WorldWideScience

Sample records for improved service life

  1. How Do Mobile Information Services Improve Quality of Life? The Case of Japanese Students

    OpenAIRE

    Ghyas, Qazi Mahdia; Kondo, Fumiyo N.

    2016-01-01

    Every technology should be geared to improve the quality of users’ lives. Our study aims to understand how mobile information services (MIS) contribute to quality of life (QoL) for young mobile users. This paper attempts to provide a comprehensive analysis of relationship between two variables: the contribution of MIS in 15 specific life domains and the contribution of MIS to overall quality of life (QoL). We examined bottom-up spillover theory with original and our additional life domains. E...

  2. Interdependence of life insurance service quality and premium

    Directory of Open Access Journals (Sweden)

    Dragan Benazić

    2006-12-01

    Full Text Available Insurance companies in Croatia feel the need to find new sources of competitive advantage on the Croatian life insurance market amid increasing competition and a poorly profiled offer of life insurance services. Lately, both marketing literature and practice seem to point to the shaping of a relationship between service quality and price as a possible solution to improving the position of insurance companies on the Croatian market. In providing life insurance services, the insurance companies should focus on the quality elements that offer certain benefits a client is willing to pay for. Changes in individual quality features have been evaluated differently by clients. Such differences in their evaluation of changes in the individual elements of service quality also reflect the willingness of clients to pay a suitable increase on their insurance premium. Improvements in the service quality features that are subjectively evaluated as important should lead to the client’s acceptance of a higher life insurance premium. The paper considers the interdependence between the quality of life insurance services and the premium from the aspect of the client’s willingness to pay a higher life insurance premium for a higher service quality.

  3. Fee-for-service cancer rehabilitation programs improve health-related quality of life.

    Science.gov (United States)

    Kirkham, A A; Neil-Sztramko, S E; Morgan, J; Hodson, S; Weller, S; McRae, T; Campbell, K L

    2016-08-01

    Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  5. Reinforcement Corrosion: Numerical Simulation and Service Life Prediction

    DEFF Research Database (Denmark)

    Michel, Alexander

    defects and b) define the end of service life once reinforcement corrosion is initiated neglecting corrosion processes during the propagation stage. The goal of this work was to develop a framework for the service life prediction of reinforced concrete covering initiation and propagation of chloride......Modelling of deterioration processes in concrete structures plays an increasing role in the design of reinforced concrete structures. Large sums are spent every year to ensure the durability of concrete structures, especially towards reinforcement corrosion. Improved durability provides increased...... structural reliability, economical improvements in form of less need for maintenance and repair as well as increased sustainability due to an increased energy and resource efficiency. Several service life prediction models dealing with reinforcement corrosion in concrete structurescan be found...

  6. NPP service life management

    International Nuclear Information System (INIS)

    Elagin, Yu.P.

    2001-01-01

    Problems of NPP service life management and service life prolongation are reviewed. Methods for the prolongation of the French NPP service life are discussed, priority directions of nuclear block service life management in regard to aging in the context of the European program of investigation into the materials aging are identified. Questions of the provision of the 60 years service life of the Mihama 1 block (Japan) and decision of the problem of the control equipment aging in Great Britain are discussed. Situation with the prolongation of licenses on the NPP operation in the USA and Spain is considered [ru

  7. In-Service Aircraft Transmission Life Modeling for Improved Flight Safety, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — It is proposed to develop an accurate, in-service transmission life-estimation system for the prediction of remaining component and system life for a helicopter...

  8. In-Service Aircraft Transmission Life Modeling for Improved Flight Safety, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — It is proposed to develop an accurate, in-service transmission life-use estimation system for the prediction of remaining component and system life for a helicopter...

  9. Identifying profiles of service users in housing services and exploring their quality of life and care needs.

    Science.gov (United States)

    Bitter, Neis A; Roeg, Diana P K; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

    2016-11-23

    Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be

  10. 9. Nuclear power plant service life prolongation

    International Nuclear Information System (INIS)

    Evropin, S.V.

    1998-01-01

    The problem of prolongation of nuclear power plant service life duration is discussed. A schematic diagram of the program developed in the course of activities dealing with NPP service time prolongation is shown and analyzed in details. It is shown that the basic moment when determining the strategy for NPP service time prolongation is the positive confirmation of the agreement between the NPP safety provisions and modern safety requirements. The other very important aspect of the problem is engineering substantiation of the measures assuring the reactor operation prolongation. The conclusion is made that available methods of recovering reactor materials properties, main components repair and replacement, the modern techniques for nondestructive testing of metals and NPP pipelines, as well as the developed approaches to reactor facility safety improvements make the prolongation of the Russian NPP service lifetimes possible from engineering viewpoint and economically desirable

  11. Using digital tech to improve life for refugees | IDRC - International ...

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

    2016-12-20

    Dec 20, 2016 ... Using digital tech to improve life for refugees ... and netbooks - can help to close the access and quality-of-service gaps for Palestinians ... individuals to enjoy more accessible and better quality health care on a continuous basis. ... health challenges by bringing life-saving information to those most in need.

  12. Solid Propulsion Systems, Subsystems, and Components Service Life Extension

    Science.gov (United States)

    Hundley, Nedra H.; Jones, Connor

    2011-01-01

    The service life extension of solid propulsion systems, subsystems, and components will be discussed based on the service life extension of the Space Transportation System Reusable Solid Rocket Motor (RSRM) and Booster Separation Motors (BSM). The RSRM is certified for an age life of five years. In the aftermath of the Columbia accident there were a number of motors that were approaching the end of their five year service life certification. The RSRM Project initiated an assessment to determine if the service life of these motors could be extended. With the advent of the Constellation Program, a flight test was proposed that would utilize one of the RSRMs which had been returned from the launch site due to the expiration of its five year service life certification and twelve surplus Chemical Systems Division BSMs which had exceeded their eight year service life. The RSRM age life tracking philosophy which establishes when the clock starts for age life tracking will be described. The role of the following activities in service life extension will be discussed: subscale testing, accelerated aging, dissecting full scale aged hardware, static testing full scale aged motors, data mining industry data, and using the fleet leader approach. The service life certification and extension of the BSMs will also be presented.

  13. Innovative predictive maintenance concepts to improve life cycle management

    NARCIS (Netherlands)

    Tinga, Tiedo

    2014-01-01

    For naval systems with typically long service lives, high sustainment costs and strict availability requirements, an effective and efficient life cycle management process is very important. In this paper four approaches are discussed to improve that process: physics of failure based predictive

  14. Indicators for functional service life of building structures

    NARCIS (Netherlands)

    Blok, R.; Teuffel, P.

    2014-01-01

    The Estimated Service Life, ESL, is of a major influence in many building assessments. The comparison and optimization of design alternatives depend on the accuracy of this ESL. More and more the Functional Service Life rather than the Technical Service Life is decisive in how long a building can be

  15. Improving health related quality of life among rural hypertensive patients through the integrative strategy of health services delivery: a quasi-experimental trial from Chongqing, China.

    Science.gov (United States)

    Miao, Yudong; Zhang, Liang; Sparring, Vibeke; Sandeep, Sandeep; Tang, Wenxi; Sun, Xiaowei; Feng, Da; Ye, Ting

    2016-08-23

    Integrative strategy of health services delivery has been proven to be effective in economically developed countries, where the healthcare systems have enough qualified primary care providers. However rural China lacks such providers to act as gatekeeper, besides, Chinese rural hypertensive patients are usually of old age, more likely to be exposed to health risk factors and they experience a greater socio-economic burden. All these Chinese rural setting specific features make the effectiveness of integrative strategy of health services in improving health related quality of life among Chinese rural hypertensive patients uncertain. In order to assess the impact of integrative strategy of health services delivery on health related quality of life among Chinese rural hypertensive patients, a two-year quasi-experimental trial was conducted in Chongqing, China. At baseline the sample enrolled 1006 hypertensive patients into intervention group and 420 hypertensive patients into control group. Physicians from village clinics, town hospitals and county hospitals worked collaboratively to deliver multidisciplinary health services for the intervention group, while physicians in the control group provided services without cooperation. The quality of life was studied by SF-36 Scale. Blood pressures were reported by town hospitals. The Difference-in-Differences model was used to estimate the differences in SF-36 score and blood pressure of both groups to assess the impact. The study showed that at baseline there was no statistical difference in SF-36 scores between both groups. While at follow-up the intervention group scored higher in overall SF-36, Role Physical, Body Pain, Social Functioning and Role Emotional than the control group. The Difference-in-Differences result demonstrated that there were statistical differences in SF-36 total score (p = 0.011), Role Physical (p = 0.027), Social Functioning (p = 0.000), Role Emotional (p = 0.002) between both

  16. Impacts of Global Warming and Sea Level Rise on Service Life of Chloride-Exposed Concrete Structures

    Directory of Open Access Journals (Sweden)

    Xiao-Jian Gao

    2017-03-01

    Full Text Available Global warming will increase the rate of chloride ingress and the rate of steel corrosion of concrete structures. Furthermore, in coastal (atmospheric marine zones, sea level rise will reduce the distance of concrete structures from the coast and increase the surface chloride content. This study proposes a probabilistic model for analyzing the effects of global warming and sea level rise on the service life of coastal concrete structures. First, in the corrosion initiation stage, an improved chloride diffusion model is proposed to determine chloride concentration. The Monte Carlo method is employed to calculate the service life in the corrosion initiation stage; Second, in the corrosion propagation stage, a numerical model is proposed to calculate the rate of corrosion, probability of corrosion cracking, and service life. Third, overall service life is determined as the sum of service life in the corrosion initiation and corrosion propagation stages. After considering the impacts of global warming and sea level rise, the analysis results show that for concrete structures having a service life of 50 years, the service life decreases by about 5%.

  17. Service life prediction and cementitious composites

    DEFF Research Database (Denmark)

    Stoklund Larsen, E.

    The present Ph.D.thesis describes and discusses the applicability of a systematic methodology recommended by CIB W80/RILEM-PSL for sevice life prediction. The report describes the most important inherent and environmental factors affecting the service life of structures of cementitious composites....... On the basis of this discription of factors and experience from a test programme described in SBI Report 222, Service life prediction and fibre reinforced cementitious composites, the applicabillity of the CIB/RILEM methodology is discussed....

  18. Indigenous health: effective and sustainable health services through continuous quality improvement.

    Science.gov (United States)

    Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

    2007-05-21

    The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

  19. Tools for in service monitoring and testing of riser to prevent failure and extend service life

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Haakon; Bondevik, Jon Olav; Skjerve, Haavard; Tveit, Oeyvind [SeaFlex AS, Asker (Norway)

    2005-07-01

    Exploration and development of new oil and gas fields is heavily dependant on use of flexible pipes and many field developments would not have been possible without them. The number of flexible risers in service is constantly increasing since relatively few offshore projects have reached the estimated operational life and the operational lifetime of several fields in-service has been extended due to new and improved technology. Many risers have been in service over a large number of years. Some risers have been operated under demanding conditions such as severe dynamic loads, high pressure and temperatures. One may in some cases find that risers actually have shorter service life than estimated in the design phase due to the severe operational conditions. In order to extend the use of the riser, some risers may have to be modified and re-terminated and prepared for a new and less demanding application. In order to operate risers safely, it is important to re-assess the fatigue life in order to prevent potential riser failure. The operator should implement methods and tools for in-service monitoring and testing. This paper addresses efficient and reliable methods and tools for monitoring of critical operational parameters as well as in-service riser testing. A brief description of structural failure modes will also be given in order to understand how to interpret test results in view of potential failure modes. (author)

  20. Health programmes for school employees: improving quality of life, health and productivity.

    Science.gov (United States)

    Kolbe, Lloyd J; Tirozzi, Gerald N; Marx, Eva; Bobbitt-Cooke, Mary; Riedel, Sara; Jones, Jack; Schmoyer, Michael

    2005-01-01

    School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and

  1. Software life after in-service

    International Nuclear Information System (INIS)

    Tseng, M.; Eng, P.

    1993-01-01

    Software engineers and designers tend to conclude a software project at the in-service milestone of the software life cycle. But the reality is that the 'life after in-service' is significantly longer than other phases of the life cycle, typically 20 years or more depending on the maintainability of the hardware platform and the designed life of the plant. During this period, the software asset (as with other physical assets in the plant) continues to be upgraded to correct deficiencies, meet new requirements, cope with obsolescence of equipment and so on. The software life cycle ends with a migration of the software to a different platform. It is typical in a software development project to put a great deal of emphasis on design methodologies, techniques, tools, development environment, standard procedures, and project management to ensure quality product is delivered on schedule and within budget. More often than not, a disproportion of emphasis is placed on the issues and needs of the in-service phase. Once the software is in-service, the designers move on to other projects, while the maintenance and support staff must manage the software. This paper examines the issues in three steps. First it presents a view of software from maintenance and support staff perspectives, including complexity of software, suitability of documentation, configuration management, training, difficulties and risks associated with making changes, required skills and knowledge. Second, it identifies the concerns raised from these viewpoints, including costs of maintaining the software, ability to meet additional requirements, availability of support tools, length of time required to engineer and install changes, and a strategy for the migration of software asset. Finally it discusses some approaches to deal with the concerns. (Author) 5 refs., fig

  2. Determination of service lives under varying loading using a life-fraction rule. Pt. 1

    International Nuclear Information System (INIS)

    Schaefer, L.

    1986-01-01

    Previously the attempt has been made to improve the often accuracy of the life-fraction rule (Robinson), applied to calculate the service lives under varying loading, by introducing constants into the mathematical representation of the rule which take into account the influence of the material and the conditions of loading. Therefore, the calculated service lives are not real predictions. In this work description based on constants is dispensed with and only one boundary condition is indicated for the life-fraction rule which is necessary and sufficient to calculate correctly any fractional damage and hence any service life under varying loading. The abbreviated wording of this boundary condition is: To calculate a fractional damage, the life fraction tsub(i) must be devided by a service life tsub(m,i), the structural condition Gsub(i) being the same. The specimen (X10NiCrTi1616 steel) will rupture as soon as the sum of fractional damages has attained unity: Σsub(i)(tsub(i)/tsub(m,i)) sub(Gsub(i)) = 1. (orig./GSCH)

  3. Software Process Improvement Journey: IBM Australia Application Management Services

    Science.gov (United States)

    2005-03-01

    See Section 5.1.2) - Client Relationship Management ( CRM ) processes-specifically, Solution Design and Solution Delivery - Worldwide Project Management ...plex systems life-cycle management , rapid solutions development, custom development, package selection and implementation, maintenance, minor...CarnegieMellon ___ Software Engineering Institute Software Process Improvement Journey: IBM Australia Application Management Services Robyn Nichols

  4. Influence of Superheated Steam Temperature Regulation Quality on Service Life of Boiler Steam Super-Heater Metal

    Directory of Open Access Journals (Sweden)

    G. T. Kulakov

    2009-01-01

    Full Text Available The paper investigates influence of change in quality of superheated steam temperature regulations on service life of super-heater metal. А dependence between metal service life and dispersion value for different steel grades has been determined in the paper. Numerical values pertaining to increase of super-heater metal service life in case of transferring from manual regulation to standard system of automatic regulation (SAR have been determined and in case of transferring from standard SAR to improved SAR. The analysis of tabular data and plotted dependencies makes it possible to conclude that any change in conditions of convection super-heater metal work due to better quality of the regulation leads to essential increase of time period which is left till the completion of the service life of a super-heater heating surface.

  5. Quality of life in Nepalese patients with low vision and the impact of low vision services

    Directory of Open Access Journals (Sweden)

    Rajendra Gyawali

    2012-10-01

    Conclusions: Low vision patients have poor quality of life as measured with the NEI VFQ-25. Low vision service is associated with improved visual function, better quality of life and high rate of patient satisfaction.

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

    Science.gov (United States)

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

    2013-06-01

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

  7. Method and apparatus to predict the remaining service life of an operating system

    Science.gov (United States)

    Greitzer, Frank L.; Kangas, Lars J.; Terrones, Kristine M.; Maynard, Melody A.; Pawlowski, Ronald A. , Ferryman; Thomas A.; Skorpik, James R.; Wilson, Bary W.

    2008-11-25

    A method and computer-based apparatus for monitoring the degradation of, predicting the remaining service life of, and/or planning maintenance for, an operating system are disclosed. Diagnostic information on degradation of the operating system is obtained through measurement of one or more performance characteristics by one or more sensors onboard and/or proximate the operating system. Though not required, it is preferred that the sensor data are validated to improve the accuracy and reliability of the service life predictions. The condition or degree of degradation of the operating system is presented to a user by way of one or more calculated, numeric degradation figures of merit that are trended against one or more independent variables using one or more mathematical techniques. Furthermore, more than one trendline and uncertainty interval may be generated for a given degradation figure of merit/independent variable data set. The trendline(s) and uncertainty interval(s) are subsequently compared to one or more degradation figure of merit thresholds to predict the remaining service life of the operating system. The present invention enables multiple mathematical approaches in determining which trendline(s) to use to provide the best estimate of the remaining service life.

  8. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    Directory of Open Access Journals (Sweden)

    Kevin R. Tarlow

    2014-01-01

    Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.

  9. The Service Life Evaluation for Concrete Structure of NPP

    International Nuclear Information System (INIS)

    Lee, Choon Min; Kim, Seong Soo; Bae, Sung Hwan; Sik, Yoon Eui

    2014-01-01

    Prolonged exposure to the marine environment degrades the durability of concrete and shortens the service life of concrete due to degradation factors such as chloride, carbonation, freezing and thawing, sulfate. Therefore, many country's organizations like the Korea Concrete Institute (KCI), the American Concrete Institute (ACI), the International Federation for Structural Concrete (FIB), the American Society for Testing and Material (ASTM) which recognized the seriousness of this deterioration proposed equation models to evaluate the service life for the concrete structures. As a result, this paper is to especially consider the service life evaluation using these equation models for concrete structure of NPP in Korea compared with 60 years as a design service life. The concrete durability evaluation for Shin-Hanul NPP units 1 and 2 is carried out by using typically proposed assessment models in domestic and foreign standard. It is confirmed that the service life of concrete durability for each of deterioration factors is significantly higher than 60 years as a design service life. As a result, the study of combined deterioration for the concrete structures of NPP in future is positively necessary and maintenance control through regular monitoring should be conducted to secure safety margin basis

  10. Through-life engineering services motivation, theory, and practice

    CERN Document Server

    Roy, Rajkumar

    2015-01-01

    Demonstrating the latest research and analysis in the area of through-life engineering services (TES), this book utilizes case studies and expert analysis from an international array of practitioners and researchers – who together represent multiple manufacturing sectors: aerospace, railway and automotive – to maximize reader insights into the field of through-life engineering services. As part of the EPSRC Centre in Through-life Engineering Services program to support the academic and industrial community, this book presents an overview of non-destructive testing techniques and applications and provides the reader with the information needed to assess degradation and possible automation of through-life engineering service activities . The latest developments in maintenance-repair-overhaul (MRO) are presented with emphasis on cleaning technologies, repair and overhaul approaches and planning and digital assistance. The impact of these technologies on sustainable enterprises is also analyzed. This book wil...

  11. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    Science.gov (United States)

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

  12. Effect of home care service on the quality of life in patients with gynecological cancer.

    Science.gov (United States)

    Aktas, Demet; Terzioglu, Fusun

    2015-01-01

    The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits (1st, 12th weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols (1st, 12th weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: 6.01±0.64), while the control group had comparatively lower quality (average mean: 4.35±0.79) within the 12 week post- discharge period (phome care services to be efficient in improving the quality of life in patients with gynecological cancer.

  13. The development of socially responsible life-sciences teachers through community service learning.

    Directory of Open Access Journals (Sweden)

    J.J. Rian de Villiers

    2012-03-01

    Full Text Available In South Africa, polices in higher education are urging tertiary institutions to produce graduates who are socially responsible citizens. One method of achieving this is through service-learning initiatives. Zoos as community partners can provide exciting educational opportunities for students to do animal behaviour studies and to develop their social responsibility. A sample of 58 preservice life-sciences teachers from a South African university completed a questionnaire on their animal behaviour studies. This study sought to determine how animal behaviour studies could successfully be incorporated as a community service-learning project in a zoo setting, what the educational value of these studies was and what the benefits were of incorporating this community service-learning component in the life-sciences course. The incorporation of the service-learning component into the zoology course led to the students’ personal and professional development, knowledge about themselves, sensitivity to cultural diversity, civic responsibility and insights into the ways in which communities operate. For a successful service-learning project, lectures, students and community partners should all have a sense of engagement. A number of suggestions are made to improve the incorporation of this service-learning component into the existing zoology course.

  14. Tools for surveying and improving the quality of life: people with special needs in focus.

    Science.gov (United States)

    Hoyningen-Süess, Ursula; Oberholzer, David; Stalder, René; Brügger, Urs

    2012-01-01

    This article seeks to describe online tools for surveying and improving quality of life for people with disabilities living in assisted living centers and special education service organizations. Ensuring a decent quality of life for disabled people is an important welfare state goal. Using well-accepted quality of life conceptions, online diagnostic and planning tools were developed during an Institute for Education, University of Zurich, research project. The diagnostic tools measure, evaluate and analyze disabled people's quality of life. The planning tools identify factors that can affect their quality of life and suggest improvements. Instrument validity and reliability are not tested according to the standard statistical procedures. This will be done at a more advanced stage of the project. Instead, the tool is developed, refined and adjusted in cooperation with practitioners who are constantly judging it according to best practice standards. The tools support staff in assisted living centers and special education service organizations. These tools offer comprehensive resources for surveying, quantifying, evaluating, describing and simulating quality of life elements.

  15. Service life prediction and fibre reinforced cementitious composites

    DEFF Research Database (Denmark)

    Stoklund Larsen, E.

    The present Ph.D.thesis addresses the service life concept on the fibre reinforced cementitious composites. The advantages and problems of adding fibre to a cementitious matrix and the influence on service life are described. In SBI Report 221, Service life prediction and cementitious somposites......, the factors affecting the pure cementitious composite are described. Different sizes and types of fibre reinforced crmentitious composites have been chosen to illustrate different ageing and deterioration mechanisms. Some ageing mechanisms can be accelerated and others cannot which is demonstrated in a test...... programme. Moisture, micro structural and mechanical properties were measured before, during and after ageing, with the purpose of giving a detailed "picture" of the materials during ageing....

  16. Analysis and modeling of hot extrusion die for its service life enhancement

    Science.gov (United States)

    Akhtar, Syed Sohail

    Aluminum extrusion finds extensive application in the construction, automobile and aerospace industries. High pressures, elevated temperatures, complex and intricate section geometries lead to repeated mechanical and thermal stresses in the die and affiliated tooling. Product rework and rejects can be traced back to various defects spread over the die life cycle: die design, die manufacture and heat treatment, process parameters, inprocess die maintenance/correction and, billet type and quality. Therefore, improved and efficient service life of die and related tooling used in the extrusion press is one the most important factors in maximizing productivity and minimizing cost for ensuring the economical efficiency of an aluminum extrusion plant. How often a die has to be scrapped and replaced with a new one directly contributes to the commercial viability of producing a certain profile. The focus of the current work is on three distinct yet inter-related studies pertaining to the improvement of aluminum extrusion die. Study-A (Die Failure Analysis) is an investigation of various modes and critical failure types based on industrial data (Chapter-2 ), examination of failed dies and finite element simulation for identification of critical process parameters and design features in die fatigue-life (Chapter-3). In Study-B (Die Surface Hardening Treatment), two-stage controlled gas nitriding process for H13 steel is evaluated, both experimentally and numerically, in terms of nitrided case morphology and properties (Chapter-4) followed by experimental and numerical investigation of the effects of repeated nitriding (Chapter-5), pre-nitriding surface preparation (Chapter-6) and die profile geometry (Chapter-7) on nitriding performance in regard to die service life. In Study-C (Effect of Billet Quality on Die Life), the effect of billet quality and related influencing extrusion parameters on the die service life is investigated based on industrial data and some regression

  17. Improving the quality of life.

    Science.gov (United States)

    Suyono, H

    1993-12-01

    It is encouraging that most developing countries now have population policies, but it is discouraging that some countries have been unable to implement their policies. Therefore, Indonesia believes technical cooperation should be strengthened among developing countries. International cooperation is working in 108 developing countries, but the desired impact has yet to be reached, and the quality of life in many countries is still unacceptable. For example, life expectancy at birth in developing countries is 14-17 years shorter for females and 10-13 years shorter for males as compared to developed countries which have superior health and welfare systems. The speed of population growth is also hindering efforts to help improve living conditions, and the biggest increase in growth will occur in Asia and Africa. This will increase the numbers of poor, hungry, and illiterate in developing countries and will lead to a lack of arable land, deterioration in education, and increase in unsafe sanitation. In order to slow population growth, quality family planning (FP) services must be provided to those who want them. By the year 2000, developed countries and donors should be ready to provide half of the required US$10.5 billion to FP services in developing countries. In Indonesia, population programs and policies have been governed by the National FP Coordinating Board as well as by the State Ministry for Population and the Environment, which was divided into two ministries in 1993 in order to deal with the enormity and seriousness of the two issues.

  18. Measuring service life and evaluating the quality of solid tires

    Directory of Open Access Journals (Sweden)

    Charoenyut Dechwayukul

    2010-08-01

    Full Text Available The objective of this research is to propose procedures for measuring service life and evaluating the quality of locallymade and used solid tires in Thailand. The solid tires were stressed and rotated until blowout on a drum-like test apparatuswhich is designed, constructed by the authors and equipped with laboratory instrumentation. Solid tires from five differentmanufacturers were selected for testing. We measured service life, length of time to tire failure, at three different loadingamplitudes and three different speeds on the testing drum. The service life of all specimens was studied and compared todetermine the possibility of using service life to evaluate the quality of a solid tire.

  19. How do Housing Subsidies Improve Quality of Life Among Homeless Adults? A Mediation Analysis.

    Science.gov (United States)

    O'Connell, Maria; Sint, Kyaw; Rosenheck, Robert

    2018-03-01

    Supported housing, combining rent subsidies with intensive case management, is associated with improvements in quality of life of homeless adults, but factors mediating their impact on quality of life have not been studied. Twelve-month outcome data from a randomized trial of the Housing and Urban Development- Veterans Affairs Supported Housing program (HUD-VASH) showed that access to a housing rent subsidy plus intensive case management (ICM) was associated with greater improvement in subjective quality of life than ICM alone. Multiple mediation analyses were applied to identify variables that significantly mediated the relationship between receipt of housing voucher and improvements in quality of life. Significant mediating covariates were those whose 95% bias-corrected confidence intervals, when added to the model predicting improvement in quality of life, did not overlap zero. Increases in the number of days housed, size of social network, and availability of emotional support appear to mediate improvement in quality of life and account for 71% of the benefit attributable to having a rent subsidy. Improvement in subjective quality of life though housing subsidies is mediated by gains in both material and psychosocial factors. Mediating factors deserve special attention in supported housing services. © Society for Community Research and Action 2018.

  20. Advanced aircraft service life monitoring method via flight-by-flight load spectra

    Science.gov (United States)

    Lee, Hongchul

    This research is an effort to understand current method and to propose an advanced method for Damage Tolerance Analysis (DTA) for the purpose of monitoring the aircraft service life. As one of tasks in the DTA, the current indirect Individual Aircraft Tracking (IAT) method for the F-16C/D Block 32 does not properly represent changes in flight usage severity affecting structural fatigue life. Therefore, an advanced aircraft service life monitoring method based on flight-by-flight load spectra is proposed and recommended for IAT program to track consumed fatigue life as an alternative to the current method which is based on the crack severity index (CSI) value. Damage Tolerance is one of aircraft design philosophies to ensure that aging aircrafts satisfy structural reliability in terms of fatigue failures throughout their service periods. IAT program, one of the most important tasks of DTA, is able to track potential structural crack growth at critical areas in the major airframe structural components of individual aircraft. The F-16C/D aircraft is equipped with a flight data recorder to monitor flight usage and provide the data to support structural load analysis. However, limited memory of flight data recorder allows user to monitor individual aircraft fatigue usage in terms of only the vertical inertia (NzW) data for calculating Crack Severity Index (CSI) value which defines the relative maneuver severity. Current IAT method for the F-16C/D Block 32 based on CSI value calculated from NzW is shown to be not accurate enough to monitor individual aircraft fatigue usage due to several problems. The proposed advanced aircraft service life monitoring method based on flight-by-flight load spectra is recommended as an improved method for the F-16C/D Block 32 aircraft. Flight-by-flight load spectra was generated from downloaded Crash Survival Flight Data Recorder (CSFDR) data by calculating loads for each time hack in selected flight data utilizing loads equations. From

  1. Reactor Dosimetry Aspects of the Service Life Extension of the Hungarian Paks NPP

    Directory of Open Access Journals (Sweden)

    Zsolnay Eva M.

    2016-01-01

    Full Text Available The service life of the Hungarian Paks Nuclear Power Plant (NPP will be extended from the originally planned 30 years to 50 years. To improve the reliability of the results obtained in frame of the old reactor pressure vessel (RPV surveillance programme, new methods have been developed, and based on them, the old exposition data have been re-evaluated for all the four reactor units. At the same time, a new RPV surveillance programme has been developed and introduced, and long term irradiations have been performed to determine the radiation damage of the surveillance specimens due to the high fast neutron exposition. Neutron transport calculations have been performed with a validated neutron transport code system to determine the fast neutron exposition of the RPVs during the extended service life. The cavity dosimetry is in the introductory phase. This paper presents the new developments in the field of the RPV surveillance dosimetry and summarises the results obtained. According to the results the service life of the NPP can safely be extended for the planned 50 years.

  2. Improving older people's life satisfaction via social networking site use: Evidence from China.

    Science.gov (United States)

    Zhou, Junjie

    2018-03-01

    This study aimed to examine the pathways by which social networking sites (SNSs) can improve older people's life satisfaction. We conducted an online survey in China that lasted eight weeks. Respondents were required to report their demographic characteristics and feelings regarding SNS use. Data were analysed using SPSS 20 and Amos 21. We collected 596 valid samples. The empirical results show that SNS use improves older people's life satisfaction by reducing their loneliness and improving their self-efficacy. Social support alleviates the negative effect of loneliness and enhances the positive effect of self-efficacy on life satisfaction. Sex differences and education differences were significant. Men and less educated people had higher levels of life satisfaction. Policymakers should offer support to SNSs targeting older people and encourage them to provide more useful services. SNS operators should encourage social support among older users and pay attention to sex differences and education differences. © 2018 AJA Inc.

  3. Forecasts on service life by fracture mechanics methods

    International Nuclear Information System (INIS)

    Munz, D.

    1985-01-01

    The service life of many component parts can frequently be divided into the stages up to the formation of a crack and of crack propagation. This holds good of fatigue crack, stress corrosion crack, and also in many cases of creep. But often the crack propagation stage is the only one of interest for service life forecasts if cracks must be reckoned with already on putting parts into service. Cracks in welding constructions are typical examples. Crack- and -fracture mechanics deal with the laws underlying crack propagation and provide quantitative information on crack propagation behaviour. (orig./DG) [de

  4. End-of-Life Inventory Decisions of Service Parts

    NARCIS (Netherlands)

    M. Pourakbar (Morteza)

    2011-01-01

    textabstractWith the spurt of technology and innovation the life cycles of parts and products have become shorter and service parts enter their final phases earlier. Final phase of a typical service part starts once the part production is ceased and ends when the last service or warranty contract

  5. Internal curing as a new tool for infrastructural renewal : reducing repair congestion, increasing service life, and improving sustainability.

    Science.gov (United States)

    2014-04-01

    Internal curing has recently been developed as a new concrete technology that has the potential to : dramatically extend the service life of concrete infrastructure elements like bridge decks. Internal curing : uses prewetted lightweight aggregate in...

  6. Reactor coolant pump service life evaluation for current life cycle optimization and license renewal

    International Nuclear Information System (INIS)

    Doroshuk, B.W.; Berto, D.S.; Robles, M.

    1990-01-01

    This paper reports that as part of the plant life cycle management and license renewal program, Baltimore Gas and Electric Company (BG and E) has completed a service life evaluation of their reactor coolant pumps, funded jointly by EPRI and performed by ABB Combustion Engineering Nuclear Power. Two of the goals of the BG and E plant life cycle management and license renewal program, and of this current evaluation, are to identify actions which would optimize current plant operation, and ensure that license renewal remains a viable option. The reactor coolant pumps (RCPs) at BG and E's Calvert Cliffs Units 1 and 2 are Byron Jackson pumps with a diffuser and a single suction. This pump design is also used in many other nuclear plants. The RCP service life evaluation assessed the effect of all plausible age-related degradation mechanisms (ARDMs) on the RCP components. Cyclic fatigue and thermal embrittlement were two ARDMs identified as having a high potential to limit the service life of the pump case. The pump case is a primary pressure boundary component. Hence, ensuring its continued structural integrity is important

  7. Rethinking Student Services: Assessing and Improving Service Quality.

    Science.gov (United States)

    Zammuto, Raymond F.; And Others

    1996-01-01

    A study investigated the quality of services in four student enrollment services administrative sub-units (recruiting, admissions, records and registration, financial aid) at a public comprehensive university, using student and staff evaluations and program evaluations. Specific changes needed to improve service delivery are identified and…

  8. Identifying profiles of service users in housing services and exploring their quality of life and care needs

    NARCIS (Netherlands)

    Bitter, N.A.; Roeg, D.P.K.; Van Nieuwenhuizen, Ch.; Van Weeghel, J.

    2016-01-01

    Background Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not

  9. Influence of flexible pin for planets on service life of wind turbine gearboxes

    International Nuclear Information System (INIS)

    Park, Young Jun; Lee, Geun Ho; Nam, Yong Yun; Kim, Jeong Kil

    2012-01-01

    An overhung mounted carrier with flexible pins is applied to the planetary gear train of a wind turbine gearbox to investigate the influence of the self aligning effect by means of the deflection of the planet spindle and the flexible pin on the lifetime of the planet gear for a wind turbine gearbox. To analyze the load distribution of planet gears, both Euler theory and commercial software are employed. By applying an overhung mounted carrier with flexible pins in the wind turbine gearbox, we can improve the misalignment performance, face load factor, and service life of the planet gears. In particular, it was confirmed that a service life of more than 20 years could be realized for wind turbine gearboxes by applying a flexible pin to overhung mounted carrier

  10. Continue service improvement at CERN computing centre

    International Nuclear Information System (INIS)

    Lopez, M Barroso; Everaerts, L; Meinhard, H; Baehler, P; Haimyr, N; Guijarro, J M

    2014-01-01

    Using the framework of ITIL best practises, the service managers within CERN-IT have engaged into a continuous improvement process, mainly focusing on service operation. This implies an explicit effort to understand and improve all service management aspects in order to increase efficiency and effectiveness. We will present the requirements, how they were addressed and share our experiences. We will describe how we measure, report and use the data to continually improve both the processes and the services being provided. The focus is not the tool or the process, but the results of the continuous improvement effort from a large team of IT experts providing services to thousands of users, supported by the tool and its local team. This is not an initiative to address user concerns in the way the services are managed but rather an on-going working habit of continually reviewing, analysing and improving the service management processes and the services themselves, having in mind the currently agreed service levels and whose results also improve the experience of the users about the current services.

  11. Analytical evaluation of the roller bearing service life

    Directory of Open Access Journals (Sweden)

    Antsupov Aleksey

    2017-01-01

    Full Text Available An analytical method has been developed for the design evaluation of the service life of roller bearings by the criterion of contact endurance of elements that does not require carrying out the experimental studies. It is based on the kinetic approach to the description of the solids destruction process and the theory of parametric reliability of machine parts. In contradistinction to the standard empirical dependence, which is currently used, the method allows one to take into account the effect of the material properties, and basic design and operational parameters on the service life. The results of the theoretical studies of the service life of roller bearing No. 212 (DIN 5412 T1 are presented for the quantitative assessment of this effect. They showed that the temperature-force loading conditions or material properties that were not taken into account might result in the prediction error of 1.5 or more times.

  12. Mobile phone use for contacting emergency services in life-threatening circumstances.

    Science.gov (United States)

    Wu, Olivia; Briggs, Andrew; Kemp, Tom; Gray, Alastair; MacIntyre, Kate; Rowley, Jack; Willett, Keith

    2012-03-01

    The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. Of 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Landslide risk impact management and web services for improving resilience: the LIFE+IMAGINE project approach

    Science.gov (United States)

    Congi, Maria Pia; Campo, Valentina; Cipolloni, Carlo; Delmonaco, Giuseppe; Guerrieri, Luca; Iadanza, Carla; Spizzichino, Daniele; Trigila, Alessandro

    2014-05-01

    The increasing damage caused by natural disasters in the last decades points out the need for interoperable added-value services to support environmental safety and human protection, by reducing vulnerability of exposed elements as well as improving the resilience of the involved communities. For this reason, to provide access to harmonized and customized data is only one of several steps towards delivering adequate support to risk assessment, reduction and management. Scope of the present work is to illustrate a methodology under development for analysis of potential impacts in areas prone to landslide hazard in the framework of the EC project LIFE+IMAGINE. The project aims to implement an infrastructure based on web services for environmental analysis, that integrates in its own architecture specifications and results from INSPIRE, SEIS and GMES. Existing web services will be customized during the project to provide functionalities for supporting the environmental integrated management. The implemented infrastructure will be applied to landslide risk scenarios, to be developed in selected pilot areas, aiming at: i) application of standard procedures to implement a landslide risk analysis; ii) definition of a procedure for assessment of potential environmental impacts, based on a set of indicators to estimate the different exposed elements with their specific vulnerability in the pilot area. More in detail, the landslide pilot will be aimed at providing a landslide risk scenario through the implementation and analysis of: 1) a landslide inventory from available historical databases and maps; 2) landslide susceptibility and hazard maps; 3) assessment of exposure and vulnerability on selected typologies of elements at risk; 4) implementation of a landslide risk scenario for different sets of exposed elements (e.g. population, road network, residential area, cultural heritage). The pilot will be implemented in Liguria, Italy, in two different catchment areas located

  14. 76 FR 24339 - Streamlining Service Delivery and Improving Customer Service

    Science.gov (United States)

    2011-05-02

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

  15. Cultural services remediated in Second Life

    DEFF Research Database (Denmark)

    Heilesen, Simon

    2008-01-01

    In 2007, the Danish Public Libraries conducted an experiment in establishing a library in the virtual world Second Life. The Info Island DK provided the framework for a number of online library services and cultural events. This study, based on interviews with most of the active participants...... in the project, discusses the experiences in remediating conventional library services into the new medium and in understanding and redefining the role of the librarian in an online virtual world....

  16. Enhanced design, operation and maintenance practices for a longer plant service life

    International Nuclear Information System (INIS)

    Raimondo, E.; Courcoux, A.

    2004-01-01

    Plant service life problems have been under detailed investigation in France and the experience acquired by our company over the past 25 years in the design, construction and maintenance of Pressurized Water Reactors has contributed to develop skills, equipment and capabilities available for efficient plant aging management and component service life extension. The service life of a nuclear power plant is deeply dependant of the provisions made during the design stage, directly linked to good operating conditions and adequate maintenance practices. This paper presents the importance of these three steps (design, operation and maintenance) for plant service life concern. (author)

  17. Improving the system of warranty service of trucks in foreign markets

    Directory of Open Access Journals (Sweden)

    Irina MAKAROVA

    2015-03-01

    Full Text Available The article is devoted to the practical methods development of improving one of the ways to ensure the health of trucks in the system warranty. Methodology is aimed at optimizing the processes of formation of warranty spare parts kits during the implementation of KAMAZ trucks in foreign markets. The example is given to demonstrate the importance of different factors in the formation of the warranty set for different regions. The algorithm was developed to assess the qualitative composition formed warranty package that will optimize the planning and organization of activity centers to improve operational reliability of commercial trucks. A basis for acceptance of the scientifically-proved decisions is the statistical data analysis of requests monitoring that allows organizing duly replacement of parts with expired service life, and also promotes customer servicing quality improvement and reliability of trucks by prevention of its failures.

  18. Successful outsourcing: improving quality of life through integrated support services.

    Science.gov (United States)

    Bates, Jason; Sharratt, Martin; King, John

    2014-01-01

    This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.

  19. ICT Services for Life Improvement for the Elderly.

    Science.gov (United States)

    Sánchez-Rico, Alejandro; Garel, Pascal; Notarangelo, Isabella; Quintana, Marcos; Hernández, Gustavo; Asteriadis, Stylianos; Popa, Mirela; Vretos, Nicholas; Solachidis, Vassilis; Burgos, Marta; Girault, Ariane

    2017-01-01

    Integrated care ICT Platform to support patients, care-givers and health/social professionals in the care of dementia and Parkinson's disease with training, empowerment, sensor-based data analysis and cooperation services based on user-friendly interfaces.

  20. Improving the efficacy of healthcare services for Aboriginal Australians.

    Science.gov (United States)

    Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle

    2018-01-16

    Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for

  1. Approaches for Modelling the Residual Service Life of Marine Concrete Structures

    Directory of Open Access Journals (Sweden)

    Amir Rahimi

    2014-01-01

    Full Text Available This paper deals with the service life design of existing reinforced concrete structures in a marine environment. The general procedure of condition assessment for estimating the residual service life of structures before a repair measure is illustrated. For assessment of the residual service life of structures which have undergone a repair measure a simplified mathematical model of chloride diffusion in a 2-layer system is presented. Preliminary probabilistic calculations demonstrate the effect of various conditions on the residual service life. First studies of the chloride diffusion in a 2-layer system have been conducted using the finite element method. Results of a long-term exposure test are presented to illustrate the performance of two different repair materials. The distribution of residual chlorides after application of a repair material is being studied in laboratory investigations. The residual chlorides migrate from the concrete layer into the new layer immediately after the repair material has been applied to the concrete member. The content and gradient of residual chlorides, along with the thickness and the chloride ingress resistance of both the remaining and the new layer of cover, will determine the residual service life of the repaired structures.

  2. Service Life Of Main Piping Component Due To Low Thermal Stresses.Fatigue

    International Nuclear Information System (INIS)

    Miroshnik, R.; Jeager, A.; Ben Haim, H.

    1998-01-01

    The paper deals with estimating the service life of the power station Main piping component and describing the repair process for extending of its service life. After a long period of service, several circular fatigue cracks have been discovered at the bottom of the Main piping component chamber. Finite element analyses of transient thermal stresses, caused by power station startup, are carried out in the paper. The calculation results show good agreement between the theoretical locations of the maximum stresses and the actual locations of the cracks. There is a good agreement between theoretical evaluation and actual service life, as well. The possibility of machining out the cracks in order to prevent their growing is examined here. The machining enables us to extend the power station component's life service

  3. Improving of enterprise consumer service system

    Directory of Open Access Journals (Sweden)

    Yа.М. Laguta

    2015-12-01

    Full Text Available The problems of consumer services at domestic enterprises are showed. The shortcomings in the service of enterprise operation are analyzed. The basic features of the functioning of the service system forming medium are determined. The authors develop the measures to improve the quality of services which can contribute to their development, expansion of the customer base, increase in sales volume (goods and services as well as improving efficiency and profitability. Taking into account the current environment of enterprises the proposed measures are formed. The article proves the expediency of the use of the client-oriented approach to a customer, the use of software programs and the improvement of the CRM-system at enterprises, the introduction of «7P» concept.

  4. Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery

    Directory of Open Access Journals (Sweden)

    Soeteman M

    2015-03-01

    Full Text Available Marijn Soeteman,1 Vera Peters,2 Jamiu O Busari1,3 1Department of Pediatrics, Atrium Medical Center, Heerlen, 2Faculty of Health, Medicine and Life Sciences, 3Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands Objective: In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic’s waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1 accessibility to caregivers and 2 quality of service and available amenities. Design: We conducted a multi-method survey using 1 a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2 specially designed questionnaires to investigate patients’ perceptions of our wait time and how to improve our services. Results: The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55% felt that 10–20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%. Finally, a large number of patients (97% were satisfied with the quality of service and with the accessibility to caregivers (94%. Conclusion: The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of

  5. Improving the Service with the Servqual Method

    Science.gov (United States)

    Midor, Katarzyna; Kučera, Marian

    2018-03-01

    At the time when economy is growing, there is strong competition in the market, and customers have increasingly higher expectations as regards quality of service and products. Under such conditions, organizations need to improve. One of the areas of improvement for an organization is to research the level of customer satisfaction. The article presents results of customer satisfaction surveys conducted by the Servqual method in a pharmaceutical service company. Use of this method allowed to improve the services provided by that pharmaceutical wholesaler, identify areas that need to be improved as soon as possible in order to improve the level of service provided.

  6. Advances in through-life engineering services

    CERN Document Server

    Roy, Rajkumar; Shaw, Andy

    2017-01-01

    This edited book offers further advances, new perspectives, and developments from world leaders in the field of through-life engineering services (TES). It builds up on the earlier book by the same authors entitled: “Through-life Engineering Services: Motivation, Theory and Practice.” This compendium introduces and discusses further, the developments in workshop-based and 'in situ' maintenance and support of high-value engineering products, as well as the application of drone technology for autonomous and self-healing product support. The links between ‘integrated planning’ and planned obsolescence, risk and cost modelling are also examined. The role of data, information, and knowledge management relative to component and system degradation and failure is also presented. This is supported by consideration of the effects upon the maintenance and support decision by the presence of 'No Fault Found' error signals within system data. Further to this the role of diagnostics and prognostics is also discusse...

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

    Science.gov (United States)

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

    2013-01-01

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

  8. DEVELOPMENT OF CUSTOMER RELATIONSHIP MANAGEMENT SYSTEM TO IMPROVE SERVICE QUALITY IN PT MANULIFE LIFE INSURANCE INDONESIA

    Directory of Open Access Journals (Sweden)

    Chriswanto Chriswanto

    2014-10-01

    Full Text Available Customer Relationship Management System (CRMS Development in order to improve service quality in PT. AJ. Manulife Indonesia is done by comprehending the performance model of the company and the factors that are affecting the company performance improvement and the quality of the decision to be taken by top management. System Dynamic is a method that can be used to stimulate complex systems. System Dynamics approach is expected to build a model of corporate performance that can be used to evaluate the quality of service to customers so that they can make decisions quickly and accurately. This study proves that the model is built with standard models used as changing targets and it can simulate a target quality of service to customers by delivering current and future achievement. Achievement in the future is influenced by the value of achievement of SLA, Response Time, and Defect, where the greater value of control, the greater value of the correction rate so that the GAP will be smaller. Correction rate which is determined in this study was 10%, 20%, and 30% of GAP (CB

  9. [Professional's expectations to improve quality of care and social services utilization in geriatric oncology].

    Science.gov (United States)

    Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine

    2015-02-01

    Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  10. End of Life: An Overview

    Science.gov (United States)

    Toner, Mary Ann; Shadden, Barbara B.

    2012-01-01

    Speech-language pathologists (SLPs) provide services to patients confronting the end of life (EOL) in a variety of settings. Instead of targeting improvement of health or sustaining life, EOL services focus primarily on quality of life. Although SLPs may not consider themselves core members of the health care team providing EOL services, the…

  11. Impact of landfill liner time-temperature history on the service life of HDPE geomembranes.

    Science.gov (United States)

    Rowe, R Kerry; Islam, M Z

    2009-10-01

    The observed temperatures in different landfills are used to establish a number of idealized time-temperature histories for geomembrane liners in municipal solid waste (MSW) landfills. These are then used for estimating the service life of different HDPE geomembranes. The predicted antioxidant depletion times (Stage I) are between 7 and 750 years with the large variation depending on the specific HDPE geomembrane product, exposure conditions, and most importantly, the magnitude and duration of the peak liner temperature. The higher end of the range corresponds to data from geomembranes aged in simulated landfill liner tests and a maximum liner temperature of 37 degrees C. The lower end of the range corresponds to a testing condition where geomembranes were immersed in a synthetic leachate and a maximum liner temperature of 60 degrees C. The total service life of the geomembranes was estimated to be between 20 and 3300 years depending on the time-temperature history examined. The range illustrates the important role that time-temperature history could play in terms of geomembrane service life. The need for long-term monitoring of landfill liner temperature and for geomembrane ageing studies that will provide improved data for assessing the likely long-term performance of geomembranes in MSW landfills are highlighted.

  12. Service life of 1-W, 0.985-μm solitary heterolasers

    International Nuclear Information System (INIS)

    Kochetkov, A A; Konyaev, V P

    2001-01-01

    The service life of solitary heterolasers at a temperature of 50 0 C (P = 1W, λ = 0.98 - 0.99 μm) is studied. The maximum service life of heterolasers under such working conditions is 60000 hours for an average pumping current 1.5 A. (lasers and amplifiers)

  13. Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients.

    Science.gov (United States)

    Hack, Carolin C; Hackl, Janina; Hüttner, Nina B M; Langemann, Hanna; Schwitulla, Judith; Dietzel-Drentwett, Svenja; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

    2018-05-01

    Although the demand from patients for integrative medicine is increasing, complementary medicine services are still quite heterogeneous and have not been incorporated into clinical routine. The aim of this study was to systematically evaluate improvements in side effects and quality of life associated with a hospital-based integrative medicine program in the modern breast cancer patient care setting. In a cross-sectional study, integrative health counseling and treatment were evaluated in women with breast cancer. Over a 15-month period, data for 75 patients from an integrative medicine consultancy service with standardized operating procedures were collected at the University Breast Center for Franconia. At baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. In the follow-up, patient-reported outcomes related to side effects of conventional cancer treatment and patients' quality of life were analyzed. Among 60 patients with the therapy goal of reducing the side effects of conventional treatment, 46 (76.7%) were successful. Among 57 patients hoping to improve disease-related quality of life, 46 (82%) reported success. Whereas patients with metastatic disease achieved a reduction in the side effects of conventional therapy, quality-of-life improvements were predominantly achieved by patients with a good treatment prognosis. Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in all phases of tumor disease. Integrative treatment services should be included as part of patient care in clinical routine work to offer patients the maximum quality of care and safety with complementary therapies.

  14. Serviceability modeling : predicting and extending the useful service life of FRT-plywood roof sheathing

    Science.gov (United States)

    Jerrold E. Winandy

    2000-01-01

    One of the most, if not the most, efficient methods of extending our existing forest resource is to prolong the service life of wood currently in-service by using those existing structures to meet our future needs (Hamilton and Winandy 1998). It is currently estimated that over 7 x 109 m3 (3 trillion bd. ft) of wood is currently in service within the United States of...

  15. Service life evaluation of non-metallic containment seals

    International Nuclear Information System (INIS)

    Pringle, T.G.

    1994-01-01

    A Service Life Evaluation Program (SLEP) was successfully completed for expansion joint seals used in the pressure relief duct of Pickering NGS, an eight unit CANDU station. These seals are part of the containment boundary, are difficult to replace and then only during station outages which are scheduled at ten year intervals. The SLEP, consisting of an accelerated aging program and a qualification test, was undertaken to determine the service life of the seals such that they would be capable of remaining functional following a combination of service life, a design basis accident and a subsequent seismic event. The Arrhenius model of aging was used for the accelerated aging program. Samples of seal material were subjected to oven aging at five temperatures, 150, 160, 170, 180 and 190 deg C. Tensile properties and hardness were measured at various aging times and Arrhenius plots constructed. Based on changes in elongation, activation energies of 1.2 eV and 1.1 eV were calculated for the reinforcing fabric and the silicone cover rubber, respectively. Hardness measurements were also taken but as expected, no precise quantitative aging relationship could be determined from material hardness. For the qualification test a representative length of seal was installed and field-spliced in a test frame built to simulate the installed configuration of the seal. It then underwent accelerated aging equivalent to the service life, followed by LOCA irradiation exposure to LOCA conditions of humidity, temperature and pressure and a design-basis seismic event. Finally, a pressure test to approximately five times design pressure was successfully performed to demonstrate the remaining margin of safety. Periodic air leakage tests indicated no deterioration in sealing performance and no physical deterioration was apparent. (author). 11 refs., 2 tabs., 8 figs

  16. Improving Customer Service in Elderly Care

    OpenAIRE

    Nielsen, Chris

    2015-01-01

    The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...

  17. Managing rail service life

    Directory of Open Access Journals (Sweden)

    Z. Popović

    2014-10-01

    Full Text Available The service life of rails depends especially on the operational loads and speeds on the railway lines, as well as on the rail maintenance policy. There are multiple aspects of rail maintenance optimization. The following article considers optimisation of rail maintenance activities relating to rail head surface condition in order to reduce corrective work on track geometry, as well as to minimize the overall costs for track maintenance. The objects of this research are issues and challenges related to rail and track maintenance in curves on modern conventional railway lines for mixed traffic.

  18. Service life and sustainable design methods: a case study

    CSIR Research Space (South Africa)

    Mc Duling, J

    2008-05-01

    Full Text Available The design life of hospitals normally varies between 50 to 60 years. This paper presents a case study of a major academic hospital that reached the end of its service life only 30 years after commissioning due to a combination of unsustainable...

  19. Service life prediction of exterior plastics vision for the future

    CERN Document Server

    Martin, Jon; Chapin, J

    2015-01-01

    This book defines the current state-of-the-art for predicting the lifetime of plastics exposed to weather and outlines future research needed to advance this important field of study. Coverage includes progress in developing new science and test methods to determine how materials respond to weather exposure. This book is ideal for researchers and professionals working in the field of service life prediction. This book also: Examines numerous consensus standards that affect commercial products allowing readers to see the future of standards related to service life prediction Provides the scientific foundation for the latest commercially viable instruments Presents groundbreaking research, including the blueprint of a new test method that will significantly shorten the service life prediction process time Covers two of the latest verified predictive models, which demonstrate realized-potential to transform the field

  20. Laser shock peening of steam turbine blade for enhanced service life

    Indian Academy of Sciences (India)

    2014-02-13

    Feb 13, 2014 ... Fretting-fatigue is an important factor influencing service life of turbine blades. The present paper describes laser shock peening of potential crack nucleation site in the root region of steam turbine blade for its enhanced service life. The experimental study, performed with an in-house developed 2.5 J/7 ns ...

  1. Improvement of in-service inspection in nuclear power plants

    International Nuclear Information System (INIS)

    2004-07-01

    During the nuclear power plant's (NPPs) operating lifetime, the operating organisation should examine the systems, structures and components (SSCs) for possible deterioration so as to determine whether they are acceptable for continued safe operation or whether remedial measures should be taken. In-service inspection (ISI) provides the systematic framework for these examinations. An effective ISI programme ensures both that the safety of the plant is not adversely affected after the commencement of operation and that the levels of reliability and availability of all plant SSCs remain in accordance with the assumptions and intent of the design and, consequently, a cost effective electricity generation is guaranteed. This report was prepared under one of the IAEA projects, 'Integrated NPP life cycle management including decommissioning'. The main objective of an integrated life cycle management programme is to enable NPPs to compete, without compromising safety, successfully in the changing energy markets throughout their service life and to facilitate life extension and eventual decommissioning through improved engineering, technological, economic and managerial actions. The Technical Working Group on NPP Life Management and other advisory groups nominated by the Member States provide recommendations on high priority needs of Member States in this area. The purpose of this TECDOC is to: discuss and evaluate the status of ISI and its evolution in NPPs of IAEA Member States; discuss and evaluate the criteria for effective ISI and the constitutive elements; discuss and evaluate the implication of the introduction of risk informed ISI (RI-ISI) concepts; generate a common recommendation as to how to benefit from utilising the potential of RI-ISI concepts for further development and, possibly, improvement of ISI effectiveness. The specific concept of this report is to treat the two key issues, i.e. inspection qualification and RI-ISI, and their complementarities, to

  2. The sustainability effects of Product/Service-System design validated through Life Cycle Assessment

    DEFF Research Database (Denmark)

    Smidt Dreijer, Leise; Birkved, Morten; Howard, Thomas J.

    2013-01-01

    and lifts. The major research question for the case is how the supplier’s continued ownership of the building materials influences the sustainability of such buildings. By using a PSS design approach in the early design stages, the architects involved in the case project were able to make design decisions......Temporary buildings are generally considered to be unsustainable due to a short life span of the materials applied in the building. The construction materials typically have a longer use life than the required use life of the building, thus functioning building materials are often discarded after...... the demolition. In an attempt to improve the sustainability of temporary buildings, a Product/Service-System (PSS) strategy is here applied to a case project. The case project concerns a temporary building made of leased materials and building components such as shipping containers, scaffolding materials...

  3. The Service Pledge for Breast Cancer – Improving services through patient involvement

    International Nuclear Information System (INIS)

    Freeman, Shauna; Kester, Ross; Greenbrook, Sally; O’Connor, Ruairi; Rawlings, Sarah

    2012-01-01

    A guiding principle for today’s National Health Service is for services to reflect the needs and choices of patients and carers. There is evidence that meaningful patient involvement and engagement of people in their own care supports relationships with NHS professionals, and improves the quality and experience of healthcare. This paper reviews the Service Pledge for Breast Cancer, developed by the charity Breakthrough Breast Cancer as a tried and tested route to delivering effective patient involvement and examines some implications for radiotherapy services. The Service Pledge, which has benefitted an estimated 19,000 patients across the UK, is a tool that enables healthcare professionals and patients to work in partnership to improve local breast cancer services. Based on the results of a patient survey and in depth interviews to determine to what extent standards of care are being met at each participating hospital, improvement goals are identified helping turn the patient voice into constructive action. Improvement goals resulting from the Service Pledge range from small changes that make a real difference to patients, through to much larger changes to local breast services. To date, there has been limited involvement of radiotherapy staff in the Service Pledge, yet radiographers play an important role in the treatment of breast cancer as most patients will be offered radiotherapy. However, radiotherapy services have been criticised for not being patient -centred and for not providing enough information, psychological and emotional support before, during and after treatment. It is contended that radiographers are ideally placed to address many of these concerns and engage further with patients through projects such as the Service Pledge, empowering their patients to voice what is most important to them and driving the quality improvements that emerge.

  4. Decentralized Local Services for Improvement of Quality of Life in the Republic of Macedonia, Case Study Tetovo Municipality

    Directory of Open Access Journals (Sweden)

    Memet Memeti

    2012-05-01

    Full Text Available The process of decentralization in Macedonia began in July 2005, after the adaption of theconstitutional amendments made which triggered the process of the decentralization in the Republic ofMacedonia. Having in mind that the decentralization implied structural changes in the Macedonian politicalsystem and in relations between the central and the local government, the implementation of the process ofthe decentralization was designed with a phased approach in order to accommodate the local governmentinstitutions with the new competencies. Among others the process of decentralization had an objective tobring the local authorities closer to the citizens through provision of quality local services. In addition it aimsto provide an opportunity for broader participation and representation of the citizens in their communities.This paper attempts to answer three main questions related to quality public services: - The process ofdecentralization has helped to improve the quality of public services? - What areas of public services undermunicipal jurisdiction are satisfied with it? - How much would you like to be informed about communityactivities? In this paper we are going to analyze the findings from the field research about the quality ofpublic service that provide the municipality of Tetovo of R. Macedonia. The paper focuses on the satisfactionon the public services and provides recommendations for future improvement of the decentralized publicservices in the Republic of Macedonia.

  5. Probabilistic Design and Management of Sustainable Concrete Infrastructure Using Multi-Physics Service Life Models

    DEFF Research Database (Denmark)

    Lepech, Michael; Geiker, Mette; Michel, Alexander

    This paper looks to address the grand challenge of integrating construction materials engineering research within a multi-scale, inter-disciplinary research and management framework for sustainable concrete infrastructure. The ultimate goal is to drive sustainability-focused innovation and adoption...... cycles in the broader architecture, engineering, construction (AEC) industry. Specifically, a probabilistic design framework for sustainable concrete infrastructure and a multi-physics service life model for reinforced concrete are presented as important points of integration for innovation between...... design, consists of concrete service life models and life cycle assessment (LCA) models. Both types of models (service life and LCA) are formulated stochastically so that the service life and time(s) to repair, as well as total sustainability impact, are described by a probability distribution. A central...

  6. Actual service life prediction of building components

    DEFF Research Database (Denmark)

    Aagaard, Niels-Jørgen; Brandt, Erik; Hansen, Ernst Jan de Place

    2014-01-01

    In recent years, sustainability and life cycle cost in the construction industry have been given great attention in many countries due to the heavy climatic and environmental impact from this sector. In Denmark, a sustainability certification scheme for buildings has been developed including....... Finally, it is discussed how to adjust the model for practical purposes, and a scheme for actual service life for selected building components important for analysis of sustainability is linked. The schemes are now being implemented as basis for sustainability certification of new buildings in Denmark....

  7. Student-Life Stress in Education and Health Service Majors

    Science.gov (United States)

    Zascavage, Victoria; Winterman, Kathleen G.; Buot, Max; Wies, Jennifer R.; Lyzinski, Natalie

    2012-01-01

    In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…

  8. Simulation for IT Service Desk Improvement

    Directory of Open Access Journals (Sweden)

    Peter Bober

    2014-07-01

    Full Text Available IT service desk is a complex service that IT service company provides to its customers. This article provides a methodology which uses discrete-event simulation to help IT service management to make decision and to plan service strategy. Simulation model considers learning ability of service desk agents and growth of knowledge database of the company. Model shows how the learning curve influences the time development of service desk quality and efficiency. This article promotes using simulation to define quantitative goals for the service desk improvement.

  9. Evaluation of HEPA filter service life

    International Nuclear Information System (INIS)

    Fretthold, J.K.; Stithem, A.R.

    1997-01-01

    Rocky Flats Environmental Technology Site (RFETS), has approximately 10,000 High Efficiency Particulate Air (HEPA) Filters installed in a variety of filter plenums. These ventilation/filtration plenum systems are used to control the release of airborne particulate contaminates to the environment during normal operations and potential accidents. This report summarizes the results of destructive and non-destructive tests on HEPA filters obtained from a wide variety of ages and service conditions. These tests were performed to determine an acceptable service life criteria for HEPA filters used at Rocky Flats Environmental Technology Site (RFETS). A total of 140 filters of various ages (1972 to 1996) and service history (new, aged unused, used) were tested. For the purpose of this report, filter age from manufacture date/initial test date to the current sample date was used, as opposed to the actual time a filter was installed in an operating system

  10. Rethinking Library Service: Improving the User Experience with Service Blueprinting

    Science.gov (United States)

    Pretlow, Cassi; Sobel, Karen

    2015-01-01

    Service blueprinting is a process that businesses use for analyzing and improving service. Originally presented in the Harvard Business Review in 1984, it has retained a strong following ever since. At present, it is experiencing a revival at numerous academic institutions. The authors of this article present the process of service blueprinting.…

  11. Multi-objective optimization of swash plate forging process parameters for the die wear/service life improvement

    Science.gov (United States)

    Hu, X. F.; Wang, L. G.; Wu, H.; Liu, S. S.

    2017-12-01

    For the forging process of the swash plate, the author designed a kind of multi-index orthogonal experiment. Based on the Archard wear model, the influences of billet temperature, die temperature, forming speed, top die hardness and friction coefficient on forming load and die wear were numerically simulated by DEFORM software. Through the analysis of experimental results, the best forging process parameters were optimized and determined, which could effectively reduce the die wear and prolong the die service life. It is significant to increase the practical production of enterprise, especially to reduce the production cost and to promote enterprise profit.

  12. A "client perspective" helps improve services.

    Science.gov (United States)

    1998-01-01

    Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.

  13. Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

    Science.gov (United States)

    McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

    2012-05-17

    Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

  14. Can life coaching improve health outcomes?

    DEFF Research Database (Denmark)

    Ammentorp, Jette

    26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013.......26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013....

  15. Physical Activity Improves Quality of Life

    Science.gov (United States)

    ... It Works Healthy Workplace Food and Beverage Toolkit Physical activity improves quality of life Updated:Mar 2,2015 ... proven to improve both mental and physical health. Physical activity boosts mental wellness. Regular physical activity can relieve ...

  16. Life assessment of gas turbine blades after long term service

    Energy Technology Data Exchange (ETDEWEB)

    Auerkari, Pertti; Salonen, Jorma [VTT, Espoo (Finland); Maekinen, Sari [Helsingin Energia, Helsinki (Finland); Karvonen, Ikka; Tanttari, Heikki [Lappeenrannan Laempoevoima, Lappeenranta (Finland); Kangas, Pekka [Neste Oil, Kilpilahti (Finland); Scholz, Alfred [Technische Univ. Darmstadt (Germany); Vacchieri, Erica [Ansaldo Richerche, Genoa (Italy)

    2010-07-01

    Turbine blade samples from three land based gas turbines have been subjected to systematic condition and life assessment after long term service (88000 - 109000 equivalent operating hours, eoh), when approaching the nominal or suggested life limits. The blades represent different machine types, materials and design generations, and uncooled blading outside the hottest front end of the turbine, i.e. blades with relatively large size and considerable expected life. For a reasonable assessment, a range of damage mechanisms need to be addressed and evaluated for the impact in the residual life. The results suggested significant additional safe life for all three blade sets. In some cases this could warrant yet another life cycle comparable to that of new blades, even after approaching the nominal end of life in terms of recommended equivalent operating hours. This is thought to be partly because of base load combined cycle operation and natural gas fuel, or modest operational loading if the design also accounted for more intensive cycling operation and more corrosive oil firing. In any case, long term life extension is only appropriate if not intervened by events of overloading, overheating or other sudden events such as foreign object damage (FOD), and if supported by the regular inspection and maintenance program to control in-service damage. Condition based assessment therefore remains an important part of the blade life management after the decision of accepted life extension. (orig.)

  17. Strategies for improving quality and methods for innovation services

    Directory of Open Access Journals (Sweden)

    Bajić Milan

    2009-01-01

    Full Text Available Contemporary concepts of business of service organisations, focus their researches on measuring quality of the services and identification of mistakes. The aim of strategies is the improvement of quality. Marketing concepts shows that the constant creation of new products and the modification of characteristics on the old products, makes possible market strategy that stimulates development of activities. This paper is focusing on the improving of service using the strategies that can innovate and improve the services. Paper seeks to demonstrate one of possible observations and importance of performance, combined with blueprinting of services and benchmarking as a useful strategies for improving and innovation of services.

  18. Reliability and service life of wood structures and buildings

    Directory of Open Access Journals (Sweden)

    Zdeňka Havířová

    2005-01-01

    Full Text Available Service life of constructions and buildings of wood is dependent on temperature and moisture conditions in layers of the building cladding where the wood framework is built in. Temperature/moisture conditions or the corresponding equilibrium moisture content (EMC of the construction show considerable effects on the functional reliability of the whole building from the viewpoint of mechanical resistance and stability (ER1, energy savings and thermal protection (ER6 and hygiene, health and environment protection (ER3. To ensure the reliability of constructions and buildings for the period of their supposed service life a more profound analysis of constructions is necessary from the aspect of a global thermal/technical evaluation.

  19. Do transactive memory and participative teamwork improve nurses' quality of work life?

    Science.gov (United States)

    Brunault, Paul; Fouquereau, Evelyne; Colombat, Philippe; Gillet, Nicolas; El-Hage, Wissam; Camus, Vincent; Gaillard, Philippe

    2014-03-01

    Improvement in nurses' quality of work life (QWL) has become a major issue in health care organizations. We hypothesized that the level of transactive memory (defined as the way groups collectively encode, store, and retrieve knowledge) and participative teamwork (an organizational model of care based on vocational training, a specific service's care project, and regular interdisciplinary staffing) positively affect nurses' QWL. This cross-sectional study enrolled 84 ward-based psychiatric nurses. We assessed transactive memory, participative teamwork, perceived organizational justice, perceived organizational support, and QWL using psychometrically reliable and valid scales. Participative teamwork and transactive memory were positively associated with nurses' QWL. Perceived organizational support and organizational justice fully mediated the relationship between participative teamwork and QWL, but not between transactive memory and QWL. Improved transactive memory could directly improve nurses' QWL. Improved participative teamwork could improve nurses' QWL through better perceived organizational support and perceived organizational justice.

  20. Are consumer surveys valuable as a service improvement tool in health services? A critical appraisal.

    Science.gov (United States)

    Patwardhan, Anjali; Patwardhan, Prakash

    2009-01-01

    In the recent climate of consumerism and consumer focused care, health and social care needs to be more responsive than ever before. Consumer needs and preferences can be elicited with accepted validity and reliability only by strict methodological control, customerisation of the questionnaire and skilled interpretation. To construct, conduct, interpret and implement improved service provision, requires a trained work force and infrastructure. This article aims to appraise various aspects of consumer surveys and to assess their value as effective service improvement tools. The customer is the sole reason organisations exist. Consumer surveys are used worldwide as service and quality of care improvement tools by all types of service providers including health service providers. The article critically appraises the value of consumer surveys as service improvement tools in health services tool and its future applications. No one type of survey is the best or ideal. The key is the selection of the correct survey methodology, unique and customised for the particular type/aspect of care being evaluated. The method used should reflect the importance of the information required. Methodological rigor is essential for the effectiveness of consumer surveys as service improvement tools. Unfortunately so far there is no universal consensus on superiority of one particular methodology over another or any benefit of one specific methodology in a given situation. More training and some dedicated resource allocation is required to develop consumer surveys. More research is needed to develop specific survey methodology and evaluation techniques for improved validity and reliability of the surveys as service improvement tools. Measurement of consumer preferences/priorities, evaluation of services and key performance scores, is not easy. Consumer surveys seem impressive tools as they provide the customer a voice for change or modification. However, from a scientific point

  1. Factors influencing improved attendance in the UK fire service.

    Science.gov (United States)

    Litchfield, I; Hinckley, P

    2016-12-01

    Sickness absence rates in the UK continue to exceed those in much of the developed world, with an annual cost to employers of £29 billion. Rates of sickness absence in the public sector are higher than those in the private sector, with the exception of the fire service where they are consistently lower. To understand the influences that increase attendance among operational firefighters. A series of semi-structured interviews undertaken with operational staff to explore their attitudes to sickness absence. Review and analysis of participant responses identified a number of key themes, namely employee well-being, including physical fitness and mental health; employee engagement with the fire service as manifested by culture, experience, nature of the job and leadership; organizational factors including the staffing model and relationship with occupational health services and policy, which describes both refinements to and implementation of targeted policies. Previously observed factors such as improved fitness and the distinct firefighter culture play a role, yet other factors emerged that could explain the differences. These include the greater work-life balance offered by their shift patterns, the terms and conditions of employment and perhaps most importantly the evolution of precisely targeted policies that understand the unique nature of the operational fire service. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

  2. BioCatalogue: a universal catalogue of web services for the life sciences.

    Science.gov (United States)

    Bhagat, Jiten; Tanoh, Franck; Nzuobontane, Eric; Laurent, Thomas; Orlowski, Jerzy; Roos, Marco; Wolstencroft, Katy; Aleksejevs, Sergejs; Stevens, Robert; Pettifer, Steve; Lopez, Rodrigo; Goble, Carole A

    2010-07-01

    The use of Web Services to enable programmatic access to on-line bioinformatics is becoming increasingly important in the Life Sciences. However, their number, distribution and the variable quality of their documentation can make their discovery and subsequent use difficult. A Web Services registry with information on available services will help to bring together service providers and their users. The BioCatalogue (http://www.biocatalogue.org/) provides a common interface for registering, browsing and annotating Web Services to the Life Science community. Services in the BioCatalogue can be described and searched in multiple ways based upon their technical types, bioinformatics categories, user tags, service providers or data inputs and outputs. They are also subject to constant monitoring, allowing the identification of service problems and changes and the filtering-out of unavailable or unreliable resources. The system is accessible via a human-readable 'Web 2.0'-style interface and a programmatic Web Service interface. The BioCatalogue follows a community approach in which all services can be registered, browsed and incrementally documented with annotations by any member of the scientific community.

  3. Performance improvement plan in customer technical services

    International Nuclear Information System (INIS)

    Lachambre, L.

    1995-01-01

    This presentation centred around the philosophy, goals, and initiatives associated with Gaz Metropolitain's performance improvement plan. Various aspects of the plan including customer surveys, new customer service policies, the creation of small working units, the decentralization of the Montreal service department, and customer-harmonized shift schedules were explored. Implementation of new service plans and contracts, the formation of improvement groups related to human resources, human resource and productivity management, leadership training, and the use of performance indicators were also explained

  4. Prediction of the Service Life of a Reinforced Concrete Column under Chloride Environment

    Directory of Open Access Journals (Sweden)

    Mohammad K. Alkam

    2015-01-01

    Full Text Available In the present investigation, service life of a reinforced concrete column exposed to chloride environment has been predicted. This study has been based on numerical simulation of chloride ion diffusion in a concrete column during its anticipated life span. The simulation process has included the concrete cover replacement whenever chloride ion concentration has reached the critical threshold value at the reinforcement surface. Repair scheduling of the concrete column under consideration has been discussed. Effects of the concrete cover thickness and the water cement ratio on the service life of the concrete column at hand have been presented. A new approach for arranging locations of reinforcement steel bars has been introduced. This approach is intended to prolong the service life of the concrete column under consideration against chloride induced corrosion.

  5. The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

    Science.gov (United States)

    2013-01-01

    Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (ppatient’s life

  6. Life Cycle Characteristics of Small Professional Service Firms

    NARCIS (Netherlands)

    Masurel, E.; van Montfort, C.A.G.M.

    2006-01-01

    Our study of professional services firms clearly revealed that firms change over the course of their life cycles. During the first three stages, diversification in sales, the differentiation in labor force, and the level of labor productivity increase. In the last stage, diversification in sales,

  7. Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

    Science.gov (United States)

    Aluri, Rao

    1993-01-01

    Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

  8. Improving Motivation in the Service Department

    OpenAIRE

    Sosingot-Sundström, Sevarine

    2015-01-01

    The objective of this study is to improve motivation of the employees in the Service Department. What motivates employees in this century beyond the normal norms of job security and money. The study is based on improving the motivation of the Service Department of Company X. This research was based on the service’s department low score in motivation after the results of the 2012 annual staff survey. The research aims to find out the cause(s) for the low motivation and also find a solution tha...

  9. A model for ageing-home-care service process improvement

    OpenAIRE

    Yu, Shu-Yan; Shie, An-Jin

    2017-01-01

    The purpose of this study was to develop an integrated model to improve service processes in ageing-home-care. According to the literature, existing service processes have potential service failures that affect service quality and efficacy. However, most previous studies have only focused on conceptual model development using New Service Development (NSD) and fail to provide a systematic model to analyse potential service failures and facilitate managers developing solutions to improve the se...

  10. A Liquid work-life under public service contracting

    DEFF Research Database (Denmark)

    Lindholst, Christian

    for staff, however, are only poorly understood in current theory and research on public service contracting through partial concepts and a tendency to focus merely on negative outcomes. Against this shortfall, the aim in this paper is to build a conceptually and empirically richer and more authentic account......A part of the reality behind public service contracting in Denmark as well as in many other countries is that a growing number of people are employed in uncertain and temporary conditions and relations in what can be characterized as ‘liquidized’ work-lives. This reality and its consequences...... of staffs’ work-life under public service contracting. The paper relies empirically on focus group interviews in two cases of staff transfers in public service contracting with different levels of liquefaction. it is found that staff transfer is a composite experience for staff with differential outcomes...

  11. Automatically exposing OpenLifeData via SADI semantic Web Services.

    Science.gov (United States)

    González, Alejandro Rodríguez; Callahan, Alison; Cruz-Toledo, José; Garcia, Adrian; Egaña Aranguren, Mikel; Dumontier, Michel; Wilkinson, Mark D

    2014-01-01

    Two distinct trends are emerging with respect to how data is shared, collected, and analyzed within the bioinformatics community. First, Linked Data, exposed as SPARQL endpoints, promises to make data easier to collect and integrate by moving towards the harmonization of data syntax, descriptive vocabularies, and identifiers, as well as providing a standardized mechanism for data access. Second, Web Services, often linked together into workflows, normalize data access and create transparent, reproducible scientific methodologies that can, in principle, be re-used and customized to suit new scientific questions. Constructing queries that traverse semantically-rich Linked Data requires substantial expertise, yet traditional RESTful or SOAP Web Services cannot adequately describe the content of a SPARQL endpoint. We propose that content-driven Semantic Web Services can enable facile discovery of Linked Data, independent of their location. We use a well-curated Linked Dataset - OpenLifeData - and utilize its descriptive metadata to automatically configure a series of more than 22,000 Semantic Web Services that expose all of its content via the SADI set of design principles. The OpenLifeData SADI services are discoverable via queries to the SHARE registry and easy to integrate into new or existing bioinformatics workflows and analytical pipelines. We demonstrate the utility of this system through comparison of Web Service-mediated data access with traditional SPARQL, and note that this approach not only simplifies data retrieval, but simultaneously provides protection against resource-intensive queries. We show, through a variety of different clients and examples of varying complexity, that data from the myriad OpenLifeData can be recovered without any need for prior-knowledge of the content or structure of the SPARQL endpoints. We also demonstrate that, via clients such as SHARE, the complexity of federated SPARQL queries is dramatically reduced.

  12. International Space Station Bacteria Filter Element Service Life Evaluation

    Science.gov (United States)

    Perry, J. L.

    2005-01-01

    The International Space Station (ISS) uses high-efficiency particulate air filters to remove particulate matter from the cabin atmosphere. Known as bacteria filter elements (BFEs), there are 13 elements deployed on board the ISS's U.S. segment in the flight 4R assembly level. The preflight service life prediction of 1 yr for the BFEs is based upon engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS program resources. Testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are provided.

  13. Accounting for ecosystem services in life cycle assessment, Part I: a critical review.

    Science.gov (United States)

    Zhang, Yi; Singh, Shweta; Bakshi, Bhavik R

    2010-04-01

    If life cycle oriented methods are to encourage sustainable development, they must account for the role of ecosystem goods and services, since these form the basis of planetary activities and human well-being. This article reviews methods that are relevant to accounting for the role of nature and that could be integrated into life cycle oriented approaches. These include methods developed by ecologists for quantifying ecosystem services, by ecological economists for monetary valuation, and life cycle methods such as conventional life cycle assessment, thermodynamic methods for resource accounting such as exergy and emergy analysis, variations of the ecological footprint approach, and human appropriation of net primary productivity. Each approach has its strengths: economic methods are able to quantify the value of cultural services; LCA considers emissions and assesses their impact; emergy accounts for supporting services in terms of cumulative exergy; and ecological footprint is intuitively appealing and considers biocapacity. However, no method is able to consider all the ecosystem services, often due to the desire to aggregate all resources in terms of a single unit. This review shows that comprehensive accounting for ecosystem services in LCA requires greater integration among existing methods, hierarchical schemes for interpreting results via multiple levels of aggregation, and greater understanding of the role of ecosystems in supporting human activities. These present many research opportunities that must be addressed to meet the challenges of sustainability.

  14. Caregivers' quality of life and quality of services for children with cancer: a review from iran.

    Science.gov (United States)

    Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; Khodaeiardekani, Mohammadreza

    2013-03-04

    Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers' quality of life and quality of services in the social work section. 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers' quality of life regarding psychological status and environmental conditions. Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers' satisfaction and quality of life.

  15. Caregivers’ Quality of Life and Quality of Services for Children with Cancer: A Review from Iran

    Science.gov (United States)

    Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; KhodaeiArdakani, Mohammadreza

    2013-01-01

    Objective: Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers’ quality of life and quality of services in the social work section. Method: 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Findings: Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers’ quality of life regarding psychological status and environmental conditions. Conclusion: Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers’ satisfaction and quality of life. PMID:23618487

  16. Improving Indonesian Construction Consulting Services

    Directory of Open Access Journals (Sweden)

    Rizal Z. Tamin

    2015-05-01

    Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.

  17. Lifetime health effects and medical costs of integrated stroke services - a non-randomized controlled cluster-trial based life table approach

    Directory of Open Access Journals (Sweden)

    Dirks Maaike

    2010-11-01

    Full Text Available Abstract Background Economic evaluation of stroke services indicates that such services may lead to improved quality of life at affordable cost. The present study assesses lifetime health impact and cost consequences of stroke in an integrated service setting. Methods The EDISSE study is a prospective non-randomized controlled cluster trial that compared stroke services (n = 151 patients to usual care (n = 187 patients. Health status and cost trial-data were entered in multi-dimensional stroke life-tables. The tables distinguish four levels of disability which are defined by the modified Rankin scale. Quality-of-life scores (EuroQoL-5D, transition and survival probabilities are based on concurrent Dutch follow-up studies. Outcomes are quality-adjusted life years lived and lifetime medical cost by disability category. An economic analysis compares outcomes from a successful stroke service to usual care, by bootstrapping individual costs and effects data from patients in each arm. Results Lifetime costs and QALYs after stroke depend on age-of-onset of first-ever stroke. Lifetime QALYs after stroke are 2.42 (90% CI - 0.49 - 2.75 for male patients in usual care and 2.75 (-0.61; 6.26 for females. Lifetime costs for men in the usual care setting are €39,335 (15,951; 79,837 and €42,944 (14,081; 95,944 for women. A comparison with the stroke service results in an ICER of €11,685 saved per QALY gained (€14,211 and €7,745 for men and women respectively. This stroke service is with 90% certainty cost-effective. Conclusions Our analysis shows the potential of large health benefits and cost savings of stroke services, taking a lifetime perspective, also in other European settings.

  18. Experimental methods for consideration of concrete cracking in service life design

    DEFF Research Database (Denmark)

    Pease, Bradley Justin; Geiker, Mette Rica; Stang, Henrik

    2011-01-01

    .e., concrete with cracks at start of service) and to more accurately estimate time-to-cracking due to reinforcement corrosion based on experimental measurements. This paper presents two non-destructive measurement techniques with potential to quantify the impact concrete cracks have on service life...

  19. Perceptions of Pre-Service Teachers on Student Burnout, Occupational Anxiety and Faculty Life Quality

    Science.gov (United States)

    Türkoglu, Muhammet Emin; Cansoy, Ramazan

    2017-01-01

    Perceptions of pre-service teachers on burnout, occupational anxiety and faculty life quality were investigated in this research. The research group consisted of 461 pre-service teachers in total studying at Afyon Kocatepe University faculty of education. "Maslach Burnout Inventory-Student Form," "Faculty Life Quality Scale"…

  20. Optimization of NPP performance and service life in a competitive electricity market

    International Nuclear Information System (INIS)

    Gueorguiev, B.; Spielgelberg - Planner, R.

    2000-01-01

    This paper discusses how the competitive electricity market has influenced nuclear power plant operations, with a focus on optimisation of NPP performance and plant service life, and how the IAEA programme has addressed some of this issues. The definitions of Plant Life, Operational Life, Design Life and Periodical Safety Reviews are developed in the paper in order to differentiate between the terms and to show the significance in terms of Plant Life Management

  1. Service life optimization and extension of structures

    International Nuclear Information System (INIS)

    Hornet, P.; Venturini, V.; Persoz, M.; Debost-Eymard, I.; Meister, E.

    1998-01-01

    In order to justify its power plants safety which conditions their service life, EDF uses a deterministic approach until now. A probabilistic approach also exists which has a decisive advantage because it quantifies risk and makes it possible to optimize maintenance volume. The application of this approach is illustrated on the case of a reactor vessel; a coupling between the Code Aster tool and a probabilistic analysis software is necessary. (authors)

  2. Threats Management Throughout the Software Service Life-Cycle

    Directory of Open Access Journals (Sweden)

    Erlend Andreas Gjære

    2014-04-01

    Full Text Available Software services are inevitably exposed to a fluctuating threat picture. Unfortunately, not all threats can be handled only with preventive measures during design and development, but also require adaptive mitigations at runtime. In this paper we describe an approach where we model composite services and threats together, which allows us to create preventive measures at design-time. At runtime, our specification also allows the service runtime environment (SRE to receive alerts about active threats that we have not handled, and react to these automatically through adaptation of the composite service. A goal-oriented security requirements modelling tool is used to model business-level threats and analyse how they may impact goals. A process flow modelling tool, utilising Business Process Model and Notation (BPMN and standard error boundary events, allows us to define how threats should be responded to during service execution on a technical level. Throughout the software life-cycle, we maintain threats in a centralised threat repository. Re-use of these threats extends further into monitoring alerts being distributed through a cloud-based messaging service. To demonstrate our approach in practice, we have developed a proof-of-concept service for the Air Traffic Management (ATM domain. In addition to the design-time activities, we show how this composite service duly adapts itself when a service component is exposed to a threat at runtime.

  3. Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

    Science.gov (United States)

    Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

    2016-02-06

    Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

  4. Improved methods for operating public transportation services.

    Science.gov (United States)

    2013-03-01

    In this joint project, West Virginia University and the University of Maryland collaborated in developing improved methods for analyzing and managing public transportation services. Transit travel time data were collected using GPS tracking services ...

  5. Effectiveness of a psycho-educational program for improving quality of life of fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Montesano Adrián

    2008-01-01

    Full Text Available Abstract Background Most fibromyalgia patients are seen in primary care (PC. However, the effectiveness of the treatments prescribed by general practitioners is usually minimal. The main objective of the present research is to assess the efficacy of structured psycho-educational intervention, combined with relaxation, developed to improve the quality of life of patients suffering fibromyalgia (FM. The second objective is to assess the cost-effectiveness of this multimodal intervention. Method/Design Design. Randomized controlled trial with a 12-month follow-up involving two groups, one of which is the intervention group that includes patients receiving a psychoeducational program and the other the control group consisting of patients treated for FM in the usual way. Setting. Three urban PC centers in the province of Barcelona (Spain. Sample. The total sample comprises 218 patients (over 18 years of age suffering FM, selected from a database (Rheumatology service-Viladecans Hospital of patients with this illness. Only those patients introduced in the database between the years 2005 and 2007 were included in the selection. Selected patients will be asked for written informed consent to participate in the study. Intervention. Multi-component program including information about the illness, counselling about physical exercise and training in autogenic relaxation. The intervention consists of nine 2-hour sessions delivered during a two-month period. The pharmacological treatment prescribed by the physician was maintained in both groups. Main variables. Sociodemographic characteristics, quality of life, use and cost of healthcare and social services. Measures. Quality of life is to be measured with the FIQ and the EuroQol-5D, and the use of healthcare services with an adapted version of the Client Service Receipt Inventory (CSRI. These variables will be measured before the beginning of the program (baseline and 1, 2, 6 and 12 months later. Discussion

  6. Regional Social Infrastructure Management as the Instrument for Improving the Quality of Life in the Ural Federal District

    Directory of Open Access Journals (Sweden)

    Valentina Sergeyevna Antonyuk

    2015-09-01

    Full Text Available The article analyzes the processes of the social sphere and the effective operation of social infrastructure in order to improve the quality of life of the population in the Russian regions. Particular attention is paid to the role of the organizational and managerial component affecting usage performance of infrastructure objects and including regulation of the institutions of social infrastructure, planning and software. The purpose of the study is to evaluate the effectiveness of management of social infrastructure through the conjugation of immediate results (the dynamics of indicators of social services and outcomes (parameters of the quality of life of the population. The hypothesis of the study was the violation of the principle of infra-systematicity in the infrastructural support of the improvement of the quality of life in the Russian regions, due to the lack of effectiveness of public administration. In the study, the following methodological approaches are used: structural, factoral, systematic and evolutionary approaches to justify the conception, develop methodology and determine the impact of changes in the parameters of social infrastructure availability for the provided services, shifts in indexes of quality of life. The paper proposes the quantitative evaluation of the effectiveness of organizational management based on the diagnosis of the adequacy of the implementation of the principle of infra-systematicity in the functioning of social infrastructure on the basis of the elasticity coefficient. The proposed approach and the received analytical data on health, education, commerce, housing, culture and sport fields have allowed to range the regions of the Ural Federal District and highlight the areas of insufficient effectiveness of the organizational and management tool for improvement of life quality. The findings of the research may serve as a core for practical recommendations for executive bodies of administrative units of

  7. Service Life and Maintenance Modelling of Reinforced Concrete Bridge Decks

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    Recent research in the area of assessment and maintenance of reinforced concrete bridge decks is presented in this paper. Three definitions of service lifetime are introduced and the difficult problem of assessing the service life is discussed. A stochastic modelling of corrosion and corrosion...... cracking is introduced and the site dependency of corrosion is stressed. Finally, a recently developed optimal repair strategy for bridges is briefly explained....

  8. review on hardfacing as method of improving the service life

    African Journals Online (AJOL)

    eobe

    soft base metal surface to enhance resistance to different wear mechanisms. .... shape and distribution of primary and eutectic carbides ... C-Si-Mn-B electrode resulted in an average hardness of ... blade material .... This consists of weld beads that run parallel to each ..... [54] Wallin, J. “Five basic steps to extend the life of.

  9. Service Life Extension of the Propulsion System of Long-Term Manned Orbital Stations

    Science.gov (United States)

    Kamath, Ulhas; Kuznetsov, Sergei; Spencer, Victor

    2014-01-01

    One of the critical non-replaceable systems of a long-term manned orbital station is the propulsion system. Since the propulsion system operates beginning with the launch of station elements into orbit, its service life determines the service life of the station overall. Weighing almost a million pounds, the International Space Station (ISS) is about four times as large as the Russian space station Mir and about five times as large as the U.S. Skylab. Constructed over a span of more than a decade with the help of over 100 space flights, elements and modules of the ISS provide more research space than any spacecraft ever built. Originally envisaged for a service life of fifteen years, this Earth orbiting laboratory has been in orbit since 1998. Some elements that have been launched later in the assembly sequence were not yet built when the first elements were placed in orbit. Hence, some of the early modules that were launched at the inception of the program were already nearing the end of their design life when the ISS was finally ready and operational. To maximize the return on global investments on ISS, it is essential for the valuable research on ISS to continue as long as the station can be sustained safely in orbit. This paper describes the work performed to extend the service life of the ISS propulsion system. A system comprises of many components with varying failure rates. Reliability of a system is the probability that it will perform its intended function under encountered operating conditions, for a specified period of time. As we are interested in finding out how reliable a system would be in the future, reliability expressed as a function of time provides valuable insight. In a hypothetical bathtub shaped failure rate curve, the failure rate, defined as the number of failures per unit time that a currently healthy component will suffer in a given future time interval, decreases during infant-mortality period, stays nearly constant during the service

  10. Improving Service Delivery of the Finance and Budget Section ...

    African Journals Online (AJOL)

    dell

    Action research was conducted in May and June 2004 aimed at improving service delivery of ... improve service delivery. (Quinby,1985). Furthermore, the intervention stage in which the development of ..... Educational leadership,. 42, 17-21.

  11. Service life assessment of timber highway bridges in USA climate zones

    Science.gov (United States)

    James P. Wacker; Brian K. Brashaw; Thomas G. Williamson; P. David Jones; Matthew S. Smith; Travis K. Hosteng; David L. Strahl; Lola E. Coombe; V.J. Gopu

    2014-01-01

    As engineers begin to estimate life-cycle costs and sustainable design approaches for timber bridges, there is a need for more reliable data about their durability and expected service life. This paper summarizes a comprehensive effort to assess the current condition of more than one hundred timber highway bridge superstructures throughout the United States. This...

  12. Congestion Prediction Modeling for Quality of Service Improvement in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Ga-Won Lee

    2014-04-01

    Full Text Available Information technology (IT is pushing ahead with drastic reforms of modern life for improvement of human welfare. Objects constitute “Information Networks” through smart, self-regulated information gathering that also recognizes and controls current information states in Wireless Sensor Networks (WSNs. Information observed from sensor networks in real-time is used to increase quality of life (QoL in various industries and daily life. One of the key challenges of the WSNs is how to achieve lossless data transmission. Although nowadays sensor nodes have enhanced capacities, it is hard to assure lossless and reliable end-to-end data transmission in WSNs due to the unstable wireless links and low hard ware resources to satisfy high quality of service (QoS requirements. We propose a node and path traffic prediction model to predict and minimize the congestion. This solution includes prediction of packet generation due to network congestion from both periodic and event data generation. Simulation using NS-2 and Matlab is used to demonstrate the effectiveness of the proposed solution.

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

    DEFF Research Database (Denmark)

    Schneider, Ronald; Thöns, Sebastian; Rogge, Andreas

    2017-01-01

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

  14. Service innovation through social robot engagement to improve dementia care quality.

    Science.gov (United States)

    Chu, Mei-Tai; Khosla, Rajiv; Khaksar, Seyed Mohammad Sadegh; Nguyen, Khanh

    2017-01-01

    Assistive technologies, such as robots, have proven to be useful in a social context and to improve the quality of life for people with dementia (PwD). This study aims to show how the engagement between two social robots and PwD in Australian residential care facilities can improve care quality. An observational method is adopted in the research methodology to discover behavioural patterns during interactions between the robots and PwD. This observational study has undertaken to explore the improvement arising from: (1) approaching social baby-face robots (AR), (2) experiencing pleasure engaging with the robots (P), (3) interacting with the robots (IR), and (4) interacting with others (IO). The findings show that social robots can improve diversion therapy service value to PwD through sensory enrichment, positive social engagement, and entertainment. More than 11,635 behavioral reactions, such as facial expressions and gestures, from 139 PwD over 5 years were coded, in order to identify the engagement effectiveness between PwD and two social robots named Sophie and Jack. The results suggest that these innovative social robots can improve the quality of care for people suffering from dementia.

  15. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia

    2016-01-01

    part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. MAIN MEASURES: Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome...... score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D™ quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training...... and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective....

  16. Climate Services to Improve Public Health

    Science.gov (United States)

    Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

    2014-01-01

    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

  17. Effective technical service in the life cycle of heavy dumpers

    Directory of Open Access Journals (Sweden)

    Михайло Валерійович Помазков

    2016-11-01

    Full Text Available A comparative analysis of the known systems of technical reliability of heavy dumpers functionality has been made. It has been stated that the previously proposed methods to determine the optimal service life of heavy-duty dumpers are not effective enough and do not take into account the whole range of factors specific to the operation of heavy dumpers in the current economic realities of industrial enterprises. Based on the analysis results, a mechanism of determining the optimal service life of heavy-duty dumpers and their constituent technical systems ensuring the operational reliability of heavy-duty dumpers has been offered. The article takes into account the analysis of resource factors, general description of system logistic tasks, the main provisions of serviceability, the resource forming in route charts at ore mining and metallurgical enterprises, the use of theoretical developments in practice. Heavy dumpers generalized description modelling shown in the article, the principle of resource use by using interchangable work at different intensity routes has received confirmation in the dumpers’ work schedule

  18. Impact of Child Life Services on Children and Families Admitted to Start the Ketogenic Diet.

    Science.gov (United States)

    Kossoff, Eric H; Sutter, Lindsay; Doerrer, Sarah C; Haney, Courtney A; Turner, Zahava

    2017-08-01

    Traditionally the ketogenic diet is started as an inpatient admission to the hospital. Starting in January 2015, child life services were made formally available during ketogenic diet admissions to help families cope. One-page surveys were then provided to 15 parents on the day of discharge and again after 3 months. Every family believed that the child life services were helpful. Children who were developmentally appropriate/mildly delayed had higher parent-reported anxiety scores than those who were moderate to severely delayed (4.4 vs 1.0, P = .02). At 3 months, child life services were deemed very helpful for the parents (mean score: 8.9, range: 5-10), and were more helpful for the parent than the child (mean 6.2, range 1-10, P = .047). One of the most helpful services was a prior phone call to parents 1 week prior. In this small pilot study, child life involvement during the start of the ketogenic diet was highly useful.

  19. Strengthening rehabilitation services in Indonesia: A brief situation analysis.

    Science.gov (United States)

    Nugraha, Boya; Setyono, Garry Rahardian; Defi, Irma Ruslina; Gutenbrunner, Christoph

    2018-04-18

    People with disability (PWD) in Indonesia are often neglected by society. Improving their life situation towards full participation in society is crucial. As a health strategy, rehabilitation can improve func-tioning, quality of life and participation in society. However, rehabilitation services in Indonesia need improvement. Making a situation analysis of rehabilitation services and their provision in the country is a pre-requisite to taking any action towards improvement. This paper compiles available data related to disability and rehabilitation services in Indonesia, using the Rehabilitation Services Assessment Tool (RSAT) as a framework. Gaps in provision were analysed, resulting in the compilation of a list of generic recommendations to improve rehabilitation services in the country. Indonesia faces many challenges in rehabilitation services, including the health workforce and the provision of services. This situation analysis and list of generic recommendations may be used in further discussions with relevant stakeholders in the country to develop a national strategy to strengthen rehabilitation services.

  20. Measuring Service-Mindedness and Its Relationship with Spirituality and Life Satisfaction

    Science.gov (United States)

    Pashak, Travis J.; Laughter, Tim C.

    2012-01-01

    A self-report measure of service-mindedness was designed in order to fill in a gap in the literature and evaluate a potential link between spirituality and satisfaction with life. A sample of 133 undergraduate students at a Catholic university in the Mid-west completed the Service-Mindedness Scale (SMS), along with the Spiritual Involvement and…

  1. Pre-Service Teachers in Second Life: Potentials of Simulations

    Science.gov (United States)

    Teoh, Jase

    2012-01-01

    An in-depth qualitative study with nine secondary pre-service teachers from an undergraduate "Language and Literacy" class was conducted to examine the potential of simulation using Second Life (SL) in teacher education. Games and simulations were operationally defined in the broadest sense to distinguish key characteristics between…

  2. A Review of Perspectives on Frameworks for Ethical Theories in Public Service Life

    Directory of Open Access Journals (Sweden)

    Deoram Sing

    2016-06-01

    Full Text Available Given the dynamic and changing interwoven and intertwined internal and external environments impacting on public service life, establishing and promoting a proper ethical foundation in public service life, has in itself emerged as a profound and daunting challenge, a worldwide phenomenon. The role of frameworks for ethical theories  –  such as teleological, deontological, virtue-based, and learning and growth, is crucial to dealing with this challenge. It is the view of the author that a keen grasp and application of the various frameworks, as well as their various components, could project their viewing and that of their components, not in isolation, but in an interconnected and intertwined manner. This could enhance the clarification of ethical and moral alternatives, as well as facilitate the spreading and diffusion of techniques for ethical reasoning and moral awareness, throughout public service life.

  3. METHODS AND RESEARCH CONCERNING SERVICE LIFE EXTENSION OF SUPORTING STRUCTURES OF TRACTION ROLLING STOCK FOR INDUSTRIAL TRANSPORT

    Directory of Open Access Journals (Sweden)

    O. M. Bondarev

    2014-04-01

    Full Text Available Purpose. The purpose of work is scientifically grounded introduction of the acquired techniques into works for service life extension of the traction and motor rolling stock for industrial transport. Methodology. To achieve the purpose it was analyzed the acquired techniques for service life extension of the traction and motor rolling stock for mainline transport. The acquired techniques during solution of problems concerning the service life extension of rolling stock units were adapted to the locomotives TGM6A and traction aggregates OPE1. Findings. On the basis of experimental and theoretical complex of studies some results were obtained. They gave the ground to determine the possibility of acquired techniques use when solving the problems on service life extension of rolling stock units concerning locomotives TGM6A and traction aggregates OPE1. Originality. On the basis of conducted experimental and theoretical studies scientific maintenance of the works providing extension of service life of traction and motor units of industrial rolling stock was executed. Practical value. Technical solutions and measures, which have to be carried out during operation within the prolonged appointed service life of traction and motor units of industrial rolling stock enterprises using locomotives and traction aggregates to provide the basic technological cycles were developed.

  4. Improving processes in financial service organizations: where to begin?

    NARCIS (Netherlands)

    Lokkerbol, J.; Does, R.J.M.M.; de Mast, J.; Schoonhoven, M.

    2012-01-01

    Purpose - The purpose of this paper is to create actionable knowledge, thereby supporting and stimulating practitioners to improve processes in the financial services sector. Design/methodology/approach - This paper is based on a case base of improvement projects in financial service organizations.

  5. Evaluation of Hose in Hose Transfer Line Service Life for Hanfords Interim Stabilization Program

    International Nuclear Information System (INIS)

    TORRES, T.D.

    2001-01-01

    RPP-6153, Engineering Task Plan for Hose-in-Hose Transfer System for the Interim Stabilization Program (Torres, 2000a), defines the programmatic goals, functional requirements, and technical criteria for the development and subsequent installation of waste transfer line equipment to support Hanford's Interim Stabilization Program. RPP-6028, Specification for Hose in Hose Transfer Lines for Hanford's Interim Stabilization Program (Torres, 2000b), has been issued to define the specific requirements for the design, manufacture, and verification of transfer line assemblies for specific waste transfer applications associated with Interim Stabilization. Included in RPP-6028 are tables defining the chemical constituents of concern to which transfer lines will be exposed. Current Interim Stabilization Program planning forecasts that the at-grade transfer lines will be required to convey pumpable waste for as much as three years after commissioning, RPP-6028 Section 3.2.7. Performance Incentive Number ORP-05 requires that all the Single Shell Tanks be Interim Stabilized by September 30, 2003. The Tri-Party Agreement (TPA) milestone M-41-00, enforced by a federal consent decree, requires all the Single Shell Tanks to be Interim stabilized by September 30, 2004. By meeting the Performance Incentive the TPA milestone is met. Prudent engineering dictates that the equipment used to transfer waste have a life in excess of the forecasted operational time period, with some margin to allow for future adjustments to the planned schedule. This document evaluates the effective service life of the Hose-in-Hose Transfer Lines, based on information submitted by the manufacturer, published literature and calculations. The effective service life of transfer line assemblies is a function of several factors. Foremost among these are the hose material's resistance to the harmful effects of process fluid characteristics, ambient environmental conditions, exposure to ionizing radiation and the

  6. Voice of the customer---a roadmap for service improvement.

    Science.gov (United States)

    Uberoi, Ravinder S; Nayak, Yogamaya; Sachdeva, Pritindira; Sibal, Anupam

    2013-01-01

    Patient satisfaction surveys help a great deal in identifying ways of improving a hospital's services. Ultimately, that translates into better care and happier patients. Moreover, it shows the staff and the community that the hospital is serious about quality and is looking for ways to improve. This article describes how the Voice of the Customer (VOC) Survey can be used as a tool for improving services. Regular monitoring of VOC scores is essential for minimizing the gaps between service delivery and patient expectations. The present study showcases the various initiatives undertaken to improve the VOC scores from an original 4.40 to 4.77 (on a 5 point scale) at the hospital under study.

  7. Determining Service Life of Respirator Cartridges Using a Simple and Practical Method: Case Study in a Car Manufacturing Industry

    Directory of Open Access Journals (Sweden)

    A.M Rashidi

    2012-01-01

    Full Text Available Background and aims: For ensuring about proper performance of air-purifying respirators in providing protection against workplace contaminants, it is necessary to change the respirator cartridges before the end of their service life. The aim of this study was determination of service life of organic vapor cartridges using a simple and practical method in a spray painting booth of a car manufacturing industry.   Methods: NIOSH MultiVapor software was used for estimating service life of respirator cartridges based on workplace conditions and cartridge specifications. Efficiency of determined service life was investigated using an apparatus for field testing of cartridges in the workplace.   Results: The results showed that existing schedule for changing the respirator cartridges is not effective and no longer provide adequate protection for sprayers against organic contaminants while working in a painting booth. It is necessary to change the cartridges before their estimated service life (every 4 hours.   Conclusion: NIOSH MultiVapor has acceptable efficiency for determining respirator cartridges service life and could be used as a simple and practical method in the workplace. Moreover, Service life estimated by this software was confirmed by cartridge field test apparatus.

  8. Measures to improve the quality of hotel services

    Directory of Open Access Journals (Sweden)

    Anca MADAR

    2017-07-01

    Full Text Available This article aims to exemplify how, starting from the evaluation of customer satisfaction on service quality, the hotel units’ management, can apply different measures and strategies to improve it. To achieve the target, a marketing research survey is conducted based on a sample of 120 customers of Hotel „Kronwell” at the end of 2013. After analysing customer’ responses a series of measures have been taken to improve the quality of services offered by this hotel, then at the end of 2015 a new research was achieved, based on the same questionnaire. The results of this research highlight the increasing of customer satisfaction as a result of improving the quality of hotel services, supported by growth in net profit, turnover and decrease of employees’ number.

  9. Improving ecosystem service frameworks to address wicked problems

    Directory of Open Access Journals (Sweden)

    Kathryn K. Davies

    2015-06-01

    Full Text Available Complex problems often result from the multiple interactions between human activities and ecosystems. The interconnected nature of ecological and social systems should be considered if these "wicked problems" are to be addressed. Ecosystem service approaches provide an opportunity to link ecosystem function with social values, but in practice the essential role that social dynamics play in the delivery of outcomes remains largely unexplored. Social factors such as management regimes, power relationships, skills, and values, can dramatically affect the definition and delivery of ecosystem services. Input from a diverse group of stakeholders improves the capacity of ecosystem service approaches to address wicked problems by acknowledging diverse sets of values and accounting for conflicting world views. Participatory modeling can incorporate both social and ecological dynamics into decision making that involves stakeholders, but is itself a complex social undertaking that may not yield precise or predictable outcomes. We explore the efficacy of different types of participatory modeling in relation to the integration of social values into ecosystem services frameworks and the generation of four important elements of social capital needed to address wicked problems: enhancing social learning and capacity building; increasing transparency; mediating power; and building trust. Our findings indicate that mediated modeling, group mapping, and mental/conceptual modeling are likely to generate elements of social capital that can improve ecosystem service frameworks. Participatory simulation, system dynamic modeling, and Bayesian belief networks, if utilized in isolation, were found to have a low likelihood of generating the social capital needed to improve ecosystem services frameworks. Scenario planning, companion modeling, group model building, and participatory mapping all generate a moderate to high level of social capital elements that improve the

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

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

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

  11. Applying GRA and QFD to Improve Library Service Quality

    Science.gov (United States)

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

    This paper applied Grey Relational Analysis (GRA) to Quality Function Deployment (QFD) to identify service improvement techniques for an academic library. First, reader needs and their importance, and satisfaction degrees were examined via questionnaires. Second, the service improvement techniques for satisfying the reader needs were developed by…

  12. Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

    Science.gov (United States)

    Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

    2015-11-01

    The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

  13. Developing a service improvement initiative for people with learning disabilities in hospice settings.

    Science.gov (United States)

    Springall, Fiona

    2018-03-21

    People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  14. Evaluation of Hose in Hose Transfer Line Service Life for Hanford's Interim Stabilization Program

    International Nuclear Information System (INIS)

    TORRES, T.D.

    2000-01-01

    RPP-6153, Engineering Task Plan for Hose-in-Hose Transfer System for the Interim Stabilization Program, defines the programmatic goals, functional requirements, and technical criteria for the development and subsequent installation of transfer line equipment to support Hanford's Interim Stabilization Program. RPP-6028, Specification for Hose in Hose Transfer Lines for Hanford's Interim Stabilization Program, has been issued to define the specific requirements for the design, manufacture, and verification of transfer line assemblies for specific waste transfer applications. Included in RPP-6028 are tables defining the chemical constituents of concern to which transfer lines will be exposed. Current Interim Stabilization Program planning forecasts that the at-grade transfer lines will be required to convey pumpable waste for as much as three years after commissioning. Prudent engineering dictates that the equipment placed in service have a working life in excess of this forecasted time period, with some margin to allow for future adjustments to the planned schedule. This document evaluates the effective service life of the Hose-in-Hose Transfer Lines, based on information submitted by the manufacturer and published literature. The effective service life of transfer line assemblies is a function of several factors. Foremost among these are process fluid characteristics, ambient environmental conditions, and the manufacturer's stated shelf life. This evaluation examines the manufacturer's certification of shelf life, the manufacturer's certifications of chemical compatibility with waste, and published literature on the effects of exposure to ionizing radiation on the mechanical properties of elastomeric materials to evaluate transfer line service life

  15. Determining service improvement priority in a zoological park

    Directory of Open Access Journals (Sweden)

    Ronald Sukwadi

    2014-01-01

    Full Text Available Purpose: The objective of this research is to determine the service improvement priority based on tourist judgements and experiences on service quality in a zoological park. Design/methodology/approach: A powerful integrated model was developed to acquire accurate critical service attributes and their priority ranks that can promote tourist satisfaction and tourist loyalty. Drawing on relevant literature, a model was proposed based on tourists’ perspective by integrating structural equation model (SEM with SERVQUAL and refined Kano models. Findings and Originality/value: Based on the analysis of data through some quantitative tools, the study helped in prioritizing the critical service attributes, which, if adopted, improved, and implemented, could lead to satisfaction of tourists. This will help a zoological park to propose more efficient and value-added improvement policies of the service Research limitations/implications: The primary limitation in the scope its sample. Because the study involved only one Zoological Park in Indonesia, the results cannot be generalized across a national wide spectrum. Originality/value: The study was the first to successfully apply an integrated model in tourism sector, which has previously not been used. The study has hopefully opened up an area of research and methodology that could provide considerable further benefits for researchers interested in this topic. Moreover, the integrated model has proven to be useful in determining the priority rank of critical service quality attributes.

  16. Associated and mediating variables related to quality of life among service users with mental disorders.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2018-02-01

    This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

  17. NASA's Evolutionary Xenon Thruster (NEXT) Project Qualification Propellant Throughput Milestone: Performance, Erosion, and Thruster Service Life Prediction After 450 kg

    Science.gov (United States)

    Herman, Daniel A.

    2010-01-01

    The NASA s Evolutionary Xenon Thruster (NEXT) program is tasked with significantly improving and extending the capabilities of current state-of-the-art NSTAR thruster. The service life capability of the NEXT ion thruster is being assessed by thruster wear test and life-modeling of critical thruster components, such as the ion optics and cathodes. The NEXT Long-Duration Test (LDT) was initiated to validate and qualify the NEXT thruster propellant throughput capability. The NEXT thruster completed the primary goal of the LDT; namely to demonstrate the project qualification throughput of 450 kg by the end of calendar year 2009. The NEXT LDT has demonstrated 28,500 hr of operation and processed 466 kg of xenon throughput--more than double the throughput demonstrated by the NSTAR flight-spare. Thruster performance changes have been consistent with a priori predictions. Thruster erosion has been minimal and consistent with the thruster service life assessment, which predicts the first failure mode at greater than 750 kg throughput. The life-limiting failure mode for NEXT is predicted to be loss of structural integrity of the accelerator grid due to erosion by charge-exchange ions.

  18. Improved servicing equipment for steam generators

    International Nuclear Information System (INIS)

    Hedtke, James C.

    1998-01-01

    To help keep personnel exposure as low as reasonably achievable and reduce critical path outage time, most nuclear plants of PWR design in the USA are now using improved equipment to service their steam generators (SGs) during outages. Because of the success of this equipment in the USA, two Belgian plants and one English plant have purchased this equipment, and other nuclear plants in Europe are also considering procurement. The improved SG servicing equipment discussed in this paper discusses consists of nozzle dams, segmented multi-stud tensioner, primary manway cover handling tool set, shield door and fastener cleaner. This equipment is specifically designed for the individual plant application and can also be specified for replacement SG projects. All of the equipment can be used without modification of the existing SGs. (author)

  19. Development of laboratory acceleration test method for service life prediction of concrete structures

    International Nuclear Information System (INIS)

    Cho, M. S.; Song, Y. C.; Bang, K. S.; Lee, J. S.; Kim, D. K.

    1999-01-01

    Service life prediction of nuclear power plants depends on the application of history of structures, field inspection and test, the development of laboratory acceleration tests, their analysis method and predictive model. In this study, laboratory acceleration test method for service life prediction of concrete structures and application of experimental test results are introduced. This study is concerned with environmental condition of concrete structures and is to develop the acceleration test method for durability factors of concrete structures e.g. carbonation, sulfate attack, freeze-thaw cycles and shrinkage-expansion etc

  20. Improving the service life and performance of CANDU fuel channels

    International Nuclear Information System (INIS)

    Causey, A.R.; Cheadle, B.A.; Coleman, C.E.; Price, E.G.

    1997-01-01

    The development objective for CANDU fuel channels is to produce a design that can operate for 40 years at 90% capacity. Steady progress toward this objective is being made. The factors that determine the life of the channel are reviewed and the processes necessary to achieve the objectives identified. Performance of future fuel channels will be enhanced by reduced operating costs, increased safety margins to postulated accident conditions, and reduced retubing costs compared to current channels. The approaches to these issues are discussed briefly in the paper. (author)

  1. Improving the service life and performance of CANDU fuel channels

    International Nuclear Information System (INIS)

    Coleman, C.E.; Cheadle, B.A.; Causey, A.R.; Doubt, G.L.; Fong, R.W.L.; Venkatapathi, S.

    1996-03-01

    The development objective for CANDU fuel channels is to produce a design that can operate for 40 years at 90% capacity. Steady progress toward this objective is being made. The factors that determine the life of a CANDU fuel channel are reviewed and the processes necessary to achieve the objectives are identified. Performance of future fuel channels will be enhanced by reduced operating costs and increased safety margins to postulated accident conditions compared with those for current channels. The approaches to these issues are discussed briefly in this report. (author)

  2. mORCA: ubiquitous access to life science web services.

    Science.gov (United States)

    Diaz-Del-Pino, Sergio; Trelles, Oswaldo; Falgueras, Juan

    2018-01-16

    Technical advances in mobile devices such as smartphones and tablets have produced an extraordinary increase in their use around the world and have become part of our daily lives. The possibility of carrying these devices in a pocket, particularly mobile phones, has enabled ubiquitous access to Internet resources. Furthermore, in the life sciences world there has been a vast proliferation of data types and services that finish as Web Services. This suggests the need for research into mobile clients to deal with life sciences applications for effective usage and exploitation. Analysing the current features in existing bioinformatics applications managing Web Services, we have devised, implemented, and deployed an easy-to-use web-based lightweight mobile client. This client is able to browse, select, compose parameters, invoke, and monitor the execution of Web Services stored in catalogues or central repositories. The client is also able to deal with huge amounts of data between external storage mounts. In addition, we also present a validation use case, which illustrates the usage of the application while executing, monitoring, and exploring the results of a registered workflow. The software its available in the Apple Store and Android Market and the source code is publicly available in Github. Mobile devices are becoming increasingly important in the scientific world due to their strong potential impact on scientific applications. Bioinformatics should not fall behind this trend. We present an original software client that deals with the intrinsic limitations of such devices and propose different guidelines to provide location-independent access to computational resources in bioinformatics and biomedicine. Its modular design makes it easily expandable with the inclusion of new repositories, tools, types of visualization, etc.

  3. MULTIMODAL FEEDBACK PROVISION IN IMPROVING PRE-SERVICE TEACHERS’ COMPETENCE

    Directory of Open Access Journals (Sweden)

    Fazri Nur Yusuf

    2017-09-01

    Full Text Available Studies on potentials of feedback over English language teaching seem not to have not been well-revealed, including studies on the use of feedback to improve English pre-service teachers’ competence. The present study investigates to what extent a multimodal feedback can influence pre-service teachers’ teaching, and which teaching aspects are influenced. Twenty five pre-service teachers taking Microteaching Course served as respondents supervised by a course advisor. The data were collected by teacher observation in a rating-scale form, self-appraisal, and interviews. The data were analyzed by using correlated sample t-test and the eight teaching components proposed by Brown (2001. The results showed that after multimodal feedback provision, pre-service teachers indicated an improvement significantly in seven out of eight teaching aspects. The provision of multimodal feedback could improve their teaching competence on preparation, instructional objective elicitation, mastery of instructional materials, use of media, and classroom management, including classroom language. But, the results do not indicate that they perform well on reflection and follow-up due to some reasons. In addition, the results evince that multimodal feedback provision could improve pre-service teachers’ pedagogical competence when the multimodal feedback is integrated with content, interpersonal relationship, and management.

  4. Improving basic life support training for medical students

    OpenAIRE

    Lami, Mariam; Nair, Pooja; Gadhvi, Karishma

    2016-01-01

    Mariam Lami, Pooja Nair, Karishma GadhviFaculty of Medicine, Imperial College, London, London, UKAbstract: Questions have been raised about basic life support (BLS) training in medical education. This article addresses the research evidence behind why BLS training is inadequate and suggests recommendations for improving BLS training for medical students.Keywords: medical education, basic life support

  5. Computational Everyday Life Human Behavior Model as Servicable Knowledge

    Science.gov (United States)

    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.

  6. Effective interventions on service quality improvement in a physiotherapy clinic.

    Science.gov (United States)

    Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

    2014-01-01

    Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (PService quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

  7. Improving the service life and performance of CANDU fuel channels

    International Nuclear Information System (INIS)

    Causey, A.R.; Cheadle, B.A.; Coleman, C.E.; Price, E.G.

    1996-02-01

    The development objective for CANDU fuel channels is to produce a design that can operate for 40 years at 90% capacity. Steady progress toward this objective is being made. The factors that determine the life of a CANDU fuel channel are reviewed and the processes necessary to achieve the objectives identified. Performance of future fuel channels will be enhanced by reduced operating costs, increased safety margins to postulated accident conditions, and reduced retubing costs compared with those for current channels. The approaches to these issues are discussed briefly in this report. (author). 14 refs., 1 tab., 8 figs

  8. Improving end-of-life care: Recommendations from the IOM.

    Science.gov (United States)

    Dobbins, Elizabeth H

    2016-09-22

    A 2014 consensus report by the Institute of Medicine offers recommendations for healthcare providers to decrease unwanted care and improve the quality of life at the end of life. This article discusses the recommendations of interest to advanced practice registered nurses.

  9. Innovation in health economic modelling of service improvements for longer-term depression: demonstration in a local health community.

    Science.gov (United States)

    Tosh, Jonathan; Kearns, Ben; Brennan, Alan; Parry, Glenys; Ricketts, Thomas; Saxon, David; Kilgarriff-Foster, Alexis; Thake, Anna; Chambers, Eleni; Hutten, Rebecca

    2013-04-26

    The purpose of the analysis was to develop a health economic model to estimate the costs and health benefits of alternative National Health Service (NHS) service configurations for people with longer-term depression. Modelling methods were used to develop a conceptual and health economic model of the current configuration of services in Sheffield, England for people with longer-term depression. Data and assumptions were synthesised to estimate cost per Quality Adjusted Life Years (QALYs). Three service changes were developed and resulted in increased QALYs at increased cost. Versus current care, the incremental cost-effectiveness ratio (ICER) for a self-referral service was £11,378 per QALY. The ICER was £2,227 per QALY for the dropout reduction service and £223 per QALY for an increase in non-therapy services. These results were robust when compared to current cost-effectiveness thresholds and accounting for uncertainty. Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services.

  10. The Climate Services Partnership (CSP): Working Together to Improve Climate Services Worldwide

    Science.gov (United States)

    Zebiak, S.; Brasseur, G.; Members of the CSP Coordinating Group

    2012-04-01

    Throughout the world, climate services are required to address urgent needs for climate-informed decision-making, policy and planning. These needs were explored in detail at the first International Conference on Climate Services (ICCS), held in New York in October 2011. After lengthy discussions of needs and capabilities, the conference culminated in the creation of the Climate Services Partnership (CSP). The CSP is an informal interdisciplinary network of climate information users, providers, donors and researchers interested in improving the provision and development of climate services worldwide. Members of the Climate Services Partnership work together to share knowledge, accelerate learning, develop new capacities, and establish good practices. These collaborative efforts will inform and support the evolution and implementation of the Global Framework for Climate Services. The Climate Services Partnership focuses its efforts on three levels. These include: 1. encouraging and sustaining connections between climate information providers, users, donors, and researchers 2. gathering, synthesizing and disseminating current knowledge on climate services by way of an online knowledge management platform 3. generating new knowledge on critical topics in climate service development and provision, through the creation of focused working groups on specific topics To date, the Climate Services Partnership has made progress on all three fronts. Connections have been fostered through outreach at major international conferences and professional societies. The CSP also maintains a website and a monthly newsletter, which serves as a resource for those interested in climate services. The second International Conference on Climate Services (ICCS2) will be held in Berlin in September. The CSP has also created a knowledge capture system that gathers and disseminates a wide range of information related to the development and provision of climate services. This includes an online

  11. Incremental cost-effectiveness of trauma service improvements for road trauma casualties: experience of an Australian major trauma centre.

    Science.gov (United States)

    Dinh, Michael M; Bein, Kendall J; Hendrie, Delia; Gabbe, Belinda; Byrne, Christopher M; Ivers, Rebecca

    2016-09-01

    Objective The aim of the present study was to estimate the cost-effectiveness of trauma service funding enhancements at an inner city major trauma centre. Methods The present study was a cost-effectiveness analysis using retrospective trauma registry data of all major trauma patients (injury severity score >15) presenting after road trauma between 2001 and 2012. The primary outcome was cost per life year gained associated with the intervention period (2007-12) compared with the pre-intervention period (2001-06). Incremental costs were represented by all trauma-related funding enhancements undertaken between 2007 and 2010. Risk adjustment for years of life lost was conducted using zero-inflated negative binomial regression modelling. All costs were expressed in 2012 Australian dollar values. Results In all, 876 patients were identified during the study period. The incremental cost of trauma enhancements between 2007 and 2012 totalled $7.91million, of which $2.86million (36%) was attributable to road trauma patients. After adjustment for important covariates, the odds of in-hospital mortality reduced by around half (adjusted odds ratio (OR) 0.48; 95% confidence interval (CI) 0.27, 0.82; P=0.01). The incremental cost-effectiveness ratio was A$7600 per life year gained (95% CI A$5524, $19333). Conclusion Trauma service funding enhancements that enabled a quality improvement program at a single major trauma centre were found to be cost-effective based on current international and Australian standards. What is known about this topic? Trauma quality improvement programs have been implemented across most designated trauma hospitals in an effort to improve hospital care processes and outcomes for injured patients. These involve a combination of education and training, the use of audit and key performance indicators. What does this paper add? A trauma quality improvement program initiated at an Australian Major Trauma Centre was found to be cost-effective over 12 years with

  12. Partnership working and improved service delivery: views of staff providing sexual health services.

    Science.gov (United States)

    Pow, Janette; Elliott, Lawrie; Raeside, Robert; Themessl-Huber, Markus; Claveirole, Anne

    2013-07-01

    Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provision, however, is lacking. Our aim was to assess the views of staff as to the conditions required for partnership working. This study was a cross-sectional survey of 687 staff offering sexual health education, information or support to young people in the Healthy Respect intervention area in Scotland. Views of each variable were scored and structural equation modelling was used to assess the theoretical model. Responses were received from 284 (41%) staff. Greater strength of partnership was directly associated with increasing the number of referrals. Establishing professional roles between organizations was also associated with increasing the number of referrals. Strength of partnership was indirectly associated with working more effectively with young people and this relationship depended on clear communication, trust, established professional roles and shared resources. Effective partnership working depends on a number of interdependent relationships between organizations, which act synergistically to improve organizational outcomes. Effective partnership working leads to improved service delivery though there is a need for better controlled studies which demonstrate the effect on health outcomes.

  13. Measuring the Effect of Tourism Services on Travelers' Quality of Life: Further Validation.

    Science.gov (United States)

    Neal, Janet D.; Sirgy, M. Joseph; Uysal, Muzaffer

    2004-01-01

    lication and extension study provided additional validational support of the original tourism services satisfaction measure in relation to QOL-related measures.Neal, Sirgy and Uysal (1999) developed a model and a measure to capture the effect of tourism services on travelers' quality of life (QOL). They hypothesized that travelers' overall life…

  14. Risk based service life prediction of underground cast iron pipes subjected to corrosion

    International Nuclear Information System (INIS)

    Li, C.Q.; Mahmoodian, M.

    2013-01-01

    Aging and deterioration of underground cast iron pipes is inevitable after their long time in service, with corrosion being the most predominant mechanism for pipe failures. Although considerable research has been undertaken in the past few decades, more is on the effects of corrosion on structural capacity of pipes than that on the prediction of their service life. This paper presents a methodology to quantitatively assess the risk of pipe collapse and predict its remaining service life using a time-dependent reliability theory. The concept of stress intensity in fracture mechanics is employed to establish the failure criterion of pipe collapse. An empirical model is derived for maximum pit growth of corrosion from the available data based on mathematical regressions. An example is provided to illustrate the application of the proposed method. It is found in the paper that the risk of pipe collapse increases with an increase in the diameter of the pipe for both external and internal corrosion. It is also found that the tougher the pipe is, the smaller the risk of its collapse. The paper concludes that a time-dependent reliability method is a very useful tool to predict the risk of pipe collapse and its remaining service life. The proposed method can help the water industry develop rehabilitation or replacement strategy for existing pipe networks with a view for better management of the pipe asset

  15. A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bjerk, Maria; Brovold, Therese; Skelton, Dawn A; Bergland, Astrid

    2017-08-14

    Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service

  16. Room service improves patient food intake and satisfaction with hospital food.

    Science.gov (United States)

    Williams, R; Virtue, K; Adkins, A

    1998-07-01

    Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics.

  17. Assessing customer satisfaction for improving NOAA's climate products and services

    Science.gov (United States)

    Meyers, J. C.; Hawkins, M. D.; Timofeyeva, M. M.

    2009-12-01

    NOAA's National Weather Service (NWS) Climate Services Division (CSD) is developing a comprehensive climate user requirements process with the ultimate goal of producing climate services that meet the needs of NWS climate information users. An important part of this effort includes engaging users through periodical surveys conducted by the Claes Fornell International (CFI) Group using the American Customer Satisfaction Index (ACSI). The CFI Group conducted a Climate Services Satisfaction (CSS) Survey in May of 2009 to measure customer satisfaction with current products and services and to gain insight on areas for improvement. The CSS Survey rates customer satisfaction on a range of NWS climate services data and products, including Climate Prediction Center (CPC) outlooks, drought monitoring, and ENSO monitoring and forecasts, as well as NWS local climate data services. In addition, the survey assesses the users of the products to give the NWS insight into its climate customer base. The survey also addresses specific topics such as NWS forecast category names, probabilistic nature of climate products, and interpretation issues. The survey results identify user requirements for improving existing NWS climate services and introducing new ones. CSD will merge the survey recommendations with available scientific methodologies and operational capabilities to develop requirements for improved climate products and services. An overview of the 2009 survey results will be presented, such as users' satisfaction with the accuracy, reliability, display and functionality of products and services.

  18. Assessment of Extension Service Delivery on Improved Cassava ...

    African Journals Online (AJOL)

    Extension service delivery is too often merely seen as a vehicle for spreading scientific and technical progress and technology transfer. In the real sense, however, dissemination of knowledge is not a one way affair from scientists to producers. The study was conducted to assess extension service delivery on improved ...

  19. The quality infrastructure measuring, analyzing, and improving library services

    CERN Document Server

    Murphy, Sarah Anne

    2013-01-01

    Summarizing specific tools for measuring service quality alongside tips for using these tools most effectively, this book helps libraries of all kinds take a programmatic approach to measuring, analyzing, and improving library services.

  20. Web-service architecture for tools supporting life-long e-Learning platforms

    NARCIS (Netherlands)

    Dimov, Alexander; Stefanov, Krassen

    2009-01-01

    Dimov, A., & Stefanov, K. (2008). Web-service architecture for tools supporting life-long e-Learning platforms. In R. Koper, K. Stefanov & D. Dicheva (Eds.), Proceedings of the 5th International TENCompetence Open Workshop "Stimulating Personal Development and Knowledge Sharing" (pp. 67-71).

  1. High energy density, long life energy storage capacitor dielectric system

    International Nuclear Information System (INIS)

    Nichols, D.H.; Wilson, S.R.

    1977-01-01

    The evolution of energy storage dielectric systems shows a dramatic improvement in life and joule density, culminating in a 50% to 300% life improvement of polypropylene film-paper-phthalate ester over paper-castor oil depending on service. The physical and electrical drawbacks of castor oil are not present in the new system, allowing the capacitor designer to utilize the superior insulation resistance, dielectric strength, and corona resistance to full advantage. The result is longer life for equal joule density or greater joule density for equal life. Field service proof of the film-Geconol system superiority is based on 5 megajoule in operation and 16 megajoule on order

  2. Stator winding service life analysis of wet winding motor RCP

    International Nuclear Information System (INIS)

    Yeoh Eingyee; Li Linsen; Wang Ziguan; Shen Feng

    2017-01-01

    The reactor coolant pump type RUV of KSB is specially designed for the Westinghouse AP1000 reactor. It is hermetically sealed, wet winding motor pump. This wet winding motor concept has higher efficiency as compared to a canned motor since there are no eddy current losses, but this makes the stator cable insulator face the challenge of degradation by γ-irradiation in coolant. Radiation dose at the RUV is evaluated in interest from the material degradation point of view and the service life of stator winding in RUV is preliminarily analyzed. The values obtained are less than the dose rate and the dose which change the mechanical properties of the insulator material. According to the preliminary analysis, it can be concluded that the degradation of cable insulator of stator winding by γ-irradiation in coolant is negligible for the 60 years' service life of reactor coolant pump. This result also ensures crosslinked polyethylene used as cable insulator of stator winding is reliable in reactor coolant pump. (author)

  3. Assessment of and Improvement Strategies for the Housing of Healthy Elderly: Improving Quality of Life

    Directory of Open Access Journals (Sweden)

    I-Ming Feng

    2018-03-01

    Full Text Available Global population is aging, particularly in developed countries and cities. Through the “Friendly Elderly Cities” and “Aging in Place” initiatives, various countries are making great efforts to improve the welfare and quality of life of the elderly, with the aim of catering to the physical and spiritual health as well as social welfare of the elderly. In this regard, the improvement of the housing environment of the elderly is one of the key factors in their quality of life and health. This study aims to effectively assess and improve the housing environment of the elderly in order to enhance their quality of life; it also aims to contribute the knowledge about improving elderly housing by applying an assessment framework using expert interviews and data collected from relevant literature. Using a mixed Multi-Criteria Decision Analysis model, a combination of the DEMATEL (Decision Making Trial and Evaluation Laboratory-based ANP (Analytic Network Process (DANP and the modified VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR methods, and the investigations and assessments in the case study, this study proposes strategies and directions for improving elderly housing. The study results indicate that, as distinct from using traditional methodologies where the hypothesis criteria are mutually independent, the proposed hybrid model (examining real-life problems by considering the mutual influences of factors identifies a priority sequence wherein emphasis is placed on improving ventilation and air quality rather than adjustment of temperature. The systemic way of thinking shifts the focus from the most apparent problems to the root cause of the problems. Doing so avoids any mismatch of resource allocation in decision-making and thus maximizes the efficiency and sustainability of the improvement.

  4. STRATEGIC MARKETING PLANNING IN SPORTS – A PERSPECTIVE OF QUALITY OF LIFE IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Caescu Stefan Claudiu

    2012-12-01

    Full Text Available Strategic marketing planning requires that the marketing objectives strategies for a specific product-market configuration be in full correlation with the directions and the resources allocated at the corporate level or at the strategic business unit one. Such a correlation is more than necessary under the current market conditions, when the economic crisis affects both consumer behavior and corporate decisions. This article focuses on the particularities of strategic marketing planning in sport, given the fact that the vast majority of sports organizations in Romania, although very active on the reference market, do not have a marketing activity correlated with the medium and long term market needs. One of these needs refers to quality of life improvement, knowing that sport activities have positive influence on many dimensions of quality of life, such as health, education, social inclusion, relaxation and leisure. The improvement within the population participation in sport (both as an active participant and as a spectator, the increased duration of leisure and the development of private financing have led to the creation of a large market, where marketing plays a central role. Therefore the marketing management process must also be implemented within the sports organization, in order to make it easier in building and maintaining a relationship with the customer, especially if the organization wants a customer orientation strategy. Such an orientation includes identifying the current needs as well as the future ones in terms of target audience, to offer a series of sports products and services that bring their significant contribution to improving the quality of life. In this paper are highlighted the influences that consumer requirements concerning quality of life have on all components of marketing management process, starting with sports organization mission statement, up to establish strategies for the marketing mix (product, price

  5. Improving coal quality and service

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-06-01

    Russia's new coal export industry has quickly produced a generation of extremely experienced operators. While improvements are happening, can buyers also expect the service, flexibility and quality control that they get from other export sources? In the light of the first-ever Coaltrans Russia conference held in April the article reports on developments in Russia's coal industry, quoting from many of the papers presented. 5 photos.

  6. Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

    Science.gov (United States)

    Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

    2017-11-01

    Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

  7. Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

    Science.gov (United States)

    Desombre, T; Eccles, G

    1998-01-01

    This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

  8. Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

    Science.gov (United States)

    Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

    2015-09-01

    The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  9. Improving quality of service in the internet

    OpenAIRE

    Flückiger, François

    2000-01-01

    The Internet transport technology was designed to be robust, resilient to link or node outages, and with no single point of failure. The resulting connectionless system supports what is called a "best effort datagram delivery service", the perfo rmance of which is often greatly unpredictable. To improve the predictability of IP-based networks, several Quality of Service technologies have been designed over the past decade. The first one, RSVP, based on reservation of resources, is operational...

  10. A Framework and Improvements of the Korea Cloud Services Certification System.

    Science.gov (United States)

    Jeon, Hangoo; Seo, Kwang-Kyu

    2015-01-01

    Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed.

  11. A Framework and Improvements of the Korea Cloud Services Certification System

    Directory of Open Access Journals (Sweden)

    Hangoo Jeon

    2015-01-01

    Full Text Available Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed.

  12. A Framework and Improvements of the Korea Cloud Services Certification System

    Science.gov (United States)

    Jeon, Hangoo

    2015-01-01

    Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed. PMID:26125049

  13. Predicting the residual life of plant equipment - Why worry

    International Nuclear Information System (INIS)

    Jaske, C.E.

    1985-01-01

    Predicting the residual life of plant equipment that has been in service for 20 to 30 years or more is a major concern of many industries. This paper reviews the reasons for increased concern for residual-life assessment and the general procedures used in performing such assessments. Some examples and case histories illustrating procedures for assessing remaining service life are discussed. Areas where developments are needed to improve the technology for remaining-life estimation are pointed out. Then, some of the critical issues involved in residual-life assessment are identified. Finally, the future role of residual-life prediction is addressed

  14. Are patient surveys valuable as a service-improvement tool in health services? An overview

    Directory of Open Access Journals (Sweden)

    Patwardhan A

    2012-05-01

    Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improve “Health for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps 

  15. Reliability and service life of wood structures and buildings

    OpenAIRE

    Zdeňka Havířová; Pavel Kubů

    2005-01-01

    Service life of constructions and buildings of wood is dependent on temperature and moisture conditions in layers of the building cladding where the wood framework is built in. Temperature/moisture conditions or the corresponding equilibrium moisture content (EMC) of the construction show considerable effects on the functional reliability of the whole building from the viewpoint of mechanical resistance and stability (ER1), energy savings and thermal protection (ER6) and hygiene, health and e...

  16. Effectiveness and efficiency of improving HIV service provision for key populations in Nicaragua

    Directory of Open Access Journals (Sweden)

    Edward Ivor Broughton

    2016-11-01

    Full Text Available ObjectiveHIV in Nicaragua is concentrated among key populations (KPs – men who have sex with men, female sex workers and female transgender – in whom prevalence is 600-4 000 times higher than the general population. The USAID PrevenSida Project is aimed at increasing healthy behavior among KPs and people with HIV and improving testing, counseling, and continuity of prevention and treatment by building capacity and improving performance of non-governmental organizations (NGOs providing services to KPs. We evaluated the cost-effectiveness of PrevenSida’s activities. MethodsThis retrospective observational evaluation used individuals in KPs covered by NGOs receiving assistance from PrevenSida from 2012 to 2014. Cost-effectiveness analysis compared PrevenSida’s intervention with business-as-usual. Model inputs were generated from epidemiological modeling and PrevenSida’s records.ResultsBy 2014, 24 NGOs received grants and technical assistance from PrevenSida with 72 955 people in KPs served at $11.32/person ($9.39 to $16.55/person depending on region. The estimated incremental cost-effectiveness ratio was $50 700/HIV case averted or $2 600/Disability-adjusted Life Year (DALY averted (95% CI: $1 000-$99 000 and $50-$5 100, respectively.ConclusionPrevenSida distributed about $600 000 in grants and used $230 000 to support 24 NGOs in 2014. Cost-effectiveness from the program perspective compared to no program was slightly over half of GDP per capita per DALY averted, considered highly cost-effective by WHO criteria. Cost and efficiency varied by region, reflecting the number of people in KPs receiving services. Cost-sharing by NGOs improved cost-effectiveness from the program perspective and likely promotes sustainability. Focused interventions for KP service provision organizations can be acceptably efficient in this setting.

  17. Evaluation of Hose in Hose Transfer Line Service Life for Hanford's Interim Stabilization Program

    Energy Technology Data Exchange (ETDEWEB)

    TORRES, T.D.

    2000-08-24

    RPP-6153, Engineering Task Plan for Hose-in-Hose Transfer System for the Interim Stabilization Program, defines the programmatic goals, functional requirements, and technical criteria for the development and subsequent installation of transfer line equipment to support Hanford's Interim Stabilization Program. RPP-6028, Specification for Hose in Hose Transfer Lines for Hanford's Interim Stabilization Program, has been issued to define the specific requirements for the design, manufacture, and verification of transfer line assemblies for specific waste transfer applications. Included in RPP-6028 are tables defining the chemical constituents of concern to which transfer lines will be exposed. Current Interim Stabilization Program planning forecasts that the at-grade transfer lines will be required to convey pumpable waste for as much as three years after commissioning. Prudent engineering dictates that the equipment placed in service have a working life in excess of this forecasted time period, with some margin to allow for future adjustments to the planned schedule. This document evaluates the effective service life of the Hose-in-Hose Transfer Lines, based on information submitted by the manufacturer and published literature. The effective service life of transfer line assemblies is a function of several factors. Foremost among these are process fluid characteristics, ambient environmental conditions, and the manufacturer's stated shelf life. This evaluation examines the manufacturer's certification of shelf life, the manufacturer's certifications of chemical compatibility with waste, and published literature on the effects of exposure to ionizing radiation on the mechanical properties of elastomeric materials to evaluate transfer line service life.

  18. From theory to practice: improving the impact of health services research

    Directory of Open Access Journals (Sweden)

    Levine Robert

    2005-01-01

    Full Text Available Abstract Background While significant strides have been made in health research, the incorporation of research evidence into healthcare decision-making has been marginal. The purpose of this paper is to provide an overview of how the utility of health services research can be improved through the use of theory. Integrating theory into health services research can improve research methodology and encourage stronger collaboration with decision-makers. Discussion Recognizing the importance of theory calls for new expectations in the practice of health services research. These include: the formation of interdisciplinary research teams; broadening the training for those who will practice health services research; and supportive organizational conditions that promote collaboration between researchers and decision makers. Further, funding bodies can provide a significant role in guiding and supporting the use of theory in the practice of health services research. Summary Institutions and researchers should incorporate the use of theory if health services research is to fulfill its potential for improving the delivery of health care.

  19. Tackling the work-life balance challenge in Professional Service Firms: the impact of projects, organizing and service characteristics

    NARCIS (Netherlands)

    Noury, L.C.; Gand, Sébastien; Sardas, Jean-Claude

    2017-01-01

    Professional Service Firms (PSFs) are currently under considerable pressure for economic reasons (low growth, pressure on cost), but also from the emergence of individual demands for work-life balance (WLB) from professionals, which challenge traditional ways of organizing both projects and careers.

  20. Home care clients in the last year of life: is material deprivation associated with service characteristics?

    Science.gov (United States)

    Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve

    2011-09-01

    To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

  1. Improving high quality, equitable maternal health services in Malawi ...

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

    Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

  2. Public Willingness to Pay to Improve Services for Individuals With Serious Mental Illness.

    Science.gov (United States)

    Stone, Elizabeth M; McGinty, Emma E

    2018-05-08

    This study measured Americans' willingness to pay an additional $50 in taxes to improve health care and social services for individuals with serious mental illness. A nationally representative online survey was conducted with 1,010 respondents. Analysis examined how respondents' demographic characteristics and attitudes toward individuals with serious mental illness correlated with their willingness to pay additional taxes to improve health care and social services for this vulnerable population. A majority of respondents expressed willingness to pay $50 in additional taxes to improve health care services (60%) and social services (58%) for individuals with serious mental illness. Those with more negative attitudes toward individuals with serious mental illness were less willing to pay additional taxes to improve either service type. Many Americans are willing to pay additional taxes to improve health care and social services for individuals with serious mental illness.

  3. Developing the Service Template: From measurement to agendas for improvement

    OpenAIRE

    Williams, CS; Saunders, M

    2007-01-01

    Traditional survey based measures of service quality are argued to be problematic when reflecting individual services and turning measurement into action. This paper reviews developments to an alternative measurement approach, the Service Template Process and offers an extension to it. The extended process appears able to measure service users’ and deliverers’ perceptions of service quality independently. It also enables participants to jointly agree an agenda for quality improvement. The e...

  4. AREVA NP products and services for NPP operation and maintenance improvement

    International Nuclear Information System (INIS)

    Dechelette, Anne; Rat, Guy Le

    2009-01-01

    AREVA supplies customized services throughout the reactor improvement process according to clients' requirements: safety, performance, availability, obsolescence, operating and maintenance conditions, environment and technical assistance. Form design studies to on site modification and implementation including requalification tests, AREVA, as OEM*, has various products and services in the field of Engineering and Upgrading to satisfy client demands. In keeping with Inpo's AP913 approach, AREVA is particularly skilled in this methodology to help utilities improve availability factor and maintenance programs. AREVA has customized its services to many utilities in cooperating with local partners, suppliers, and engineering service providers through partnerships, consortiums, joint ventures, etc. AREVA's knowledge of the fleet's operation and maintenance experience helps NPP clients to identify the most cost effective improvements and approaches. Different examples of modifications of modifications and improvements performed in France and abroad illustrate AREVA's involvement in the NPP continuous upgrade process

  5. Public health dental hygiene: an option for improved quality of care and quality of life.

    Science.gov (United States)

    Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura

    2013-10-01

    The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.

  6. Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

    NARCIS (Netherlands)

    Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

    2010-01-01

    BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

  7. MBI FRAMEWORK EXTENSION TOWARDS CLOUD SERVICE IMPROVEMENT FROM CONSUMER PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Soňa Karkošková

    2017-03-01

    Full Text Available Cloud computing is changing the way that organizations utilize IT resources with a corresponding impact on the role of IT management. To help organizations with managing their business informatics, Management of Business Informatics (MBI framework has been developed. The problem was that this framework did not explicitly reflect managing cloud services from cloud service consumer perspective and specifically did not address managing of cloud service improvement from consumer perspective. Therefore, analysis of MBI framework was performed from cloud service consumer viewpoint to design extension of MBI framework towards cloud service improvement management. Proposal of MBI framework extension in an output of research process according to Design Science Research Methodology and its evaluation approach is based on methodology for the design and implementation of case studies for scientific purposes and on descriptive evaluation method using scenario.

  8. Improve services project -- Republic of the Marshall Islands.

    Science.gov (United States)

    Langidrik, J

    1995-01-01

    The Republic of the Marshall Islands has 60 dispensary sites, each staffed by 1 health assistant, to cover 80-800 people/site on 34 atolls. Until the spring of 1994, only curative services were available on a regular basis, and preventive services were provided by traveling health teams from the urban centers. In 1994, the health assistants in selected outer islands were trained to administer immunizations from vaccines which are sent regularly by air. Additional project sites are being selected. In 1993, 2 dispensaries initiated a project to 1) increase the number of women with access to prenatal care during the first trimester, 2) increase immunization levels, 3) improve access to preventive services, and 4) improve reporting and record-keeping systems. This project includes an important training component for the health assistant, the wife of the health assistant, the traditional birth attendant, the youth peer educator, community leaders, and a member of the local council. By 1994, this project was expanded to 13 dispensaries on 2 atolls. In 1995, 18 more dispensaries on 4 more atolls will be able to offer these additional services.

  9. A Model for Service Life Control of Selected Device Systems

    Directory of Open Access Journals (Sweden)

    Zieja Mariusz

    2014-04-01

    Full Text Available This paper presents a way of determining distribution of limit state exceedence time by a diagnostic parameter which determines accuracy of maintaining zero state. For calculations it was assumed that the diagnostic parameter is deviation from nominal value (zero state. Change of deviation value occurs as a result of destructive processes which occur during service. For estimation of deviation increasing rate in probabilistic sense, was used a difference equation from which, after transformation, Fokker-Planck differential equation was obtained [4, 11]. A particular solution of the equation is deviation increasing rate density function which was used for determining exceedance probability of limit state. The so-determined probability was then used to determine density function of limit state exceedance time, by increasing deviation. Having at disposal the density function of limit state exceedance time one determined service life of a system of maladjustment. In the end, a numerical example based on operational data of selected aircraft [weapon] sights was presented. The elaborated method can be also applied to determining residual life of shipboard devices whose technical state is determined on the basis of analysis of values of diagnostic parameters.

  10. Evaluating Fidelity to a Modified NIATx Process Improvement Strategy for Improving HIV Services in Correctional Facilities.

    Science.gov (United States)

    Pankow, Jennifer; Willett, Jennifer; Yang, Yang; Swan, Holly; Dembo, Richard; Burdon, William M; Patterson, Yvonne; Pearson, Frank S; Belenko, Steven; Frisman, Linda K

    2018-04-01

    In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.

  11. Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services.

    Science.gov (United States)

    Cranwell, K; Polacsek, M; McCann, T V

    2017-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments. Introduction Mental health service users with medical co-morbidity frequently experience difficulties accessing appropriate treatment in medical hospitals, and often there is poor collaboration within and between services. Little is known about mental health nurses' perspectives on how to address these problems. Aim To explore mental health nurses

  12. Improving maternity services for Indigenous women in Australia: moving from policy to practice.

    Science.gov (United States)

    Kildea, Sue; Tracy, Sally; Sherwood, Juanita; Magick-Dennis, Fleur; Barclay, Lesley

    2016-10-17

    The well established disparities in health outcomes between Indigenous and non-Indigenous Australians include a significant and concerning higher incidence of preterm birth, low birth weight and newborn mortality. Chronic diseases (eg, diabetes, hypertension, cardiovascular and renal disease) that are prevalent in Indigenous Australian adults have their genesis in utero and in early life. Applying interventions during pregnancy and early life that aim to improve maternal and infant health is likely to have long lasting consequences, as recognised by Australia's National Maternity Services Plan (NMSP), which set out a 5-year vision for 2010-2015 that was endorsed by all governments (federal and state and territory). We report on the actions targeting Indigenous women, and the progress that has been achieved in three priority areas: The Indigenous maternity workforce; Culturally competent maternity care; and; Developing dedicated programs for "Birthing on Country". The timeframe for the NMSP has expired without notable results in these priority areas. More urgent leadership is required from the Australian government. Funding needs to be allocated to the priority areas, including for scholarships and support to train and retain Indigenous midwives, greater commitment to culturally competent maternity care and the development and evaluation of Birthing on Country sites in urban, rural and particularly in remote and very remote communities. Tools such as the Australian Rural Birth Index and the National Maternity Services Capability Framework can help guide this work.

  13. Improving basic life support training for medical students.

    Science.gov (United States)

    Lami, Mariam; Nair, Pooja; Gadhvi, Karishma

    2016-01-01

    Questions have been raised about basic life support (BLS) training in medical education. This article addresses the research evidence behind why BLS training is inadequate and suggests recommendations for improving BLS training for medical students.

  14. Energizing Local Values For Tourism Services Improvement

    Directory of Open Access Journals (Sweden)

    Budi Purnomo

    2012-06-01

    Full Text Available People in most cultures would probably agree that politeness is needed during their interaction. However there may be differing opinions as to when they should be polite. In tourism industry, tourism service providers’ act as hosts and tourists act as guests. Typically hosts will try to act politely and use appropriate politeness norms when serving guests to ensure their satisfaction. The research findings show that the tourism service providers in Central Java use various unggah-ungguh ‘politeness norms’ when serving English speaking tourists and Indonesian speaking tourists. Besides that, there are some violations made by the tourism service providers in using unggah-ungguh ‘politeness norms’. The research findings also show that there are similar and different perspectives on unggah-ungguh ‘politeness norms’ between English speaking tourists with Western culture backgrounds and Indonesian speaking tourists with Indonesian culture backgrounds towards the politeness norms used by the tourism service providers in Central Java. The findings imply the needs of energizing unggah-ungguh ‘politeness norms’ which is discovered from well known noble Javanese values used by the tourism service providers for tourism service improvement.

  15. Service quality improvement of ground staff at Don Mueang International Airport

    Directory of Open Access Journals (Sweden)

    Sittichai Sricharoenpramong

    2018-01-01

    Full Text Available The purposes of this research were to: 1 evaluate the service quality of the ground staff at Don Mueang International Airport (DMK, 2 compare the ground staff quality service perception of Thai passengers at DMK, and 3 provide guidelines for service quality improvement of the DMK airlines ground staff. A sample size of 400 Thai domestic passengers was accidentally selected at DMK. A questionnaire was used as a research tool for data collection. Five dimensions of service quality were evaluated: reliability, responsiveness, assurance, empathy, and tangibles. It was found that the service quality of ground staff was moderate. The highest dimension of service quality realization was tangibles, followed successively by reliability, assurance, empathy, and responsiveness. The passengers' perception of the ground staff's service quality varied by gender and age group. Guidelines were proposed for the improvement of ground staff service quality at DMK based on the findings. Keywords: airport, ground staff, quality of service

  16. Evaluation of Service Life of Polystyrene in Tropical Marine Environment by Principal Component Analysis

    Directory of Open Access Journals (Sweden)

    Dongdong Song

    2015-01-01

    Full Text Available To predict the service life of polystyrene (PS under an aggressive environment, the nondimensional expression Z was established from a data set of multiple properties of PS by principal component analysis (PCA. In this study, PS specimens were exposed to the tropical environment on Xisha Islands in China for two years. Chromatic aberration, gloss, tensile strength, elongation at break, flexural strength, and impact strength were tested to evaluate the aging behavior of PS. Based on different needs of industries, each of the multiple properties could be used to evaluate the service life of PS. However, selecting a single performance variation will inevitably hide some information about the entire aging process. Therefore, finding a comprehensive measure representing the overall aging performance of PS can be highly significant. Herein, PCA was applied to obtain a specific property (Z which can represent all properties of PS. Z of PS degradation showed a slight decrease for the initial two months of exposure after which it increased rapidly in the next eight months. Subsequently, a slower increase of Z value was observed. From the three different stages shown as Z value increases, three stages have been identified for PS service life.

  17. Proceedings of the IAEA Specialists' Meeting on experience and further improvement of in-service inspection methods and programmes of NPPs with particular emphasis on on-line techniques

    International Nuclear Information System (INIS)

    1989-01-01

    The proceedings are presented of an IAEA specialists meeting devoted to the exchange of views and experience with respect to understanding and quantifying materials ageing and degradation processes, to assessing residual life of components, to in-service materials testing, all this with the objective of improving reliability and, wherever possible, extending the useful life of nuclear power plants. (L.O.)

  18. Chronic care model in primary care: can it improve health-related quality of life?

    Directory of Open Access Journals (Sweden)

    Aryani FMY

    2016-01-01

    Full Text Available Faridah Md Yusof Aryani,1 Shaun Wen Huey Lee,2 Siew Siang Chua,3 Li Ching Kok,4 Benny Efendie,2 Thomas Paraidathathu5 1Pharmaceutical Services Division, Ministry of Health Malaysia, Petaling Jaya, 2School of Pharmacy, Monash University Malaysia, Bandar Sunway, 3Department of Pharmacy, Faculty of Medicine, University of Malaya, 4Clinical Research Centre, Kuala Lumpur Hospital, Kuala Lumpur, 5School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia Purpose: Chronic diseases such as hypertension, diabetes mellitus, and hyperlipidemia are public health concerns. However, little is known about how these affect patient-level health measures. The aim of the study was to examine the impact of a chronic care model (CCM on the participant’s health-related quality of life (QoL. Patients and methods: Participants received either usual care or CCM by a team of health care professionals including pharmacists, nurses, dietitians, and general practitioners. The participants in the intervention group received medication counseling, adherence, and dietary advice from the health care team. The QoL was measured using the EQ-5D (EuroQoL-five dimension, health-related quality of life questionnaire and comparison was made between usual care and intervention groups at the beginning and end of the study at 6 months. Results: Mean (standard deviation EQ-5D index scores improved significantly in the intervention group (0.92±0.10 vs 0.95±0.08; P≤0.01, but not in the usual care group (0.94±0.09 vs 0.95±0.09; P=0.084. Similarly, more participants in the intervention group reported improvements in their QoL compared with the usual care group, especially in the pain/discomfort and anxiety/depression dimensions. Conclusion: The implementation of the CCM resulted in significant improvement in QoL. An interdisciplinary team CCM approach should be encouraged, to ultimately result in behavior changes and improve the QoL of the patients. Keywords: diabetes

  19. Quality improvement initiatives in a case management service: case study.

    Science.gov (United States)

    Davies, Deborah J

    2015-01-01

    This article explores the importance of quality practices in underpinning the person-centred approach at a Community Options Program (COP) case management service in northern NSW. The NSW community care sector does not have a statutory excellence body to identify, promote and support improved practices and quality and safety across community services, and therefore the COP provider decided to establish a dedicated role to focus on the quality improvement of its service. The subsequent quality improvement initiatives have included mapping the clients' journey through the service, identifying areas to standardise practice, and creating service pathways. The clients' journey was used as the framework to identify where standardised practice was required, and a robust process was implemented to develop over 25 good practice guidelines and tools that addressed the variations in practice and enabled the service pathways to be developed. Prior to trialling the guidelines and tools, staff received education sessions on the anticipated changes to practice, and the practicality and applicability of the guidelines were evaluated at the end of the trials. This information was reviewed and the guidelines were amended accordingly before being rolled out. The guidelines have been in use for over 12 months and have provided the benchmark against which to audit practice, and have resulted in key performance improvements such as an increase in client review rates and a rise in the feedback response rate from clients, with a noticeable shift in the comments about the brokered support worker to acknowledging the role of their case manager. Formalising informal supports for those clients that lived alone also increased, which means these people are less reliant on services and there is a reduced risk of social isolation.

  20. Improvement of bench life-tests for automotive batteries

    Science.gov (United States)

    Richter, G.

    A common method for rating the endurance of automotive batteries is the bench life-test according to DIN, IEC, SAE or JIS. With an increasing number of maintenance-free batteries on the market, the application of these tests becomes more problematic. This is due to a step-by-step capacity decline during cycling if the content of autimony in the grid-alloy is decreased. The degradation in performance is caused by the phenomenon of acid stratification. Because this debilitating effect occurs only rarely in service (vehicle movement) if charging and discharging is well balanced, there is a need for a new bench life-test with conditions that are more representative of practical conditions. Research has shown that the main changes should be: (i) an accelerated (moved) battery during cycling; (ii) slightly lower charging or discharging capacity amplitude, also with a lower mean value.

  1. Role of yoga in the improvement of 'Quality of life' among the ...

    African Journals Online (AJOL)

    Yoga has proven value in treatment of various psychiatric disorders like Anxiety, Depression and Obsessive compulsive disorder. But its role in improving quality of life, among Schizophrenics was not established thoroughly. Present study was aimed to study the role of Yoga in improvement of Quality of Life among ...

  2. Using life strategies to explore the vulnerability of ecosystem services to invasion by alien plants

    NARCIS (Netherlands)

    Vicente, J.; Pinro, A.; Araujo, M.; Lomba, A.; Randin, C.; Guisan, A.; Honrado, J.; Verburg, P.H.

    2013-01-01

    Invasive plants can have different effects on ecosystem functioning and on the provision of ecosystem services, with the direction and magnitude of such effects depending on the service and ecosystem being considered, but also on the life strategies of the invaders. Strategies can influence

  3. Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services.

    Science.gov (United States)

    Stoneman, Alice; Atkinson, David; Davey, Maureen; Marley, Julia V

    2014-10-07

    Management of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia. Retrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit. diabetes care related activities, clinical outcome measures and factors influencing good diabetes related care and effective CQI. A total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change. Well

  4. Life cycle assessment needs predictive spatial modelling for biodiversity and ecosystem services

    Science.gov (United States)

    Chaplin-Kramer, Rebecca; Sim, Sarah; Hamel, Perrine; Bryant, Benjamin; Noe, Ryan; Mueller, Carina; Rigarlsford, Giles; Kulak, Michal; Kowal, Virginia; Sharp, Richard; Clavreul, Julie; Price, Edward; Polasky, Stephen; Ruckelshaus, Mary; Daily, Gretchen

    2017-01-01

    International corporations in an increasingly globalized economy exert a major influence on the planet's land use and resources through their product design and material sourcing decisions. Many companies use life cycle assessment (LCA) to evaluate their sustainability, yet commonly-used LCA methodologies lack the spatial resolution and predictive ecological information to reveal key impacts on climate, water and biodiversity. We present advances for LCA that integrate spatially explicit modelling of land change and ecosystem services in a Land-Use Change Improved (LUCI)-LCA. Comparing increased demand for bioplastics derived from two alternative feedstock-location scenarios for maize and sugarcane, we find that the LUCI-LCA approach yields results opposite to those of standard LCA for greenhouse gas emissions and water consumption, and of different magnitudes for soil erosion and biodiversity. This approach highlights the importance of including information about where and how land-use change and related impacts will occur in supply chain and innovation decisions. PMID:28429710

  5. Life cycle assessment needs predictive spatial modelling for biodiversity and ecosystem services

    Science.gov (United States)

    Chaplin-Kramer, Rebecca; Sim, Sarah; Hamel, Perrine; Bryant, Benjamin; Noe, Ryan; Mueller, Carina; Rigarlsford, Giles; Kulak, Michal; Kowal, Virginia; Sharp, Richard; Clavreul, Julie; Price, Edward; Polasky, Stephen; Ruckelshaus, Mary; Daily, Gretchen

    2017-04-01

    International corporations in an increasingly globalized economy exert a major influence on the planet's land use and resources through their product design and material sourcing decisions. Many companies use life cycle assessment (LCA) to evaluate their sustainability, yet commonly-used LCA methodologies lack the spatial resolution and predictive ecological information to reveal key impacts on climate, water and biodiversity. We present advances for LCA that integrate spatially explicit modelling of land change and ecosystem services in a Land-Use Change Improved (LUCI)-LCA. Comparing increased demand for bioplastics derived from two alternative feedstock-location scenarios for maize and sugarcane, we find that the LUCI-LCA approach yields results opposite to those of standard LCA for greenhouse gas emissions and water consumption, and of different magnitudes for soil erosion and biodiversity. This approach highlights the importance of including information about where and how land-use change and related impacts will occur in supply chain and innovation decisions.

  6. Life cycle assessment needs predictive spatial modelling for biodiversity and ecosystem services.

    Science.gov (United States)

    Chaplin-Kramer, Rebecca; Sim, Sarah; Hamel, Perrine; Bryant, Benjamin; Noe, Ryan; Mueller, Carina; Rigarlsford, Giles; Kulak, Michal; Kowal, Virginia; Sharp, Richard; Clavreul, Julie; Price, Edward; Polasky, Stephen; Ruckelshaus, Mary; Daily, Gretchen

    2017-04-21

    International corporations in an increasingly globalized economy exert a major influence on the planet's land use and resources through their product design and material sourcing decisions. Many companies use life cycle assessment (LCA) to evaluate their sustainability, yet commonly-used LCA methodologies lack the spatial resolution and predictive ecological information to reveal key impacts on climate, water and biodiversity. We present advances for LCA that integrate spatially explicit modelling of land change and ecosystem services in a Land-Use Change Improved (LUCI)-LCA. Comparing increased demand for bioplastics derived from two alternative feedstock-location scenarios for maize and sugarcane, we find that the LUCI-LCA approach yields results opposite to those of standard LCA for greenhouse gas emissions and water consumption, and of different magnitudes for soil erosion and biodiversity. This approach highlights the importance of including information about where and how land-use change and related impacts will occur in supply chain and innovation decisions.

  7. Ethnographic Exploration of Empowerment to Improve Elderly Residents’ Quality of Life

    Science.gov (United States)

    Tabatabaei, Seyed Zia; Ebrahimi, Fatemeh; Hamzah, Azimi Bin Hj; Rezaeian, Mohsen; Kamrani, Mahnaz Akbari

    2017-01-01

    Background: Evidence underscores that empowerment is central to improve the elderly residents’ quality of life. In truth, empowerment is a process through which individuals gain better control over their life. The aim of this study was to explore how perceived empowerment influence on the quality of life among elderly Malay residents. Materials and Methods: A focus ethnographic approach was employed in a Malaysian residential home between May 2011 and January 2012. Data were gathered from participant observations, field notes, in-depth interviews, and exploring related documents. Results: The analysis of the data gathered in the current study resulted in the development of three themes – social life and its requirements, caregivers’ skills empowerment, and listening and supporting. Conclusions: Findings of the study provide new insights that are useful in charting new guideline for care providers and policy makers to improve the elderly residents’ quality of life. PMID:29034000

  8. Can endurance training improve physical capacity and quality of life in young Fontan patients?

    Science.gov (United States)

    Hedlund, Eva R; Lundell, Bo; Söderström, Liselott; Sjöberg, Gunnar

    2018-03-01

    Children after Fontan palliation have reduced exercise capacity and quality of life. Our aim was to study whether endurance training could improve physical capacity and quality of life in Fontan patients. Fontan patients (n=30) and healthy age- and gender-matched control subjects (n=25) performed a 6-minute walk test at submaximal capacity and a maximal cycle ergometer test. Quality of life was assessed with Pediatric Quality of Life Inventory Version 4.0 questionnaires for children and parents. All tests were repeated after a 12-week endurance training programme and after 1 year. Patients had decreased submaximal and maximal exercise capacity (maximal oxygen uptake 35.0±5.1 ml/minute per·kg versus 43.7±8.4 ml/minute·per·kg, pquality of life score (70.9±9.9 versus 85.7±8.0, pimproved their submaximal exercise capacity in a 6-minute walk test (from 590.7±65.5 m to 611.8±70.9 m, pquality of life (pimprove maximal exercise capacity. At follow-up, submaximal exercise capacity had increased further and improved quality of life was sustained. The controls improved their maximal exercise capacity (pquality of life after training. At follow-up, improvement of maximal exercise capacity was sustained. We believe that an individualised endurance training programme for Fontan patients improves submaximal exercise capacity and quality of life in Fontan patients and the effect on quality of life appears to be long-lasting.

  9. Life extension, power upgrade, and return to service work for Pickering NGS and other PWR and CANDU plants

    International Nuclear Information System (INIS)

    Millman, J.; Idvorian, N.; Schneider, W.

    2002-01-01

    Work on life extension, power upgrade and return to service has been performed and is in progress for a number of PWR and CANDU plants. For PWR plants, power upgrade work has been done for the new replacement steam generators in several cases. This work consists of redoing the formal equipment qualification analysis and reports for the uprated operating conditions to support the application for license adjustment. Life extension assessments have been performed for several CANDU plants. These are highly detailed assessments in which the particular steam generator is reassessed part by part as to the ability of each to sustain full life operation and also extended life operation. Return to service work for Pickering NGSA specifically has included this type of assessment and also specific repair, cleaning and retrofit activities including secondary side inspection, waterlancing, divider plate repair, eddy current inspection, etc. Steam generator modifications and retrofit work have been performed in a number of cases. The paper discusses various life extension, power upgrade, equipment modification and return to service activities all of which are part of the renewed drive in the industry to realise the full potential of nuclear plants by getting more and better performance from the extended service of existing plants. (author)

  10. Improving the delivery of preventive care services.

    Science.gov (United States)

    Hung, Dorothy Y

    2007-05-01

    Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

  11. International Space Station Bacteria Filter Element Post-Flight Testing and Service Life Prediction

    Science.gov (United States)

    Perry, J. L.; von Jouanne, R. G.; Turner, E. H.

    2003-01-01

    The International Space Station uses high efficiency particulate air (HEPA) filters to remove particulate matter from the cabin atmosphere. Known as Bacteria Filter Elements (BFEs), there are 13 elements deployed on board the ISS's U.S. Segment. The pre-flight service life prediction of 1 year for the BFEs is based upon performance engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS Program resources. Thus testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are discussed. Recommendations for realizing significant savings to the ISS Program are presented.

  12. Residential immersive life skills programs for youth with disabilities: service providers' perceptions of change processes.

    Science.gov (United States)

    King, Gillian; McPherson, Amy; Kingsnorth, Shauna; Stewart, Debra; Glencross-Eimantas, Tanya; Jones-Galley, Kimberlea; Morrison, Andrea; Isihi, Ana Maria; Gorter, Jan Willem

    2015-05-01

    Residential immersive life skills (RILS) programs are designed to equip youth with physical disabilities with the foundational life skills required to assume adult roles. The objective was to determine RILS service providers' perceptions of the active ingredients of the intervention change process. Thirty-seven service providers from various disciplines completed measures to assess expertise status and participated in qualitative interviews. Qualitative themes were derived, and similarities and differences in themes were identified for blinded groups of novices, intermediates, and experts. The three main themes, reflecting change processes, were: (a) creating a supportive program atmosphere with multiple opportunities for learning, (b) using strategies to support, encourage, and engage youth, and (c) intentionally fostering youth experiences of skill development, social interaction, and pride in accomplishment. In contrast to the novices, experts displayed a more holistic perspective and paid attention to higher-order issues such as providing opportunities and enabling youth. The findings indicate how RILS service providers work to create a program atmosphere and employ strategies to intentionally foster particular youth experiences. The findings explicate service providers' theories of practice, the intentional design of RILS program environments to bring about client change, and the value of service provider expertise. Implications for Rehabilitation Service providers of youth independence-oriented life skills programs can intentionally create a learning-oriented and supportive program atmosphere by using non-directive, coaching/guiding, and engagement strategies Youth experiences of skill development, shared experience with others, and pride in accomplishment can be cultivated by providing a range of learning opportunities, including choice making, problem-solving, and skill mastery Compared to more novice service providers, experts discussed managing the

  13. A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

    Science.gov (United States)

    Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

    2018-03-23

    The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

  14. Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.

    Science.gov (United States)

    Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca; Mhlanga, Fortune

    2014-01-01

    Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. IMPROVING THE LOGISTICAL PROCESSES IN CORPORATE SERVICE SYSTEM

    Directory of Open Access Journals (Sweden)

    Irina MAKAROVA

    2016-03-01

    Full Text Available The study deals with enhancing the reliability of freight cars by improving the corporate service system. Assessing of the quality of spare parts suppliers is discussed. An algorithm for supplier selection and an evaluation method, based on cluster analysis of indicators of supplier reliability, is proposed. Alternative developments for a service network, in view of expanding of the car fleet powered by natural gas-based fuel have been considered.

  16. Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project.

    Science.gov (United States)

    Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M

    2015-11-01

    Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.

  17. [Interventions to improve quality of life in oncological patients].

    Science.gov (United States)

    Klinkhammer-Schalke, Monika; Steinger, Brunhilde; Koller, Michael; Lindberg, Patricia

    2017-05-01

    The assessment of quality of life is a central aspect in the current debate in support groups, certified cancer centres, benefit assessment, and also in palliative care. Accordingly, quality of life has become an essential part of clinical trials for more than two decades. But most of the time results are presented in a descriptive manner without any concrete therapeutic consequences for the improvement of quality of life. Likewise, there are no uniform recommendations for considering quality of life data in the decision-making process. Therefore, a guide with recommendations for the assessment of quality of life in trials has been developed. Its implementation is illustrated by a complex intervention for a targeted diagnosis and therapy of quality of life in patients with breast cancer or colorectal cancer. The basis is a standardised quality of life assessment and the presentation of results in an intelligible fashion as well as the close collaboration of all healthcare providers to create regional network structures for the targeted support of patients in both the inpatient and outpatient sector. Copyright © 2017. Published by Elsevier GmbH.

  18. A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life.

    Directory of Open Access Journals (Sweden)

    Tara Kidd

    Full Text Available Self-management interventions have become increasingly popular in the management of long-term health conditions; however, little is known about their impact on psychological well-being in people with Multiple Sclerosis (MS.To examine the effectiveness of self-management interventions on improving depression, anxiety and health related quality of life in people with MS.A structured literature search was conducted for the years 2000 to 2016. The review process followed the PRISMA guidelines, and is registered with PROSPERO (no. CRD42016033925.The review identified 10 RCT trials that fulfilled selection criteria and quality appraisal. Self-management interventions improved health-related quality of life in 6 out of 7 studies, with some evidence of improvement in depression and anxiety symptoms.Although the results are promising more robust evaluation is required in order to determine the effectiveness of self-management interventions on depression, anxiety and quality of life in people with MS. Evaluation of the data was impeded by a number of methodological issues including incomplete content and delivery information for the intervention and the exclusion of participants representing the disease spectrum. Recommendations are made for service development and research quality improvement.

  19. Fatigue life prediction of oil ducts under service loads

    Energy Technology Data Exchange (ETDEWEB)

    Meggiolaro, Marco A.; Castro, Jaime T.P. [Pontificia Univ. Catolica do Rio de Janeiro, RJ (Brazil)

    2003-07-01

    A methodology to calculate the residual initiation and propagation lives of fatigue cracks in oil pipelines with corrosion-like defects is proposed and applied to predict the residual life of an old duct made of API 5L Gr. B steel, in service for more than 40 years. Since its inauguration, this pipeline has carried several heated products under variable temperatures and pressures. The calculated (nominal) service stresses are very high, due to thermal loads that induce significant bending in curved parts of the duct, with peaks close to the yield strength of the steel. The elastic- plastic fatigue damage at a notch or a corrosion pit root is calculated using the {epsilon}N method, and the effects of surface semi-elliptical cracks in its internal (or external) wall is studied considering appropriate stress intensity factor expressions and the actual service loads. In the presence of surface flaws associated to stress concentration factors of the order of three, a fatigue crack likely will initiate in the pipeline. However, if these surface cracks are small compared to the duct wall thickness, their predicted propagation rates are very low. (author)

  20. Methodologies for assessment of the service life of pressure tubes in Indian PHWRs

    International Nuclear Information System (INIS)

    Sinha, R.K.; Sharma, A.; Madhusoodanan, K.; Sinha, S.K.; Malshe, U.D.

    1997-01-01

    For estimating safe service life of pressure tubes in Indian PHWRs, analytical methodologies have been developed to evaluate creep deformation, deuterium pick-up rate, blister growth at cold spot, and operating domain required for achieving leak-before-break. The paper provides an overview of these methodologies, and results of some studies carried out towards evolution of proposed fitness-for-service criteria for a pressure tube in contact with its calandria tube. (author)

  1. Recreation as a Related Service: Focusing on the Quality of Life of Students with Disabilities

    Science.gov (United States)

    Diodati, Melissa R.

    2017-01-01

    Leisure participation is influential on the quality of life of individuals. Individuals with disabilities can face barriers in leisure participation, impacting their quality of life. IDEA (2004) recognizes recreation as a related service as one way to enhance the leisure experiences for students with disabilities. The purpose of this embedded case…

  2. Previous utilization of service does not improve timely booking in ...

    African Journals Online (AJOL)

    Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study ... Journal Home > Vol 24, No 3 (2010) > ... Results: Past experience on antenatal care service utilization did not come out as a predictor for ...

  3. Flexible pavement rehabilitation design based on pavement service life time span left

    OpenAIRE

    Gamelyak, I.; Shevchuk, V.

    2005-01-01

    The design of flexible pavement rehabilitation is analysed in terms of durability-cost. A notion of the remaining service life span is described. the model of rehabilitation strategy selection is presented for both design project and operation stages. the results can be used in the pavement management system.

  4. Improving Customer Service at the Agricultural Development Banks ...

    African Journals Online (AJOL)

    Improving Customer Service at the Agricultural Development Banks in Ghana: An Application of the Queuing Theory. ... African Journal of Management Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue ...

  5. The effect of a home delivery meal service of energy- and protein-rich meals on quality of life in malnourished outpatients suffering from lung cancer

    DEFF Research Database (Denmark)

    Leedo, Eva; Gade, Josephine; Granov, Sabrina

    2017-01-01

    Undernutrition is prevalent in cancer patients and associated with increased incidence of complications and mortality. We investigated the effects of a home delivery meal service, providing a selection of energy-dense, protein-rich meals, on quality of life (QoL) in malnourished lung cancer....... Intervention exerted a significant positive effect on performance score after 12 wk (P = 0.047). Increased energy and protein intakes were strongly associated with improved QoL, functional score, hand grip strength, symptom and performance scores. Food delivery service with energy- and protein-rich main meals...

  6. Improving Library and Information Services: Use of Appropriate ...

    African Journals Online (AJOL)

    Information Communication Technology in Nigerian Libraries. Murtala Aliyu ... The focus of this paper is on how to improve services in libraries and information centers in. Nigeria by ..... games, video and educational materials. Database on ...

  7. Child life services.

    Science.gov (United States)

    Wilson, Jerriann M

    2006-10-01

    Child life programs have become standard in most large pediatric centers and even on some smaller pediatric inpatient units to address the psychosocial concerns that accompany hospitalization and other health care experiences. The child life specialist focuses on the strengths and sense of well-being of children while promoting their optimal development and minimizing the adverse effects of children's experiences in health care or other potentially stressful settings. Using play and psychological preparation as primary tools, child life interventions facilitate coping and adjustment at times and under circumstances that might prove overwhelming otherwise. Play and age-appropriate communication may be used to (1) promote optimal development, (2) present information, (3) plan and rehearse useful coping strategies for medical events or procedures, (4) work through feelings about past or impending experiences, and (5) establish therapeutic relationships with children and parents to support family involvement in each child's care, with continuity across the care continuum. The benefits of this collaborative work with the family and health care team are not limited to the health care setting; it may also optimize reintegration into schools and the community.

  8. Family Quality of Life: A Key Outcome in Early Childhood Intervention Services--A Scoping Review

    Science.gov (United States)

    Bhopti, Anoo; Brown, Ted; Lentin, Primrose

    2016-01-01

    A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…

  9. Quality of life evaluation of workers for diagnostic radiology services

    International Nuclear Information System (INIS)

    Fernandes, Ivani Martins

    2011-01-01

    The main objective of this study was to evaluate the quality of life (QOL) of diagnostic radiology services workers at a hospital of Sao Paulo city. It aimed also to draw the profile of these workers identifying the variables, as its influence on their quality of life. A descriptive exploratory study with qualitative and quantitative approaches was carried out. The data were collected using the questionnaires: the abbreviated instrument for the assessment of the QOL, World Health Organization Quality of Life Instrument bref (WHOQOL-bref) and a questionnaire including the social demographic variables, work conditions and the variables that express the lifestyle of individuals, both questionnaires self-applied. The sample was formed by 118 workers, among them: physicians, technologists/technicians in radiology, nurses, technicians and assistants in nursing, and others health professionals. The data analysis included descriptive statistics, nonparametric tests and the use of a linear regression model. The reliability of the instrument for the studied sample was verified by Cronbach's Alpha Coefficient (α). The WHOQOL-bref proved to be an adequate instrument, with a good level of internal consistency (α=0.884), being easily and quickly administrated for the evaluation of the QOL. The study provided an overview of the perception of quality of life of the studied group. (author)

  10. Improving Acceptance, Integration, and Health Among LGBT Service Members

    Science.gov (United States)

    2017-10-01

    through multiple rounds of internal testing and quality assurance procedures. Recruitment for the Phase II survey was initiated on August 25, 2017...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators...burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis

  11. Leveraging Available Data to Support Extension of Transportation Packages Service Life

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, K.; Abramczyk, G.; Bellamy, S.; Daugherty, W.; Hackney, B.; Hoffman, E.; Skidmore, E.; Stefek, T.

    2012-06-12

    Data obtained from testing shipping package materials have been leveraged to support extending the service life of select shipping packages while in nuclear materials transportation. Increasingly, nuclear material inventories are being transferred to an interim storage location where they will reside for extended periods of time. Use of a shipping package to store nuclear materials in an interim storage location has become more attractive for a variety of reasons. Shipping packages are robust and have a qualified pedigree for their performance in normal operation and accident conditions within the approved shipment period and storing nuclear material within a shipping package results in reduced operations for the storage facility. However, the shipping package materials of construction must maintain a level of integrity as specified by the safety basis of the storage facility through the duration of the storage period, which is typically well beyond the one year transportation window. Test programs have been established to obtain aging data on materials of construction that are the most sensitive/susceptible to aging in certain shipping package designs. The collective data are being used to support extending the service life of shipping packages in both transportation and storage.

  12. Leveraging Available Data to Support Extension of Transportation Packages Service Life

    International Nuclear Information System (INIS)

    Dunn, K.; Abramczyk, G.; Bellamy, S.; Daugherty, W.; Hackney, B.; Hoffman, E.; Skidmore, E.; Stefek, T.

    2012-01-01

    Data obtained from testing shipping package materials have been leveraged to support extending the service life of select shipping packages while in nuclear materials transportation. Increasingly, nuclear material inventories are being transferred to an interim storage location where they will reside for extended periods of time. Use of a shipping package to store nuclear materials in an interim storage location has become more attractive for a variety of reasons. Shipping packages are robust and have a qualified pedigree for their performance in normal operation and accident conditions within the approved shipment period and storing nuclear material within a shipping package results in reduced operations for the storage facility. However, the shipping package materials of construction must maintain a level of integrity as specified by the safety basis of the storage facility through the duration of the storage period, which is typically well beyond the one year transportation window. Test programs have been established to obtain aging data on materials of construction that are the most sensitive/susceptible to aging in certain shipping package designs. The collective data are being used to support extending the service life of shipping packages in both transportation and storage.

  13. Shift work to balance everyday life - a salutogenic nursing perspective in home help service in Sweden.

    Science.gov (United States)

    Agosti, Madelaine Törnquist; Andersson, Ingemar; Ejlertsson, Göran; Janlöv, Ann-Christin

    2015-01-01

    Nurses in Sweden have a high absence due to illness and many retire before the age of sixty. Factors at work as well as in private life may contribute to health problems. To maintain a healthy work-force there is a need for actions on work-life balance in a salutogenic perspective. The aim of this study was to explore perceptions of resources in everyday life to balance work and private life among nurses in home help service. Thirteen semi-structured individual interviews and two focus group interviews were conducted with home help service nurses in Sweden. A qualitative content analysis was used for the analyses. In the analyses, six themes of perceptions of recourses in everyday life emerged; (i) Reflecting on life. (ii) Being healthy and taking care of yourself. (iii) Having a meaningful job and a supportive work climate. (iv) Working shifts and part time. (v) Having a family and a supporting network. (vi) Making your home your castle. The result points out the complexity of work-life balance and support that the need for nurses to balance everyday life differs during different phases and transitions in life. In this salutogenic study, the result differs from studies with a pathogenic approach. Shift work and part time work were seen as two resources that contributed to flexibility and a prerequisite to work-life balance. To have time and energy for both private life and work was seen as essential. To reflect on and discuss life gave inner strength to set boundaries and to prioritize both in private life and in work life. Managers in nursing contexts have a great challenge to maintain and strengthen resources which enhance the work-life balance and health of nurses. Salutogenic research is needed to gain an understanding of resources that enhance work-life balance and health in nursing contexts.

  14. Building abstinent networks is an important resource in improving quality of life.

    Science.gov (United States)

    Muller, Ashley Elizabeth; Skurtveit, Svetlana; Clausen, Thomas

    2017-11-01

    To investigate changes in social network and quality of life of a substance use disorder cohort as they progressed through treatment. Multi-site, prospective, observational study of 338 adults entering substance use disorder treatment. Patients at 21 facilities across Norway contributed baseline data when they initiated treatment, and follow-up data was collected from them one year later. The cohort was divided into those who completed, dropped out, and remained in treatment one year after treatment initiation. For each treatment status group, general linear models with repeated measures analyzed global and social quality of life with the generic QOL10 instrument over time. The between-group factor was a change in social network variable from the EuropASI. Those who gained an abstinent network reported the largest quality of life improvements. Improvements were smallest or negligible for the socially isolated and those who were no longer in contact with the treatment system. Developing an abstinent network is particularly important to improve the quality of life of those in substance use disorder treatment. Social isolation is a risk factor for impaired quality of life throughout the treatment course. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Improved methods of creep-fatigue life assessment of components

    Energy Technology Data Exchange (ETDEWEB)

    Scholz, Alfred; Berger, Christina [Inst. fuer Werkstoffkunde (IfW), Technische Univ. Darmstadt (Germany)

    2009-07-01

    The improvement of life assessment methods contributes to a reduction of efforts at design and an effective long term operation of high temperature components, reduces technical risk and increases high economical advantages. Creep-fatigue at multi-stage loading, covering cold start, warm start and hot start cycles in typical loading sequences e.g. for medium loaded power plants, was investigated here. At hold times creep and stress relaxation, respectively, lead to an acceleration of crack initiation. Creep fatigue life time can be calculated by a modified damage accumulation rule, which considers the fatigue fraction rule for fatigue damage and the life fraction rule for creep damage. Mean stress effects, internal stress and interaction effects of creep and fatigue are considered. Along with the generation of advanced creep data, fatigue data and creep fatigue data as well scatter band analyses are necessary in order to generate design curves and lower bound properties inclusive. Besides, in order to improve lifing methods the enhancement of modelling activities for deformation and life time are important. For verification purposes, complex experiments at variable creep conditions as well as at creep fatigue interaction under multi-stage loading are of interest. Generally, the development of methods to transfer uniaxial material properties to multiaxial loading situations is a current challenge. For specific design purposes, a constitutive material model is introduced which is implemented as an user subroutine for Finite Element applications due to start-up and shut-down phases of components. Identification of material parameters have been performed by Neural Networks. (orig.)

  16. Unwanted facial hair removal with laser treatment improves quality of life of patients.

    Science.gov (United States)

    Maziar, Ali; Farsi, Nader; Mandegarfard, Manijeh; Babakoohi, Shahab; Gorouhi, Farzam; Dowlati, Yahya; Firooz, Alireza

    2010-02-01

    Unwanted facial hair can have adverse psychological effects on women and reduce their quality of life. To assess the effects of unwanted facial hair removal with laser on improving quality of life. In this study, 70 patients treated for unwanted facial hair by laser were assessed by Dermatology Life Quality Index (DLQI) questionnaire on admission and 3 months later after three sessions of laser treatment. The DLQI score before treatment was 9.42 +/- 5.99, which was reduced to 3.12 +/- 3.40 after laser treatment (p facial hair removal with laser can improve the quality of life of patients.

  17. Laser shock peening of steam turbine blade for enhanced service life

    Indian Academy of Sciences (India)

    2014-02-13

    Feb 13, 2014 ... study to develop indigenous LSP process for enhanced service life ... DINX10Cr- 0.08–0.13 11.5–12.5 2.2–2.8 0.1–0.5 1.6–1.8 0.6–0.9 0.25–0.4 Balance ... LSP is done by scanning the taped surface of the work piece with a ...

  18. Service life prediction for 50-year-old buildings in marine environments

    Directory of Open Access Journals (Sweden)

    Agustín Sánchez-Deza

    2018-03-01

    Full Text Available Steel reinforcing bars are often coated with rusts formed during service in reinforced concrete (RC structures. Rust layers growing on steel rebars induce expansive stresses and cause cracking on cover concrete. This study uses steel corrosion rate results measured on reinforced concrete buildings of more than 50 years of age located in marine environments and considers the pressure generated by the volume expansion of corrosion product layers to calculate the service life of the RC structures using a numerical simulation, estimating the time to corrosion cracking of the concrete cover. Akaganeite, goethite, lepidocrocite, hematite, magnetite and maghemite were identified by X-ray diffraction as crystalline phase constituents of the rust layers.

  19. Life extension of semi-submersible drilling unit

    Energy Technology Data Exchange (ETDEWEB)

    Hadley, I.; Sinclair, C.I.K. [TWI, Cambridge (United Kingdom). Structural Integrity Dept.; Magne, E. [Schlumberger Sedco Forex, Montrouge (France)

    1995-12-31

    This paper describes the life extension of a semi-submersible drilling rig built in the early 1970`s. A nominal design life of 20 years was estimated at the time of building; however, in the interim period, numerous improvements have been made in fatigue life estimation ad life improvement techniques, raising the possibility that a further 20 years of operation could be considered. The life extension strategy made use of a number of aspects of offshore technology which were not available at the time of construction of the rig. Finite element studies and results from offshore research programs were used to gauge the effect of fatigue life improvement techniques. The program demonstrated the feasibility of extending the operation of the rig for a further 20 years, with the interval between in-service inspection increased to every five years. It also provided a valuable database of fracture toughness data for the rig materials, which may be used in future work to address reliability issues.

  20. SCM: A method to improve network service layout efficiency with network evolution

    Science.gov (United States)

    Zhao, Qi; Zhang, Chuanhao

    2017-01-01

    Network services are an important component of the Internet, which are used to expand network functions for third-party developers. Network function virtualization (NFV) can improve the speed and flexibility of network service deployment. However, with the evolution of the network, network service layout may become inefficient. Regarding this problem, this paper proposes a service chain migration (SCM) method with the framework of “software defined network + network function virtualization” (SDN+NFV), which migrates service chains to adapt to network evolution and improves the efficiency of the network service layout. SCM is modeled as an integer linear programming problem and resolved via particle swarm optimization. An SCM prototype system is designed based on an SDN controller. Experiments demonstrate that SCM could reduce the network traffic cost and energy consumption efficiently. PMID:29267299

  1. SCM: A method to improve network service layout efficiency with network evolution.

    Science.gov (United States)

    Zhao, Qi; Zhang, Chuanhao; Zhao, Zheng

    2017-01-01

    Network services are an important component of the Internet, which are used to expand network functions for third-party developers. Network function virtualization (NFV) can improve the speed and flexibility of network service deployment. However, with the evolution of the network, network service layout may become inefficient. Regarding this problem, this paper proposes a service chain migration (SCM) method with the framework of "software defined network + network function virtualization" (SDN+NFV), which migrates service chains to adapt to network evolution and improves the efficiency of the network service layout. SCM is modeled as an integer linear programming problem and resolved via particle swarm optimization. An SCM prototype system is designed based on an SDN controller. Experiments demonstrate that SCM could reduce the network traffic cost and energy consumption efficiently.

  2. Alternative strategies to improve the beneficial effects of exercise throughout life : dietary and physiological aspects

    NARCIS (Netherlands)

    R.T. Mankowski (Robert Tomasz)

    2015-01-01

    markdownabstractAbstract It is certain that the aging process leads to death, but decreasing the levels of pathology throughout life improves the quality of life and extends life span. Therefore, this dissertation focuses on alternative strategies that may contribute to improving the aging

  3. Life management of SG for WWER plants

    International Nuclear Information System (INIS)

    Trunov, N. B.; Dragunov, Yu. G.; Banyuk, G. F.

    2004-01-01

    Nowadays, 252 steam generators (SG) of horizontal type are in operation at WWER plants constructed by the Russian designs. In connection with end of the specified service life of the reactor plant equal to 30 years the activities are performed on service life extension of the main equipment including the SG. At some Units, throughout the design service life of SG there were problems resulting in necessity of SG replacement. At the same time the SGs at some Units are in successful operation above the design service life. This report deals with the peculiarities of operation of the horizontal SGs and the problems to be highlighted as the most important for service life extension. The main component to determine possibility for SG service life extension is the SG tubing. As the operating experience shows it is water chemistry of the secondary circuit that is the main factor influencing operability of the SG tubing. Therefore, differences in water chemistry organization leads to significant differences in operability of the SG tubing at various Units and in some cases within one Unit. Owing to the fact that the cases of water chemistry disturbance and the process of tubes fouling with the corrosion products of the main condensate system are not excluded, the damages continue to occur. Tube integrity shall be inspected by eddy current method using the various instrument complexes. This method has certain disadvantages but allows to estimate the degree and direction of degradation processes. The results of eddy current test (ECT) can be used to determine the plugging criterion for defective tubes. The significant number of defective tubes at some Units makes a choice of the plugging criterion to be an important problem, on which solution the SG safety, reliability and service life depends. The report deals with directions of activities in service life management for the SG at WWER plants. Main activities are improvement of water chemistry and non-destructive tests.(author)

  4. The relationship between health literacy and quality of life among frequent users of health care services: a cross-sectional study.

    Science.gov (United States)

    Couture, Éva Marjorie; Chouinard, Maud-Christine; Fortin, Martin; Hudon, Catherine

    2017-07-06

    Although health literacy and quality of life are important concepts in health care, the link between them is unclear, especially for a population of frequent users of health care services with chronic diseases. Low health literacy is a common problem that has been linked to several negative health outcomes. Quality of life is an important health outcome in patient-centered care. Frequent users of health care services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. The objective of this study was to examine the relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services with chronic diseases. This study presents the cross-sectional analysis of data collected through the V1SAGES project, a randomized controlled trial on the effectiveness of a case management intervention in primary care in Quebec, Canada. Participants (n = 247) were frequent users of health care services presenting at least one chronic condition. Health literacy was measured by the Newest Vital Sign (NVS), and the physical and mental components of quality of life were evaluated by the Short Form Health Survey Version 2 (SF-12v2). The association between health literacy (independent variable) and the physical and mental components of quality of life was examined using biserial correlation. No association was found between health literacy and quality of life (physical component: r = 0.108, ρ = 0.11; mental component: r = 0.147, ρ = 0.15). This study suggests that there is no relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services. NCT01719991 . Registered October 25, 2012.

  5. Prediction of pavement remaining service life based on repetition of load and permanent deformation

    Science.gov (United States)

    Usman, R. S.; Setyawan, A.; Suprapto, M.

    2018-03-01

    One of the methods which was applied in the assessment of flexible pavement performance was mechanistic method assuming structures of road pavement to become multi-layer structure for flexible pavement, that the vehicle load working on the pavement layer under repetition with power failure worth 1 (one) unit which was assumed as evenly distributed static load, and therefore the pavement material would provide response in the form of stress, strain, and deflection. This is closely related in order to assess the structure of flexible pavement and to predict the remaining service life on the roads of Pulau Indah sta 0 + 000 to sta. 0 + 845 in Kota Kupang, Nusa Tenggara Timur. The performance appraisal indicator which was used was fatigue cracking happening bottom of the asphalt layer and permanent deformation (rutting) on the surface of subgrade. The strain estimate on the flexible pavement layer structure needs carefulness and high accuracy and therefore a software like KENPAVE which produces horizontal tensile strain of 8,802E-05 and vertical compressive strain of 2,642E-04 was used. By applying equation of The Asphalt Instituteit was obtained repetition of permit load when reaching fatigue cracking (Nf) was 16.071.516 ESAL and permanent deformation (rutting) was 14.703.867 ESAL and also it was predicted the remaining service life of pavement applied the equation of AASTHO 1993 by considering Traffic Multiplier factor (TM 1.8, TM 1.9 and TM 2.0) obtained the remaining life service due to fatigue of 5.51% in the year of 13th (TM 1.8), 7.95% in the year of12th (TM 1.9) and 3.11% (TM 2.0) in the year of 12th, also the remaining service life due to rutting of 4.69% in the year of 12th(TM 1.8), 7.79% in the year of 11th (TM 1.9), and 2.94 in the year of 11th (TM 2.0).

  6. X Marks the Spot: Creating and Managing a Single Service Point to Improve Customer Service and Maximize Resources

    Science.gov (United States)

    Venner, Mary Ann; Keshmiripour, Seti

    2016-01-01

    This article will describe how merging service points in an academic library is an opportunity to improve customer service and utilize staffing resources more efficiently. Combining service points provides libraries with the ability to create a more positive library experience for patrons by minimizing the ping-pong effect for assistance. The…

  7. Operations and quality management for public service delivery improvement.

    Directory of Open Access Journals (Sweden)

    Paulin Mbecke

    2014-10-01

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

  8. Nonformal Education in Improving Quality of Life of Underprivileged Children

    Directory of Open Access Journals (Sweden)

    Abdullah Al Mamun

    2013-02-01

    Full Text Available This study explores the role of Non-formal Primary Education (NFPE in improving the quality of the life of underprivileged children in Bangladesh considering their economic, health, environmental issues and life skills. It uses a mixed method approach of research where three NGOs which run NFPE programs were selected purposefully. Data were derived from six NGO officers, nine teachers, ninety students and eighteen guardians by using two sets of questionnaires for NGO officers and teachers, an interview schedule for guardians and 9 focus group discussions with the students. The findings show that there is no income generating program initiated by the organizations for the learners along with education. So, the scope of their income has reduced. But their daily life behavior and skills have improved. Besides, their awareness on health and environmental issues have increased. The findings lead to some recommendations which will give insights to policy makers and professionals engaged in this field.

  9. Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

    Science.gov (United States)

    Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

    2013-01-01

    this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics

  10. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  11. Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

    Science.gov (United States)

    Petkari, Eleni; Pietschnig, Jakob

    2015-01-01

    Background Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients’ satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment. Aim This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction. Methods: In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined. Results Analyses revealed a highly significant medium-sized effect (r = .30, p service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs. Conclusion Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients’ perception of the service adequacy for achieving QoL enhancement into account. PMID:26275139

  12. Shift work to balance everyday life - a salutogenic nursing perspective in home help service in Sweden

    OpenAIRE

    Agosti, Madelaine T?rnquist; Andersson, Ingemar; Ejlertsson, G?ran; Janl?v, Ann-Christin

    2015-01-01

    Background: Nurses in Sweden have a high absence due to illness and many retire before the age of sixty. Factors at work as well as in private life may contribute to health problems. To maintain a healthy work–force there is a need for actions on work-life balance in a salutogenic perspective. The aim of this study was to explore perceptions of resources in everyday life to balance work and private life among nurses in home help service. Methods: Thirteen semi-structured individual interviews...

  13. The Mystery Shopper Technique as a way of improving hotel gastronomy services

    Directory of Open Access Journals (Sweden)

    Ewa Wszendybył-Skulska

    2015-04-01

    Full Text Available The problems connected with the issue of service quality is an important aspect in the service industry, however it is difficult to measure. It may be quite difficult to estimate it unequivocally and objectively due to the fact that each service includes more or fewer materi-al elements. It is impossible to improve something that has not been measured and estimated before and one does not know whether it fulfils the requirements. Hotel gastronomy services are a kind of service that are partly materialized which makes the quality estimation easier. Nevertheless, one ought to remember that they are also shaped by non-material elements that influence the final quality estimation which seems to be problematic. The so-called Mystery Shopper Technique as a way of improving the quality of hotel gastronomy services is pre-sented in the article.

  14. Citizen and Resident Satisfaction with Public Services in Qatar : And the impact on quality of life

    OpenAIRE

    Benmansour, Nada Abdelkader , [بن منصور، ندى عبد القادر

    2016-01-01

    In Qatar notable differences in public service satisfaction exist across individual state services, across nationality groupings, and across demographic categories. Among all citizens and residents, however, there is an empirical link between satisfaction with state services and overall perceptions of quality of life. Policymakers should thus study efforts to collect regular and systematic data on the performance of key public institutions, including through the collection of consumer feedbac...

  15. Improvements in ecosystem services from investments in natural capital.

    Science.gov (United States)

    Ouyang, Zhiyun; Zheng, Hua; Xiao, Yi; Polasky, Stephen; Liu, Jianguo; Xu, Weihua; Wang, Qiao; Zhang, Lu; Xiao, Yang; Rao, Enming; Jiang, Ling; Lu, Fei; Wang, Xiaoke; Yang, Guangbin; Gong, Shihan; Wu, Bingfang; Zeng, Yuan; Yang, Wu; Daily, Gretchen C

    2016-06-17

    In response to ecosystem degradation from rapid economic development, China began investing heavily in protecting and restoring natural capital starting in 2000. We report on China's first national ecosystem assessment (2000-2010), designed to quantify and help manage change in ecosystem services, including food production, carbon sequestration, soil retention, sandstorm prevention, water retention, flood mitigation, and provision of habitat for biodiversity. Overall, ecosystem services improved from 2000 to 2010, apart from habitat provision. China's national conservation policies contributed significantly to the increases in those ecosystem services. Copyright © 2016, American Association for the Advancement of Science.

  16. Improving Acceptance, Integration and Health among LGBT Service Members

    Science.gov (United States)

    2017-10-01

    these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy

  17. Smart Service Portfolios: Do the Cities Follow Standards?

    NARCIS (Netherlands)

    Anthopoulos, Leonidas; Janssen, M.F.W.H.A.; Weerakkody, Vishanth

    2016-01-01

    Smart services concern the core element of a smart city, since they support the realization of urban "intelligence" in terms of people, economy, governance, environment, mobility and leaving. Smart services aim to enhance quality of life within a city and in this respect to improve "livability". The

  18. Remediating cultural services in Second Life: The case of Info Island DK

    DEFF Research Database (Denmark)

    Heilesen, Simon

    2009-01-01

    In 2007, Info Island DK was created as a virtual library in Second Life. This is an account of how library services of the physical library and the net library were remediated into a 3-D virtual world. The Info Island DK library was not widely adopted by any of the intended target groups, even if...

  19. Integrating mental health services into primary HIV care for women: the Whole Life project.

    OpenAIRE

    Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, i...

  20. Methodological aspects to be considered in evaluating the economics of service measures

    International Nuclear Information System (INIS)

    Bald, M.

    1987-01-01

    For the purposes of the report, service measures is used as a term denoting all those steps which exceed the framework of normal in-service maintenance and repair and serve to improve economics over the normal case. Positive impacts are to be achieved on such parameters as availability, efficiency, and service life. One of the aspects investigated is the effect, if any, of such measures on the residual service life of plants in operation for a long period of time already. Residual service life in this case means the remaining span of effective technical and economic operation which, in these model calculations, also includes part of the period of depreciation. (orig.) [de

  1. Second life battery energy storage system for residential demand response service

    DEFF Research Database (Denmark)

    Saez-de-Ibarra, Andoni; Martinez-Laserna, Egoitz; Koch-Ciobotaru, Cosmin

    2015-01-01

    vehicles, during their main first life application, for providing residential demand response service. The paper considers the decayed characteristics of these batteries and optimizes the rating of such a second life battery energy storage system (SLBESS) for maximizing the economic benefits of the user......The integration of renewable energies and the usage of battery energy storage systems (BESS) into the residential buildings opens the possibility for minimizing the electricity bill for the end-user. This paper proposes the use of batteries that have already been aged while powering electric......'s energy consumption during a period of one year. Furthermore, simulations were performed considering real data of PV generation, consumption, prices taken from the Spanish market and costs of battery and photovoltaic systems....

  2. Innovation in user-centered skills and performance improvement for sustainable complex service systems.

    Science.gov (United States)

    Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    In order to leverage individual and organizational learning and to remain competitive in current turbulent markets it is important for employees, managers, planners and leaders to perform at high levels over time. Employee competence and skills are extremely important matters in view of the general shortage of talent and the mobility of employees with talent. Two factors emerged to have the greatest impact on the competitiveness of complex service systems: improving managerial and employee's knowledge attainment for skills, and improving the training and development of the workforce. This paper introduces the knowledge-based user-centered service design approach for sustainable skill and performance improvement in education, design and modeling of the next generation of complex service systems. The rest of the paper cover topics in human factors and sustainable business process modeling for the service industry, and illustrates the user-centered service system development cycle with the integration of systems engineering concepts in service systems. A roadmap for designing service systems of the future is discussed. The framework introduced in this paper is based on key user-centered design principles and systems engineering applications to support service competitiveness.

  3. Determinants of Customer Satisfaction and Loyalty in Vietnamese Life-Insurance Setting

    Directory of Open Access Journals (Sweden)

    Ha Thu Nguyen

    2018-04-01

    Full Text Available Sustainable services are often regarded as sustainable strategies and operations producing goods and services that satisfy customer needs and significantly improve social and environmental performance. To be sustainable, service providers must satisfy consumers’ needs or otherwise they will become redundant and economically irrelevant. This paper presents the results of an empirical study on the determinants of customer satisfaction and loyalty in life-insurance services in Vietnam based on a database collected through a questionnaire survey of 1476 customers during 2017. A path analysis technique is applied to test the proposed framework on the direct and indirect relationship between variables. The results of statistical analysis indicate that customer satisfaction in life-insurance services is significantly explained by such factors as corporate image, service quality and perceived value. Our findings suggest that a life-insurance service provider should focus on enhancing service quality and corporate image in order to obtain customer satisfaction that leads to customer loyalty.

  4. Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service.

    Science.gov (United States)

    Powell, A E; Davies, H T O; Bannister, J; Macrae, W A

    2009-06-01

    Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Case studies were conducted comprising documentary review and semi-structured interviews (71) with anaesthetists, surgeons, nurses, other health professionals, and managers working in and around three broadly typical acute pain services. Although the precise details differed to some degree, the three acute pain services all faced the same broad range of inter-related challenges identified in the organizational change literature (i.e. structural, political, cultural, educational, emotional, and physical/technological challenges). The services were largely isolated from wider organizational objectives and activities and struggled to engage other health professionals in improving postoperative pain management against a background of limited resources, turbulent organizational change, and inter- and intra-professional politics. Despite considerable efforts they struggled to address these challenges effectively. The literature on organizational change and quality improvement in health care suggests that it is only by addressing the multiple challenges in a comprehensive way across all levels of the organization and health-care system that sustained improvements in patient care can be secured. This helps to explain why the hard work and commitment of acute pain services over the years have not always resulted in significant improvements in routine postoperative pain management for all surgical patients. Using this literature and adopting a whole-organization quality improvement approach tailored to local circumstances may produce a step-change in the quality of routine postoperative pain management.

  5. Improving Acceptance, Integration, and Health Among LGBT Service Members

    Science.gov (United States)

    2016-10-01

    lifting of the bans – remains alive and well, with some LGBT service members experiencing interpersonal and institutional discrimination ...being among LGBT service members and improve unit cohesion. The military has always been a leader in understanding and implementing gender and...matters. These should be people that you know and who know you. These should be people you have had contact with in the past 3 months or so – either in

  6. Responsive parenting is associated with improved type 1 diabetes-related quality of life.

    Science.gov (United States)

    Botello-Harbaum, M; Nansel, T; Haynie, D L; Iannotti, R J; Simons-Morton, B

    2008-09-01

    Improved quality of life is an important treatment goal for children and adolescents with type 1 diabetes. While previous research supports a relationship between family environment and quality of life, little research has addressed the relationship of parenting style constructs to quality of life in children with chronic disease. The present investigation assesses the relationship of parent responsiveness and demandingness with diabetes-related quality of life among children and adolescents with type 1 diabetes. Baseline and 12-month follow-up self-report assessments were collected on a sample of 81 children with type 1 diabetes participating in an efficacy trial of a behavioural intervention to enhance adherence. The sample had a mean age of 13.3 years (SD=1.7) and duration of diabetes of 7.7 years (SD=3.7). Multiple regression analyses were conducted to determine the relationship of parent responsiveness and demandingness to diabetes-related quality of life at each time point. After adjusting for demographic and diabetes characteristics, as well as diabetes-specific parent-child behaviours, parent responsiveness was significantly associated with baseline diabetes-related quality of life (beta=0.23; P=0.04). This relationship was sustained at 12-month follow-up (beta=0.22; P=0.04) after adjusting for baseline quality of life and treatment group assignment, suggesting that parent responsiveness is associated with improved quality of life. Findings indicate the importance of a supportive and emotionally warm parenting style in promoting improved quality of life for children with type 1 diabetes. Appropriate parenting skills should be an element of diabetes family management health care.

  7. The Association Between Home Palliative Care Services and Quality of End-of-Life Care Indicators in the Province of Québec.

    Science.gov (United States)

    Gagnon, Bruno; Nadeau, Lyne; Scott, Susan; Dumont, Serge; MacDonald, Neil; Aubin, Michèle; Mayo, Nancy

    2015-07-01

    In Canada, governments have increased spending on home care to promote better end-of-life care. In the province of Québec, Canada, home palliative care (PC) services (HPCS) are provided by Public Local Community-Based Health Care Service providers (Centres Locaux de Services Communautaires [CLSC]) with universal coverage. Accordingly, there should be no regional variations of these services and their effect on quality of end-of-life PC (QEoLPC) indicators. To test if all the CLSCs provided the same level of HPCS to cancer patients in the province of Québec, Canada, and the association between level of HPCS and QEoLPC indicators. Characteristics of 52,316 decedents with cancer were extracted from administrative databases between 2003 and 2006. Two gender-specific "adjusted performance of CLSCs in delivering HPCS" models were created using gender-specific hierarchical regression adjusted for patient and CLSC neighborhood characteristics. Using the same approach, the strength of the association between the adjusted performance of CLSCs in delivering HPCS and the QEoLPC indicators was estimated. Overall, 27,255 (52.1%) decedents had at least one HPCS. Significant variations in the adjusted performance of CLSC in delivering HPCS were found. Higher performance led to a lower proportion of men having more than one emergency room visit during the last month of life (risk ratio [RR] 0.924; 95% CI 0.867-0.985), and for women, a higher proportion dying at home (RR 2.255; 95% CI 1.703-2.984) and spending less time in hospital (RR 0.765; 95% CI 0.692-0.845). Provision of HPCS remained limited in Québec, but when present, they were associated with improved QEoLPC indicators. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  8. The AskIT Service Desk: A Model for Improving Productivity and Reducing Costs

    Energy Technology Data Exchange (ETDEWEB)

    Ashcraft, Phillip Lynn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Fogle, Blythe G. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Cummings, Susan M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lopez, Leon [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-29

    This was prepared for the business process improvement presentation to the Department of Energy. Los Alamos National Laboratory provides a single point of contact, the AskIT Service Desk, to address issues that impact customer productivity. At the most basic level, what customers want is for their calls to be received, to get a response from a knowledgeable analyst, and to have their issues resolved and their requests fulfilled. Providing a centralized, single point of contact service desk makes initiating technical or business support simple for the customer and improves the odds of immediately resolving the issue or correctly escalating the request to the next support level when necessary. Fulfilling customer requests through automated workflow also improves customer productivity and reduces costs. Finally, customers should be provided the option to solve their own problems through easy access to self-help resources such as frequently asked questions (FAQs) and how-to guides. To accomplish this, everyone who provides and supports services must understand how these processes and functions work together. Service providers and those who support services must “speak the same language” and share common objectives. The Associate Directorate for Business Innovation (ADBI) began the journey to improve services by selecting a known service delivery framework (Information Technology Infrastructure Library, or ITIL). From this framework, components that contribute significant business value were selected.

  9. Improved waste management services – Will the Act make a difference?

    CSIR Research Space (South Africa)

    Oelofse, Suzanna HH

    2009-05-01

    Full Text Available This document focuses on the improved waste management services and the Waste Act 59 of 2008. It provide in formation on the Integrated Waste Management Plans, technical capacity – infrastructure, the backlog in adequate service provision, the facts...

  10. Influence of coating quality on the service life of land-based gas turbine blades

    Energy Technology Data Exchange (ETDEWEB)

    Cheruvu, N.S. [Southwest Research Institute, San Antonio (United States)

    2007-06-15

    The land-based gas turbine blades operate at severe operating conditions: higher metal temperatures and stresses, and severe duty cycles. Metallic coatings with or without a top ceramic coating have been used to protect the turbine blades. The durability of the coating system is one of the prime life-limiting factors of modem gas turbine blades. The quality of the coating plays a critical role on the coating life. This paper discusses the failure mechanisms of the coatings and describes how the quality of the coating affects the service life of a gas turbine blade. A few case studies are presented in the paper. (orig.)

  11. The Efficacy of Psychosocial Occupational Therapy Services on Quality of life of Chronic Pschiatric Patents

    Directory of Open Access Journals (Sweden)

    Elaheh Hojjati-Abed

    2010-04-01

    Full Text Available Objective: Quality of life has recently been recognized as an important goal of health care in psychiatry. In this study quality of life of chronic psychiatric patients was evaluated after psychosocial occupational therapy interventions. Materials & Methods: This study is interventional and quasi experimental. Twoenty four chronic mental patients who had refered to SINA Daily Center as intervention group and fifty chronic mental patients as control group were selected by simle and convenient sampling. The instrument was Wisconsin Quality of Life Client Questionnaire that included 8 subscales. Occupational therapy services consisting group therapy, activity therapy and art therapy, according to center’ plane, were performed during 3 months (2 times in week, 90 minutes in each session for intervention group. Independent T test & Paired T test were used for data analysis. Results: There was no significant difference between two groups in parts of QOL before intervention, but after intervention, significant differences were observed in mean scores of satisfaction level, occupational activities, psychological well–being, physical health and total quality o life (P<0.001, also social relation (P=0.005 and economic situation (P=0.003.There was no significant difference between two group in symptoms (P=0.277 and activity of daily living (P=0.020 after intervention. Conclusion: Psychosocial occupational therapy services are effective on satisfaction level and quality of life of chronic psychiatric patients.

  12. Applying Quality Function Deployment Model in Burn Unit Service Improvement.

    Science.gov (United States)

    Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi

    2016-01-01

    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.

  13. Improving queuing service at McDonald's

    Science.gov (United States)

    Koh, Hock Lye; Teh, Su Yean; Wong, Chin Keat; Lim, Hooi Kie; Migin, Melissa W.

    2014-07-01

    Fast food restaurants are popular among price-sensitive youths and working adults who value the conducive environment and convenient services. McDonald's chains of restaurants promote their sales during lunch hours by offering package meals which are perceived to be inexpensive. These promotional lunch meals attract good response, resulting in occasional long queues and inconvenient waiting times. A study is conducted to monitor the distribution of waiting time, queue length, customer arrival and departure patterns at a McDonald's restaurant located in Kuala Lumpur. A customer survey is conducted to gauge customers' satisfaction regarding waiting time and queue length. An android app named Que is developed to perform onsite queuing analysis and report key performance indices. The queuing theory in Que is based upon the concept of Poisson distribution. In this paper, Que is utilized to perform queuing analysis at this McDonald's restaurant with the aim of improving customer service, with particular reference to reducing queuing time and shortening queue length. Some results will be presented.

  14. The effect of quality circles on job satisfaction and quality of work-life of staff in emergency medical services.

    Science.gov (United States)

    Hosseinabadi, Reza; Karampourian, Arezou; Beiranvand, Shoorangiz; Pournia, Yadollah

    2013-10-01

    Quality circles, as a participatory management technique, offer one alternative for dealing with frustration and discontent of today's workers. This study was conducted to investigate the effect of implementation of quality circles on nurses' quality of work-life and job satisfaction. In this study, two emergency medical services (EMS) of Hamedan province were selected and randomly assigned as the experimental and control groups. After the experimental group was trained and quality circles were established in this group, the levels of quality of work-life and job satisfaction were measured in the two groups. Then, the statistical analyses were performed using t-test. After the intervention, the results showed significant differences between the scores of motivational factors (p=0.001), the total scores of job satisfaction (p=0.003), and the scores of some quality of work life (QWL) conceptual categories including the use and development of capacities (p=0.008), the total space of life (p=0.003), and the total scores of QWL (p=0.031) in the experimental group compared to those in the control group. This study confirms the effectiveness of quality circles in improving quality of work-life and job satisfaction of nurses working in EMS, and offers their application as a management method that can be used by EMS managers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Improvement of quality of life following 6 months of methadone maintenance therapy in Malaysia.

    Science.gov (United States)

    Baharom, Nizam; Hassan, Mohd Rohaizat; Ali, Norsiah; Shah, Shamsul Azhar

    2012-08-01

    Methadone Maintenance Therapy (MMT) is one of the popular choices for drug substitution therapy and is fairly new in Malaysia. Aside from its role in harm reduction against HIV infection, MMT programme may potentially enhances clients' quality of life. This study aims to identify the impact of MMT programme on clients' quality of life after 6 months in treatment and to explore factors that may be associated with changes in their quality of life. In this retrospective report review, 122 subjects from 2 government MMT clinics were selected from the district of Tampin, Negeri Sembilan, Malaysia. The raw score from the WHO Quality of Life questionnaire (WHOQOL-BREF), at baseline and 6 months after therapy were collected and converted to 0-100 scale form to give quality of life scores for four domains; physical, psychological, social relationships and environment. Other variables of interest were socio-demography, age when joining MMT programme, age and duration of illicit drug use, HIV and Hepatitis C status, and the Opiate Treatment Index (OTI) score on drug use, sexual and social aspect at the baseline. Statistical analysis used the SPSS version 16. There was significant improvement in all four domains of quality of life, after 6 months of MMT. The largest improvement was for psychological domain (mean score difference 15.54 ± 20.81). Multivariable linear regression analysis showed that, for the physical domain, there was no significant predictor. For both the psychological and social domains, having tertiary education is a significant predictor for improvement in both aspects of quality of life. Negative HIV status is associated with improvement for the environment domain. There was a significant short term improvement in the quality of life of MMT clients who stayed in the programme for at least 6 months in the district of Tampin, Negeri Sembilan, Malaysia.

  16. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2018-03-01

    Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  17. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

  18. Cognitive-behavioral therapy improves the quality of life of patients with acromegaly.

    Science.gov (United States)

    Kunzler, Lia Silvia; Naves, Luciana Ansaneli; Casulari, Luiz Augusto

    2018-06-01

    The delayed diagnosis, altered body image, and clinical complications associated with acromegaly impair quality of life. To assess the efficacy of the cognitive-behavioral therapy (CBT) technique "Think Healthy" to increase the quality of life of patients with acromegaly. This non-randomized clinical trial examined ten patients with acromegaly (nine women and one man; mean age, 55.5 ± 8.4 years) from a convenience sample who received CBT. The intervention included nine weekly group therapy sessions. The quality of life questionnaire the 36-Item Short Form Survey (SF-36) and the Beck Depression Inventory (BDI) were administered during the pre- and post-intervention phases. The Wilcoxon signed-rank test was performed to assess the occurrence of significant differences. According to the SF-36, the general health domain significantly improved (d'  = - 0.264; p = 0.031). The mental health domain improved considerably (d'  = - 1.123; p = 0.012). Physical functioning showed a non-significant trend toward improvement (d'  = - 0.802; p = 0.078), although four of the five patients who showed floor effects improved and remained at this level. Regarding emotional well-being, five patients showed floor effects and four improved, and the condition did not change among any of the four patients who showed ceiling effects. No significant changes were found with regard to the other domains. No significant differences in the BDI were found before or after the intervention. The technique presented herein effectively improved the quality of life of patients with acromegaly with different levels of disease activity, type, and treatment time.

  19. Improving quality of life in patients with hidradenitis suppurativa

    DEFF Research Database (Denmark)

    Dufour, D.N.; Esmann, S.; Jemec, G.B.

    2012-01-01

    Hidradenitis suppurativa is a chronic recurrent inflammatory skin disease with abscess formation and scarring predominantly in the inverse areas. The disease is often difficult to treat and patients experience a decreased quality of life (QoL) and related psychosocial morbidity. Current knowledge...... on improving QoL in patients with hidradenitis suppurativa is therefore reviewed. The literature is limited but indicates that there are two ways of improving patients' QoL: therapy of the somatic disease or psychosocial interventions....

  20. Improvement in the distribution of services in multi-agent systems with SCODA

    Directory of Open Access Journals (Sweden)

    Jesús Ángel ROMÁN GALLEGO

    2016-06-01

    Full Text Available The distribution of services on multi-agent systems allows it to reduce to the agents their computational load. The functionality of the system does not reside in the agents themselves, however it is ubiquitously distributed so that allows you to perform tasks in parallel avoiding an additional computational cost to the elements in the system. The distribution of services that offers SCODA (Distributed and Specialized Agent Communities allows an intelligent management of these services provided by agents of the system and the parallel execution of threads that allow to respond to requests asynchronously, which implies an improvement in the performance of the system at both the computational level as the level of quality of service in the control of these services. The comparison carried out in the case of study that is presented in this paper demonstrates the existing improvement in the distribution of services on systems based on SCODA.

  1. LibAnswers: Analyzing tickets (questions) to improve our library's virtual reference service(s)

    KAUST Repository

    Ramli, Rindra M.

    2017-05-01

    Analyze the questions received in LibAnswers (ticketing system) in order to improve the quality of our virtual reference services. Tickets that were received between June 2015 to April 2017 were analyzed and categorized. It was noted that most questions asked revolved around electronic resources issues as well as circulation/access issues.

  2. LibAnswers: Analyzing tickets (questions) to improve our library's virtual reference service(s)

    KAUST Repository

    Ramli, Rindra M.; Ba-Rayyan, Faten A.

    2017-01-01

    Analyze the questions received in LibAnswers (ticketing system) in order to improve the quality of our virtual reference services. Tickets that were received between June 2015 to April 2017 were analyzed and categorized. It was noted that most questions asked revolved around electronic resources issues as well as circulation/access issues.

  3. Strategy for 100-year life of the ACR-1000 concrete containment structure

    International Nuclear Information System (INIS)

    Abrishami, H.; Elgohary, M.

    2006-01-01

    The purpose of this paper is to present the Plant Life Management (PLiM) strategy for the concrete containment structure of the ACR-1000 (Advanced CANDU Reactor) designed by AECL. The ACR-1000 is designed for 100-year plant life including 60-year operating life and additional 40-year decommissioning period of time. The approach adopted for the PLiM strategy of the concrete containment structure is a preventive one, key areas being: 1) design methodology, 2) material performance and 3) life cycle management and ageing management program. In the design phase, in addition to strength and serviceability, durability is a major requirement during the service life and decommissioning phase of the ACR structure. Parameters affecting durability design include: a) concrete performance, b) structural application, and c) environmental conditions. Due to the complex nature of the environmental effects acting on structures during the service life of project, it is considered that true improved performance during the service life can be achieved by improving the material characteristics. Many recent innovations in advanced concrete materials technology have made it possible to produce modern concrete such as high-performance concrete with exceptional performance characteristics. In this paper, the PLiM strategy for the ACR-1000 concrete containment is presented. In addition to addressing the design methodology and material performance areas, a systematic approach for ageing management program for the concrete containment structure is presented. (author)

  4. Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?

    Science.gov (United States)

    Greenstein, Caroline; Lowell, Anne; Thomas, David Piers

    2016-06-01

    To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Case study based at one paediatric physiotherapy service Community-based paediatric allied health service in Northern Australia. Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Comparison of findings from the two studies Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. © 2015 National Rural Health Alliance Inc.

  5. Measuring and improving customer satisfaction with government services

    Science.gov (United States)

    Glen D. Alexander

    1995-01-01

    Two years ago, Ohio State Park developed a methodology of measuring customer satisfaction, to gauge the effectiveness of our customer service. What follows is a discussion of our installation of systems to measure and improve customer satisfaction, the interpretation of the data, and the positive results we have enjoyed.

  6. Decentralisation in Uganda: Prospects for Improved Service Delivery

    African Journals Online (AJOL)

    Financial decentralisation, on the other hand, attempted to assign responsibilities and taxes between the centre and local governments, to enable the transfer of grants and other resources to different parts of the country, and to improve service delivery. This paper will review different government, public and academic ...

  7. Place of Death and Use of Health Services in the Last Year of Life

    OpenAIRE

    Grande, Gunn E.; McKerral, Angela; Addington-Hall, Julia M.; Todd, Chris J.

    2003-01-01

    Aim: To investigate whether health service input in the last year of life differs between cancer patients who die at home versus those dying in inpatient care. Methods: Post hoc exploratory case-control study of 127 home deaths and 200 inpatient deaths. Retrospective electronic record linkage of patients' community and inpatient care during the last year of life. Results: Patients who died at home began their home nursing care closer to death than those who died as inpatients. Their first con...

  8. Fuzzy Life-Extending Control of Anti-Lock Braking System

    Directory of Open Access Journals (Sweden)

    Ahmed M. El-Garhy

    2013-12-01

    Full Text Available The repeated operation of the Anti-Lock Braking System (ABS causes accumulation of structural damages in its different subsystems leading to reduction in their functional life time. This paper proposes a Fuzzy Logic based Life-Extending Control (FLEC system for increasing the service life of the ABS. FLEC achieves significant improvement in service life by the trade-off between satisfactory dynamic performance and safe operation. The proposed FLEC incorporates structural damage model of the ABS. The model utilizes the dynamic behavior of the ABS and predicts the wear rates of the brake pads/disc. Based on the predicted wear rates, the proposed fuzzy logic controller modifies its control strategy on-line to keep safe operation leading to increase in service time of the ABS. FLEC is fine tuned via genetic algorithm and its effectiveness is verified through simulations of emergency stops of a passenger vehicle model.

  9. Adolescent health care: improving access by school-based service.

    Science.gov (United States)

    Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N

    1985-10-01

    Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused

  10. Improving Internal Customer Service

    Science.gov (United States)

    1990-09-01

    34Companies are recognizing that treating customers and associates like people has a very high value" (21:20). 2 Customer service has become more that... customer service is also a strategy with the focus towards people , not product (24:1). Customers are demanding quality service for several reasons...34 (39:45). External Customers . External customers are an organization’s ultimate consumers . They purchase the end product or service an organization

  11. A repeated short educational intervention improves asthma control and quality of life.

    Science.gov (United States)

    Plaza, Vicente; Peiró, Meritxell; Torrejón, Montserrat; Fletcher, Monica; López-Viña, Antolín; Ignacio, José María; Quintano, José Antonio; Bardagí, Santiago; Gich, Ignasi

    2015-11-01

    We assessed the effectiveness of an asthma educational programme based on a repeated short intervention (AEP-RSI) to improve asthma control (symptom control and future risk) and quality of life. A total of 230 adults with mild-to-moderate persistent uncontrolled asthma participated in a 1-year cluster randomised controlled multicentre study. The AEP-RSI was given in four face-to-face sessions at 3-month intervals, and included administration of a written personalised action plan and training on inhaler technique. Centres were randomised to the AEP-RSI (intervention) group or usual clinical practice group. Specialised centres using a standard educational programme were the gold standard group. A significant improvement in the Asthma Control Test score was observed in all three groups (pQuality of Life Questionnaire scores (0.95±1.04 and 0.89±0.84 versus 0.52±0.97, respectively). The AEP-RSI was effective in improving asthma symptom control, future risk and quality of life. Copyright ©ERS 2015.

  12. Camouflage for patients with vitiligo vulgaris improved their quality of life.

    Science.gov (United States)

    Tanioka, Miki; Yamamoto, Yosuke; Kato, Mayumi; Miyachi, Yoshiki

    2010-03-01

    Cosmetic camouflage is important for patients with vitiligo vulgaris. However, few studies have investigated its benefit for vitiligo patients. To analyze the psychological effects on patients with vitiligo vulgaris by camouflage lessons performed in vitiligo clinics in Kyoto University Hospital and Fukui Red Cross Hospital, Dermatological Life Quality Index (DLQI) questionnaires were collected before and 1 month after camouflage lessons. Patients with vitiligo vulgaris, who visited our clinics in 2008 and had never experienced camouflage, were enrolled in this study. They took camouflage lessons and continued subsequent self-camouflage for 1 month. Control patients took no lessons and no camouflage. Camouflage improved the scores of DLQI when compared with those without camouflage (P = 0.005). Camouflage improved DLQI scores from 5.90 to 4.48. In DLQI subcategories, camouflage lessons improved a subcategory of "symptoms and feelings" (P = 0.0037). These data supported the idea that camouflage for patients with vitiligo not only covers the white patches but also improves their quality of life.

  13. Improving outpatient services for elderly patients in Taiwan: a qualitative study.

    Science.gov (United States)

    Kuo, Ren-Jieh; Wu, Yung-Hung; Hsu, Tsung-Shin; Chen, Liang-Kung

    2011-01-01

    The rapid pace of population aging poses significant importance of establishing an age-friendly health care system, including outpatient, inpatient, intermediate, and long-term care. The main purpose of this study is to evaluate the quality of outpatient services for elderly patients in Taiwan. Quality function deployment (QFD) is a tool effectively shortening the research-and-development period, reducing costs, and fulfilling customer needs (CNs). This study applied Kano's model and the analytic network process (ANP) to improve the basic framework of QFD. Kano's model enables a thorough understanding of elderly patients' needs and problems with regard to medical care services, so that appropriate outpatient services can be offered to them from the outset. In addition, adapting the supermatrix of ANP to the calculation of the house of quality (HoQ) will reduce subjective judgments. Using Kano's model and an integrated ANP-QFD approach, we extracted five needs of elderly patients and calculated their priorities: 'Professional medical care services convincing patients' (27%), 'With sufficient knowledge to answer patients' questions' (23.5%), 'Providing fast services to solve patients' problems' (19.3%), 'Voluntarily serving patients' (19.1%), and 'Providing proper medical equipment to patients' (11.1%). We then identified six outpatient service attributes deserving of improvement and their priorities: 'Physician with a high level of professionalism and giving clear interpretation of patient's condition' (25%), 'Staff with good communication skills and assistance to patients' (22%), 'High standardization of operating procedures' (18%), 'Staff getting on-the-job training periodically' (15%), 'Facilities sufficient and fitting for elderly patients' (10%), and 'Applying IT (internet) to help patients to receive medical care' (10%). In conclusion, we reconstructed an integrated QFD model which will not only reduce costs but also reveal the crucial outpatient service items

  14. Periodontal surgery improves oral health-related quality of life in chronic periodontitis patients in Asian population.

    Science.gov (United States)

    Chou, Yu-Hsiang; Yang, Yi-Hsin; Kuo, Hsiao-Ching; Ho, Kun-Yen; Wang, Wen-Chen; Hu, Kai-Fang

    2017-10-01

    The effect of periodontal surgery on patients' quality of life was investigated. Sixty patients received regenerative surgery or resective osseous surgery. Oral health-related quality of life and health-related quality of life instruments were used to assess the participants' quality of life before surgery and 4 weeks after surgery. Periodontal surgery can improve patients' quality of life by alleviating the physical pain and psychological discomfort. The scores were lower (more favorable) in the regenerative surgery group, and the functional limitations of the regenerative surgery group improved substantially compared with those of the resective osseous surgery group (P = 0.0421). The patients' oral health-related quality of life scores improved significantly after periodontal surgery. Clinicians can take advantage of the positive functional oral health-related quality of life impacts of regenerative surgery. Copyright © 2017. Published by Elsevier Taiwan.

  15. Effects on in-service education on improving science teaching in Swaziland

    NARCIS (Netherlands)

    Stronkhorst, Robert; van den Akker, Jan

    2006-01-01

    This paper discusses the findings of an evaluative and interpretive study into the potential of in-service education to improve science education in Swaziland. Short-term and long-term effects of an in-service intervention are evaluated in terms of changes in classroom processes. The teaching

  16. Childhood adverse life events, disordered eating, and body mass index in US Military service members.

    Science.gov (United States)

    Bakalar, Jennifer L; Barmine, Marissa; Druskin, Lindsay; Olsen, Cara H; Quinlan, Jeffrey; Sbrocco, Tracy; Tanofsky-Kraff, Marian

    2018-03-02

    US service members appear to be at high-risk for disordered eating. Further, the military is experiencing unprecedented prevalence of overweight and obesity. US service members also report a high prevalence of childhood adverse life event (ALE) exposure. Despite consistent links between early adversity with eating disorders and obesity, there is a dearth of research examining the association between ALE exposure and disordered eating and weight in military personnel. An online survey study was conducted in active duty personnel to examine childhood ALE history using the Life Stressor Checklist - Revised, disordered eating using the Eating Disorder Examination - Questionnaire total score, and self-reported body mass index (BMI, kg/m 2 ). Among 179 respondents, multiple indices of childhood ALE were positively associated with disordered eating. Traumatic childhood ALE and subjective impact of childhood ALE were associated with higher BMI and these associations were mediated by disordered eating. Findings support evaluating childhood ALE exposure among service members with disordered eating and weight concerns. Moreover, findings support the need for prospective research to elucidate these relationships. © 2018 Wiley Periodicals, Inc.

  17. DS-CDMA system outer loop power control and improvement for multi-service

    Institute of Scientific and Technical Information of China (English)

    Guan Mingxiang; Guo Qing; Li Xing

    2008-01-01

    When a new user accesses the CDMA system, the load will change drastically, and therefore, the advanced outer loop power control (OLPC) technology has to be adopted to enrich the target signal interference ratio (SIR) and improve the system performance. The existing problems about DS-CDMA outer loop power control for multi-service are introduced and the power control theoretical model is analyzed. System simulation is adopted on how to obtain the theoretical performance and parameter optimization of the power control algorithm. The OLPC algorithm is improved and the performance comparisons between the old algorithm and the improved algorithm are given. The results show good performance of the improved OLPC algorithm and prove the validity of the improved method for multi-service.

  18. Services and Supports, Partnership, and Family Quality of Life: Focus on Deaf-Blindness

    Science.gov (United States)

    Kyzar, Kathleen B.; Brady, Sara E.; Summers, Jean Ann; Haines, Shana J.; Turnbull, Ann P.

    2016-01-01

    In this study, the authors examined the moderating effects of partnership on the relationship between services and supports adequacy and family quality of life (FQOL) for families of children with deaf-blindness ages birth to 21. A social-ecological approach enabled examining the impact of disability on the family system. A survey, consisting of…

  19. Quality of Life: Domains for Understanding Maths Anxiety in First Year Pre-Service Teachers through Identity Work

    Science.gov (United States)

    Wilson, Sue

    2016-01-01

    Mathematics anxiety in primary pre-service teachers' affects their future teaching of mathematics and achievement of students. Data collected via Critical Incident Technique were used to investigate this anxiety as perceived and identified by first year pre-service teachers. This paper proposes the application of the Quality of Life conceptual…

  20. Comparative Effectiveness of Usual Source of Care Approaches to Improve End-of-Life Outcomes for Children With Intellectual Disability.

    Science.gov (United States)

    Lindley, Lisa C; Cozad, Melanie J

    2017-09-01

    Children with intellectual disability (ID) are at risk for adverse end-of-life outcomes including high emergency room utilization and hospital readmissions, along with low hospice enrollment. The objective of this study was to compare the effectiveness of usual source of care approaches to improve end-of-life outcomes for children with ID. We used longitudinal California Medicaid claims data. Children were included who were 21 years with fee-for-service Medicaid claims, died between January 1, 2007, and December 31, 2010, and had a moderate-to-profound ID diagnosis. End-of-life outcomes (i.e., hospice enrollment, emergency room utilization, hospital readmissions) were measured via claims data. Our treatments were usual source of care (USC) only vs. usual source of care plus targeted case management (USC plus TCM). Using instrumental variable analysis, we compared the effectiveness of treatments on end-of-life outcomes. Ten percent of children with ID enrolled in hospice, 73% used the emergency room, and 20% had three or more hospital admissions in their last year of life. USC plus TCM relative to USC only had no effect on hospice enrollment; however, it significantly reduced the probability of emergency room utilization (B = -1.29, P life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Improved quality of life in hyperthyroidism patients after surgery.

    Science.gov (United States)

    Bukvic, Branka; Zivaljevic, Vladan; Sipetic, Sandra; Diklic, Aleksandar; Tausanovic, Katarina; Stojanovic, Dragos; Stevanovic, Dejan; Paunovic, Ivan

    2015-02-01

    The most common causes of hyperthyroidism are Graves disease (GD) and toxic nodular goiter (TNG). GD and TNG might influence patients' quality of life (QoL). The aim of our study was to analyze and compare the QoL of patients with GD with that of TNG patients and to evaluate the influence of surgical treatment on their QoL. A prospective case-control study was conducted at the Center for Endocrine surgery in Belgrade, Serbia. The ThyPRO questionnaire was used in the QoL assessment of the GD and TNG patients (31 and 28, respectively) pre- and post-operatively. All patients were receiving antithyroid drugs, and none of the patients were overtly hyperthyroid at the time of completing the preoperative questionnaire. The QoL of the GD patients was worse than that of the TNG patients, with significant differences in eye symptoms, anxiety, and sex life domains (P < 0.001, P = 0.005, and P = 0.004, respectively), preoperatively, and in eye symptoms, anxiety, emotional susceptibility, and overall QoL (P = 0.001, P = 0.027, P = 0.005 and P = 0.013, respectively), postoperatively. The improvement in QoL in the GD patients was significant after surgical treatment in all ThyPRO domains. In the TNG patients, the improvement was significant in all but one ThyPRO domain, sex life (P = 0.066). The QoL of GD patients is worse than those of TNG patients. Surgery may improve QoL in patients with GD and TNG even if they have achieved satisfying thyroid status with medication treatment, preoperatively. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Strategies for Improving the Quality of Polling Service in Wireless Metropolitan Area Network

    Directory of Open Access Journals (Sweden)

    Yang Zhi-Jun

    2017-01-01

    Full Text Available Four kinds of service types are defined in IEEE 802.16. In order to provide the Quality of Service (Qos for different services, the system must use a reasonable resource allocation method and scheduling algorithm to efficiently and fairly allocate bandwidth resources. Although in the IEEE 802.16 MAC, for the uplink real-time polling service (rtPS and non-real-time polling service (nrtPS business type of data transmission are used to polling, but do not provide business-based services. In this paper, the distinction between priority service of rtPS and nrtPS is carried out, and the simulation experiment is used to analyze the performance characteristics of the protocol under the distinction of high and low priority. Wherein the theoretical values of the average delay and the information packets are compared with the experimental values. The average query cycle and throughput are also evaluated. Which proves the validity of the improved service strategy and improves the service characteristics of the system.

  3. Health technology assessment to improve the medical equipment life cycle management.

    Science.gov (United States)

    Margotti, Ana E; Ferreira, Filipa B; Santos, Francisco A; Garcia, Renato

    2013-01-01

    Health technology assessment (HTA) is a tool to support decision making that is intended to assist healthcare managers in their strategic decisions. The use of HTA as a tool for clinical engineering is especially relevant in the domain of the medical equipment once it could improve the performance of the medical equipment. It would be done by their systematically evaluation in several aspects, in their life cycle. In Brazil, the Institute of Biomedical Engineering (IEB-UFSC) through the clinical engineering area has been working on the development of methodologies and improvements on HTA for medical equipment. Therefore, this paper presents the effort to create specific methodologies that will improve the dissemination of HTA, focusing on incorporation and utilization phase of the medical equipment life cycle. This will give a better support to the decision makers in the management of the health care system.

  4. Australian mental health consumers contributions to the evaluation and improvement of recovery-oriented service provision.

    Science.gov (United States)

    Marshal, Sarah L; Oades, Lindsay G; Growe, Trevor P

    2010-01-01

    One key component of recovery-oriented mental health services, typically overlooked, involves genuine collaboration between researchers and consumers to evaluate and improve services delivered within a recovery framework. Eighteen mental health consumers working with staff who had received training in the Collaborative Recovery Model (CRM) took part in in-depth focus group meetings, of approximately 2.5 hours each, to generate feedback to guide improvement of the CRM and its use in mental health services. Consumers identified clear avenues for improvement for the CRM both specific to the model and broadly applicable to recovery-oriented service provision. Findings suggest consumers want to be more engaged and empowered in the use of the CRM from the outset. Improved sampling procedures may have led to the identification of additional dissatisfied consumers. Collaboration with mental health consumers in the evaluation and improvement of recovery-oriented practice is crucial with an emphasis on rebuilding mental health services that are genuinely oriented to support recovery.

  5. Development of a method of continuous improvement of services using the Business Intelligence tools

    Directory of Open Access Journals (Sweden)

    Svetlana V. Kulikova

    2018-01-01

    Full Text Available The purpose of the study was to develop a method of continuous improvement of services using the Business Intelligence tools.Materials and methods: the materials are used on the concept of the Deming Cycle, methods and Business Intelligence technologies, Agile methodology and SCRUM.Results: the article considers the problem of continuous improvement of services and offers solutions using methods and technologies of Business Intelligence. In this case, the purpose of this technology is to solve and make the final decision regarding what needs to be improved in the current organization of services. In other words, Business Intelligence helps the product manager to see what is hidden from the “human eye” on the basis of received and processed data. Development of a method based on the concept of the Deming Cycle and Agile methodologies, and SCRUM.The article describes the main stages of development of method based on activity of the enterprise. It is necessary to fully build the Business Intelligence system in the enterprise to identify bottlenecks and justify the need for their elimination and, in general, for continuous improvement of the services. This process is represented in the notation of DFD. The article presents a scheme for the selection of suitable agile methodologies.The proposed concept of the solution of the stated objectives, including methods of identification of problems through Business Intelligence technology, development of the system for troubleshooting and analysis of results of the introduced changes. The technical description of the project is given.Conclusion: following the work of the authors there was formed the concept of the method for the continuous improvement of the services, using the Business Intelligence technology with the specifics of the enterprises, offering SaaS solutions. It was also found that when using this method, the recommended development methodology is SCRUM. The result of this scientific

  6. [Compatibility of Work and Family Life of Employees in the Healthcare Sector: An Issue in Health Services Research].

    Science.gov (United States)

    Lukasczik, Matthias; Ahnert, Jutta; Ströbl, Veronika; Vogel, Heiner; Donath, Carolin; Enger, Ilka; Gräßel, Elmar; Heyelmann, Lena; Lux, Heidemarie; Maurer, Jochen; Özbe, Dominik; Spieckenbaum, Stefanie; Voigtländer, Elzbieta; Wildner, Manfred; Zapf, Andreas; Zellner, Angela; Hollederer, Alfons

    2017-05-18

    Background Healthcare professionals are confronted with specific work-related demands that influence work-family relations and might indirectly affect the quality of healthcare. This paper seeks to provide an overview of the current state of research on this topic of relevance to health services research. The overview may serve as a starting point for modifying structures in the healthcare system (especially in rural regions) with the aim of improving work-family compatibility. Methods A systematic national and international literature search was conducted in terms of a scoping review. The following criteria/contents to be covered in publications were defined: work-family compatibility; work-family interface and work-family conflict in employees working in healthcare; healthcare professions in rural areas and links with work-family issues; interventions to improve work-family compatibility. 145 publications were included in the overview. Results The available literature focuses on physicians and nursing staff while publications on other professions are largely lacking. The methodological quality of existing studies is mostly low, including a lack of meta-analyses. Several studies document dissatisfaction in physicians and nursing staff regarding reconciliation of work and family life. Only few intervention studies were found that seek to improve work-life compatibility; few of them focus on employees in healthcare. There are also deficits with respect to linking work-family issues with aspects of healthcare in rural areas. Conclusions There is a shortage of systematic national and international research regarding work-family compatibility, especially when it comes to the evaluation of interventions. The overview provides starting points for improving work-family compatibility in healthcare. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Production layout improvement in emergency services: a participatory approach.

    Science.gov (United States)

    Zanatta, Mateus; Amaral, Fernando Gonçalves

    2012-01-01

    Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.

  8. Effect of corrosion on the fatigue service-life on steel and reinforced concrete beams

    NARCIS (Netherlands)

    Veerman, R.P.; van Breugel, K.; Koenders, E.A.B.

    2015-01-01

    Chloride-induced corrosion is a point of big concern in reinforced concrete (RC) structures. To monitor the actual health and to predict the remaining service-life of structures, it is important to understand the structural behaviour and the failure mechanism of structures exposed to chlorides under

  9. Improving the Life Chances of Vulnerable Children and Families with Prenatal and Infancy Support of Parents: The Nurse-Family Partnership

    Directory of Open Access Journals (Sweden)

    David L. Olds

    2012-07-01

    adverse maternal and child outcomes that are important in their own right, but that also have significant implications for the development of criminal behavior. This paper summarizes a three-decade program of research that has attempted to improve the health and development of mothers and infants and their future life prospects with prenatal and infancy home visiting by nurses. The program, known as the Nurse-Family Partnership, is designed for low-income mothers who have had no previous live births. The home visiting nurses have three major goals: to improve the outcomes of pregnancy by helping women improve their prenatal health; to improve the child’s health and development by helping parents provide more sensitive and competent care of the child; and to improve parental life-course by helping parents plan future pregnancies, complete their educations, and find work. Given consistent effects on prenatal health behaviors, parental care of the child, child abuse and neglect, child health and development, maternal life-course, and criminal involvement of the mothers and children, the program is now being offered for public investment throughout the United States, where careful attention is being given to ensuring that the program is being conducted in accordance with the program model tested in the randomized trials. The program also is being adapted, developed, and tested in countries outside of the US: the Netherlands, England, Scotland, Northern Ireland, Australia, and Canada, as well as Native American and Alaskan Native populations in the US, where programmatic adjustments are being made to accommodate different populations served and health and human service contexts. We believe it is important to test this program in randomized controlled trials in these new settings before it is offered for public investment.

  10. Improving mental health service responses to domestic violence and abuse.

    Science.gov (United States)

    Trevillion, Kylee; Corker, Elizabeth; Capron, Lauren E; Oram, Siân

    2016-10-01

    Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse.

  11. Improving the Efficiency of Medical Services Systems: A New Integrated Mathematical Modeling Approach

    Directory of Open Access Journals (Sweden)

    Davood Shishebori

    2013-01-01

    Full Text Available Nowadays, the efficient design of medical service systems plays a critical role in improving the performance and efficiency of medical services provided by governments. Accordingly, health care planners in countries especially with a system based on a National Health Service (NHS try to make decisions on where to locate and how to organize medical services regarding several conditions in different residence areas, so as to improve the geographic equity of comfortable access in the delivery of medical services while accounting for efficiency and cost issues especially in crucial situations. Therefore, optimally locating of such services and also suitable allocating demands them, can help to enhance the performance and responsiveness of medical services system. In this paper, a multiobjective mixed integer nonlinear programming model is proposed to decide locations of new medical system centers, link roads that should be constructed or improved, and also urban residence centers covered by these medical service centers and link roads under investment budget constraint in order to both minimize the total transportation cost of the overall system and minimize the total failure cost (i.e., maximize the system reliability of medical service centers under unforeseen situations. Then, the proposed model is linearized by suitable techniques. Moreover, a practical case study is presented in detail to illustrate the application of the proposed mathematical model. Finally, a sensitivity analysis is done to provide an insight into the behavior of the proposed model in response to changes of key parameters of the problem.

  12. IMPROVING LOGISTICS SERVICES THROUGH THE TECHNOLOGY USED IN FLEET MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Mauro Vivaldini

    2012-12-01

    Full Text Available Outsourcing logistics has established itself in the area of the LSP (Logistics Service Provider, which offers a range of services to its customers. In this line, transportation is characterized as one of the most important services, and therefore efficient fleet management is essential for establishing a high level of customer service. With advances in technology and vehicle tracking systems, this approach of management has gained new possibilities for the improvement of logistics services. By studying the specific case of an LSP, this paper investigates the use of these technologies in the management of their business and services. The results indicate that the LSP seeks to increase its services and to streamline information in order to respond to customer needs in real time. It is also evident in this case under study that the combination of the technology available together with the fleet management system has become a distinguishing feature for this LSP, one which increases their skills and important information for both customers and business.

  13. Enhancing the prospects for palliative care at the end of life: A statewide educational demonstration project to improve advance care planning.

    Science.gov (United States)

    Litzelman, Debra K; Cottingham, Ann H; Griffin, Wilma; Inui, Thomas S; Ivy, Steven S

    2016-12-01

    Although patients want to participate in discussions and decisions about their end-of-life care, studies show that providers frequently fail to invite them to explore advanced care preferences or goals for living. The purpose of our demonstration project was to provide education and coaching to individuals, health providers, and organizations across the state of Indiana intended to facilitate these conversations, documenting and honoring individuals' life goals and preferences for care during the final stages of life. Education and training engaged community members as well as healthcare providers to: (1) improve participant comfort and facility discussing end-of-life issues; (2) improve knowledge of healthcare choices, including palliative and hospice care; and (3) prepare all participants to explore and document personal values, life goals, and priorities as well as goals of care. Between January of 2013 and June of 2015, the team educated close to 5,000 participants. Participants' ratings of the quality and perceived usefulness of the educational events ranged from 4 to 5 (using a 5-point scale, with 5 = most effective). Participant comments were overwhelmingly favorable and indicated an intention to put the advance care planning resources, communication skills, knowledge of palliative and hospice care, and personal renewal techniques into practice. Participant motivation to foster advance care planning, discussions of palliative care, and end-of-life conversations was facilitated by the reframing of these conversations as identifying goals of care and priorities for living well during an important stage of life. Successful strategies included helping providers and patients to adopt a broader meaning for "sustaining hope" (not for cure, but for engaging in highly valued activities), developing provider communication skills and comfort in initiating potentially difficult discussions, engaging a new community health workforce who will develop trusting

  14. Comparing the Life Cycle Energy Consumption, Global Warming and Eutrophication Potentials of Several Water and Waste Service Options

    Directory of Open Access Journals (Sweden)

    Xiaobo Xue

    2016-04-01

    Full Text Available Managing the water-energy-nutrient nexus for the built environment requires, in part, a full system analysis of energy consumption, global warming and eutrophication potentials of municipal water services. As an example, we evaluated the life cycle energy use, greenhouse gas (GHG emissions and aqueous nutrient releases of the whole anthropogenic municipal water cycle starting from raw water extraction to wastewater treatment and reuse/discharge for five municipal water and wastewater systems. The assessed options included conventional centralized services and four alternative options following the principles of source-separation and water fit-for-purpose. The comparative life cycle assessment identified that centralized drinking water supply coupled with blackwater energy recovery and on-site greywater treatment and reuse was the most energy- and carbon-efficient water service system evaluated, while the conventional (drinking water and sewerage centralized system ranked as the most energy- and carbon-intensive system. The electricity generated from blackwater and food residuals co-digestion was estimated to offset at least 40% of life cycle energy consumption for water/waste services. The dry composting toilet option demonstrated the lowest life cycle eutrophication potential. The nutrients in wastewater effluent are the dominating contributors for the eutrophication potential for the assessed system configurations. Among the parameters for which variability and sensitivity were evaluated, the carbon intensity of the local electricity grid and the efficiency of electricity production by the co-digestion with the energy recovery process were the most important for determining the relative global warming potential results.

  15. In-flight food delivery and waste collection service: the passengers’ perspective and potential improvement

    Science.gov (United States)

    Romli, F. I.; Rahman, K. Abdul; Ishak, F. D.

    2016-10-01

    Increased competition in the commercial air transportation industry has made service quality of the airlines as one of the key competitive measures to attract passengers against their rivals. In-flight services, particularly food delivery and waste collection, have a notable impact on perception of the overall airline's service quality because they are directly and interactively provided to passengers during flight. An online public survey is conducted to explore general passengers' perception of current in-flight food delivery and waste collection services, and to identify potential rooms for improvement. The obtained survey results indicate that in-flight service does have an effect on passengers' choice of airlines. Several weaknesses of the current service method and possible improvements have been established from the collected responses.

  16. Age Weights for Health Services Derived from the Relative Social Willingness-to-Pay Instrument.

    Science.gov (United States)

    Richardson, Jeff; McKie, John; Iezzi, Angelo; Maxwell, Aimee

    2017-04-01

    The effect of a patient's age on the social valuation of health services remains controversial, with empirical results varying in magnitude and implying a different age-value profile. This article employs a new methodology to re-examine these questions. Data were obtained from 2 independent Web-based surveys that administered the Relative Social Willingness to Pay instrument. In the first survey, the age of the patient receiving a life-saving service was varied. Patients were left with either poor mental or physical health. In the second survey, patient age was varied for a service that fully cured the patient's poor mental or physical health. In total, therefore, 4 sets of age weights were obtained: weights for life-extending services with poor physical or mental health outcomes and weights for quality-of-life improvement for patients in poor mental or physical health. Results were consistent. Increasing age was associated in each case with a monotonic decrease in the social valuation of the services. The decrease in value was quantitatively small until age 60 years. By age 80 years, the social value of services had declined by about 50%. The decline commenced at an earlier age in the context of physical health, although the magnitude of the decrement by age 80 years was unrelated to the type of service. With 1 exception, there was little difference in the valuation of services by the age of the survey respondent. Respondents aged >60 years placed a lower, not higher, value on quality-of-life improvement for elderly individuals than other respondents. There was no difference in the valuation of life-extending services.

  17. An Internet-Based Physical Activity Intervention to Improve Quality of Life of Inactive Older Adults

    DEFF Research Database (Denmark)

    Broekhuizen, Karen; de Gelder, Jelle; Wijsman, Carolien A

    2016-01-01

    BACKGROUND: Increasing physical activity is a viable strategy for improving both the health and quality of life of older adults. OBJECTIVE: The aim of this study was to assess if an Internet-based intervention aimed to increase physical activity was effective in improving quality of life of inact...

  18. [Nurses as a support to improve the quality of life during assisted reproduction].

    Science.gov (United States)

    Castells-Ayuso, Paula; Berenguer-Labaig, Cristina; Sánchez-Martín, Pascual; Sánchez-Martín, Fernando

    2015-01-01

    The aim of this study was to measure how infertility and assisted reproduction treatments (including artificial insemination) could affect the quality of life, and to evaluate how nurses could be helpful in this process, by alleviating anxiety and increasing the quality of life. A cross-sectional observational study was conducted on 48 patients (26 cycles) in an Assisted Reproduction Unit from 2nd December 2013 to 30th April 2014. Socio-demographic data were obtained, with the quality of life being assessed using the FertiQoL questionnaire before and after the treatment, and the consultations with a nurse by telephone or e-mail of these patients were also analyzed. The study results show a decreased quality of life in these patients, which was worse in men and in couples who had no previous children. Patient-centered care improved quality of life and tolerability to the assisted reproduction treatment. Patients frequently telephoned the nurse to solve their doubts and problems. The present study suggests that nurses can play an important role in improving the quality of life of patients undergoing assisted reproduction treatment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  19. Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

    Science.gov (United States)

    Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

    2016-12-01

    Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

  20. THE EFFECTS OF ROOM SERVICE TO IMPROVE PATIENTS’ FOOD SATISFACTION AND FOOD ACCEPTANCE

    OpenAIRE

    Muhammad Iqbal; Susetyowati Susetyowati; Martalena Br Purba

    2017-01-01

    The improvement of patients’ food satisfaction and acceptance in the hospitals is primarily needed in the food service  system.  Room service is a new concept in the food service area. This study aims to compare the effects of two different types of food service systems; room service and conventional service system. The study with quasi-experimental design is conducted to the subject of 66 inpatients who were taken using a quota sampling method. Subjects were divided into different groups, th...

  1. Robotics and Automation for Flight Deck Aircraft Servicing

    Energy Technology Data Exchange (ETDEWEB)

    Chesser, J.B.; Draper, J.V.; Pin, F.G.

    1999-03-01

    One of the missions of the Future Aircraft Carriers Program is to investigate methods that would improve aircraft turnaround servicing activities on carrier decks. The major objectives and criteria for evaluating alternative aircraft servicing methods are to reduce workload requirements, turnaround times (TAT), and life-cycle costs (LCC). Technologies in the field of Robotics and Automation (R and A) have the potential to significantly contribute to these objectives. The objective of this study was to investigate aircraft servicing functions on carrier decks which would offer the potentially most significant payoff if improved by various R and A technologies. Improvement in this case means reducing workload, time and LCC. This objective was accomplished using a ''bottom-up'' formalized approach as described in the following.

  2. Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study

    Directory of Open Access Journals (Sweden)

    Ashley Wilder Smith

    2013-04-01

    Full Text Available Introduction: Cancer for adolescents and young adults (AYA differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under- or inadequately served by current support services, which may affect health-related quality of life (HRQOL.Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE study, a population-based cohort (n=484, age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical and health insurance variables.Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%, mental health (15%, and support group (14% services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s<0.0001. Specific unmet services were related to particular outcomes (e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s<0.001. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains.Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental

  3. A Comparison of Quality of Life Outcomes for People with Intellectual Disabilities in Supported Employment, Day Services and Employment Enterprises

    Science.gov (United States)

    Beyer, Stephen; Brown, Tony; Akandi, Rachel; Rapley, Mark

    2010-01-01

    Background: Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for…

  4. Quality of life improves in children and adolescents during a community-based overweight and obesity treatment.

    Science.gov (United States)

    Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine; Kloppenborg, Julie T; Baker, Jennifer L; Holm, Jens-Christian

    2017-06-01

    The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree of obesity. Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys) completed another PedsQL after a median of 13 months of treatment. Quality of life improved (p quality of life (p ≤ 0.047). However, improvements also occurred in children and adolescents with low socioeconomic status or who increased their BMI SDS (p quality of life occurred in children and adolescents during a community-based overweight and obesity treatment, even in children and adolescents who increased their BMI SDS. Thus, improvements may be due to the treatment itself and not exclusively to reductions in BMI SDS. Clinicaltrials.gov, ID-no.: NCT02013843.

  5. IMPROVING QUALITY OF WORK LIFE THROUGH ELECTROPHYSIOLOGY: AN IDEA ACCEPTED BY INDUSTRY

    Directory of Open Access Journals (Sweden)

    Evanthia Giagloglou

    2015-12-01

    Full Text Available Quality of Work Life (QWL and Occupational Health and Safety (OHS are two interconnected and important human needs. Modern industry shows a clear will for improving QWL and OHS, nevertheless, existent automatization and technological advances may negatively influence employees' wellbeing and result as triggers to their health deterioration. Subjective measures of employees workload can help, however, the lack of objectivity may be an issue. Improvement of working life needs objective measures. There is technology for measuring objectively employees' psychophysiology, but is considered to interfere with the flexibility needed for performing working tasks. Today electrophysiological methods require minimal dimensions, are wireless connected, allow movement and are proved to be useful in capturing psychophysical wellbeing. This study shows that the industry is ready to accept electrophysiological measures for monitoring and improving the employees' wellbeing.

  6. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    Science.gov (United States)

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2014-08-14

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

  7. A Comparative Assessment of Life-Cycle Greenhouse Gas Emissions from Hypothetical Electric Airport Transportation Services in Thailand

    Science.gov (United States)

    Koiwanit, J.

    2018-05-01

    Global warming is an increase of average temperature in the atmosphere, which causes adverse effects on the environment. Carbon dioxide (CO2) from transportation sector is one of the main contributors of the overall greenhouse gases (GHG). To cope with this issue, electric car services are increasingly seen as popular alternative modes of green transportation especially for urban cities as it is more flexible, more environmentally-friendly, and less expensive than the use of conventional vehicles. The study analyses and compare the hypothetical electric car systems from airport transportation services. Center of Environmental Science of Leiden University (CML) 2001, the Life Cycle Impact Assessment (LCIA) method, is applied to convert life cycle inventory data into environmental impacts. The observed results showed that the electric shuttle bus had the highest impact in global warming potential (GWP) compared to other transportation types. Alternatively, this Life Cycle Assessment (LCA) study that evaluated different transportations provided important information for decision makers on quantifying the differences between each scenario.

  8. Den præhospitale service i Danmark

    DEFF Research Database (Denmark)

    Trier, H; Larsen, C F

    1993-01-01

    In Denmark, emergency ambulances are dispatched by 41 centres manned either by trained firemen (in Copenhagen) or policemen (outside Copenhagen). In 1990, emergency ambulance calls totalled 284,000. Utilisation of emergency ambulance services increases with urbanisation. A doctor-manned ambulance...... is in operation in Copenhagen, and in some other large towns anaesthesiology and intensive care teams can be dispatched from hospital to give on-the-spot care. In less populated areas, some general practitioners give advanced life-support. Although many areas are serviced by ambulances equipped...... with defibrillators, the majority of patients receive only basic life-support from ambulance personnel. New initiatives resulting from a recent report by a commission appointed by central authorities, and focused on prehospital treatment, are expected to improve the service by raising the level of training given...

  9. The Effects of Different Aspects of Tourism Services on Travelers' Quality of Life: Model Validation, Refinement, and Extension

    OpenAIRE

    Neal, Janet Davis

    2000-01-01

    The Effects of Different Aspects of Tourism Services on Travelers' Quality of Life: Model Validation, Refinement, and Extension by Janet Davis Neal ABSTRACT Numerous satisfaction studies have been conducted in both tourism and marketing which have examined various aspects of travelers and/or consumers. Quality of life satisfaction studies look beyond the types of satisfaction experiences that endure for only a short time to those that "spill over" into individuals' life domains ...

  10. The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients

    Directory of Open Access Journals (Sweden)

    Engeser Peter

    2007-05-01

    Full Text Available Abstract Background The care of palliative patients challenges the health care system in both quantity and quality. Especially the role of primary care givers needs to be strengthened to provide them with the knowledge and the confidence of applying an appropriate end-of-life care to palliative patients. To improve health care services for palliative patients in primary care, interested physicians in and around Heidelberg, Germany, are enabled to participate in the community-based program 'Palliative Medical Initiative North Baden (PAMINO' to improve their knowledge in dealing with palliative patients. The impact of this program on patients' health and quality of life remains to be evaluated. Methods/Design The evaluation of PAMINO is a non-randomized, controlled study. Out of the group of primary care physicians who took part in the PAMINO program, a sample of 45 physicians and their palliative patients will be compared to a sample of palliative patients of 45 physicians who did not take part in the program. Every four weeks for 6 months or until death, patients, physicians, and the patients' family caregivers in both groups answer questions to therapy strategies, quality of life (QLQ-C15-PAL, POS, pain (VAS, and burden for family caregivers (BSFC. The inclusion of physicians and patients in the study starts in March 2007. Discussion Although participating physicians value the increase in knowledge they receive from PAMINO, the effects on patients remain unclear. If the evaluation reveals a clear benefit for patients' quality of life, a larger-scale implementation of the program is considered. Trial registration: The study was registered at ‘current controlled trials (CCT’, registration number: ISRCTN78021852.

  11. Centers for medicare and medicaid services: using an episode-based payment model to improve oncology care.

    Science.gov (United States)

    Kline, Ronald M; Bazell, Carol; Smith, Erin; Schumacher, Heidi; Rajkumar, Rahul; Conway, Patrick H

    2015-03-01

    Cancer is a medically complex and expensive disease with costs projected to rise further as new treatment options increase and the United States population ages. Studies showing significant regional variation in oncology quality and costs and model tests demonstrating cost savings without adverse outcomes suggest there are opportunities to create a system of oncology care in the US that delivers higher quality care at lower cost. The Centers for Medicare and Medicaid Services (CMS) have designed an episode-based payment model centered around 6 month periods of chemotherapy treatment. Monthly per-patient care management payments will be made to practices to support practice transformation, including additional patient services and specific infrastructure enhancements. Quarterly reporting of quality metrics will drive continuous quality improvement and the adoption of best practices among participants. Practices achieving cost savings will also be eligible for performance-based payments. Savings are expected through improved care coordination and appropriately aligned payment incentives, resulting in decreased avoidable emergency department visits and hospitalizations and more efficient and evidence-based use of imaging, laboratory tests, and therapeutic agents, as well as improved end of life care. New therapies and better supportive care have significantly improved cancer survival in recent decades. This has come at a high cost, with cancer therapy consuming $124 billion in 2010. CMS has designed an episode-based model of oncology care that incorporates elements from several successful model tests. By providing care management and performance based payments in conjunction with quality metrics and a rapid learning environment, it is hoped that this model will demonstrate how oncology care in the US can transform into a high value, high quality system. Copyright © 2015 by American Society of Clinical Oncology.

  12. Improving Preservice Teachers’ Self-Efficacy through Service Learning: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Carianne Bernadowski

    2013-07-01

    Full Text Available University students have been barraged with service learning opportunities both as course required and as volunteer opportunities in recent years. Currently, many universities now require students to participate in engaged learning as a graduation requirement. Situated in Bandura’s theory of self-efficacy, this study examines the effects service learning has on students teaching self-efficacy when required to participate in an activity (course connected, compared to when they chose to volunteer in service learning projects. As instructors of preservice teachers it is our commitment to prepare these students to their maximum potential. Identifying best practices for teacher preparation is an overarching goal of this study. A pre/post survey examined students’ self-perceptions for each service opportunity in regards to their perceived teaching self-efficacy. Results indicate that students’ self-efficacy improved when service learning was connected or imbedded in the context of learning and connected to a specific course. These findings indicate course connected service learning has a greater impact on preservice teachers’ perceptions of their ability to be effective future classroom teachers. Therefore course connected service learning can be viewed as a best practice in preservice teaching instruction.

  13. Improving Life-Cycle Cost Management of Spacecraft Missions

    Science.gov (United States)

    Clardy, Dennon

    2010-01-01

    This presentation will explore the results of a recent NASA Life-Cycle Cost study and how project managers can use the findings and recommendations to improve planning and coordination early in the formulation cycle and avoid common pitfalls resulting in cost overruns. The typical NASA space science mission will exceed both the initial estimated and the confirmed life-cycle costs by the end of the mission. In a fixed-budget environment, these overruns translate to delays in starting or launching future missions, or in the worst case can lead to cancelled missions. Some of these overruns are due to issues outside the control of the project; others are due to the unpredictable problems (unknown unknowns) that can affect any development project. However, a recent study of life-cycle cost growth by the Discovery and New Frontiers Program Office identified a number of areas that are within the scope of project management to address. The study also found that the majority of the underlying causes for cost overruns are embedded in the project approach during the formulation and early design phases, but the actual impacts typically are not experienced until late in the project life cycle. Thus, project management focus in key areas such as integrated schedule development, management structure and contractor communications processes, heritage and technology assumptions, and operations planning, can be used to validate initial cost assumptions and set in place management processes to avoid the common pitfalls resulting in cost overruns.

  14. Libraries and E-Commerce: Improving Information Services and Beyond.

    Science.gov (United States)

    Harris, Lesley Ellen

    2000-01-01

    Explains e-commerce and discusses how it can be used by special libraries. Highlights include library goals; examples of successful uses of e-commerce; how e-commerce can improve information services, including access to information, new information resources, delivery of information, and broadening information markets; and developing an…

  15. A simple method to prolong the service life of radioactive sources for external radiotherapy.

    Science.gov (United States)

    Xu, Yingjie; Tian, Yuan; Dai, Jianrong

    2014-07-08

    A radioactive source is usually replaced and disposed after being used for a certain amount of time (usually a half-life). In this study, a simple method is proposed to prolong its service life. Instead of replacing the used source with a new source of full activity, a new source of less activity is added in the source holder in front of the used one, so that the total activity of two sources is equal to the initial activity of the used source or even higher. Similarly, more sources can be added to the previous ones. Attenuation of front source(s) to the back source(s) was evaluated with exponential attenuation equation, and variation of source-focus distance (SFD) with inverse square law for Leksell 4C Gamma Knife, which served as an example of external radiotherapy units. When the number of front sources increased from 1 to 3, the relative air kerma decreased from 36.5% to 5.0%. Both the attenuation effect and SFD variation contributed to the decrease in air kerma, with the former being the major factor. If the height of the source can be decreased in some way, such as increasing the specific activity of sources, the sources can be used more efficiently. The method prolongs the service life of sources by several factors, and reduces the expense of source exchange and reclamation.

  16. Improving student satisfaction of Andalas University Dormitory through Service Quality and Importance Performance Analysis

    Science.gov (United States)

    Putri, Nilda Tri; Anggraini, Larisa

    2018-03-01

    Residential satisfaction of university dormitories serve as one of the significant aspects in the framework of sustainability in higher education. This research investigated the quality of dormitory services in Andalas University Dormitory based on student’s satisfaction. According to management residential, the enrollment of residential student has increased gradually in Andalas University. In 2016, capacity of residential student is 1686, but only 1081 students can stay at dormitory because some rooms in bad condition. There are a lot of problems and complaints regarding dormitory’s service quality i.e water problems, leaky rooms and bathrooms, cleanliness and inadequate facilities in residential college. In addition, there are 20% of last year student’s residential check out before the time of contract runs out. The aim of this research are understanding the level of GAP exists between expectation and perception students’ residential in the content of service quality and evaluating the improvement priority services using Importance Performance Analysis. This study is measuring service quality by using Responsiveness, Assurance, Empathy, Reliability and Tangible dimension. A negative GAP indicates that the actual services are than what was expected and the GAP is highlighted area for improvement. Based on IPA, management should improve this following dimension services : responsiveness, tangible and assurance dimension.

  17. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

    Directory of Open Access Journals (Sweden)

    Anne Kumurenzi

    2015-12-01

    Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study. Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills. Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

  18. The Interrelation of Prayer and Worship Service Attendance in Moderating the Negative Impact of Life Event Stressors on Mental Well-Being.

    Science.gov (United States)

    Rainville, G

    2017-09-13

    The interrelation of worship service attendance and private prayer in moderating the negative impact of life event stressors on mental well-being is examined using hierarchical multiple regressions on a national sample of 2601 Americans. A theoretical model is proposed in which stressful life events are made less distressing under conditions in which exposure to pro-social content at worship services is internalized through frequent private prayer. Interactive models controlling for a block of potential confounds are run to confirm that the stress-moderating effects of worship service attendance are noted only when attendance is complemented by relatively frequent engagement in private prayer.

  19. Effectiveness of Positive Psychotherapy in Improving Opiate Addicts’ Quality of Life

    Directory of Open Access Journals (Sweden)

    P Porzoor

    2016-02-01

    Full Text Available Objective: This study was aimed to assess the effectiveness of positive psychotherapy based on quality of life in improving opiate addicts’ quality of life. Method: A quasi experimental research design long with control group and pre-test, post-test and follow-up was employed for the conduct of this study. All the opiate addicts referring to treatment centers of Ardebil city in 2013 constituted the statistical population of the study and the number of 36 participants was selected as the sample via purposive sampling and randomly assigned into experimental and control groups. Quality-of-life-based psychotherapy was conducted on the experimental group in 8 sessions while the control group received no intervention. Quality of life questionnaire was used for data collection purposes. Results: The results suggested the effectiveness of the intervention in quality of life. Conclusion: This intervention, which is formed from the combination positive psychology and cognitive-behavioral approach, can be used as an effective treatment method.

  20. Replacement of major nuclear power plant components for service life extension

    International Nuclear Information System (INIS)

    Novak, S.

    1987-01-01

    Problems are discussed associated with replacement of nuclear power plant components with the aim to extend their original scheduled life. The existing foreign experience shows that it is technically feasible to replace practically all basic components for which the necessity of replacement is established. Data is summed up on the replacement of steam generators in US and West German nuclear power plants showing the duration of the job, the total consumption of manhours, the collective dose equivalent and the cost. Attention is also focused on implemented and projected replacements of circulation pipes in nuclear power plants abroad. Based on these figures, the cost is estimated of the replacement of the reactor vessel and the steam generators for WWER-440 nuclear power plants. The conclusion is arrived at that even based on a conservative estimate, the extension by 20 years of the service life of a nuclear power plant is economically more effective than the construction of a new plant. (Z.M.) 2 tabs., 15 refs., 3 figs

  1. Don't fix it, make it better! : using frontline service employees to improve recovery performance

    NARCIS (Netherlands)

    Heijden, van der G.A.H.; Schepers, J.J.L.; Nijssen, E.J.; Ordanini, A.

    2013-01-01

    This study examines how frontline service employees (FSEs) can learn from recovery services and improve their performance accordingly. While research recognizes that FSEs can fulfill an innovation role by sourcing customer knowledge and developing ideas for performance improvement, it remains

  2. Profile and Predictors of Service Needs for Families of Children with Autism Spectrum Disorders

    Science.gov (United States)

    Hodgetts, Sandra; Zwaigenbaum, Lonnie; Nicholas, David

    2015-01-01

    Purpose: Increasing demand for autism services is straining service systems. Tailoring services to best meet families' needs could improve their quality of life and decrease burden on the system. We explored overall, best, and worst met service needs, and predictors of those needs, for families of children with autism spectrum disorders. Methods:…

  3. IoT in Action: Design and Implementation of a Building Evacuation Service

    Directory of Open Access Journals (Sweden)

    Selahattin Gokceli

    2017-01-01

    Full Text Available With the development of sensor technologies, various application areas have emerged. The usage of these technologies and exploitation of recent improvements have clear benefits on building applications. Such use-cases can improve smart functions of buildings and can increase the end-user comfort. As a similar notion, building automation systems (BAS are smart systems that target to provide automated management of various control services and to improve resource usage efficiency. However, buildings generally contain hardware and control services from a diverse set of characteristics. The automated and central management of such functions can be challenging. In order to overcome such issues, an Emergency Evacuation Service is proposed for BAS, where requirements of such central management model are analyzed and model content and subservice definitions are prepared. A crucial scenario, which could be a necessity for future BAS, is defined and an approach for evacuation of people in the buildings at emergency situations is proposed. For real-life scenarios, the Evacuation Service is implemented by using a low-cost design, which is appropriate for Internet of Things (IoT based BAS applications. As demonstrated, the proposed service model can provide effective performance in real-life deployments.

  4. Penerapan Best Practice IT Service Management dalam Perbaikan IT Service Desk: Studi Kasus PT. Matahari Putra Prima

    Directory of Open Access Journals (Sweden)

    Hendra Hendra

    2011-06-01

    Full Text Available Information Technology (IT grows very rapidly and affects every aspect of business life to support competition with other companies that have the same field. PT. Matahari Putra Prima has implemented a computerized system as one of its business strategy in achieving the company's business objectives. With the implementation of IT in the company, the role of Service Desk is indispensable in providing services to users. This study aims to identify and analyze the implementation of IT Service Desk of PT. Matahari Putra Prima to the users. This research is expected to increase and improve the quality of IT Service Desk PT. Matahari Putra Prima based on the IT Service Management (ITSM. 

  5. Implementation of the systems approach to improve a pharmacist-managed vancomycin dosing service.

    Science.gov (United States)

    Gagnon, David J; Roberts, Russel; Sylvia, Lynne

    2014-12-01

    Quality improvements achieved by applying the systems approach to assess the clinical effectiveness, operational efficiency, and financial feasibility of a pharmacist-managed vancomycin dosing service are described. Faced with increased patient volumes and resource demands, the pharmacy department at Tufts Medical Center conducted an evaluation of its adult inpatient vancomycin dosing service using the systems approach, which emphasizes multidisciplinary assessment of system inputs, processes, and outcomes and consensus-building methods to identify needed changes and recommended action steps. A multidisciplinary committee composed of representatives of the medical center's pharmacy, internal medicine, infectious diseases, nursing, phlebotomy, and clinical laboratory services was assembled; in a series of three moderated monthly sessions, committee members deliberated and ultimately reached consensus on a list of action items. Relative to a concurrent intradepartmental assessment of the vancomycin dosing service based solely on pharmacist feedback, the systems approach identified a greater number and wider array of needed improvements in key program areas. Quality improvements implemented as a direct result of the systems-based analysis included a policy change authorizing pharmacists to order serum vancomycin determinations without physician cosignature and inclusion of a vancomycin dosing algorithm in the institutional antibiotic dosing guide. Future changes based on deliverable action items will result in a structured process to help direct program resources toward the patients most in need of pharmacist-managed vancomycin dosing services. The systems approach allowed for a comprehensive multidisciplinary evaluation of the service, as indicated by the identification of process improvements not identified by the department of pharmacy alone. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Roger D., E-mail: Roger.Newman@lthtr.nhs.uk [Dept. of Speech and Language Therapy, Lancashire Teaching Hospitals, Sharoe Green lane, Fulwood, Preston PR2 9HT (United Kingdom); University of Salford (United Kingdom); Nightingale, Julie [University of Salford (United Kingdom)

    2011-11-15

    Quality Issue: Although costly and time consuming, videofluoroscopic swallowing (VFS) examinations are the gold standard for imaging of oro-pharyngeal dysphagia, and demand is likely to increase with an ageing population. Traditional radiologist-led VFS services in the UK are gradually being replaced by practitioner-led clinics undertaken jointly by speech and language therapists and radiographers. This article explores the impact on patient access of a practitioner-led VFS clinic at a large teaching hospital. Initial Assessment: Specific information pertaining to VFS patient waiting times and service quality was collected for a twelve month period both pre- and post-clinic formation. Choice of Solution: Additional capacity was achieved with the introduction of the practitioner-led clinic, with overall patient access improving by 111%. Mean waiting times for in-patients reduced by 75%, many of whom had the procedure on the same day as referral, with out-patients waiting times reducing by 62.5%. Evaluation: The data demonstrates that patient access and report turnaround times are significantly improved, with no adverse effects as measured by inadequate studies, incorrect reports, complaints and documented radiation dose levels. Lessons Learnt: Practitioner-led VFS services can be recommended as a safe and efficient method of improving service provision.

  7. Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

    International Nuclear Information System (INIS)

    Newman, Roger D.; Nightingale, Julie

    2011-01-01

    Quality Issue: Although costly and time consuming, videofluoroscopic swallowing (VFS) examinations are the gold standard for imaging of oro-pharyngeal dysphagia, and demand is likely to increase with an ageing population. Traditional radiologist-led VFS services in the UK are gradually being replaced by practitioner-led clinics undertaken jointly by speech and language therapists and radiographers. This article explores the impact on patient access of a practitioner-led VFS clinic at a large teaching hospital. Initial Assessment: Specific information pertaining to VFS patient waiting times and service quality was collected for a twelve month period both pre- and post-clinic formation. Choice of Solution: Additional capacity was achieved with the introduction of the practitioner-led clinic, with overall patient access improving by 111%. Mean waiting times for in-patients reduced by 75%, many of whom had the procedure on the same day as referral, with out-patients waiting times reducing by 62.5%. Evaluation: The data demonstrates that patient access and report turnaround times are significantly improved, with no adverse effects as measured by inadequate studies, incorrect reports, complaints and documented radiation dose levels. Lessons Learnt: Practitioner-led VFS services can be recommended as a safe and efficient method of improving service provision.

  8. Quality of life improvement in HIV-1 patients treated with raltegravir in a real-life observational study: RACING.

    Science.gov (United States)

    Spire, Bruno; Nait-Ighil, Lella; Pugliese, Pascal; Poizot-Martin, Isabelle; Jullien, Vincent; Marcelin, Anne-Geneviève; Billaud, Eric

    2017-01-01

    Good efficacy and safety of raltegravir in person living with HIV was demonstrated in clinical trials over five years, but real-life data, particularly about quality of life (QoL), are lacking. QoL was evaluated over time in adult patients first treated or switched to regimens containing raltegravir in an observational cohort study. Patient QoL was evaluated using the Fatigue Impact Scale (FIS) and the HIV Symptom Index (HSI). Data were collected at baseline and at 1, 3, 6, 12, 18, and 24 months. Baseline FIS and HSI subscores were compared with the scores at each visit using the paired Wilcoxon test. The impact of time, sociodemographic and medical variables upon patient-perceived fatigue and symptoms was also assessed using mixed multivariate models. From baseline, all FIS and HSI subscores improved significantly after one month of treatment. In addition, psychosocial FIS subscores and both the frequency of bothersome symptoms and HSI subscores improved significantly at each visit. Physical FIS subscores also improved significantly, except at month 18, whereas both cognitive and total FIS subscores improved only after 6 months and 24 months, respectively. In multivariate analysis, employment was independently associated over time with improved improvement in both FIS and HSI subscores. Patient QoL improved significantly over a 24-month period of treatment with a raltegravir-containing regimen. FIS and HSI are sensitive tools to measure the impact of new antiretroviral combinations on a patient's perception of QoL.

  9. Improving couples' quality of life through a Web-based prostate cancer education intervention.

    Science.gov (United States)

    Song, Lixin; Rini, Christine; Deal, Allison M; Nielsen, Matthew E; Chang, Hao; Kinneer, Patty; Teal, Randall; Johnson, David C; Dunn, Mary W; Mark, Barbara; Palmer, Mary H

    2015-03-01

    To evaluate the feasibility and acceptability of a newly developed web-based, couple-oriented intervention called Prostate Cancer Education and Resources for Couples (PERC). Quantitative, qualitative, mixed-methods approach. Oncology outpatient clinics at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center at UNC–Chapel Hill. 26 patients with localized prostate cancer (PCa) and their partners. Pre- and postpilot quantitative assessments and a postpilot qualitative interview were conducted. General and PCa-specific symptoms, quality of life, psychosocial factors, PERC’s ease of use, and web activities. Improvement was shown in some PCa-specific and general symptoms (small effect sizes for patients and small-to-medium effect sizes for partners), overall quality of life, and physical and social domains of quality of life for patients (small effect sizes). Web activity data indicated high PERC use. Qualitative and quantitative analyses indicated that participants found PERC easy to use and understand,as well as engaging, of high quality, and relevant. Overall, participants were satisfied with PERC and reported that PERC improved their knowledge about symptom management and communication as a couple. PERC was a feasible, acceptable method of reducing the side effects of PCa treatment–related symptoms and improving quality of life. PERC has the potential to reduce the negative impacts of symptoms and enhance quality of life for patients with localized PCa and their partners, particularly for those who live in rural areas and have limited access to post-treatment supportive care.

  10. Pricing, subsidies, and the poor : demand for improved water services in Central America

    OpenAIRE

    Walker, Ian; Ordonez, Fidel; Serrano, Pedro; Halpern, Jonathan

    2000-01-01

    Reformulating tariff and subsidy policies is central to improving water and sanitation services in developing countries. The traditional model of state enterprise service provision, coupled with residential tariffs set well below the cost of service, has generally delivered unsatisfactory results. Low internal generation of funds has impeded expansion of networks into poor communities and ...

  11. The relationship between childhood poverty, military service, and later life depression among men: Evidence from the Health and Retirement Study.

    Science.gov (United States)

    Bareis, Natalie; Mezuk, Briana

    2016-12-01

    Childhood poverty has been associated with depression in adulthood, but whether this relationship extends to later life major depression (MD) or is modified by military service is unclear. Data come from the Health and Retirement Study (HRS) 2010 wave, a longitudinal, nationally representative study of older adults. Men with data on military service and childhood poverty were included (N=6330). Childhood poverty was assessed by four indicators (i.e., parental unemployment, residential instability) experienced before age 16. Military service was categorized as veteran versus civilian, and during draft versus all-volunteer (after 1973) eras. Past year MD was defined by the Composite International Diagnostic Inventory. Four in ten men ever served, with 13.7% in the all-volunteer military. Approximately 12% of civilians, 8% draft era and 24% all-volunteer era veterans had MD. Childhood poverty was associated with higher odds of MD (Odds Ratio (OR): 2.38, 95% Confidence Interval (CI): 1.32-4.32) and higher odds of military service (OR: 2.58, 95% CI: 1.58-4.21). Military service was marginally associated with MD (OR: 1.28, 95% CI: 0.98-1.68) and did not moderate the association between childhood poverty and MD. Self-report data is subject to recall bias. The HRS did not assess childhood physical and emotional abuse, or military combat exposure. Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of MD. Assessing childhood poverty in service members may identify risk for depression in later life. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Trace saver: A tool for network service improvement and personalised analysis of user centric statistics

    Science.gov (United States)

    Bilal, Muhammad; Asfand-e-Yar, Mockford, Steve; Khan, Wasiq; Awan, Irfan

    2012-11-01

    Mobile technology is among the fastest growing technologies in today's world with low cost and highly effective benefits. Most important and entertaining areas in mobile technology development and usage are location based services, user friendly networked applications and gaming applications. However, concern towards network operator service provision and improvement has been very low. The portable applications available for a range of mobile operating systems which help improve the network operator services are desirable by the mobile operators. This paper proposes a state of the art mobile application Tracesaver, which provides a great achievement over the barriers in gathering device and network related information, for network operators to improve their network service provision. Tracesaver is available for a broad range of mobile devices with different mobile operating systems and computational capabilities. The availability of Tracesaver in market has proliferated over the last year since it was published. The survey and results show that Tracesaver is being used by millions of mobile users and provides novel ways of network service improvement with its highly user friendly interface.

  13. A New Manufacturing Service Selection and Composition Method Using Improved Flower Pollination Algorithm

    Directory of Open Access Journals (Sweden)

    Wenyu Zhang

    2016-01-01

    Full Text Available With an increasing number of manufacturing services, the means by which to select and compose these manufacturing services have become a challenging problem. It can be regarded as a multiobjective optimization problem that involves a variety of conflicting quality of service (QoS attributes. In this study, a multiobjective optimization model of manufacturing service composition is presented that is based on QoS and an environmental index. Next, the skyline operator is applied to reduce the solution space. And then a new method called improved Flower Pollination Algorithm (FPA is proposed for solving the problem of manufacturing service selection and composition. The improved FPA enhances the performance of basic FPA by combining the latter with crossover and mutation operators of the Differential Evolution (DE algorithm. Finally, a case study is conducted to compare the proposed method with other evolutionary algorithms, including the Genetic Algorithm, DE, basic FPA, and extended FPA. The experimental results reveal that the proposed method performs best at solving the problem of manufacturing service selection and composition.

  14. Developing the Social Life Cycle Assessment

    DEFF Research Database (Denmark)

    Jørgensen, Andreas

    social audits. Through an interview with a social auditor it is suggested that the auditor varies the procedures for carrying out the audit in order to get the most valid result. For example, the auditor has to take into account the various tricks a company in a given context normally uses to cheat......This thesis seeks to add to the development of the Social Life Cycle Assessment (SLCA), which can be defined as an assessment method for assessing the social impacts connected to the life cycle of a product, service or system. In such development it is important to realise that the SLCA is only...... appealing to the extent that it does what it is supposed to do. In this thesis, this goal of SLCA is defined as to support improvements of the social conditions for the stakeholders throughout the life cycle of the assessed product, system or service. This effect should arise through decision makers...

  15. [Supply medicinal products improvement in outpatient care in a hospital pharmacy service].

    Science.gov (United States)

    Santiago Pérez, A; Peña Pedrosa, J A; Alguacil Pau, A I; Pérez Morales, A; Molina Muñoz, P; Benítez Giménez, M T

    Pharmaceutical care to outpatients is currently one of the main occupations of hospital pharmacy services (PEX). There are several questionnaires to measure the satisfaction of the PEX of a pharmacy service, and the results of these questionnaires can generate improvement actions that result in satisfaction. To verify if a satisfaction questionnaire for outpatients is valid for the generation of improvements in the care provided, and if after its implementation, the same questionnaire is able to detect changes in satisfaction. Prospective study of a single center carried out in a tertiary hospital in 2015 and 2016. A questionnaire previously validated with 16 Likert-type items was used. Demographic and classification data were collected. A descriptive analysis was performed and the internal consistency was calculated using the Cronbach's α value. A total of 258 questionnaires were collected in 2015 and 493 in 2016. There were no differences in the baseline characteristics of the patients and users of the service. The items with the lowest satisfaction scores in 2015 (comfort of the waiting room, dispensing privacy, drug pick-up time and medication pick-up time) guided the improvement actions to be implemented. In 2016 there was an improvement in the waiting time until collection in 12.3% (p = 0.002); in the comfort of the waiting room 4.9% (p = 0.304); business hours for medication collection, 10.7% (p = 0.013); and in the confidentiality of the dispensation 4% (p = 0.292). The remaining scores fluctuated minimally, with no statistical significance at all. A 5.1% improvement in overall satisfaction was found (p improve the care received in an outpatient unit of a pharmacy service. This same questionnaire is a tool to monitor the changes implemented to improve the care received. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Residual life management. Maintenance improvement

    International Nuclear Information System (INIS)

    Sainero Garcia, J.; Hevia Ruperez, F.

    1995-01-01

    The terms Residual Life Management, Life Cycle Management and Long-Term Management are synonymous with a concept which aims to establish efficient maintenance for the profitable and safe operation of a power plant for as long as possible. A Residual Life Management programme comprises a number of stages, of which Maintenance Evaluation focuses on how power plant maintenance practices allow the mitigation and control of component ageing. with this objective in mind, a methodology has been developed for the analysis of potential degradative phenomena acting on critical components in terms of normal power plant maintenance practices. This methodology applied to maintenance evaluation enables the setting out of a maintenance programme based on the Life Management concept, and the programme's subsequent up-dating to allow for new techniques and methods. Initial applications have shown that although, in general terms, power plant maintenance is efficient, the way in which Residual Life Management is approached requires changes in maintenance practices. These changes range from modifications to existing inspection and surveillance methods or the establishment of new ones, to the monitoring of trends or the performance of additional studies, the purpose of which is to provide an accurate evaluation of the condition of the installations and the possibility of life extension. (Author)

  17. The Role of Work-Life Balance Practices in Order to Improve Organizational Performance

    OpenAIRE

    IOAN LAZAR; CODRUTA OSOIAN; PATRICIA RATIU

    2010-01-01

    Well known in the literature as work life balance, the quality relationship between paid work and unpaid responsibilities is critical for success in today’s competitive business world. The issue of work-life balance has been developed in response to demographic, economic and cultural changes. The purpose of this paper is to establish whether work-life balance initiatives and practices can be considered as strategic human resource management decisions that can translate into improved individua...

  18. Integration of EA and IT service to improve performance at higher education organizations

    Directory of Open Access Journals (Sweden)

    Hermanto Agus

    2018-01-01

    Full Text Available One of the perceived benefits of the use of information technology is the increased accuracy and speed of information that greatly helped the operations of an institution or organization. Politeknik XYZ as one of the organizations / institutions in the field of education, now need to consider the strategic role of information technology in supporting academic activities and develop a wide range of academic services, especially for students. Accordingly, in this study has been carried out the planning and improvement of information technology services in accordance with EA and IT Service standards, based on analysis using ACMM maturity level. The end result of architectural planning and service enhancement developed with TOGAF and ITIL is to be used as a reference in the improvement the role of information systems and technology in supporting business process organizations at Polytechnic XYZ. This study demonstrates the importance of raising awareness of the interdependent relationship between architecture and quality of service management in the organization of information technology.

  19. How to improve psychiatric services: a perspective from critical psychiatry.

    Science.gov (United States)

    de Silva, Prasanna

    2017-09-02

    Concern has been expressed from both within and outwith psychiatry about the relative lack of improvement of mental health services. Critical psychiatry is an emerging school of thought, mainly the product of practicing clinicians, which could be useful in remedying this situation. This article outlines, for psychiatrists and doctors of other specialities, practices which could be improved, and the competencies required to achieve this, in terms of knowledge, skills and attitudes.

  20. Are global and regional improvements in life expectancy and in child, adult and senior survival slowing?

    Directory of Open Access Journals (Sweden)

    Ryan J Hum

    Full Text Available Improvements in life expectancy have been considerable over the past hundred years. Forecasters have taken to applying historical trends under an assumption of continuing improvements in life expectancy in the future. A linear mixed effects model was used to estimate the trends in global and regional rates of improvements in life expectancy, child, adult, and senior survival, in 166 countries between 1950 and 2010. Global improvements in life expectancy, including both child and adult survival rates, decelerated significantly over the study period. Overall life expectancy gains were estimated to have declined from 5.9 to 4.0 months per year for a mean deceleration of -0.07 months/year2; annual child survival gains declined from 4.4 to 1.6 deaths averted per 1000 for a mean deceleration of -0.06 deaths/1000/year2; adult survival gains were estimated to decline from 4.8 to 3.7 deaths averted per 1000 per year for a mean deceleration of -0.08 deaths/1000/year2. Senior survival gains however increased from 2.4 to 4.2 deaths averted per 1000 per year for an acceleration of 0.03 deaths/1000/year2. Regional variation in the four measures was substantial. The rates of global improvements in life expectancy, child survival, and adult survival have declined since 1950 despite an increase in the rate of improvements among seniors. We postulate that low-cost innovation, related to the last half-century progress in health-primarily devoted to children and middle age, is reaping diminishing returns on its investments. Trends are uneven across regions and measures, which may be due in part to the state of epidemiological transition between countries and regions and disparities in the diffusion of innovation, accessible only in high-income countries where life expectancy is already highest.

  1. Life course models: improving interpretation by consideration of total effects.

    Science.gov (United States)

    Green, Michael J; Popham, Frank

    2017-06-01

    Life course epidemiology has used models of accumulation and critical or sensitive periods to examine the importance of exposure timing in disease aetiology. These models are usually used to describe the direct effects of exposures over the life course. In comparison with consideration of direct effects only, we show how consideration of total effects improves interpretation of these models, giving clearer notions of when it will be most effective to intervene. We show how life course variation in the total effects depends on the magnitude of the direct effects and the stability of the exposure. We discuss interpretation in terms of total, direct and indirect effects and highlight the causal assumptions required for conclusions as to the most effective timing of interventions. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.

  2. Can life coaching improve health outcomes? - A systematic review of intervention studies

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming

    2013-01-01

    BACKGROUND In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for ...... suggest that the description and categorisation of the coaching methods are described more comprehensively, and that research into this area is supplemented by a more qualitative approach....... between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. METHODS Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were......BACKGROUND In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need...

  3. Quality of life of depressed and suicidal patients seeking services from traditional and faith healers in rural Kenya.

    Science.gov (United States)

    Musyimi, Christine W; Mutiso, Victoria N; Nayak, Sameera S; Ndetei, David M; Henderson, David C; Bunders, Joske

    2017-05-08

    In rural Kenya, traditional and faith healers provide an alternative pathway to health care, including mental health care. However, not much is known about the characteristics of the populations they serve. The purpose of this study was to determine the relationship between depression, suicidal ideation, and socio-demographic variables with Quality of Life (QoL) indicators in a sample seeking mental health services from traditional and faith healers in rural Kenya. Understanding QoL in this sample can help develop mental health policy and training to improve the well-being of this population. This was a cross-sectional epidemiological survey (n = 443) conducted over a period of 3 months among adult patients seeking care from traditional and faith healers in rural Kenya. Data were collected using the Beck Depression Inventory II (BDI-II), Beck Scale for Suicide Ideation (BSS) and WHO Quality of Life Survey- BREF (WHOQOL-BREF), and analyzed using correlation analyses, parametric tests, and regression analyses. Increasing levels of depression were associated with lower QoL among patients seeking care from traditional and faith healers. BSS scores were significantly negatively correlated with overall, physical, psychological, and environmental QoL, p Kenya. Evidence suggests that traditional and faith healers treat patients with a variety of QoL issues. Further research should focus on understanding how these issues tie into QoL, and how these healers can target these to improve care.

  4. Efficacy of a process improvement intervention on delivery of HIV services to offenders: a multisite trial.

    Science.gov (United States)

    Pearson, Frank S; Shafer, Michael S; Dembo, Richard; Del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L; Belenko, Steven; Frisman, Linda K; Visher, Christy A; Pich, Michele; Patterson, Yvonne

    2014-12-01

    We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments.

  5. Managing Quality by Action Research--Improving Quality Service Delivery in Higher Education as a Marketing Strategy.

    Science.gov (United States)

    Corbitt, Brian

    1998-01-01

    Describes two action research projects undertaken at an Australian university to improve quality of services to foreign students and improve the institution's image through word of mouth, or informal marketing. Each project, although small, facilitated changes or improvements to a targeted service. The role of management in empowering employees…

  6. Estimation of the temporary service life of DC arc plasmatron cathode

    Science.gov (United States)

    Kulygin, V. M.; Pereslavtsev, A. V.; Tresvyatskii, S. S.

    2017-09-01

    The service life of the cathode of a DC arc plasmatron continuously working with tubular electrodes that operate in the air has been considered using the semi-phenomenological approach. The thermal emission, that ensures the necessary flow of electrons, and the evaporation of the cathode material, which determines its erosion, have been taken as the basic physical phenomena that constitute the workflow. The relationships that enable the estimation of the cathode's operating time have been obtained using the known regularities of these phenomena and experimental data available in the literature. The resulting evaluations coincide satisfactorily with the endurance test results.

  7. Improving healthcare for Aboriginal Australians through effective engagement between community and health services.

    Science.gov (United States)

    Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

    2016-07-07

    Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians. The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation. Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were

  8. Strategies for improved French-language health services

    Science.gov (United States)

    Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

    2015-01-01

    Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060

  9. Re-engineering pre-employment check-up systems: a model for improving health services.

    Science.gov (United States)

    Rateb, Said Abdel Hakim; El Nouman, Azza Abdel Razek; Rateb, Moshira Abdel Hakim; Asar, Mohamed Naguib; El Amin, Ayman Mohammed; Gad, Saad abdel Aziz; Mohamed, Mohamed Salah Eldin

    2011-01-01

    The purpose of this paper is to develop a model for improving health services provided by the pre-employment medical fitness check-up system affiliated to Egypt's Health Insurance Organization (HIO). Operations research, notably system re-engineering, is used in six randomly selected centers and findings before and after re-engineering are compared. The re-engineering model follows a systems approach, focusing on three areas: structure, process and outcome. The model is based on six main components: electronic booking, standardized check-up processes, protected medical documents, advanced archiving through an electronic content management (ECM) system, infrastructure development, and capacity building. The model originates mainly from customer needs and expectations. The centers' monthly customer flow increased significantly after re-engineering. The mean time spent per customer cycle improved after re-engineering--18.3 +/- 5.5 minutes as compared to 48.8 +/- 14.5 minutes before. Appointment delay was also significantly decreased from an average 18 to 6.2 days. Both beneficiaries and service providers were significantly more satisfied with the services after re-engineering. The model proves that re-engineering program costs are exceeded by increased revenue. Re-engineering in this study involved multiple structure and process elements. The literature review did not reveal similar re-engineering healthcare packages. Therefore, each element was compared separately. This model is highly recommended for improving service effectiveness and efficiency. This research is the first in Egypt to apply the re-engineering approach to public health systems. Developing user-friendly models for service improvement is an added value.

  10. Stress-life interrelationships associated with alkaline fuel cells

    Science.gov (United States)

    Thaller, Lawrence H.; Martin, Ronald E.; Stedman, James K.

    1987-01-01

    A review is presented concerning the interrelationships between applied stress and the expected service life of alkaline fuel cells. Only the physical, chemical, and electrochemical phenomena that take place within the fuel cell stack portion of an overall fuel cell system will be discussed. A brief review will be given covering the significant improvements in performance and life over the past two decades as well as summarizing the more recent advances in understanding which can be used to predict the performance and life characteristics of fuel cell systems that have yet to be built.

  11. Self-esteem, readiness for self-improvement and life satisfaction in Indian and Polish female students

    Directory of Open Access Journals (Sweden)

    Zawadzka Anna Maria

    2016-06-01

    Full Text Available The study examines the question of how personal self-esteem, collective self-esteem and readiness for self-improvement are linked to satisfaction with life in women from countries differing with regard to level of collectivism. Our study participants were Polish (less collectivistic and Indian (more collectivistic female students. The obtained results indicate that personal self-esteem plays a very important role in satisfaction with life of women from the two countries. However, collective self-esteem is not directly related to satisfaction with life among women from the two cultures analyzed. Structural Equation Modeling showed that: a in the Indian group readiness for self-improvement is more important for satisfaction with life than in the Polish group and it is significantly related to satisfaction with life through collectivistic self-esteem, b the direct influence of both personal and collective self-esteem on satisfaction with life is more significant in the Polish group than in the Indian group.

  12. Activity and Life After Survival of a Cardiac Arrest (ALASCA and the effectiveness of an early intervention service: design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Bakx Wilbert GM

    2007-08-01

    Full Text Available Abstract Background Cardiac arrest survivors may experience hypoxic brain injury that results in cognitive impairments which frequently remain unrecognised. This may lead to limitations in daily activities and participation in society, a decreased quality of life for the patient, and a high strain for the caregiver. Publications about interventions directed at improving quality of life after survival of a cardiac arrest are scarce. Therefore, evidence about effective rehabilitation programmes for cardiac arrest survivors is urgently needed. This paper presents the design of the ALASCA (Activity and Life After Survival of a Cardiac Arrest trial, a randomised, controlled clinical trial to evaluate the effects of a new early intervention service for survivors of a cardiac arrest and their caregivers. Methods/design The study population comprises all people who survive two weeks after a cardiac arrest and are admitted to one of the participating hospitals in the Southern part of the Netherlands. In a two-group randomised, controlled clinical trial, half of the participants will receive an early intervention service. The early intervention service consists of several consultations with a specialised nurse for the patient and their caregiver during the first three months after the cardiac arrest. The intervention is directed at screening for cognitive problems, provision of informational, emotional and practical support, and stimulating self-management. If necessary, referral to specialised care can take place. Persons in the control group will receive the care as usual. The primary outcome measures are the extent of participation in society and quality of life of the patient one year after a cardiac arrest. Secondary outcome measures are the level of cognitive, emotional and cardiovascular impairment and daily functioning of the patient, as well as the strain for and quality of life of the caregiver. Participants and their caregivers will be followed

  13. Does a voucher program improve reproductive health service delivery and access in Kenya?

    Science.gov (United States)

    Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

    2015-05-23

    Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

  14. The Dilemma of Accountability and Good Governance for Improved Public Service Delivery in Nigeria

    Directory of Open Access Journals (Sweden)

    Kehinde David Adejuwon

    2012-12-01

    Full Text Available The public sector in Nigeria is irrefutably beset with gross  incompetence and ineffective management. Perplexing difficulties endure in the Nigerian public sector in spite of a number of reform programmes that have been designed to enhance efficient and effective service delivery for almost two decades. The fact that public service has failed dismally to achieve its laudable objectives is the reason for the vote of no confidence passed on its administrators by majority of the Nigerian populace. The article examines the dilemma of accountability and good governance in Nigeria and demonstrates that the critical point in achieving meaningful developments in the country intrinsically lay with improved service delivery in the public sector. The basic reason why the public service has become the scorn of the people is because for too long, both the government and public servants have paid lip service to the crucial issue of effective and efficient service delivery. The article argues that improved service delivery will improve both the performance and the image of public service and re-awaken the citizens’ interest and trust in them to do business with public servants. It suggests that  in order to bring sanity back to the Nigerian Public Service,  all unprofessional tendencies such as ethnicity bias and nepotism in appointments and promotions, lack of security of tenure of office, and appointment of non-career public servants into key positions in the public service must stop. Also,  effective service delivery must be tailored to the circumstances of Nigeria. The study made use of secondary data obtained from various sources. It therefore concludes that without a reawakening of the culture of accountability and transparency lost over the years, the trusting relationship needed to forge between the government and the governed for the actualization of good governance will not materialize.

  15. A METHOD FOR IMPROVEMENT OF OBJECTIVITY OF E-SERVICE QUALITY EVALUATION

    Directory of Open Access Journals (Sweden)

    Renata Mekovec

    2007-12-01

    Full Text Available Measurement and improvement of e-service quality is important for sustaining competitive advantage of an e-commerce web site. A number of e-service quality measures have recently been developed that predominantly rely on the subjective evaluation of diverse quality attributes. To increase the objectivity of e-service quality measurement a recently developed measure of e-service quality has been adapted in a way that replaces its Likert type scales for evaluation of specific attributes with check-lists that include specific observable elements for appraisal and a scoring procedure. The consistency of scoring with this adaptation of an e-service quality measure was investigated in comparison to the use of the standard measure with Likert type scales and by the use of untrained and trained evaluators. The results of the empirical evaluation indicate a greater inter-rater consistency when the adapted/objective measure is used for evaluation of the efficiency dimension of e-service quality.

  16. Improvement in the quality of the catering service of a rehabilitation hospital.

    Science.gov (United States)

    Donini, L M; Castellaneta, E; De Guglielmi, S; De Felice, M R; Savina, C; Coletti, C; Paolini, M; Cannella, C

    2008-02-01

    Malnutrition due to undernutrition or overnutrition is highly prevalent in hospital in-patients and it decisively conditions patients clinical outcome. One of the most influencing factors of malnutrition in hospitalized patients is--at least in part--the Catering Service Quality. Is to verify, over a 5 year period, the course of the quality of the institutional Catering Service, verifying the effectiveness of the quality improvement process used. Quality control was performed by objective (meal order accuracy, proper distribution of food in trolleys, route time from the kitchen to the ward and time of food distribution, food weight and temperature, waste assessment) and subjective assessment (quality was measured by giving the patients a questionnaire after meals). The survey included: 572 meals and 591 interviews. A significant amount of "qualitative" errors (lack of respect for patient preferences or at the moment of supplying the food trolley) have been found. Over the time and the amount of patients that wasted a considerable amount of the portion served was considerably reduced food temperature have been improved. Also patient satisfaction with menu variability, portion size, temperature and cooking quality improved over time. The overall ratings of meals under observation improved too in fact, positive opinions ranged from 18% in 2002 to 48.3% in 2006. Ongoing research and quality verification, which include all catering service workers, yields a constant improvement in quality. Patients in healthcare settings should receive a service they appreciates, but it should be--at the same time--correct from a nutritional point of view. For this reason, it is necessary a continuous mediation between customers satisfaction and nutritionists work, dieticians and nursing staff. From this point of view the educational approach becomes essential to feed patient compliance to dietetic treatment that will continue after discharge.

  17. Improvement by the Life Cycle Control System of University Production With Use of CALS-Tehnology

    Directory of Open Access Journals (Sweden)

    Yuriy I. Dreizis

    2013-01-01

    Full Text Available The mechanism of management by life cycle of production of university with use of CALS technologies is described. Tasks of service of marketing and the quality management department, connected with university product quality control are defined

  18. A Literature Review on Quality Teacher’s Working Life

    Directory of Open Access Journals (Sweden)

    Ishak Siti Intan Diyana

    2018-01-01

    Full Text Available Quality of work life is becoming an imperative issue to achieve the goals of the organization in every sector whether it is education, tourism, service sector, manufacturing, banking sector and other. Quality of work life it about work environment, reward, organizational commitment, recognition, participative management, work life balance, welfare facilities, proper grievances handling, job satisfaction and other. High quality of work life can give a result in better organizational performance, effectiveness and innovativeness. Quality of work life also affects the social responsibility. This is because quality of work life can improves the family life as well as work life of the individual. This paper focuses and analyse the literature review on the quality of teacher work life.justified.

  19. On the need for data for the verification of service life models for frost damage

    DEFF Research Database (Denmark)

    Geiker, Mette Rica; Engelund, Sven

    1999-01-01

    The purpose of this paper is to draw the attention to the need for the verification of service life models for frost attack on concrete and the collection of relevant data. To illustrate the type of data needed the paper presents models for internal freeze/thaw damage (internal cracking including...

  20. Using family and staff experiences of a botulinum toxin-A service to improve service quality.

    Science.gov (United States)

    Burton, K L O; Bau, K; Lewis, J; Aroyan, K R; Botha, B; Botman, A G M; Stewart, K; Waugh, M-C A; Paget, S P

    2017-11-01

    The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care. Sixteen staff of a BoNT-A service participated in a patient journey mapping exercise. Nine families of the service participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Data from the staff session and interviews were analysed independently using grounded, hermeneutic thematic analysis. Staff sessions revealed 5 core themes that related to impacting on the family experience. Family interviews revealed 4 core themes, with 7 subthemes and 1 latent theme. Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics. © 2017 John Wiley & Sons Ltd.

  1. Cancer Services and Their Initiatives to Improve the Care of Indigenous Australians

    Directory of Open Access Journals (Sweden)

    Emma V. Taylor

    2018-04-01

    Full Text Available Indigenous Australians continue to experience significantly poorer outcomes from cancer than non-Indigenous Australians. Despite the importance of culturally appropriate cancer services in improving outcomes, there is a lack of awareness of current programs and initiatives that are aimed at meeting the needs of Indigenous patients. Telephone interviews were used to identify and describe the Indigenous-specific programs and initiatives that are implemented in a subset of the services that participated in a larger national online survey of cancer treatment services. Fourteen services located across Australia participated in the interviews. Participants identified a number of factors that were seen as critical to delivering culturally appropriate treatment and support, including having a trained workforce with effective cross-cultural communication skills, providing best practice care, and improving the knowledge, attitudes, and understanding of cancer by Indigenous people. However, over a third of participants were not sure how their service compared with others, indicating that they were not aware of how other services are doing in this field. There are currently many Indigenous-specific programs and initiatives that are aimed at providing culturally appropriate treatment and supporting Indigenous people affected by cancer across Australia. However, details of these initiatives are not widely known and barriers to information sharing exist. Further research in this area is needed to evaluate programs and initiatives and showcase the effective approaches to Indigenous cancer care.

  2. Merchandising. Michigan School Food Service Training Manual.

    Science.gov (United States)

    Michigan State Univ., East Lansing. Cooperative Extension Service.

    The Merchandising Food Service Training Manual contains 12 lessons and 2 appendixes. Class activities and handouts are interspersed among techniques for selling and merchandising meals, information about life value roles and how food participants may improve public images, material about customers' backgrounds and attitudes, methods of competitors…

  3. Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?☆

    Science.gov (United States)

    Angott, Andrea M.; Comerford, David A.; Ubel, Peter A.

    2014-01-01

    Objective To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making. Method In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants’ quality-of-life and mood forecasts for life with an ostomy were assessed. Results Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy. Conclusion Video interventions may improve mood and quality-of-life forecasts for medical conditions, including those that may elicit disgust, such as ostomy. Practice implications Video interventions focusing on patients’ experience of illness continue to show promise as components of decision aids, even for emotionally charged health states such as ostomy. PMID:23177398

  4. Visual impairment, coping strategies and impact on daily life: a qualitative study among working-age UK ex-service personnel.

    Science.gov (United States)

    Stevelink, Sharon A M; Malcolm, Estelle M; Fear, Nicola T

    2015-11-12

    Sustaining a visual impairment may have a substantial impact on various life domains such as work, interpersonal relations, mobility and social and mental well-being. How to adjust to the loss of vision and its consequences might be a challenge for the visually impaired person. The purpose of the current study was to explore how younger male ex-Service personnel cope with becoming visually impaired and how this affects their daily life. Semi-structured interviews with 30 visually impaired male ex-Service personnel, all under the age of 55, were conducted. All participants are members of the charity organisation Blind Veterans UK. Interviews were analysed thematically. Younger ex-Service personnel applied a number of different strategies to overcome their loss of vision and its associated consequences. Coping strategies varied from learning new skills, goal setting, integrating the use of low vision aids in their daily routine, to social withdrawal and substance misuse. Vision loss affected on all aspects of daily life and ex-Service personnel experienced an on-going struggle to accept and adjust to becoming visually impaired. Health care professionals, family and friends of the person with the visual impairment need to be aware that coping with a visual impairment is a continuous struggle; even after a considerable amount of time has passed, needs for emotional, social, practical and physical support may still be present.

  5. Perceived stress and life satisfaction: social network service use as a moderator.

    Science.gov (United States)

    Niu, Qikun; Liu, Yihao; Sheng, Zitong; He, Yue; Shao, Xiaolin

    2011-01-01

    Social Network Service (SNS) has become a buzzword in recent media coverage with the development of the second generation of Web-based communities. In China, SNS has played an increasingly important role in its users' daily lives, especially among students. With a sample of 471 college students, we tested the direct relationship between perceived stress and life satisfaction using a regression analysis. Moreover, we found SNS use could buffer the negative effect of perceived stress. This study has practical implications on Internet users' SNS use.

  6. Improving quality of life in ageing populations: what can volunteering do?

    Science.gov (United States)

    Cattan, Mima; Hogg, Eddy; Hardill, Irene

    2011-12-01

    The year 2011 was declared the 'European Year of Volunteering' to recognise the contribution volunteers make to society. Such cross-national events reflect the high profile of volunteering and political imperatives to promote it. The purpose of this review is to provide a comprehensive review of current knowledge (articles published between 2005 and 2011) regarding the role of volunteering in improving older people's quality of life (QoL) and to identify areas requiring further research. Volunteering was defined as an activity that is freely chosen, does not involve remuneration and helps or benefits those beyond an individual's immediate family. Our search identified 22 studies and 5 review articles that addressed the benefits of volunteering on older people's quality of life. Most of the research had been conducted in the United States, Canada and Australia using data from longitudinal studies. The majority of the studies concluded that there is a positive association between older people's quality of life and engagement in volunteering. Due to the study designs and the heterogeneity of the research, causality is difficult to demonstrate and the knowledge the studies bring to the subject is variable. This review shows that volunteering may help to maintain and possibly improve some older adults' quality of life. However, there are still major gaps in our understanding of who actually benefits, the social and cultural context of volunteering and its role in reducing health and social inequalities. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Improving inpatient postnatal services: midwives views and perspectives of engagement in a quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Wray Julie

    2011-11-01

    Full Text Available Abstract Background Despite major policy initiatives in the United Kingdom to enhance women's experiences of maternity care, improving in-patient postnatal care remains a low priority, although it is an aspect of care consistently rated as poor by women. As part of a systems and process approach to improving care at one maternity unit in the South of England, the views and perspectives of midwives responsible for implementing change were sought. Methods A Continuous Quality Improvement (CQI approach was adopted to support a systems and process change to in-patient care and care on transfer home in a large district general hospital with around 6000 births a year. The CQI approach included an initial assessment to identify where revisions to routine systems and processes were required, developing, implementing and evaluating revisions to the content and documentation of care in hospital and on transfer home, and training workshops for midwives and other maternity staff responsible for implementing changes. To assess midwifery views of the quality improvement process and their engagement with this, questionnaires were sent to those who had participated at the outset. Results Questionnaires were received from 68 (46% of the estimated 149 midwives eligible to complete the questionnaire. All midwives were aware of the revisions introduced, and two-thirds felt these were more appropriate to meet the women's physical and emotional health, information and support needs. Some midwives considered that the introduction of new maternal postnatal records increased their workload, mainly as a consequence of colleagues not completing documentation as required. Conclusions This was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their

  8. Radiological information systems: improvements in service, economy, and quality control?

    International Nuclear Information System (INIS)

    Gross-Fengels, W.; Weber, M.

    1997-01-01

    By means of complete service control and standardized accounting processes, radiological information systems clearly contribute to improved results. They provide the prerequisites for the establishment of expanded networks and allow comprisons with comparable institutions. The quality of patient care can be improved since, for example, the production time from referral to finished result becomes shorter. Direct access to patient and findings data from several positions is possible. Preliminary results can be viewed immediately. The patient's history is accessible to authorized users at all times. The exact reproducibility and assignment of services leads to more clarity. By means of the information available form RIS, rapid adaptive processes can be undertaken. The system assists the to fulfill the requirements of health regulations. The above-mentioned relationships demonstrate that the EDP systems are well accepted by physicians, medical assistants, and administrators and represent an indispensable aid for solving problems. (orig.) [de

  9. Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self-Assessment Evaluations - Redacted

    Science.gov (United States)

    2016-12-20

    from mandatory disclosure under the Freedom of Information Act. Defense Logistics Agency Disposition Services Needs to Improve Demilitarization...Project No. D2016-D000RD-0057.000) │ i Results in Brief Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self...Assessment Evaluations Visit us at www.dodig.mil December 20, 2016 Objective Our audit objective was to determine whether the Defense Logistics Agency

  10. Associations between family characteristics and parental empowerment in the family, family service situations and the family service system.

    Science.gov (United States)

    Vuorenmaa, M; Perälä, M-L; Halme, N; Kaunonen, M; Åstedt-Kurki, P

    2016-01-01

    Parental empowerment signifies parents' sense of confidence in managing their children, interacting with services that their children use and improving child care services. High empowerment is associated with parents' resilience to demands and their confidence to make decisions and take actions that positively affect their families. Most families with children access various healthcare and education services. Professionals working in these services are therefore ideally placed to reinforce parental empowerment. However, little is known about the characteristics associated with parental empowerment within a generic sample of parents or in the context of basic child care services. The aim of this study was to assess how family characteristics are associated with maternal and paternal empowerment in the family, in service situations and in the service system. Parental empowerment was measured among 955 parents (mothers = 571; fathers = 384) of children aged 0-9 years using the Generic Family Empowerment Scale. Family characteristics were assessed through questions on children, parents and the life situation. Associations between empowerment and family characteristics were evaluated using one-way analysis of variance and t-test. Parental empowerment was predicted by multiple linear regression analysis. Parents' concerns related to their parenting, such as whether they possessed sufficient skills as a parent or losing their temper with children, as well as experiences of stress in everyday life, were negatively associated with all dimensions of maternal and paternal empowerment. Both determinants were more common and more significant in empowerment than child-related problems. Promoting parental self-confidence and providing appropriate emotional and concrete support for everyday functioning may reinforce parental empowerment, thereby enhancing families' well-being and coping, as well as improving their access to required services and timely support. Finally

  11. Colil: a database and search service for citation contexts in the life sciences domain.

    Science.gov (United States)

    Fujiwara, Toyofumi; Yamamoto, Yasunori

    2015-01-01

    To promote research activities in a particular research area, it is important to efficiently identify current research trends, advances, and issues in that area. Although review papers in the research area can suffice for this purpose in general, researchers are not necessarily able to obtain these papers from research aspects of their interests at the time they are required. Therefore, the utilization of the citation contexts of papers in a research area has been considered as another approach. However, there are few search services to retrieve citation contexts in the life sciences domain; furthermore, efficiently obtaining citation contexts is becoming difficult due to the large volume and rapid growth of life sciences papers. Here, we introduce the Colil (Comments on Literature in Literature) database to store citation contexts in the life sciences domain. By using the Resource Description Framework (RDF) and a newly compiled vocabulary, we built the Colil database and made it available through the SPARQL endpoint. In addition, we developed a web-based search service called Colil that searches for a cited paper in the Colil database and then returns a list of citation contexts for it along with papers relevant to it based on co-citations. The citation contexts in the Colil database were extracted from full-text papers of the PubMed Central Open Access Subset (PMC-OAS), which includes 545,147 papers indexed in PubMed. These papers are distributed across 3,171 journals and cite 5,136,741 unique papers that correspond to approximately 25 % of total PubMed entries. By utilizing Colil, researchers can easily refer to a set of citation contexts and relevant papers based on co-citations for a target paper. Colil helps researchers to comprehend life sciences papers in a research area more efficiently and makes their biological research more efficient.

  12. Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

    Directory of Open Access Journals (Sweden)

    Scheffer Gert J

    2010-03-01

    Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

  13. Artificial intelligence guides system's best practices, cutting costs and improving services.

    Science.gov (United States)

    1999-06-01

    One for the history books. Clinical care improvement initiatives guided by a sophisticated artificial intelligence program have helped a major Virginia integrated health system make dramatic improvements in the cost and quality of its health care services. Find out how the technological innovation has earned Sentara Health System a place in the permanent collection of the Smithsonian's National Museum of American History.

  14. The Armed Services and Model Employer Status for Child Support Enforcement: A Proposal to Improve Service of Process

    National Research Council Canada - National Science Library

    Cook, Alan L

    1996-01-01

    .... The Order directed DoD and other federal agencies to study methods of improving service of process for child support enforcement on their employees and uniformed members, with particular emphasis...

  15. Improving productivity levels: family planning services for factory workers.

    Science.gov (United States)

    Darmokusumo, H V

    1989-10-01

    In May 1984, the Minister of Manpower in Indonesia, the Chairman of the BKKBN, and representatives of the employers' and workers' organizations of Indonesia issued a joint decree pledging that they would work together to enhance the implementation of the family planning program among workers in the organized sector. 1 objective of the decree is to improve workers' productivity and the standard of living of workers and their families by implementing a family planning program. 1 baseline survey and a clinic-based survey in 5 provinces revealed that 90% of women workers are between 21-40, or are of reproductive age, and are sexually active. Only about 50% are practicing family planning; the other 50% are afraid to practice family planning due to potential side effects of various methods. This fear was most often caused by negative rumors spread by unsatisfied family planning clients. Placing materials for family planning promotion such as instructional posters and video programs advertising contraceptive services in the work setting may increase knowledge and help alleviate some of this fear. Other studies of family planning services show that employees prefer female medical doctors or midwives as service providers, employees are willing to pay for services (but can only afford a small fee), and family planning service points should be near employees' work sites.

  16. 25 CFR 256.25 - Is my Federal government-assisted dwelling eligible for services under the Housing Improvement...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Is my Federal government-assisted dwelling eligible for services under the Housing Improvement Program? 256.25 Section 256.25 Indians BUREAU OF INDIAN AFFAIRS... dwelling eligible for services under the Housing Improvement Program? Yes. You may receive services under...

  17. Using internal marketing to improve organizational commitment and service quality.

    Science.gov (United States)

    Tsai, Yafang; Wu, Shih-Wang

    2011-12-01

    The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  18. Helping COPD patients change health behavior in order to improve their quality of life

    Directory of Open Access Journals (Sweden)

    Almagro P

    2013-07-01

    Full Text Available Pere Almagro, Alejandra CastroAcute Geriatric Care Unity, Internal Medicine Department, University Hospital Mútua de Terrassa, Barcelona, SpainAbstract: Chronic obstructive pulmonary disease (COPD is one of the most prevalent and debilitating diseases in adults worldwide and is associated with a deleterious effect on the quality of life of affected patients. Although it remains one of the leading causes of global mortality, the prognosis seems to have improved in recent years. Even so, the number of patients with COPD and multiple comorbidities has risen, hindering their management and highlighting the need for futures changes in the model of care. Together with standard medical treatment and therapy adherence – essential to optimizing disease control – several nonpharmacological therapies have proven useful in the management of these patients, improving their health-related quality of life (HRQoL regardless of lung function parameters. Among these are improved diagnosis and treatment of comorbidities, prevention of COPD exacerbations, and greater attention to physical disability related to hospitalization. Pulmonary rehabilitation reduces symptoms, optimizes functional status, improves activity and daily function, and restores the highest level of independent physical function in these patients, thereby improving HRQoL even more than pharmacological treatment. Greater physical activity is significantly correlated with improvement of dyspnea, HRQoL, and mobility, along with a decrease in the loss of lung function. Nutritional support in malnourished COPD patients improves exercise capacity, while smoking cessation slows disease progression and increases HRQoL. Other treatments such as psychological and behavioral therapies have proven useful in the treatment of depression and anxiety, both of which are frequent in these patients. More recently, telehealthcare has been associated with improved quality of life and a reduction in exacerbations

  19. Implementation of occupational health service improvements through application of total quality management processes.

    Science.gov (United States)

    Thomas, Elizabeth Anne

    2011-06-01

    The occupational health services department for a manufacturing division of a high-technology firm was redesigned from an outsourced model, in which most services were provided by an outside clinic vendor, to an in-house service model, in which services were provided by an on-site nurse practitioner. The redesign and implementation, accomplished by a cross-functional team using Total Quality Management processes, resulted in a comprehensive occupational health services department that realized significant cost reduction, increased compliance with regulatory and company requirements, and improved employee satisfaction. Implications of this project for occupational health nurses are discussed.

  20. The eSourcing Capability Model for Service Providers: Knowledge Manage-ment across the Sourcing Life-cycle

    OpenAIRE

    Laaksonen, Pekka

    2011-01-01

    Laaksonen, Pekka The eSourcing Capability Model for Service Providers: Knowledge Manage-ment across the Sourcing Life-cycle Jyväskylä: Jyväskylän yliopisto, 2011, 42 s. Tietojärjestelmätiede, kandidaatintutkielma Ohjaaja(t): Käkölä, Timo Tässä kandidaatintutkielmassa selvitettiin sitä, miten the eSourcing Capability Model for Service Providers-mallin käytännöt (practices) ovat liittyneet tietä-myksenhallinnan neljään prosessiin: tiedon luominen, varastointi/noutaminen, jakamine...

  1. Value for money of changing healthcare services? Economic evaluation of quality improvement

    Science.gov (United States)

    Severens, J

    2003-01-01

    

 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

  2. Fedora Content Modelling for Improved Services for Research Databases

    DEFF Research Database (Denmark)

    Elbæk, Mikael Karstensen; Heller, Alfred; Pedersen, Gert Schmeltz

    A re-implementation of the research database of the Technical University of Denmark, DTU, is based on Fedora. The backbone consists of content models for primary and secondary entities and their relationships, giving flexible and powerful extraction capabilities for interoperability and reporting....... By adopting such an abstract data model, the platform enables new and improved services for researchers, librarians and administrators....

  3. Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

    Science.gov (United States)

    Silva, Luiz Sergio; Barreto, Sandhi Maria

    2012-01-01

    Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

  4. Improvement in quality of life and sexual functioning in a comorbid sample after the unified protocol transdiagnostic group treatment.

    Science.gov (United States)

    de Ornelas Maia, Ana Claudia Corrêa; Sanford, Jenny; Boettcher, Hannah; Nardi, Antonio E; Barlow, David

    2017-10-01

    Patients with multiple mental disorders often experience sexual dysfunction and reduced quality of life. The unified protocol (UP) is a transdiagnostic treatment for emotional disorders that has the potential to improve quality of life and sexual functioning via improved emotion management. The present study evaluates changes in quality of life and sexual functioning in a highly comorbid sample treated with the UP in a group format. Forty-eight patients were randomly assigned to either a UP active-treatment group or a medication-only control group. Treatment was delivered in 14 sessions over the course of 4 months. Symptoms of anxiety and depression were assessed using the Beck Anxiety Inventory and Beck Depression Inventory. Sexual functioning was assessed by the Arizona Sexual Experience Scale (ASEX), and quality of life was assessed by the World Health Organization Quality of Life-BREF scale (WHOQOL-BREF). Quality of life, anxiety and depression all significantly improved among participants treated with the UP. Some improvement in sexual functioning was also noted. The results support the efficacy of the UP in improving quality of life and sexual functioning in comorbid patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Engaging service providers in improving industry performance

    International Nuclear Information System (INIS)

    Oberth, R.

    2012-01-01

    Effective task leadership is the key to achieving results in the nuclear industry and in most other industries. One of the themes of this conference is to discuss how the nuclear industry can undertake Issue-Identification and Definition as a means of 'identifying what needs attention' and then 'defining what needs to be done to make that happen'. I will explore this theme from the perspective of the 'Service Provider' - which by the definition of this conference includes everyone not within an operating utility - meaning 'those involved in everything from inspection and repair to research and plant architecture' - basically the member companies of my association, OCI. Our members take the definition of the roles and responsibilities of the 'Service Provider' community very seriously. In the context of this discussion a key utility function is the early definition of requirements and expectations of Service Providers in supplying to these requirements. Let's explore for a moment the Service Provider role and perspective. Service Providers are by nature pro-active - they seek ways to engage with utilities (and tier one vendors) to solve problems and achieve good outcomes. They come to industry conferences like this one to learn about upcoming utility programs and supply opportunities and how they can improve performance. Service Providers particularly want to hear senior utility people comment on emerging issues even those at the very early identification stage. Some Clarification of Roles is in Order - as that is the focus of this conference: 'Issue-Identification and Definition'. 'Issue-Identification' is the utility's job - it is the utility's role to identify as early as possible 'what needs attention and what their needs and expectations are'. This takes place before service provider engagement. 'Issue-Definition' is more challenging. It means 'determining and prioritizing what needs to be done to deal with the situation at hand'. This typically involves

  6. Colonoscopic screening for colorectal cancer improves quality of life measures: a population-based screening study

    Directory of Open Access Journals (Sweden)

    Shadbolt Bruce

    2006-10-01

    Full Text Available Abstract Background Screening asymptomatic individuals for neoplasia can have adverse consequences on quality of life. Colon cancer screening is widespread but the quality of life (QOL consequences are unknown. This study determined the impact of screening colonoscopy on QOL measures in asymptomatic average-risk participants. Methods Asymptomatic male and female participants aged 55–74 years were randomly selected from the Australian Electoral Roll or six primary care physicians' databases. Participants completed the Short-Form (SF-36 Quality of Life Assessment at baseline and at a mean of 39 days after colonoscopy. Outcome measures were (i significant changes in raw scores in any of the eight SF-36 domains assessed following colonoscopic screening and (ii improvements or declines in previously validated categories, representing clinically significant changes, within any of the eight SF-36 domains. Results Baseline QOL measures were similar to those of a matched general population sample. Role Limitations due to Emotions, Mental Health and Vitality raw scores significantly improved following colonoscopy (P Conclusion Average-risk persons benefit significantly from colon cancer screening with colonoscopy, improving in Mental Health and Vitality domains of Quality of Life. This improvement is not offset by declines in other domains.

  7. Should the service life of nuclear power plants be limited for technical reasons?

    International Nuclear Information System (INIS)

    Schomer, E.

    1995-01-01

    German nuclear power plant operating licenses take into account the fact that the design lifetime of the facilities is 40 years. The technological lifetime, however, is governed by actual ageing processes and operational burden. The service life of nuclear power plants can be extended by replacement of the steam generator and by repair or replacement of the reactor pressure vessel or parts thereof. Attention is also paid to the reactor protection systems. (J.B.). 8 figs

  8. Improving the patient booking service to reduce the number of missed appointments at East London NHS Foundation Trust Community Musculoskeletal Physiotherapy Service.

    Science.gov (United States)

    Tan, Elizabeth; Shah, Amar; De Souza, Warren; Harrison, Mark; Chettur, Chris; Onathukattil, Maimoona; Smart, Michelle; Mata, Marlon; Chitewe, Auzewell; Binley, Emma

    2017-01-01

    The East London National Health Service Foundation Trust (ELFT) Community Musculoskeletal (MSK) Physiotherapy Service had reported a high rate of non-attendance at scheduled appointments. This was leading to delayed access to treatment for patients and a reduced capacity for service users, as well as a waste of clinical resources. The aim of this quality improvement project was therefore to reduce the percentage of missed appointments within this department. This study was undertaken by the ELFT community MSK service, with support from the ELFT Quality Improvement team. To begin with, patient complaints were explored; these indicated that the main reason for missing appointments was due to issues with the patient booking service. Baseline data were initially collected for both new referrals and follow-up patients. The proposed changes were then introduced, which included text message reminders, first via a manual platform and then via an automated system. Ongoing data were recorded to note the effectiveness of these changes. Following the intervention, non-attendance of newly referred patients reduced by 43.35% (23.76%-13.46%) after both cycles. Non-attendance of follow-up patients reduced by 44.14% (23.74%-13.26%) after the second cycle alone. By listening to the opinions of service users, it was possible to improve the patient booking system and the flexibility of appointments. This resulted in a reduction in the percentage of appointments missed. These changes will continue to be monitored within this department to ensure sustainability but there is also now potential for similar interventions to be trialled in other health service departments.

  9. Improving ELM-Based Service Quality Prediction by Concise Feature Extraction

    Directory of Open Access Journals (Sweden)

    Yuhai Zhao

    2015-01-01

    Full Text Available Web services often run on highly dynamic and changing environments, which generate huge volumes of data. Thus, it is impractical to monitor the change of every QoS parameter for the timely trigger precaution due to high computational costs associated with the process. To address the problem, this paper proposes an active service quality prediction method based on extreme learning machine. First, we extract web service trace logs and QoS information from the service log and convert them into feature vectors. Second, by the proposed EC rules, we are enabled to trigger the precaution of QoS as soon as possible with high confidence. An efficient prefix tree based mining algorithm together with some effective pruning rules is developed to mine such rules. Finally, we study how to extract a set of diversified features as the representative of all mined results. The problem is proved to be NP-hard. A greedy algorithm is presented to approximate the optimal solution. Experimental results show that ELM trained by the selected feature subsets can efficiently improve the reliability and the earliness of service quality prediction.

  10. Strategies for Designing and Developing Services for Manufacturing Firms

    DEFF Research Database (Denmark)

    Tan, Adrian Ronald; Matzen, Detlef; McAloone, Tim C.

    2010-01-01

    Product/service-systems (PSS) are in effect an approach to designing integrated products and services with a focus on both customer- and product life cycleactivities . Literature offers a range of service-oriented design strategies from product-oriented DfX approaches to more customer...... manufacturing companies may align their product and service development activities with their business strategies.......-oriented approaches such as integrated solutions and service design. These design strategies are mapped out in relation to how applicable they are to different types of services. Case studies from two industrial companies are used to confront the existing literature in order to improve understanding of how...

  11. Improvement of maternal health services through the use of mobile phones.

    Science.gov (United States)

    Noordam, A Camielle; Kuepper, Barbara M; Stekelenburg, Jelle; Milen, Anneli

    2011-05-01

    To analyse, on the basis of the literature, the potential of mobile phones to improve maternal health services in Low and Middle Income Countries (LMIC). Wide search for scientific and grey literature using various terms linked to: maternal health, mobile telecommunication and LMIC. Applications requiring an internet connection were excluded as this is not widely available in LMIC yet. Few projects exist in this field and little evidence is available as yet on the impact of mobile phones on the quality of maternal health services. Projects focus mainly on the delay in receiving care--that is in recognizing the need and making the decision to seek care--and the delay in arriving at the health facility. This is achieved by connecting lesser trained health workers to specialists and coordination of referrals. Ongoing projects focus on empowering women to seek health care. There is broad agreement that access to communication is one of several essential components to improve maternal health services and hence the use of mobile phones has much potential. However, there is a need for robust evidence on constraints and impacts, especially when financial and human resources will be invested. Concurrently, other ways in which mobile phones can be used to benefit maternal health services need to be further explored, taking into consideration privacy and confidentiality. © 2011 Blackwell Publishing Ltd.

  12. Effect of the Length of Traffic Flow Records on the Estimate of a Bridge Service Life

    Directory of Open Access Journals (Sweden)

    Krejsa Jan

    2016-12-01

    Full Text Available The service life of bridges is significantly affected by fatigue of used material induced by heavy vehicles. Therefore, precise determination of the vehicle weight is of crucial importance for the calculation of fatigue damage and the prediction of the bridge serviceability. This paper investigates accuracy of the determination of fatigue depending on the length of traffic flow recording. The presented data were obtained from the measurements carried out on a bridge of the Prague Highway Ring. The analysis reveals that the optimal length of traffic recording is about 30 days.

  13. Integration of HIV care into maternal health services: a crucial change required in improving quality of obstetric care in countries with high HIV prevalence.

    Science.gov (United States)

    Madzimbamuto, Farai D; Ray, Sunanda; Mogobe, Keitshokile D

    2013-06-10

    The failure to reduce preventable maternal deaths represents a violation of women's right to life, health, non-discrimination and equality. Maternal deaths result from weaknesses in health systems: inadequate financing of services, poor information systems, inefficient logistics management and most important, the lack of investment in the most valuable resource, the human resource of health workers. Inadequate senior leadership, poor communication and low staff morale are cited repeatedly in explaining low quality of healthcare. Vertical programmes undermine other service areas by creating competition for scarce skilled staff, separate reporting systems and duplication of training and tasks. Confidential enquiries and other quality-improvement activities have identified underlying causes of maternal deaths, but depend on the health system to respond with remedies. Instead of separate vertical programmes for management of HIV, tuberculosis, and reproductive health, integration of care and joint management of pregnancy and HIV would be more effective. Addressing health system failures that lead to each woman's death would have a wider impact on improving the quality of care provided in the health service as a whole. More could be achieved if existing resources were used more effectively. The challenge for African countries is how to get into practice interventions known from research to be effective in improving quality of care. Advocacy and commitment to saving women's lives are crucial elements for campaigns to influence governments and policy -makers to act on the findings of these enquiries. Health professional training curricula should be updated to include perspectives on patients' rights, communication skills, and integrated approaches, while using adult learning methods and problem-solving techniques. In countries with high rates of Human Immunodeficiency Virus (HIV), indirect causes of maternal deaths from HIV-associated infections now exceed direct causes

  14. Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

    Science.gov (United States)

    Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

    2015-08-28

    Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy

  15. Improving Service Quality by Using Organizational Citizenship Behavior: Iranian Evidence

    Directory of Open Access Journals (Sweden)

    Nour-Mohammad Yaghoubi

    2011-09-01

    Full Text Available Nowadays, with increasing service industries, service marketing and service quality have become an important challenge to organizations. The attempts of organizations in this situation are witnesses to this matter. In the past years, the organizations tried to reach service quality appropriation and satisfaction of self-external customers by concepts and approaches of external marketing. One of the important features of service is the direct interaction with customers and having customer-oriented behaviors. Furthermore, with introducing the internal marketing and the important roles of it, an internal customer of organizations, on achievement of organizational plans, was noted to internal marketing more and more than before. So, the study researchers are going to argue about internal marketing and the effect of it on organizational citizenship behaviors and service quality and the important role of it on development and improvement of service quality by using organizational citizenship behaviors. For this purpose, first the researchers have studied internal marketing and its important components and then have done the same to the other items and finally have applied a quantitative study on all of them. It should be mentioned that the researchers have employed SPSS 17.0 and Lisrel 8.54 for data analysis. The findings of the present study illustrated that there is an appropriate interaction among all the items, which has been studied here and the structural equations for the conceptual framework of this study are goodness of fit.

  16. Analysis of the characteristics of taxi services as a prerequisite for their improvement

    Directory of Open Access Journals (Sweden)

    Vujić Nenad

    2014-01-01

    Full Text Available The expansion of services sector is the characteristics of modern and developed societies that influence national economy. Therefore, the analysis of services, as a concept and part of marketing is very significant. In this sense, the paper researches a particular service - the taxi services in the capital of Serbia. Through this research, the authors try to define the groups of customer of taxi services and their preference and attitudes. The research was performed in period May to July 2014, by direct contact with customer of taxi services. The results of research have confirmed the initial hypothesis and provide possibilities for further insight into the way of using taxi services and general circumstances that characterize them in mentioned region. On this basis, it is provided proposals for improvement of taxi services and easier outreach of target groups.

  17. Exploring, Documenting, and Improving Humanitarian Service Learning through Engineers Without Borders USA

    OpenAIRE

    Buchanan, Elizabeth; Berg, Devin; Lee, Tina; Buchanan, Elizabeth; Lacksonen, Tom

    2017-01-01

    Exploring, Documenting, and Improving Humanitarian Service Learning through Engineers without Borders-USA is a four-year project exploring a variety of challenges and opportunities in university-based service learning programs. Specifically, this project looks holistically at the inception and evolution of a new Engineers Without Borders USA chapter, while analyzing characteristics, values, and demographics of individuals involved in EWB community-based humanitarian projects in multiple chapt...

  18. Biological Web Service Repositories Review.

    Science.gov (United States)

    Urdidiales-Nieto, David; Navas-Delgado, Ismael; Aldana-Montes, José F

    2017-05-01

    Web services play a key role in bioinformatics enabling the integration of database access and analysis of algorithms. However, Web service repositories do not usually publish information on the changes made to their registered Web services. Dynamism is directly related to the changes in the repositories (services registered or unregistered) and at service level (annotation changes). Thus, users, software clients or workflow based approaches lack enough relevant information to decide when they should review or re-execute a Web service or workflow to get updated or improved results. The dynamism of the repository could be a measure for workflow developers to re-check service availability and annotation changes in the services of interest to them. This paper presents a review on the most well-known Web service repositories in the life sciences including an analysis of their dynamism. Freshness is introduced in this paper, and has been used as the measure for the dynamism of these repositories. © 2017 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

  19. Opportunities and Challenges of Cloud Computing to Improve Health Care Services

    Science.gov (United States)

    2011-01-01

    Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed. PMID:21937354

  20. Opportunities and challenges of cloud computing to improve health care services.

    Science.gov (United States)

    Kuo, Alex Mu-Hsing

    2011-09-21

    Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed.

  1. Productivity and quality improvements in health care through airboss mobile messaging services.

    Science.gov (United States)

    Shah, P J; Martinez, R; Cooney, E

    1997-01-01

    The US health care industry is in the midst of revolutionary changes. Under tremendous pressures from third-party payers and managed care programs to control costs while providing high quality medical services, health care entities are now looking at information technologies to help them achieve their goals. These goals typically include improved productivity, efficiency and decision-making capabilities among staff members. Moreover, hospitals and other health care facilities that provide a broad and integrated range of inpatient and outpatient care, wellness and home care services are in the best position to offer comprehensive packages to managed care and private insurers. Many health care providers and administrators are considered mobile employees. This mobility can range from intra-building and intra-campus to multi-site and metropolitan areas. This group often relies on a variety of information technologies such as personal computers, communicating laptops, pagers, cellular phones, wireline phones, cordless phones and fax machines to stay in touch and handle information needs. These health care professionals require mobile information access and messaging tools to improve communications, control accessibility and enhance decision-making capabilities. AirBoss mobile messaging services could address the health care industry's need for improved messaging capabilities for its mobile employees. The AirBoss family of services supports integrated voice services, data messaging, mobile facsimile and customized information delivery. This paper describes overview of the current mobile data networking capability, the AirBoss architecture, the health care-related applications it addresses and long-term benefits. In addition, a prototype application for mobile home health care workers is illustrated. This prototype application provides integrated e-mail, information services, web access, real-time access and update of patient records from wireline or wireless networks

  2. Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being.

    Science.gov (United States)

    Martinussen, Monica; Kaiser, Sabine; Adolfsen, Frode; Patras, Joshua; Richardsen, Astrid M

    2017-07-01

    This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T 1 ) and after (T 2 , T 3 ) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T 1 to T 2 . No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T 3 ) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

  3. What do customers want from improved residential electricity services? Evidence from a choice experiment

    International Nuclear Information System (INIS)

    Huh, Sung-Yoon; Woo, JongRoul; Lim, Sesil; Lee, Yong-Gil; Kim, Chang Seob

    2015-01-01

    Improvements in customer satisfaction as well as product/service quality represent a common objective of all businesses, and electricity services are no exception. Using choice experiments and a mixed logit model, this study quantitatively analyzes customers' preferences and their marginal willingness to pay for improved residential electricity services. The study provides an ex ante evaluation of customers' acceptance of hypothetical electricity services. According to the results, customers consider the electricity bill and the electricity mix as the two most important attributes when choosing their electricity services. Customers are willing to pay 2.2% more in the average electricity bill (an additional monthly electricity bill of KRW 1,064; USD 0.96) for a significant increase in the share of renewable energy, which is far less than the actual cost of achieving this renewable target. Therefore, it is better to maintain the current electricity mix in principle, and the renewable share should be gradually expanded instead of making a sudden change in the electricity mix. In addition, customers are willing to pay KRW 6,793 (USD 6.15) more to reduce blackouts once in a year and KRW 64/year (USD 0.06/year) to reduce a minute of each blackout. -- Highlights: •Customers' preferences for improved residential electricity services are analyzed. •Empirical setting is a sample of residents in South Korea. •The electricity bills and electricity mix are important to customers. •Increase in electricity bill of different electricity mix is considered

  4. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  5. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    Science.gov (United States)

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  6. Viscoelastic response of HTPB based solid fuel to horizontal and vertical storage slumping conditions and it's affect on service life

    International Nuclear Information System (INIS)

    Nawaz, Q.; Nizam, F.

    2011-01-01

    Frequent use of solid fuels as thrust generating energy source in modern day space vehicle systems has created a need to assess their serviceability for long term storage under various conditions. Solid fuel grain, the most important part of any solid fuel system, responds visco elastically to any loading condition. For the assessment of the service life of any solid fuel system, the solid fuel grain has to be structurally evaluated in applied storage conditions. Structural integrity of the grain is exceptionally significant to guarantee the successful operation of the solid fuel system. In this work, numerical simulations have been performed to assess the mechanical stresses and strains induced in an HTPB based solid fuel grain during service life employing ABAQUS standard FEA software using 4-node bilinear quadrilateral elements. For finite element analysis (FEA), typical 2-D and p/nth axisymmetric section of 5-point (n) star grain geometry is considered. Mechanical loads include the horizontal or vertical 1-g (solid fuel weight) storage condition. The simulation results are compared with the analytical results for the same grain geometry. Analytically measured slump deflections in grain segment at various storage times have been found in good relation with the FEA based simulation results. This proves the validity of the procedure adopted and is helpful in assessment of the service life of solid fuel systems. (author)

  7. Family Education as an Element to Improve Quality of Life of Children with Special Needs

    OpenAIRE

    Kokle-Narbuta, Iveta

    2015-01-01

    The current research aims to analyse the importance of family education in improving life quality of children with special needs. Nowadays our society aim for sustainable development which means equal rights and possibilities for all the citizens but reality shows a different situation, especially it concerns children with special needs. Family education could be one of possible ways how to improve the quality of life. In the current article the author looks on family education as a solution ...

  8. Assessing the impact of care farms on quality of life and offending: a pilot study among probation service users in England.

    Science.gov (United States)

    Elsey, Helen; Farragher, Tracey; Tubeuf, Sandy; Bragg, Rachel; Elings, Marjolein; Brennan, Cathy; Gold, Rochelle; Shickle, Darren; Wickramasekera, Nyantara; Richardson, Zoe; Cade, Janet; Murray, Jenni

    2018-03-17

    To assess the feasibility of conducting a cost-effectiveness study of using care farms (CFs) to improve quality of life and reduce reoffending among offenders undertaking community orders (COs). To pilot questionnaires to assess quality of life, connection to nature, lifestyle behaviours, health and social-care use. To assess recruitment and retention at 6 months and feasibility of data linkage to Police National Computer (PNC) reconvictions data and data held by probation services. Pilot study using questionnaires to assess quality of life, individually linked to police and probation data. The pilot study was conducted in three probation service regions in England. Each site included a CF and at least one comparator CO project. CFs are working farms used with a range of clients, including offenders, for therapeutic purposes. The three CFs included one aquaponics and horticulture social enterprise, a religious charity focusing on horticulture and a family-run cattle farm. Comparator projects included sorting secondhand clothes and activities to address alcohol misuse and anger management. We recruited 134 adults (over 18) serving COs in England, 29% female. 52% of participants completed follow-up questionnaires. Privatisation of UK probation trusts in 2014 negatively impacted on recruitment and retention. Linkage to PNC data was a more successful means of follow-up, with 90% consenting to access their probation and PNC data. Collection of health and social-care costs and quality-adjusted life year derivation were feasible. Propensity score adjustment provided a viable comparison method despite differences between comparators. We found worse health and higher reoffending risk among CF participants due to allocation of challenging offenders to CFs, making risk of reoffending a confounder. Recruitment would be feasible in a more stable probation environment. Follow-up was challenging; however, assessing reconvictions from PNC data is feasible and a potential primary

  9. Improving Productivity via QWL Centers.

    Science.gov (United States)

    Bentley, Marion T.; Hansen, Gary B.

    1980-01-01

    Gives a brief history of productivity improvement legislation in the United States and of the development and demise of the National Center for Productivity and Quality of Working Life (QWL). Describes existing productivity and QWL centers, including their locations, scope, services, and activities, and urges greater support at the federal level.…

  10. Service Blueprint for Improving Clinical Guideline Adherence via Mobile Health Technology

    OpenAIRE

    Y. O'Connor; C. Heavin; S. O' Connor; J. Gallagher; J. Wu; J. O'Donoghue

    2015-01-01

    Background: To improve the delivery of paediatric healthcare in low resource settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which ...

  11. Responses of Aboriginal and Torres Strait Islander Primary Health-Care Services to Continuous Quality Improvement Initiatives.

    Science.gov (United States)

    Larkins, Sarah; Woods, Cindy E; Matthews, Veronica; Thompson, Sandra C; Schierhout, Gill; Mitropoulos, Maxwell; Patrao, Tania; Panzera, Annette; Bailie, Ross Stewart

    2015-01-01

    Indigenous primary health-care (PHC) services participating in continuous quality improvement (CQI) cycles show varying patterns of performance over time. Understanding this variation is essential to scaling up and sustaining quality improvement initiatives. The aim of this study is to examine trends in quality of care for services participating in the ABCD National Research Partnership and describe patterns of change over time and examine health service characteristics associated with positive and negative trends in quality of care. PHC services providing care for Indigenous people in urban, rural, and remote northern Australia that had completed at least three annual audits of service delivery for at least one aspect of care (n = 73). Longitudinal clinical audit data from use of four clinical audit tools (maternal health, child health, preventive health, Type 2 diabetes) between 2005 and 2013 were analyzed. Health center performance was classified into six patterns of change over time: consistent high improvement (positive), sustained high performance (positive), decline (negative), marked variability (negative), consistent low performance (negative), and no specific increase or decrease (neutral). Backwards stepwise multiple logistic regression analyses were used to examine the associations between health service characteristics and positive or negative trends in quality of care. Trends in quality of care varied widely between health services across the four audit tools. Regression analyses of health service characteristics revealed no consistent statistically significant associations of population size, remoteness, governance model, or accreditation status with positive or negative trends in quality of care. The variable trends in quality of care as reflected by CQI audit tools do not appear to be related to easily measurable health service characteristics. This points to the need for a deeper or more nuanced understanding of factors that moderate the

  12. THE EFFECT OF LEISURE TIME ON TOURISTIC RESOURCES AND ON THE QUALITY OF LIFE

    OpenAIRE

    Gabriela-Liliana CIOBAN; Gabriela Corina SLUSARIUC

    2014-01-01

    The presence of the "actors" on the tourist stage of Romania brings in the context of socioeconomic, cultural and educational life needs, wishes, proposals and suggestions for the improvement of tourism infrastructure and also for an increase in the diversity of leisure activities. The development of technique, technology and computer technology have contributed to the multiplication of tourism products and services which led to an improved quality of life. At the same time, identification of...

  13. CONSERVATION OF HISTORIC WATERFRONT TO IMPROVE THE QUALITY OF LIFE IN OLD DHAKA

    Directory of Open Access Journals (Sweden)

    Mohammed Mahbubur Rahman

    2017-07-01

    Full Text Available Liveability of a city is related to the quality of life (QOL assessed by the impact of the quality of physical environment on liveability and the role of recreation in psychological wellbeing of individuals. Like in major Asian cities, the historic waterfront and architectural heritage of Dhaka are important components of the fabric. Despite diminution, it continues to affect the social life of Old Dhaka residents. In recent years, protection of the waterfront from illegal encroachment and pollution has become a major concern, amidst a lack of understanding of the river’s role in improving the QOL of the waterfront residents and the role of community involvement. By comparing waterfronts in similar contexts and through literature review and observations, the authors investigate how the conservation of the historic waterfront can contribute to the improvement of quality of life in Old Dhaka, and suggest ways to protect the riverfront with this objective. Seeing waterfronts as products of human intervention into nature, this paper discusses the socio-political forces that shape this, and investigates how conservation of the historic landscape can improve the QOL of the nearby residents. It uses a case study approach based on documentary research, unstructured and nonparticipant observations, and interviews with community leaders, environmental activists and local bodies.

  14. The Application of Waiting Lines System in Improving Customer Service Management: The Examination of Malaysia Fast Food Restaurants Industry

    Science.gov (United States)

    Ismail, Zurina; Shokor, Shahrul Suhaimi AB

    2016-03-01

    Rapid life time change of the Malaysian lifestyle had served the overwhelming growth in the service operation industry. On that occasion, this paper will provide the idea to improve the waiting line system (WLS) practices in Malaysia fast food chains. The study will compare the results in between the single server single phase (SSSP) and the single server multi-phase (SSMP) which providing Markovian Queuing (MQ) to be used for analysis. The new system will improve the current WLS, plus intensifying the organization performance. This new WLS were designed and tested in a real case scenario and in order to develop and implemented the new styles, it need to be focusing on the average number of customers (ANC), average number of customer spending time waiting in line (ACS), and the average time customers spend in waiting and being served (ABS). We introduced new WLS design and there will be prompt discussion upon theories of benefits and potential issues that will benefit other researchers.

  15. Do telemedical interventions improve quality of life in patients with COPD?

    DEFF Research Database (Denmark)

    Gregersen, Thorbjorn L.; Green, Allan; Frausing, Ejvind

    2016-01-01

    OBJECTIVE: Telehealth is an approach to disease management, which may hold the potential of improving some of the features associated with COPD, including positive impact on disease progression, and thus possibly limiting further reduction in quality of life (QoL). Our objective was, therefore......, three studies found statistically significant improvements in QoL for patients allocated to telemedical interventions. However, all of the other included studies found no statistically significant differences between control and telemedical intervention groups in terms of QoL. CONCLUSION: Telehealth...

  16. Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge.

    Science.gov (United States)

    Wagner, Anjuli D; Mugo, Cyrus; Bluemer-Miroite, Shay; Mutiti, Peter M; Wamalwa, Dalton C; Bukusi, David; Neary, Jillian; Njuguna, Irene N; O'Malley, Gabrielle; John-Stewart, Grace C; Slyker, Jennifer A; Kohler, Pamela K

    2017-07-01

    To determine whether continuous quality improvement (CQI) improves quality of HIV testing services for adolescents and young adults (AYA). CQI was introduced at two HIV testing settings: Youth Centre and Voluntary Counseling and Testing (VCT) Center, at a national referral hospital in Nairobi, Kenya. Primary outcomes were AYA satisfaction with HIV testing services, intent to return, and accurate HIV prevention and transmission knowledge. Healthcare worker (HCW) satisfaction assessed staff morale. T tests and interrupted time series analysis using Prais-Winsten regression and generalized estimating equations accounting for temporal trends and autocorrelation were conducted. There were 172 AYA (Youth Centre = 109, VCT = 63) during 6 baseline weeks and 702 (Youth Centre = 454, VCT = 248) during 24 intervention weeks. CQI was associated with an immediate increase in the proportion of AYA with accurate knowledge of HIV transmission at Youth Centre: 18 vs. 63% [adjusted risk difference (aRD) 0.42,95% confidence interval (CI) 0.21 to 0.63], and a trend at VCT: 38 vs. 72% (aRD 0.30, 95% CI -0.04 to 0.63). CQI was associated with an increase in the proportion of AYA with accurate HIV prevention knowledge in VCT: 46 vs. 61% (aRD 0.39, 95% CI 0.02-0.76), but not Youth Centre (P = 0.759). In VCT, CQI showed a trend towards increased intent to retest (4.0 vs. 4.3; aRD 0.78, 95% CI -0.11 to 1.67), but not at Youth Centre (P = 0.19). CQI was not associated with changes in AYA satisfaction, which was high during baseline and intervention at both clinics (P = 0.384, P = 0.755). HCW satisfaction remained high during intervention and baseline (P = 0.746). CQI improved AYA knowledge and did not negatively impact HCW satisfaction. Quality improvement interventions may be useful to improve adolescent-friendly service delivery.

  17. Identification of Facilitators and Deterrents of the Quality of Life in Elderly Women and Men: A Phenomenological Research

    Directory of Open Access Journals (Sweden)

    Ali Imanzadeh

    2018-01-01

    Conclusion Our study indicates that to improve the life, the elderly should pay attention to factors such as the role of religious beliefs, proper nutrition, meeting relatives, reminiscence, and establishing proper social relationships. In addition, removing barriers such as breaking the taboo of elderly marriage, financial support, and providing counseling services could improve their quality of life.

  18. Rehabilitation of limb apraxia improves daily life activities in patients with stroke.

    Science.gov (United States)

    Smania, N; Aglioti, S M; Girardi, F; Tinazzi, M; Fiaschi, A; Cosentino, A; Corato, E

    2006-12-12

    We randomly assigned 33 patients with left hemisphere stroke, limb apraxia, and aphasia to an apraxia or a control (aphasia) treatment group. Before and after each treatment, patients underwent a comprehensive neuropsychological testing battery and a caregiver evaluation of patient's activities of daily life (ADL) independence. Apraxia severity was related with ADL independence. Control (aphasia) treatment improved patients' language and intelligence performance. Apraxia treatment specifically improved praxic function and ADL.

  19. Non-destructive testing for plant life assessment

    International Nuclear Information System (INIS)

    2005-01-01

    The International Atomic Energy Agency (IAEA) is promoting industrial applications of nondestructive testing (NDT) technology, which includes radiography testing (RT) and related methods, to assure safety and reliability of operation of industrial facilities and processes. NDT technology is essentially needed for improvement of the quality of industrial products, safe performance of equipment and plants, including safety of metallic and concrete structures and constructions. The IAEA is playing an important role in promoting the NDT use and technology support to Member States, in harmonisation for training and certification of NDT personnel, and in establishing national accreditation and certifying bodies. All these efforts have led to a stage of maturity and self sufficiency in numerous countries especially in the field of training and certification of personnel, and in provision of services to industries. This has had a positive impact on the improvement of the quality of industrial goods and services. NDT methods are primarily used for detection, location and sizing of surface and internal defects (in welds, castings, forging, composite materials, concrete and many more). Various NDT methods are applied for preventive maintenance (aircraft, bridge), for the inspection of raw materials, half-finished and finished products, for in-service-inspection and for plant life assessment studies. NDT is essential for quality control of the facilities and products, and for fitness - for purpose assessment (so-called plant life assessment). NDT evaluates remaining operation life of plant components (processing lines, pipes, vessels) providing an accurate diagnosis that allows predicting extended life operation beyond design life. Status and trends on the NDT for plant life assessment have been discussed in many IAEA meetings related with NDT development, training and education. Experts have largely demonstrated that, using NDT methods, a comprehensive assessment of the life

  20. Improved gas installations and services. Phase 1: Analysis project. Part report

    International Nuclear Information System (INIS)

    Nielsen, K.J.

    1996-05-01

    As Danish gas companies receive a large number of complaints related to the installation and operation of gas installations it was suggested that a course for personnel should be established in order to raise the standard of services and installation requirements. The first phase of the described project was to evaluate the quality of the gas installers' services so as to determine which aspects of installation and services should be emphasized during such a course. Interviews were carried out and questionnaires (illustrated within the document) sent out to installaters etc. Recommendations include that the level of information given to customers should be raised, also in relation to maintenance, and that installation should be improved. Analyses of the degree of customers' satisfaction, of the nature of the quality of services etc. expected, subjects for further training in this area and details of the training system are dealt with

  1. Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

    Science.gov (United States)

    Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

    2017-09-07

    While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

  2. Quality of life long-term after body contouring surgery following bariatric surgery: sustained improvement after 7 years.

    Science.gov (United States)

    van der Beek, Eva S J; Geenen, Rinie; de Heer, Francine A G; van der Molen, Aebele B Mink; van Ramshorst, Bert

    2012-11-01

    Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery. Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery. Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery. This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity. Therapeutic, IV.

  3. Operational safety and reactor life improvements of Kyoto University Reactor

    International Nuclear Information System (INIS)

    Utsuro, M.; Fujita, Y.; Nishihara, H.

    1990-01-01

    Recent important experience in improving the operational safety and life of a reactor are described. The Kyoto University Reactor (KUR) is a 25-year-old 5 MW light water reactor provided with two thermal columns of graphite and heavy water as well as other kinds of experimental facilities. In the graphite thermal column, noticeable amounts of neutron irradiation effects had accumulated in the graphite blocks near the core. Before the possible release of the stored energy, all the graphite blocks in the column were successfully replaced with new blocks using the opportunity provided by the installation of a liquid deuterium cold neutron source in the column. At the same time, special seal mechanisms were provided for essential improvements to the problem of radioactive argon production in the column. In the heavy-water thermal column we have accomplished the successful repair of a slow leak of heavy water through a thin instrumentation tube failure. The repair work included the removal and reconstructions of the lead and graphite shielding layers and welding of the instrumentation tube under radiation fields. Several mechanical components in the reactor cooling system were also exchanged for new components with improved designs and materials. On-line data logging of almost all instrumentation signals is continuously performed with a high speed data analysis system to diagnose operational conditions of the reactor. Furthermore, through detailed investigations on critical components, operational safety during further extended reactor life will be supported by well scheduled maintenance programs

  4. Design and analysis of seals for extended service life

    Science.gov (United States)

    Bower, Mark V.

    1992-01-01

    Space Station Freedom is being developed for a service life of up to thirty years. As a consequence, the design requirements for the seals to be used are unprecedented. Full scale testing to assure the selected seals can satisfy the design requirements are not feasible. As an alternative, a sub-scale test program has been developed by MSFC to calibrate the analysis tools to be used to certify the proposed design. This research has been conducted in support of the MSFC Integrated Seal Test Program. The ultimate objective of this research is to correlate analysis and test results to qualify the analytical tools, which in turn, are to be used to qualify the flight hardware. This research is totally focused on O-rings that are compressed by perpendicular clamping forces. In this type of seal the O-ring is clamped between the sealing surfaces by loads perpendicular to the circular cross section.

  5. Improving the quality of communication and service provision for renal patients of South Asian origin: the contribution of a cultural and health improvement officer.

    Science.gov (United States)

    Akhtar, Tahira; Hipkiss, Vicki; Stoves, John

    2014-09-01

    A large number of patients with advanced chronic kidney disease in Bradford, UK are of South Asian origin. Effective delivery of care for these patients demands a consistently high standard of communication between patients, their families and renal unit staff. Communication may be problematic for a number of reasons, including language barriers and an incomplete appreciation of important cultural or religious beliefs. In 2010, we received charitable funding for an Ethnic Liaison Support Worker, renamed Cultural and Health Improvement Officer (CHIO). The CHIO is able to engage with and support patients, relatives and other members of the multidisciplinary renal team. Core responsibilities include ensuring that patients and their families feel at ease whenever they are in communication with the renal services team in Bradford; contributing to formal discussion and explanation of important clinical issues in the patient's first language (typically Urdu or Punjabi), thereby encouraging patients to feel more involved in decisions about their care; listening to ad hoc patient queries and concerns and addressing these directly or indirectly through timely involvement of other members of the renal team; cultivating a greater awareness of and empathy towards the holistic needs of patients and their families within the renal MDT; and strengthening the links between renal and social care services. The involvement of the CHIO is especially important when discussing sensitive and complex issues such as conservative and end-of-life care with patients and their families, as communication needs to be detailed, precise and unequivocal. This is crucial to providing a bespoke supportive service for our all patients, especially those who have opted for conservative management. The significant contribution of the CHIO to the quality of renal services in Bradford has been recognised and a permanent CHIO post has now been established. © 2014 European Dialysis and Transplant Nurses

  6. Acceptance towards Goods and Services Tax (GST and Quality of Life: Antecedent and outcome using partial least square method

    Directory of Open Access Journals (Sweden)

    Arlinah Abd Rashid

    2016-06-01

    Full Text Available The good and service tax (GST in Malaysia was implemented in 2015 as a tax reform program to generate a stable source of revenue. This study explores the respondents’ behaviour towards GST, a week post-implementation. The partial least square (PLS modelling was used to establish the relationship between acceptance, knowledge and feelings towards GST as well as the household quality of life. There is a positive relationship between the antecedents and the quality of life. Acceptance of GST exerts a significant relationship towards feelings and quality of life. The study concludes that Malaysians, in general, accept GST that ensures a better quality of life in the future.

  7. Life Cycle Thinking and Integrated Product Deliveries in renovation projects: Extending the concept of Integrated Product Deliveries with Product Service Systems

    DEFF Research Database (Denmark)

    Schipull Kauschen, Jan

    2012-01-01

    on renovation projects from Denmark, using different forms of IPDs for façade renovation and discusses the different stakeholder’s perspectives on life cycle thinking and their interests and values regarding sustainable building. Furthermore is the concept of Product Service Systems (PSS) as a valuable...... IPDs with regard to longevity and adaptability. CONCLUSION The new type of service-focused IPD and the related life-cycle responsibility (development, building phase, maintenance and dismantling/adaption/recycling) creates incentive to integrate life cycle thinking into the development process of IPDs......, resulting in more sustainable building solutions with a greater extend of positive environmental, economical and social impacts. The research presented will also show the importance of adaption and configuration of these complex building components by architects and planners, as they will have a great...

  8. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

    Science.gov (United States)

    Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

    2010-10-01

    To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration 5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (pimprovements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

  9. Supervised physical exercise to improve the quality of life of cancer patients: the EFICANCER randomised controlled trial.

    Science.gov (United States)

    Sancho, Aintzane; Carrera, Sergio; Arietaleanizbeascoa, Marisol; Arce, Veronica; Gallastegui, Nere Mendizabal; Giné March, Anna; Sanz-Guinea, Aitor; Eskisabel, Araceli; Rodriguez, Ana Lopez; Martín, Rosa A; Lopez-Vivanco, Guillermo; Grandes, Gonzalo

    2015-02-06

    The optimal form of exercise for individuals with cancer has yet to be identified, but there is evidence that exercise improves their quality of life. The aim of this study is to assess the efficacy and efficiency of an innovative physical exercise programme, for individuals undergoing chemotherapy for breast, gastrointestinal or non-small cell lung tumours, for improving quality of life, reducing level of fatigue, and enhancing functional capacity over time. We will conduct a clinical trial in 66 patients with stage IV breast, gastrointestinal or non-small cell lung cancer, recruited by the Department of Oncology of the referral hospital from 4 primary care health centres of the Basque Health Service (Osakidetza). These patients will be randomised to one of two groups. The treatment common to both groups will be the usual care for cancer: optimized usual drug therapies and strengthening of self-care; in addition, patients in the intervention group will participate in a 2-month exercise programme, including both aerobic and strength exercises, supervised by nurses in their health centre. The principal outcome variable is health-related quality of life, measured blindly with the 30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire and Short Form-36 four times: at baseline, and 2, 6 and 12 months later. The secondary outcome variables are fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire), functional capacity (6-Minute Walk Test and cardiorespiratory test), muscle strength (hand-held dynamometry and sit-to-stand test), radiological response to treatment (Response Evaluation Criteria In Solid Tumors) and progression-free and overall survival. Age, sex, diagnosis, chemotherapy regimen, Eastern Cooperative Oncology Group performance status and smoking status will be considered as predictive variables. Data will be analysed on an intention-to-treat basis, comparing changes at each time

  10. Creating a Liveable City - Eco-services, Systems and Place

    Science.gov (United States)

    Hamilton, R. J.; Dean, M.; Birtles, P. J.; Hore, J.; Dahlenburg, J.

    2014-12-01

    The use of an ecosystem service framework for natural resource management has gained increasing traction in the public sector. This is of especial interest in cities as residual ecosystems - typically located along creeks and estuaries, or remaining in scattered pockets throughout the urban area - offer some of the highest value social and economic returns per capita for the land area they occupy, yet are often impractical to manage from more traditional approaches to conservation. We posit that the well-being of humans and other species is the outcome of healthy, functioning ecosystems, and that, from a policy perspective, it is essential to consider services in this context. We arrange ecosystem services into three categories: life-enabling, life-sustaining and life-fulfilling, in a modification to the categories of the Millennium Ecosystem Assessment, and identify additional eco-services unique to urban areas. At local scale, these contribute to the well-being of city residents and positively affect quality of life, forming essential elements of urban liveability. However, dynamics of co-located built and natural environments challenge the capacity of ecosystems to function and provide their full suite of services. Using Sydney as an example, we outline a modular framework of socio-ecological systems and places to show how eco-services supporting liveability can be considered in conceptual and physical space. At a policy level, framing systems-based management objectives that protect, improve and re-discover desirable ecosystem services within the city (as opposed to further increasing the environmental footprint outside), will allow for unique, positive, socially-enabling outcomes for urban centres, in Australia, and globally.

  11. Influence of service life on Life Cycle Assessments

    NARCIS (Netherlands)

    van Nunen, H.; Hendriks, N.A.; Erkelens, P.A.

    2003-01-01

    Environmental assessment is part of present decision making. But, because of difficulties the assessments are not as profound as could be. Life Cycle Assessment (LCA) is a cradle-to-grave approach and consequently a time factor is embedded. Until now this time factor is fixed and calculations are

  12. Pilates and aerobic training improve levels of depression, anxiety and quality of life in overweight and obese individuals.

    Science.gov (United States)

    Vancini, Rodrigo Luiz; Rayes, Angeles Bonal Rosell; Lira, Claudio Andre Barbosa de; Sarro, Karine Jacon; Andrade, Marilia Santos

    2017-12-01

    To compare the effects of Pilates and walking on quality of life, depression, and anxiety levels. Sixty-three overweight/obese participants were randomly divided into: control (n = 20), walking (n = 21), and Pilates (n = 22) groups. Pilates and walking groups attended eight weeks of 60-minute exercise sessions three times per week. Quality of life, depression, and state- and trait-anxiety levels were evaluated before and after eight weeks of training. Scores of quality of life, depression, and trait-anxiety improved in the Pilates and walking groups. State-anxiety levels improved only in the walking group. Pilates and walking positively impact quality of life, depression and anxiety. The Pilates method could be used as an alternative to improve mood disorders in overweight/obese individuals.

  13. Household demand for improved sanitation services in Kumasi, Ghana: A contingent valuation study

    Science.gov (United States)

    Whittington, Dale; Lauria, Donald T.; Wright, Albert M.; Choe, Kyeongae; Hughes, Jeffrey A.; Swarna, Venkateswarlu

    1993-06-01

    A contingent valuation survey was conducted in Kumasi, Ghana, to estimate households' willingness to pay for two types of improved sanitation services: improved ventilated pit latrines and water closets connected to a sewer system. Over 1200 randomly selected households throughout the city were interviewed. Most households were willing to pay more for improved sanitation service than they were currently paying for their existing sanitation system (mostly public and bucket latrines), but in absolute terms the potential revenues from households are not large, of the order of US$1.40 per household per month (about 1-2% of household income). The results of the study confirm the conventional wisdom that conventional sewerage is not affordable to the vast majority of households without massive government subsidies. On the other hand, it appears that only modest subsidies are required to achieve relatively high levels of coverage with on-site sanitation (improved ventilated pit latrines). This is because improved ventilated pit latrines are much cheaper than conventional sewerage and because most households are willing to pay about as much for a ventilated pit latrine as for a water closet connected to a sewer. Several tests were conducted to check the accuracy of respondents' answers to contingent valuation questions. The findings indicate that contingent valuation surveys can be successfully carried out in cities in developing countries for public services such as sanitation and that reasonably reliable information can be obtained on household demand for different sanitation technologies.

  14. Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

    Science.gov (United States)

    Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

    2013-01-01

    For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

  15. Considerations related to plant life management for Cernavoda-1

    International Nuclear Information System (INIS)

    Cojan, Mihail

    2002-01-01

    approach defined for Cernavoda-1 PLiM and some activities including R and D aimed at addressing gaps in knowledge, improving plant monitoring, maintenance, and inspection of critical components (CSSC) and understanding the influence of various factors on service life

  16. Quality-of-life improvement after free gracilis muscle transfer for smile restoration in patients with facial paralysis.

    Science.gov (United States)

    Lindsay, Robin W; Bhama, Prabhat; Hadlock, Tessa A

    2014-01-01

    Facial paralysis can contribute to disfigurement, psychological difficulties, and an inability to convey emotion via facial expression. In patients unable to perform a meaningful smile, free gracilis muscle transfer (FGMT) can often restore smile function. However, little is known about the impact on disease-specific quality of life. To determine quantitatively whether FGMT improves quality of life in patients with facial paralysis. Prospective evaluation of 154 FGMTs performed at a facial nerve center on 148 patients with facial paralysis. The Facial Clinimetric Evaluation (FaCE) survey and Facial Assessment by Computer Evaluation software (FACE-gram) were used to quantify quality-of-life improvement, oral commissure excursion, and symmetry with smile. Free gracilis muscle transfer. Change in FaCE score, oral commissure excursion, and symmetry with smile. There were 127 successful FGMTs on 124 patients and 14 failed procedures on 13 patients. Mean (SD) FaCE score increased significantly after successful FGMT (42.30 [15.9] vs 58.5 [17.60]; paired 2-tailed t test, P improved significantly in all subgroups (nonflaccid cohort, 37.8 [19.9] vs 52.9 [19.3]; P = .02; flaccid cohort, 43.1 [15.1] vs 59.6 [17.2]; P improved from a mean (SD) of 13.8 (7.46) to 4.88 (3.47) (P improvement in quality of life after FGMT in patients who could not recover a meaningful smile after facial nerve insult. Quality-of-life improvement was not statistically different between donor nerve groups or facial paralysis types.

  17. Improving marketing strategies of sea freight forwarding services - Thien Hong Joint Stock company

    OpenAIRE

    Pham, Thanh Huyen

    2015-01-01

    Analyzing and improving marketing strategies of Thien Hong Joint Stock company - a newborn company in the field of sea freight forwarding service in Vietnam. This thesis focused on the 4Ps (product, price, placement, promotion) in marketing strategy, how to apply the theory of services marketing in a business to business company and a special industry effectively.

  18. Recruitment, soldiers and the experience of army life: compulsory military service in Peru and Colombia (1919-1933

    Directory of Open Access Journals (Sweden)

    Carlos Camacho Arango

    2018-05-01

    Full Text Available The article studies different aspects of mandatory military service in Peru and Colombia from 1919 to 1933 including recruitment; the social, “racial”, and geographical origins of soldiers; and army life in both countries. Documents from military archives in the U.S. and France, as well as writings from Peruvian and Colombian commissioned and non-commissioned officers were the main sources used. The method is comparative and it shows clear features in common, including the scarcity of resources that affected all aspects of service.

  19. Adoption of Lean Thinking and Service Improvement for Care Home Service

    OpenAIRE

    Chuang-Chun Chiou

    2014-01-01

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

  20. An urgent need to improve life conditions of seniors.

    Science.gov (United States)

    Hebert, R

    2010-10-01

    In the fall of 2007, the Government of Quebec set up a Public Consultation on Living Conditions of Seniors. Fifty sessions were held in 26 cities across all 17 regions of the province. More than 4000 seniors attended the sessions and 275 briefs were received from scientists and associations. Three themes were identified in the report published in 2008: supporting seniors and their caregivers, reinforcing the place of seniors in society, and preventing problems associated with aging (suicide, abuse, addictions). The main actions that I recommended included: Increasing the Guaranteed Income Supplement to prevent poverty; Modifying pension plans and working conditions to allow for progressive retirement; Making a major investment in home care to provide access to services regardless of place of residence; Introducing an Autonomy Support Benefit and autonomy insurance program for financing services to support people with disabilities; Generalizing an Integrated Service Delivery Network providing services to frail older people; Better training for professionals in gerontology. I also recommended setting up a National Policy on Seniors to align all government departments and agencies, municipalities and the private sector around a vision, objectives and a set of actions for improving the integration of seniors in an aging society. This would contribute to a more equitable, interdependent and wiser society. Unfortunately, the Government did not support these recommendations. It is now time for scientists to get involved in leading policy on seniors and in the political arena.

  1. Cost and impact of a quality improvement programme in mental health services.

    Science.gov (United States)

    Beecham, Jennifer; Ramsay, Angus; Gordon, Kate; Maltby, Sophie; Walshe, Kieran; Shaw, Ian; Worrall, Adrian; King, Sarah

    2010-04-01

    To estimate the cost and impact of a centrally-driven quality improvement initiative in four UK mental health communities. Total costs in year 1 were identified using documentation, a staff survey, semi-structured interviews and discussion groups. Few outcome data were collected within the programme so thematic analysis was used to identify the programme's impact within its five broad underlying principles. The survey had a 40% response. Total costs ranged between pound164,000 and pound458,000 per site, plus staff time spent on workstreams. There was a very hazy view of the resources absorbed and poor recording of expenditure and activity. The initiative generated little demonstrable improvements in service quality but some participants reported changes in attitudes. Given the difficult contexts, short time-scales and capacity constraints, the programme's lack of impact is not surprising. It may, however, represent a worthwhile investment in cultural change which might facilitate improvements in how services are delivered.

  2. PRECISE:PRivacy-prEserving Cloud-assisted quality Improvement Service in hEalthcare.

    Science.gov (United States)

    Chen, Feng; Wang, Shuang; Mohammed, Noman; Cheng, Samuel; Jiang, Xiaoqian

    2014-10-01

    Quality improvement (QI) requires systematic and continuous efforts to enhance healthcare services. A healthcare provider might wish to compare local statistics with those from other institutions in order to identify problems and develop intervention to improve the quality of care. However, the sharing of institution information may be deterred by institutional privacy as publicizing such statistics could lead to embarrassment and even financial damage. In this article, we propose a PRivacy-prEserving Cloud-assisted quality Improvement Service in hEalthcare (PRECISE), which aims at enabling cross-institution comparison of healthcare statistics while protecting privacy. The proposed framework relies on a set of state-of-the-art cryptographic protocols including homomorphic encryption and Yao's garbled circuit schemes. By securely pooling data from different institutions, PRECISE can rank the encrypted statistics to facilitate QI among participating institutes. We conducted experiments using MIMIC II database and demonstrated the feasibility of the proposed PRECISE framework.

  3. THE CONTRIBUTION OF THE FOREIGN LANGUAGES IN IMPROVING THE SERVICES IN HIGHER EDUCATION

    Directory of Open Access Journals (Sweden)

    Silaghi Simona

    2012-12-01

    Full Text Available In the eyes of the whole world, the European Union had and has a huge influence upon the economical, commercial, legal, social and cultural conditions of the member states and now it represents a reality and a certainty. In this society of globalization and technology the young generation plays an important role in building the Europe of tomorrow. Due to the political social and economic changes that have occurred in our lives in the recent decades doubled by the tremendous development of the digital technology the academic education must take important steps towards a united Europe, a unity achieved mainly through the means of education. “The best school is the one, where above all, you learn to learn” said the Romanian historian and philosopher Nicolae Iorga. Nowadays the best school gives students the opportunity to learn at least a foreign language, offering them the possibility of academic or professional mobility. Our paper aims to present the role of foreign languages in improving not only the students' quality of life but also the services in higher education.

  4. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Directory of Open Access Journals (Sweden)

    Sheila Cyril

    Full Text Available Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services.We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia.Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers.This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD

  5. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health

  6. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N

    2016-01-01

    Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services. We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure

  7. System-level change in mental health services in North Wales: An observational study using systems thinking.

    Science.gov (United States)

    Evans, S; Huxley, P J; Maxwell, N; Huxley, K L S

    2014-06-01

    To describe changes to mental health services using systems thinking. Structured standardized quality of life assessment (Manchester Short Quality of Life Assessment: MANSA) was used to establish service user priorities for changes to service provision (part of a process known as check in systems thinking). Current service performance in these priority areas was identified, and changes to service arrangements were planned, implemented and monitored by task and finish (T&F) groups (making use of a process known as flow in systems thinking). 81 MANSA assessments were completed at the check stage (by NM). Work finances and leisure activities emerged as service user priority areas for change, and T&F groups were established with representation of all sectors and service users. Ways to make improvements were observed, planned and implemented by T&F groups (the flow stage). The systems approach reveals how services and quality of life have been changed for patients in Wrexham. Further generalizable research is needed into the potential benefits of using systems thinking in mental health service evaluation. © The Author(s) 2013.

  8. Improving science literacy and education through space life sciences

    Science.gov (United States)

    MacLeish, M. Y.; Moreno, N. P.; Tharp, B. Z.; Denton, J. J.; Jessup, G.; Clipper, M. C.

    2001-01-01

    The National Space Biomedical Research Institute (NSBRI) encourages open involvement by scientists and the public at large in the Institute's activities. Through its Education and Public Outreach Program, the Institute is supporting national efforts to improve Kindergarten through grade twelve (K-12) and undergraduate education and to communicate knowledge generated by space life science research to lay audiences. Three academic institution Baylor College of Medicine, Morehouse School of Medicine and Texas A&M University are designing, producing, field-testing, and disseminating a comprehensive array of programs and products to achieve this goal. The objectives of the NSBRI Education and Public Outreach program are to: promote systemic change in elementary and secondary science education; attract undergraduate students--especially those from underrepresented groups--to careers in space life sciences, engineering and technology-based fields; increase scientific literacy; and to develop public and private sector partnerships that enhance and expand NSBRI efforts to reach students and families. c 2001. Elsevier Science Ltd. All rights reserved.

  9. Service quality that improves customer satisfaction in a university: a case study in Institut Teknologi Indonesia

    Science.gov (United States)

    Theresia, L.; Bangun, R.

    2017-12-01

    Universities should provide better service quality to get more customers. The purpose of this study was to find service quality which has impact on the increasing of customer satisfaction in a university. This study is a case study in Institut Teknologi Indonesia (ITI). The result of the study will help ITI to improve its service quality to increase customer satisfaction. This study employs path analysis technique. The data were collected through questionnaires developed from the literature. Questionnaires have two parts namely 1) service quality and 2) customer satisfaction. Service quality is measured through 22 questions with five service quality dimensions: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance and 5) Empathy. Customer Satisfaction is measured through 4 questions. The data then are processed by SPSS. The results showed that the students preferred to tangible quality improvement than intangible aspect.

  10. Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

    Science.gov (United States)

    McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

    2018-02-01

    Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ 2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ 2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ 2 used for the plate waste analysis. Significance was assessed at P<0.05. This study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0

  11. Accounting for ecosystem services in Life Cycle Assessment, Part II: toward an ecologically based LCA.

    Science.gov (United States)

    Zhang, Yi; Baral, Anil; Bakshi, Bhavik R

    2010-04-01

    Despite the essential role of ecosystem goods and services in sustaining all human activities, they are often ignored in engineering decision making, even in methods that are meant to encourage sustainability. For example, conventional Life Cycle Assessment focuses on the impact of emissions and consumption of some resources. While aggregation and interpretation methods are quite advanced for emissions, similar methods for resources have been lagging, and most ignore the role of nature. Such oversight may even result in perverse decisions that encourage reliance on deteriorating ecosystem services. This article presents a step toward including the direct and indirect role of ecosystems in LCA, and a hierarchical scheme to interpret their contribution. The resulting Ecologically Based LCA (Eco-LCA) includes a large number of provisioning, regulating, and supporting ecosystem services as inputs to a life cycle model at the process or economy scale. These resources are represented in diverse physical units and may be compared via their mass, fuel value, industrial cumulative exergy consumption, or ecological cumulative exergy consumption or by normalization with total consumption of each resource or their availability. Such results at a fine scale provide insight about relative resource use and the risk and vulnerability to the loss of specific resources. Aggregate indicators are also defined to obtain indices such as renewability, efficiency, and return on investment. An Eco-LCA model of the 1997 economy is developed and made available via the web (www.resilience.osu.edu/ecolca). An illustrative example comparing paper and plastic cups provides insight into the features of the proposed approach. The need for further work in bridging the gap between knowledge about ecosystem services and their direct and indirect role in supporting human activities is discussed as an important area for future work.

  12. Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality.

    Science.gov (United States)

    Bowblis, John R; Roberts, Amy Restorick

    2018-06-01

    Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.

  13. Listening to those on the frontline: service users' experiences of London tuberculosis services

    Directory of Open Access Journals (Sweden)

    Boudioni M

    2011-06-01

    Full Text Available Markella Boudioni, Susan McLaren, Ruth Belling, Leslie WoodsInstitute for Leadership and Service Improvement, Faculty of Health and Social Care, London South Bank University, London, UKAim: To explore tuberculosis (TB service users' experiences and satisfaction with care provision.Background: Thirty-nine percent of all new UK TB cases occur in London. Prevalence varies considerably between and within boroughs. Overall, research suggests inadequate control of London's TB transmission; TB has become a health care priority for all London Primary Care Trusts. Service users' experiences and satisfaction with care provision have not been explored adequately previously.Methods: A qualitative research design, using semi-structured face-to-face interviews was used. Ten service users, purposively selected in key risk groups across London, were interviewed. All interviews were digitally recorded with users' permission, transcribed verbatim, and analyzed thematically.Results: Participants were treated in local hospitals for 6–12 months. Treatment was administered by TB nurses to inpatients and outpatients receiving directly observed therapy in consultation with medical staff and home visits for complex cases. Two participants did not realize the importance of compliance. Overall, they were satisfied with many TB services' aspects, communication, and service organization. Early access, low suspicion index amongst some GPs, and restricted referral routes were identified as service barriers. Other improvement areas were information provision on drug side effects, diet, nutritional status, and a few health professionals' attitudes. The effects on people varied enormously from minimal impact to psychological shock; TB also affected social and personal aspects of their life. With regard to further support facilities, some positive views on managed accommodation by TB-aware professionals for those with accommodation problems were identified.Conclusion: This

  14. End-of-Life Care and Discussions in Japanese Geriatric Health Service Facilities: A Nationwide Survey of Managing Directors' Viewpoints.

    Science.gov (United States)

    Kanoh, Asako; Kizawa, Yoshiyuki; Tsuneto, Satoru; Yokoya, Shoji

    2018-01-01

    Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan. We conducted a nationwide cross-sectional survey by mailing questionnaires about EOL care and EOLDs to 3437 GHSF managing directors. The questionnaire was developed through a literature review and discussion among the researchers and experts. Descriptive statistics summarized the data. We also analyzed the factors related to GHSFs conducting EOLDs using Fisher exact tests. The response rate was 20.7% (713 of 3437). Among the respondents, 75.2% (536 of 713) of GHSFs provided EOL care and 73.1% (521 of 713) conducted EOLDs. The most common reasons for difficulties in providing EOL care included the lack of EOL education for nurses and care workers, and their fear about caring for dying residents. End-of-life discussions were mostly initiated after the deterioration of a resident's condition and were conducted with families by physicians. Statistically significant factors of GHSFs conducting EOLDs included providing EOL education for nurses and care workers, availability of private room for critically ill residents, emergency on-call doctors, and EOL care. Adequate practical staff education programs for EOL care including EOLDs may be crucial for quality of end-of-life care in aged care facilities.

  15. Proposition of Improved Methodology in Creep Life Extrapolation

    International Nuclear Information System (INIS)

    Kim, Woo Gon; Park, Jae Young; Jang, Jin Sung

    2016-01-01

    To design SFRs for a 60-year operation, it is desirable to have the experimental creep-rupture data for Gr. 91 steel close to 20 y, or at least rupture lives significantly higher than 10"5 h. This requirement arises from the fact that, for the creep design, a factor of 3 times for extrapolation is considered to be appropriate. However, obtaining experimental data close to 20 y would be expensive and also take considerable time. Therefore, reliable creep life extrapolation techniques become necessary for a safe design life of 60 y. In addition, it is appropriate to obtain experimental longterm creep-rupture data in the range 10"5 ∼ 2x10"5 h to improve the reliability of extrapolation. In the present investigation, a new function of a hyperbolic sine ('sinh') form for a master curve in time-temperature parameter (TTP) methods, was proposed to accurately extrapolate the long-term creep rupture stress of Gr. 91 steel. Constant values used for each parametric equation were optimized on the basis of the creep rupture data. Average stress values predicted for up to 60 y were evaluated and compared with those of French Nuclear Design Code, RCC-MRx. The results showed that the master curve of the 'sinh' function was a wider acceptance with good flexibility in the low stress ranges beyond the experimental data. It was clarified clarified that the 'sinh' function was reasonable in creep life extrapolation compared with polynomial forms, which have been used conventionally until now.

  16. Proposition of Improved Methodology in Creep Life Extrapolation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo Gon; Park, Jae Young; Jang, Jin Sung [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    To design SFRs for a 60-year operation, it is desirable to have the experimental creep-rupture data for Gr. 91 steel close to 20 y, or at least rupture lives significantly higher than 10{sup 5} h. This requirement arises from the fact that, for the creep design, a factor of 3 times for extrapolation is considered to be appropriate. However, obtaining experimental data close to 20 y would be expensive and also take considerable time. Therefore, reliable creep life extrapolation techniques become necessary for a safe design life of 60 y. In addition, it is appropriate to obtain experimental longterm creep-rupture data in the range 10{sup 5} ∼ 2x10{sup 5} h to improve the reliability of extrapolation. In the present investigation, a new function of a hyperbolic sine ('sinh') form for a master curve in time-temperature parameter (TTP) methods, was proposed to accurately extrapolate the long-term creep rupture stress of Gr. 91 steel. Constant values used for each parametric equation were optimized on the basis of the creep rupture data. Average stress values predicted for up to 60 y were evaluated and compared with those of French Nuclear Design Code, RCC-MRx. The results showed that the master curve of the 'sinh' function was a wider acceptance with good flexibility in the low stress ranges beyond the experimental data. It was clarified clarified that the 'sinh' function was reasonable in creep life extrapolation compared with polynomial forms, which have been used conventionally until now.

  17. Analytical Method to Estimate Fatigue Life Time Duration in Service for Runner Blade Mechanism of Kaplan Turbines

    Directory of Open Access Journals (Sweden)

    Ana – Maria Budai

    2010-10-01

    Full Text Available The paper present an analytical method that can be used to determianted fatigue life time duration in service for runner blade mechanism of Kaplan turbines. The study was made for lever button of runer blade mechanism using two analytical relation to calculate the maximum number of stress cycles whereupon the mechanism work without any damage. To estimate fatigue life time duration will be used a formula obtained from one of most comon cumulative damage methodology taking in consideration the real exploatation conditions of a specified Kapaln turbine.

  18. Durapgulf, a local service life model for the durability of concrete structures in the South of Iran

    International Nuclear Information System (INIS)

    Shekarchi, M.; Ghods, P.; Alizadeh, R.; Chini, M.; Hoseini, M.

    2008-01-01

    Reinforced concrete structures were widely constructed in the south of Iran for the infrastructures of ports and oil exploration. Unfortunately, the deterioration of concrete structures in this marine area, which is mainly due to the chloride-induced corrosion of rebars in concrete, imposes hundreds of millions dollars of repair cost every year. During the last decades, extensive studies have been conducted to evaluate the effect of different parameters on chloride diffusion into concrete, corrosion initiation, and its propagation. In order to predict the time required for various steps of the corrosion phenomena, many numerical models have been developed. In this paper, development of Durapgulf (a service of life design model), which can predict the corrosion initiation of reinforced concrete (RC) structures in the south of Iran, is described and also the application of this model for service life design of RC structures is demonstrated in a hypothetical example and verified with other experimental results in this region. (author)

  19. Using a service sector segmented approach to identify community stakeholders who can improve access to suicide prevention services for veterans.

    Science.gov (United States)

    Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda

    2014-04-01

    Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  20. QUALITY MANAGEMENT TOOLS APPLYING IN THE STRATEGY OF LOGISTICS SERVICES QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Agnieszka Czajkowska

    2015-11-01

    Full Text Available Combination of factors such as: properly organized logistics process, lack of nonconformities, transport damages avoiding and transport in accordance Just In Time idea significantly reduces costs and streamlines the entire production process. This paper proposes the quality management tool for the logistics services assessment based on the results obtained in the selected company operating in Eastern Europe. Customers’ expectations and perceptions were compared using the SERVQUAL method that concerns the service quality assessment in five areas such as: materiality, reliability, promptness, competency and empathy. The research method SERVQUAL allows assessing the service quality level and identifying company areas that requires corrective actions within the improvement process.