsma, Christiaan

    2013-01-01

    “I am just a stereotype” sang Terry Hall in 1980. Ariola records took them in and made the band The Specials a world success. How will that process go in 2014? Will they put it on You Tube for free? Do they need a record company? Will they have less or more fans, earn less or more money? Focus group interviews with 90 people between the ages of 15 and 25 were successfully employed to create 20 new business models for the digital music industry. Analysis with grounded theory revealed that a ne...

  18. Pay More Attention: a national mixed methods study to identify the barriers and facilitators to ensuring equal access to high-quality hospital care and services for children and young people with and without learning disabilities and their families.

    Science.gov (United States)

    Oulton, Kate; Wray, Jo; Carr, Lucinda; Hassiotis, Angela; Jewitt, Carey; Kerry, Sam; Tuffrey-Wijne, Irene; Gibson, Faith

    2016-12-09

    the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Using an Integrated Group Decision Method Based on SVM, TFN-RS-AHP, and TOPSIS-CD for Cloud Service Supplier Selection

    Directory of Open Access Journals (Sweden)

    Lian-hui Li

    2017-01-01

    Full Text Available To solve the cloud service supplier selection problem under the background of cloud computing emergence, an integrated group decision method is proposed. The cloud service supplier selection index framework is built from two perspectives of technology and technology management. Support vector machine- (SVM- based classification model is applied for the preliminary screening to reduce the number of candidate suppliers. A triangular fuzzy number-rough sets-analytic hierarchy process (TFN-RS-AHP method is designed to calculate supplier’s index value by expert’s wisdom and experience. The index weight is determined by criteria importance through intercriteria correlation (CRITIC. The suppliers are evaluated by the improved TOPSIS replacing Euclidean distance with connection distance (TOPSIS-CD. An electric power enterprise’s case is given to illustrate the correctness and feasibility of the proposed method.

  20. Coal export facilitation

    International Nuclear Information System (INIS)

    Eeles, L.

    1998-01-01

    There is a wide range of trade barriers, particularly tariffs, in current and potential coal market. Commonwealth departments in Australia play a crucial role in supporting government industry policies. This article summarises some of more recent activities of the Department of Primary Industries and Energy (DPIE) in facilitating the export of Australian Coals. Coal export facilitation activities are designed to assist the Australian coal industry by directing Commonwealth Government resources towards issues which would be inappropriate or difficult for the industry to address itself

  1. Developing User-Driven Climate Information Services to Build Resilience Amongst Groups at Risk of Drought and Flood in Arid and Semi-Arid Land Counties in Kenya

    Science.gov (United States)

    Githungo, W. N.; Shaka, A.; Kniveton, D.; Muithya, L.; Powell, R.; Visman, E. L.

    2014-12-01

    The Arid and Semi-Arid Land (ASAL) counties of Kitui and Makueni in Kenya are experiencing increasing climate variability in seasonal rainfall, including changes in the onset, cessation and distribution of the two principal rains upon which the majority of the population's small-holder farmers and livestock keepers depend. Food insecurity is prevalent with significant numbers also affected by flooding during periods of intense rainfall. As part of a multi-partner Adaptation Consortium, Kenya Meteorological Services (KMS) are developing Climate Information Services (CIS) which can better support decision making amongst the counties' principal livelihoods groups and across County Government ministries. Building on earlier pilots and stakeholder discussion, the system combines the production of climate information tailored for transmission via regional and local radio stations with the establishment of a new SMS service. SMS are provided through a network of CIS intermediaries drawn from across key government ministries, religious networks, non-governmental and community groups, aiming to achieve one SMS recipient per 3-500 people. It also introduces a demand-led, premium-rate SMS weather information service which is designed to be self-financing in the long term. Supporting the ongoing process of devolution, KMS is downscaling national forecasts for each county, and providing seasonal, monthly, weekly and daily forecasts, as well as warnings of weather-related hazards. Through collaboration with relevant ministries, government bodies and research institutions, including livestock, agriculture, drought management and health, technical advisories are developed to provide guidance on application of the climate information. The system seeks to provide timely, relevant information which can enable people to use weather and climate information to support decisions which protect life and property and build resilience to ongoing climate variability and future change.

  2. Interim report on the scientific investigations in the Animas River watershed, Colorado to facilitate remediation decisions by the U.S. Bureau of Land Management and the U.S. Forest Service, March 29, 2000 meeting, Denver, Colorado

    Science.gov (United States)

    ,

    2000-01-01

    INTRODUCTION The joint U.S. Department of the Interior and U.S. Department of Agriculture Abandoned Mine Lands Initiative (AMLI) was developed as a collaborative effort between the Federal land management agencies (FLMA, that is the U.S. Bureau of Land Management and the U.S. Forest Service) and the U.S. Geological Survey (USGS) in 1996. The stated goal of the AML Initiative was to develop a strategy for gathering and communicating the scientific information needed to develop effective and cost-efficient remediation of abandoned mines within the framework of a watershed. Four primary objectives of the AMLI are to: 1. Provide the scientific information needed (in the short-term) by the FLMAs to make decisions related to the design and implementation of cleanup actions, 2. Develop a multi-disciplined, multi-division approach that integrates geologic, hydrologic, geochemical and ecological information into a knowledge base for sound decision making, 3. Transfer technologies developed within the scientific programs of the USGS to the field and demonstrate their suitability to solve real, practical problems, and 4. Establish working relationships among involved members of land management and regulatory agencies within the framework of a watershed approach to the cleanup of abandoned mines. Long-term process-based research, including development of analytical tools, is recognized as being critical to the long-term success in remediating watersheds impacted by historical mining activities (AML 5-year plan, http://amli.usgs.gov/amli). In a meeting of Federal agencies (U.S. Bureau of Land Management [BLM], U.S. Bureau of Reclamation [BOR], U.S. National Park Service [NPS], U.S. Forest Service [USFS], the U.S. Environmental Protection Agency [EPA], the U.S. Fish and Wildlife Service [F&WS]), and State agencies (Colorado Division of Public Health and Environment, Colorado Division of Mines and Geology), several watersheds were examined within the state whose water quality was

  3. Bringing a Network-Oriented Approach to Domestic Violence Services: A Focus Group Exploration of Promising Practices.

    Science.gov (United States)

    Goodman, Lisa A; Banyard, Victoria; Woulfe, Julie; Ash, Sarah; Mattern, Grace

    2016-01-01

    Despite powerful evidence that informal social support contributes to survivors' safety and well-being, mainstream domestic violence (DV) programs have not developed comprehensive models for helping isolated survivors re-engage with these networks. Although many advocates use network-oriented strategies informally, they often do so without resources, funding, or training. This qualitative focus group study explored advocates' use and perceptions of network-oriented strategies. Advocates working in a range of DV programs across one state described the importance of network-oriented work and articulated its five dimensions, including helping survivors build their capacity to form healthy relationships, identify helpful and harmful network members, re-engage with existing networks, develop new relationships, and respond more effectively to network members. © The Author(s) 2015.

  4. Asexual sporulation facilitates adaptation

    NARCIS (Netherlands)

    Zhang, Jianhua; Debets, A.J.M.; Verweij, P.E.; Melchers, W.J.G.; Zwaan, B.J.; Schoustra, S.E.

    2015-01-01

    Understanding the occurrence and spread of azole resistance in Aspergillus fumigatus is crucial for public health. It has been hypothesized that asexual sporulation, which is abundant in nature, is essential for phenotypic expression of azole resistance mutations in A. fumigatus facilitating

  5. Facilitators in Ambivalence

    Science.gov (United States)

    Karlsson, Mikael R.; Erlandson, Peter

    2018-01-01

    This is part of a larger ethnographical study concerning how school development in a local educational context sets cultural and social life in motion. The main data "in this article" consists of semi-structural interviews with teachers (facilitators) who have the responsibility of carrying out a project about formative assessment in…

  6. Facilitation of Adult Development

    Science.gov (United States)

    Boydell, Tom

    2016-01-01

    Taking an autobiographical approach, I tell the story of my experiences facilitating adult development, in a polytechnic and as a management consultant. I relate these to a developmental framework of Modes of Being and Learning that I created and elaborated with colleagues. I connect this picture with a number of related models, theories,…

  7. Trade Facilitation in Ethiopia:

    African Journals Online (AJOL)

    Tilahun_EK

    so doing, it attempts to examine how Ethiopia's WTO Accession and trade facilitation ... the more expensive imports, exports and production becomes rendering. Ethiopian ..... can reserve the right to refuse requests of importers for the fifth valuation method to ..... units may find it easier to deal with post clearance audit. In the ...

  8. Facilitated IEP Meetings. PHP-c90

    Science.gov (United States)

    PACER Center, 2004

    2004-01-01

    To help special education planning teams reach agreements, the Minnesota Department of Education and the Minnesota Special Education Mediation Service (MNSEMS) provide the option of facilitated IEP meetings. This option is available for IEP (Individualized Education Program), IIIP (Individual Interagency Intervention Plan), and IFSP (Individual…

  9. Extension arm facilitated pegylation of alphaalpha-hemoglobin with modifications targeted exclusively to amino groups: functional and structural advantages of free Cys-93(beta) in the PEG-Hb adduct.

    Science.gov (United States)

    Li, Dongxia; Hu, Tao; Manjula, Belur N; Acharya, Seetharama A

    2009-11-01

    Cys-93(beta) of hemoglobin (Hb) was reversibly protected as a mixed disulfide with thiopyridine during extension arm facilitated (EAF) PEGylation and its influence on the structural and functional properties of the EAF-PEG-Hb has been investigated. Avoiding PEGylation of Cys-93(beta) in the EAF-PEG-Hb lowers the level of perturbation of heme pocket, alpha1beta2 interface, autoxidation, heme loss, and the O(2) affinity, as compared to the EAF-PEG-Hb with PEGylation of Cys-93(beta).The structural and functional advantages of reversible protection of Cys-93(beta) during EAF PEGylation of oxy-Hb has been compared with Euro PEG-Hb generated by EAF PEGylation of deoxy Hb where Cys-93(beta) is free in the final product. The alphaalpha-fumaryl cross-linking and EAF PEGylation targeted exclusively to Lys residues has been combined together for generation of second-generation EAF-PEG-Hb with lower oxygen affinity. The PEG chains engineered on Lys as well as PEGylation of Cys-93(beta) independently contribute to the stabilization of oxy conformation of Hb and hence increase the oxygen affinity of Hb. However, oxygen affinity of the EAF-PEG-alphaalpha-Hb is more sensitive to the presence of PEGylation on Cys-93(beta) than that of the EAF-PEG-Hb. The present modified EAF PEGylation platform is expected to facilitate the design of novel versions of the EAF-PEG-Hbs that can now integrate the advantages of avoiding PEGylation of Cys-93(beta).

  10. Combining PPI with qualitative research to engage 'harder-to-reach' populations: service user groups as co-applicants on a platform study for a trial.

    Science.gov (United States)

    Morgan, Heather; Thomson, Gill; Crossland, Nicola; Dykes, Fiona; Hoddinott, Pat

    2016-01-01

    research is intended for their benefit. However, the interface between PPI and qualitative research has received little attention. In a multi-disciplinary, mixed methods study to inform the design of incentive trials for smoking cessation in pregnancy and breastfeeding, we combined PPI and qualitative research, with some overlap. Mother and baby groups from two geographically separate disadvantaged areas, with diverse experiences of the smoking and breastfeeding, but no training or previous involvement in research, were recruited as PPI research grant co-applicants. An iterative partnership approach facilitated involvement in research conduct and design across all project phases. Group PPI members were also invited to contribute to more formal qualitative data collection, as and when indicated by the research questions, and emerging analysis. We engaged with 'harder-to-reach' women in mother and baby group settings, rather than in academic or home environments. These settings were relaxed and informal, which facilitated rapport-building, disclosures of unexpected information and maintained trust. Twenty-one women participated in standard PPI activities: feedback on study protocols and documents; piloting questionnaires and interview schedules. PPI members voiced some different perspectives from those captured within the qualitative dataset. Nineteen participated in focused qualitative research. Novel aspects were audio recorded PPI discussions, which contributed qualitative data; first, to interpret systematic review findings and construct intervention vignettes for use in the qualitative research; second, to assist with recruitment to improve sample diversity in the formal qualitative dataset; and third, to translate theory and findings presented in a researcher generated logic model into a lay tool. This had face validity for potential trial participants and used the metaphor of a ladder. Combining and overlapping PPI and qualitative research added 'harder

  11. PS-109 Barriers and facilitators to implementing drug changes caused by drug tenders and shortages

    DEFF Research Database (Denmark)

    Rishøj, Rikke Mie; Christrup, Lona Louring; Clemmensen, Marianne H

    2015-01-01

    . Purpose To identify barriers and facilitators for implementing drug changes due to drug tenders and shortages in Danish public hospitals. Material and methods Six focus group interviews were conducted at three hospitals in different regions of the country. At each hospital two focus group interviews were...... thematically through content analysis. Results Barriers Identified included: frequent changes of labelling, packages and drug names. Furthermore, implementing drug changes requires extra resources and finance. Technologies such as computerised physician order entry and barcode scanning systems were perceived...... as potential facilitators, but also as barriers in cases where the quality and implementation of the systems were not adequate. Facilitators included: hospital pharmacy services and lower drug prices. Furthermore recommendations on generic prescription, optimisation of the tendering process and support...

  12. Gruppenleistungen beim Review von Multiple-Choice-Fragen - Ein Vergleich von face-to-face und virtuellen Gruppen mit und ohne Moderation [Review of multiple-choice-questions and group performance - A comparison of face-to-face and virtual groups with and without facilitation

    Directory of Open Access Journals (Sweden)

    Schüttpelz-Brauns, Katrin

    2010-11-01

    Full Text Available [english] Background: Multiple choice questions (MCQs are often used in exams of medical education and need careful quality management for example by the application of review committees. This study investigates whether groups communicating virtually by email are similar to face-to-face groups concerning their review process performance and whether a facilitator has positive effects.Methods: 16 small groups of students were examined, which had to evaluate and correct MCQs under four different conditions. In the second part of the investigation the changed questions were given to a new random sample for the judgement of the item quality.Results: There was no significant influence of the variables “form of review committee” and “facilitation”. However, face-to-face and virtual groups clearly differed in the required treatment times. The test condition “face to face without facilitation” was generally valued most positively concerning taking over responsibility, approach to work, sense of well-being, motivation and concentration on the task.Discussion: Face-to-face and virtual groups are equally effective in the review of MCQs but differ concerning their efficiency. The application of electronic review seems to be possible but is hardly recommendable because of the long process time and technical problems.[german] Einleitung: Multiple-Choice-Fragen (MCF werden in vielen Prüfungen der medizinischen Ausbildung verwendet und bedürfen aus diesem Grund einer sorgfältigen Qualitätssicherung, beispielsweise durch den Einsatz von Review-Komitees. Anhand der vorliegenden empirischen Studie soll erforscht werden, ob virtuell per E-Mail kommunizierende Review-Komitees vergleichbar sind mit face-to-face Review-Komitees hinsichtlich ihrer Leistung beim Review-Prozess und ob sich Moderation positiv auswirkt.Methodik: 16 Kleingruppen von Psychologie-Studenten hatten die Aufgabe unter vier verschiedenen Versuchsbedingungen MCF zu bewerten und zu

  13. Increasing awareness about self and facilitation practice in preparation for transitioning to a new role – the critical reflective process of becoming a certified professional facilitator

    Directory of Open Access Journals (Sweden)

    Pauline Bergin

    2015-11-01

    Full Text Available Background and context: I have been working as a practice developer in the Australian healthcare system for more than 10 years. For the last seven of those I was a lead facilitator for a practice development programme that is being implemented across a large statewide health service. The programme’s purpose is to create person-centred care environments that enable patient and staff empowerment. My role was in a small team that supported facilitators predominantly at local health district and state levels. The intent was to phase out the team over time as capacity increased and local teams gained the required skills and knowledge to continue implementing the programme. During the two-year final transition phase, a strategic plan was implemented to guide the development of systems and capacity that would support the programme once the team had exited. A decision was made to shorten the phasing-out period and during this transition period I found myself facing an unknown and unpredictable future, for the first time in my career promoting something other than my clinical nursing skills. As I transitioned into an independent facilitator role I wanted to consolidate my expertise as a facilitator, to gain further learning in specific areas and to achieve recognition of the facilitation skill set I had honed over time, and which has now become my way of working. Given that my experience was limited to the healthcare context, diverse though it is, I pondered which of my skills would stand me in good stead to enable groups and organisations as an independent professional facilitator and what additional skills I’d need. I was encouraged to become a certified professional facilitator by colleagues who were using process facilitation and person-centredness more broadly. This paper reflects my experience of the preparation, assessment and accreditation process, the feedback I received from my international assessors and how these are influencing my

  14. Perceptions of diabetes, barriers to disease management, and service needs: a focus group study of working adults with diabetes in Hawaii.

    Science.gov (United States)

    Fukunaga, Landry L; Uehara, Denise L; Tom, Tammy

    2011-03-01

    Research about the support needs for and barriers to successful disease management of working adults with diabetes is limited. Our objective was to gain an in-depth understanding of how working adults in Hawaii perceive diabetes, barriers to disease management, and the services needed to keep people healthy and working. From November 2008 through March 2009, we conducted focus group interviews with 74 employed adults with diabetes enrolled in the Hawaii Demonstration to Maintain Independence and Employment project. Responses to questions were analyzed within and across groups to identify recurring themes. A third layer of analysis examined themes across responses to all questions, specifically, how barriers related to identified service needs. Employed participants with diabetes experienced pervasive effects on their lives as a result of the disease, although they interpreted these effects positively or negatively. Barriers to disease management, such as additional health issues, social prejudice, and lack of social support, indicated a need to educate the general public about the disease. Participants identified needing social support from other people with diabetes, psychological support to address the emotional side of diabetes, and coordinated teams of specialists to address medication side effects and other health-related barriers to disease management. Many participants discussed the challenge of integrating diabetes management with work and family responsibilities and the need for monetary support. This study provides insight into how employed adults perceived their disease and what they perceived as challenges to successfully managing diabetes. The findings provide future directions for community and workplace diabetes initiatives.

  15. The epidemiology of dependence in older people in Nigeria: prevalence, determinants, informal care, and health service utilization. A 10/66 dementia research group cross-sectional survey.

    Science.gov (United States)

    Uwakwe, Richard; Ibeh, Christian C; Modebe, Anne Ifeoma; Bo, Emeka; Ezeama, Nkiru; Njelita, Ifeoma; Ferri, Cleusa P; Prince, Martin J

    2009-09-01

    To describe the prevalence and determinants of dependence in older Nigerians and associations with informal care and health service utilization. A single-phase cross-sectional catchment area survey. Dunukofia, a rural community in southeastern Nigeria. One thousand two hundred thirty-eight adults aged 65 and older, for whom full data were available on 914. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, cognitive impairment, physical impairments, and self-reported diagnoses. The interviewer rated dependence as not needing care, needing some care, or needing much care. The prevalence of dependence and the independent contribution of underlying health conditions were estimated. Sources of income, care arrangements, caregiver strain, and health service use are described according to level of dependence. The prevalence of dependence was 24.3% (95% confidence interval=22.1-26.5%), with a concentration in participants aged 80 and older. Only 1% of participants received a pension, and fewer than 7% had paid work. Those who were dependent were less likely than others to receive income from their family. Cognitive impairment, physical impairments, stroke, and depression were each independently associated with dependence. Depression made the largest contribution. Dependence was strongly associated with health service use (particularly private doctor and traditional healer services) and with high levels of out-of-pocket expenditure. In Nigeria, dependence is an important outcome given rapid demographic aging and increases in chronic disease prevalence in all developing regions. Enhancing the social protection of dependent older adults should be a policy priority. Cognitive and mental disorders are important contributors to disability and dependence; more attention should be given to their prevention, detection, and treatment.

  16. Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building.

    Science.gov (United States)

    Ager, Alastair K; Lembani, Martina; Mohammed, Abdulaziz; Mohammed Ashir, Garba; Abdulwahab, Ahmad; de Pinho, Helen; Delobelle, Peter; Zarowsky, Christina

    2015-01-01

    Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pathways of response and adaptation. Structured interviews were conducted with 39 stakeholders from three local government areas selected to represent the diversity of conflict experience across the state: Damaturu, Fune and Nguru, and with four officers of the PRRINN-MNCH program providing technical assistance for primary care development in the state. A group model building session was convened with 11 senior stakeholders, which used participatory scripts to review thematic analysis of interviews and develop a preliminary systems model linking identified variables. Population migration and transport restrictions have substantially impacted access to health provision. The human resource for health capability of the state has been severely diminished through the outward migration of (especially non-indigenous) health workers and the suspension of programmes providing external technical assistance. The political will of the Yobe State government to strengthen health provision - through lifting a moratorium on recruitment and providing incentives for retention and support of staff - has supported a recovery of health systems functioning. Policies of free-drug provision and decentralized drug supply appear to have been protective of the operation of the health system. Community resources and cohesion have been significant assets in combatting the impacts of the insurgency on service utilization and quality. Staff commitment and motivation - particularly amongst staff indigenous to the state - has protected health care quality and enabled flexibility of human resource deployment. A systems analysis using participatory group model building provided a mechanism to identify key pathways of threat and adaptation with regard to health service functioning. Generalizable

  17. Laser facilitates vaccination

    Directory of Open Access Journals (Sweden)

    Ji Wang

    2016-01-01

    Full Text Available Development of novel vaccine deliveries and vaccine adjuvants is of great importance to address the dilemma that the vaccine field faces: to improve vaccine efficacy without compromising safety. Harnessing the specific effects of laser on biological systems, a number of novel concepts have been proposed and proved in recent years to facilitate vaccination in a safer and more efficient way. The key advantage of using laser technology in vaccine delivery and adjuvantation is that all processes are initiated by physical effects with no foreign chemicals administered into the body. Here, we review the recent advances in using laser technology to facilitate vaccine delivery and augment vaccine efficacy as well as the underlying mechanisms.

  18. Facilitating Learning at Conferences

    DEFF Research Database (Denmark)

    Ravn, Ib; Elsborg, Steen

    2011-01-01

    The typical conference consists of a series of PowerPoint presentations that tend to render participants passive. Students of learning have long abandoned the transfer model that underlies such one-way communication. We propose an al-ternative theory of conferences that sees them as a forum...... for learning, mutual inspiration and human flourishing. We offer five design principles that specify how conferences may engage participants more and hence increase their learning. In the research-and-development effort reported here, our team collaborated with conference organizers in Denmark to introduce...... and facilitate a variety of simple learning techniques at thirty one- and two-day conferences of up to 300 participants each. We present ten of these techniques and data evaluating them. We conclude that if conference organizers allocate a fraction of the total conference time to facilitated processes...

  19. Reusable Component Services

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Reusable Component Services (RCS) is a super-catalog of components, services, solutions and technologies that facilitates search, discovery and collaboration in...

  20. Effects of Group Interactive Brainstorming on Creativity

    OpenAIRE

    Park-Gates, Shari Lane

    2001-01-01

    Effects of Group Interactive Brainstorming on Creativity By Shari Park-Gates Committee Co Chairs: Anna Marshall-Baker and Jeanete E. Bowker Near Environments (ABSTRACT) Corporations spend a great deal of time and money trying to facilitate innovation in their employees. The act of introducing something new, a product or a service that is viable and innovative is often increased by enhancing or nurturing creativity. This experimental study investigated the effect o...

  1. Chromosomal and molecular abnormalities in a group of Brazilian infertile men with severe oligozoospermia or non-obstructive azoospermia attending an infertility service

    Directory of Open Access Journals (Sweden)

    Fernanda A. Mafra

    2011-04-01

    Full Text Available PURPOSE: To determine the frequency of genetic alterations in a population of Brazilian infertile men with severe oligozoospermia or non-obstructive azoospermia. MATERIALS AND METHODS: Retrospective study of a group of 143 infertile men with severe oligozoospermia or non-obstructive azoospermia from the Andrology Outpatient Clinic of the Human Reproduction Service at the ABC School of Medicine. Of these patients, 100 had severe oligozoospermia, and 43 non-obstructive azoospermia. All patients underwent a genetic study which included karyotype analysis and Y-microdeletion investigation. RESULTS: Genetic abnormalities were found in 18.8% of the studied patients. Chromosomal abnormalities were found in 6.2% of the patients, being more prevalent in the azoospermia group (11.6% than in the oligozoospermia group (4%. Chromosomal variants were found in 8.3%, and Y-chromosome microdeletions in 4.2% of patients. CONCLUSION: The high frequency of genetic alterations (18.8% in our series justified performing a genetic investigation in a population with idiopathic infertility, as results may help determine the prognosis, as well as the choice of an assisted reproduction technique. Moreover, a genetic investigation could minimize the risk of transmitting genetic abnormalities to future generations such as genetic male infertility, mental retardation, genital ambiguity and/or birth defects.

  2. Essence: Facilitating Software Innovation

    DEFF Research Database (Denmark)

    Aaen, Ivan

    2008-01-01

      This paper suggests ways to facilitate creativity and innovation in software development. The paper applies four perspectives – Product, Project, Process, and People –to identify an outlook for software innovation. The paper then describes a new facility–Software Innovation Research Lab (SIRL......) – and a new method concept for software innovation – Essence – based on views, modes, and team roles. Finally, the paper reports from an early experiment using SIRL and Essence and identifies further research....

  3. Diagnosis-related group (DRG)-based case-mix funding system, a promising alternative for fee for service payment in China.

    Science.gov (United States)

    Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian

    2018-05-13

    Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.

  4. [se-atlas - the health service information platform for people with rare diseases : Supporting research on medical care institutions and support groups].

    Science.gov (United States)

    Haase, Johanna; Wagner, Thomas O F; Storf, Holger

    2017-05-01

    se-atlas - the health service information platform for rare diseases - is part of the German National Action Plan for People with Rare Diseases and is funded by the German Federal Ministry of Health. The objective of se-atlas as a web-based platform is to illustrate those medical care institutions that are linked to rare diseases, in a transparent and user-friendly way. The website provides an overview of medical care institutions and support groups focusing on rare diseases in Germany. The primary target groups of se-atlas are affected patients, their relatives and physicians but can also include non-medical professionals and the general public. In order to make it easier to look up medical care institutions or support groups and optimize the search results displayed, various strategies are being developed and evaluated. Hence, the allocation of diseases to appropriate medical care institutions and support groups is currently a main focus. Since its launch in 2015, se-atlas has grown continuously and now incorporates five times more entries than were included 20 months prior. Among this data are the current rare diseases centres in Germany, which play a major role in providing patient-centred healthcare by acting as primary contact points for people with rare diseases. Further expansion and maintenance of the data base raises several organisational and software-related challenges. For one, the data should be completed by adding more high-quality information, while not neglecting the existing entries and maintaining their high level of quality in the long term.

  5. Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

    Directory of Open Access Journals (Sweden)

    Young-Shin Lee

    2017-01-01

    Full Text Available Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women completed both the assessment of BMD of the femoral neck and an interview survey. One’s own risks of osteoporosis, screening behaviors, and health care providers’ advice were analyzed according to three age (pre-, peri-, and post-menopausal groups, BMD levels, and health insurance coverage. Overall, health insurance coverage and having a primary health care provider of Korean American women were 59.0% and 32.0%, respectively; 61.9% had lower than normal BMD levels, which were significantly increased by advanced age. Individual awareness of risks of osteoporosis and screening behaviors were significantly higher in peri-menopausal than in pre- and post-menopausal groups, but no differences were found in health care providers’ information. The awareness and care providers’ information by BMD level or health insurance did not differ. The findings show a discrepancy between individual perceptions and behaviors and health care providers’ recommendations regard to bone health. Health behaviors should be guided by professional health care providers. The women in the post-menopausal stage need to be educated about the high risk of osteoporosis and its management.

  6. Creating new library services through collaboration with resident groups : Aimimg at human resource development and information literacy education in ways only libraries can do : Study on activities of an NPO called Ueda Library Club

    Science.gov (United States)

    Morita, Utako

    Creating new library services through collaboration with resident groups : Aimimg at human resource development and information literacy education in ways only libraries can do : Study on activities of an NPO called Ueda Library Club

  7. Diffusion of new technology, health services and information after a crisis: a focus group study of the Sichuan "5.12" Earthquake.

    Science.gov (United States)

    Zhou, Hong; Shi, Lu; Mao, Yuping; Tang, Juan; Zeng, Yu

    2014-01-01

    The Sichuan "5.12" Earthquake in 2008 occurred in a relatively underdeveloped area in China. The rainy weather, the mountainous environment and the local languages all posed major challenges to the dissemination of information and services after the disaster. By adopting a communication perspective, this study applies the diffusion of innovations theory to investigate how healthcare professionals diffused health technologies, health information and services during the rescue and relief operation. The authors conducted three focus group sessions with the health professionals who had attended to the rescue and relief work of the Sichuan "5.12" Earthquake in 2008. A range of questions regarding the diffusion of innovations were asked during these sessions. The health professionals used their cell phones to communicate with other healthcare providers, disseminated knowledge of health risks and injuries to affected residents with pamphlets and posters and attended daily meetings at the local government offices. They reported on the shortage of maritime satellite cell phones and large-size tents for medical use, and the absence of fully equipped ambulances. Volunteers, local health professionals and local officials provided health information and services in different ways. However, the diffusion of health information and services was less likely to reach those living next to transportation centers, in remote areas and in disaster areas neglected by the media. New communication devices such as cell phones and the mobile Internet enabled medical professionals to coordinate the rescue and relief work after this major natural disaster, at a time when the country's emergency response system still had plenty of room for improvement. In future, the mobile Internet should be used as a means of collecting bottom-up disaster reports so that the media will not neglect any disaster areas as they did during the Sichuan Earthquake. Rescue relief work would have been substantially

  8. What works in 'real life' to facilitate home deaths and fewer hospital admissions for those at end of life?: results from a realist evaluation of new palliative care services in two English counties.

    Science.gov (United States)

    Wye, Lesley; Lasseter, Gemma; Percival, John; Duncan, Lorna; Simmonds, Bethany; Purdy, Sarah

    2014-01-01

    WE EVALUATED END OF LIFE CARE SERVICES IN TWO ENGLISH COUNTIES INCLUDING: coordination centres, telephone advice line, 'Discharge in Reach' nurses, a specialist community personal care team and community nurse educators. Elsewhere, we published findings detailing high family carer satisfaction and fewer hospital admissions, Accident and Emergency attendances and hospital deaths for service users compared to controls. The aim of this paper is to discuss what contributed to those outcomes. Using realist evaluation, data collection included documentation (e.g. referral databases), 15 observations of services and interviews with 43 family carers and 105 professionals. Data were analysed using framework analysis, applying realist evaluation concepts. Findings were discussed at successive team meetings and further data was collected until team consensus was reached. Services 'worked' primarily for those with cancer with 'fast track' funding who were close to death. Factors contributing to success included services staffed with experienced palliative care professionals with dedicated (and sufficient) time for difficult conversations with family carers, patients and/or clinical colleagues about death and the practicalities of caring for the dying. Using their formal and informal knowledge of the local healthcare system, they accessed community resources to support homecare and delivered excellent services. This engendered confidence and reassurance for staff, family carers and patients, possibly contributing to less hospital admissions and A&E attendances and more home deaths. With demand for 24-hour end of life care growing and care provision fragmented across health and social care boundaries, services like these that cut across organisational sectors may become more important. They offer an overview to help navigate those desiring a home death through the system.

  9. Facilitating Knowledge Sharing

    DEFF Research Database (Denmark)

    Holdt Christensen, Peter

    knowledge sharing is to ensure that the exchange is seen as equitable for the parties involved, and by viewing the problems of knowledge sharing as motivational problems situated in different organizational settings, the paper explores how knowledge exchange can be conceptualized as going on in four...... distinct situations of exchange denominated organizational exchange yielding extrinsic rewards, organizational exchange yielding intrinsic rewards, financial exchange, and social exchange. The paper argues that each situation of exchange has distinct assumptions about individual behaviour...... and the intermediaries regulating the exchange, and facilitating knowledge sharing should therefore be viewed as a continuum of practices under the influence of opportunistic behaviour, obedience or organizational citizenship behaviour. Keywords: Knowledge sharing, motivation, organizational settings, situations...

  10. Improving pathways into mental health care for black and ethnic minority groups: a systematic review of the grey literature.

    Science.gov (United States)

    Moffat, Joanne; Sass, Bernd; McKenzie, Kwame; Bhui, Kamaldeep

    2009-01-01

    Black and ethnic minorities show different pathways to care services and different routes out of care. These often involve non-statutory sector services. In order to improve access to services, and to develop appropriate and effective interventions, many innovations are described but the knowledge about how to improve pathways to recovery has not been synthesized. Much of this work is not formally published. Hence, this paper addresses this oversight and undertakes a review of the grey literature. The key components of effective pathway interventions include specialist services for ethnic minority groups, collaboration between sectors, facilitating referral routes between services, outreach and facilitating access into care, and supporting access to rehabilitation and moving out of care. Services that support collaboration, referral between services, and improve access seem effective, but warrant further evaluation. Innovative services must ensure that their evaluation frameworks meet minimum quality standards if the knowledge gained from the service is to be generalized, and if it is to inform policy.

  11. Barriers and facilitators to accessing skilled birth attendants in Afar region, Ethiopia.

    Science.gov (United States)

    King, Rosemary; Jackson, Ruth; Dietsch, Elaine; Hailemariam, Asseffa

    2015-05-01

    to explore barriers and facilitators that enable women to access skilled birth attendance in Afar Region, Ethiopia. researchers used a Key Informant Research approach (KIR), whereby Health Extension Workers participated in an intensive training workshop and conducted interviews with Afar women in their communities. Data was also collected from health-care workers through questionnaires, interviews and focus groups. fourteen health extension workers were key informants and interviewers; 33 women and eight other health-care workers with a range of experience in caring for Afar childbearing women provided data as individuals and in focus groups. participants identified friendly service, female skilled birth attendants (SBA) and the introduction of the ambulance service as facilitators to SBA. There are many barriers to accessing SBA, including women׳s low status and restricted opportunities for decision making, lack of confidence in health-care facilities, long distances, cost, domestic workload, and traditional practices which include a preference for birthing at home with a traditional birth attendant. many Afar men and women expressed a lack of confidence in the services provided at health-care facilities which impacts on skilled birth attendance utilisation. ambulance services that are free of charge to women are effective as a means to transfer women to a hospital for emergency care if required and expansion of ambulance services would be a powerful facilitator to increasing institutional birth. Skilled birth attendants working in institutions need to ensure their practice is culturally, physically and emotionally safe if more Afar women are to accept their midwifery care. Adequate equipping and staffing of institutions providing emergency obstetric and newborn care will assist in improving community perceptions of these services. Most importantly, mutual respect and collaboration between traditional birth attendants (Afar women׳s preferred caregiver), health

  12. A case study: the evolution of a "facilitator model" liaison program in an academic medical library.

    Science.gov (United States)

    Crossno, Jon E; DeShay, Claudia H; Huslig, Mary Ann; Mayo, Helen G; Patridge, Emily F

    2012-07-01

    What type of liaison program would best utilize both librarians and other library staff to effectively promote library services and resources to campus departments? The case is an academic medical center library serving a large, diverse campus. The library implemented a "facilitator model" program to provide personalized service to targeted clients that allowed for maximum staff participation with limited subject familiarity. To determine success, details of liaison-contact interactions and results of liaison and department surveys were reviewed. Liaisons successfully recorded 595 interactions during the program's first 10 months of existence. A significant majority of departmental contact persons (82.5%) indicated they were aware of the liaison program, and 75% indicated they preferred email communication. The "facilitator model" provides a well-defined structure for assigning liaisons to departments or groups; however, training is essential to ensure that liaisons are able to communicate effectively with their clients.

  13. Expert and novice facilitated modelling

    DEFF Research Database (Denmark)

    Tavella, Elena; Papadopoulos, Thanos

    2015-01-01

    , and empirically supports the claim that facilitation skills can be taught to participants to enable them to self-facilitate workshops. Differences were also found, which led to the introduction of a new dimension—‘internal versus external’ facilitation. The implications of our findings for effective training...

  14. Facilitating post traumatic growth

    Directory of Open Access Journals (Sweden)

    Cox Helen

    2004-07-01

    Full Text Available Abstract Background Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house. Methods In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity. Results Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living. Conclusion There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and spiritual growth.

  15. SSRI Facilitated Crack Dancing

    Directory of Open Access Journals (Sweden)

    Ravi Doobay

    2017-01-01

    Full Text Available Choreoathetoid movement secondary to cocaine use is a well-documented phenomenon better known as “crack dancing.” It consists of uncontrolled writhing movements secondary to excess dopamine from cocaine use. We present a 32-year-old male who had been using cocaine for many years and was recently started on paroxetine, a selective serotonin reuptake inhibitor (SSRI for worsening depression four weeks before presentation. He had been doing cocaine every 2 weeks for the last three years and had never “crack danced” before this episode. The authors have conducted a thorough literature review and cited studies that suggest “crack dancing” is associated with excess dopamine. There has never been a documented case report of an SSRI being linked with “crack dancing.” The authors propose that the excess dopaminergic effect of the SSRI lowered the dopamine threshold for “crack dancing.” There is a communication with the Raphe Nucleus and the Substantia Nigra, which explains how the SSRI increases dopamine levels. This is the first documented case of an SSRI facilitating the “crack dance.”

  16. Facilitation of Retention by White Noise

    Science.gov (United States)

    Baumeister, Alfred A.; Kistler, Doris

    1975-01-01

    This study attempted to determine if white noise (an arousing stimulus), when presented at the time of recall, facilitates performance of second and fifth grade students, and if this effect generalizes across different kinds of learning tasks. Findings indicate that white noise produces improvements in performance in both age groups. (GO)

  17. Facilitating community-based interprofessional education and ...

    African Journals Online (AJOL)

    Facilitating community-based interprofessional education and collaborative practice in a health sciences faculty: Student perceptions and experiences. ... It became apparent that students need to be prepared to work in interprofessional groups. The overall intervention was perceived positively, allowing students to become ...

  18. Facilitating Creativity in Science Students' through Teacher ...

    African Journals Online (AJOL)

    The study ascertained how teachers facilitate the creativity skills of the Pupils as an outcome of professional development. 450 primary school pupils and 50 Basic science teachers in the primary schools were sampled. The study adopted the Solomon four group design. The Torrance Test for Creative thinking (TTCT) and ...

  19. Developing facilitation skills--a narrative.

    Science.gov (United States)

    Newton, Jennifer M

    2003-07-01

    Effective facilitation has been identified in the literature as one of three elements, along with context and evidence, that have a dynamic and coexisting relationship to enable the successful uptake of evidence into practice. This paper presents an overview of the concept of facilitation within the context of practice development, ahead of a personal and professional reflective account of a 'developing facilitator'. In the summer of 2001, the author was instrumental in organising the first Practice Development School in Melbourne. Thrown in at the deep end, she found herself co-facilitating with an experienced practice developer from the United Kingdom. Having never facilitated in the arena of an action learning group, nor worked in the field of practice development, there was initially a sense of impending overload and drowning in the new knowledge and skills that needed to be acquired. Drawing upon the work of narrative inquiry the author shares her experiences in the anticipation that in telling her story it will assist others in their journey of becoming a facilitator.

  20. Comparative analysis of the current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology.

    Science.gov (United States)

    Babić, Uroš; Soldatović, Ivan; Vuković, Dejana; Milićević, Milena Šantrić; Stjepanović, Mihailo; Kojić, Dejan; Argirović, Aleksandar; Vukotić, Vinka

    2015-03-01

    Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. The data were obtained from the information system used in the Clinical Hospital Center "Dr. Dragiša Mišović"--Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p payment system (β = 0.843, p payment system (β = 0.737, p payment method and the pro- jected DRG payment methods (β = 0.501, p Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs) per DRG. Given that aggregate costs of treatment under two hospital payment methods compared in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reductions of days of hospitalization and complications), and consequently invoiced amounts would be reduced.

  1. GRAFISK FACILITERING - En magtanalyse af styringen i konsulentværktøjet grafisk facilitering

    OpenAIRE

    Munch, Anna; Boholt, Marianne

    2012-01-01

    Abstract The topic of this thesis is the relatively new consultancy tool of graphic facilitation (GF). GF is a method that combines hand-drawn images and big picture thinking. A graphic facilitator leads a group through a process that results in visual output such as a poster or pamphlet. Our thesis analyses this management tool from a power perspective in an attempt to determine the power relations inherent in its practice. Our theoretical basis is French philosopher Michel Foucault’s theory...

  2. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

    The birth of a baby is a family experience. However, in the United Kingdom birth often occurs outside the family environment, in hospital. Both home and hospital births have risks and benefits, but research shows that, for most women, it is as safe to give birth at home as it is in hospital. Women report home-birth to be satisfying with lowered risks of intervention and less likelihood of being separated from their family. It is also more cost effective for the National Health Service. Yet, whilst midwives are working hard to promote home birth as an option, it remains controversial. The aim of this paper is to raise awareness of the safety of home birth and the needs of women and midwives when a home birth is chosen. It provides an overview of care required and the role of the midwife in the ensuring care is woman-centred and personalised.

  3. System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Fradgley

    2018-01-01

    Full Text Available Efficient patient-centred quality improvement requires an understanding of the system-wide areas of dissatisfaction along with evidence to identify the programs which can be strategically targeted according to specific patient characteristics and preferences. This cross-sectional study reports the proportion of chronic disease outpatients selecting 23 patient-centred improvement initiatives. Using univariate tests and multivariable logistic regressions, this multi-site study also identifies initiatives differentially selected by outpatients according to clinical and demographic characteristics. A total of 475 outpatients participated (49% response. Commonly selected initiatives included: reducing wait-times (22.3%; convenient appointment scheduling (16.0%; and receiving up-to-date treatment information (16.0%. Within univariate tests, preferences for information and service accessibility initiatives were not significantly associated with specific subgroups. However, seven initiatives were preferred according to age, gender, diagnosis status, and chronic disease type within multivariate models. For example, neurology outpatients were more likely to select assistance to manage psychological symptoms when compared to oncology outpatients (OR: 2.89. Study findings suggest that system-wide programs to enhance information provision are strategic approaches to improve experiences across patient characteristics. Furthermore, a few initiatives can be targeted to specific groups and emphasized the importance of detailed scoping analyses and tailored implementation plans when designing patient-centred quality improvement programs.

  4. The Prevalence of Only-Child Status Among Children and Adolescents Referred to a Gender Identity Service Versus a Clinical Comparison Group.

    Science.gov (United States)

    Hughes, S Kathleen; VanderLaan, Doug P; Blanchard, Ray; Wood, Hayley; Wasserman, Lori; Zucker, Kenneth J

    2017-08-18

    Several studies indicate that homosexual males have a high proportion of older brothers compared to heterosexual males. Natal males with gender dysphoria who are likely to be homosexual also display this sibship pattern. Until recently, there was little evidence linking homosexuality and/or gender dysphoria in females to unique sibship characteristics. Two studies have indicated that natal female youth clinically referred for gender dysphoria are more likely to be only children (Schagen, Delemarre-van de Waal, Blanchard, & Cohen-Kettenis, 2012; VanderLaan, Blanchard, Wood, & Zucker, 2014). However, these studies did not include control groups of youth clinically referred for other reasons. Thus, it is unclear whether the increased likelihood of only-child status is specific to gender-referred natal females. This study compared only-child status among youth referred to a mental health service for gender dysphoria (778 males, 245 females) versus other reasons (783 males, 281 females). Prehomosexual gender-referred males were less likely to be only children than clinical controls. Contrary to previous findings, gender-referred females were not more likely to be only children, indicating that increased likelihood of only-child status is not specific to gender-referred females, but is characteristic of clinic-referred females more generally.

  5. Employing the nominal group technique to explore the views of pharmacists, pharmacy assistants and women on community pharmacy weight management services and educational resources.

    Science.gov (United States)

    Fakih, Souhiela; Marriott, Jennifer L; Hussainy, Safeera Y

    2016-04-01

    The objectives of this study were to investigate how pharmacists, pharmacy assistants and women feel about community pharmacy involvement in weight management, and to identify what pharmacists, pharmacy assistants and women want in weight management educational resources. Three homogenous and one heterogeneous nominal group (NG) sessions of up to 120-min duration were conducted with nine women, ten pharmacists and eight pharmacy assistants. The NG technique was used to conduct each session to determine the most important issues that should be considered surrounding community pharmacy weight management services and development of any educational resources. The heterogeneous NG session was used to finalise what women, pharmacists and pharmacy assistants want in educational resources. Overall, pharmacists, pharmacy assistants and women believe that pharmacy staff have an important role in the management of overweight and obesity because of their accessibility, trust and the availability of products in pharmacy. Regarding the most suitable healthcare professional(s) to treat overweight and obesity, the majority of participants believed that no one member of the healthcare team was most suitable and that overweight and obesity needs to be treated by a multidisciplinary team. The importance of having weight management educational resources for pharmacy staff and women that come from trustworthy resources without financial gain or commercialisation was also emphasised. Pharmacists, pharmacy assistants and women feel that community pharmacies have a definite role to play in weight management. Pharmacy-specific weight management educational resources that are readily available to pharmacy staff and women are highly desirable. © 2015 Royal Pharmaceutical Society.

  6. Trends in levels of self-reported psychological distress among individuals who seek psychiatric services over eight years: a comparison between age groups in three population surveys in Stockholm County.

    Science.gov (United States)

    Kosidou, Kyriaki; Lundin, Andreas; Lewis, Glyn; Fredlund, Peeter; Dal, Henrik; Dalman, Christina

    2017-10-11

    Psychiatric service use has increased in Sweden and in other developed countries, particularly among young people. Possible explanations include lower threshold for help-seeking among young people, but evidence is scarce. We analysed the 2002, 2006 and 2010 Stockholm public health surveys for changes in the mean level of psychological distress among adult users of psychiatric in- and outpatient services in four age groups: 18-24, 25-44, 45-64 and ≥65 years. Psychological distress was measured via the 12-item General Health Questionnaire (GHQ-12), using the Likert scoring method 0-1-2-3. In- and out-patient psychiatric service use within 6 months from the surveys was obtained from registers. The mean level of distress among young adults 18-24 years who utilize psychiatric services decreased between 2002 (mean GHQ-12 score, 95% confidence interval 20.5, 18.1-23.0) and 2010 (16.2, 14.6-17.7), while it remained fairly stable in older age groups. Results were similar in sex-stratified analyses, although the decrease was statistically significant only among young women 18-24 years. At the end of the follow-up, the level of distress among patients was similar for all age-groups. There were no differences between age groups in the level of distress when seeking care at the end of the follow-up period, supporting that there is no age-specific over- or under-consumption of psychiatric care in later years. However, the lowered threshold for help-seeking among young adults over time might have contributed to increases in psychiatric service use in the young age group. Public health policy and service delivery planning should consider the needs of the widening group of young users of psychiatric services.

  7. Development of e-Juba, a preliminary proof of concept unmanned aerial vehicle designed to facilitate the transportation of microbiological test samples from remote rural clinics to National Health Laboratory Service laboratories.

    Science.gov (United States)

    Mendelow, B; Muir, P; Boshielo, B T; Robertson, J

    2007-11-01

    For students and academics within the field of Medical Microbiology and Infectious Diseases, it is readily apparent what an enormous professional contribution Professor Hendrik Koornhof has made to this critically important specialty, not only in Africa, but worldwide. For those outside of the specialty, his contributions as a thoroughly decent person and role model are no less evident. What emerges in both spheres is his clear commitment to the welfare of others, as opposed to himself. His modesty and self-effacing nature have endeared Hendrik to many generations of students, peers and others who have indeed been privileged to have benefited from knowing him and working with him. In his 50 years with the South African Institute for Medical Research, and subsequently with the National Health Laboratory Service, Hendrik Koornhof has been the ideal academic, who is not as concerned about receiving financial rewards, recognition, etc. as about contributing to scientific knowledge. Many of his contributions have been in guiding others by his words and his deeds, and as a result he has been rewarded in seeing the accomplishments of his students, many of whom have gone on to achieve greatness in diverse fields, both locally and abroad. As we reflect in this festschrift on Hendrik's many achievements over 80 years, we thank him for more than just his research and teaching contributions over half a century with the South African Institute for Medical Research and the National Health Laboratory Service. We thank him for showing us what a privilege it is to work in the world of academia. Although we are not microbiologists, we thank him for having inspired us with the will to address problems of service delivery in the fight against microbiological diseases, which constitute the overwhelming bulk of the burden of disease in the developing world, both in Africa and further afield.

  8. 112 fadama users group characteristics that influence facilitators

    African Journals Online (AJOL)

    2010-03-01

    Mar 1, 2010 ... Programme on Food Security, NSPFS (2003). The paradox is .... systems include crop rotation, shifting cultivation ..... from the literary and information technology sources to ..... national fadama development office,. Abuja PCU ...

  9. Integrated services

    International Nuclear Information System (INIS)

    Chafcouloff, S.; Michel, G.; Trice, M.; Clark, G.; Cosad, C.; Forbes, K.

    1995-01-01

    Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs

  10. Integrated services

    Energy Technology Data Exchange (ETDEWEB)

    Chafcouloff, S.; Michel, G.; Trice, M. [Schlumberger Integrated Project Management Group, Montrouge (France); Clark, G. [Schlumberger Testing Services, Aberdeen (United Kingdom); Cosad, C.; Forbes, K. [Schlumberger Integrated Project Management Group, Aberdeen (United Kingdom)

    1995-12-31

    Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs

  11. Widening a Bottleneck: Towards a Better Patient Flow in Health Services : An analysis of utilization of specialized health services for diagnose-groups at the municipality level. Studied period from years 1999 to 2007

    OpenAIRE

    Perez, Alejandra Palacio

    2010-01-01

    BACKGROUND: The coordination reform is currently a hot political topic. Part of the reform’s delivery arrangements is related to the expansion of municipal health services. This aims to relocate health services and increase the municipalities’ share of responsibility. Financial measures are also proposed to support the other policy arrangements. Before these policies are introduce, it is important to see if an expansion and relocation of health services to the municipalities reduce the use of...

  12. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Directory of Open Access Journals (Sweden)

    Babić Uroš

    2015-01-01

    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  13. Creating psychological connections between intervention recipients: development and focus group evaluation of a group singing session for people with aphasia.

    Science.gov (United States)

    Tarrant, Mark; Warmoth, Krystal; Code, Chris; Dean, Sarah; Goodwin, Victoria A; Stein, Ken; Sugavanam, Thavapriya

    2016-02-23

    The study sought to identify key design features that could be used to create a new framework for group-based health interventions. We designed and tested the first session of a group intervention for stroke survivors with aphasia which was aimed at nurturing new psychological connections between group members. The intervention session, a participant focus group and interviews with intervention facilitators were held in a local community music centre in the South West of England. A convenience sample of 10 community-dwelling people with poststroke aphasia participated in the session. Severity of aphasia was not considered for inclusion. Participants took part in a 90-min group singing session which involved singing songs from a specially prepared song book. Musical accompaniment was provided by the facilitators. Participants and group facilitators reported their experiences of participating in the session, with a focus on activities within the session related to the intervention aims. Researcher observations of the session were also made. Two themes emerged from the analysis, concerning experiences of the session ('developing a sense of group belonging') and perceptions of its design and delivery ('creating the conditions for engagement'). Participants described an emerging sense of shared social identity as a member of the intervention group and identified fixed (eg, group size, session breaks) and flexible (eg, facilitator responsiveness) features of the session which contributed to this emergence. Facilitator interviews and researcher observations corroborated and expanded participant reports. Engagement with health intervention content may be enhanced in group settings when intervention participants begin to establish positive and meaningful psychological connections with other group members. Understanding and actively nurturing these connections should be a core feature of a general framework for the design and delivery of group interventions. Published by the

  14. The Public's Attitude Toward Public Library Services in Essex County, New Jersey; A Research Study Conducted for the Essex County Library Directors Group Public Relations Committee.

    Science.gov (United States)

    Market Dynamics, Inc., Princeton, NJ.

    In order to structure an effective campaign aimed at increasing the usage of the public libraries in Essex County, New Jersey, this research project was undertaken to determine the consumer attitudes toward various aspects of public library services. These aspects include: extent of public library usage; awareness of library services offered,…

  15. Duty of Care and Autonomy: How Support Workers Managed the Tension between Protecting Service Users from Risk and Promoting Their Independence in a Specialist Group Home

    Science.gov (United States)

    Hawkins, R.; Redley, M.; Holland, A. J.

    2011-01-01

    Background: In the UK those paid to support adults with intellectual disabilities must manage two potentially conflicting duties that are set out in policy documents as being vital to their role: protecting service users (their duty of care) and recognising service users' autonomy. This study focuses specifically on the support of people with the…

  16. Barriers and facilitators to using NHS Direct: a qualitative study of 'users' and 'non-users'.

    Science.gov (United States)

    Cook, Erica J; Randhawa, Gurch; Large, Shirley; Guppy, Andy; Chater, Angel M; Ali, Nasreen

    2014-10-25

    NHS Direct, introduced in 1998, has provided 24/7 telephone-based healthcare advice and information to the public in England and Wales. National studies have suggested variation in the uptake of this service amongst the UK's diverse population. This study provides the first exploration of the barriers and facilitators that impact upon the uptake of this service from the perspectives of both 'users' and 'non- users'. Focus groups were held with NHS Direct 'users' (N = 2) from Bedfordshire alongside 'non-users' from Manchester (N = 3) and Mendip, Somerset (N = 4). Each focus group had between five to eight participants. A total of eighty one people aged between 21 and 94 years old (M: 58.90, SD: 22.70) took part in this research. Each focus group discussion lasted approximately 90 minutes and was audiotape-recorded with participants' permission. The recordings were transcribed verbatim. A framework approach was used to analyse the transcripts. The findings from this research uncovered a range of barriers and facilitators that impact upon the uptake of NHS Direct. 'Non-users' were unaware of the range of services that NHS Direct provided. Furthermore, 'non-users' highlighted a preference for face-to face communication, identifying a lack of confidence in discussing healthcare over the telephone. This was particularly evident among older people with cognitive difficulties. The cost to telephone a '0845' number from a mobile was also viewed to be a barrier to access NHS Direct, expressed more often by 'non-users' from deprived communities. NHS Direct 'users' identified that awareness, ease of use and convenience were facilitators which influenced their decision to use the service. An understanding of the barriers and facilitators which impact on the access and uptake of telephone-based healthcare is essential to move patients towards the self-care model. This research has highlighted the need for telephone-based healthcare services to increase public awareness; through

  17. SNOW CLEARING SERVICE WINTER 2001-2002

    CERN Multimedia

    ST-HM Group; Tel. 72202

    2001-01-01

    As usual at this time of the year, the snowing clearing service, which comes under the control of the Transport Group (ST-HM), is preparing for the start of snow-clearing operations (timetable, stand-by service, personnel responsible for driving vehicles and machines, preparation of useful and necessary equipment, work instructions, etc.) in collaboration with the Cleaning Service (ST-TFM) and the Fire Brigade (TIS-FB). The main difficulty for the snow-clearing service is the car parks, which cannot be properly cleared because of the presence of CERN and private vehicles parked there overnight in different parts of the parking areas. The ST-HM Transport Group would therefore like to invite you to park vehicles together in order to facilitate the access of the snow ploughs, thus allowing the car parks to be cleared more efficiently before the personnel arrives for work in the mornings.

  18. Working through a psychotherapy group's political cultures.

    Science.gov (United States)

    Ettin, Mark F; Cohen, Bertram D

    2003-10-01

    Macropolitical evolution, starting with authoritarian monarchism, has moved through anarchistic transitions either to the totalitarianism of fascism and communism or to liberal and social democracy. We posit analogous micropolitical development in process-oriented therapy groups: "dependence" and "counterdependence" corresponding to monarchism and anarchism; and "independence" and "interdependence" to liberal and social democracy, respectively. Transition from counterdependence to independence and interdependence may be: (1) facilitated through group members' cooperative experience of rebellion, or (2) blocked by collective identification, the internalization of dystopian or utopian fantasies that coalesce as "group-self" perceptions. We explore how group therapists work clinically with and through these several "political cultures" in the service of group and self transformation.

  19. Pediatric obesity community programs: barriers & facilitators toward sustainability.

    Science.gov (United States)

    Po'e, Eli K; Gesell, Sabina B; Lynne Caples, T; Escarfuller, Juan; Barkin, Shari L

    2010-08-01

    Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify common barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organizations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent reviewers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: programmatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in developing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic.

  20. Registration Service

    CERN Multimedia

    GS Department

    2010-01-01

    Following a reorganization in Building 55, please note that the Registration Service is now organised as follows :  Ground floor: access cards (76903). 1st floor : registration of external firms’ personnel (76611 / 76622); car access stickers (76633); biometric registration (79710). Opening hours: 07-30 to 16-00 non-stop. GS-SEM Group General Infrastructure Services Department