Derek Mohammed; Ronda Mariani
This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the...
Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.
Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.
The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)
Harris, Jenine K; Carothers, Bobbi J; Wald, Lana M; Shelton, Sarah C; Leischow, Scott J
In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.
Jenine K. Harris
Full Text Available Background. In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS. Design and Methods. Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91% responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.
Logan, T K; Walker, Robert; Hunt, Gretchen
The topic of modern-day slavery or human trafficking has received increased media and national attention. However, to date there has been limited research on the nature and scope of human trafficking in the United States. This article describes and synthesizes nine reports that assess the U.S. service organizations' legal representative knowledge of, and experience with, human trafficking cases, as well as information from actual cases and media reports. This article has five main goals: (a) to define what human trafficking is, and is not; (b) to describe factors identified as contributing to vulnerability to being trafficked and keeping a person entrapped in the situation; (c) to examine how the crime of human trafficking differs from other kinds of crimes in the United States; (d) to explore how human trafficking victims are identified; and, (e) to provide recommendations to better address human trafficking in the United States.
Full Text Available Background: Today’s healthcare organizations are challenged by pressures to meet growing population demands and enhance community health through improving service quality. Quality function deployment is one of the widely-used customerdriven approaches for health services development. In the current study, quality function deployment is used to improve the quality of chemotherapy unit services. Methods: First, we identified chemotherapy outpatient unit patients as chemotherapy unit customers. Then, the Delphi technique and component factor analysis with orthogonal rotation was employed to determine their expectations. Thereafter, data envelopment analysis was performed to specify user priorities. We determined the relationships between patients’ expectations and service elements through expert group consensus using the Delphi method and the relationships between service elements by Pearson correlation. Finally, simple and compound priorities of the service elements were derived by matrix calculation. Results: Chemotherapy unit patients had four main expectations: access, suitable hotel services, satisfactory and effective relationships, and clinical services. The chemotherapy unit has six key service elements of equipment, materials, human resources, physical space, basic facilities, and communication and training. There were four-level relationships between the patients’ expectations and service elements, with mostly significant correlations between service elements. According to the findings, the functional group of basic facilities was the most critical factor, followed by materials. Conclusion: The findings of the current study can be a general guideline as well as a scientific, structured framework for chemotherapy unit decision makers in order to improve chemotherapy unit services.
Luiza Santangelo Reis
Full Text Available The aim of this study is to analyze the relationship between the “cost” and “production” variables in a telecommunications company, measuring the latter in the unit of measure termed Network Units (NU. The study shows a Pearson correlation coefficient of 0.55 -evaluated as moderate - over the course of a 24-month period and resulting from 177 trials. Subsequently, only the work teams composed of the company´s standard structure were taken into consideration, which yielded 32 observations of interest and a derived correlation coefficient of 0.8. Finally, the data pertaining to each individual work team over a determined length of time was analyzed, showing strong correlation coefficients in seven of the eleven, and in the remainder, a moderate linear relationship between the variables analyzed. These results suggest the viability of applying the NU production measurement model in the telecommunications company in question
... 39 Postal Service 1 2010-07-01 2010-07-01 false The United States Postal Service. 221.1 Section 221.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION GENERAL ORGANIZATION § 221.1 The United States Postal Service. The United States Postal Service was established as an...
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions of the Ombuds......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...
Jelinek, P.; Lenders, M.
The United States of America is the world's largest market for uranium enrichment services. After the disintegration of the Soviet Union, Russian uranium is entering the world market on an increasing scale. The U.S. tries to protect its market and, in this connection, also the European market from excessive price drops by taking anti-dumping measures. In order to become more competitive, American companies have adapted modern enrichment techniques from Europe. European - U.S. joint ventures are to help, also technically and economically, to integrate military uranium, accumulating as a consequence of worldwide disarmament, into the commercial fuel cycle for the peaceful use of nuclear power. (orig.) [de
... 7 Agriculture 10 2010-01-01 2010-01-01 false United States Customs Service. 1212.32 Section 1212... § 1212.32 United States Customs Service. “United States Customs Service” or “Customs” means the United States Customs and Border Protection, an agency of the Department of Homeland Security. Honey Packers and...
Rosa E. Lillo
Full Text Available We examine the service mechanism of two queueing models with two units in tandem. In the first model, customers who complete service in Unit 1 must wait in an intermediate buffer until the ongoing service in Unit II ends. In the second model, jobs can be pre-positioned in an intermediate buffer to await service in Unit II. Under the assumption of phase-type service times, the steady-state regime of the service system is studied in detail.
Krajewski-Jaime, Elvia R.; And Others
Cultural competence assumes greater importance in the United States as international relations shift and the United States changes its own demographic makeup. Hispanics have significant health care needs and cultural beliefs that influence their acceptance of service. As part of an effort to build cultural competence in undergraduate social work…
Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi
Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 1005 [Docket No. FDA-2007-N-0091; (formerly 2007N-0104)] Service of Process on Manufacturers; Manufacturers Importing Electronic Products Into the United States; Agent Designation; Change of Address AGENCY: Food and Drug...
Arney, Janna B.; Jones, Irma
At its core, service-learning is about creating opportunities for students to apply theory they learn in the classroom to real-world problems and real-world needs. A service-learning project was initiated with the CEO of the Brownsville Chamber of Commerce. The project required 2nd-year business communication students to interview community…
Explains shared services, where common business practices are applied by a staff unit focused entirely on delivering needed services at the highest value and lowest cost to internal customers. Highlights include accountability; examples of pioneering shared services organizations; customer focus transition; relationship management; expertise…
Snelders, H.M.J.J.; Perik, E.M.; Secomandi, F.
This paper investigates the degree of control that designers might have over human relations in services. For this purpose, a number of speculative service designs were devised to address work-related stress. We focus on three of the generated designs, where design interventions have made changes to
Wilson, Jon; Clarke, Tim; Lower, Rebecca; Ugochukwu, Uju; Maxwell, Sarah; Hodgekins, Jo; Wheeler, Karen; Goff, Andy; Mack, Robert; Horne, Rebecca; Fowler, David
Young people attempting to access mental health services in the United Kingdom often find traditional models of care outdated, rigid, inaccessible and unappealing. Policy recommendations, research and service user opinion suggest that reform is needed to reflect the changing needs of young people. There is significant motivation in the United Kingdom to transform mental health services for young people, and this paper aims to describe the rationale, development and implementation of a novel youth mental health service in the United Kingdom, the Norfolk Youth Service. The Norfolk Youth Service model is described as a service model case study. The service rationale, national and local drivers, principles, aims, model, research priorities and future directions are reported. The Norfolk Youth Service is an innovative example of mental health transformation in the United Kingdom, comprising a pragmatic, assertive and "youth-friendly" service for young people aged 14 to 25 that transcends traditional service boundaries. The service was developed in collaboration with young people and partnership agencies and is based on an engaging and inclusive ethos. The service is a social-recovery oriented, evidence-based and aims to satisfy recent policy guidance. The redesign and transformation of youth mental health services in the United Kingdom is long overdue. The Norfolk Youth Service represents an example of reform that aims to meet the developmental and transitional needs of young people at the same time as remaining youth-oriented. © 2017 John Wiley & Sons Australia, Ltd.
Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising
Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan
Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates
The turn to neoliberalism in welfare policy suggests that human services need to be based on a market approach. The problem with this suggestion is that it presupposes marketing information such that service providers can market their services for identified client needs. In the field of intellectual disability (ID) services this type of information is not available. The method is a reflective analysis of the key presupposition of a market-orientated approach to disability services, namely that service providers know who needs what. Using insights from marketing theory the paper engages in a reflective thought experiment to lay out the intricacies of this presupposition. The analysis results in an argument regarding the validation of a market-based approach to disability services. First, this approach has its limits in view of the question of whether the specific and atypical needs of people with ID, as well as their financial position as potential consumers constitute a market. Second, the approach has limited validity both in view of the ability of people with ID to act as consumers, and of the restrictions imposed upon them by the eligibility criteria for welfare and support programmes. A market-based approach to disability services and supports can be helpful to spur innovation and further political and philosophical inquiry in human services, but the neoliberal optimism about the market as the only successful mechanism for service distribution is misplaced.
Oct 26, 2005 ... The United States Soil Conservation Service (SCS) curve number method is used to estimate rainfall .... Precipitation is an important element in many engineering ... National Aeronautics and Space Administration (NASA).
Nur Adiana Hiau Abdullah
Full Text Available This paper examines the variables that might explain the initial service charge (ISC imposed on unit-holders of Malaysian unit trust funds in the year 1999. By using 39 openend unit trust funds, customer service and board structure variables are found to have asignificant effect in explaining the variations of ISC. Financial performance variables do not seem to have any influence on the level of ISC charged to the unit-holders. Our results also showed that funds which charged higher ISC do not necessarily provide higher returns to investors. Furthermore, there are unit trust funds that are having an initial service charge beyond the maximum 10% level required by the Securities Commissions or did not fulfil the independent directors requirement.
This chapter describes documented and undocumented immigrant populations in the United States. It discusses salient factors influencing their status as immigrants as well as adult education services available to them through publicly funded programs, social units, and community centers, especially churches and libraries.
Full Text Available This paper aims at presenting and analysing the performance appraisalsystems and the human potential development in hotelunits. It aims at integrating and updating many aspects of performanceappraisal while concentrating on the hotel units systemto prove the importance of human resource evaluation in hotelunits and the procedure that is to be followed by the enterprisefor further development of hotel employees. HR evaluation analysisis presented through relevant theoretical background on theevaluation method and the presentation of the practical problematicalissues in order to create an image for a whole evaluationsystem of HR in Greek hotel enterprises.
Yang, Yeonglin H; San Diego State University
This research studies third party logistics (3PL) providers in the United States to investigate how the industry has strategically developed its service offerings in response to the customers’ growing needs in managing global supply chains. Logistics management has significant impacts on various aspects of supply chains such as response time, total supply chain cost, sourcing risk, customer service, security, etc. The results show that 3PL services vary based on industry served, region served...
Broken Families. Hearings before the Subcommittee on Family and Human Services of the Committee on Labor and Human Resources. United States Senate, Ninety-Eighth Congress, First Session (March 22 and 24, 1983) on Oversight on the Breakdown of the Traditional Family Unit, Focusing on the Effects of Divorce, Separation and Conflict within Marriage on Children and on Women and Men.
Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.
These hearings of the Subcommittee on Family and Human Services deal with the effects of divorce and single parenthood on children and adults. Discussion centers on the types of effects and their variations based on the age of the child; the time of divorce; sex of the child; and degree of communication between the child and both parents following…
Dalmida, Safiya George; Amerson, Roxanne; Foster, Jennifer; McWhinney-Dehaney, Leila; Magowe, Mabel; Nicholas, Patrice K; Pehrson, Karen; Leffers, Jeanne
This article explores approaches to service involvement and provides direction to nurse leaders and others who wish to begin or further develop global (local and international) service or service learning projects. We review types of service involvement, analyze service-related data from a recent survey of nearly 500 chapters of the Honor Society of Nursing, Sigma Theta Tau International (STTI), make recommendations to guide collaborative partnerships and to model engagement in global and local service and service learning. This article offers a literature review and describes results of a survey conducted by the STTI International Service Learning Task Force. Results describe the types of service currently conducted by STTI nursing members and chapters, including disaster response, service learning, and service-related responses relative to the Millennium Development Goals (MDGs). The needs of chapter members for information about international service are explored and recommendations for promoting global service and sustainability goals for STTI chapters are examined. Before engaging in service, volunteers should consider the types of service engagement, as well as the design of projects to include collaboration, bidirectionality, sustainability, equitable partnerships, and inclusion of the United Nations Sustainable Development Goals. STTI supports the learning, knowledge, and professional development of nurses worldwide. International service and collaboration are key to the advancement of the nursing profession. Culturally relevant approaches to international service and service learning are essential to our global organization, as it aims to impact the health status of people globally. © 2016 Sigma Theta Tau International.
... Machines Corporation, Global Technology Services Business Unit, Integrated Technology Services, Cost and..., applicable to workers of International Business Machines Corporation, Global Technology Services Business... engaged in activities related to support for the Global Technology Services Business Unit. The company...
U.S. Environmental Protection Agency — This EnviroAtlas web service contains layers depicting hydrologic unit boundary layers and labels for the Subregion level (4-digit HUCs), Subbasin level (8-digit...
Robert C Holman
Full Text Available BACKGROUND: Prion diseases are a family of rare, progressive, neurodegenerative disorders that affect humans and animals. The most common form of human prion disease, Creutzfeldt-Jakob disease (CJD, occurs worldwide. Variant CJD (vCJD, a recently emerged human prion disease, is a zoonotic foodborne disorder that occurs almost exclusively in countries with outbreaks of bovine spongiform encephalopathy. This study describes the occurrence and epidemiology of CJD and vCJD in the United States. METHODOLOGY/PRINCIPAL FINDINGS: Analysis of CJD and vCJD deaths using death certificates of US residents for 1979-2006, and those identified through other surveillance mechanisms during 1996-2008. Since CJD is invariably fatal and illness duration is usually less than one year, the CJD incidence is estimated as the death rate. During 1979 through 2006, an estimated 6,917 deaths with CJD as a cause of death were reported in the United States, an annual average of approximately 247 deaths (range 172-304 deaths. The average annual age-adjusted incidence for CJD was 0.97 per 1,000,000 persons. Most (61.8% of the CJD deaths occurred among persons >or=65 years of age for an average annual incidence of 4.8 per 1,000,000 persons in this population. Most deaths were among whites (94.6%; the age-adjusted incidence for whites was 2.7 times higher than that for blacks (1.04 and 0.40, respectively. Three patients who died since 2004 were reported with vCJD; epidemiologic evidence indicated that their infection was acquired outside of the United States. CONCLUSION/SIGNIFICANCE: Surveillance continues to show an annual CJD incidence rate of about 1 case per 1,000,000 persons and marked differences in CJD rates by age and race in the United States. Ongoing surveillance remains important for monitoring the stability of the CJD incidence rates, and detecting occurrences of vCJD and possibly other novel prion diseases in the United States.
...) of products or outputs produced. Audit Objectives. We conducted this part of our audit to find out whether unit costs for goods and services provided by DFAS were determined in accordance with DoD policies and based on actual costs incurred...
The United States Soil Conservation Service (SCS) curve number method is used to estimate rainfall runoff from three sub-watersheds in South-Eastern Botswana. This approach uses the NASA Endeavour Shuttle Radar Topography Mission (SRTM) DEMs, digital soil data from the Botswana Ministry of Agriculture, rainfall ...
Reports on approaches to measuring the service quality of academic libraries in the United Kingdom. Discusses the role of government and the national background of quality measurement; measurement frameworks; better use of statistics; benchmarking; measuring user satisfaction; and possible future development. (Author/LRW)
Ahmad Tajuddin bin Ali
This article contains the research and development activities planned to be undertaken, and the services to be provided by the Nuclear Energy Unit. The fields of research have been selected to aid the development in the use of Nuclear Science and Technology, whilst the proposed services are geared towards widening the use to this technology in socio-economic development. Objectives in the research fields have been identified following a number of consultations with IAEA, foreign and local experts, and involved careful study of local requirements. The services provided will cater for all, especially institutions involved in nuclear technology both from the public and private sectors. This effort is in line with the role of the Unit as the national promoter and coordinator in the utilization of nuclear technology in the country
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Secret Service D...—United States Secret Service 1. In general. This appendix applies to the United States Secret Service. 2. Public reading room. The United States Secret Service will provide a room on an ad hoc basis when...
Victor Teodor Alistar
Full Text Available The main objective of this article is to examine the notion of management, as an area of study which analyses, regulates and renders the theoretical and technical support in order to provide rationality within the processes that unfold in the civil service. In order to accomplish this task, human resources management will be analyzed as a process which relies in exerting four main functions: ensuring, developing, motivating and maintaining the human resources, which are conditioned by external factors that must be taken into consideration, such as: legislative framework, labor force, unions, cultural context (here one includes management practices and philosophy, and economic circumstances. All these factors are considered to have a significant impact on the management of human resources.
... Machines Corporation, Global Technology Services Business Unit, Integrated Technology Services, Cost and... Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team working from various... Technology Services Business Unit. The company reports that workers leased from Datrose, Inc., were employed...
Shaw, Dorothy; Cook, Rebecca J
Universal access to reproductive health is a target of Millennium Development Goal (MDG) 5B, and along with MDG 5A to reduce maternal mortality by three-quarters, progress is currently too slow for most countries to achieve these targets by 2015. Critical to success are increased and sustainable numbers of skilled healthcare workers and financing of essential medicines by governments, who have made political commitments in United Nations forums to renew their efforts to reduce maternal mortality. National essential medicine lists are not reflective of medicines available free or at cost in facilities or in the community. The WHO Essential Medicines List indicates medicines required for maternal and newborn health including the full range of contraceptives and emergency contraception, but there is no consistent monitoring of implementation of national lists through procurement and supply even for basic essential drugs. Health advocates are using human rights mechanisms to ensure governments honor their legal commitments to ensure access to services essential for reproductive health. Maternal mortality is recognized as a human rights violation by the United Nations and constitutional and human rights are being used, and could be used more effectively, to improve maternity services and to ensure access to drugs essential for reproductive health. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Gray, Mel; Dean, Mitchell; Agllias, Kylie
This article provides an overview of recent perspectives on neoliberalism, which serve as a foundation for the assessment of neoliberalism's influence on human services practice. Conventionally, neoliberalism has been conceived of as an ideology, but more recent perspectives regard neoliberalism...... as an art of government, a thought collective, and an uneven but path-dependent process of regulatory development. We argue that these new perspectives have the potential to contribute to our critical capacity and open avenues for the analysis of contemporary transformations of public policy and its...
Austin, Michael J; Claassen, Jennette; Vu, Catherine M; Mizrahi, Paola
Knowledge management has recently taken a more prominent role in the management of organizations as worker knowledge and intellectual capital are recognized as critical to organizational success. This analysis explores the literature of knowledge management including the individual level of tacit and explicit knowledge, the networks and social interactions utilized by workers to create and share new knowledge, and the multiple organizational and managerial factors associated with effective knowledge management systems. Based on the role of organizational culture, structure, leadership, and reward systems, six strategies are identified to assist human service organizations with implementing new knowledge management systems.
Zhibin Jiang; Yuyan Tan; Özgür Yalçınkaya
This paper deals with the problem of scheduling additional train unit (TU) services in a double parallel rail transit line, and a mixed integer programming (MIP) model is formulated for integration strategies of new trains connected by TUs with the objective of obtaining higher frequencies in some special sections and special time periods due to mass passenger volumes. We took timetable scheduling and TUs scheduling as an integrated optimization model with two objectives: minimizing travel ti...
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being. PMID:26295249
Aldridge, M G
Catholic health care organizations are experiencing a tension between evangelical mission and expanding competition in medical markets. For the voluntary, not-for-profit health and human services system to survive and grow, hospital communities must find new revenue sources that do not create dependence on state and federal monies. The United States entered the Age of Maturity in 1985 as the "baby boomers" born between 1945 and 1957 became 40 years old, requiring health care providers to begin to plan for their care in old age. This large aging population, combined with a longer life span for Americans, will put increased burdens on health care organizations, particularly for chronic care, up to the year 2020 or beyond. Changes in family structure and social networks will be necessary as more people care for older relatives. The ratio of nonworkers to workers will increase, further burdening national and state tax bases, Social Security, and other worker-contributor programs. Investment banks are one option to finance the older population's increased needs for health and human services. Investment banks are funded by donations from the private sector (local and national businesses), the public sector (state, national, and local agencies), and new for-profit ventures for older persons. The contributions themselves remain in a central fund, with only the interest generated being used to fund local organizations committed to financial self-sufficiency and to helping the elderly. Older persons will carry increased economic and political clout in the Age of Maturity and will constitute a large percentage of hospitals' business. Therefore hospitals will have to develop a strong market position among the elderly. They must consider integrating a new service mix of both health and human services. Candidates for new hospital services for the elderly include housing programs, long-term care and continuum of care programs, employment programs, retirement planning, estate
Harrison, Jeffrey P; Ferguson, Emily D
Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.
Hugelius, G.; Ahlström, A.; Loisel, J.; Harden, J. W.
Soils provide numerous and indispensable services to ecological systems and human societies. As human populations and human land use changes, the capacity of soils to maintain these services may also change. To investigate this we provide the first global scale study based on the soil service index (SSI; see presentations by Harden et al. and Loisel et al. in this session for more details). In this index multiple soil services are numerically or quantitatively assessed, normalized to a unit-less scale for purposes of intercomparability. Soil services assessed under the SSI include organic matter and/or organic carbon storage; plant productivity; CO2 or GHG exchange with the atmosphere; water storage capacity; and nutrient storage and/or availability. The SSI may be applied at any scale. Here we present a first global application of the SSI and provide broad-scale analyses of soil service spatial distributions. We assess how the SSI will change under projected changes in human societies populations and human land use (following representative concentration pathway scenarios). Present and future potential utilization and vulnerability of soil resources are analyzed in the context of human population distributions and its projected changes. The SSI is designed to be broadly useful across scientific, governance and resource management organizations. To exemplify this, the parameterization of this is global soil service estimate is based on only open source input data.
... 46 Shipping 4 2010-10-01 2010-10-01 false Periodic servicing of hydrostatic release units. 122.740... hydrostatic release units. (a) Each hydrostatic release unit, other than a disposable unit, must be serviced... hydrostatic release unit must be marked in clearly legible letters with an expiration date of two years after...
... 49 Transportation 7 2010-10-01 2010-10-01 false Qualified human service organizations. 604.7... organizations. (a) A recipient may provide charter service to a qualified human service organization (QHSO) for... disabilities; or (3) With low income. (b) If an organization serving persons described in paragraph (a) of this...
Castillo, Yuleinys; Fischer, Jerome M.
The skills and tasks in the human services field are highly connected to emotional intelligence abilities. The purpose of the study was to investigate the effect of an expressive writing program involving human service students in an undergraduate rehabilitation services course. The program was developed to enhance their emotional intelligence.…
Full Text Available This article summarizes the author's recent research into the fit between software-as-a-service (SaaS tools and the requirements of particular business units. First, an overview of SaaS is provided, including a summary of its benefits to users and software vendors. Next, the approach used to gather and analyze data about the SaaS solutions offered on the Force.com AppExchange is outlined. Finally, the article describes the managerial implications of this research.
Full Text Available ABSTRACT: This study consisted in a bibliographic review, which goal was a survey of the main national literature that approaches the humanization in the surgical unit, identifying and demonstrating the needs and the importance of the nursing staff daily activities. The search was made selecting the key words and the period between 1985 and 2002, where 31 articles were selected. Analyzing them we discussed about the theme, classifying it in four stages that made sense to the humanization for the nursing assistance in the surgical unit, describing aspects of the nursing graduation releasing for humanization, making ethics considerations to the assistance and demonstrating the needs of the humanized care in the presence of the technological development. We concluded that the humanization of the nursing assistance in the surgical units is a challenge, however, the humanized care is possible and essential to the nursing practice, mainly in a technological environment like the surgical unit. KEYWORDS: Operating Room Nursing; Assistance; Ethics.
Schwarz, Corinne; Unruh, Erik; Cronin, Katie; Evans-Simpson, Sarah; Britton, Hannah; Ramaswamy, Megha
The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital's emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims.
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Customs Service C... Customs Service 1. In general. This appendix applies to the United States Customs Service. It sets forth... records and accounting of disclosures. (a) For records which are maintained at the United States Customs...
... POSTAL SERVICE International Product Change--United States Postal Service Inbound Market-Dominant... Inbound Market-Dominant Multi- Service Agreements to the Market-Dominant Products List pursuant to 39 U.S... the Postal Regulatory Commission to Add Market-Dominant Multi-Service Agreements with Foreign Postal...
... 32 National Defense 3 2010-07-01 2010-07-01 true Service of civil process outside the United... AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.12 Service of civil process outside the United States. (a) Process of foreign courts. In foreign countries service of process...
... 32 National Defense 3 2010-07-01 2010-07-01 true Service of civil process within the United States... CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.10 Service of civil process within the United States. (a) Policy. DA officials will not prevent or evade the service or process in...
... 46 Shipping 7 2010-10-01 2010-10-01 false Periodic servicing of hydrostatic release units. 185.740... Equipment § 185.740 Periodic servicing of hydrostatic release units. (a) Each hydrostatic release unit... specified by the Commandant. (b) Each disposable hydrostatic release unit must be marked with an expiration...
... 46 Shipping 4 2010-10-01 2010-10-01 false Periodic servicing of hydrostatic-release units. 131.585... OPERATIONS Tests, Drills, and Inspections § 131.585 Periodic servicing of hydrostatic-release units. (a) Except a disposable hydrostatic-release unit with an expiration date, each hydrostatic-release unit must...
Herzberg, Judith T.
Human services educators and scholars maintain that they are teaching social change theory and skills that will allow students to engage in large-scale social change. A review of the literature, from a critical theory perspective, offered little evidence that social change is being taught in human services programs. In this collective case study,…
Kock, Henrik; Wallo, Andreas; Nilsson, Barbro; Hoglund, Cecilia
Purpose: In this article, the area of interest is an emerging type of organisation called human resource intermediaries (HRIs), which focus on delivering human resource (HR) services to public sector organisations and private companies. The purpose of this article is, thus, to explore HRIs as deliverers of HR services. More specifically, the…
Human Service Education: A Journal of the National Organization for Human Service Education, 1996
Describes a code of ethics that reflects the unique history of the human service profession. Provides a definition for human services and gives guidelines in meeting responsibility to clients, to the community and society, and to colleagues. Also provides statements guiding responsibility to the profession, to employers, and to self. (RJM)
The paper represents essentially an attempt to analyse and comprehend the role of Human Resource Management (HRM) in effective service delivery in Nigeria. The paper advocates that the revamping and transformation of the Nigerian Civil Service to render effective service to the public lies not in the continuous ...
Dayton, Rebecca; Edwards, Carrie; Sisler, Michelle
This packet contains a unit on teaching about volcanoes. The following question is addressed: How do volcanoes affect human life? The unit covers approximately three weeks of instruction and strives to present volcanoes in an holistic form. The five subject areas of art, language arts, mathematics, science, and social studies are integrated into…
St. Germain, S.; Boring, R.; Banaseanu, G.; Akl, Y.; Chatri, H.
This paper uses the insights from the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) methodology to help identify human actions currently modeled in the single unit PSA that may need to be modified to account for additional challenges imposed by a multi-unit accident as well as identify possible new human actions that might be modeled to more accurately characterize multi-unit risk. In identifying these potential human action impacts, the use of the SPAR-H strategy to include both errors in diagnosis and errors in action is considered as well as identifying characteristics of a multi-unit accident scenario that may impact the selection of the performance shaping factors (PSFs) used in SPAR-H. The lessons learned from the Fukushima Daiichi reactor accident will be addressed to further help identify areas where improved modeling may be required. While these multi-unit impacts may require modifications to a Level 1 PSA model, it is expected to have much more importance for Level 2 modeling. There is little currently written specifically about multi-unit HRA issues. A review of related published research will be presented. While this paper cannot answer all issues related to multi-unit HRA, it will hopefully serve as a starting point to generate discussion and spark additional ideas towards the proper treatment of HRA in a multi-unit PSA.
... 32 National Defense 3 2010-07-01 2010-07-01 true Service of criminal process within the United... OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.9 Service of criminal process within the United States. (a) Surrender of personnel. Guidance for surrender of military personnel...
... Monitoring Systems; Approved Mobile Transmitting Units and Communications Service Providers for Use in... relevant features of the enhanced mobile transmitting unit (E-MTU) VMS and communications service providers... with the Orbcomm mobile communications provider service. Skymate can be reached at 866-SKYMATE and...
... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Services rendered by Cuba to United... REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 515.548 Services rendered by Cuba to United States aircraft. Specific licenses are issued for payment to Cuba of charges for services...
This special issue contains a collection of manuscripts that were originally intended to be included in the special issue on "Physics and Economics of Ecosystem Services Flows" (Volume 101, guest editors H. Su, J. Dong and S. Nagarajan) and "Biogeochemical Processes in the Changing Wetland Environment" (Volume 103, guest editors J. Bai, L. Huang and H. Gao). All of them are addressing issues related to ecosystem services in different settings. Ecosystem services are of high value for both the ecosystems and human communities, and understanding the impacts of environmental processes and human activities on ecosystems is of fundamental importance for the preservation of these services.
Penteado, Eliane Villas Bôas de Freitas; de França, Maria Goretti; Ramalhoto, Ana Maria de Brito; de Oliveira, Ana Maria; Machado, Bruno Rangel Cortoppassi; Genipapeiro, Joana Angélica Matos
This article discusses the implementation of ergonomics in a service unit of a major company in the energy sector. From the perspective of management, it analyses the process of implementation of ergonomics programmes in four operational areas. The objective was to diagnose the level of implementation of ergonomics. The study is descriptive, undertaken through the interaction with the technical staff of the operational areas involved, incorporating the perception of these role players concerning their work routines. The results indicated significant differences in the level of implementation of the programmes, especially those concerning structural conditions. Important conquests were registered, such as the investment in the training of specialists, the establishment of a facilitator network and the improvement of the standard for the directioning and alignment of the execution of initiatives. The linking in of the programmes with those of occupational health management emphasises its contribution to the safety and well-being of the workforce through interventions aimed mainly at eliminating and reducing ergonomic biomechanical risks. However, the need to broaden and deepen the ergonomic approach regarding organizational and cognitive aspects, as well as the insertion of ergonomics in project design of new work spaces and processes were also identified.
... 32 National Defense 3 2010-07-01 2010-07-01 true Service of criminal process outside the United... AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.11 Service of... status of forces agreements, govern the service of criminal process of foreign courts and the surrender...
Grünbaum, Niels Nolsøe; Hollensen, Svend; Kahle, Lynn
The purpose of this article is to extend the understanding of the industrial buying process in connection with purchasing professional business (B2B) services, specifically human resource (HR) consulting services. Early B2B buying-behavior literature strongly emphasizes the rational aspects...... of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies choose a consulting services supplier. Five hypotheses are developed based...
Social Security Administration — This database contains only a very small subset of the Human Resources Operational Data Store data. It supports the SSA Employee and Office Data Retrieval (SEODR)...
Conducted case study of philanthropic giving among 29 companies in Cambridge, Massachusetts. Found that most corporations used informal rather than formal process for making funding decisions, with many firms relying on tradition, social contacts, and intuition to guide allocations. Findings suggest ways that social services administrators can…
Bruynooghe, Kevin; Verhaeghe, Mieke; Bracke, Piet
Exchange theory and homophily theory give rise to counteracting expectations for the interaction between human service organizations. Based on arguments of exchange theory, more interaction is expected between dissimilar organizations having complementary resources. Based on arguments of homophily theory, organizations having similar characteristics are expected to interact more. Interorganizational relations between human service organizations in two regional networks in Flanders are examined in this study. Results indicate that human service organizations tend to cooperate more with similar organizations as several homophily effects but not one effect of dissimilarity were found to be significant. The results of this study contribute to the understanding of interorganizational networks of human service organizations and have implications for the development of integrated care.
The module provides a link to an article that is part of a series of articles in Issues in Ecology. This article discusses the many services an ecosystem provides in order to sustain and fulfill human needs.
Toward the Application of Constructivism and Constructionism to Work-Related Training in Service of the Enhancement of Human Capital Development in Postsecondary Education Settings in the United States
Education research and employer surveys reveal that the skill gap in the United States spans across the realms of academic foundations, industry qualifications and technical competencies, higher-order cognitive skills, and behavioral skills and values. The purpose of this investigation was to identify key components of the two theoretical models…
Moore, Stephen T.
Discusses a normative strategy toward pricing human services, which will allow providers to develop pricing strategies within the context of organizational missions, goals, and values. Pricing is an effective tool for distributing resources and improving efficiency, and can be used as a tool for encouraging desired patterns of service utilization.…
K. K. Govender
Full Text Available This article reports the results of an empirical evaluation of a conceptual service encounter management model (Govender, 1999. The various hypotheses proposed to show a relationship between formal and informal socialisation strategies, and the bank employees' perception of the organisational climate and their role are empirically evaluated. Furthermore, the mediated effects of these socialization tactics on the bank customers perception of the service quality was also ascertained by matching a random sample of 210 bank employees with 1050 customers. Opsomming Hierdie artikel rapporteer die resultate van n empiriese evaluering van n konseptuele dienservaringsbestuursmodel (Govender, 1999. Verskeie hipoteses word voorgehou om n verband tussen formele en informele sosialise- ringstrategiee aan te toon, en die bankwerkers se persepsie van die organisatoriese klimaat en hulle rolle word empirics geevalueer.Verder word die modererende effek van hierdie sosialiseringstrategie op die bankkliente se persepsie van dienskwaliteit bepaal deur 'n ewekansige steekproefvan 210 bankwerkers met 1050 kliente af te paar.
Song, C.; Lee, W. K.; Jeon, S. W.; Kim, T.; Lim, C. H.
Application of ecosystem service concept in environmental related decision making could be numerical and objective standard for policy maker between preserving and developing perspective of environment. However, pursuing maximum benefit from natural capital through ecosystem services caused failure by losing ecosystem functions through its trade-offs. Therefore, difference between ecosystem functions and services were demonstrated and would apply human relating perspectives. Assessment results of ecosystem functions and services can be divided 3 parts. Tree growth per year set as the ecosystem function factor and indicated through so called pure function map. After that, relating functions can be driven such as water conservation, air pollutant purification, climate change regulation, and timber production. Overall process and amount are numerically quantified. These functional results can be transferred to ecosystem services by multiplying economic unit value, so function reflecting service maps can be generated. On the other hand, above services, to implement more reliable human demand, human reflecting service maps are also be developed. As the validation, quantified ecosystem functions are compared with former results through pixel based analysis. Three maps are compared, and through comparing difference between ecosystem function and services and inversed trends in function based and human based service are analysed. In this study, we could find differences in PF, FRS, and HRS in relation to based ecosystem conditions. This study suggests that the differences in PF, FRS, and HRS should be understood in the decision making process for sustainable management of ecosystem services. Although the analysis is based on in sort existing process separation, it is important to consider the possibility of different usage of ecosystem function assessment results and ecosystem service assessment results in SDG policy making. Furthermore, process based functional approach
Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira
Abstract Objective: To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Methods: Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted preva...
Tatiana Mota Xavier de Meneses; Maria Inês Couto de Oliveira; Cristiano Siqueira Boccolini
Abstract Objective: To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Methods: Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted preva...
Alargarsamy Balasubramanian, A.C.
The research interests and applicability of robotics have diversified and seen a
tremendous growth in recent years. There has been a shift from industrial robots operating in constrained settings to consumer robots working in dynamic environments associated closely with everyday human
Reagles, Kenneth W.; Butler, Alfred S.
The Human Service Scale is an assessment instrument for measuring the progress of the rehabilitation client and the effectiveness of rehabilitation programs. The theory behind the scale is based on Maslow's hierarchy of human needs. The development and some potential uses of the scale are discussed. (EC)
... 39 Postal Service 1 2010-07-01 2010-07-01 false Availability of the Mailing Standards of the United States Postal Service, Domestic Mail Manual. 111.2 Section 111.2 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] GENERAL INFORMATION ON POSTAL SERVICE § 111.2...
... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Additional rules for United States Secret Service employees. [Reserved] 3101.111 Section 3101.111 Administrative Personnel DEPARTMENT OF THE....111 Additional rules for United States Secret Service employees. [Reserved] ...
Bacon, E. Miles
This student guide is for Unit 6, Emission Control Systems, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with inspecting, testing, and servicing an emission control system. A companion review exercise book and posttests are available separately as CE 031 221-222. An introduction tells how this unit fits…
... 1974; United States Citizenship and Immigration Services--010 Asylum Information and Pre-Screening... system of records to the Department of Homeland Security's inventory, entitled Unites States Citizenship... Citizenship and Immigration Services (202-272-1663), 20 Massachusetts Avenue, NW., 3rd Floor, Washington, DC...
This student guide is for Unit 5, Fuel and Carburetion Systems, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with inspecting and servicing the fuel and carburetion systems. A companion review exercise book and posttests are available separately as CE 031 218-219. An introduction tells how this unit fits…
Morse, David T.
This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 4, Secondary Circuit, available separately as CE 031 214. Focus of the posttests is testing and servicing the secondary ignition circuit. One multiple choice posttest is provided that covers the seven performance objectives contained in the unit. (No…
Bacon, E. Miles
This student guide is for Unit 4, Secondary Circuit, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with how to test and service the secondary ignition circuit. A companion review exercise book and posttests are available separately as CE 031 215-216. An introduction tells how this unit fits into the total…
Bacon, E. Miles
This student guide is for Unit 3, Primary Circuit, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with how to test the primary ignition circuit. A companion review exercise book and posttests are available separately as CE 031 212-213. An introduction tells how this unit fits into the total tune-up service,…
Richardson, Roger L.; Bacon, E. Miles
This student guide is for Unit 2, Charging System, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with how to test the charging system. A companion review exercise book and posttests are available separately as CE 031 209-210. An introduction tells how this unit fits into the total tune-up service, defines…
... Monitoring Systems; Approved Mobile Transmitting Units and Communications Service Providers for Use in the... features of the VMS. ADDRESSES: To obtain copies of the list of NOAA-approved VMS mobile transmitting units and NOAA-approved VMS communications service providers, please contact the VMS Support Center at...
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Coordination with United States Customs Service... FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.8 Coordination with United States Customs Service. (a) Nothing in this part shall preclude examination of imported materials pursuant to the Customs laws and...
Is the Human Development Index (HDI) of the United Nations Development Programme (UNDP) a relevant indicator? Jean Claude Saha. Abstract. No Abstract. African Journal of Economic Policy Vol. 12(1) 2005: 1-27. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Do, Ha Manh; Sheng, Weihua; Liu, Meiqin
This paper proposes and implements an open framework of active auditory learning for a home service robot to serve the elderly living alone at home. The framework was developed to realize the various auditory perception capabilities while enabling a remote human operator to involve in the sound event recognition process for elderly care. The home service robot is able to estimate the sound source position and collaborate with the human operator in sound event recognition while protecting the privacy of the elderly. Our experimental results validated the proposed framework and evaluated auditory perception capabilities and human-robot collaboration in sound event recognition.
The United States takes a highly relativistic stance toward the Universal Declaration of Human Rights. It regards the socio-economic rights and the right to development as without status; exempts itself from all provisions of the Declaration by failing to sign the conventions designed to implement these provisions; and unilaterally qualifies its support of civil and political rights. Leading recipients of U.S. aid have traditionally included regimes with atrocious human rights records. Those struggling for human rights should have no illusions about the systems of power and their servants.
Benson, Janie; Clark, Kathryn Andersen; Gerhardt, Ann; Randall, Lynne; Dudley, Susan
The objective of this study was to describe the availability of early surgical and medical abortion among members of the National Abortion Federation (NAF) and to identify factors affecting the integration of early abortion services into current services. Telephone interviews were conducted with staff at 113 Planned Parenthood affiliates and independent abortion providers between February and April 2000, prior to FDA approval of mifepristone. Early abortion services were available at 59% of sites, and establishing services was less difficult than or about what was anticipated. Sites generally found it easier to begin offering early surgical abortion than early medical abortion. Physician participation was found to be critical to implementing early services. At sites where some but not all providers offered early abortion, variations in service availability resulted. Given the option of reconsidering early services, virtually all sites would make the same decision again. These data suggest that developing mentoring relationships between experienced early abortion providers/sites and those not offering early services, and training physicians and other staff, are likely to be effective approaches to expanding service availability.
Christian Guillermet Fernández
Full Text Available War and peace have perpetually alternated in history. Consequently, peace has always been seen as an endless project, even a dream, to be in brotherhood realized by everyone across the earth. Since the XVII century the elimination of war and armed conflict has been a political and humanitarian objective of all nations in the world. Both the League of Nations and the United Nations were conceived with the spirit of eliminating the risk of war through the promotion of peace, cooperation and solidarity among Nations. The Universal Declaration of Human Rights and the subsequent human rights instruments were drafted with a sincere aspiration of promoting the value of peace and human rights worldwide. International practice shows the close linkage between the disregard of human rights and the existence of war and armed conflict. It follows that the role of human rights in the prevention of war and armed conflict is very important. Since 2008 the Human Rights Council has been working on the ‘Promotion of the Right of Peoples to Peace.’ Pursuant resolutions 20/15 and 23/16 the Council decided firstly to establish, and secondly to extend the mandate of the Open-Ended Working Group (OEWG aimed at progressively negotiating a draft United Nations declaration on the right to peace. The OEGW welcomed in its second session (July 2014 the approach of the Chairperson-Rapporteur, which is basically based on the relationship between the right to life and human rights, peace and development.
Research on the visual system focuses on using electrophysiology, pharmacology and other invasive tools in animal models. Non-invasive tools such as scalp electroencephalography and imaging allow examining humans but show a much lower spatial and/or temporal resolution. Under special clinical conditions, it is possible to monitor single-unit activity in humans when invasive procedures are required due to particular pathological conditions including epilepsy and Parkinson's disease. We review our knowledge about the visual system and visual memories in the human brain at the single neuron level. The properties of the human brain seem to be broadly compatible with the knowledge derived from animal models. The possibility of examining high-resolution brain activity in conscious human subjects allows investigators to ask novel questions that are challenging to address in animal models.
Full Text Available Human communication is prevalently a mediated process. Mediators are units of environment, which are attributed functions within the local value set. They are utilised in such a way as to optimise the change of human states. In this article, a mediator-centred interpretation of the human communication is given. The interpretation follows closely the concept of mediated interaction developed within physics. It is conjectured that collection of mediators, which the humans use, has a well-defined average. The averaged collection permits reliable interpretation as a human communication spectrum. Relation of the intensity of a spectral component with regard to different senses, and with regard to intensity of interaction is discussed.
Pribyl, Paul F.
This training unit on water supply is part of a 17-unit course package written to aid instructors in the development, teaching, and evaluation of fire fighters in the Wisconsin Fire Service Certification Series. The purpose stated for the 4-hour unit is to assist the firefighter in the proper use of water supplies and the understanding of the…
Yang, Taeyang; Lee, Seungji; Seomoon, Eunbi; Kim, Sung-Phil
Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs) in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG). A total of 56 text stimuli composed of service brand name (S1) followed by extended service name (S2) were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori . The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels ( p service-to-service brand extension from goods-to-goods.
This historical study details the U.S. Air Service's logistics operations at home and abroad in an attempt to determine the relationship between the process and more recently established logistic principles...
There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.
Hyde, Cheryl A
Comprehensive multicultural organizational development (MCOD) is increasingly necessary in human services agencies. This article presents results from an exploratory study that identified challenges and solutions to MCOD, against the backdrop of daily realities of agency life. The author conducted interviews with 20 consultants and 20 practitioners experienced in MCOD. Qualitative analysis revealed four challenges--socioeconomic environment, organizational dynamics, conceptualization of the change effort, and consultant competence; and four solutions--collaborative environmental relations, leadership development, assessment and planning, and consultant selection. Results suggest the complexities of MCOD and ways that human services agencies can sustain such efforts.
Human milk, widely understood to be beneficial for infants, can be lifesaving for preterm neonates, especially in reducing the risk of necrotizing enterocolitis. Donor human milk (DHM) is an option when mothers are unable to provide milk or have an inadequate supply for their infants. Nonprofit donor human milk banks are established to provide safe, processed human milk from milk donated by healthy lactating mothers who have undergone a rigorous screening process. These milk banks, operating under the auspices of the Human Milk Banking Association of North America, obtain, process, and dispense human milk under strict guidelines set by the association. Increasing the supply of donor human milk to meet a dramatic increase in demand poses a significant challenge for nonprofit milk banks. Efforts to increase supply nationwide include education of providers, use of social media to engage potential donors, and outreach to news media. In parallel, milk banks are establishing regional depots to collect donations, and additional milk banks are being developed. This article describes the current nonprofit milk bank industry in the United States, its challenges, and its future prospects. © 2013 by the American College of Nurse‐Midwives.
Current debates on conscientious objection to military service reveal a conflict between conscription and individual freedom of conscience; they question the scope of human rights and liberties as well as raise an issue of their extension. The majority of member states of UN and CoE officially recognize a right to conscientious objection. However, the flow of complaints to international human rights monitoring bodies demonstrates absence of a general consensus on the concept, origin and legal...
D Evan Mercer; David Cooley; Katherine Hamilton
Forests provide a variety of critical services to human societies, including carbon sequestration, water purification, and habitat for millions of species. Because landowners have traditionally not been paid for the services their land provides to society, financial incentives are usually too low to sustain production of services at optimal levels. To remedy this, a...
Edwards, James G.
The Maslach Burnout Inventory (MBI) was used to assess the level and intensity of burnout in 165 California State University at Long Beach college seniors preparing for the human services professions, specifically teaching, nursing, criminal justice, and social welfare. A comparison group of 80 engineering seniors was also assessed. The 40-item…
McFadden, Hope; Moracco, John
Burnout in human service organizations can be caused by funding problems, overwork, the nature of clients, and ineffective management. A social-professional support group should be a formal part of the organizational structure to provide opportunities for evaluation and feedback, as well as individual help to professionals. (JAC)
VanDierendonck, D; Schaufeli, W.B; Buunk, Abraham (Bram)
This research investigated the impact on burnout of inequity experienced by human service professionals. Two studies were conducted, among therapists working with inmates in a forensic psychiatric center (N = 112) and among staff members of an institute for the direct care of mentally disabled (N =
Accessibility of services for early infant diagnosis of Human Immunodeficiency Virus in sub-Saharan Africa: a systematic review. ... infants who received a virological test within the first 2 months of life in sub-Saharan Africa varied from 3 to 58%, far below the 80% recommended level by the World Health Organization.
The paper is aimed at examining the poverty profile of Nigeria and its consequences on access to health care services and human capital development in the country. It is a startling paradox that about two – thirds of Nigerians are poor despite living in a country with vast potential wealth. Apart from looking at the theoretical ...
Ørberg Jensen, Peter D.; Petersen, Bent
In this exploratory study we look at human asset aspects of offshore outsourcing of services that over time become more advanced and strategic potent to the outsourcing firms. As a consequence, the outsourcing firms might want to internalize the operations. We focus on the ways that outsourcing......, the internalization process....
...(Seventh). An RSU includes an automated teller machine, automated loan machine, and automated device for... a remote service unit by a national bank. A remote service unit (RSU) is an automated facility...
U.S. Geological Survey, Department of the Interior — The USGS Governmental Unit Boundaries service from The National Map (TNM) represents major civil areas for the Nation, including States or Territories, counties (or...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Weather Service (NWS) Storm Prediction Center uses RSS feeds to disseminate all watches, warnings and advisories for the United States that are...
Alonso, E; Rubio, A; March, J C; Danet, A
The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.
Full Text Available Health services and policy research (HSPR represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publiclyfunded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending.
Full Text Available Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG. A total of 56 text stimuli composed of service brand name (S1 followed by extended service name (S2 were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori. The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels (p < 0.05. The N400 amplitude was more negative for the mid- and high-level fits than the low level. The ERP results of P300 and N400 indicate that the early stage of brain extension evaluation might first detect low-fit brand extension as an improbable target followed by the late stage of the integration of S2 into S1. Along with previous findings, our results demonstrate different cognitive evaluation of service-to-service brand extension from goods-to-goods.
Yang, Taeyang; Lee, Seungji; Seomoon, Eunbi; Kim, Sung-Phil
Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs) in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG). A total of 56 text stimuli composed of service brand name (S1) followed by extended service name (S2) were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori. The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels (p < 0.05). The N400 amplitude was more negative for the mid- and high-level fits than the low level. The ERP results of P300 and N400 indicate that the early stage of brain extension evaluation might first detect low-fit brand extension as an improbable target followed by the late stage of the integration of S2 into S1. Along with previous findings, our results demonstrate different cognitive evaluation of service-to-service brand extension from goods-to-goods. PMID:29479313
This document has two intended audiences. The first part, ``Geothermal Energy at a Glance,`` is intended for energy system decision makers and others who are interested in wide ranging aspects of geothermal energy resources and technology. The second part, ``Technology Specifics,`` is intended for engineers and scientists who work with such technology in more detailed ways. The glossary at the end of the document defines many of the specialized terms. A directory of US geothermal industry firms who provide goods and services for clients around the world is available on request.
... NUCLEAR REGULATORY COMMISSION [NRC-2012-0044; Docket No. 50-423] Central Vermont Public Service Corporation (Millstone Power Station, Unit 3); Order Approving Application Regarding Corporate Restructuring and Conforming Amendment I Dominion Nuclear Connecticut, Inc. (DNC), Central Vermont Public Service...
Morse, David T.; May, Theodore R.
This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 6, Emission Control Systems, available separately as CE 031 220. Focus of the posttests is inspecting, testing, and servicing emission control systems. One multiple choice posttest is provided that covers the seven performance objectives contained in…
Bacon, E. Miles
This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 6, Emission Control Systems, available separately as CE 031 220. Focus of the exercises and pretests is inspecting, testing, and servicing emission control systems. Pretests and performance checklists are provided for each of the…
Bacon, E. Miles
This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 4, Secondary Circuit, available separately as CE 031 214. Focus of the exercises and pretests is testing and servicing the secondary ignition circuit. Pretests and performance checklists are provided for each of the seven…
Morse, David T.
This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 5, Fuel and Carburetion Systems; available separately as CE 031 217. Focus of the posttests is the inspecting and servicing of the fuel and carburetion systems. One multiple choice posttest is provided that covers the 10 performance objectives…
Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C
Goodson-Roberts, Ludy; And Others
This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 1, Battery and Cranking System. Focus of the posttests is the testing of the battery and cranking system. Four multiple choice posttests are provided, one for each of the performance objectives contained in the unit. (No answer keys are provided.)…
Richardson, Roger L.; Bacon, E. Miles
This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 2, Charging System, available separately as CE 031 208. Focus of the posttest is on the testing of the charging system. One multiple choice posttest is provided, that covers the three performance objectives contained in the unit. (No answer key is…
Morse, David T.
This book of posttests is designed to accompany the Engine Tune-Up Service Student Guide for Unit 3, Primary Circuit, available separately as CE 031 211. Focus of the posttests is setting the primary ignition circuit. One multiple choice posttest is provided, covering the eight performance objectives contained in the unit. (No answer key is…
Macy, Rebecca J; Graham, Laurie M
Children, youth, and adults of both genders are sex trafficked into and throughout the United States every day. Regrettably, little attention has been given to how human service providers might identify the sex-trafficking victims they are likely to encounter. To address this knowledge gap, the authors review 20 documents with the aim of detecting and synthesizing service identification recommendations in the scientific literature, government reports, and documents produced by organizations working with sex-trafficking victims. The review shows consensus regarding identification recommendations, including (a) trafficking indicators, (b) victim interaction strategies, (c) immediate response strategies, and (d) child-specific information. The review also shows consensus regarding screening questions that are important for service providers to use in identifying sex-trafficking victims. These questions relate to the victims' safety, employment, living environment, and travel and immigration status in addition to specific questions used with children and youth. The review results offer human service providers a preliminary set of screening strategies and questions that can be used to identify sex-trafficking victims in the context of human services. Building on the review findings, the authors offer policy and research recommendations.
André, Adriana Maria; Ciampone, Maria Helena Trench; Santelle, Odete
To identify factors producing new trends in basic health care unit management and changes in management models. This was a prospective study with ten health care unit managers and ten specialists in the field of Health in São Paulo, Southeastern Brazil, in 2010. The Delphi methodology was adopted. There were four stages of data collection, three quantitative and the fourth qualitative. The first three rounds dealt with changing trends in management models, manager profiles and required competencies, and the Mann-Whitney test was used in the analysis. The fourth round took the form of a panel of those involved, using thematic analysis. The main factors which are driving change in basic health care units were identified, as were changes in management models. There was consensus that this process is influenced by the difficulties in managing teams and by politics. The managers were found to be up-to-date with trends in the wider context, with the arrival of social health organizations, but they are not yet anticipating these within the institutions. Not only the content, but the professional development aspect of training courses in this area should be reviewed. Selection and recruitment, training and assessment of these professionals should be guided by these competencies aligned to the health service mission, vision, values and management models.
Agnus M. Kim
Full Text Available Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age–sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.
....). List of Subjects in 28 CFR Part 0 Authority delegations (Government agencies), Government employees... Marshals Service employee, agent, or contractor. This proposed fee increase reflects the current costs to.... Marshals Service employee, agent, or contractor, plus travel costs and any other out-of- pocket expenses...
A SURVEY BY QUESTIONNAIRE WAS MADE OF THE PROBLEM OF USER SERVICES AND EXTENSION SERVICES USED IN THE DISSEMINATION OF MATERIALS AND INFORMATION TO A SELECTED NUMBER OF INDUSTRIAL LIBRARIES. THE SURVEY RESULTED IN DATA CONCERNING STAFF SIZE, PROFESSIONAL-TO-CLERICAL RATIO, SIZE OF BOOK, DOCUMENT, PERIODICAL AND MICROFORM COLLECTIONS, LIBRARY…
Full Text Available Workplace violence is present in many work sectors, but in the area of mental health, nurses have a higher risk due to the close relationship they have with users. This study analyzed hostile user statements against nursing professionals of Mental Health Services and Emergency Units in Health Service (MHS hospitals in Murcia, Spain, and determined the frequency of exposure to the different violent user behaviors. The study was carried out with a sample of 518 nursing professionals from four hospital services: Mental Health, Emergency Units, Medical Hospitalization, and Maternal-and-Child. The nursing staff of Mental Health and Emergency Units was the most exposed to violence. Non-physical violence was more frequent in Emergency Units, whereas physical violence was more frequent in Mental Health. Among the consequences of exposure to non-physical violence are workers’ emotional exhaustion and the presence of psychological distress.
Ohlson, C G; Söderfeldt, M; Söderfeldt, B; Jones, I; Theorell, T
Workers in human service organizations are often confronted with conflicting demands in providing care or education. The aim of this cross-sectional study was to relate levels of endocrine stress markers to perceived job strain in two human service organizations. Employees in two local units of the social insurance organization and two local units of the individual and family care sections of the social welfare in Sweden were selected and 103 employees participated (56% participation rate). The perceived job strain was assessed with a standardized questionnaire containing questions of the demand-control model. Questions specially designed to measure emotional demands were also included. The stress markers cortisol, prolactin, thyroid-stimulating hormone, testosterone and IgA and IgG were analysed in blood samples. The main finding was an association between high emotional strain and increased levels of prolactin. The levels of cortisol, but none of the other four stress markers, increased slightly with emotional strain. Emotional strain experienced in human service work may cause psychological stress. The increase in prolactin was modest but consistent with findings in other published studies on stress-related endocrine alterations. Copyright 2001 S. Karger AG, Basel.
This report provides the Nuclear Regulatory Commission with a single source that documents known guidelines for conducting formal Human Factors evaluations of Video Display Units (VDUs). The handbook is a ''cookbook'' of acceptance guidelines for the reviewer faced with the task of evaluating VDUs already designed or planned for service in the control room. The areas addressed are video displays, controls, control/display integration, and workplace layout. Guidelines relevant to each of those areas are presented. The existence of supporting research is also indicated for each guideline. A Comment section and Method for Assessment section are provided for each set of guidelines
Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R
The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.
Rysavy, F R; Bishop, M J; Gibbs, G P; Williams, G W
This paper presents an overview of computing and networking facilities developed by the Medical Research Council to provide online computing support to the Human Genome Mapping Project (HGMP) in the UK. The facility is connected to a number of other computing facilities in various centres of genetics and molecular biology research excellence, either directly via high-speed links or through national and international wide-area networks. The paper describes the design and implementation of the current system, a 'client/server' network of Sun, IBM, DEC and Apple servers, gateways and workstations. A short outline of online computing services currently delivered by this system to the UK human genetics research community is also provided. More information about the services and their availability could be obtained by a direct approach to the UK HGMP-RC.
Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi
We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.
Hamel, D.R. [Department of Agriculture-Forest Service, Washington, DC (United States)
This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.
Cary, Maria; Oram, Siân; Howard, Louise M; Trevillion, Kylee; Byford, Sarah
Previous studies have found a high prevalence of depression and post-traumatic stress disorder (PTSD) among survivors of human trafficking. European countries are required to assist trafficked people in their psychological recovery, but there are no rigorous data on the costs of doing so. The objectives of this study were to quantify the use of secondary mental health services by survivors of human trafficking; to estimate the cost of survivors' use of secondary mental health services provided by the UK National Health Service (NHS); and to identify factors that predict higher costs of mental health service provision. Historical cohort study of psychiatric patients who had experienced human trafficking. The South London and Maudsley NHS Trust (SLaM) Biomedical Research Centre Case Register Interactive Search (CRIS) database was used to identify anonymised full patient records of patients who had experienced human trafficking and who had accessed SLaM mental health services between 2007 and 2012. Data were extracted on socio-demographic and trafficking characteristics and contacts with mental health services. Total costs were calculated by multiplying each resource use item by an appropriate unit cost. Factors that predicted high mental health service costs were analysed using regression models. One hundred nineteen patients were included in the analysis. Mean total mental health service costs per patient were £27,293 (sd 80,985) and mean duration of contact with services was 1490 (sd 757) days (approximately 4 years). Regression analysis showed that higher costs were associated with diagnosis of psychotic disorder (p trafficking violence (p = 0.06). Patients diagnosed with psychotic disorders cost approximately £32,635 more than patients with non-psychotic disorders/psychological distress but no formal diagnosis and patients whose clinical notes documented pre-trafficking violence cost £88,633 more than patients for whom pre-trafficking violence was not
Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E
Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.
McGinn, Conor; Cullinan, Michael F; Culleton, Mark; Kelly, Kevin
Multipurpose robots that can perform a range of useful tasks have the potential to increase the quality of life for many people living with disabilities. Owing to factors such as high system complexity, as-yet unresolved research questions and current technology limitations, there is a need for effective strategies to coordinate the development process. Integrating established methodologies based on human-centred design and universal design, a framework was formulated to coordinate the robot design process over successive iterations of prototype development. An account is given of how the framework was practically applied to the problem of developing a personal service robot. Application of the framework led to the formation of several design goals which addressed a wide range of identified user needs. The resultant prototype solution, which consisted of several component elements, succeeded in demonstrating the performance stipulated by all of the proposed metrics. Application of the framework resulted in the development of a complex prototype that addressed many aspects of the functional and usability requirements of a personal service robot. Following the process led to several important insights which directly benefit the development of subsequent prototypes. Implications for Rehabilitation This research shows how universal design might be used to formulate usability requirements for assistive service robots. A framework is presented that guides the process of designing service robots in a human-centred way. Through practical application of the framework, a prototype robot system that addressed a range of identified user needs was developed.
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challange has been to integrate ecology with economics to better understand the effects of human policies and acti...
Alleman, Brandon W; Luger, Tana; Reisinger, Heather Schacht; Martin, Rene; Horowitz, Michael D; Cram, Peter
There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited. To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered. DESIGN, PARTICIPANTS, AND OUTCOMES: Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected. We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US--most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports. The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical
.... 4(b). When a statute does not address issues of how to calculate fees or what costs to include in..., investment, productivity, innovation, or on the ability of United States-based enterprises to compete with...
Kandel, Himal; Murthy, G V S; Bascaran, Covadonga
Uncorrected refractive error is a public health problem globally and in Nepal. Planning of refraction services is hampered by a paucity of data. This study was conducted to determine availability and distribution of human resources for refraction, their efficiency, the type and extent of their training; the current service provision of refraction services and the unmet need in human resources for refraction in Central Nepal. This was a descriptive cross-sectional study. All refraction facilities in the Central Region were identified through an Internet search and interviews of key informants from the professional bodies and parent organisations of primary eye centres. A stratified simple random sampling technique was used to select 50 per cent of refraction facilities. The selected facilities were visited for primary data collection. Face-to-face interviews were conducted with the managers and the refractionists available in the facilities using a semi-structured questionnaire. Data was collected in 29 centres. All the managers (n=29; response rate 100 per cent) and 50 refractionists (Response rate 65.8 per cent) were interviewed. Optometrists and ophthalmic assistants were the main providers of refraction services (n=70, 92.11 per cent). They were unevenly distributed across the region, highly concentrated around urban areas. The median number of refractions per refractionist per year was 3,600 (IQR: 2,400 - 6,000). Interviewed refractionists stated that clients' knowledge, attitude and practice related factors such as lack of awareness of the need for refraction services and/or availability of existing services were the major barriers to the output of refraction services. The total number of refractions carried out in the Central Region per year was 653,176. An additional 170 refractionists would be needed to meet the unmet need of 1,323,234 refractions. The study findings demand a major effort to develop appropriately trained personnel when planning
US Department of Education, 2007
This fact sheet presents questions and answers related to the human trafficking of children in the United States. It describes human trafficking and its extent in the United States, how human traffickers target children for coerced labor and sex exploitation, how to identify victims of human trafficking, how to report a suspected incidence of…
Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise
In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources. © The Author(s) 2014.
Packard, Thomas; Patti, Rino; Daly, Donna; Tucker-Tatlow, Jennifer
This is a study of organizational change strategies employed in seven county human service agencies to improve the coordination of services through the structural integration of previously free standing organizations or the development of voluntary interagency collaborative service delivery systems. The central question involves the identification of organizational change tactics which contributed to the success of the organizational change initiatives. The literature on organizational change is reviewed, with particular attention to a framework developed by Fernandez and Rainey based on their extensive review and synthesis of the research on successful change strategies in the public and business sectors. Qualitative and quantitative data were gathered from over 250 individuals and from agency documents. Findings are compared with the success factors identified by Fernandez and Rainey, and refinements to their propositions are suggested. More precise methods for measuring successful and unsuccessful change initiatives are suggested. Implications for practice and research are presented.
Almansa, J. F.; Burgos, D. E.; Guerrero, R.
The age of the recommendations on minimum human and material resources of the SEFM, along with the emergence of new imaging techniques and new equipment, plus analysis of recent international publications relating to the subject and the establishment of relative value units in several Spanish regions, justify a revision of the minimum necessary human resources to carry out the tasks of Radio physics service with adequate safety and quality.
Litaker, Harry L.; Archer, Ronald D.; Szabo, Richard; Twyford, Evan S.; Conlee, Carl S.; Howard, Robert L.
Landing and supporting a permanent outpost on a planetary surface represents humankind's capability to expand its own horizons and challenge current technology. With this in mind, habitability of these structures becomes more essential given the longer durations of the missions. The purpose of this evaluation was to obtain preliminary human-in-the-loop performance data on the Habitat Demonstration Unit (HDU) in a Pressurized Excursion Module (PEM) configuration during a 14-day simulated lunar exploration field trial and to apply this knowledge to further enhance the habitat's capabilities for forward designs. Human factors engineers at the NASA/Johnson Space Center's Habitability and Human Factors Branch recorded approximately 96 h of crew task performance with four work stations. Human factors measures used during this study included the NASA Task Load Index (TLX) and customized post questionnaires. Overall the volume for the PEM was considered acceptable by the crew; however; the habitat's individual work station volume was constrained when setting up the vehicle for operation, medical operations, and suit maintenance while general maintenance, logistical resupply, and geo science was considered acceptable. Crew workload for each station indicated resupply as being the lowest rated, with medical operations, general maintenance, and geo science tasks as being light, while suit maintenance was considered moderate and general vehicle setup being rated the highest. Stowage was an issue around the habitat with the Space Exploration Vehicle (SEV) resupply stowage located in the center of the habitat as interfering with some work station volumes and activities. Ergonomics of the geo science station was considered a major issue, especially with the overhead touch screens.
... 1974; Department of Homeland Security/United States Secret Service--003 Non-Criminal Investigation... Security/United States Secret Service--003 Non-Criminal Investigation Information System.'' As a result of... Secret Service, 245 Murray Lane SW., Building T-5, Washington, DC 20223. For privacy issues please...
Lee, Sun Ki; Lee, Sang Kook; Jeong, Il Suk; Song, Taek Ho; Kwon, Jong Ju; Hong, Seong Yul; Lee, Jin Hwan
Because of circulating water filtration system(CFI) and essential service water system(SEC) of Ulchin unit 1 and 2 were designed by commonness water intake structure, circulating water filtration system is managed by quality grade Q class. In this study, circulating water filtration system (CFI) examined revision possibility from present quality grade Q class to R class. It is proving that the operation of essential service water system (SEC) is always available regardless CFI conditions
Herrick, Rick; McKay, Michael; Olsen, Timothy; Horton, William; Florida, Mark; Moore, Charles J.; Marcus, Daniel S.
Full Text Available The XNAT informatics platform is an open source data management tool used by biomedical imaging researchers around the world. An important feature of XNAT is its highly extensible architecture: users of XNAT can add new data types to the system to capture the imaging and phenotypic data generated in their studies. Until recently, XNAT has had limited capacity to broadcast the meaning of these data extensions to users, other XNAT installations, and other software.We have implemented a data dictionary service for XNAT, which is currently being used on ConnectomeDB, the Human Connectome Project (HCP public data sharing website. The data dictionary service provides a framework to define key relationships between data elements and structures across the XNAT installation. This includes not just core data representing medical imaging data or subject or patient evaluations, but also taxonomical structures, security relationships, subject groups, and research protocols. The data dictionary allows users to define metadata for data structures and their properties, such as value types (e.g. textual, integers, floats and valid value templates, ranges, or field lists. The service provides compatibility and integration with other research data management services by enabling easy migration of XNAT data to standards-based formats such as RDF, JSON, and XML. It also facilitates the conversion of XNAT’s native data schema into standard neuroimaging ontology structures and provenances.
Shwartz, L.; Rosu, D.; Loewenstern, D.; Buco, M. J.; Guo, S.; Lavrado, Rafael Coelho; Gupta, M.; De, P.; Madduri, V.; Singh, J. K.
In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21
García-Palmieri, Mario R
Available information (2004-2008) concerning population statistics, the occurrence of cardiovascular disease, cardiovascular services and human resources in Puerto Rico is presented. Relevant information concerning life expectancy at birth, death by specific causes in a recent four years period, the commonest causes of death, and the related cardiovascular risk factors prevalence data available is included. The surgical and medical interventional services rendered to cardiovascular patients in different institutions and their locations in Puerto Rico in the year 2008 is presented. Some remarks concerning the productivity of physicians by our Schools of Medicine is included. Information about ACGME accredited postgraduate cardiovascular training programs conducted in Puerto Rico is presented. Data concerning the prevalence of hypertension, diabetes mellitus, overweight and obesity obtained by BRFSS in presented.
Full Text Available Background Although health services are designed and implemented to improve human health, the errors in health services are a very common phenomenon and even sometimes fatal in this field. Medical errors and their cost are global issues with serious consequences for the patients’ community that are preventable and require serious attention. Objectives The current study aimed to identify possible nursing errors applying human error identification in systems tool (HEIST in the intensive care units (ICUs of hospitals. Patients and Methods This descriptive research was conducted in the intensive care unit of a hospital in Khuzestan province in 2013. Data were collected through observation and interview by nine nurses in this section in a period of four months. Human error classification was based on Rose and Rose and Swain and Guttmann models. According to HEIST work sheets the guide questions were answered and error causes were identified after the determination of the type of errors. Results In total 527 errors were detected. The performing operation on the wrong path had the highest frequency which was 150, and the second rate with a frequency of 136 was doing the tasks later than the deadline. Management causes with a frequency of 451 were the first rank among identified errors. Errors mostly occurred in the system observation stage and among the performance shaping factors (PSFs, time was the most influencing factor in occurrence of human errors. Conclusions Finally, in order to prevent the occurrence and reduce the consequences of identified errors the following suggestions were proposed : appropriate training courses, applying work guidelines and monitoring their implementation, increasing the number of work shifts, hiring professional workforce, equipping work space with appropriate facilities and equipment.
Jit, Mark; Choi, Yoon Hong; Edmunds, W John
To assess the cost effectiveness of routine vaccination of 12 year old schoolgirls against human papillomavirus infection in the United Kingdom. Economic evaluation. UK. Population Schoolgirls aged 12 or older. Costs, quality adjusted life years (QALYs), and incremental cost effectiveness ratios for a range of vaccination options. Vaccinating 12 year old schoolgirls with a quadrivalent vaccine at 80% coverage is likely to be cost effective at a willingness to pay threshold of pound30,000 (euro37,700; $59,163) per QALY gained, if the average duration of protection from the vaccine is more than 10 years. Implementing a catch-up campaign of girls up to age 18 is likely to be cost effective. Vaccination of boys is unlikely to be cost effective. A bivalent vaccine with the same efficacy against human papillomavirus types 16 and 18 costing pound13- pound21 less per dose (depending on the duration of vaccine protection) may be as cost effective as the quadrivalent vaccine although less effective as it does not prevent anogenital warts. Routine vaccination of 12 year old schoolgirls combined with an initial catch-up campaign up to age 18 is likely to be cost effective in the UK. The results are robust to uncertainty in many parameters and processes. A key influential variable is the duration of vaccine protection.
Spencer-Cavaliere, Nancy; Kingsley, Bethan C.; Norris, Carmen
Despite recognition that social inclusion is a primary goal within the field of human services, people with disabilities continue to live lives of clienthood, marginalisation, and exclusion and human services staff struggle to make social inclusion a priority. The purpose of this study was to explore the perspectives of human services staff about…
...-2011-0011] Public Health Service Guideline for Reducing Transmission of Human Immunodeficiency Virus... public comment on the draft Public Health Service Guideline for Reducing Transmission of Human..., Attn: Public Health Service Guideline for Reducing Transmission of Human Immunodeficiency Virus (HIV...
Kemicer-Chmielewska, Ewa; Karakiewicz, Beata
The cause for this document is to present a deliberation on public health facility image development on the medical services market. Marketization of the health service, growing awareness of Polish citizens and their expectation of high service quality as well as increased competition in the healthcare system market is the reason why health unit managers need to put a lot of strength and effort in sustaining or improving the image of the facility they run. Such action gives a chance for obtaining a competitive advantage.
Wang, Da-Shang; Zheng, Hua; Ouyang, Zhi-Yun
Sustainable ecosystem services supply is the basis of regional sustainable development, and human beings can satisfy and improve their well-being through ecosystem services consumption. To understand the relationships between ecosystem services supply and consumption and human well-being is of vital importance for coordinating the relationships between the conservation of ecosystem services and the improvement of human well-being. This paper summarized the diversity, complexity, and regionality of ecosystem services supply, the diversity and indispensability of ecosystem services consumption, and the multi-dimension, regionality, and various evaluation indices of human well-being, analyzed the uncertainty and multi-scale correlations between ecosystem services supply and consumption, and elaborated the feedback and asynchronous relationships between ecosystem services and human well-being. Some further research directions for the relationships between ecosystem services supply and consumption and human well-being were recommended.
Hawkins, Nathaniel M; Wright, David J; Capewell, Simon
Poor outcomes and poor uptake of evidence based therapies persist for patients with heart failure in the United Kingdom. We offer a strategic analysis of services, defining the context, organization and objectives of the service, before focusing on implementation and performance. Critical flaws in past service development and performance are apparent, a consequence of failed performance management, policy and political initiative. The barriers to change and potential solutions are common to many health care systems. Integration, information, financing, incentives, innovation and values: all must be challenged and improved if heart failure services are to succeed. Modern healthcare requires open adaptive systems, continually learning and improving. The system also needs controls. Performance indicators should be simple, clinically relevant, and outcome focused. Heart failure presents one of the greatest opportunities to improve symptoms and survival with existing technology. To do so, heart failure services require radical reorganization. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Carol Raish; Alice M. McSweeney
The U.S. Forest Service (FS) has a long, shared history with the Spanish and Mexican land grants of northern New Mexico. The Treaty of Guadalupe Hidalgo, which ended the war between the United States and Mexico, was supposed to recognize and respect the property rights of the resident Hispano population. In many cases the intent of the Treaty was not honored. During...
Mogk, Lylas; Goodrich, Gregory
This article discusses the history of low vision services in the United States. The field began to gain momentum as the term "low vision" was conceptualized and coined, and this momentum is rapidly increasing with changes in the demographics of visual impairment.
During 1965, the RA reactor staff provided services to other organizational units in: designing new systems, repair of electronic equipment, installing measuring devices, constructing mechanical elements in the workshop. [Serbo-Croat] U toku 1965. godine reaktor RA je pruzio usluge drugim jedinicama i to: projektovanjem novih sistema, popravkom elektronskih uredjaja, instaliranjem mernih sistema, izradom mehanickih elemenata i sklopova u mehanickoj radionici.
... Company, Palo Verde Nuclear Generating Station, Unit 3; Environmental Assessment and Finding of No.... NPF-74, issued to Arizona Public Service Company (APS, the licensee), for operation of Palo Verde... Statement for the Palo Verde Nuclear Generating Station, NUREG-0841, dated February 1982. Agencies and...
Bacon, E. Miles
This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 3, Primary Circuit, available separately as CE 031 211. Focus of the exercises and pretests is testing the primary ignition circuit. Pretests and performance checklists are provided for each of the eight performance objectives…
Richardson, Roger L.; Bacon, E. Miles
This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 2, Charging System, available separately as CE 031 208. Focus of the exercises and pretests is testing the charging system. Pretests and performance checklists are provided for each of the three performance objectives contained in…
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Customs Service C Appendix C to Subpart A of Part 1 Money and Finance: Treasury Office of the Secretary of the Treasury... Houston, TX 77029. Phone: (713) 985-6712; FAX: (713) 985-6705. St. Louis: 4477 Woodson Road St. Louis, MO...
Williams, Donald B.
By analyzing the scope and structure of agricultural extension services in Australia, Great Britain, and the United States, this work attempts to set guidelines for measuring progress and guiding extension efforts. Extension training, agricultural policy, and activities of national, international, state, and provincial bodies are examined. The…
Block, Cady; Santos, Octavio A; Flores-Medina, Yvonne; Rivera Camacho, Diego Fernando; Arango-Lasprilla, Juan Carlos
To provide a brief presentation of preliminary data on rehabilitation services provided by clinical neuropsychologists within the United States. This survey utilized data extracted from a larger international research study conducted in 39 countries including N = 173 professionals who reported to engage in neuropsychological rehabilitative services within the past year (63.6% female, 44.36 ± 11.83 years of age) took part in the study. Neuropsychologists providing rehabilitation services in the United States in the past year were more likely to provide individual versus group therapy, likely to employ technology (e.g., personal computers, mobile phones/smartphones) as part of treatment services, see a range of diagnostic groups most prominently traumatic brain injury and stroke/vascular conditions, and work to address a range of both cognitive (e.g., memory, attention/concentration, and executive functioning) and psychological (e.g., emotional/behavioral adjustment and well-being, awareness of disability/disease) issues. Prior published surveys suggest that clinical neuropsychologists have a growing involvement in rehabilitation services within the United States but with little clarity as to the actual characteristics of actual professional activities and practices. The present study aimed to provide such information and hopefully will be helpful in promoting additional systematic studies in this area. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Andersen, Lars Peter Sønderbo; Hogh, Annie; Biering, Karin
BACKGROUND: Threats and violence at work are major concerns for employees in many human service sectors. The prevention of work-related violence is a major challenge for employees and management. OBJECTIVE: The purpose of this study was to identify prospective associations between psycho-social w......BACKGROUND: Threats and violence at work are major concerns for employees in many human service sectors. The prevention of work-related violence is a major challenge for employees and management. OBJECTIVE: The purpose of this study was to identify prospective associations between psycho...... rewards at work, low role clarity, many role conflicts, many work-family conflicts and low organizational justice had statistically significant associations with high levels of work-related threats. Furthermore, high emotional demands, low predictability, low role clarity, many role conflicts, many work......-family conflicts, low supervisor quality and low support from nearest supervisor had statistically significant associations with high levels of work-related violence. Finally, across the four sectors both similar and different associations between psycho-social work environment and work-related violence...
This article examines how the U.S. government's stance on human rights and human rights education has shifted from leading the creation of the 1948 Universal Declaration of Human Rights through the United Nations Human Rights Commission, with Eleanor Roosevelt as chair of the Commission, to one in which human rights education has only a minimal…
Borritz, Marianne; Christensen, Karl Bang; Bultmann, Ute; Rugulies, Reiner; Lund, Thomas; Andersen, Ingelise; Villadsen, Ebbe; Diderichsen, Finn; Kristensen, Tage S.
Objectives: The objective of this study was to examine if burnout and psychosocial factors predicted long-term sickness absence (>2 weeks) at work unit level. Methods: Data were collected prospectively at 82-work units in human services (PUMA cohort, PUMA: Danish acronym for Burnout, Motivation and
Goussinsky, Ruhama; Reshef, Arie; Yanay-Ventura, Galit; Yassour-Borochowitz, Dalit
Qualitative research is an inherent part of the human services profession, since it emphasizes the great and multifaceted complexity characterizing human experience and the sociocultural context in which humans act. In the department of human services at Emek Yezreel College, Israel, we have developed a three-phase model to ensure a relatively…
In September 2015, the United Nations adopted the sustainable development goals (SDGs) to address among others poverty and inequality within and among countries of the world. In particular, the SDGs aim at ameliorating the position of disadvantaged and vulnerable groups in societies. One of the over-arching goals of the SDGs is to ensure that no one is left behind in the realisation of their access to health care. African governments are obligated under international and regional human rights law to ensure access to healthcare services for everyone, including indigenous populations, on a non-discriminatory basis. This requires the governments to adopt appropriate measures that will remove barriers to healthcare services for disadvantaged and marginalised groups such as indigenous peoples.
Karssenberg, Derek; Vaartjes, Ilonca; Kamphuis, Carlijn; Strak, Maciek; Schmitz, Oliver; Soenario, Ivan; de Jong, Kor
The exposome is the totality of human environmental exposures from conception onwards. Identifying the contribution of the exposome to human diseases and health is a key issue in health research. Examples include the effect of air pollution exposure on cardiovascular diseases, the impact of disease vectors (mosquitos) and surface hydrology exposure on malaria, and the effect of fast food restaurant exposure on obesity. Essential to health research is to disentangle the effects of the exposome and genome on health. Ultimately this requires quantifying the totality of all human exposures, for each individual in the studied human population. This poses a massive challenge to geoscientists, as environmental data are required at a high spatial and temporal resolution, with a large spatial and temporal coverage representing the area inhabited by the population studied and the time span representing several decades. Then, these data need to be combined with space-time paths of individuals to calculate personal exposures for each individual in the population. The Global and Geo Health Data Centre is taking this challenge by providing a web service capable of enriching population data with exposome information. Our web service can generate environmental information either from archived national (up to 5 m spatial and 1 h temporal resolution) and global environmental information or generated on the fly using environmental models running as microservices. On top of these environmental data services runs an individual exposure service enabling health researchers to select different spatial and temporal aggregation methods and to upload space-time paths of individuals. These are then enriched with personal exposures and eventually returned to the user. We illustrate the service in an example of individual exposures to air pollutants calculated from hyper resolution air pollution data and various approaches to estimate space-time paths of individuals.
Bledsoe, Sarah E; Rizo, Cynthia F; Wike, Traci L; Killian-Farrell, Candace; Wessel, Julia; Bellows, Anne-Marie O; Doernberg, Alison
Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes. However, few pregnant adolescent women with depression receive psychiatric services, especially low-income or racial/ethnic minority adolescent women. This qualitative study explores perceptions of depression, psychiatric services, and barriers to accessing services in a sample of low-income, pregnant racial/ethnic minority adolescent women. Our goal was to better understand the experiences of depression during pregnancy for these vulnerable adolescent women, and thereby improve their engagement and retention in services for perinatal depression. We recruited 20 pregnant adolescent women who screened positive for depression from 2 public health prenatal clinics in the southeastern United States. Participants were low-income and primarily racial/ethnic minority women between 14 and 20 years old. Data were collected through individual in-depth, ethnographically informed interviews. Generally, participants lacked experience with psychiatric services and did not recognize their symptoms as depression. However, participants perceived a need for mood improvement and were interested in engaging in services that incorporated their perspective and openly addressed stigma. Participants reported practical and psychological barriers to service engagement, but identified few cultural barriers. Family perceptions of psychiatric services served as both a barrier and support. Adolescent women are more likely to engage in psychiatric services if those services reduce practical and psychological barriers, promise relief from the symptoms perceived as most meaningful, and address underlying causes of depression. Culture may affect Latina adolescent women's perceptions of depression and services. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
MacLaren, Robert; Brett McQueen, R; Campbell, Jon
To compare pharmacist and prescriber perceptions of the clinical and financial outcomes of pharmacy services in the intensive care unit (ICU). ICU pharmacists were invited to participate in the survey and were asked to invite two ICU prescriber colleagues to complete questionnaires. ICUs with clinical pharmacy services. The questionnaires were designed to solicit frequency, efficiency, and perceptions about the clinical and financial impact (on a 10-point scale) of pharmacy services including patient care (eight functions), education (three functions), administration (three functions), and scholarship (four functions). Basic services were defined as fundamental, and higher-level services were categorized as desirable or optimal. Respondents were asked to suggest possible sources of funding and reimbursement for ICU pharmacy services. Eighty packets containing one 26-item pharmacy questionnaire and two 16-item prescriber questionnaires were distributed to ICU pharmacists. Forty-one pharmacists (51%) and 46 prescribers (29%) returned questionnaires. Pharmacists had worked in the ICU for 8.3 ± 6.4 years and devoted 50.3 ± 18.7% of their efforts to clinical practice. Prescribers generally rated the impact of pharmacy services more favorably than pharmacists. Fundamental services were provided more frequently and were rated more positively than desirable or optimal services across both groups. The percent efficiencies of providing services without the pharmacist ranged between 40% and 65%. Both groups indicated that salary support for the pharmacist should come from hospital departments of pharmacy or critical care or colleges of pharmacy. Prescribers were more likely to consider other sources of funding for pharmacist salaries. Both groups supported reimbursement of clinical pharmacy services. Critical care pharmacy activities were associated with perceptions of beneficial clinical and financial outcomes. Prescribers valued most services more than pharmacists
Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira
To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p≤0.05). 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR=7.06), receiving information on breast milk expression by the primary health care unit (APR=3.65), and receiving help from the unit professionals to breastfeed (APR=2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR=0.09). Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation. Copyright © 2017. Published by Elsevier Editora Ltda.
Tatiana Mota Xavier de Meneses
Full Text Available Abstract Objective: To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Methods: Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p ≤ 0.05. Results: 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR = 7.06, receiving information on breast milk expression by the primary health care unit (APR = 3.65, and receiving help from the unit professionals to breastfeed (APR = 2.24 were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR = 0.09. Conclusions: Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation.
O. A. Lyndyuk
Full Text Available European integration of Ukraine requires new philosophy of governance modernization and organization, an effective functioning of the civil service system. The urgency of the implementation of humanization approach is a priority for modernization of the national civil service system. The problem of humanization of the civil service in the context of the European integration of Ukraine has been studied in the article. The essence of concepts of «humanism» and «humanization of the civil service» has been considered. Humanism is understood as reflected anthropocentrism, with the human being the object with the highest value. The term «humanization of the civil service» means a deliberate reorientation of the civil service and its objects to recognize a human as an absolute value, «a measure of all things» and to meet the vital needs of society, creating conditions for its full self-realization and ensuring sustainable human development. The civil service must guarantee the security and stability of life and protect rights, freedoms and interests of each individual. Humanization of civil service is also determined as strengthening the rights and freedoms of civil servants, special protection of their dignity and the formation of new humanistic principles of civil service. The features of humanization of the national civil service have been analyzed. It has been found that the human is considered to be the highest value and the content and direction of civil servants activity is determined by ensuring his rights and freedoms. The necessity of changing the priorities of civil service modernization on the basis of humanization, orientation on meeting the needs of human and citizen, as well as creating conditions for closer implementation of national civil service standards to those used in the European Union has been proved. Changes in the philosophy of the civil service of Ukraine should be directed to «serving people», functioning of «service
Coleman, Gill; Wiggins, Liz
Purpose The purpose of this paper is to argue for the widening of attention in healthcare improvement efforts, to include an awareness of the humanity of people who work in the sector and an appreciation of the part human connection plays in engagement around good quality work. Theoretical frameworks and research approaches which draw on action-based, interpretive and systemic thinking are proposed, as a complement to current practices. Design/methodology/approach The paper describes the early stages of an action research (AR) project, which used the appreciative inquiry "4D" framework to conduct participative inquiry in Hamad Medical Corporation's ambulance service in Qatar, in which staff became co-researchers. Findings The co-researchers were highly motivated to work with improvement goals as a result of their participation in the AR. They, and their managers, saw each other and the work in new ways and discovered that they had much to offer. Research limitations/implications This was a small-scale pilot project, from which findings must be considered tentative. The challenges of establishing good collaboration across language, culture and organisational divides are considerable. Practical implications Appreciative and action-oriented inquiry methods can serve not only to find things out, but also to highlight and give value to aspects of humanity in the workplace that are routinely left invisible in formal processes. This, in turn, can help with quality improvement. Originality/value This paper is a challenge to the orthodox way of viewing healthcare organisations, and improvement processes within them, as reliant on control rather than empowerment. An alternative is to actively include the agency, sense-making capacity and humanity of those involved.
Stephenson, Jennifer L.; Maluf, Katrina S.
The paired motor unit analysis provides in vivo estimates of the magnitude of persistent inward currents (PIC) in human motoneurons by quantifying changes in the firing rate (ΔF) of an earlier recruited (reference) motor unit at the time of recruitment and derecruitment of a later recruited (test) motor unit. This study assessed the variability of ΔF estimates, and quantified the dependence of ΔF on the discharge characteristics of the motor units selected for analysis. ΔF was calculated for 158 pairs of motor units recorded from nine healthy individuals during repeated submaximal contractions of the tibialis anterior muscle. The mean (SD) ΔF was 3.7 (2.5) pps (range −4.2 to 8.9 pps). The median absolute difference in ΔF for the same motor unit pair across trials was 1.8 pps, and the minimal detectable change in ΔF required to exceed measurement error was 4.8 pps. ΔF was positively related to the amount of discharge rate modulation in the reference motor unit (r2=0.335; Precruitment of the reference and test motor units (r2=0.229, Pmotor unit activity (r2=0.110, Precruitment threshold of the test motor unit (r2=0.237, Pmotor unit analysis. PMID:21459110
Schaefer, Mark; Goldman, Erica; Bartuska, Ann M; Sutton-Grier, Ariana; Lubchenco, Jane
The concept of nature as capital is gaining visibility in policies and practices in both the public and private sectors. This change is due to an improved ability to assess and value ecosystem services, as well as to a growing recognition of the potential of an ecosystem services approach to make tradeoffs in decision making more transparent, inform efficient use of resources, enhance resilience and sustainability, and avoid unintended negative consequences of policy actions. Globally, governments, financial institutions, and corporations have begun to incorporate natural capital accounting in their policies and practices. In the United States, universities, nongovernmental organizations, and federal agencies are actively collaborating to develop and apply ecosystem services concepts to further national environmental and economic objectives. Numerous federal agencies have begun incorporating these concepts into land use planning, water resources management, and preparations for, and responses to, climate change. Going forward, well-defined policy direction will be necessary to institutionalize ecosystem services approaches in federal agencies, as well as to guide intersector and interdisciplinary collaborative research and development efforts. In addition, a new generation of decision support tools are needed to further the practical application of ecosystem services principles in policymaking and commercial activities. Improved performance metrics are needed, as are mechanisms to monitor the status of ecosystem services and assess the environmental and economic impacts of policies and programs. A greater national and international financial commitment to advancing ecosystem services and natural capital accounting would likely have broad, long-term economic and environmental benefits.
Engel, Ronald E.; Randecker, Victor; Johnson, Wesley
The Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA) inspects domestic and imported meat and poultry food products to assure the public that they are safe, wholesome, not economically adulterated and properly labeled. The Service also monitors the activities of meat and poultry plants and related activities in allied industries, and establishes standards and approves labels for meat and poultry products. As part of its responsibility, shortly after the Chernobyl accident occurred, FSIS developed a plan to assess this accident's impact on domestically produced and imported meat and poultry
Engel, Ronald E; Randecker, Victor; Johnson, Wesley [Food Safety and Inspection Service, United States Department of Agriculture (United States)
The Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA) inspects domestic and imported meat and poultry food products to assure the public that they are safe, wholesome, not economically adulterated and properly labeled. The Service also monitors the activities of meat and poultry plants and related activities in allied industries, and establishes standards and approves labels for meat and poultry products. As part of its responsibility, shortly after the Chernobyl accident occurred, FSIS developed a plan to assess this accident's impact on domestically produced and imported meat and poultry.
Kong, Ningning; Fosmire, Michael; Branch, Benjamin Dewayne
In the academic libraries' efforts to support digital humanities and social science, GIS service plays an important role. However, there is no general service model existing about how libraries can develop GIS services to best engage with digital humanities and social science. In this study, we adopted the action research method to develop and…
... 49 Transportation 7 2010-10-01 2010-10-01 false Listing of Human Service Federal Financial... (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Pt. 604, App. A Appendix A to Part 604—Listing of Human Service Federal Financial Assistance Programs Federal Programs...
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...] Arizona Public Service Company, et al. Palo Verde Nuclear Generating Station, Units 1, 2, and 3... NPF-74, issued to the Arizona Public Service Company (APS, or the licensee), for operation of the Palo Verde Nuclear Generating Station (PVNGS, the facility), Units 1, 2, and 3, respectively, located in...
... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary [Docket No. DHS-2011-0083] Privacy Act of 1974; Department of Homeland Security/United States Secret Service--004 Protection Information System... Security (DHS)/United States Secret Service (USSS)-004 System name: DHS/USSS-004 Protection Information...
... students in the United States. The AMA's comment states that: MA [Medicare Advantage] plans in competitive... Services, Inc.; Public Comment and Response on Proposed Final Judgment Pursuant to the Antitrust Procedures... on the proposed Final Judgment in United States v. Humana Inc. and Arcadian Management Services, Inc...
Bailey, E Fiona; Fridel, Keith W; Rice, Amber D
Although studies of the principal tongue protrudor muscle genioglossus (GG) suggest that whole muscle GG electromyographic (EMG) activities are preserved in nonrapid eye movement (NREM) sleep, it is unclear what influence sleep exerts on individual GG motor unit (MU) activities. We characterized the firing patterns of human GG MUs in wakefulness and NREM sleep with the aim of determining 1) whether the range of MU discharge patterns evident in wakefulness is preserved in sleep and 2) what effect the removal of the "wakefulness" input has on the magnitude of the respiratory modulation of MU activities. Microelectrodes inserted into the extrinsic tongue protrudor muscle, the genioglossus, were used to follow the discharge of single MUs. We categorized MU activities on the basis of the temporal relationship between the spike train and the respiration cycle and quantified the magnitude of the respiratory modulation of each MU using the eta (eta(2)) index, in wakefulness and sleep. The majority of MUs exhibited subtle increases or decreases in respiratory modulation but were otherwise unaffected by NREM sleep. In contrast, 30% of MUs exhibited marked sleep-associated changes in discharge frequency and respiratory modulation. We suggest that GG MUs should not be considered exclusively tonic or phasic; rather, the discharge pattern appears to be a flexible feature of GG activities in healthy young adults. Whether such flexibility is important in the response to changes in the chemical and/or mechanical environment and whether it is preserved as a function of aging or in individuals with obstructive sleep apnea are critical questions for future research.
Andrews, Hannah; Singh, Yogen
Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.
Mieke van der Bijl-Brouwer
Full Text Available Service design is one of the keys to improving how we target today’s complex societal problems. The predominant view of service systems is mechanistic and linear. A service infrastructure—which includes solutions like service blueprints, scripts, and protocols—is, in some ways, designed to control the behavior of service professionals at the service interface. This view undermines the intrinsic motivation, expertise, and creativity of service professionals. This article presents a different perspective on service design. Using theories of social systems and complex responsive processes, I define service organizations as ongoing iterated patterns of relationships between people, and identify them as complex social service systems. I go on to show how the human-centeredness of design practices contributes to designing for such service systems. In particular, I show how a deep understanding of the needs and aspirations of service professionals through phenomenological themes contributes to designing for social infrastructures that support continuous improvement and adaptation of the practices executed by service professionals at the service interface.
Bell, C M; Crystal, M; Detsky, A S; Redelmeier, D A
Historical comparisons indicate that US hospitals are more expensive than Canadian hospitals, but health care system reform might have changed the relative costs and timeliness of health care in the 2 countries. To estimate the price and convenience of selected hospital services in the United States and Canada for patients in 1997 had they paid out-of-pocket. Cross-sectional telephone survey conducted May 1996 to April 1997. The 2 largest acute care general hospitals from every city in the United States and Canada with a population greater than 500000. Each hospital was telephoned and asked their price and waiting time for 7 services: magnetic resonance imaging of the head without gadolinium; a screening mammogram; a 12-lead electrocardiogram; a prothrombin time measurement; a session of hemodialysis; a screening colonoscopy; and a total knee replacement. Waiting times were measured in days until earliest appointment and charges were converted to American currency. Overall, 48 US and 18 Canadian hospitals were surveyed. Median waiting times were significantly shorter in American hospitals for 4 services, particularly a magnetic resonance imaging of the head (3 days vs 150 days; Preplacement ($26805 vs $10651; Preplacement in the United States. US hospitals still provide higher prices and faster care than Canadian hospitals for patients who pay out-of-pocket.
Barnes, Christopher M; Jiang, Kaifeng; Lepak, David P
The strategic human capital literature indicates the importance of human capital to work unit performance. However, we argue that human capital only aids performance when it is translated into actions beneficial to the unit. We examine a set of common human capital leveraging characteristics (including the use of extended shifts, night shifts, shift flexibility, norms for work as a priority over sleep, and norms for constant connectivity) as factors that enhance the effect of human capital on human capital utilization. We also draw from the 2-process model of sleep regulation to examine how these characteristics undermine employee sleep, and thus weaken the link between human capital and work unit performance efficiency. Overall, we propose that human capital leveraging strategies initially enhance the effect of human capital on work unit performance, but over time weaken the effect of human capital on work unit performance efficiency. Thus, strategies intended to enhance the beneficial effect of human capital on work unit performance can end up doing the opposite. (c) 2016 APA, all rights reserved).
Ryan, John Charles
In 2011 the author taught, for the first time, the well-established unit CCA3101/4101 Environmental Humanities in the School of Communications and Arts at ECU (Edith Cowan University) in Western Australia. The unit has a 20-year history through associate professor Rod Giblett and parallels the development of the environmental humanities as a field…
Thomas, C. K.; Bakels, R.; Klein, C. S.; Zijdewind, I.
Spinal cord injury (SCI) results in widespread variation in muscle function. Review of motor unit data shows that changes in the amount and balance of excitatory and inhibitory inputs after SCI alter management of motoneurons. Not only are units recruited up to higher than usual relative forces when
... 39 Postal Service 1 2010-07-01 2010-07-01 false Mailing Standards of the United States Postal Service, Domestic Mail Manual; incorporated by reference of regulations governing domestic mail services... the approval of the Director of the Federal Register.” In conformity with that provision, and with 39...
... Application of the McNamara-O'Hara Service Contract Act Covered Contracts Generally § 4.112 Contracts to furnish services “in the United States.” (a) The Act and the provisions of this part apply to contract... Act. (b) A service contract to be performed in its entirety outside the geographical limits of the...
Valdez, Carmen R.; Budge, Stephanie L.
This study evaluated an adolescent depression in-service training for school staff in the United States. A total of 252 school staff (e.g., teachers, principals, counselors) completed assessments prior to and following the in-service and a subsample of these staff participated in focus groups following the in-service and three months later.…
... low income, advanced age, or with disabilities), shall register on FTA's charter registration Web site... service organization and whether the qualified human service organization is exempt from taxation under...
statements of work would be useful in ensuring ethical govern- ment procurement practices. Conclusions The United States conducts diplomatic, defense...THE EVOLVING CONTINGENCY CONTRACTING MARKET: PRIVATE SECTOR SELF-REGULATION AND UNITED STATES GOVERNMENT MONITORING OF PROCUREMENT OF STABILITY...MARKET: PRIVATE SECTOR SELF-REGULATION AND UNITED STATES GOVERNMENT MONITORING OF PROCUREMENT OF STABILITY OPERATIONS SERVICES Whitney Grespin January
Full Text Available Efficiency is generally defined as the extent to which resources or effort is employed in order to achieve a certain purpose or objective. As per an economic perspective, this term may also mean a minimum quantity of supplies which can generate a maximum result. But can we talk about efficiency in terms of human resources and their allocation to a specific task? And how one asses the activity of the employees when considering service encounters? This study aims to provide an answer to these two questions from an emotional labor perspective: individuals employ their emotional abilities in order to perform a certain job. This is a process under a commercial perspective: the wage represents the exchange value for these competencies.
Oladapo, Abiola O; Rascati, Karen L
To provide a summary of published survey articles regarding the provision of medication therapy management (MTM) services in the United States. A literature search was conducted to identify original articles on MTM-related surveys conducted in the United States, involving community and outpatient pharmacists, physicians, patients, or pharmacy students and published by the primary researchers who conducted the study. Search engines used included PubMed, Medline, and International Pharmaceutical Abstracts (IPA). If MTM was in the keyword list, mesh heading, title, or abstract, the article was reviewed. References from these articles were searched to determine whether other relevant articles were available. A total of 405 articles were initially reviewed; however, only 32 articles met the study requirements. Of the 32 articles, 17 surveyed community/outpatient pharmacists, 3 surveyed pharmacy students, 4 surveyed physicians, and 8 surveyed patients. The survey periods varied across the different studies, with the earliest survey conducted in 2004 and the most recent survey conducted in 2009. The surveys were conducted via the telephone, US mail, interoffice mail, e-mails, Internet/Web sites, hand-delivered questionnaires, and focus groups. Despite the identified barriers to the provision of MTM services, pharmacists reportedly found it professionally rewarding to provide these services. Pharmacists claimed to have adequate clinical knowledge, experience, and access to information required to provide MTM services. Pharmacy students were of the opinion that the provision of MTM services was important to the advancement of the pharmacy profession and in providing patients with a higher level of care. Physicians supported having pharmacists adjust patients’ drug therapy and educate patients on general drug information but not in selecting patients’ drug therapy. Finally, patients suggested that alternative ways need to be explored in describing and marketing MTM
Pazol, Karen; Robbins, Cheryl L; Black, Lindsey I; Ahrens, Katherine A; Daniels, Kimberly; Chandra, Anjani; Vahratian, Anjel; Gavin, Lorrie E
Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services. QFP describes how to provide these services and recommends using family planning and other primary care visits to screen for and offer the full range of these services. This report presents baseline estimates of the use of these preventive services before the publication of QFP that can be used to monitor progress toward improving the quality of preventive care received by women and men of reproductive age. 2011-2013. Three surveillance systems were used to document receipt of preventive health services among women and men of reproductive age as recommended in QFP. The National Survey of Family Growth (NSFG) collects data on factors that influence reproductive health in the United States since 1973, with a focus on fertility, sexual activity, contraceptive use, reproductive health care, family formation, child care, and related topics. NSFG uses a stratified, multistage probability sample to produce nationally representative estimates for the U.S. household population of women and men aged 15-44 years. This report uses data from the 2011-2013 NSFG. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences
Elizabeth A. Shannon
Research purpose: The aim of this study was to determine whether staff from the Tasmanian Department of Health and Human Services (Australia experienced increased levels of self-efficacy, social support within the workplace and positive affect, following participation in a leadership development programme. Research design, approach and method: Quantitative and qualitative methods were used, allowing for triangulation of results. The General Self-Efficacy Scale and the Berlin Social-Support Scale (perceived available support, instrumental were applied in an online survey administered before and nine months following the programme. Participant satisfaction surveys captured immediate responses and semi-structured interviews captured longer-term reflections. Main findings: Descriptive statistics indicated a moderate overall increase in self-efficacy, with strong increases in resilience, dealing with opposition, resourcefulness and problem solving. There was some evidence of greater overall social support and a strong increase in the development of social support networks. There was no support for an increase in participants’ positive orientation towards their jobs in the quantitative data. The impact of adverse environmental factors on participants’ perceptions also became evident through the interviews. Practical implications: Leadership development programmes that strengthen positive psychological resources provide participants with confidence and resilience in times of change. Organisations benefit from increased levels of employee self-efficacy as engagement and problem-solving abilities are enhanced. Contribution/value-add: These results contribute to the body of knowledge associated with effective leadership development.
Adashi, Eli Y; Dean, Laura A
An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Caruana, Erin L; Kuys, Suzanne S; Clarke, Jane; Bauer, Sandra G
This study determined the impact of a pragmatic 6-day physiotherapy service on length of stay, functional independence, gait and balance in people undergoing inpatient rehabilitation, compared to a 5-day service. A prospective cohort study with historical comparison was undertaken in a mixed inpatient rehabilitation unit. Intervention period participants (2011) meeting inclusion criteria were eligible for a 6-day physiotherapy service. All other participants, including the historical cohort (2010) received usual care (5-day physiotherapy). Length of stay, functional independence, gait and balance performance were measured. A total of 536 individuals participated in this study; 270 in 2011 (60% received 6-day physiotherapy) and 266 in 2010. Participants in 2011 showed a trend for reduced length of stay (1.7 days, 95%CI -0.53 to 3.92) compared to 2010. Other measures showed no significant differences between cohorts. In 2011, those receiving 6-day physiotherapy were more dependent, but showed significantly improved functional independence and balance compared to those receiving 5-day physiotherapy (p physiotherapy service in a "real-world" rehabilitation setting demonstrated a trend towards reduced length of stay, and improved functional gains. This service could lead to cost-savings for hospitals and improved patient flow. Implications for Rehabilitation "Real-world" implementation of a 6-day physiotherapy service in rehabilitation shows a trend for reducing length of stay. This reduction in length of stay may lead to cost-savings for the hospital system, and improve patient flow into rehabilitation. Patients receiving 6-day physiotherapy made significant gains in balance and functional independence compared to patients receiving 5-day physiotherapy services in the rehabilitation setting.
Paks NPP had a serious event at Unit 2 in April 2003. This event was connected to Service Pool 1, there was a cleaning tank int he pool to clean the fuel assemblies from sediments. The sediment problem has occurred at three of our four units, the cause of this problem was the decontamination of the steam generators. We have not made any decontamination at Unit 4 only, and there is no any problem at Unit 4 at all. The plant tried out the mentioned cleaning method at Unit 2 first time, and the event happened at that time. Because of the event the function of Service Pool 1 was not available, the damaged fuel and the cleaning tank is in the pool at this moment. We got the permission from the authority body to operate again Unit 2. This operation, the planned campaign was a short one because of the limited possibility to set up a proper core from the fuel assemblies what were available. Because of the short campaign we had to prepare a proper solution to accomplish the refuelling at Unit 2. The main obstacle was the unavailable functionality of Service Pool 1 which used to carry in fresh fuel and carry out the spent fuel with usage of C30 casks (we have two C30 casks, as it shown in their names the casks can contain 30 fuel assemblies, fresh or spent fuel depending on the given activity have to be done). The plant started to find out what would be the proper solution to replace the function of Service Pool 1 and the C30 support plate was found out as the possible solution to this problem. This C30 support plate is ready to launch the C30 casks or containers with the fresh or spent fuel into the reactor. It means that this C30 support plate is adjusted to the reactor main surface and in this way it ready to serve replacing Service Pool 1. Of course the reactor is empty during the preparation phase of the refuelling. First we carry out the spent fuel from the spent fuel pool, after that the fresh fuel is carried in and just after these preparing activities can be started
Li, Jing; Zhou, Z X
Due to the accelerated growth of society, the gaps between the capacity of ecosystems to provide services and human needs are steadily widening. Natural, semi-natural, or managed ecosystems had been able to provide ecosystem services to meet the needs of social development. Four agricultural ecosystem services (net primary production (NPP), carbon sequestration and oxygen production (CSOP), water interception, soil conservation and agriculture production) were quantified in Guanzhong-Tianshui economic region. Estimates of ecosystem services were obtained from the analysis of satellite imagery and the use of well-known models. Based on the ecological services in Guanzhong-Tianshui economic region, this study mainly analysed the driving mechanism of the changes from the two aspects of natural drivers and human drivers. Natural drivers (climate, soil, elevation, land cover) had incentive to the ecological services. Human activity was quantified by an integrated human activity index (HAI) based on population density, farmland ratio, and the influence of road networks and residential areas. We found relationships between ecosystem services, human activities and many natural factors, however these varied according to the service studied. Human activities were mostly negatively related to each ecosystem services, while population and residential land ware positively related to agricultural production. Land use change had made a contribution to ecosystem services. Based on the selected ecosystem services and HAI, we provided sustainable ecosystem management suggestions.
Hofman, Erwin; Meijerink, Jeroen Gerard
This paper tests the utility of platform thinking, a design principle that has so far been applied to product development yet under-researched in service settings, for improving the value of services. A key principle of platform thinking is to balance the reuse of service components with the
Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana
In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting
Derr, Amelia Seraphia
Objective Immigrants face stressors unique to the experience of migration that may exacerbate or cause mental health problems but access care at rates far below the general population, leaving them at risk of untreated mental health conditions. This review synthesizes current findings on mental health service utilization among immigrants to inform future research efforts addressing disparities in access to care. Methods A systematic literature search of seven databases yielded 62 articles that met inclusion criteria: peer-reviewed reports of empirical studies based in the United States with an explicit focus on immigrant mental health service use. Each article was evaluated, and information was extracted by using a structured abstracting form. Results Studies have shown that immigrants from Asia, Latin America, and Africa use mental health services at lower rates than nonimmigrants, despite an equal or greater need. Lower usage has been found to be more pronounced among men, the uninsured, and the undocumented. Structural barriers to service use reported included lack of insurance, high cost, and language barriers. Studies have shown that social support is particularly important for immigrants and that those who seek help for mental health concerns tend to turn first to family, friends, or religious leaders. Conclusions Important areas for future research on disparities in mental health service use among immigrants include expanding research and analytic design to emphasize understudied groups and the heterogeneity of immigrant experiences over time, studying interventions that foster collaboration between formal and informal service sectors, and examining the role of social support in problem recognition and treatment initiation. PMID:26695493
Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel
To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: email@example.com
York Hotel and Towers, New York, NY, 25 September 2012), accessed 21 March 2015, http://www.whitehouse.gov/the-press- office/2012/09/ 25/remarks...with law enforcement for greater societal good will not come before the satisfaction of more basic human survival needs, including protection from...of Homeland Security (DHS) DHS: Immigration and Customs Enforcement (ICE) Investigations (22 U.S.C. 7110(i)) $18.0 $10.0 DHS: Human Smuggling and
Bevins, S.N.; Tracey, J.A.; Franklin, S.P.; Schmit, V.L.; MacMillan, M.L.; Gage, K.L.; Schriefer, M.E.; Logan, K.A.; Sweanor, L.L.; Alldredge, M.W.; Krumm, C.; Boyce, W.M.; Vickers, W.; Riley, S.P.D.; Lyren, L.M.; Boydston, E.E.; Fisher, R.N.; Roelke, M.E.; Salman, M.; Crooks, K.R.; VandeWoude, S.
Plague seroprevalence was estimated in populations pumas and bobcats in the western United States. High levels of exposure in plague-endemic regions indicate the need to consider the ecology and pathobiology of plague nondomestic felid hosts to better understand the role of these species in disease persistence and transmission.
Ujba, V V; Olesova, V N; Khavkina, E Yu; Novozemtseva, T N; Shmakov, A N; Chuyanova, E Yu
The article presents the results of the survey of 150 dentists from 10 closed administrative units of FMBA health care system of Russia in connection with the dynamics of dental staff withdrawal and reduce of volume of preventive work in schools and factories. These problems were found to be associated with the lack of regulations on mandatory preventive dental examinations of workers with occupational hazards, low tariffs for dental services in obligatory medical insurance program, poor wages an lack of apartments for young dentists.
Cuffe, Kendra M; Esie, Precious; Leichliter, Jami S; Gift, Thomas L
The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD
..., Department of Health and Human Services and Department of Agriculture; Memorandum of Understanding Regarding... Memorandum of Understanding (MOU). The MOU will support and encourage cooperation and communication between... Department of Human Services (HHS) and the U.S. Department of Agriculture (USDA). HHS's Centers for Disease...
Lashewicz, Bonnie; McGrath, Jenny; Smyth, Maria
This article is an examination of strategies for engaging students in programs of human services education. We describe an in class mask-making activity, used by three human services instructors at an undergraduate university in western Canada, as a means of engaging students to grow in individual and collaborative awareness and skills. We present…
Hausknecht, John P; Trevor, Charlie O; Howard, Michael J
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.
Jenkins, Dusty D.
Implementing service learning into college courses has been shown to have positive benefits for both students and community members; however, service learning has not been largely evaluated in the literature on human sexuality courses. Thus, the purpose of the current study was to design, implement, and evaluate a service learning project in a…
Amy Farrell; Monica J DeLateur; Colleen Owens; Stephanie Fahy
In an effort to combat human trafficking, the United States federal government and all fifty states passed new laws that criminalise human trafficking and support the identification and prosecution of human trafficking perpetrators. Despite the passage of these laws, only a small number of human trafficking cases have been prosecuted in the last fifteen years. Guided by the notion that prosecutors seek to avoid uncertainty when making decisions to pursue criminal prosecution, we explore how h...
Li, Y.; Albayrak, A.; Goossens, R.H.M.; Xiao, D.; Jakimowicz, J.J.
Because of high risk and instability of the patients in Intensive care unit(ICU), the design of ICU is very difficult. ICU design, auxiliary building design, lighting design, noise control and other aspects can also enhance its management. In this paper, we compare ICU design in China and Holland based on related standards. We also premeditate the indoor environment from planning perspective, analyze patients, their families, medical staff and space requirement to conduct research in ICU desi...
Recommendations of the working group of the United Nations conference on the preservation and improvement of the human environment are presented. Emphasis was placed on conservation of natural resources. (CH)
Dr. Kiersten Kugeler discusses the Epidemiology of Human Plague in the United States. Created: 2/23/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 2/23/2015.
Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.
Hall, Kelli Stidham; Moreau, Caroline; Trussell, James
Building upon previous work describing declining rates and socioeconomic disparities in sexual and reproductive health (SRH) service use among young women in the United States, we reexamined patterns and determinants of SRH service use in 2006-2010. We used the latest data from the National Survey of Family Growth to evaluate SRH service use including contraceptive, sexually transmitted infection (STI) and other gynecological exam services among 3780 women ages 15-24 years. We compared proportions of service use across survey years and employed multiple logistic regression to estimate the influence of time and women's sociodemographic characteristics on the likelihood of SRH service use. The proportion of women using SRH services increased from 50% (2006-2007) to 54% (2007-2008) and 57% (2008-2010) [all year odds ratios (ORs) 1.4, p valuessexually experienced women, the proportions using SRH and contraceptive services were unchanged, while STI service use increased from 22% (2006-2007) to 33% (2008-2009) (OR 1.7, confidence interval 1.1-2.4, p=.009). Differentials in service use existed across sociodemographic groups, largely with lower proportions of service use among women of social disadvantage. Our results suggest a reversal of negative trends but continuing social disparities in young women's use of SRH services in the United States. Copyright © 2012 Elsevier Inc. All rights reserved.
The elderly prison population is increasing and there is a significant amount of unidentified psychiatric morbidity among elderly prisoners. A sizeable number of elderly subjects are referred to regional forensic units. These units are able to provide advice but are reluctant to admit frail, physically ill and vulnerable elderly into their unit because the ward environment is considered inappropriate for them. A sizeable number of inpatients in medium and high secure units are elderly. This paper is an exploratory audit of referrals from a medium and high secure forensic psychiatry unit to a specialist consultation-only liaison old age psychiatry service, which was specifically developed to service the forensic unit. The demographic and clinical characteristics of the patients seen by this specialist service were similar to elderly inpatients in medium and high secure units. All referrals were judged to be appropriate and new management advice was provided in all cases. Main reasons for referral included diagnostic advice, placement advice and treatment advice. Establishing a diagnosis of dementia was considered important because Alzheimer's disease and Lewy body dementia can be treated with cholinesterase inhibitors. Placement advice was the most difficult to provide because of paucity of residential and nursing homes able and willing to accept patients with a forensic history. There is a need for a comprehensive model of specialist forensic old age psychiatry service at a regional or supraregional level. A consensus needs to be reached on the exact configuration of such a service.
Nicholas, Christian L; Bei, Bei; Worsnop, Christopher; Malhotra, Atul; Jordan, Amy S; Saboisky, Julian P; Chan, Julia K M; Duckworth, Ella; White, David P; Trinder, John
single motor unit recordings of the genioglossus (GG) muscle indicate that GG motor units have a variety of discharge patterns, including units that have higher discharge rates during inspiration (inspiratory phasic and inspiratory tonic), or expiration (expiratory phasic and expiratory tonic), or do not modify their rate with respiration (tonic). Previous studies have shown that an increase in GG muscle activity is a consequence of increased activity in inspiratory units. However, there are differences between studies as to whether this increase is primarily due to recruitment of new motor units (motor unit recruitment) or to increased discharge rate of already active units (rate coding). Sleep-wake state studies in humans have suggested the former, while hypercapnia experiments in rats have suggested the latter. In this study, we investigated the effect of hypercapnia on GG motor unit activity in humans during wakefulness. sleep research laboratory. sixteen healthy men. each participant was administered at least 6 trials with P(et)CO(2) being elevated 8.4 (SD = 1.96) mm Hg over 2 min following a 30-s baseline. Subjects were instrumented for GG EMG and respiratory measurements with 4 fine wire electrodes inserted subcutaneously into the muscle. One hundred forty-one motor units were identified during the baseline: 47% were inspiratory modulated, 29% expiratory modulated, and 24% showed no respiratory related modulation. Sixty-two new units were recruited during hypercapnia. The distribution of recruited units was significantly different from the baseline distribution, with 84% being inspiratory modulated (P units active during baseline, nor new units recruited during hypercapnia, increased their discharge rate as P(et)CO(2) increased (P > 0.05 for all comparisons). increased GG muscle activity in humans occurs because of recruitment of previously inactive inspiratory modulated units.
Jan 1, 2009 ... civil service organizations to make them accountable and responsible for ... changing the structure of the civil service organisations. More generally .... method to measure productivity of IT based on before and after IT investment .... 2000, and the wealth value of office equipment4, of Federal. Offices as a ...
Hollensen, Svend; Grünbaum, Niels Nolsøe; Andresen, Marc
Early B2B buying-behavior literature strongly emphasizes the rational aspects of buying behavior in B2B services. Based on a comprehensive exploratory study of Danish companies’ purchases of HR consulting services, the authors provide insights into the factors that determine how Danish companies ...
Hansen, Naja L; Hansen, S; Christensen, L. O. D.
lateralis and medialis of quadriceps), but not or rarely for paired recordings from ankle and knee muscles. The data demonstrate that human motor units within a muscle as well as synergistic muscles acting on the same joint receive a common synaptic drive during human gait. It is speculated that the common...... drive responsible for the motor unit synchronization during gait may be similar to that responsible for short-term synchronization during tonic voluntary contraction....
... NUCLEAR REGULATORY COMMISSION [Docket Nos. STN 50-528, STN 50-529, and STN 50-530; NRC-2010-0114] Arizona Public Service Company, Palo Verde Nuclear Generating Station, Units 1, 2, and 3; Environmental...-74, issued to Arizona Public Service Company (APS, the licensee), for operation of the Palo Verde...
... NUCLEAR REGULATORY COMMISSION [Docket No. STN 50-530; NRC-2010-0281] Arizona Public Service Company, et al., Palo Verde Nuclear Generating Station, Unit 3; Temporary Exemption 1.0 Background Arizona Public Service Company (APS, the licensee) is the holder of Facility Operating License No. NPF-74, which...
This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 5, Fuel and Carburetion Systems, available separately as CE 031 217. Focus of the exercises and pretests is inspecting and servicing the fuel and carburetion systems. Pretests and performance checklists are provided for each of the…
Linda A. Joyce; David T. Price; David P. Coulson; Daniel W. McKenney; R. Martin Siltanen; Pia Papadopol; Kevin. Lawrence
A set of climate change projections for the United States was developed for use in the 2010 USDA Forest Service RPA Assessment. These climate projections, along with projections for population dynamics, economic growth, and land use change in the United States, comprise the RPA scenarios and are used in the RPA Assessment to project future renewable resource conditions...
... Service Company, Palo Verde Nuclear Generating Station, Units 1, 2, and 3, Notice of Issuance of Renewed... Company (licensee), the operator of the Palo Verde Nuclear Generating Station, Units 1, 2, and 3 (PVNGS... Plants: Supplement 43, Regarding Palo Verde Nuclear Generating Station,'' issued January 2011, discusses...
Goodson-Roberts, Ludy; And Others
This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 1, Battery and Cranking System. Focus of the exercises and pretests is testing the battery and cranking system. Pretests and performance checklists are provided for each of the four performance objectives contained in the unit.…
... North Korea to United States aircraft authorized. 500.585 Section 500.585 Money and Finance: Treasury... TREASURY FOREIGN ASSETS CONTROL REGULATIONS Licenses, Authorizations and Statements of Licensing Policy § 500.585 Payments for services rendered by North Korea to United States aircraft authorized. Payments...
Emily Jane Davis; Eric M. White; Lee K. Cerveny; David Seesholtz; Meagan L. Nuss; Donald R. Ulrich
In the United States, over 191 million acres of land is managed by the United States Department of Agriculture Forest Service, a federal government agency. In several western U.S. states, organized collaborative groups have become a de facto governance approach to providing sustained input on management decisions on much public land. This is most extensive in Oregon,...
Barbieri, Silvio; Fragnière, Emmanuel; Sitten, Marshall S.; Zambrano, Gabriel
In the field of service design, modeling is often used to visually represent the structures, flow, and operations of a service. This modeling, usually referred to as a “workflow” or “service blueprint”, is usually conceptualized in a linear or matrix form. These models, while useful for visualizing the structures and processes involved in service production, fail to consider the contribution of human factors – motivation, emotion, satisfaction, etc. – that are also essential elements of servi...
McFerran, Don; Hoare, Derek J; Carr, Simon; Ray, Jaydip; Stockdale, David
Tinnitus service provision in the United Kingdom has been investigated from the healthcare provider's perspective demonstrating considerable regional variation particularly regarding availability of psychological treatments. An audiological-based tinnitus service, however, was reportedly available for all tinnitus patients in the UK. The aim of the current study was to define and evaluate nationwide tinnitus healthcare services from the patients' viewpoint. Secondary analyses were performed on data from a 33-item questionnaire provided by the British Tinnitus Association. The questionnaire had been distributed via email and social media. Responses from 937 participants who had or had previously experienced tinnitus were analysed. All but one person had at some time consulted their GP. About one in five received medication in primary care. The majority were referred to secondary care, generally an ENT surgeon or audiovestibular physician; some were referred directly to audiological services. In secondary care the majority underwent audiometric testing and over half underwent MRI scanning. Drugs were prescribed less frequently in secondary care. About one third of patients were referred onwards from diagnostic services in secondary care to receive therapeutic interventions for tinnitus. Therapy was generally delivered by an audiologist or hearing therapist. Just under two fifths of people discharged from secondary care returned to their GP, with most returning within one year. Over a third of this group were re-referred to secondary care. Few patients saw a psychologist (2.6%) though some psychological treatments were delivered by appropriately trained audiologists. Negative counselling from healthcare professionals in both primary and secondary care settings was reported. Although the UK has developed a national service for patients with tinnitus many people find it difficult to access, being blocked at the primary care level or after secondary care diagnostic
Fernando A. Wilson
Full Text Available Background. There are limited research and substantial uncertainty about the level of eye care utilization in the United States. Objectives. Our study estimated eye care utilization using, to our knowledge, every known nationally representative, publicly available database with information on office-based optometry or ophthalmology services. Research Design. We analyzed the following national databases to estimate eye care utilization: the Medical Expenditure Panel Survey (MEPS, National Health Interview Survey (NHIS, Joint Canada/US Survey of Health (JCUSH, Behavioral Risk Factor Surveillance System (BRFSS, and the National Ambulatory Medical Care Survey (NAMCS. Subjects. US adults aged 18 and older. Measures. Self-reported utilization of eye care services. Results. The weighted number of adults seeing or talking with any eye doctor ranges from 87.9 million to 99.5 million, and the number of visits annually ranges from 72.9 million to 142.6 million. There were an estimated 17.2 million optometry visits and 55.8 million ophthalmology visits. Conclusions. The definitions and estimates of eye care services vary widely across national databases, leading to substantial differences in national estimates of eye care utilization.
Jenny Marcela Cardona Bedoya
Full Text Available This article presents the results of processes thesis of "Master in Management and Marketing Management and Global New Markets" for the University Camilo José Cela. The data collection is done through an exploratory research and the study of business unit Unit Providing Services of Virtual Training Unipanamericana - Compensate. Considering secondary sources we identified: 1 The most important in the world and in Colombia at the level of new technologies, 2 The development trends of the array Mic Mac establishes the relationship between trends and portfolio of the business unit. And 3 Identify the growth of applications and the impact of E-learning. The collection and analysis of information on the qualitative method developed through interviews, aiming to identify trends that impact the marketing plan. In the analysis were found four trends that impact the line of business: The joint educational levels, The new educational experiences, Changes in learning models and Strengthening education systems. These trends were explored in an evaluative context, to identify new technologies that are necessary for professional development.
Jane M. Watson
Full Text Available This paper addresses issues associated with the development of a unit preparing pre-service teachers to be quantitatively literate in three respects. These issues surround (i the need to be aware of numeracy demands across the curriculum, (ii the need to model numerate behavior in all interactions of teachers, and (iii the need to be able to interpret and use system data provided from local and national testing programs. The context for the unit described is Australia, where a national testing program for literacy and numeracy requires teachers to analyze extensive data on their students, a national curriculum requires teachers of all subjects and levels to encompass literacy and numeracy in their teaching, and national standards for the teaching profession are being progressively introduced to set and assess teachers’ proficiency across their careers. The unit consists of 12 topics covered in lectures and tutorial material, which was offered to over 800 students in External and On-campus modes in 2010.
Tobagi, Fouad A.; Dalgic, Ismail; Pang, Joseph
The design and implementation of interface units for high speed Fiber Optic Local Area Networks and Broadband Integrated Services Digital Networks are discussed. During the last years, a number of network adapters that are designed to support high speed communications have emerged. This approach to the design of a high speed network interface unit was to implement package processing functions in hardware, using VLSI technology. The VLSI hardware implementation of a buffer management unit, which is required in such architectures, is described.
Full Text Available Abstract Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. Method A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. Results The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Conclusions Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.
Bui, David P; Pollack Porter, Keshia; Griffin, Stephanie; French, Dustin D; Jung, Alesia M; Crothers, Stephen; Burgess, Jefferey L
Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and unwanted events through an iterative process of scoping hazards, risk assessment, and implementing controls. We describe the process, outputs, and lessons learned from the application of a proactive RM process to reduce ESVCs in US fire departments. Three fire departments representative of urban, suburban, and rural geographies, participated in a facilitated RM process delivered through focus groups and stakeholder discussion. Crash reports from department databases were reviewed to characterize the context, circumstances, hazards and risks of ESVCs. Identified risks were ranked using a risk matrix that considered risk likelihood and severity. Department-specific control measures were selected based on group consensus. Interviews, and focus groups were used to assess acceptability and utility of the RM process and perceived facilitators and barriers of implementation. Three to six RM meetings were conducted at each fire department. There were 7.4 crashes per 100 personnel in the urban department and 10.5 per 100 personnel in the suburban department; the rural department experienced zero crashes. All departments identified emergency response, backing, on scene struck by, driver distraction, vehicle/road visibility, and driver training as high or medium concerns. Additional high priority risks varied by department; the urban department prioritized turning and rear ending crashes; the suburban firefighters prioritized inclement weather/road environment and low visibility related crashes; and the rural volunteer fire department prioritized exiting station, vehicle failure, and inclement weather/road environment related incidents. Selected controls included new policies and standard operating procedures to reduce emergency response, cameras to enhance driver
socio-economic development because it is essential for a virile labour force ... Poverty and access to health care services are major development problems ..... including preventive, curative and palliative intervention, whether directed to.
In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21% of interruptions were caused by human error. We focus on Change Management, the process with the largest risk of human error, and identify the main instances of human errors as the 4 Wrongs: request, time, configuration item, and command. Analysis of change records revealed that the humanerror prevention by partial automation is highly relevant. We propose the HEP Framework, a framework for execution of IT Service Delivery operations that reduces human error by addressing the 4 Wrongs using content integration, contextualization of operation patterns, partial automation of command execution, and controlled access to resources.
Lin, Jonathan F S; Kulić, Dana
Many applications in rehabilitation and sports training require the assessment of the patient’s status based on observation of their movement. Small wireless sensors, such as accelerometers and gyroscopes, can be utilized to provide a quantitative measure of the human movement for assessment. In this paper, a kinematics-based approach is developed to estimate human leg posture and velocity from wearable sensors during the performance of typical physiotherapy and training exercises. The proposed approach uses an extended Kalman filter to estimate joint angles from accelerometer and gyroscopic data and is capable of recovering joint angles from arbitrary 3D motion. Additional joint limit constraints are implemented to reduce drift, and an automated approach is developed for estimating and adapting the process noise during online estimation. The approach is validated through a user study consisting of 20 subjects performing knee and hip rehabilitation exercises. When compared to motion capture, the approach achieves an average root-mean-square error of 4.27 cm for unconstrained motion, with an average joint error of 6.5°. The average root-mean-square error is 3.31 cm for sagittal planar motion, with an average joint error of 4.3°. (paper)
Robert, Mark E; Linthicum, Fred H
Profile count method for estimating cell number in sectioned tissue applies a correction factor for double count (resulting from transection during sectioning) of count units selected to represent the cell. For human spiral ganglion cell counts, we attempted to address apparent confusion between published correction factors for nucleus and nucleolus count units that are identical despite the role of count unit diameter in a commonly used correction factor formula. We examined a portion of human cochlea to empirically derive correction factors for the 2 count units, using 3-dimensional reconstruction software to identify double counts. The Neurotology and House Histological Temporal Bone Laboratory at University of California at Los Angeles. Using a fully sectioned and stained human temporal bone, we identified and generated digital images of sections of the modiolar region of the lower first turn of cochlea, identified count units with a light microscope, labeled them on corresponding digital sections, and used 3-dimensional reconstruction software to identify double-counted count units. For 25 consecutive sections, we determined that double-count correction factors for nucleus count unit (0.91) and nucleolus count unit (0.92) matched the published factors. We discovered that nuclei and, therefore, spiral ganglion cells were undercounted by 6.3% when using nucleolus count units. We determined that correction factors for count units must include an element for undercounting spiral ganglion cells as well as the double-count element. We recommend a correction factor of 0.91 for the nucleus count unit and 0.98 for the nucleolus count unit when using 20-µm sections. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
Kehoe, Rebecca R; Collins, Christopher J
To clarify the potential value of a targeted system of human resource (HR) practices, we explore the unique effects of a relationship-oriented HR system and the more commonly studied high commitment HR system on unit performance in the context of knowledge-intensive work. We develop theoretical arguments suggesting that the high commitment HR system contributes to unit performance through its positive effects on employees' collective organizational commitment, general and firm-specific human capital, and access to knowledge. We argue that the relationship-oriented HR system contributes to unit performance through its positive effects on employees' collective access to knowledge by fostering a social context and interpersonal exchange conditions which support employees' ongoing access to knowledge flows within and outside their unit and broader organization. Based on unit-level data collected from a matched sample of employees and managers in 128 units in the science and engineering division of a large hydroelectric power organization, our results suggest that the targeted, relationship-oriented HR system is related to firm performance and may complement a broader, high commitment approach to managing knowledge workers. Specifically, the positive relationship between the high commitment HR system and unit performance is mediated by employees' collective organizational commitment, firm-specific human capital, and access to knowledge in other organizational units; whereas the positive relationship between the relationship-oriented HR system and unit performance is mediated by units' access to knowledge within the unit, in other units, and outside the organization. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Chevallereau, Christine; Pisla, Doina; Bleuler, Hannes; Rodić, Aleksandar
Medical and service robotics integrates several disciplines and technologies such as mechanisms, mechatronics, biomechanics, humanoid robotics, exoskeletons, and anthropomorphic hands. This book presents the most recent advances in medical and service robotics, with a stress on human aspects. It collects the selected peer-reviewed papers of the Fourth International Workshop on Medical and Service Robots, held in Nantes, France in 2015, covering topics on: exoskeletons, anthropomorphic hands, therapeutic robots and rehabilitation, cognitive robots, humanoid and service robots, assistive robots and elderly assistance, surgical robots, human-robot interfaces, BMI and BCI, haptic devices and design for medical and assistive robotics. This book offers a valuable addition to existing literature.
Bhattacharyya, Sarmishtha; Benbow, Susan Mary
The proportion of older people from black and minority ethnic (BME) groups in the United Kingdom (UK) is increasing steadily as the population ages. The numbers with dementia, depression, and other mental health problems are predicted to increase. Government policy documents have highlighted gaps in services for BME elders and/or the need to develop culturally appropriate services, in order to prevent people from BME communities from becoming socially excluded and finding services hard to access. This paper reviews published examples of innovative services and key learning points from them. A search was carried out on Pubmed, Medline, and Google Scholar for service developments aimed at BME elders in the UK. Sixteen relevant papers and reports were identified and were analysed to identify learning points and implications for clinical practice and policy. Commissioning issues included were forward planning for continuing funding and mainstreaming versus specialist services. Provider management issues included were employing staff from the communities of interest, partnership, and removing language barriers. Provider service issues included were education for service provider staff on the needs of BME elders, making available information in relevant languages, building on carers' and users' experiences, and addressing the needs of both groups. A model for structuring understanding of the underutilisation of services by BME elders is suggested. The main emphasis in future should be to ensure that learning is shared, disseminated, and applied to the benefit of all communities across the whole of the UK and elsewhere. Person-centred care is beneficial to all service users.
Jan 1, 2009 ... had no impact on the size of jobs that require high-level of human resource capacity. Furthermore ... level human resource capacity has an effect on the size of supervisors, which is the main ...... depreciation. 5 This indicates ...
AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY A Case Study on Human Capital Mismanagement in the United States Air Force By John P...Force does not effectively manage its human capital to develop and retain a technically literate acquisitions workforce. A detailed look at the...Several solutions are suggested to improve the human capital management and increase the quality and relevancy of the acquisitions community at
Ronis, Scott T; Slaunwhite, Amanda K; Malcom, Kathryn E
This paper reviews how child and youth mental health care services in Canada, the United States, and the Netherlands are organized and financed in order to identify systems and individual-level factors that may inhibit or discourage access to treatment for youth with mental health problems, such as public or private health insurance coverage, out-of-pocket expenses, and referral requirements for specialized mental health care services. Pathways to care for treatment of mental health problems among children and youth are conceptualized and discussed in reference to health insurance coverage and access to specialty services. We outline reforms to the organization of health care that have been introduced in recent years, and the basket of services covered by public and private insurance schemes. We conclude with a discussion of country-level opportunities to enhance access to child and youth mental health services using existing health policy levers in Canada, the United States and the Netherlands.
Dae-Il Kan; Kil-Yoo Kim; Jae-Joo Ha
We performed an importance analysis of In-Service Testing (IST) components for Ulchin Unit 3 using the integrated evaluation method for categorizing component safety significance developed in this study. The importance analysis using the developed method is initiated by ranking the component importance using quantitative PSA information. The importance analysis of the IST components not modeled in the PSA is performed through the engineering judgment, based on the expertise of PSA, and the quantitative and qualitative information for the IST components. The PSA scope for importance analysis includes not only Level 1 and 2 internal PSA but also Level 1 external and shutdown/low power operation PSA. The importance analysis results of valves show that 167 (26.55%) of the 629 IST valves are HSSCs and 462 (73.45%) are LSSCs. Those of pumps also show that 28 (70%) of the 40 IST pumps are HSSCs and 12 (30%) are LSSCs. (authors)
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challenge has been to integrate ecology with economics to better understand the effects of human policies and acti...
Yang, Wu; Dietz, Thomas; Liu, Wei; Luo, Junyan; Liu, Jianguo
The Millennium Ecosystem Assessment (MA) estimated that two thirds of ecosystem services on the earth have degraded or are in decline due to the unprecedented scale of human activities during recent decades. These changes will have tremendous consequences for human well-being, and offer both risks and opportunities for a wide range of stakeholders. Yet these risks and opportunities have not been well managed due in part to the lack of quantitative understanding of human dependence on ecosystem services. Here, we propose an index of dependence on ecosystem services (IDES) system to quantify human dependence on ecosystem services. We demonstrate the construction of the IDES system using household survey data. We show that the overall index and sub-indices can reflect the general pattern of households' dependences on ecosystem services, and their variations across time, space, and different forms of capital (i.e., natural, human, financial, manufactured, and social capitals). We support the proposition that the poor are more dependent on ecosystem services and further generalize this proposition by arguing that those disadvantaged groups who possess low levels of any form of capital except for natural capital are more dependent on ecosystem services than those with greater control of capital. The higher value of the overall IDES or sub-index represents the higher dependence on the corresponding ecosystem services, and thus the higher vulnerability to the degradation or decline of corresponding ecosystem services. The IDES system improves our understanding of human dependence on ecosystem services. It also provides insights into strategies for alleviating poverty, for targeting priority groups of conservation programs, and for managing risks and opportunities due to changes of ecosystem services at multiple scales.
Scott, Julia K; Leary, Sam D; Ness, Andy R; Sandy, Jonathan R; Persson, Martin; Kilpatrick, Nicky; Waylen, Andrea E
Cleft care provision in the United Kingdom has been centralized over the past 15 years to improve outcomes for children born with cleft lip and palate. However, to date, there have been no investigations to examine how well these multidisciplinary teams are performing. In this pilot study, a cross-sectional questionnaire surveyed members of all health care specialties working to provide cleft care in 11 services across the United Kingdom. Team members were asked to complete the Team Work Assessment (TWA) to investigate perceptions of team working in cleft services. The TWA comprises 55 items measuring seven constructs: team foundation, function, performance and skills, team climate and atmosphere, team leadership, and team identity; individual constructs were also aggregated to provide an overall TWA score. Items were measured using five-point Likert-type scales and were converted into percentage agreement for analysis. Responses were received from members of every cleft team. Ninety-nine of 138 cleft team questionnaires (71.7%) were returned and analyzed. The median (interquartile range) percentage of maximum possible score across teams was 75.5% (70.8, 88.2) for the sum of all items. Team performance and team identity were viewed most positively, with 82.0% (75.0, 88.2) and 88.4% (82.2, 91.4), respectively. Team foundation and leadership were viewed least positively with 79.0% (72.6, 84.6) and 76.6% (70.6, 85.4), respectively. Cleft team members perceive that their teams work well, but there are variations in response according to construct.
Semmler, J G
It is well known that unaccustomed eccentric exercise leads to muscle damage and soreness, which can produce long-lasting effects on muscle function. How this muscle damage influences muscle activation is poorly understood. The purpose of this brief review is to highlight the effect of eccentric exercise on the activation of muscle by the nervous system, by examining the change in motor unit activity obtained from surface electromyography (EMG) and intramuscular recordings. Previous research shows that eccentric exercise produces unusual changes in the EMG–force relation that influences motor performance during isometric, shortening and lengthening muscle contractions and during fatiguing tasks. When examining the effect of eccentric exercise at the single motor unit level, there are substantial changes in recruitment thresholds, discharge rates, motor unit conduction velocities and synchronization, which can last for up to 1 week after eccentric exercise. Examining the time course of these changes suggests that the increased submaximal EMG after eccentric exercise most likely occurs through a decrease in motor unit conduction velocity and an increase in motor unit activity related to antagonist muscle coactivation and low-frequency fatigue. Furthermore, there is a commonly held view that eccentric exercise produces preferential damage to high-threshold motor units, but the evidence for this in humans is limited. Further research is needed to establish whether there is preferential damage to high-threshold motor units after eccentric exercise in humans, preferably by linking changes in motor unit activity with estimates of motor unit size using selective intramuscular recording techniques.
Motomura, Yoichi; Nishida, Yoshifumi
A project called `Open life matrix' is not only a research activity but also real problem solving as an action research. This concept is realized by large-scale data collection, probabilistic causal structure model construction and information service providing using the model. One concrete outcome of this project is childhood injury prevention activity in new team consist of hospital, government, and many varieties of researchers. The main result from the project is a general methodology to apply probabilistic causal structure models as servicable knowledge for action research. In this paper, the summary of this project and future direction to emphasize action research driven by artificial intelligence technology are discussed.
Wilkinson, Vanessa; Malhotra, Atul; Nicholas, Christian L; Worsnop, Christopher; Jordan, Amy S; Butler, Jane E; Saboisky, Julian P; Gandevia, Simon C; White, David P; Trinder, John
Single motor unit recordings of the human genioglossus muscle reveal motor units with a variety of discharge patterns. Integrated multiunit electromyographic recordings of genioglossus have demonstrated an abrupt increase in the muscle's activity at arousal from sleep. The aim of the present study was to determine the effect of arousal from sleep on the activity of individual motor units as a function of their particular discharge pattern. Genioglossus activity was measured using intramuscular fine-wire electrodes inserted via a percutaneous approach. Arousals from sleep were identified using the ASDA criterion and the genioglossus electromyogram recordings analyzed for single motor unit activity. Sleep research laboratory. Sleep and respiratory data were collected in 8 healthy subjects (6 men). 138 motor units were identified during prearousalarousal sleep: 25% inspiratory phasic, 33% inspiratory tonic, 4% expiratory phasic, 3% expiratory tonic, and 35% tonic. At arousal from sleep inspiratory phasic units significantly increased the proportion of a breath over which they were active, but did not appreciably increase their rate of firing. 80 new units were identified at arousals, 75% were inspiratory, many of which were active for only 1 or 2 breaths. 22% of units active before arousal, particularly expiratory and tonic units, stopped at the arousal. Increased genioglossus muscle activity at arousal from sleep is primarily due to recruitment of inspiratory phasic motor units. Further, activity within the genioglossus motoneuron pool is reorganized at arousal as, in addition to recruitment, approximately 20% of units active before arousals stopped firing.
Zampas, Christina; Andión-Ibañez, Ximena
The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations
Khoo, B.Y.; Sit, K.H.; Wong, K.P.
The human platelets possess a full complement of enzymes capable of synthesizing N-acetyldopamine (NADA) 35 sulfate from ATP, Mg ++ and sodium 35 sulfate. The pH optimum for this three-step overall sulfate conjugation (comprising of the ATP sulfurylase, APS kinase and phenolsulfotransferase reactions) is 8.6 and the reactions proceeded progressively for several hours. Both ATP and Mg ++ ions, above their respective optimal concentrations of 5 and 7 mM, inhibited the sulfate conjugation of NADA. The apparent Km values for NADA as determined by the phenolsulfotransferase (PST) and overall reactions were similar in magnitude being 2.6 and 4.8 μM, respectively, while that for sodium 35 sulfate was 202 μM. A comparison of these two activities in 62 platelet preparations of normal subjects showed that the rate of the PST reaction was generally higher than the overall reaction even though the PST assay was carried out at suboptimal concentration of PAPS. There was a positive correlation (r=0.82) between the two sets of data, suggesting that the PST reaction probably has some control over the rate of overall sulfate conjugation
Walker, Mary Ellen; Anonson, June; Szafron, Michael
The relationship between political environment and health services accessibility (HSA) has not been the focus of any specific studies. The purpose of this study was to address this gap in the literature by examining the relationship between political environment and HSA. This relationship that HSA indicators (physicians, nurses and hospital beds per 10 000 people) has with political environment was analyzed with multiple least-squares regression using the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). The components of democracy were represented by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) sub-scores. The EIUDI sub-scores and the HSA indicators were evaluated for significant relationships with multiple least-squares regression. While controlling for a country's geographic location and level of democracy, we found that two components of a nation's political environment: functioning of government and political participation, and their interaction had significant relationships with the three HSA indicators. These study findings are of significance to health professionals because they examine the political contexts in which citizens access health services, they come from research that is the first of its kind, and they help explain the effect political environment has on health. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Spanner, J.C. Sr.
This paper describes a study conducted to identify, characterize, and evaluate the human reliability aspects of ultrasonic testing/inservice inspection (UT/ISI). Recent measurements of UT/ISI system effectiveness have revealed wide variations in performance; suggesting that insufficient emphasis is being placed on the human reliability aspects of nondestructive examination. It appears that NDE performance can be improved through application of the human factors principles relating to the task, training, procedure, environmental, and individual difference variables. These variables are collectively referred to as performance-shaping factors. A man-machine systems model was developed to describe the UT/ISI process using functional task descriptors. The relative operating characteristic (ROC) analysis method, which is derived from signal detection theory, offers unique attributes for analyzing NDT performance. The results of a limited human factors evaluation conducted in conjunction with a mini-round robin test are also described
Introduction A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). Methods The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). Results In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers. PMID:25750545
A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers.
Deborah S. Carr
For many decades, the natural resource profession has approached the management of public lands as exclusively a natural science endeavor requiring purely technical solutions. With the adoption of an ecosystem management philosophy, the USDA Forest Service has acknowledged the centrality of people in land management policy and decision-making. This paper explores the...
Ecosystem services are the benefits that society receives from nature and they include the regulation of climate, the pollination of crops, the provisioning of intellectual inspiration and recreational environment, as well as many essential goods such as food, fiber, and wood. Rangeland ecosystem se...
Alexander J Martos
Full Text Available LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs.This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by "LGBT community health centers" today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September-December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS software ArcGIS for Desktop.LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services.LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people.
Martos, Alexander J; Wilson, Patrick A; Meyer, Ilan H
LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs. This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by "LGBT community health centers" today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September-December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop. LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services. LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people.
Wilson, Patrick A.; Meyer, Ilan H.
Background LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs. Methods This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by “LGBT community health centers” today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September–December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop. Findings LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services. Conclusions LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people
Lee, Seoyoung; Kim, Eun-Kyung
The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals. Copyright © 2017. Published by Elsevier B.V.
Title: Public Comment on Department of Health and Human Services (DHHS) 2018 Physical Activity Guidelines Author: Wayne E. Cascio, Director, Environmental Public Health Division, US EPA Abstract: In the 2008 Physical Activity Guidelines, the effects of air pollution and advers...
Student poverty is an issue with which far too many students are confronted. Student affairs professionals must increase their awareness of this human dynamic and develop programs, services, and personal knowledge to support students faced with this challenge.
Full Text Available Samer Hamidi School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates Introduction: A national health account (NHA provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD. Methods: The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA. Results: In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE. Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita, compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion: The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of
Human subjects research ethics were developed to ensure responsible conduct when university researchers learn by interacting with community members. As service-learning students also learn by interacting with community members, a similar set of principles may strengthen the ethical practice of service-learning. This article identifies ethical…
Carbone, Dominic J.
The intersection of work and family life has always been a popular topic of discussion among family theorists. This study examined human service employees in direct service positions coping with work stress, family stress, and work-family conflict. The effects of work stress, family stress and work-family conflict on depression were examined.…
Compton, Jana E; Harrison, John A; Dennis, Robin L; Greaver, Tara L; Hill, Brian H; Jordan, Stephen J; Walker, Henry; Campbell, Holly V
Human alteration of the nitrogen (N) cycle has produced benefits for health and well-being, but excess N has altered many ecosystems and degraded air and water quality. US regulations mandate protection of the environment in terms that directly connect to ecosystem services. Here, we review the science quantifying effects of N on key ecosystem services, and compare the costs of N-related impacts or mitigation using the metric of cost per unit of N. Damage costs to the provision of clean air, reflected by impaired human respiratory health, are well characterized and fairly high (e.g. costs of ozone and particulate damages of $28 per kg NO(x)-N). Damage to services associated with productivity, biodiversity, recreation and clean water are less certain and although generally lower, these costs are quite variable (ecosystem services provides decision-makers an integrated view of N sources, damages and abatement costs to address the significant challenges associated with reducing N pollution. Published 2011. This article is a US Government work and is in the public domain in the USA.
Butler, Erin E; Dominy, Nathaniel J
The gastrocnemius muscle-tendon unit (MTU) is central to human locomotion. Structural variation in the human gastrocnemius MTU is predicted to affect the efficiency of locomotion, a concept most often explored in the context of performance activities. For example, stiffness of the Achilles tendon varies among individuals with different histories of competitive running. Such a finding highlights the functional variation of individuals and raises the possibility of similar variation between populations, perhaps in response to specific ecological or environmental demands. Researchers often assume minimal variation in human populations, or that industrialized populations represent the human species as well as any other. Yet rainforest hunter-gatherers, which often express the human pygmy phenotype, contradict such assumptions. Indeed, the human pygmy phenotype is a potential model system for exploring the range of ecomorphological variation in the architecture of human hindlimb muscles, a concept we review here. © 2015 Anatomical Society.
Ecosystem services in urban areas can improve public health and well-being by mitigating natural and anthropogenic pollution, and by promoting healthy lifestyles that include engagement with nature and enhanced opportunities for physical activity and social interaction. EPA’s EnviroAtlas online mapping tool identifies urban environmental features linked in the scientific and medical literature to specific aspects of public health and well-being. EnviroAtlas researchers have synthesized newly-generated one-meter resolution landcover data, downscaled census population data, and other existing datasets such as roads and parks. Resulting geospatial metrics represent health-related indicators of urban ecosystem services supply and demand by census block-group and finer scales. EnviroAtlas maps include percent of the population with limited window views of trees, tree cover along walkable roads, overall neighborhood green space, and proximity to parks. Demographic data can be overlaid to perform analyses of disproportionate distribution of urban ecosystem services across population groups. Together with the Eco-Health Relationship Browser, EnviroAtlas data can be linked to numerous aspects of public health and well-being including school performance, physical fitness, social capital, and longevity. EnviroAtlas maps have been developed using consistent methods to allow for comparisons between neighborhoods and across multiple U.S. communities. To feature eco-heal
... representative to the service location (at other than a specified duty point) is more than 25 miles from an FGIS... representative will be assessed from the FGIS office to the service point and return. When commercial modes of transportation (e.g., airplanes) are required, the actual expense incurred for the round-trip travel will be...
... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of... Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial... collection. By this notice, the Financial Management Service solicits comments concerning the Form FMS-1133...
Lígia Márcia Martins
Full Text Available This article puts in question the affectional-cognitive unit which sustains the human activity, with the purpose to light incorrectness of approaches which dichotomize reason and emotion. It asserts that such dissociations are founded in theorical-methodological principles which set bounds for explanations about the human psychism, so that the overcoming of referred dualisms puts on as a method matter. For making explicit that assertion, it resorted to Historic-Cultural Psychology, based on that it explains about the psychism as subjective image of objective reality, of Vygotskyan criticisms to Cartesian dualism and the need of a historic-cultural approach on emotion studies, intend to analyzing the human activity as a affective-cognitive unit and the imbricated relations that are waged, within it, among affections, emotions, feelings and thoughts. Once presented the interrelations between emotions and cognitions this exhibition argues that the concepts are necessary as a minimum unit of analysis both of thought and feelings.
Borritz, Marianne; Christensen, KB; Bültmann, Ute
and Job satisfaction) followed up during the proceeding 18 months regarding onset of long-term sickness absence. Questionnaire data regarding burnout and psychosocial factors were aggregated at work unit level. We used Poisson regression models with psychosocial factors and burnout as predictors of long...... work environment, and equally important, the organizations should be attentive to employees with symptoms of burnout......Objectives: The objective of this study was to examine if burnout and psychosocial factors predicted long-term sickness absence (>2 weeks) at work unit level. Methods: Data were collected prospectively at 82-work units in human services (PUMA cohort, PUMA: Danish acronym for Burnout, Motivation...
... for Human Prescription Drugs and Biologics; 0910-AF11 Requirements for Pregnancy and Lactation... containing the analgesic acetaminophen or aspirin and sodium bicarbonate used as an antacid ingredient. The... NPRM (Amendment) (Pediatric) To Be Determined NPRM (Amendment) (Sodium Bicarbonate) To Be Determined...
...-AB58 Specifications, and Certification Criteria for Electronic Health Record Technology (Rulemaking... Electronic Submission of Data From Studies Evaluating Human Drugs and Biologics....... 0910-AC52 137 Over-the... 147 Cigars Subject to the Family Smoking Prevention and Tobacco Control Act 0910-AG38 Food and Drug...
Chobotov, V. A.
Control elements such as sensors, momentum exchange devices, and thrusters are described which can be used to define space replaceable units (SRU), in accordance with attitude control, guidance, and navigation performance requirements selected for NASA space serviceable mission spacecraft. A number of SRU's are developed, and their reliability block diagrams are presented. An SRU assignment is given in order to define a set of feasible space serviceable spacecraft for the missions of interest.
Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki
Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the
Thatte, Nandita; Choi, Yoonjoung
Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be
Sullivan, Michael [Nexant Inc., Burlington, MA (United States); Schellenberg, Josh [Nexant Inc., Burlington, MA (United States); Blundell, Marshall [Nexant Inc., Burlington, MA (United States)
This report updates the 2009 meta-analysis that provides estimates of the value of service reliability for electricity customers in the United States (U.S.). The meta-dataset now includes 34 different datasets from surveys fielded by 10 different utility companies between 1989 and 2012. Because these studies used nearly identical interruption cost estimation or willingness-to-pay/accept methods, it was possible to integrate their results into a single meta-dataset describing the value of electric service reliability observed in all of them. Once the datasets from the various studies were combined, a two-part regression model was used to estimate customer damage functions that can be generally applied to calculate customer interruption costs per event by season, time of day, day of week, and geographical regions within the U.S. for industrial, commercial, and residential customers. This report focuses on the backwards stepwise selection process that was used to develop the final revised model for all customer classes. Across customer classes, the revised customer interruption cost model has improved significantly because it incorporates more data and does not include the many extraneous variables that were in the original specification from the 2009 meta-analysis. The backwards stepwise selection process led to a more parsimonious model that only included key variables, while still achieving comparable out-of-sample predictive performance. In turn, users of interruption cost estimation tools such as the Interruption Cost Estimate (ICE) Calculator will have less customer characteristics information to provide and the associated inputs page will be far less cumbersome. The upcoming new version of the ICE Calculator is anticipated to be released in 2015.
Moughrabieh, Anas; Weinert, Craig
The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.
The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country. PMID:26788827
Full Text Available Abstract Background This paper addresses an important practical challenge to staff management. In 2000 the United Nations committed themselves to the ambitious targets embodied in the Millennium Development Goals (MDGs. Only five years later, it was clear that poor countries were not on track to achieve them. It was also clear that achieving the three out of the eight MDGs that concern health would only be possible if the appropriate human resources (HR were in place. Methods We use a case study based on semi-structured interview data to explore the steps that Namibia, a country facing severe health problems that include an alarmingly high AIDS infection rate, has taken to manage its health workers. Results In the fifteen years since independence, Namibia has patiently built up a relatively good strategic framework for health policy in the context of government policy as a whole, including strong training arrangements at every level of health staffing, and it has brought HIV/AIDS under the strategic umbrella through its National Strategic Plan for HIV/AIDS. Its major weakness is that it has not kept pace with the rise in HIV/AIDS and TB infection: the community counselling service, still at the pilot stage at the time of this study, was the only specific response. That has created a tension between building long-term capacity in a strategic context and responding to the short-term demands of the AIDS and TB crisis, which in turn affects the ability of HR to contribute to improving health outcomes. Conclusion It is suggested that countries like Namibia need a new paradigm for staffing their health services. Building on the existing strategic framework, it should target the training of 'mid-level cadres'. Higher-level cadres should take on the role of supporting and monitoring the mid-level cadres. To do that, they will need management training and a performance management framework for staff support and monitoring.
Duchateau, Jacques; Enoka, Roger M
Soon after Edward Liddell [1895-1981] and Charles Sherrington [1857-1952] introduced the concept of a motor unit in 1925 and the necessary technology was developed, the recording of single motor unit activity became feasible in humans. It was quickly discovered by Edgar Adrian [1889-1977] and Detlev Bronk [1897-1975] that the force exerted by muscle during voluntary contractions was the result of the concurrent recruitment of motor units and modulation of the rate at which they discharged action potentials. Subsequent studies found that the relation between discharge frequency and motor unit force was characterized by a sigmoidal function. Based on observations on experimental animals, Elwood Henneman [1915-1996] proposed a "size principle" in 1957 and most studies in humans focussed on validating this concept during various types of muscle contractions. By the end of the 20th C, the experimental evidence indicated that the recruitment order of human motor units was determined primarily by motoneuron size and that the occasional changes in recruitment order were not an intended strategy of the central nervous system. Fundamental knowledge on the function of Sherrington's "common final pathway" was expanded with observations on motor unit rotation, minimal and maximal discharge rates, discharge variability, and self-sustained firing. Despite the great amount of work on characterizing motor unit activity during the first century of inquiry, however, many basic questions remain unanswered and these limit the extent to which findings on humans and experimental animals can be integrated and generalized to all movements. 2011 Elsevier B.V. All rights reserved.
Seoyoung Lee, RN, MSN
Conclusions: There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals.
FitzMaurice, Priscilla L; Freier, Jerome E; Geter, Kenneth D
Epidemiologists, veterinary medical officers and animal health technicians within Veterinary Services (VS) are actively utilising global positioning system (GPS) technology to obtain positional data on livestock and poultry operations throughout the United States. Geospatial data, if acquired for monitoring and surveillance purposes, are stored within the VS Generic Database (GDB). If the information is collected in response to an animal disease outbreak, the data are entered into the Emergency Management Response System (EMRS). The Spatial Epidemiology group within the Centers for Epidemiology and Animal Health (CEAH) has established minimum data accuracy standards for geodata acquisition. To ensure that field-collected geographic coordinates meet these minimum standards, field personnel are trained in proper data collection procedures. Positional accuracy is validated with digital atlases, aerial photographs, Web-based parcel maps, or address geocoding. Several geospatial methods and technologies are under investigation for future use within VS. These include the direct transfer of coordinates from GPS receivers to computers, GPS-enabled digital cameras, tablet PCs, and GPS receivers preloaded with custom ArcGIS maps - all with the objective of reducing transcription and data entry errors and improving the ease of data collection in the field.
Tudor, T.L.; Noonan, C.L.; Jenkin, L.E.T.
This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of 'waste management', to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%
Rashid, Faisal M.; Dennis, Emily L.; Villalon-Reina, Julio E.; Jin, Yan; Lewis, Jeffrey D.; York, Gerald E.; Thompson, Paul M.; Tate, David F.
Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving differential or rotational movement of the brain inside the skull. Over 3 million mTBIs occur annually in the United States alone. Many of the individuals who sustain an mTBI go on to recover fully, but around 20% experience persistent symptoms. These symptoms often last for many weeks to several months. The thalamus, a structure known to serve as a global networking or relay system for the rest of the brain, may play a critical role in neurorehabiliation and its integrity and connectivity after injury may also affect cognitive outcomes. To examine the thalamus, conventional tractography methods to map corticothalamic pathways with diffusion-weighted MRI (DWI) lead to sparse reconstructions that may contain false positive fibers that are anatomically inaccurate. Using a specialized method to zero in on corticothalamic pathways with greater robustness, we noninvasively examined corticothalamic fiber projections using DWI, in 68 service members. We found significantly lower fractional anisotropy (FA), a measure of white matter microstructural integrity, in pathways projecting to the left pre- and postcentral gyri - consistent with sensorimotor deficits often found post-mTBI. Mapping of neural circuitry in mTBI may help to further our understanding of mechanisms underlying recovery post-TBI.
Moxley, David P; Calligan, Holly Feen
The arts have been integral to the human experience fostering innovation in social arrangements, strengthening group cohesion, and merging esthetics with the utilitarian properties of technology. For intervention design research in the human services the arts can harness innovation and creativity in meeting human needs and addressing social issues. Given their capacities to stimulate expression of first person experience through interpretative strategies, the arts can equip people and groups, including researchers, with opportunities to express primary experiential knowledge through creative means, portray useful ways of meeting human needs, educate others about the social issues people experience, and formulate intervention strategies or even models to address the causes and consequences of those issues. In this paper, the authors discuss how the arts can inform and deepen human service intervention design and development and, as a result, advance innovation in the human services. They offer a rationale supporting the inclusion of the arts in the design of human service interventions, examine the contributions of the arts to the formulation of intervention concept and developmental research to further improve interventions, and consider how the arts can advance the reflexivity of intervention designers. The authors draw implications for how researchers can position the arts in the nine steps of intervention design and development the authors offer in this paper. Copyright © 2015 Elsevier Ltd. All rights reserved.
Keith Stockmann; Nathaniel Anderson; Jesse Young; Ken Skog; Sean Healey; Dan Loeffler; Edward Butler; J. Greg Jones; James Morrison
Global forests capture and store significant amounts of carbon through photosynthesis. When carbon is removed from forests through harvest, a portion of the harvested carbon is stored in wood products, often for many decades. The United States Forest Service (USFS) and other agencies are interested in accurately accounting for carbon flux associated with harvested wood...
Keith Stockmann; Nathaniel Anderson; Jesse Young; Ken Skog; Sean Healey; Dan Loeffler; Edward Butler; J. Greg Jones; James Morrison
Global forests capture and store significant amounts of carbon through photosynthesis. When carbon is removed from forests through harvest, a portion of the harvested carbon is stored in wood products, often for many decades. The United States Forest Service (USFS) and other agencies are interested in accurately accounting for carbon flux associated with harvested wood...
Dan Loeffler; Nathaniel Anderson; Keith Stockmann; Ken Skog; Sean Healey; J. Greg Jones; James Morrison; Jesse Young
Global forests capture and store significant amounts of carbon through photosynthesis. When carbon is removed from forests through harvest, a portion of the harvested carbon is stored in wood products, often for many decades. The United States Forest Service (USFS) and other agencies are interested in accurately accounting for carbon flux associated with harvested wood...
Keith Stockmann; Nathaniel Anderson; Jesse Young; Ken Skog; Sean Healey; Dan Loeffler; Edward Butler; J. Greg Jones; James Morrison
Edward Butler; Keith Stockmann; Nathaniel Anderson; Ken Skog; Sean Healey; Dan Loeffler; J. Greg Jones; James Morrison; Jesse Young
Dan Loeffler; Nathaniel Anderson; Keith Stockmann; Ken Skog; Sean Healey; J. Greg Jones; James Morrison; Jesse Young
Dan Loeffler; Nathaniel Anderson; Keith Stockmann; Ken Skog; Sean Healey; J. Greg Jones; James Morrison; Jesse Young
Edward Butler; Keith Stockmann; Nathaniel Anderson; Jesse Young; Ken Skog; Sean Healey; Dan Loeffler; J. Greg Jones; James Morrison
... Force Reserve Officers Training Corps, when ordered to annual training duty for 14 days or more... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Work as a member of a uniformed service of the United States. 404.1019 Section 404.1019 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...
Haar Romenij, ter B.M.; Denier van der Gon, J.J.; Gielen, C.C.A.M.
Changes in recruitment threshold of individual motor units of the human biceps (caput longum), a multifunctional muscle, were investigated during different tasks, i.e., isometric flexion of the elbow, isometric supination of the forearm, and isometric exorotation of the humerus of the 110° flexed
David J. Nowak; Satoshi Hirabayashi; Allison Bodine; Eric. Greenfield
Trees remove air pollution by the interception of particulate matter on plant surfaces and the absorption of gaseous pollutants through the leaf stomata. However, the magnitude and value of the effects of trees and forests on air quality and human health across the United States remains unknown. Computer simulations with local environmental data reveal that trees and...
Cynthia T. Fowler
Forestry management practices can shape patterns of health, illness, and disease. A primary goal for owners federal, state, andprivate forests is to crap ecosystem management plans that simultaneously optimize forest health and human health. Fire-a major forest management issue in the United States-complicates these goals. Wildfires are natural phenomena with...
This teaching unit, designed for advanced high school students and average junior college students in a humanities oriented literature course, has one primary objective: to correlate similar thinking in two different time periods and locales. The philosophy of Taoism in ancient China and the philosophy of transcendentalism in nineteenth century…
Waters, Rebecca A; Buchanan, Angus
Being 'person-centred' in the delivery of health and human services has become synonymous with quality care, and it is a core feature of policy reform in Australia and other Western countries. This research aimed to identify the uses, definitions and characteristics of the term 'person-centred' in the ageing, mental health and disability literature. A thematic analysis identified seven common core themes of person-centredness: honouring the person, being in relationship, facilitating participation and engagement, social inclusion/citizenship, experiencing compassionate love, being strengths/capacity focussed, and organisational characteristics. These suggest a set of higher-order experiences for people that are translated differently in different human services. There is no common definition of what it means to be person-centred, despite being a core feature of contemporary health and human service policy, and this suggests that its inclusion facilitates further misunderstanding and misinterpretation. A common understanding and policy conceptualisation of person-centredness is likely to support quality outcomes in service delivery especially where organisations work across human service groups. Further research into the application and service expressions of being 'person-centred' in context is necessary. Copyright © 2017 Elsevier B.V. All rights reserved.
Semmens, Darius; Kepner, William; Goodrich, David
A consortium of federal, academic, and nongovernment organization (NGO) partners have established a collaborative research enterprise in the San Pedro River Basin to develop methods, standards, and tools to assess and value ecosystem goods and services. The central premise of ecosystem services research is that human condition is intrinsically linked to the environment. Human health and well-being (including economic prosperity) depend on important supporting, regulating, provisioning, and cultural services that we derive from our surrounding ecosystems. The AGAVES project is intended as a demonstration study for incorporating ecosystem services information into resource management policy and decisionmaking. Accordingly, a nested, multiscale project design has been adopted to address a range of stakeholder information requirements. This design will further facilitate an evaluation of how well methods developed in this project can be transferred to other areas.
Koivusalo, Meri; Tritter, Jonathan
The ambitious and comprehensive Transatlantic Trade and Investment Partnership Agreement (TTIP/TAFTA) agreement between the European Union and United States is now being negotiated and may have far-reaching consequences for health services. The agreement extends to government procurement, investment, and further regulatory cooperation. In this article, we focus on the United Kingdom National Health Service and how these negotiations can limit policy space to change policies and to regulate in relation to health services, pharmaceuticals, medical devices, and health industries. The negotiation of TTIP/TAFTA has the potential to "harmonize" more corporate-friendly regulation, resulting in higher costs and loss of policy space, an example of "trade creep" that potentially compromises health equity, public health, and safety concerns across the Atlantic.
Valerie Esposito; Spencer Phillips; Roelof Boumans; Azur Moulaert; Jennifer Boggs
The Intergovernmental Panel on Climate Change (IPCC) (2007) reports a likely 2 Â°C to 4.5 Â°C temperature rise in the upcoming decades. This warming is likely to affect ecosystems and their ability to provide services that benefit human well-being. Ecosystem services valuation (ESV), meanwhile, has emerged as a way to recognize the economic value embodied in these...
Gevorgyan, A.; Galstyan, A.; Donovan, M.
This paper presents a discussion of a study to define the programs for development of the human resource infrastructure needed for a new nuclear power plant unit in the Republic of Armenia. While Armenia has a workforce experienced in operation and regulation of a nuclear power plant (NPP), a significant portion of the current Armenia Nuclear Power Plant (ANPP) workforce is approaching retirement age and will not be available for the new plant. The Government of Armenia is performing a human resource infrastructure study in cooperation with the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO), sponsored by the JAEA. The study of Human Resource Development for Armenia uses the INPRO methodology for assessment of human resources. The results of this study will provide the basis for decisions on human resource development programs for nuclear power in Armenia and provide a model for countries with the limited resources that are working to develop nuclear energy in the future. (authors)
Nicole, Madelyn; Fairbrother, Michele; Nagarajan, Srivalli Vilapakkam; Blackford, Julia; Sheepway, Lyndal; Penman, Merrolee; McAllister, Lindy
Through a collaborative university-hospital partnership, a student-led service model (SLS-model) was implemented to increase student placement capacity within a physiotherapy department of a 150 bed Sydney hospital. This study investigates the perceived barriers and enablers to increasing student placement capacity through student-led services…
Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E
Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.
R. van der Walt
Full Text Available This article examines to what extent current South African university courses/programmes in Human Resources Management and Industrial Psychology prepare students for a career in entrepreneurship. It is argued that human resources practitioners have much to offer in the line of services and advice to small enterprises on how to succeed. The data of the survey are analysed through a qualitative approach. The findings indicate that entrepreneurship training currently receives limited attention in the training of human resources practitioners and industrial psychologists. Key words and phrases: entrepreneurial education, human resources management, industrial psychology
Full Text Available The paper examines human factors derailing extension services delivery in developing countries. Poor management of rewards and incentives; quality of work life; poor assessment system; limited quality of human resource; inadequate extension support training materials; inconsistencies of government programmes; inadequate staff training and poor extension programme evaluation were viewed as major constraints. Considering the role of extension to agricultural development, the paper recommends that efforts should be made by the various stakeholders in agricultural extension services to improve the capability of human resources involved in extension services and highlights the need for government agricultural programmes to be consistent to enable the beneficiaries of such programmes derive the benefits that will boost productivity in agriculture.
Miara, A.; Vorosmarty, C. J.; Stewart, R.; Wollheim, W. M.; Rosenzweig, B.
Major strategic issues facing the global thermoelectric sector include environmental regulation, climate change and increasing electricity demand. We have addressed such issues by modeling thermoelectric generation in the Northeastern United States that is reliant on cooling under five sensitivity tests to evaluate losses/gains in power production, thermal pollution and suitable aquatic habitat, comparing the contemporary baseline (2000-2010) with potential future states. Integral to the analysis, we developed a methodology to quantify river water availability for cooling, which we define as an ecosystem service. Projected climate conditions reduce river water available for efficient power plant operations and the river's capacity to absorb waste heat, causing a loss of regional thermoelectric generation (RTG) (2.5%) in some summers that, compared to the contemporary baseline, is equal to the summertime electricity consumption of 1.3 million Northeastern US homes. Vulnerabilities to warm temperatures and thermal pollution can be alleviated through the use of more efficient natural gas (NG) power plants that have a reduced reliance on cooling water. Conversion of once-through (OT) to cooling tower (CT) systems and the Clean Water Act (CWA) temperature limit regulation, both of which reduce efficiencies at the single plant level, show potential to yield beneficial increases in RTG. This is achieved by obviating the need for large volumes of river water, thereby reducing plant-to-plant interferences through lowering the impact of upstream thermal pollution and preserving a minimum standard of cooling water. The results and methodology framework presented here, which can be extrapolated to other regional assessments with contrasting climates and thermoelectric profiles, can identify opportunities and support decision-making to achieve more efficient energy systems and riverine ecosystem protection.
Miara, Ariel; Vörösmarty, Charles J; Rosenzweig, Bernice; Stewart, Robert J; Wollheim, Wilfred M
Major strategic issues facing the global thermoelectric sector include environmental regulation, climate change and increasing electricity demand. We have addressed such issues by modeling thermoelectric generation in the Northeastern United States that is reliant on cooling under five sensitivity tests to evaluate losses/gains in power production, thermal pollution and suitable aquatic habitat, comparing the contemporary baseline (2000–2010) with potential future states. Integral to the analysis, we developed a methodology to quantify river water availability for cooling, which we define as an ecosystem service. Projected climate conditions reduce river water available for efficient power plant operations and the river’s capacity to absorb waste heat, causing a loss of regional thermoelectric generation (RTG) (2.5%) in some summers that, compared to the contemporary baseline, is equal to the summertime electricity consumption of 1.3 million Northeastern US homes. Vulnerabilities to warm temperatures and thermal pollution can be alleviated through the use of more efficient natural gas (NG) power plants that have a reduced reliance on cooling water. Conversion of once-through (OT) to cooling tower (CT) systems and the Clean Water Act (CWA) temperature limit regulation, both of which reduce efficiencies at the single plant level, show potential to yield beneficial increases in RTG. This is achieved by obviating the need for large volumes of river water, thereby reducing plant-to-plant interferences through lowering the impact of upstream thermal pollution and preserving a minimum standard of cooling water. The results and methodology framework presented here, which can be extrapolated to other regional assessments with contrasting climates and thermoelectric profiles, can identify opportunities and support decision-making to achieve more efficient energy systems and riverine ecosystem protection. (letter)
... Inspection Service (FGIS) with the authority to charge and collect reasonable fees to cover the cost of performing official services. The fees also cover the costs associated with managing the program. After a... associated administrative and supervisory costs. The fees for official inspection and weighing services were...
Hastings, Tessa J.; Hohmann, Lindsey A.; McFarland, Stuart J.; Teeter, Benjamin S.; Westrick, Salisa C.
Use of non-traditional settings such as community pharmacies has been suggested to increase human papillomavirus (HPV) vaccination uptake and completion rates. The objectives of this study were to explore HPV vaccination services and strategies employed by pharmacies to increase HPV vaccine uptake, pharmacists’ attitudes towards the HPV vaccine, and pharmacists’ perceived barriers to providing HPV vaccination services in community pharmacies. A pre-piloted mail survey was sent to 350 randomly...
Beavers, R. L.
83 National Park Service (NPS) units contain nearly 12,000 miles of coastal, estuarine and Great Lakes shoreline and their associated resources. Iconic natural features exist along active shorelines in NPS units, including, e.g., Cape Cod, Padre Island, Hawaii Volcanoes, and the Everglades. Iconic cultural resources managed by NPS include the Cape Hatteras Lighthouse, Fort Sumter, the Golden Gate, and heiaus and fish traps along the coast of Hawaii. Impacts anticipated from sea level rise include inundation and flooding of beaches and low lying marshes, shoreline erosion of coastal areas, and saltwater intrusion into the water table. These impacts and other coastal hazards will threaten park beaches, marshes, and other resources and values; alter the viability of coastal roads; and require the NPS to re-evaluate the financial, safety, and environmental implications of maintaining current projects and implementing future projects in ocean and coastal parks in the context of sea level rise. Coastal erosion will increase as sea levels rise. Barrier islands along the coast of Louisiana and North Carolina may have already passed the threshold for maintaining island integrity in any scenario of sea level rise (U.S. Climate Change Science Program Synthesis and Assessment Program Report 4.1). Consequently, sea level rise is expected to hasten the disappearance of historic coastal villages, coastal wetlands, forests, and beaches, and threaten coastal roads, homes, and businesses. While sea level is rising in most coastal parks, some parks are experiencing lower water levels due to isostatic rebound and lower lake levels. NPS funded a Coastal Vulnerability Project to evaluate the physical and geologic factors affecting 25 coastal parks. The USGS Open File Reports for each park are available at http://woodshole.er.usgs.gov/project-pages/. These reports were designed to inform park planning efforts. NPS conducted a Storm Vulnerability Project to provide ocean and coastal
Tania Ivón Sosa Ibarra
Full Text Available Achieving quality of service is a necessity in this highly competitive and turbulent world, one of the elements that influence it is training. This research was designed and implemented a training procedure to improve the quality of services in a cafeteria of Development, were detected with the training needs of their staff to plan and implement actions that will raise the skills of workers. Surveys were conducted to determine the state of opinion of internal and external clients implemented before and after the procedure and to evaluate the quality of service received from the selected attributes to the application of Delphi method experts. The unit has made progress recognized and improved economic indicators becoming a reference center in the municipality, which shows that is possible to provide quality services from training workers.
Steurbaut, Kristof; Van Hoecke, Sofie; Colpaert, Kirsten; Lamont, Kristof; Taveirne, Kristof; Depuydt, Pieter; Benoit, Dominique; Decruyenaere, Johan; De Turck, Filip
The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, Infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches.
Kohut, P.; Musicki, Z.; Fitzpatrick, R.
This report summarizes a study performed by Brookhaven National Laboratory for the US Nuclear Regulatory Commission in support of the resolution of NRC Generic Issue 130. GI-130 is concerned with the potential core damage vulnerability resulting from failure of the emergency service water (ESW) system in selected multiplant units. These multiplant units are all twin pressurized water reactor designs that have only two ESW pumps per unit (one per train) backed up by a unit crosstie capability. This generic issue applies to seven US sites (14 plants). The study established and analyzed the core damage vulnerability and identified potential improvements for the ESW system. It obtained generic estimates of the risk reduction potential and cost effectiveness of each potential improvement. The analysis also investigated the cost/benefit aspects of selected combinations of potential improvements. 4 figs., 62 tabs
... 42 Public Health 1 2010-10-01 2010-10-01 false What criteria will the Department of Health and Human Services use to decide which family planning services projects to fund and in what amount? 59.7... FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.7 What criteria will the...
Rivers, J E; Komaroff, E; Kibort, A C
Publicly funded drug-user treatment programs in both urban and rural areas are under unprecedented pressure to adapt to multiple perspectives of their mission, reduced governmental funding, diminished entitlement program resources for clients, managed care reforms, and continuing unmet need for services. This article describe an ongoing health services research study that is investigating how these and related health and human service programs currently serve and cross-refer chronic drug users and how they perceive and are reacting to systemic pressures. Interim analysis on intra-agency diversity and managed care perceptions are reported.
Eaton, Kenneth A; Pitts, Nigel B
Over the years, several members of the staff of the Dental Health Services Research Unit (DHSRU) at Dundee have published papers in Primary Dental Care. Furthermore, its Director, Professor Nigel Pitts, together with Drs Jan Clarkson and Gail Topping have co-edited a number of the Faculty of General Dental Practice (UK)'s standards manuals and contributed to others. It had been suggested to the Unit by several parties that, having been in funded existence for some 30 years, it would be appropriate to mark this anniversary with a conference to explore 'Dental Health Services Research: After 30 years, what was the impact, what have we learned and where are we going?' So, following a range of consultations, the conference was convened at the West Park Conference Centre in Dundee with a mixed audience representing both dental research and dental practice.
American Conservation and Youth Service Corps Act of 1989. Hearing on S. 322 before the Subcommittee on Children, Family, Drugs and Alcoholism of the Committee on Labor and Human Resources. United States Senate, One Hundred First Congress, First Session (Hartford, Connecticut).
Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.
Within this document are testimony and prepared statements delivered at a congressional subcommittee hearing in a Connecticut high school on a bill that would encourage volunteering by 15- to 26-year-olds by creating a National Youth Service Program. The bill is summarized within the document. The following individuals' presentations about how to…
Alzheimer's Disease and Related Dementias. Hearing before the Subcommittee on Aging of the Committee on Labor and Human Resources. United States Senate, Ninety-Ninth Congress, Second Session on Review of Health Care Services Available for People with Alzheimer's Disease and Related Dementia and To Review Proposals Related to the Treatment of Alzheimer's Disease.
Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.
A Senate hearing reviewing health care services available for people with Alzheimer's disease and related dementia and reviewing proposals related to the treatment of Alzheimer's disease is presented in this document. Statements are given by Senators Charles E. Grassley, Albert Gore, Paula Hawkins, Howard M. Metzenbaum, Larry Pressler, and Paul…
Myklebust, Lars Henrik; Sørgaard, Knut; Wynn, Rolf
Objectives In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care. Methods Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays. Results The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients’ use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized), a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays. Conclusion Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care. PMID:26604843
Myklebust, Lars Henrik; Sørgaard, Knut; Wynn, Rolf
In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care. Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays. The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients' use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized), a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays. Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care.
Agénor, Madina; Muzny, Christina A; Schick, Vanessa; Austin, Erika L; Potter, Jennifer
Although sexual minority women are at risk of sexually transmitted infections (STIs) and cervical cancer, few nationally representative studies have assessed sexual orientation disparities in sexual health care among women. Using data from the 2011-2013 and 2013-2015 waves of the National Survey of Family Growth, which provide a national probability sample of U.S. women aged 15-44years (N=11,300), we used multivariable logistic regression to examine the associations between sexual behavior and sexual identity (modeled separately) and STI testing in the past year, Pap test use in the last 3years, lifetime HIV testing, and lifetime human papillomavirus (HPV) testing. Women with male and female lifetime sexual partners had higher adjusted odds of being tested for STIs ([odds ratio:] 1.61; [95% confidence interval:] 1.37-1.89), HIV (1.66; 1.29-2.14), and HPV (1.79; 1.41-2.25) and similar adjusted odds of obtaining a Pap test (0.98; 0.76-1.27) than women with only male lifetime sexual partners. Self-identified bisexual women had higher adjusted odds of obtaining an STI (1.43; 1.10-1.86) and HIV (1.69; 1.24-2.30) test but lower adjusted odds of obtaining a Pap test in the last 3years (0.66; 0.47-0.93) than heterosexual-identified women. Women with only female lifetime sexual partners had lower adjusted odds of receiving an STI (0.14; 0.07-0.28) and Pap (0.10; 0.03-0.27) test than women with only male lifetime sexual partners. Results comparing self-identified lesbian and heterosexual women were similar. Health care facilities should monitor and address sexual orientation disparities in women's sexual health care and ensure the provision of high-quality sexual health services to all women. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available We take a social-ecological systems perspective to investigate the linkages between ecosystem services and human well-being in South Africa. A recent paper identified different types of social-ecological systems in the country, based on distinct bundles of ecosystem service use. These system types were found to represent increasingly weak direct feedbacks between nature and people, from rural "green-loop" communities to urban "red-loop" societies. Here we construct human well-being bundles and explore whether the well-being bundles can be used to identify the same social-ecological system types that were identified using bundles of ecosystem service use. Based on national census data, we found three distinct well-being bundle types that are mainly characterized by differences in income, unemployment and property ownership. The distribution of these well-being bundles approximates the distribution of ecosystem service use bundles to a substantial degree: High levels of income and education generally coincided with areas characterised by low levels of direct ecosystem service use (or red-loop systems, while the majority of low well-being areas coincided with medium and high levels of direct ecosystem service use (or transition and green-loop systems. However, our results indicate that transformations from green-loop to red-loop systems do not always entail an immediate improvement in well-being, which we suggest may be due to a time lag between changes in the different system components. Using human well-being bundles as an indicator of social-ecological dynamics may be useful in other contexts since it is based on socio-economic data commonly collected by governments, and provides important insights into the connections between ecosystem services and human well-being at policy-relevant sub-national scales.
Hamann, Maike; Biggs, Reinette; Reyers, Belinda
We take a social-ecological systems perspective to investigate the linkages between ecosystem services and human well-being in South Africa. A recent paper identified different types of social-ecological systems in the country, based on distinct bundles of ecosystem service use. These system types were found to represent increasingly weak direct feedbacks between nature and people, from rural "green-loop" communities to urban "red-loop" societies. Here we construct human well-being bundles and explore whether the well-being bundles can be used to identify the same social-ecological system types that were identified using bundles of ecosystem service use. Based on national census data, we found three distinct well-being bundle types that are mainly characterized by differences in income, unemployment and property ownership. The distribution of these well-being bundles approximates the distribution of ecosystem service use bundles to a substantial degree: High levels of income and education generally coincided with areas characterised by low levels of direct ecosystem service use (or red-loop systems), while the majority of low well-being areas coincided with medium and high levels of direct ecosystem service use (or transition and green-loop systems). However, our results indicate that transformations from green-loop to red-loop systems do not always entail an immediate improvement in well-being, which we suggest may be due to a time lag between changes in the different system components. Using human well-being bundles as an indicator of social-ecological dynamics may be useful in other contexts since it is based on socio-economic data commonly collected by governments, and provides important insights into the connections between ecosystem services and human well-being at policy-relevant sub-national scales.
Vázquez-Román, S; Bustos-Lozano, G; López-Maestro, M; Rodríguez-López, J; Orbea-Gallardo, C; Samaniego-Fernández, M; Pallás-Alonso, C R
The benefits of donor human milk compared with artificial formulas have been well demonstrated; nevertheless the impact in the clinical practice of opening a human milk bank within a neonatal unit has not yet been studied. The main aim of this study was to analyze the impact on the clinical practice of opening a human milk bank in a neonatal unit to provide donor human milk for preterm infants ≤ 32 weeks of gestational age. A before and after study was designed, with the intervention being the opening a human milk bank. Preterm infants ≤ 32 weeks of gestational age born in the Hospital 12 Octubre from July to December 2005 and January to June 2008 (firsts 6 months after opening the human milk bank) were included. After opening the human milk bank, enteral feedings were started 31h before (Partificial formula, the exposure to formula in the first 15 days of life was reduced from 50% to 16.6%, and it's consumption during the first 28 days of life was significantly reduced. There was a higher consumption of own mother's milk during the hospital stay, and a higher rate of exclusive breastfeeding at hospital discharge (54% vs 40%). The availability of donor human milk has led to quicker progression with enteral feedings and earlier withdrawal of parenteral nutrition. It has reduced the exposure to artificial formulas, and has also increased the intake of own mother's milk during the hospital stay and the rate of exclusive breastfeeding at hospital discharge. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Full Text Available Within the framework of bureaucratic and human capital theories, an eclectic approach, the study examines the nexus between academic staff recruitment in Nigerian tertiary institutions and human capital development as well as service delivery with specific reference to universities. It is generally agreed that higher education is a sine-qua-non for human capital development and efficient service delivery. Higher education is a prerequisite for the production of highly competent experts, which in turn, contributes to the development of organizations and the economy at large. For these to be achieved, the right content and academic staff must be in place to perform this varied function. However, over the years the quality of human capital coming out of Nigerian universities and its impact on service delivery has become a source of concern to employers of labour and all stakeholders. Inferential opinions have traced the problem to the recruitment of incompetent academic staff. To investigate the issues raised, the study relied heavily on primary and secondary data and multi stage sampling was used to select the sample population. The data collected was presented in pie chart and simple percentage. Similarly, in order to test the hypotheses and establish the degree of dependence or independence of the variables under investigation, the chi-square statistical technique was used. The findings of the study revealed among others, that Nigerian universities do not employ merit, qualification and competency in the academic staff recruitment. It also established that there is a significant relationship between merit, qualification and competency based academic staff recruitment and human capital development and service delivery. To enhance human capital development and service delivery in Nigerian universities, the study recommends among others, that an independent body like the National University Commission (NUC should be given the responsibility of
U.S. Department of Health & Human Services — This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury...
Sato, T.; Nishiyama, A. [Fuji Denki Reiki Co. Ltd., Tokyo (Japan)
The market of automatic tea service machines demands sanitation, reduction in time required for pouring tea, feeding the material, cleaning the inside of the machine, the maintenance and service of the machine, and excellent design. To meet these demands, Fuji Electric has changed the former configuration and components for functions and has developed a new series of instantaneous automatic tea service machines based on a new concept. This paper outlines the advantages of the instantaneous cooling tank and improvements in handling. (author)
Chung, M C; Cumella, S; Wensley, J; Easthope, Y
This paper describes some recent research on forensic diversion services and the application of such services in Birmingham, UK. Key components include the diversion scheme in court, diversion at point of arrest, and the remand prison liaison scheme. Various community facilities, such as a specialized bail hostel and landlady schemes to which offenders are possibly referred, are also briefly described. We advocate the need for further research in order to examine the effectiveness of the services in Birmingham.
Scotti, Dennis J; Harmon, Joel; Behson, Scott J
This study assesses the importance of customer-contact intensity at the service encounter level as a determinant of service quality assessments. Using data from the U.S. Department of Veterans Affairs, it shows that performance-driven human resources practices play an important role as determinants of employee customer orientation and service capability in both high-contact (outpatient healthcare) and low-contact (benefits claim processing) human service contexts. However, there existed significant differences across service delivery settings in the salience of customer orientation and the congruence between employee and customer perceptions of service quality, depending on the intensity of customer contact. In both contexts, managerial attention to high-performance work systems and customer-orientation has the potential to favorably impact perceptions of service quality, amplify consumer satisfaction, and enhance operational efficiency.
Cadogan, J. [U.S. Department of Energy (US); Milligan, M. [National Renewable Energy Laboratory (US); Wan, Y. [National Renewable Energy Laboratory (US); Kirby, B. [Oak Ridge National Laboratory (US)
With the advent of competition in the electric power marketplace, this paper reviews changes that affect wind and other renewable energy technologies, and discusses the role of federal and state policies in the recent wind installations in the United States. In particular, it reviews the implications of ancillary service requirements on a wind farm and presents initial operating results of monitoring one Midwest wind farm. Under federal energy policy, each generator must purchase, or otherwise provide for, ancillary services, such as dispatch, regulation, operation reserve, voltage regulation, and scheduling required to move power to load. As a renewable technology that depends on the forces of nature, short-term output variations are inherently greater for a wind farm than for a gas-fired combined cycle or a supercritical coal-fired unit.
Hannah, D. M.; Mao, F.; Karpouzoglou, T.; Clark, J.; Buytaert, W.
To explore the dynamics of socio-hydrological systems under change, the concepts of resilience and ecosystem services serve as useful tools. In this context, resilience refers to the capacity of a socio-hydrological system to retain its structural and functional state despite perturbations, while ecosystem services offer a good proxy of the state that reflects human-water intersections. Efforts are needed to maintain and improve socio-hydrological resilience for future contingencies to secure hydrological ecosystem services supply. This requires holistic indicators of resilience for coupled human-water systems that are essential for quantitative assessment, change tracking, inter-case comparison, as well as resilience management. However, such indicators are still lacking. Our research aims to propose widely applicable resilience indicators that are suitable for the coupled human-water context, and compatible with ecosystem services. The existing resilience indicators for both eco-hydrological and socio-economic sectors are scrutinised, screened and analysed to build these new indicators. Using the proposed indicators, we compare the resilience and its temporal change among a set of example regions, and discusses the linkages between socio-hydrological resilience and hydrological ecosystem services with empirical cases.
Seki, K; Narusawa, M
To examine the factors affecting the control of human motor units, rate coding strategies of the motor units were investigated in upper limb and intrinsic hand muscles during voluntary isometric contraction of steady force levels up to 80% of maximal voluntary contraction. Numerous spike trains from single motor units were recorded from the m. first dorsal interosseous (FDI) and the m. biceps brachii (BB) of eight human subjects by means of tungsten micro-electrodes, and the mean firing rate (MFR) was calculated for each subject and inter-individual comparisons made. The MFRs of the FDI were larger than that of the BB at the higher force level, and substantial differences were not found between these muscles at the lower force level. The slope of the linear regression line of MFRs vs. exerted forces for the FDI was more than twice that for the BB. Therefore, isometric force control of the FDI depends more on the rate coding strategy. The difference in rate coding between the FDI and BB motor units may be determined by factors other than muscle fiber composition, because both muscles are known to possess a similar composition of fiber types. Possible mechanisms underlying these characteristics of rate coding strategy are considered in this report.
In a human nutrition class, students are paired with university faculty or staff volunteer participants. Students teach their service learning partners how to record their food consumption and physical activity during a typical 7-day period. Using these data, students complete nutritional assessments of their partners. (Contains 2 figures.)
Human alteration of the nitrogen (N) cycle has produced benefits for health and well-being, but excess N has altered many ecosystems and degraded air and water quality. US regulations mandate protection of the environment in terms that directly connect to ecosystem services. Here...
Liebkind, Karmela; Eranen, Liisa
Investigates the attitudes of future members in human service professions toward victims, based on the qualities effected by trauma victims and their helpers. Reports that the high-trauma and poorly adapted victims elicited more negative attitudes than did the low-trauma and well-adapted victims. (CMK)
Corey, Gerald; Corey, Schneider Marianne; Callanan, Patrick
This article presents multiple facets of a team approach to teaching and facilitating an ethics course for undergraduate human services students and a graduate ethics course for students majoring in counseling. Starting with general points, this article describes a specific, week-to-week approach to a 1-semester course, concluding with sample…
Heidi Asbjornsen; Alex S. Mayer; Kelly W. Jones; Theresa Selfa; Leonardo Saenz; Randall K. Kolka; Kathleen E. Halvorsen
Payments for watershed services (PWS) as a policy tool for enhancing water quality and supply have gained momentum in recent years, but their ability to lead to sustainable watershed outcomes is uncertain. Consequently, the demand for effective monitoring and evaluation (M&E) of PWS impacts on coupled human and natural systems (CHANS) and their implications for...
Camasso, Michael J.; Dick, Janet
The feasibility of applying multiattribute utility theory to the needs assessment and priority-setting activities of human services planning councils was studied in Essex County (New Jersey). Decision-making and information filtering processes are explored in the context of community planning. (SLD)
Estimating value of estuarine habitat to human beneficiaries requires that we understand how habitat alteration impacts function through both production and delivery of ecosystem goods and services (EGS). Here we expand on the habitat valuation technique of Bell (1997) with an es...
... 39 Postal Service 1 2010-07-01 2010-07-01 false Amendments to the Mailing Standards of the United.... 39 June 16, 1991 56 FR 56015 40 September 15, 1991 56 FR 56013 41 December 15, 1991 57 FR 21611 42... July 1, 1997 62 FR 30457 53 January 1, 1998 62 FR 63851 54 January 10, 1999 64 FR 39 55 January 10...
Rhatigan, Jennifer L.
In the past, men like Leonardo da Vinci and Jules Verne imagined the future and envisioned fantastic inventions such as winged flying machines, submarines, and parachutes, and posited human adventures like transoceanic flight and journeys to the Moon. Today, many of their ideas are reality and form the basis for our modern world. While individual visionaries like da Vinci and Verne are remembered for the accuracy of their predictions, today entire nations are involved in the process of envisioning and defining the future development of mankind, both on and beyond the Earth itself. Recently, Russian, European, and Chinese teams have all announced plans for developing their own next generation human space vehicles. The Chinese have announced their intention to conduct human lunar exploration, and have flown three crewed space missions since 2003, including a flight with three crew members to test their extravehicular (spacewalking) capabilities in September 2008. Very soon, the prestige, economic development, scientific discovery, and strategic security advantage historically associated with leadership in space exploration and exploitation may no longer be the undisputed province of the United States. Much like the sponsors of the seafaring explorers of da Vinci's age, we are motivated by the opportunity to obtain new knowledge and new resources for the growth and development of our own civilization. NASA's new Constellation Program, established in 2005, is tasked with maintaining the United States leadership in space, exploring the Moon, creating a sustained human lunar presence, and eventually extending human operations to Mars and beyond. Through 2008, the Constellation Program developed a full set of detailed program requirements and is now completing the preliminary design phase for the new Orion Crew Exploration Vehicle (CEV), the Ares I Crew Launch Vehicle, and the associated infrastructure necessary for humans to explore the Moon. Component testing is well
Dade County Public Schools, Miami, FL.
This unit of instruction deals primarily with environmental influence. The course includes instruction on communicable diseases, prevention of diseases, and the optimal environment (pure food, water, air, waste disposal methods, pesticides, radioactivity, and the effects the laws governing each one have on human life). No requisite for prior…
Hartsfield, John W.; Hartsfield, Kendra J.
Since its beginning, the space program has caught the attention of young people. This space science activity booklet was designed to provide information and learning activities for students in elementary grades. It contains chapters on: (1) primitive beliefs about flight; (2) early fantasies of flight; (3) the United States human spaceflight…
... authority to charge and collect reasonable fees to cover the cost of performing official services. These fees also cover the costs associated with managing the program. After a financial review of GIPSA's Fees for Official Inspection and Weighing Services, including a comparison of the costs and revenues...
Air Mobility Command AFDW Air Force District of Washington AFSPC Air Force Space Command AT&L Acquisition Technologies and Logistics CPM ...were commonly performed in industry. The types of services included advertising for Navy recruitment, custodial services on Air Force bases, and on
Tim M. Daw
Full Text Available Although ecosystem services are increasingly recognized as benefits people obtain from nature, we still have a poor understanding of how they actually enhance multidimensional human well-being, and how well-being is affected by ecosystem change. We develop a concept of "ecosystem service elasticity" (ES elasticity that describes the sensitivity of human well-being to changes in ecosystems. ES Elasticity is a result of complex social and ecological dynamics and is context dependent, individually variable, and likely to demonstrate nonlinear dynamics such as thresholds and hysteresis. We present a conceptual framework that unpacks the chain of causality from ecosystem stocks through flows, goods, value, and shares to contribute to the well-being of different people. This framework builds on previous conceptualizations, but places multidimensional well-being of different people as the final element. This ultimately disaggregated approach emphasizes how different people access benefits and how benefits match their needs or aspirations. Applying this framework to case studies of individual coastal ecosystem services in East Africa illustrates a wide range of social and ecological factors that can affect ES elasticity. For example, food web and habitat dynamics affect the sensitivity of different fisheries ecosystem services to ecological change. Meanwhile high cultural significance, or lack of alternatives enhance ES elasticity, while social mechanisms that prevent access can reduce elasticity. Mapping out how chains are interlinked illustrates how different types of value and the well-being of different people are linked to each other and to common ecological stocks. We suggest that examining chains for individual ecosystem services can suggest potential interventions aimed at poverty alleviation and sustainable ecosystems while mapping out of interlinkages between chains can help to identify possible ecosystem service trade-offs and winners and
Lee, Winona K; Harris, Chessa C D; Mortensen, Kawika A; Long, Linsey M; Sugimoto-Matsuda, Jeanelle
Service learning is endorsed by the Liaison Committee on Medical Education (LCME) as an integral part of U.S. medical school curricula for future physicians. Service learning has been shown to help physicians in training rediscover the altruistic reasons for pursuing medicine and has the potential to enhance students' perspectives of humanism in medicine. The Kalaupapa service learning project is a unique collaboration between disadvantaged post-baccalaureate students with an underserved rural community. This study was conducted to determine whether the Kalaupapa service learning curricula enhanced student perspectives of humanism in medicine at an early stage of their medical training. Program participants between 2008 and 2014 (n = 41) completed written reflections following the conclusion of the service learning project. Four prompts guided student responses. Reflections were thematically analyzed. Once all essays were read, team members compared their findings to condense or expand themes and assess levels of agreement. Emerging themes of resilience and unity were prominent throughout the student reflections. Students expressed respect and empathy for the patients' struggles and strengths, as well as those of their peers. The experience also reinforced students' commitment to service, particularly to populations in rural and underserved communities. Students also gained a deeper understanding of the patient experience and also of themselves as future physicians. To identify and address underserved and rural patients' health care needs, training programs must prepare an altruistic health care workforce that embraces the humanistic element of medicine. The Kalaupapa service learning project is a potential curricular model that can be used to enhance students' awareness and perspectives of humanism in medicine.
Jones, Debra M; McAllister, Lindy; Lyle, David M
Access to healthcare is a fundamental human right for all Australians. Article 19 of the Universal Declaration of Human Rights acknowledges the right to freedom of opinion and to seek, receive and impart information and ideas. Capacities for self-expression and effective communication underpin the realisation of these fundamental human rights. For rural and remote Australian children this realisation is compromised by complex disadvantages and inequities that contribute to communication delays, inequity of access to essential speech-language pathology services and poorer later life outcomes. Localised solutions to the provision of civically engaged, accessible, acceptable and sustainable speech-language pathology services within rural and remote Australian contexts are required if we are to make substantive human rights gains. However, civically engaged and sustained healthcare can significantly challenge traditional professionalised perspectives on how best to design and implement speech-language pathology services that seek to address rural and remote communication needs and access inequities. A failure to engage these communities in the identification of childhood communication delays and solutions to address these delays, ultimately denies children, families and communities of their human rights for healthcare access, self-expression, self-dignity and meaningful inclusion within Australian society.
Walker, T; Edge, D; Shaw, J; Wilson, H; McNair, L; Mitchell, H; Gutridge, K; Senior, J; Sutton, M; Meacock, R; Abel, K
WHAT IS KNOWN ON THE SUBJECT?: Three pilot UK-only Women's Enhanced Medium Secure Services (WEMSS) was opened in 2007 to support women's movement from high secure care and provide a bespoke, women-only service. Evidence suggests that women's secure services are particularly challenging environments to work in and staffing issues (e.g., high turnover) can cause difficulties in establishing a therapeutic environment. Research in this area has focused on the experiences of service users. Studies which have examined staff views have focused on their feelings towards women in their care and the emotional burden of working in women's secure services. No papers have made a direct comparison between staff working in different services. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: This is the first study to explore the views and experiences of staff in the three UK WEMSS pilot services and contrast them with staff from women's medium secure services. Drawing upon data from eighteen semi-structured interviews (nine WEMSS, nine non-WEMSS), key themes cover staff perceptions of factors important for women's recovery and their views on operational aspects of services. This study extends our understanding of the experiences of staff working with women in secure care and bears relevance for staff working internationally, as well as in UK services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study reveals the importance of induction and training for bank and agency staff working in women's secure services. Further, regular clinical supervision should be mandatory for all staff so they are adequately supported. Introduction Women's Enhanced Medium Secure Services (WEMSS) is bespoke, gender-sensitive services which opened in the UK in 2007 at three pilot sites. This study is the first of its kind to explore the experiences of WEMSS staff, directly comparing them to staff in a standard medium secure service for women. The literature to date has focused on the experiences of
... Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT TAXES AND... employ of an instrumentality of the United States specifically exempted from the employer tax. Services... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services in employ of an instrumentality of the...
McNulty, P A; Cresswell, A G
We investigated the recruitment behaviour of low threshold motor units in flexor digitorum superficialis by altering two biomechanical constraints: the load against which the muscle worked and the initial muscle length. The load was increased using isotonic (low load), loaded dynamic (intermediate load) and isometric (high load) contractions in two studies. The initial muscle position reflected resting muscle length in series A, and a longer length with digit III fully extended in series B. Intramuscular EMG was recorded from 48 single motor units in 10 experiments on five healthy subjects, 21 units in series A and 27 in series B, while subjects performed ramp up, hold and ramp down contractions. Increasing the load on the muscle decreased the force, displacement and firing rate of single motor units at recruitment at shorter muscle lengths (Precruitment pattern was observed between loaded dynamic and isotonic contractions, but not between isometric and loaded dynamic contractions. Thus, the recruitment properties of single motor units in human flexor digitorum superficialis are sensitive to changes in both imposed external loads and the initial length of the muscle.
Full Text Available Human Resources Information System is a Decision Support System that provides necessary information regarding human resources in an organization. Web-based e-HR is one of the best practical solution in human resources management that allows employees to focus more on their job instead of HR administration procedures. By implementing Employee Self Service (ESS it is expected that worker satisfaction can be improved and in turn will also improve employees’ performance. The web-based ESS is characterized by personalized information approach which offers personal and management services on information access and structured workflow process. The object covered in this research is HR administration of PT. BCP to create and implement ESS with system prototype development and UML modeling tool. The resulting system is designed to quickly access the information and company procedures to shorten the time for BCP’s employee administration and documentation
Teo, Wendy Zi Wei
This article attempts to tackle the ethically and morally troubling issue of emigration of physicians from the United Kingdom, and whether it can be justified. Unlike most research that has already been undertaken in this field, which looks at migration from developing countries to developed countries, this article takes an in-depth look at the migration of physicians between developed countries, in particular from the United Kingdom (UK) to other developed countries such as Canada, Australia, New Zealand, and the United States (US). This examination was written in response to a current and critical crisis in the National Health Service (NHS), where impending contract changes may bring about a potential exodus of junior doctors.
Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila
Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743
Hammer, Carol Scheffner; Farkas, George; Hillemeier, Marianne M.; Maczuga, Steve; Cook, Michael; Morano, Stephanie
Purpose We sought to identify factors predictive of or associated with receipt of speech/language services during early childhood. We did so by analyzing data from the Early Childhood Longitudinal Study–Birth Cohort (ECLS-B; Andreassen & Fletcher, 2005), a nationally representative data set maintained by the U.S. Department of Education. We addressed two research questions of particular importance to speech-language pathology practice and policy. First, do early vocabulary delays increase children's likelihood of receiving speech/language services? Second, are minority children systematically less likely to receive these services than otherwise similar White children? Method Multivariate logistic regression analyses were performed for a population-based sample of 9,600 children and families participating in the ECLS-B. Results Expressive vocabulary delays by 24 months of age were strongly associated with and predictive of children's receipt of speech/language services at 24, 48, and 60 months of age (adjusted odds ratio range = 4.32–16.60). Black children were less likely to receive speech/language services than otherwise similar White children at 24, 48, and 60 months of age (adjusted odds ratio range = 0.42–0.55). Lower socioeconomic status children and those whose parental primary language was other than English were also less likely to receive services. Being born with very low birth weight also significantly increased children's receipt of services at 24, 48, and 60 months of age. Conclusion Expressive vocabulary delays at 24 months of age increase children’s risk for later speech/language services. Increased use of culturally and linguistically sensitive practices may help racial/ethnic minority children access needed services. PMID:26579989
Chandra, Anjani; Copen, Casey E; Stephen, Elizabeth Hervey
This report presents nationally representative estimates and trends for infertility service use among women aged 15-44 and 25-44 in the United States in 1982-2010. While greater detail on types of infertility service is shown for women, basic data on types of infertility service use, as reported by men aged 25-44, are also presented. Data for this report come primarily from the 2006-2010 National Survey of Family Growth (NSFG), consisting of 22,682 interviews with men and women aged 15-44, conducted from June 2006 through June 2010. The response rate for females in the 2006-2010 NSFG was 78%, and for males was 75%. Selected trends are shown based on prior NSFG cycles. Twelve percent of women aged 15-44 in 2006-2010 (7.3 million women), or their husbands or partners, had ever used infertility services. Among women aged 25-44, 17% (6.9 million) had ever used any infertility service, a significant decrease from 20% in 1995. Thirty-eight percent of nulliparous women with current fertility problems in 2006-2010 had ever used infertility services, significantly less than 56% of such women in 1982. In all survey years, ever-use of medical help to get pregnant was highest among older and nulliparous women, non-Hispanic white women, women with current fertility problems, and women with higher levels of education and household income. The most commonly used infertility services among women aged 25-44 in 2006-2010 were advice, testing, medical help to prevent miscarriage, and ovulation drugs. Ever-use of infertility services was reported by 9.4% of men aged 25-44 in 2006-2010, similar to levels seen in 2002. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Full Text Available Lars Henrik Myklebust,1 Knut Sørgaard,1,2 Rolf Wynn21Psychiatric Research Centre of North Norway, Nordland Hospital Trust, Bodø, 2Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, NorwayObjectives: In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care.Methods: Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays.Results: The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients' use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized, a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays.Conclusion: Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care.Keywords: psychiatry, hospitalization, decentralization, outpatients, continuity of care, health service research, affective
Meijerink, Jeroen Gerard; Bondarouk, Tatiana
Although traditionally applied independently, this study combines two theoretical perspectives – the intellectual capital theory and the consumer perspective – to uncover value-creating configurations of human resource management (HRM) service providers' and workers' knowledge resources. We examined
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This EnviroAtlas dataset...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This EnviroAtlas dataset...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The EnviroAtlas Potentially...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The EnviroAtlas Potential...
Neonatal Intensive Care (NICU) patients have individual nutritional requirements often requiring Patient Specific Parenteral Nutrition (PSPN). From October 2015, the national PSPN compounding service availability changed from 7 days per week service to 5 days per week (i.e. no weekend and limited bank holiday ordering available). The aim of this study was to examine the introduction of a 5 day only PSPN supply on neonatal patient parenteral nutrition availability in a tertiary NICU.
.... Several efforts are underway that address the current land mine problem. The United States established the Demining Assistance Program to initiate research and development into cost effective demining techniques...
... Routes; Northeast United States AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule.../DME 040[deg] radial northeast of Kennedy VOR/DME. V-16 then turns east bound, bypassing the Deer Park...
Samer Hamidi School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates Introduction: A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Duba...
Acampora, Alfonso P., Ed.; Nebelkopf, Ethan, Ed.
The World Federation of Therapeutic Communities is an international association of drug treatment centers that use the "Therapeutic Community" (TC) to combat chemical dependency and drug addiction. Their 1985 conference focused on bridging services between the TC and the traditional human service systems. A total of 85 separate papers were…
Tyakht, Alexander V; Popenko, Anna S; Belenikin, Maxim S; Altukhov, Ilya A; Pavlenko, Alexander V; Kostryukova, Elena S; Selezneva, Oksana V; Larin, Andrei K; Karpova, Irina Y; Alexeev, Dmitry G
Rose, Lisa Hale
In spite of open access to community college education, specifically human service associate degree programs, students with criminal justice histories do not necessarily have an unobstructed pathway to obtaining the degree and admission to the baccalaureate programs in human services and social work that are almost always selective. The first…
Full Text Available The paper focuses on the changes in ecosystem services in the most important coal field from the Southern Carpathians (Romania. The time horizon considered is the interval 1950-2010, characterized by two major processes: intensive development of the mining industry (1950-1989 and subsequent restructuring of mining, with significant consequences since 1996. Socio-economic phenomena associated with these two stages in the evolution of the region have generated major changes in ecosystem services, leading to increased human vulnerability, both to extreme events (natural hazards and pressure from economic factors.
Gopalakrishnan, Varsha; Hirabayashi, Satoshi; Ziv, Guy; Bakshi, Bhavik R.
Vegetation including canopy, grasslands, and shrublands can directly sequester pollutants onto the plant surface, resulting in an improvement in air quality. Until now, several studies have estimated the pollution removal capacity of canopy cover at the level of a county, but no such work exists for grasslands and shrublands. This work quantifies the air pollution removal capacity of grasslands and shrublands at the county-level in the United States and estimates the human health benefits associated with pollution removal using the i-Tree Eco model. Sequestration of pollutants is estimated based on the Leaf Area Index (LAI) obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) derived dataset estimates of LAI and the percentage land cover obtained from the National Land Cover Database (NLCD) for the year 2010. Calculation of pollution removal capacity using local environmental data indicates that grasslands and shrublands remove a total of 6.42 million tonnes of air pollutants in the United States and the associated monetary benefits total 268 million. Human health impacts and associated monetary value due to pollution removal was observed to be significantly high in urban areas indicating that grasslands and shrublands are equally critical as canopy in improving air quality and human health in urban regions.
Syphard, Alexandra D.; Keeley, Jon E.; Pfaff, Anne Hopkins; Ferschweiler, Ken
Growing human and ecological costs due to increasing wildfire are an urgent concern in policy and management, particularly given projections of worsening fire conditions under climate change. Thus, understanding the relationship between climatic variation and fire activity is a critically important scientific question. Different factors limit fire behavior in different places and times, but most fire-climate analyses are conducted across broad spatial extents that mask geographical variation. This could result in overly broad or inappropriate management and policy decisions that neglect to account for regionally specific or other important factors driving fire activity. We developed statistical models relating seasonal temperature and precipitation variables to historical annual fire activity for 37 different regions across the continental United States and asked whether and how fire-climate relationships vary geographically, and why climate is more important in some regions than in others. Climatic variation played a significant role in explaining annual fire activity in some regions, but the relative importance of seasonal temperature or precipitation, in addition to the overall importance of climate, varied substantially depending on geographical context. Human presence was the primary reason that climate explained less fire activity in some regions than in others. That is, where human presence was more prominent, climate was less important. This means that humans may not only influence fire regimes but their presence can actually override, or swamp out, the effect of climate. Thus, geographical context as well as human influence should be considered alongside climate in national wildfire policy and management.
Al Shehhi, Nawal; Aziz, Faisal; Al Hosani, Farida; Aden, Bashir; Blair, Iain
Worldwide, human brucellosis remains an important and widespread infection. In the past, there were limited data on the occurrence of human brucellosis in the United Arab Emirates and the reported incidence appeared to be low compared with similar areas. In 2009, a new web-based infectious disease surveillance system was introduced in the Emirate of Abu Dhabi. This paper reports data from this new system on human brucellosis for the 6 years 2010 to 2015. A dataset was extracted for each case of human brucellosis reported to the notification system for the 6 year period January 2010 to December 2015. Annual brucellosis rates by age-group, gender, nationality and, geographical region were calculated and compared. A total of 480 cases of brucellosis were reported. The overall crude notification rate was 3 · 3 per 100,000 population but higher rates were seen in certain population subgroups notably expatriate males of working age in the Eastern Region (approximately 10 per 100,000) and UAE nationals of all ages and both genders in Abu Dhabi (between 4 -- 24 per 100,000). These findings reflect environmental and behavioral factors linked to occupation and leisure time activities associated with the large number of small non-commercial livestock farms in Abu Dhabi. Controlling human brucellosis in these circumstances will be challenging.
Kachur, Rachel; Hall, Wendasha; Coor, Alexandra; Kinsey, Jennine; Collins, Dayne; Strona, F V
Since the late 1990s, health departments and STD programs throughout the U.S. have used technologies, such as the internet and mobile phones, to provide services to persons with a sexually transmitted infection, including HIV, and their sex partners, also known as partner services. This study reviewed the published literature to assess and compare partner services outcomes as a result of using technology and to calculate cost savings through cases averted. We conducted a structured literature review of all U.S. studies that examined the use of technology to notify persons exposed to an STD (syphilis, chlamydia, gonorrhea), including HIV, by health care professionals in the U.S. from 2000 to 2017. Outcome measures, including the number of the number of partners notified, screened or tested; and new positives identified, were captured and cost savings were calculated, when data were available. Seven studies were identified. Methods used for partner services differed across studies, although email was the primary mode in 6 (83%) of the 7 studies. Only 2 of the 7 studies compared use of technology for partner services to traditional partner services. Between 10% and 97% of partners were successfully notified of their exposure through the use of technology and between 34% and 81% were screened or tested. Five studies reported on new infections identified, which ranged from 3-19. Use of technology for partner serves saved programs between $22,795 and $45,362 in direct and indirect medical costs. Use of technology for partner services increased the number of partners notified, screened or tested, and new infections found. Importantly, the use of technology allowed programs to reach partners who otherwise would not have been notified of their exposure to an STD or HIV. Improved response times and time to treatment were also seen as was re-engagement into care for previous HIV positive patients. Data and outcome measures across the studies were not standardized, making it
Hilgert, Jeffrey A
This article introduces the idea of human rights to the topic of workers' compensation in the United States. It discusses what constitutes a human rights approach and explains how this approach conflicts with those policy ideas that have provided the foundation historically for workers' compensation in the United States. Using legal and historical research, key international labor and human rights standards on employment injury benefits and influential writings in the development of the U.S. workers' compensation system are cited. Workers' injury and illness compensation in the United States does not conform to basic international human rights norms. A comprehensive review of the U.S. workers' compensation system under international human rights standards is needed. Examples of policy changes are highlighted that would begin the process of moving workers' compensation into conformity with human rights standards. Copyright © 2012 Wiley Periodicals, Inc.
Huang, I-Chun; Holzbauer, Jerome J; Lee, Eun-Jeong; Chronister, Julie; Chan, Fong; O'Neil, John
The aim of this study was to examine the relationship between vocational rehabilitation services provided and work outcomes among people with cerebral palsy (CP), taking in to account demographic characteristics. From the US Department of Education Rehabilitation Service Administration Case Service Report (RSA-911) database, data from 3162 individuals with CP (1820 males [57.6%] and 1342 females [42.4% age range 16-54 y) whose cases were closed in 2009, were used in this study. A total of 1567 cases (49.6%) were closed with clients being categorized as 'successful employment' and 1595 cases (50.4%) were closed with clients being classified as unemployed. Multivariate logistic regression was used to examine the relationship between services provided and work outcomes with regard to demographic characteristics. Males aged between 26 and 54 years old with higher education attainment were more likely to be employed. Individuals receiving disability benefits were less likely to be employed. After controlling for the effect of demographic and work disincentive variables, five vocational rehabilitation services significantly predicted employment outcomes (pemployability, to address their much needed work adjustment skills, to establish independent living, and to eventually reach their full potential in participation in society. © 2013 Mac Keith Press.
Chesson, Harrell W; Ekwueme, Donatus U; Saraiya, Mona; Markowitz, Lauri E
We describe a simplified model, based on the current economic and health effects of human papillomavirus (HPV), to estimate the cost-effectiveness of HPV vaccination of 12-year-old girls in the United States. Under base-case parameter values, the estimated cost per quality-adjusted life year gained by vaccination in the context of current cervical cancer screening practices in the United States ranged from $3,906 to $14,723 (2005 US dollars), depending on factors such as whether herd immunity effects were assumed; the types of HPV targeted by the vaccine; and whether the benefits of preventing anal, vaginal, vulvar, and oropharyngeal cancers were included. The results of our simplified model were consistent with published studies based on more complex models when key assumptions were similar. This consistency is reassuring because models of varying complexity will be essential tools for policy makers in the development of optimal HPV vaccination strategies.
Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C
BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...
Luo, Zengliang; Zuo, Qiting; Shao, Quanxi
In order to study river health status from harmonic relationship between human and natural environment, a river health evaluation method was proposed from the aspects of ecosystem integrity and human service demand, and the understanding of river health connotation. The proposed method is based on the harmony theory and two types of river health assessment methods (the forecasting model and index evaluation). A new framework for assessing river water health was then formed from the perspective of harmony and dynamic evolution between human service demand and river ecosystem integrity. As a case study, the method and framework were applied to the Shaying River Basin, a tributary of the most polluted Huaihe River Basin in China. The health status of the river's ecosystem and its effect on the mainstream of Huaihe River were evaluated based on water ecological experiment. The results indicated that: (1) the water ecological environment in Shaying River was generally poor and showed a gradual changing pattern along the river. The river health levels were generally "medium" in the upstream but mostly "sub-disease" in the midstream and downstream, indicating that the water pollution in Shaying River were mainly concentrated in the midstream and downstream; (2) the water pollution of Shaying River had great influence on the ecosystem of Huaihe River, and the main influencing factors were TN, followed by TP and COD Mn ; (3) the natural attribute of river was transferring toward to the direction of socialization due to the increasing human activities. The stronger the human activity intervention is, the faster the transfer will be and the more river's attributes will match with human service demand. The proposed framework contributes to the research in water ecology and environment management, and the research results can serve as an important reference for basin management in Shaying River and Huaihe River. Copyright © 2018. Published by Elsevier B.V.
Borrero, Sonya; Schwarz, Eleanor B; Creinin, Mitchell; Ibrahim, Said
This study sought to examine the independent effect of patient race or ethnicity on the use of family planning services and on the likelihood of receiving counseling for sterilization and other birth control methods. This study used national, cross-sectional data collected by the 2002 National Survey of Family Growth (NSFG). Our analysis included women aged 18-44 years who had heterosexual intercourse within the past 12 months, who were not actively seeking to get pregnant, and who had not undergone surgical sterilization. The primary outcome was receipt of family planning services within the past 12 months. Specific services we examined were (1) provision of or prescription for a method of birth control, (2) checkup related to using birth control, (3) counseling about sterilization, and (4) counseling about birth control. Although we found no racial/ethnic differences in the overall use of family planning services, there were racial/ethnic differences in the specific type of service received. Hispanic and black women were more likely than white women to receive counseling for birth control (adjusted OR 1.5, 95% confidence interval [CI] 1.2, 1.8, and adjusted OR 1.3, 95% CI 1.1, 1.7, respectively). Hispanic women were more likely than white women to report having been counseled about sterilization (adjusted OR 1.5, 95% CI 1.0, 2.3). Minority women were more likely to receive counseling about sterilization and other birth control methods. However, there were no differences in access to family planning services by race or ethnicity. Future studies are needed to examine the quality and content of contraceptive counseling received by minority compared with nonminority women.
Kalina, C M; Fitko, J
1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.
Shefer, Abigail; Markowitz, Lauri; Deeks, Shelley; Tam, Theresa; Irwin, Kathleen; Garland, Suzanne M; Schuchat, Anne
Successful incorporation of a new vaccine into a nation's vaccination program requires addressing a number of issues, including: 1) establishing national recommendations; 2) assuring education of and acceptance by the public and medical community; 3) establishing and maintaining an appropriate infrastructure for vaccine delivery; 4) financing the vaccine and the program, in addition to political will. This article reviews the early experience with implementation of human papillomavirus (HPV) vaccination programs. It focuses on the United States of America and Canada and provides a brief report on Australia, where introduction is underway.
Kim, Kyounghae; LeClaire, Anna-Rae
To critically appraise factors influencing human papillomavirus (HPV) vaccination among immigrant parents in the United States, a comprehensive search of electronic databases and reference lists was conducted. The findings from 22 articles were ordered based on a socioecological model. About 30% of children initiated and 14% completed a three-dose series. Correlates of HPV vaccine initiation rates included lack of information, concerns about vaccine safety and promiscuity, providers' recommendations, school mandates, financial issues, immigration laws, and living in disadvantaged neighborhoods. Upstream initiatives embracing cultural descriptors could facilitate HPV vaccination, reducing HPV-related disparities in cancer among immigrants in the US.
Layman, Craig A; Jud, Zachary R; Archer, Stephanie K; Riera, David
Water filtration is one of the most important ecosystem services provided by sessile organisms in coastal ecosystems. As a consequence of increased coastal development, human-made shoreline structures (e.g., docks and bulkheads) are now common, providing extensive surface area for colonization by filter feeders. We estimate that in a highly urbanized sub-tropical estuary, water filtration capacity supported by filter feeding assemblages on dock pilings accounts for 11.7 million liters of water h −1 , or ∼30% of the filtration provided by all natural oyster reef throughout the estuary. Assemblage composition, and thus filtration capacity, varied as a function of piling type, suggesting that the choice of building material has critical implications for ecosystem function. A more thorough depiction of the function of coastal ecosystems necessitates quantification of the extensive ecosystem services associated with human-made structures. (paper)
Bess, Kimberly D; Perkins, Douglas D; McCown, Diana L
Transformative organizational change requires organizational learning capacity, which we define in terms of (1) internal and (2) external organizational systems alignment, and promoting a culture of learning, including (3) an emphasis on exploration and information, (4) open communication, (5) staff empowerment, and (6) support for professional development. We shortened and adapted Watkins and Marsick's Dimensions of Learning Organizations Questionnaire into a new 16-item Organizational Learning Capacity Scale (OLCS) geared more toward nonprofit organizations. The OLCS and its subscales measuring each of the above 6 dimensions are unusually reliable for their brevity. ANOVAs for the OLCS and subscales clearly and consistently confirmed extensive participant observations and other qualitative data from four nonprofit human service organizations and one local human service funding organization.
This decree approve the organizational structure project of The regulatory energy and water services ( URSEA). This unit is responsible for monitoring the activities related to electricity, gas, drinking water, sanitation and oil, fuel and other hydrocarbon derivatives
Hudson, Anna L; Gandevia, Simon C; Butler, Jane E
During breathing, there is differential activity in the human parasternal intercostal muscles and the activity is tightly coupled to the known mechanical advantages for inspiration of the same regions of muscles. It is not known whether differential activity is preserved for the non-respiratory task of ipsilateral trunk rotation. In the present study, we compared single motor units during resting breathing and axial rotation of the trunk during apnoea. We not only confirmed non-uniform recruitment of motor units across parasternal intercostal muscles in breathing, but also demonstrated that the same motor units show an altered pattern of recruitment in the non-respiratory task of trunk rotation. The output of parasternal intercostal motoneurones is modulated differently across spinal levels depending on the task and these results help us understand the mechanisms that may govern task-dependent differences in motoneurone output. During inspiration, there is differential activity in the human parasternal intercostal muscles across interspaces. We investigated whether the earlier recruitment of motor units in the rostral interspaces compared to more caudal spaces during inspiration is preserved for the non-respiratory task of ipsilateral trunk rotation. Single motor unit activity (SMU) was recorded from the first, second and fourth parasternal interspaces on the right side in five participants in two tasks: resting breathing and 'isometric' axial rotation of the trunk during apnoea. Recruitment of the same SMUs was compared between tasks (n = 123). During resting breathing, differential activity was indicated by earlier recruitment of SMUs in the first and second interspaces compared to the fourth space in inspiration (P motor units showed an altered pattern of recruitment because SMUs in the first interspace were recruited later and at a higher rotation torque than those in the second and fourth interspaces (P recruitment measures, was good-excellent [intraclass
Burgess, Lynn; Brevik, Eric
In September of 2012 the United States found itself facing a fungal meningitis outbreak that was traced back to contaminated steroid injections. The fungus Exserohilium rostratum, which is found in soil, among other locations in the environment, was identified as the main cause of the health issues created by the contaminated steroids. As of November 7, 2012 419 cases of fungal meningitis, stroke due to presumed fungal meningitis, or other central nervous system-related infections, 10 cases of peripheral joint infections, and 31 deaths linked to the contaminated steroids had been documented. However, the life cycle and soil ecology of E. rostratum is not well understood, and such knowledge would aid human health professionals in understanding the pathogenic potential of E. rostratum. Therefore, soil scientists have a role to play in developing the most effective ways to combat human health challenges such as the 2012 fungal meningitis outbreak.
In his address at the meeting of representatives from the League of Arab States on the subject 'Peace and Development: Nuclear Energy in the Service of Humanity', the Director General of the IAEA described the role of the Agency for the development of peaceful uses of nuclear energy, focussing on the four main topics: technology transfer for development, contribution of verification and safeguards to peace and security, the role of nuclear power, and the importance of nuclear safety
guidance and actions towards that end service product . Also to be considered is that not only are the stakeholders independent in their needs for strategy...from http://www.firerescue1.com/fire- ems/articles/770081-Ex-DC-fire-chief-rerets- intergrating Doyle, J. (2008, April 13). San Francisco 911 misses
Sullivan, M.J.; Mercurio, Matthew; Schellenberg, Josh
Information on the value of reliable electricity service can be used to assess the economic efficiency of investments in generation, transmission and distribution systems, to strategically target investments to customer segments that receive the most benefit from system improvements, and to numerically quantify the risk associated with different operating, planning and investment strategies. This paper summarizes research designed to provide estimates of the value of service reliability for electricity customers in the US. These estimates were obtained by analyzing the results from 28 customer value of service reliability studies conducted by 10 major US electric utilities over the 16 year period from 1989 to 2005. Because these studies used nearly identical interruption cost estimation or willingness-to-pay/accept methods it was possible to integrate their results into a single meta-database describing the value of electric service reliability observed in all of them. Once the datasets from the various studies were combined, a two-part regression model was used to estimate customer damage functions that can be generally applied to calculate customer interruption costs per event by season, time of day, day of week, and geographical regions within the US for industrial, commercial, and residential customers. Estimated interruption costs for different types of customers and of different duration are provided. Finally, additional research and development designed to expand the usefulness of this powerful database and analysis are suggested.
Kwak, Yoonyoung; Lu, Ting; Christ, Sharon L.
Background: Many adolescents are referred to Child Protective Services for possible maltreatment every year, but not much is known about their organized and unstructured activity participation. Objective: The purposes of this study are to provide a description of organized and unstructured activity participation for adolescents who were possible…
...-27043; Amdt. No. 61-132] RIN 2120-AI77 Fees for Certification Services and Approvals Performed Outside..., 2007 (72 FR 18556). In that rule, the FAA amended its regulations to revise the fee requirement for... direct final rule revising the fee requirement of 14 CFR 61.13 for the issuance of an airman certificate...
Van Sickle, Meta; Bogan, Margaret B.; Kamen, Michael; Baird, William; Butcher, Carolyn
There is increasing pressure to evaluate and document the capabilities of students exiting teacher education programs. A professional portfolio can serve as an effective tool for documenting this process. Faculty wishing to institute portfolios in pre-service teacher assessment should be aware of the difficulties that arise during discourse and…
McLean, J.A.; Beaton, D.L.
The fitness for service process provides a unique proven methodology for assessing and correcting post-LOCA damage, essential to plant restart. The process uses the as-built plant configuration for modelling input and features self correcting feedback from inspection to validate assessment models. This paper focuses on the process steps and the infrastructure necessary to execute the process
Tatiana Mota Xavier de Meneses
Conclusions: Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation.
Planned Parenthood--World Population, New York, NY.
To provide federal, state, and local health agencies with information needed to achieve the national objectives of improving health, assisting families to escape poverty, and providing parents with freedom of choice in determining the number and spacing of their children, information was collected from 3,072 United States counties. Data from a…
We analyzed the potential physical and economic impacts of climate change on freshwater fisheries and coral reefs in the United States, examining a reference scenario and two policy scenarios that limit global greenhouse gas (GHG) emissions. We modeled shifts in suitable habitat ...
Lakatos, Patricia P.; Matic, Tamara; Carson, Melissa C.; Williams, Marian E.
Infants are born primed to develop attachment relationships. However, when infants are hospitalized in the neonatal intensive care unit at birth, the stress and trauma associated with the highly specialized medical environment can threaten the development of a nurturing and secure caregiving relationship. Infant mental health is an evidence-based…
Brian H. Hill; Randall K. Kolka; Frank H. McCormick; Matthew A. Starry
Ecosystem production functions for water supply, climate regulation, and water purification were estimated for 568 headwater streams and their catchments. Results are reported for nine USA ecoregions. Headwater streams represented 74-80% of total catchment stream length. Water supply per unit catchment area was highest in the Northern Appalachian Mountains ecoregion...
Engel, Rafael J; Rosen, Daniel; Weaver, Addie; Soska, Tracy
This article reports the findings of one county's human service network's readiness to treat gambling related problems in anticipation of the opening of a new casino. Using a cross-sectional survey design, questionnaires were mailed to executive directors of all mental health, family counseling, drug and alcohol, and faith-based, addiction-related organizations in the county (N = 248); 137 (55.2%) agency directors responded to the questionnaire. The survey requested information about agency demographics, training, screening, treatment, and public awareness/education. Descriptive statistics and bivariate analyses were used to summarize the findings. The analyses revealed a lack of human service response to the impending start of casino gambling. More than three-quarters of respondents had not sent staff for training in screening or treating gambling disorders, did not screen for problem gambling, did not treat problem gambling, and did not refer clients to other agencies for treatment of gambling-related problems. The most common reason offered for not engaging in prevention and treatment activities was that problem gambling is not considered an issue for the agency. There were differences between mental health and/or substance abuse focused agencies and other service providers. Based on the findings of this study, specific strategies to enhance the service delivery network's capacity to address problem gambling are suggested.
Hopf, Suzanne C
Receipt of accessible and appropriate specialist services and resources by all people with communication and/or swallowing disability is a human right; however, it is a right rarely achieved in either Minority or Majority World contexts. This paper considers communication specialists' efforts to provide sustainable services for people with communication difficulties living in Majority World countries. The commentary draws on human rights literature, particularly Article 19 of the Universal Declaration of Human Rights and the Communication Capacity Research program that includes: (1) gathering knowledge from policy and literature; (2) gathering knowledge from the community; (3) understanding speech, language and literacy use and proficiency; and (4) developing culturally and linguistically appropriate resources and assessments. To inform the development of resources and assessments that could be used by speech-language pathologists as well as other communication specialists in Fiji, the Communication Capacity Research program involved collection and analysis of data from multiple sources including 144 community members, 75 school students and their families, and 25 teachers. The Communication Capacity Research program may be applicable for achieving the development of evidence-based, culturally and linguistically sustainable SLP services in similar contexts.
Beck, Dana C; Choi, Kristen R; Munro-Kramer, Michelle L; Lori, Jody R
The purpose of this review is to integrate evidence on human trafficking in Ethiopia and identify gaps and recommendations for service delivery, research and training, and policy. A scoping literature review approach was used to systematically search nursing, medical, psychological, law, and international databases and synthesize information on a complex, understudied topic. The search yielded 826 articles, and 39 met the predetermined criteria for inclusion in the review. Trafficking in Ethiopia has occurred internally and externally in the form of adult and child labor and sex trafficking. There were also some reports of organ trafficking and other closely related human rights violations, such as child marriage, child soldiering, and exploitative intercountry adoption. Risk factors for trafficking included push factors (poverty, political instability, economic problems, and gender discrimination) and pull factors (demand for cheap labor). Trafficking was associated with poor health and economic outcomes for victims. Key recommendations for service delivery, research and training, and policy are identified, including establishing comprehensive services for survivor rehabilitation and reintegration, conducting quantitative health outcomes research, and reforming policy around migration and trafficking. Implementing the recommendations identified by this review will allow policy makers, researchers, and practitioners to take meaningful steps toward confronting human trafficking in Ethiopia.
Wilder, David A; Lipschultz, Joshua; Gehrman, Chana
The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to assess the environmental variables that contribute to poor employee performance in human service settings. Although the PDC-HS has been shown to effectively identify variables contributing to problematic performance, interventions based on only two of the four PDC-HS domains have been evaluated to date. In addition, the extent to which PDC-HS-indicated interventions are more effective than nonindicated interventions for two domains remains unclear. In the current study, we administered the PDC-HS to supervisors to assess the variables contributing to infrequent teaching of verbal operants and use of a timer by therapists at a center-based autism treatment program. Each of the four PDC-HS domains was identified as contributing to poor performance for at least one therapist. We then evaluated PDC-HS-indicated interventions for each domain. In addition, to assess the predictive validity of the tool, we evaluated various nonindicated interventions prior to implementing a PDC-HS-indicated intervention for two of the four domains. Results suggest that the PDC-HS-indicated interventions were effective across all four domains and were more effective than the nonindicated interventions for the two domains for which they were evaluated. Results are discussed in terms of the utility of the PDC-HS to identify appropriate interventions to manage therapist performance in human service settings.
Leung, V.; Basdekas, D.; Mazetis, G.
The essential service water system (ESWS) is required to provide cooling in nuclear power plants during normal operation and accident conditions. The ESWS typically supports component cooling water heat exchangers, containment spray heat exchangers, high-pressure injection pump oil coolers, emergency diesel generators, and auxiliary building ventilation coolers. Failure of the ESWS function could lead to severe consequences. This report presents the regulatory analysis for GI-130, ''Essential Service Water System Failures at Multi-Unit Sites.'' The risk reduction estimates, cost/benefit analyses, and other insights gained during this effort have shown that implementation of the recommendations will significantly reduce risk and that these improvements are warranted in accordance with the backfit rule, 10 CFR 50.109(a)(3). 19 refs., 16 tabs
Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul
With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.
U.S. Department of Health & Human Services — Medicaid Fraud Control Units (MFCU or Unit) investigate and prosecute Medicaid fraud as well as patient abuse and neglect in health care facilities. OIG certifies,...
Wing, Paul; Langelier, Margaret H; Continelli, Tracey A; Battrell, Ann
The purpose of this article is to summarize a larger study that developed a statistical index that defines the professional practice environment of dental hygienists (DHs) in the United States, and to determine the extent to which the index scores are related to the number of DHs and dentists, the utilization of dental services, and selected oral health outcomes across the 50 states. A Dental Hygiene Professional Practice Index (DHPPI) defines the professional status, supervision requirements, tasks permitted, and reimbursement options for DHs in each of the 50 states and the District of Columbia, as of December 31, 2001. Spearman rank order correlations between the DHPPI and numbers of oral health professionals, utilization of oral health services, and oral health outcomes in the 50 states are also presented. The analyses revealed that: There are significant differences in the legal practice environments (as reflected in the DHPPI) across the 50 states and the District of Columbia. Between 1990 and 2001, the number of DHs per capita increased by 46% in the United States, while the number of dentists per 100,000 population increased by only 10%. The DHPPI was not significantly correlated with the number of DHs or dentists in the 50 states in 2001. The DHPPI was significantly positively correlated with the salaries of DHs in 2001. The DHPPI was also significantly and positively correlated with a number of indicators of utilization of oral health services and oral health outcomes. Both access to oral health services and oral health outcomes are positively correlated with the DHPPI. This suggests that states with low DHPPI scores would be logical candidates for revised DH practice statutes and regulations to accomplish these objectives.
Lemeshewsky, W.; Macaluso, C.; Smith, P.; Teer, B.
The Office of Civilian Radioactive Waste Management (OCRWM) in the United States Department of Energy (DOE) has the responsibility under the Nuclear Waste Policy Act of 1982 (the Act) for the shipment of spent nuclear fuel (SNF) from commercial reactors to a Federal facility for storage and/or disposal. The Act requires the use of private industry to the 'fullest extent possible' in the transportation of spent fuels. An OCRWM goal is to develop a safe, efficient and effective transportation system while meeting the mandate of the Act. OCRWM has then develop a strategy for a market driven approach for the acquisition of transportation services and equipment. To implement this strategy, OCRWM is planning to issue a Request for Proposal (RPF) for the provision of the required services and equipment to accept SNF from the utilities and transport the SNF to a Federal facility. Two draft RPFs have been issued with the second draft incorporating comments on the first draft from potential contractors and other interested parties. The overall strategy as outlined in the draft RPF relies on private industry to use the innovative powers of the marketplace to help DOE accomplish its mission objectives. DOE intends to pursue this procurement strategy whether or not the OCRWM program includes interim storage. The concept described in the draft RPF provides for DOE to purchase services and equipment from a contractor-operated waste acceptance and transportation organization. The contractor is expected to provide initial financing for the project including that necessary for initial acquisition of operational equipment, establish the necessary management organization, and mobilize the necessary resources and capabilities to provide the SNF delivery services at a fixed rate. DOE will retain final approval on all routes and maintain primary responsibility to the States, tribes, and local units of government for assuring appropriate interaction and consideration of their input on
Hunter, David J; Frank, John
We offer a UK-based commentary on the recent "Perspective" published in IJHPM by Thakkar and Sullivan. We are sympathetic to the authors' call for increased funding for health service and policy research (HSPR). However, we point out that increasing that investment - in any of the three countries they compare: Canada, the United States and the United Kingdom- will ipso facto not necessarily lead to any better use of research by health system decision-makers in these settings. We cite previous authors' descriptions of the many factors that tend to make the worlds of researchers and decision-makers into "two solitudes." And we call for changes in the structure and funding of HSPR, particularly the incentives now in place for purely academic publishing, to tackle a widespread reality: most published research in HSPR, as in other applied fields of science, is never read or used by the vast majority of decision-makers, working out in the "real world. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Santiago Omar Caballero Morales
Full Text Available Dysarthria is a motor speech disorder due to weakness or poor coordination of the speech muscles. This condition can be caused by a stroke, traumatic brain injury, or by a degenerative neurological disease. Commonly, people with this disorder also have muscular dystrophy, which restricts their use of switches or keyboards for communication or control of assistive devices (i.e., an electric wheelchair or a service robot. In this case, speech recognition is an attractive alternative for interaction and control of service robots, despite the difficulty of achieving robust recognition performance. In this paper we present a speech recognition system for human and service robot interaction for Mexican Spanish dysarthric speakers. The core of the system consisted of a Speaker Adaptive (SA recognition system trained with normal-speech. Features such as on-line control of the language model perplexity and the adding of vocabulary, contribute to high recognition performance. Others, such as assessment and text-to-speech (TTS synthesis, contribute to a more complete interaction with a service robot. Live tests were performed with two mild dysarthric speakers, achieving recognition accuracies of 90–95% for spontaneous speech and 95–100% of accomplished simulated service robot tasks.
van Leeuwen, F.C.|info:eu-repo/dai/nl/265778646
‘Women’s rights are human rights!’ This notion may seem self evident, as the international system for the promotion and the protection of human rights that was installed under the auspice of the United Nations (UN) builds on the idea of equality in dignity and rights of men and women. Yet, as was
Hughes, E F; Lewit, E M; Pauly, M V
The overall approach of SOSSUS to the study of surgical services, the interpretation of findings, and policy recommendations are rightly called into question. But singular concern with the consequences of monopolistic control by the profession is no substitute for analysis of the dynamics among demand, production, and supply of surgery. Any delivery system--and many models are feasible--involving consumers, providers, and payers is a market in which multidimensional behavior must be anticipated.
different based on deployment status and exposure to an austere environment where antimalarial agents with MRSA/MSSA activity are used. However, the...adequate hygiene practices. Further, these deployments are often to geo- graphic regions that require antimalarial chemoprophy- laxis. The use of...genes. Methods Participants Two populations of healthy active duty service members (101 non-deployed personnel in San Antonio, Texas, USA and 100
Station acceptance of the RTS work was completed in early November, 1984. The unit completed a successful integrated leak rate test, hot function test, and 200 hour warranty run in December, 1984 six weeks ahead of the CPUC mandate. Capital expenditures, although greater than the initial forecast, were two million dollars less than the 37.5 million dollar CPUC cap. The unit has run essentially trouble-free at current rated power until the current 1985 outage. Strategies and lessons learned that contributed to a successful RTS (e.g., all regulatory and economic constraints were met) included the use of numerous brainstorm sessions between SCE, Bechtel, and other consultants; innovative state of the art technical criterion (e.g., realistic versus overly conservative engineering); and budget and schedule contingencies consistent with the known and unknown risks
Zweifel, Peter; Tai-Seale, Ming
This article seeks to assess whether physician payment reforms in the United States and Switzerland were likely to attain their objectives. We first introduce basic contract theory, with the organizing principle being the degree of information asymmetry between the patient and the health care provider. Depending on the degree of information asymmetry, different forms of payment induce "appropriate" behavior. These theoretical results are then pitted against the RBRVS of the United States to find that a number of its aspects are not optimal. We then turn to Switzerland's Tarmed and find that it fails to conform with the prescriptions of economic contract theory as well. The article closes with a review of possible reforms that could do away with uniform fee schedules to improve the performance of the health care system.
Hsieh, Hwey-Lian; Lin, Hsing-Juh; Shih, Shang-Shu; Chen, Chang-Po
The present study examined a mangrove ecosystem in northern Taiwan to determine how the various components of ecosystem function, ecosystem services and human wellbeing are connected. The overall contributions of mangrove services to specific components of human wellbeing were also assessed. A network was developed and evaluated by an expert panel consisting of hydrologists, ecologists, and experts in the field of culture, landscape or architecture. The results showed that supporting habitats was the most important function to human wellbeing, while water quality, habitable climate, air quality, recreational opportunities, and knowledge systems were services that were strongly linked to human welfare. Security of continuous supply of services appeared to be the key to a comfortable life. From a bottom-up and top-down perspective, knowledge systems (a service) were most supported by ecosystem functions, while the security of continuous supply of services (wellbeing) had affected the most services. In addition, the overall benefits of mangrove services to human prosperity concentrated on mental health, security of continuous supply of services, and physical health.
Full Text Available The present study examined a mangrove ecosystem in northern Taiwan to determine how the various components of ecosystem function, ecosystem services and human wellbeing are connected. The overall contributions of mangrove services to specific components of human wellbeing were also assessed. A network was developed and evaluated by an expert panel consisting of hydrologists, ecologists, and experts in the field of culture, landscape or architecture. The results showed that supporting habitats was the most important function to human wellbeing, while water quality, habitable climate, air quality, recreational opportunities, and knowledge systems were services that were strongly linked to human welfare. Security of continuous supply of services appeared to be the key to a comfortable life. From a bottom-up and top-down perspective, knowledge systems (a service were most supported by ecosystem functions, while the security of continuous supply of services (wellbeing had affected the most services. In addition, the overall benefits of mangrove services to human prosperity concentrated on mental health, security of continuous supply of services, and physical health.
Héroux, Martin E; Brown, Harrison J; Inglis, J Timothy; Siegmund, Gunter P; Blouin, Jean-Sébastien
Human medial gastrocnemius (MG) motor units (MUs) are thought to occupy small muscle territories or regions, with low-threshold units preferentially located distally. We used intramuscular recordings to measure the territory of muscle fibres from MG MUs and determine whether these MUs are grouped by recruitment threshold or joint action (ankle plantar flexion and knee flexion). The territory of MUs from the MG muscle varied from somewhat localized to highly distributed, with approximately half the MUs spanning at least half the length and width of the muscle. There was also no evidence of regional muscle activity based on MU recruitment thresholds or joint action. The CNS does not have the means to selectively activate regions of the MG muscle based on task requirements. Human medial gastrocnemius (MG) motor units (MUs) are thought to occupy small muscle territories, with low-threshold units preferentially located distally. In this study, subjects (n = 8) performed ramped and sustained isometric contractions (ankle plantar flexion and knee flexion; range: ∼1-40% maximal voluntary contraction) and we measured MU territory size with spike-triggered averages from fine-wire electrodes inserted along the length (seven electrodes) or across the width (five electrodes) of the MG muscle. Of 69 MUs identified along the length of the muscle, 32 spanned at least half the muscle length (≥ 6.9 cm), 11 of which spanned all recording sites (13.6-17.9 cm). Distal fibres had smaller pennation angles (P recruitment threshold or contraction type, nor was there a relationship between MU territory size and recruitment threshold (Spearman's rho = -0.20 and 0.13, P > 0.18). MUs in the human MG have larger territories than previously reported and are not localized based on recruitment threshold or joint action. This indicates that the CNS does not have the means to selectively activate regions of the MG muscle based on task requirements. © 2015 The Authors. The Journal of
Hoath, Steven B; Leahy, D G
The concept that mammalian epidermis is structurally organized into functional epidermal units has been proposed on the basis of stratum corneum (SC) architecture, proliferation kinetics, melanocyte:keratinocyte ratios (1:36), and, more recently, Langerhans cell: epidermal cell ratios (1:53). This article examines the concept of functional epidermal units in human skin in which the maintenance of phi (1.618034) proportionality provides a central organizing principle. The following empirical measurements were used: 75,346 nucleated epidermal cells per mm2, 1394 Langerhans cells per mm2, 1999 melanocytes per mm2, 16 (SC) layers, 900-microm2 corneocyte surface area, 17,778 corneocytes per mm2, 14-d (SC) turnover time, and 93,124 per mm2 total epidermal cells. Given these empirical data: (1) the number of corneocytes is a mean proportional between the sum of the Langerhans cell + melanocyte populations and the number of epidermal cells, 3393/17,778-17,778/93,124; (2) the ratio of nucleated epidermal cells over corneocytes is phi proportional, 75,346/17,778 approximately phi3; (3) assuming similar 14-d turnover times for the (SC) and Malpighian epidermis, the number of corneocytes results from subtraction of a cellular fraction equal to approximately 2/phi2 x the number of living cells, 75,436 - (2/phi2 x 75,346) approximately 17,778; and (4) if total epidermal turnover time equals (SC) turnover time x the ratio of living/dead cells, then compartmental turnover times are unequal (14 d for (SC) to 45.3 d for nucleated epidermis approximately 1/2phi) and cellular replacement rates are 52.9 corneocytes/69.3 keratinocytes per mm2 per h approximately 2/phi2. These empirically derived equivalences provide logicomathematical support for the presence of functional epidermal units in human skin. Validation of a phi proportional unit architecture in human epidermis will be important for tissue engineering of skin and the design of instruments for skin measurement.
glass ceiling for advancement on the members of the lesser tribes. For that reason, Perry asserts that the Air Force has no choice but to change. 65...quarter century is clear: the Soviets in Afghanistan, the Israelis in Lebanon , the United States in Somalia, Afghanistan, and Iraq. Smaller, irregular...Air Force has used to justify procurement of addition numbers of fifth-generation F-22‘s above the final-buy ceiling (187 aircraft) established by
Coordinator(a) de Servicios Clinicos. Parte I (Unidad I-IV). Parte II (Unidad V-VI). Guia. Documento de Trabajo (Clinical Services Coordinator. Part I. Units I-IV. Part II. Units V-VI. Guide. Working Document).
Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.
This guide is intended for instructing secondary students in the occupation of clinical services coordinator in a hospital. The first part contains four units on the following subjects: the occupation of clinical services coordinator; interpersonal relationships; ethical/legal aspects; and communications (telephone, intercom, and others). For each…
Harker, Rachel; Pidgeon, Aileen M; Klaassen, Frances; King, Steven
Human service professionals are concerned with the intervention and empowerment of vulnerable social populations. The human service industry is laden with employment-related stressors and emotionally demanding interactions, which can lead to deleterious effects, such as burnout and secondary traumatic stress. Little attention has been given to developing knowledge of what might enable human service workers to persist and thrive. Cultivating and sustaining resilience can buffer the impact of occupational stressors on human service professionals. One of the psychological factors associated with cultivating resilience is mindfulness. The aim of this current research is to improve our understanding of the relationship between resilience, mindfulness, burnout, secondary traumatic stress, and psychological distress among human service professionals. The current study surveyed 133 human service professionals working in the fields of psychology, social work, counseling, youth and foster care work to explore the predictive relationship between resilience, mindfulness, and psychological distress. The results showed that higher levels of resilience were a significant predictor of lower levels of psychological distress, burnout and secondary traumatic stress. In addition, higher levels of mindfulness were a significant predictor of lower levels of psychological distress and burnout. The findings suggest that cultivating resilience and mindfulness in human service professionals may assist in preventing psychological distress burnout and secondary traumatic stress. Limitations of this study are discussed together with implications for future research.
Wershow, H J
The European social democracies have been more generous than the United States in social provision, including services to aged. The momentum of provision has slowed down in recent years. We suggest that prosperity which has led to use of foreign laborers in menial jobs has caused this slow down. The dynamics are similar to the historical U.S. use of "non-100% Americans" as our menial workers. Changes in social policy strategies are needed: 1) universal provision, rather than programs aimed at minorities, is needed to enlist support of stable working and middle classes; 2) tax reforms, which lower progressive income-tax structures for middle incomes, and value-added tax, may be necessary to overcome anti-tax ideologies; 3) clear priorities as to most necessary services must be established by the gerontological community.
Vermeulen, Emma Emmerenza
Main aim: To supply recommendations to implement a Hazard Analysis of Critical Control Points (HACCP) system in a hospital food service unit serving low bacterial diets in order to prevent or decrease the infection rates in Hematopoietic Stem Cell Transplant (HSCT) patients. Objectives: Firstly, to investigate the current food safety and hygiene status in a hospital food service unit, serving low bacterial diets, by means of a questionnaire and bacterial swabs taken from the...
The advantages of usage of cloud technologies, particularly, of Gmail service Google Apps in work of organizational-educational units of higher educational institutions are analyzed in this work. The main accents are put concerning usage of corporate e-mail Gmail service Google Apps, with the help of which informational-analytical support of activity of organizational-educational units of the University is provided. The author of the publication underlines key advantages of Gmail and analyses...
Nakanishi, N; Tatara, K
Britain's National Health Service (NHS) came into existence in 1948. It was the first comprehensive health system in any Western society to be based on the national provision of services and to offer free medical care to the entire population. The NHS has gone through several developments since, in particular the reorganisations of 1974 and 1982 and the general management overhaul of 1984. Until 1991, however, the NHS kept to the following principles: health service for everyone; sharing of financial costs and free at the point of use; geographical equality; the same high standard of care for everyone; selection on the basis of need for health care; and encouragement of a non-exploitative ethos. Britain's achievement with respect to health care has generally received high praise. Nevertheless, Mrs. Thatcher's government was convinced that the NHS contained a number of serious weakness. This view sprang from the government's belief that, because the NHS did not have a competitive market structure, it lacked an incentive for efficient behaviour. The reforms that were introduced in 1991 were designed to overcome these perceived flaws by creating a limited or internal market in health care, in which multiple providers of services compete with each other for the custom of independent purchasers. Competitive pressures now focus greater attention on patient needs, and the separation of purchasing functions has placed resource allocation under greater scrutiny. Making hospitals financially dependent on general practitioner (GP) referrals has resulted in consultants establishing closer contact with GPs. More is being done in GP surgeries and this has the effect not only of widening the range of general practice but also of raising GP standards. However, there are also some internal problems. Administrative costs have increased steeply, and new inequalities are developing as a consequence of competition. To reduce management costs and to allocate as much of the NHS budget as
17 B. LABOR ECONOMICS .................................................................................17...statistical software, STATA. Dr. Elda Pema from the Naval Postgraduate School provided me with an excellent foundation in Labor Economics , Econometrics...underpinnings of the subject. Labor economics serves as the fundamental basis, thus an overview of the applicable economic theories is conducted. Human
Full Text Available The advantages of usage of cloud technologies, particularly, of Gmail service Google Apps in work of organizational-educational units of higher educational institutions are analyzed in this work. The main accents are put concerning usage of corporate e-mail Gmail service Google Apps, with the help of which informational-analytical support of activity of organizational-educational units of the University is provided. The author of the publication underlines key advantages of Gmail and analyses its opportunities. Main characteristics of corporate e-mail Gmail service Google Apps are described. It is identified that implementation of corporate e-mail Gmail service Google Apps is a part of creation of certain information system, that will ensure united information space of a modern higher educational institution. Effective organization of educational process, that was used by methodist of organizational-educational units (Scientific-methodological centre of research, scientific projects and programs of Borys Grinchenko Kyiv University in the work of corporate mail Gmail service Google Aps is analyzed and presented. It is identified, that creation and improvement of mechanisms of building corporate content with the help of Gmail service Google Apps will allow the collaborators of organizational-educational units of the higher educational institution to plan and organize educational process. Such organization of educational process optimizes the activity of organizational-educational units of higher educational institutions.
Elmekkawi, Amir; O'Connor, Deborah L; Stone, Debbie; Yoon, Eugene W; Larocque, Michael; McGeer, Allison; Unger, Sharon
Unpasteurized human donor milk typically contains a variety of bacteria. The impact of neonatal intensive care unit (NICU) admission of the donor's infant and duration of lactation on bacterial contamination of human milk is unknown. Research aim: This study aimed (a) to describe the frequency/concentration of skin commensal bacteria and pathogens in unpasteurized human donor milk and (b) to assess the impact of NICU admission and (c) the duration of milk expression on bacterial colonization of donated milk. The authors conducted a retrospective cohort study of human milk donated to the Rogers Hixon Ontario Human Milk Bank from January 2013 to June 2014. Milk samples from each donor were cultured every 2 weeks. The study included 198 donor mothers, of whom 63 had infants admitted to the NICU. Of 1,289 cultures obtained, 1,031 (80%) had detectable bacterial growth and 363 (28%) yielded bacterial growth in excess of 10 7 cfu/L, a local threshold for allowable bacteria prior to pasteurization. The mean (standard deviation) donation period per donor was 13.0 (7.5) weeks. Milk from mothers with NICU exposure had significantly higher concentrations of commensals, but not pathogens, at every time period compared with other mothers. For every 1-month increase in donation from all donors, the odds ratio of presence of any commensal in milk increased by 1.13 (95% confidence interval [1.03, 1.23]) and any pathogen by 1.31 (95% confidence interval [1.20, 1.43]). Commensal bacteria were more abundant in donor milk expressed from mothers exposed to neonatal intensive care. Bacterial contamination increased over the milk donation period.
Grimm, Nancy B.; Groffman, Peter M; Staudinger, Michelle D.; Tallis, Heather
The third United States National Climate Assessment emphasized an evaluation of not just the impacts of climate change on species and ecosystems, but also the impacts of climate change on the benefits that people derive from nature, known as ecosystem services. The ecosystems, biodiversity, and ecosystem services component of the assessment largely drew upon the findings of a transdisciplinary workshop aimed at developing technical input for the assessment, involving participants from diverse sectors. A small author team distilled and synthesized this and hundreds of other technical input to develop the key findings of the assessment. The process of developing and ranking key findings hinged on identifying impacts that had particular, demonstrable effects on the U.S. public via changes in national ecosystem services. Findings showed that ecosystem services are threatened by the impacts of climate change on water supplies, species distributions and phenology, as well as multiple assaults on ecosystem integrity that, when compounded by climate change, reduce the capacity of ecosystems to buffer against extreme events. As ecosystems change, such benefits as water sustainability and protection from storms that are afforded by intact ecosystems are projected to decline across the continent due to climate change. An ongoing, sustained assessment that focuses on the co-production of actionable climate science will allow scientists from a range of disciplines to ascertain the capability of their forecasting models to project environmental and ecological change and link it to ecosystem services; additionally, an iterative process of evaluation, development of management strategies, monitoring, and reevaluation will increase the applicability and usability of the science by the U.S. public.
Shapiro, Aurelie C.; Bhagabati, Nirmal
Mapping and evaluating ecosystem services is of increasing concern and urgency for conservation organizations such as WWF. Coupling biodiversity assessments with ecosystem services e.g., carbon sequestration, water regulation, sediment reduction, is an effective way to visualize additional financial and human benefits of conservation for decision makers. WWF is eager to apply various Earth Observation data to conservation applications for consistent mapping and monitoring of natural ecosystems and the potential impacts of their loss on humans and wildlife alike. Such examples include forest carbon mapping, integrated evaluation of ecosystem services (via the InVEST tool) and bundling endangered Tiger habitat with various ecosystem services for bundled benefits.
Nahal, Ayoub; Batac, Crystal Mildred O; Slaw, Renee J; Bauer, Thomas W
- The production of whole slide images is the most advanced form of digital pathology, in which a high-resolution digital scanner is used to rapidly scan glass microscope slides and produce a computer-generated whole slide image that can be saved, stored in a network-attached storage device, and accessed through slide management software within the hospital domain and remotely by authorized users. Digital transformation of glass slides has revolutionized the practice of anatomic pathology by facilitating and expediting consultative services, improving clinical workflow, and becoming an indispensable tool in education and research. - To highlight the institutional need of Cleveland Clinic Abu Dhabi (Abu Dhabi, United Arab Emirates) and the cultural background for obtaining the United Arab Emirates' first comprehensive digital pathology program; to describe a multiphase road map for achieving full implementation of this platform; and to describe the system's clinical applications and its future potential growth. - At Cleveland Clinic Abu Dhabi, we prioritized our efforts to initiate digital consultations (eConsultations) and digital immunohistochemistry services (eIHC) with Cleveland Clinic Laboratories (Cleveland, Ohio). After this, we established an internal archiving system together with a subspecialty-based, organ-specific digital library of pathologic diseases. - We describe the strategic adoption and implementation of digital pathology into the clinical workflow of the pathology and laboratory medicine institute of Cleveland Clinic Abu Dhabi, and we highlight its impact on clinical operations, educational activities, and patient care.
Christopher E. McCoy
Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.
This study investigates the so-called "thematic approach" as a method available to the United Nations Commission on Human Rights to take cognizance of and to react upon violations of human rights worldwide. To this end, three different thematic procedures, the Working Group on Enforced or
In this article the influence of the European Court of Human Rights’ case-law on the United Nations Human Rights Committee will be analysed. This particular choice of supervisory bodies enables us to trace such potential influence adequately since both the Court and the Committee supervise treaties
records, therefoa- e , written authorization from the veta -an or ne.’Ct of kin is not rEqUired. However, in ordet" to protect the privacy of the...line E -mail: MPR.email@example.com Older military personnel records (generally prior to World War I, depending on the service branch) are located at...AFB, DC 20032-5000 E -mail: firstname.lastname@example.org http://www.afhso.af.mil/ (202) 404-2264 National Museum of the U.S. Air Force 1100
Review of the human resources needed for development of the activity in a service hospital radio physics; Revision de los medios humanos necesarios para el desarrollo de la actividad en un servicio de radiofisica hospitalaria
Almansa, J. F.; Burgos, D. E.; Guerrero, R.
The age of the recommendations on minimum human and material resources of the SEFM, along with the emergence of new imaging techniques and new equipment, plus analysis of recent international publications relating to the subject and the establishment of relative value units in several Spanish regions, justify a revision of the minimum necessary human resources to carry out the tasks of Radio physics service with adequate safety and quality.
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
Full Text Available As many said, industry 4.0 is an epoch-making revolution which brought the manufacturing market much faster changes and severer competitions. As an important part of the manufacturing system, facility layout has direct impact on business benefit; at the same time, despite the intelligent factory, intelligent production has its own characteristics. However, there is one point on which industry and academia have basically formed a consensus: it is not true that industry 4.0 does not need human beings; on the contrary, human initiative plays an unabated role in the development of industry 4.0. This paper will focus on the dynamic facility layout of the manufacturing unit. Based on the system above and the traditional optimization model, a mathematic model is built to find the best solution combining safety, sustainability, high efficiency, and low cost. And penalty function with adaptive penalty factor and advanced artificial bee colony algorithm is used to solve the constrained model. In the end, by studying few cases, the model is proved to be effective in both efficiency improvement and the implementation of safe and comfort human-machine interaction.
Alonso, Lou, Comp.
Listed in the directory are over 200 educational programs and services for deaf blind children in the United States and U. S. territories. It is noted that the 10 coordinators of regional centers for services to deaf blind children have aided in compilation of the directory. Listings are arranged by state within the New England, Mid-Atlantic…
David N. Wear; Robert Huggett; Ruhong Li; Benjamin Perryman; Shan Liu
The 626 million acres of forests in the conterminous United States represent significant reserves of biodiversity and terrestrial carbon and provide substantial flows of highly valued ecosystem services, including timber products, watershed protection benefits, and recreation. This report describes forecasts of forest conditions for the conterminous United States in...
Geneva Area City Schools, OH.
Five curriculum units for the second grade level focus on: (1) clothing producers and suppliers, and the clothing industry; (2) postal service workers and the postal system; (3) janitorial workers; (4) workers who build, furnish, and maintain homes and the housing industry; and (5) various community workers. Behavioral unit objectives emphasize…
Jones, Daniel O.
Fluid service and/or electrical conductivity for a fuel cell assembly is promoted. Open-faced flow channel(s) are formed in a flow field plate face, and extend in the flow field plate face between entry and exit fluid manifolds. A resilient gas diffusion layer is located between the flow field plate face and a membrane electrode assembly, fluidly serviced with the open-faced flow channel(s). The resilient gas diffusion layer is restrained against entering the open-faced flow channel(s) under a compressive force applied to the fuel cell assembly. In particular, a first side of a support member abuts the flow field plate face, and a second side of the support member abuts the resilient gas diffusion layer. The support member is formed with a plurality of openings extending between the first and second sides of the support member. In addition, a clamping pressure is maintained for an interface between the resilient gas diffusion layer and a portion of the membrane electrode assembly. Preferably, the support member is spikeless and/or substantially flat. Further, the support member is formed with an electrical path for conducting current between the resilient gas diffusion layer and position(s) on the flow field plate face.
Full Text Available Since the introduction of iPhone in 2007, many location-based services (LBSs have been created and new LBSs are found every day. This research proposes yet another LBS, which is practical and was not found before to the best of authors' knowledge. The problem is described as follows. It happens all the times while several groups of people are traveling towards a destination, they lose contact from each other on the way. This research tries to have the groups travel as closely as possible until they reach the destination. It uses a method of minimum covering ellipses to find whether the groups are separated by more than a threshold/distance. If they are, the system will find a convenient rendezvous for all groups by using a method of geometric median. After meeting at the rendezvous, the groups reset the service and continue their journey. By using this LBS, travelers do not need to worry about losing connections with others. This method can also be applied to the problem of finding a convenient meeting place for mobile users.
Dal’Asta, Ana Paula; Brigatti, Newton; Amaral, Silvana; Escada, Maria Isabel Sobral; Monteiro, Antonio Miguel Vieira
Every spatial unit of human occupation is part of a network structuring an extensive process of urbanization in the Amazon territory. Multi-resolution remote sensing data were used to identify and map human presence and activities in the Sustainable Forest District of Cuiabá-Santarém highway (BR-163), west of Pará, Brazil. The limits of spatial units of human occupation were mapped based on digital classification of Landsat-TM5 (Thematic Mapper 5) image (30m spatial resolution). High-spatial-...
Jonny; Nasution, Januar
Value stream mapping is a tool which is needed to let the business leader of XYZ Hospital to see what is actually happening in its business process that have caused longer lead time for self-produced medicines in its pharmacy unit. This problem has triggered many complaints filed by patients. After deploying this tool, the team has come up with the fact that in processing the medicine, pharmacy unit does not have any storage and capsule packing tool and this condition has caused many wasting times in its process. Therefore, the team has proposed to the business leader to procure the required tools in order to shorten its process. This research has resulted in shortened lead time from 45 minutes to 30 minutes as required by the government through Indonesian health ministry with increased %VA (valued added activity) or Process Cycle Efficiency (PCE) from 66% to 68% (considered lean because it is upper than required 30%). This result has proved that the process effectiveness has been increase by the improvement.
Jonny; Nasution, Januar
Value stream mapping is a tool which is needed to let the business leader of XYZ Hospital to see what is actually happening in its business process that have caused longer lead time for self-produced medicines in its pharmacy unit. This problem has triggered many complaints filed by patients. After deploying this tool, the team has come up with the fact that in processing the medicine, pharmacy unit does not have any storage and capsule packing tool and this condition has caused many wasting times in its process. Therefore, the team has proposed to the business leader to procure the required tools in order to shorten its process. This research has resulted in shortened lead time from 45 minutes to 30 minutes as required by the government through Indonesian health ministry with increased %VA (valued added activity) or Process Cycle Efficiency (PCE) from 66% to 68% (considered lean because it is upper than required 30%). This result has proved that the process effectiveness has been increase by the improvement.
Rafael Silva Marconato
Full Text Available ABSTRACT Objective: to check the association of the proposed priorities of the institutional protocol of risk classification with the outcomes and evaluate the profile of the care provided in an emergency unit. Method: observational epidemiological study based on data from the computerized files of a Reference Emergency Unit. Care provided to adults was evaluated regarding risk classification and outcomes (death, hospitalization and hospital discharge based on the information recorded in the emergency bulletin. Results: the mean age of the 97,099 registered patients was 43.4 years; 81.5% cases were spontaneous demand; 41.2% had been classified as green, 15.3% yellow, 3.7% blue, 3% red and 36.and 9% had not received a classification; 90.2% of the patients had been discharged, 9.4% hospitalized and 0.4% had died. Among patients who were discharged, 14.7% had been classified as yellow or red, 13.6% green or blue, and 1.8% as blue or green. Conclusion: the protocol of risk classification showed good sensitivity to predict serious situations that can progress to death or hospitalization.
Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto
Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.
Eklund, Carina; Forslund, Ola; Wallin, Keng-Ling; Dillner, Joakim
Accurate and internationally comparable human papillomavirus (HPV) DNA detection and typing services are essential for HPV vaccine research and surveillance. This study assessed the proficiency of different HPV typing services offered routinely in laboratories worldwide. The HPV Laboratory Network (LabNet) has designed international proficiency panels that can be regularly issued. The HPV genotyping proficiency panels of 2013 and 2014 contained 43 and 41 coded samples, respectively, composed of purified plasmids of sixteen HPV types (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68a and 68b) and 3 extraction controls. Proficient typing was defined as detection in both single and multiple infections of 50 International Units of HPV 16 and HPV 18 and 500 genome equivalents for the other 14 HPV types, with at least 97% specificity. Ninety-six laboratories submitted 136 datasets in 2013 and 121 laboratories submitted 148 datasets in 2014. Thirty-four different HPV genotyping assays were used, notably Linear Array, HPV Direct Flow-chip, GenoFlow HPV array, Anyplex HPV 28, Inno-LiPa, and PGMY-CHUV assays. A trend towards increased sensitivity and specificity was observed. In 2013, 59 data sets (44%) were 100% proficient compared to 86 data sets (59%) in 2014. This is a definite improvement compared to the first proficiency panel, issued in 2008, when only 19 data sets (26%) were fully proficient. The regularly issued global proficiency program has documented an ongoing worldwide improvement in comparability and reliability of HPV genotyping services. Copyright © 2018 Elsevier B.V. All rights reserved.
Peterson, L.R.; Lappa, D.A.; Moore, J.W.
A human factors engineering preliminary design review of the Saint Lucie Unit 2 control room was performed at the site on August 3 through August 7, 1981. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. This report was prepared on the basis of the HFEB's review of the applicant's Preliminary Design Assessment and the human factors engineering design review/audit performed at the site. The review team included human factors consultants from BioTechnology, Inc., Falls Church, Virginia, and from Lawrence Livermore National Laboratory (University of California), Livermore, California
Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances
In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011
Tschampl, Cynthia A; Garnick, Deborah W; Zuroweste, Edward; Razavi, Moaven; Shepard, Donald S
A major problem resulting from interrupted tuberculosis (TB) treatment is the development of drug-resistant TB, including multidrug-resistant TB (MDR TB), a more deadly and costly-to-treat form of the disease. Global health systems are not equipped to diagnose and treat the current burden of MDR TB. TB-infected foreign visitors and temporary US residents who leave the country during treatment can experience treatment interruption and, thus, are at greater risk for drug-resistant TB. Using epidemiologic and demographic data, we estimated TB incidence among this group, as well as the proportion of patients referred to transnational care-continuity and management services during relocation; each year, ≈2,827 visitors and temporary residents are at risk for TB treatment interruption, 222 (8%) of whom are referred for transnational services. Scale up of transnational services for persons at high risk for treatment interruption is possible and encouraged because of potential health gains and reductions in healthcare costs for the United States and receiving countries.
This EnviroAtlas dataset contains biodiversity metrics reflecting ecosystem services or other aspects of biodiversity for reptile species, based on the number of reptile species as measured by predicted habitat present within a pixel. These metrics were created from grouping national level single species habitat models created by the USGS Gap Analysis Program into smaller ecologically based, phylogeny based, or stakeholder suggested composites. The dataset includes reptile species richness metrics for all reptile species, lizards, snakes, turtles, poisonous reptiles, Natureserve-listed G1,G2, and G3 reptile species, and reptile species listed by IUCN (International Union for Conservation of Nature), PARC (Partners in Amphibian and Reptile Conservation) and SWPARC (Southwest Partners in Amphibian and Reptile Conservation). This dataset was produced by a joint effort of New Mexico State University, US EPA, and USGS 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
Within the United Kingdom, the nuclear power generation programme is supported by nuclear fuel services including uranium enrichment, fuel fabrication and reprocessing, operated by British Nuclear Fuels Limited (BNFL). These have entailed the processing of large quantities of uranium and of plutonium and fission products arising in the course of irradiation of fuel in nuclear power stations and have necessitated substantial programmes for the radiological protection of the public and of the workers employed in the industry. This paper presents and reviews the statistics of doses recorded in the various sectors of nuclear fuel services operations against the background of the standards to which the industry is required to operate. A description is given of the development of BNFL policy in keeping with the objective of being recognized as among those industries regarded as safe and the resource implications of measures to reduce doses received by workers are reviewed in the light of experience. Finally, the paper reviews the epidemiological data which have been, and continue to be, collected for workers who have been employed in these nuclear fuel services. (author)
Thomas W. Pavkov
Full Text Available The Family Access Project will deploy innovative community empowerment, education, consensus building, and information system development strategies to strengthen community, ensure the efficient and effective delivery of needed services, and address the unique needs of families requiring public assistance from a host of public and private agencies in Lake County. The goal of the project is to enhance community life through improved care coordination by linking new technologies to the human service delivery process. Upon completion, the project will assist in the enhancement of community-based services through the development of rules of data transaction and data standards and the deploy-ment of a secure messaging/document exchange network. By putting technology in the hands of consumers we also hope to impact the economic development and workforce readiness goals set forth in our community's welfare to work programs. These innovations will require educational innovations in order to facilitate the use of technology by both provider and consumer end-users. Proposed innovations include tutorials related to data standards development, peer train-the-trainer training in the development and use of technology to support service system reforms; and ongoing support through a technical assistance clearinghouse and help desk.
Connor, A; Lillywhite, R; Cooke, M W
Anthropogenic climate change presents a major global health threat. However, the very provision of healthcare itself is associated with a significant environmental impact. Carbon footprinting techniques are increasingly used outside of the healthcare sector to assess greenhouse gas emissions and inform strategies to reduce them. This study represents the first assessment of the carbon footprint of an individual specialty service to include both direct and indirect emissions. This was a component analysis study. Activity data were collected for building energy use, travel and procurement. Established emissions factors were applied to reconcile this data to carbon dioxide equivalents (CO(2)eq) per year. The Dorset Renal Service has a carbon footprint of 3006 tonnes CO(2)eq per annum, of which 381 tonnes CO(2)eq (13% of overall emissions) result from building energy use, 462 tonnes CO(2)eq from travel (15%) and 2163 tonnes CO(2)eq (72%) from procurement. The contributions of the major subsectors within procurement are: pharmaceuticals, 1043 tonnes CO(2)eq (35% of overall emissions); medical equipment, 753 tonnes CO(2)eq (25%). The emissions associated with healthcare episodes were estimated at 161 kg CO(2)eq per bed day for an inpatient admission and 22 kg CO(2)eq for an outpatient appointment. These results suggest that carbon-reduction strategies focusing upon supply chain emissions are likely to yield the greatest benefits. Sustainable waste management and strategies to reduce emissions associated with building energy use and travel will also be important. A transformation in the way that clinical care is delivered is required, such that lower carbon clinical pathways, treatments and technologies are embraced. The estimations of greenhouse gas emissions associated with outpatient appointments and inpatient stays calculated here may facilitate modelling of the emissions of alternative pathways of care.
Simona Cristina Martin
Full Text Available The indicators of demand distribution for various types of accommodation provide information regarding changing tourist preferences for different ways of tourist accommodation. Appreciation of economic efficiency for hotels activity is done through quantitative results obtained in accommodation units. For this purpose it uses, currently, a partial or synthetic indicators system. Taking into account the fact that, in appreciation of hotel business, it must start from the premise that it may not be fully reflected only in terms of economic results, but also through social results, appear obvious the need to maintain costs at a level that satisfies both requirements at the same time. Achieving superior social-financial indicators, remains one of the main goals also in hotel activities, but do not be overlooked the fact that it is necessary that these indicators must be obtained by ensuring a higher level of satisfaction of consumers requirements. Only simultaneous achievement of these two objectives can provide raising efficiency in accommodation sector.
Edwards, R G
Numerous biomedical scientists have contributed to the wide knowledge on the growth of preimplantation human embryos in vitro, now improving every aspect of the form of clinical care. These data were gained ethically in many countries, to open new vistas including the alleviation of infertility, preimplantation genetic diagnosis and stem cells, combined with some recent reports on human reproductive cloning. After detailed consultations with scientists, clinicians, ethicists and lawyers, many governments passed legislation permitting research under their own particular socially-defined conditions. Virtually all of them rejected reproductive cloning; a few have accepted therapeutic cloning. These legislatures saluted the many biomedical scientists striving to improve IVF and its derivatives, recognizing their immense medical potential. A motion recently placed before the United Nations then recommended a worldwide ban on all forms of human cloning. Proponents included the Vatican and many Roman Catholic countries, the USA and others. Opponents included Belgium, China, Japan, Brazil, UK, Germany and France. Mediation was achieved by Iran and other Muslim nations, and led to a motion passed by single vote for a two-year delay. This may be the first-ever proposal to ban worldwide a particular form of research. It sounds the alarm bells for further research. It raises questions about the UN being an appropriate forum for ethical decisions affecting the entire world and its future medicine. Large blocs of nations committed to particular religions and outlooks confronted each other, a situation in total contrast to the detailed and widespread consultations made by individual governments when deciding their own individual ethics. This event was clearly a narrow escape for free research as defined by each country's own jurisprudence. It also places research on human embryology and reproductive biomedicine into a more critical situation than before. Current liberalism in
Led by the agency director, the agency engaged in a Strategic Review, based on a comprehensive assessment of agency performance that identified strategies to improve organizational effectiveness through increased data-informed practice and knowledge management. The Strategic Review gathered information on staff perceptions, perceptions of external stakeholders, changing citywide and neighborhood demographics, policy mandates, and budget and workload issues. The need for the review was based upon multiple, substantial changes not addressed in the 2000 Strategic Plan, including the 2004 merger of the Department of Human Services and the Department of Aging and Adult Services, changes among the executive management team, transitions among key political entities, new policy mandates and changing budget allocations. This case study describes the Strategic Review process and content, summarizing key challenges and lessons related to addressing workload demands, fostering positive staff attitudes, balancing internal and external information needs, and integrating data use and planning processes across the agency. Copyright © Taylor & Francis Group, LLC
... agencies and Industry in the broad areas of biotechnology and analytical chemistry. DATES: The agreement... Pharmaceutical Science, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New...
Hutchings Hayley A
Full Text Available Abstract Background The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. Methods This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely collected by the unit – Referral numbers, Activity, Number of patients waiting and Number of lost slots. Nine of the endoscopy units had previously participated in the Modernising Endoscopy Services (MES project during 2003 to redesign their endoscopy services. These MES sites had access to additional funding and data collection software. The other ten (Control sites had modernised independently. All data was requested in two phases and corresponded to eight specific time points between January 2003 and April 2006. Results Only eight of 19 endoscopy units submitted routinely collected, service-related data. Another site's data was collected specifically for the study. A further two units claimed to routinely collect service-related data but did not submit any to the study. The remaining eight did not collect any service-related endoscopy data routinely and liaised with their Trust for data. Of the eight sites submitting service-related data, only three were MES project sites. Of these three, the data variables collected were limited and none collected the complete set of endoscopy data variables requested. Of the other five sites, two collected all four endoscopy data types. Data for the three MES project sites went back as far as January 2003, whilst the five Control sites were only able to submit data from December 2003 onwards. Conclusion There was a lack of service-related endoscopy data routinely collected by the study sites, especially those who had participated in the MES project. Without this data, NHS endoscopy services cannot have a true understanding of their services, cannot identify problems and cannot measure the impact of any
Z. Zenn Bien
Full Text Available The smart house under consideration is a service-integrated complex system to assist older persons and/or people with disabilities. The primary goal of the system is to achieve independent living by various robotic devices and systems. Such a system is treated as a human-in-the loop system in which human- robot interaction takes place intensely and frequently. Based on our experiences of having designed and implemented a smart house environment, called Intelligent Sweet Home (ISH, we present a framework of realizing human-friendly HRI (human-robot interaction module with various effective techniques of computational intelligence. More specifically, we partition the robotic tasks of HRI module into three groups in consideration of the level of specificity, fuzziness or uncertainty of the context of the system, and present effective interaction method for each case. We first show a task planning algorithm and its architecture to deal with well-structured tasks autonomously by a simplified set of commands of the user instead of inconvenient manual operations. To provide with capability of interacting in a human-friendly way in a fuzzy context, it is proposed that the robot should make use of human bio-signals as input of the HRI module as shown in a hand gesture recognition system, called a soft remote control system. Finally we discuss a probabilistic fuzzy rule-based life-long learning system, equipped with intention reading capability by learning human behavioral patterns, which is introduced as a solution in uncertain and time-varying situations.