EPA Facility Registry Service (FRS): RCRA_LQG

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): AIRS_AFS

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U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): RCRA_TRANS

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U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): PCS_NPDES

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U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): CERCLIS_NPL

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that are...

EPA Facility Registry Service (FRS): AIRS_AQS

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U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): ACRES

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of sites that link to...

EPA Facility Registry Service (FRS): Facility Interests Dataset Download

Data.gov (United States)

U.S. Environmental Protection Agency — This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are...

16 CFR 240.7 - Services or facilities.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Services or facilities. 240.7 Section 240.7 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR ADVERTISING ALLOWANCES AND OTHER MERCHANDISING PAYMENTS AND SERVICES § 240.7 Services or facilities. The terms services...

EPA Facility Registry Service (FRS): AIRS_AFS Sub Facilities

Data.gov (United States)

U.S. Environmental Protection Agency — The Air Facility System (AFS) contains compliance and permit data for stationary sources regulated by EPA, state and local air pollution agencies. The sub facility...

EPA Facility Registry Service (FRS): OIL

Data.gov (United States)

U.S. Environmental Protection Agency — This dataset contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Oil...

EPA Facility Registry Service (FRS): RCRA_INACTIVE

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of hazardous waste...

EPA Facility Registry Service (FRS): RCRA_ACTIVE

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of active hazardous...

EPA Facility Registry Service (FRS): RCRA_TSD

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of Hazardous Waste...

Lambdastation: a forwarding and admission control service to interface production network facilities with advanced research network paths

Energy Technology Data Exchange (ETDEWEB)

DeMar, Philip; Petravick, Don; /Fermilab

2004-12-01

Over the past several years, there has been a great deal of research effort and funding put into the deployment of optical-based, advanced technology wide-area networks. Fermilab and CalTech have initiated a project to enable our production network facilities to exploit these advanced research network facilities. Our objective is to forward designated data transfers across these advanced wide area networks on a per-flow basis, making use our capacious production-use storage systems connected to the local campus network. To accomplish this, we intend to develop a dynamically provisioned forwarding service that would provide alternate path forwarding onto available wide area advanced research networks. The service would dynamically reconfigure forwarding of specific flows within our local production-use network facilities, as well as provide an interface to enable applications to utilize the service. We call this service LambdaStation. If one envisions wide area optical network paths as high bandwidth data railways, then LambdaStation would functionally be the railroad terminal that regulates which flows at the local site get directed onto the high bandwidth data railways. LambdaStation is a DOE-funded SciDac research project in its very early stage of development.

EPA Facility Registry Service (FRS): PCS_NPDES_MAJOR

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that are...

EPA Facility Registry Service (FRS): AIRS_AFS_MAJOR

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

Service quality for facilities management in hospitals

CERN Document Server

Sui Pheng, Low

2016-01-01

This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...

EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet Download

Data.gov (United States)

U.S. Environmental Protection Agency — This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are...

The Relative Patient Costs and Availability of Dental Services, Materials and Equipment in Public Oral Care Facilities in Tanzania.

OpenAIRE

Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J

2015-01-01

Background Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. Methods A survey of all dis...

The keys to CERN conference rooms - Managing local collaboration facilities in large organisations

International Nuclear Information System (INIS)

Baron, T; Domaracky, M; Duran, G; Fernandes, J; Ferreira, P; Lopez, J B Gonzalez; Jouberjean, F; Lavrut, L; Tarocco, N

2014-01-01

For a long time HEP has been ahead of the curve in its usage of remote collaboration tools, like videoconference and webcast, while the local CERN collaboration facilities were somewhat behind the expected quality standards for various reasons. This time is now over with the creation by the CERN IT department in 2012 of an integrated conference room service which provides guidance and installation services for new rooms (either equipped for videoconference or not), as well as maintenance and local support. Managing now nearly half of the 246 meeting rooms available on the CERN sites, this service has been built to cope with the management of all CERN rooms with limited human resources. This has been made possible by the intensive use of professional software to manage and monitor all the room equipment, maintenance and activity. This paper focuses on presenting these packages, either off-the-shelf commercial products (asset and maintenance management tool, remote audio-visual equipment monitoring systems, local automation devices, new generation touch screen interfaces for interacting with the room) when available or locally developed integration and operational layers (generic audio-visual control and monitoring framework) and how they help overcoming the challenges presented by such a service. The aim is to minimise local human interventions while preserving the highest service quality and placing the end user back in the centre of this collaboration platform.

Analysis of Student Satisfaction Toward Quality of Service Facility

Science.gov (United States)

Napitupulu, D.; Rahim, R.; Abdullah, D.; Setiawan, MI; Abdillah, LA; Ahmar, AS; Simarmata, J.; Hidayat, R.; Nurdiyanto, H.; Pranolo, A.

2018-01-01

The development of higher education is very rapid rise to the tight competition both public universities and private colleges. XYZ University realized to win the competition, required continuous quality improvement, including the quality of existing service facilities. Amenities quality services is believed to support the success of the learning activities and improve user satisfaction. This study aims to determine the extent to which the quality of the services effect on user satisfaction. The research method used is survey-based questionnaire that measure perception and expectation. The results showed a gap between perception and expectations of the respondents have a negative value for each item. This means XYZ service facility at the university is not currently meet the expectations of society members. Three service facility that has the lowest index is based on the perception of respondents is a laboratory (2.56), computer and multimedia (2.63) as well as wifi network (2.99). The magnitude of the correlation between satisfaction with the quality of service facilities is 0.725 which means a strong and positive relationship. The influence of the quality of service facilities to the satisfaction of the students is 0.525 meaning that the variable quality of the services facility can explain 52.5% of the variable satisfaction. The study provided recommendations for improvements to enhance the quality of services facility at the XYZ university facilities.

Political economy of decentralising HIV and AIDS treatment services to primary healthcare facilities in three Nigerian states.

Science.gov (United States)

Mbachu, Chinyere; Onwujekwe, Obinna; Ezumah, Nkoli; Ajayi, Olayinka; Sanwo, Olusola; Uzochukwu, Benjamin

2016-09-01

Decentralisation is defined as the dispersion, distribution or transfer of resources, functions and decision-making power from a central authority to regional and local authorities. It is usually accompanied by assignment of accountability and responsibility for results. Fundamental to understanding decentralisation is learning what motivates central governments to give up power and resources to local governments, and the practical significance of this on their positions regarding decentralisation. This study examined key political and institutional influences on role-players' capacity to support decentralisation of HIV and AIDS treatment services to primary healthcare facilities, and implications for sustainability. In-depth interviews were conducted with 55 purposively selected key informants, drawn from three Nigerian states that were at different stages of decentralising HIV and AIDS treatment services to primary care facilities. Key informants represented different categories of role-players involved in HIV and AIDS control programmes. Thematic framework analysis of data was done. Support for decentralisation of HIV and AIDS treatment services to primary healthcare facilities was substantial among different categories of actors. Political factors such as the local and global agenda for health, political tenure and party affiliations, and institutional factors such as consolidation of decision-making power and improvements in career trajectories, influenced role-players support for decentralisation of HIV and AIDS treatment services. It is feasible and acceptable to decentralise HIV and AIDS treatment services to primary healthcare facilities, to help improve coverage. However, role-players' support largely depends on how well the reform aligns with political structures and current institutional practices.

EPA Facility Registry Service (FRS): ER_TRI

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): ER_TSCA

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): ER_RMP

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): ER_RCRATSD

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): ER_EPLAN

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

EPA Facility Registry Service (FRS): ER_CERCLIS

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

Analyzing the equity of public primary care provision in Kenya: variation in facility characteristics by local poverty level

Directory of Open Access Journals (Sweden)

Toda Mitsuru

2012-12-01

Full Text Available Abstract Introduction Equitable access to health care is a key health systems goal, and is a particular concern in low-income countries. In Kenya, public facilities are an important resource for the poor, but little is known on the equity of service provision. This paper assesses whether poorer areas have poorer health services by investigating associations between public facility characteristics and the poverty level of the area in which the facility is located. Methods Data on facility characteristics were collected from a nationally representative sample of public health centers and dispensaries across all 8 provinces in Kenya. A two-stage cluster randomized sampling process was used to select facilities. Univariate associations between facility characteristics and socioeconomic status (SES of the area in which the facility was located were assessed using chi-squared tests, equity ratios and concentration indices. Indirectly standardized concentration indices were used to assess the influence of SES on facility inputs and service availability while controlling for facility type, province, and remoteness. Results For most indicators, we found no indication of variation by SES. The clear exceptions were electricity and laboratory services which showed evidence of pro-rich inequalities, with equity ratios of 3.16 and 3.43, concentration indices of 0.09 (p Conclusions The paper shows how local area poverty data can be combined with national health facility surveys, providing a tool for policy makers to assess the equity of input and service availability. There was little evidence of inequalities for most inputs and services, with the clear exceptions of electricity and laboratory services. However, efforts are required to improve the availability of key inputs and services across public facilities in all areas, regardless of SES.

Assessment Of The Location And Availability Of Public Facilities And Services In Port Harcourt Metropolis In Rivers State Nigeria

Directory of Open Access Journals (Sweden)

Eyenghe Tari

2015-06-01

Full Text Available ABSTRACT The continues increase in both urban and rural population has birthed the problem of inadequate availability of facilities and social services thus giving rise to social disparity and unequal access to basic facilities and services by people of the same population spectrum. Consequently the problem of social disparity inequality is on the increase and is gaining global and local attention. Despite the efforts of government to combat this social problem it is still raising its head in form of unequal access to educational facilities heath care good roads emergency services and etcetera. Hence the study was intended to ascertain whether or not there is disparity in distribution and access to facilities and services by assessing facilities and services in Port Harcourt City. The study adopted the simple random technique for data collection. Also primary and secondary data were the major data collected with the use of closed ended structured questionnaire. However the result of the study showed that income formed a major determining factor in the distribution of facilities and services in Port Harcourt while population threshold was not considered significantly in the study area. However the study revealed that there is gap in the distribution of facilities and services in Port Harcourt City. The recommendations included the involvement of the citizens at grass root in decision making facilities and services should be provided with respect to actual population on ground income level should not determine facilities and service distribution. The study concluded that there is disparity and unequal access in the distribution of social services and facilities.

The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

Directory of Open Access Journals (Sweden)

Jeannie Samuel

2016-12-01

Full Text Available Background and objective: Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design: Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results: Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions: Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women

The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

Science.gov (United States)

Samuel, Jeannie

2016-01-01

Background and objective Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP) that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women themselves, can play an

47 CFR 69.106 - Local switching.

Science.gov (United States)

2010-10-01

... foreign services that use local exchange switching facilities. (c) If end users of an interstate or... local exchange carriers shall establish rate elements for local switching as follows: (1) Price cap... use local exchange switching facilities for the provision of interstate or foreign services. The...

Design Criteria: School Food Service Facilities.

Science.gov (United States)

Florida State Dept. of Education, Tallahassee.

This guide is intended for architects, district superintendents, and food service directors whose responsibility it is to plan food service facilities. It first discusses the factors to be considered in food service planning, presents cost studies, and lists the responsibilities of those involved in the planning. Other sections concern selection,…

Site and facility transportation services planning documents

Energy Technology Data Exchange (ETDEWEB)

Ratledge, J.E. (Oak Ridge National Lab., TN (USA)); Danese, L.; Schmid, S. (Science Applications International Corp., Oak Ridge, TN (USA))

1990-01-01

The Office of Civilian Radioactive Waste Management (OCRWM) will eventually ship Purchasers' (10 CFR 961.3) spent nuclear fuel from approximately 122 commercial nuclear facilities. The preparation and processing of Site and Facility Specific Transportation Services Planning Documents (SPDs) and Site Specific Servicing Plans (SSSPs) provides a focus for advanced planning and the actual shipping of waste, as well as the overall development of transportation requirements for the waste transportation system. SPDs will be prepared for each of the affected nuclear waste facilities over the next 2 years with initial emphasis on facilities likely to be served during the earliest years of the Federal Waste Management System (FWMS) operations. 3 figs., 1 tab.

Site and facility transportation services planning documents

International Nuclear Information System (INIS)

Ratledge, J.E.; Danese, L.; Schmid, S.

1990-01-01

The Office of Civilian Radioactive Waste Management (OCRWM) will eventually ship Purchasers' (10 CFR 961.3) spent nuclear fuel from approximately 122 commercial nuclear facilities. The preparation and processing of Site and Facility Specific Transportation Services Planning Documents (SPDs) and Site Specific Servicing Plans (SSSPs) provides a focus for advanced planning and the actual shipping of waste, as well as the overall development of transportation requirements for the waste transportation system. SPDs will be prepared for each of the affected nuclear waste facilities over the next 2 years with initial emphasis on facilities likely to be served during the earliest years of the Federal Waste Management System (FWMS) operations. 3 figs., 1 tab

EPA Linked Open Data: Facility Registry Service

Data.gov (United States)

U.S. Environmental Protection Agency — The Facility Registry Service (FRS) identifies facilities, sites, or places subject to environmental regulation or of environmental interest to EPA programs or...

Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

Directory of Open Access Journals (Sweden)

Aveledi Blandine

2009-12-01

Full Text Available Abstract Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC. Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC and family planning (FP. Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive. Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1 providing necessary equipment and renovations to health facilities; 2 improving supply management systems; 3 providing comprehensive competency

Congestion Service Facilities Location Problem with Promise of Response Time

Directory of Open Access Journals (Sweden)

Dandan Hu

2013-01-01

Full Text Available In many services, promise of specific response time is advertised as a commitment by the service providers for the customer satisfaction. Congestion on service facilities could delay the delivery of the services and hurts the overall satisfaction. In this paper, congestion service facilities location problem with promise of response time is studied, and a mixed integer nonlinear programming model is presented with budget constrained. The facilities are modeled as M/M/c queues. The decision variables of the model are the locations of the service facilities and the number of servers at each facility. The objective function is to maximize the demands served within specific response time promised by the service provider. To solve this problem, we propose an algorithm that combines greedy and genetic algorithms. In order to verify the proposed algorithm, a lot of computational experiments are tested. And the results demonstrate that response time has a significant impact on location decision.

The keys to CERN conference rooms - Managing local collaboration facilities in large organisations

CERN Multimedia

Baron, T; Duran, G; Correia Fernandes, J; Ferreira, P; Gonzalez Lopez, J B; Jouberjean, F; Lavrut, L; Tarocco, N

2013-01-01

For a long time HEP has been ahead of the curve in its usage of remote collaboration tools, like videoconference and webcast, while the local CERN collaboration facilities were somewhat behind the expected quality standards for various reasons. This time is now over with the creation by the CERN IT department in 2012 of an integrated conference room service which provides guidance and installation services for new rooms (either equipped for video-conference or not), as well as maintenance and local support. Managing now nearly half of the 250 meeting rooms available on the CERN sites, this service has been built to cope with the management of all CERN rooms with limited human resources. This has been made possible by the intensive use of professional software to manage and monitor all the room equipment, maintenance and activity. This paper will focus on presenting these packages, either off-the-shelf commercial products (asset and maintenance management tool, remote audiovisual equipment monitoring systems, ...

Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.

Science.gov (United States)

Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard

2016-01-01

This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.

EPA Facility Registry Service (FRS): ALL FRS INTERESTS LAYER

Data.gov (United States)

U.S. Environmental Protection Agency — This data provides location and attribute information on all facilities in EPA's Facility Registry Service (FRS) for a internet web feature service . The FRS is an...

Wireless local network architecture for Naval medical treatment facilities

OpenAIRE

Deason, Russell C.

2004-01-01

Approved for public release; distribution is unlimited In today's Navy Medicine, an approach towards wireless networks is coming into view. The idea of developing and deploying workable Wireless Local Area Networks (WLAN) throughout Naval hospitals is but just a few years down the road. Currently Naval Medical Treatment Facilities (MTF) are using wired Local Area Networks (LANs) throughout the infrastructure of each facility. Civilian hospitals and other medical treatment facilities have b...

Optimal pricing policies for services with consideration of facility maintenance costs

Science.gov (United States)

Yeh, Ruey Huei; Lin, Yi-Fang

2012-06-01

For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.

Site and facility waste transportation services planning documents

International Nuclear Information System (INIS)

Ratledge, J.E.; Schmid, S.; Danese, L.

1991-01-01

The Office of Civilian Radioactive Waste Management (OCRWM) will eventually ship Purchasers' (10 CFR 961.3) spent nuclear fuel from approximately 122 commercial nuclear facilities. The preparation and maintenance of Site- and Facility-Specific Transportation Services Planning Documents (SPDs) and Site-Specific Servicing Plans (SSSPs) provides a focus for advanced planning and the actual shipping of waste, as well as the overall development of transportation requirements for the waste transportation system. SPDs will be prepared for each of the affected nuclear waste facilities, with initial emphasis on facilities likely to be served during the earliest years of the Federal Waste Management System (FWMS) operations

Healthcare facility commissioning – the transition of clinical services

CSIR Research Space (South Africa)

Van der Watt, R

2016-07-01

Full Text Available structure of bricks and mortar into a functional facility with staff, equipment, medication, supplies, etc. ready to eventually receive patients who need care and cure. Beyond these tangible elements, there are also many intangibles which are required, e... in order for the new facility to deliver the intended clinical services. These include links to the emergency services which brings patients in need of emergency care to the facility, links to other healthcare facilities for more specialized care...

Consumer satisfaction with the services of prosthetics and orthotics facilities

NARCIS (Netherlands)

Bosmans, Joline; Geertzen, Jan; Dijkstra, Pieter U.

2009-01-01

Consumer satisfaction with the services provided in a prosthetics and orthotics (PO) facility has seldom been studied. The aim of this study was to analyze consumer satisfaction regarding the services provided by 15 PO facilities in The Netherlands. Consumers (n=1,364) of these PO facilities who

Facility Service Market an European Overview based on EU Statistics

Directory of Open Access Journals (Sweden)

Alexander Redlein

2017-01-01

Full Text Available The macro-economic impact of facility management and facility services in special was not scientifically analysed by now. Some studies analysed single countries but were mainly lacking solid data. Especially a Pan European comparison is lacking. This paper presents the results of an in depth analysis of the Eurostat figures. It compares the facility service industry with other industries in particular the construction industry. It also compares the largest European economies (Germany, France and Italy. The study concentrates on the outsourced services only, as these are listed in the European Statistics. The results show big differences between the European countries. It also highlights that the facility service industry is the third largest regarding number of employees and the fourth largest regarding value added.

EPA Facility Registry Service (FRS): ER_WWTP_NPDES

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of Waste Water Treatment...

Cryogenic technology review of cold neutron source facility for localization

Energy Technology Data Exchange (ETDEWEB)

Lee, Hun Cheol; Park, D. S.; Moon, H. M.; Soon, Y. P. [Daesung Cryogenic Research Institute, Ansan (Korea); Kim, J. H. [United Pacific Technology, Inc., Ansan (Korea)

1998-02-01

This Research is performed to localize the cold neutron source(CNS) facility in HANARO and the report consists of two parts. In PART I, the local and foreign technology for CNS facility is investigated and examined. In PART II, safety and licensing are investigated. CNS facility consists of cryogenic and warm part. Cryogenic part includes a helium refrigerator, vacuum insulated pipes, condenser, cryogenic fluid tube and moderator cell. Warm part includes moderator gas control, vacuum equipment, process monitoring system. Warm part is at high level as a result of the development of semiconductor industries and can be localized. However, even though cryogenic technology is expected to play a important role in developing the 21st century's cutting technology, it lacks of specialists and the research facility since the domestic market is small and the research institutes and government do not recognize the importance. Therefore, it takes a long research time in order to localize the facility. The safety standard of reactor for hydrogen gas in domestic nuclear power regulations is compared with that of the foreign countries, and the licensing method for installation of CNS facility is examined. The system failure and its influence are also analyzed. 23 refs., 59 figs., 26 tabs. (Author)

Consumer satisfaction with the services of prosthetics and orthotics facilities.

Science.gov (United States)

Bosmans, Joline; Geertzen, Jan; Dijkstra, Pieter U

2009-03-01

Consumer satisfaction with the services provided in a prosthetics and orthotics (P&O) facility has seldom been studied. The aim of this study was to analyze consumer satisfaction regarding the services provided by 15 P&O facilities in The Netherlands. Consumers (n = 1,364) of these P&O facilities who were fitted with a prosthesis, orthopaedic shoes, an orthosis, or another device, were asked to rate the overall services provided and whether they were satisfied with the device provided and its delivery time. Additionally, they filled in a modified SERVQUAL questionnaire (see Appendix). Consumers gave the service provided by P&O facilities a mean overall rating of 8.1. The highest ratings were given by consumers fitted with a prosthesis (mean overall rating of services: 8.4). In total, 78% of the consumers were satisfied with the device provided and 93% with the delivery time. The results of our study showed that, on the SERVQUAL, 50% of the statements fulfilled the criteria for a satisfactory quality of the services. The overall consumer rating of the service provided by P&O facilities is high and depends on the device provided. The outcomes on the SERVQUAL were moderate. In future, it is important to study consumer satisfaction more extensively in order to improve the quality of P&O services in daily practice. Additionally, specific questionnaires need to be developed to measure all aspects of prosthetic and orthotic care, with the aim to improve the services.

Small and Home-Based Businesses: Measures of Success and the Contribution of Local Development Services

Science.gov (United States)

Brooks, Lara; Whitacre, Brian; Shideler, Dave; Muske, Glenn; Woods, Mike

2012-01-01

Small and home-based businesses have long been identified by Extension educators as an important component of economic development, particularly in rural areas. The services available to these businesses can take many forms, including management training, accessibility of local funding, providing incubation facilities, or setting up mentoring…

The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

Science.gov (United States)

Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J

2015-07-01

Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.

Innovation Sources and Role of ICT in Facilities Services

DEFF Research Database (Denmark)

Scupola, Ada; Holzweber, Markus; Tuunainen, VK.

2010-01-01

structured interviews with main actors in the facilities management market. Our main finding is that facilities services innovation is mainly driven by management. However, employees also contribute to innovation. Customers have also a role in co-creation and as customer pull, even though these roles seem......In this paper, we investigate innovation sources in facilities services and the role that ICT has in supporting such innovation processes. Based on literature review, we propose a conceptual framework, which is then used to analyze empirical data. The empirical data was collected through seven semi...

A data skimming service for locally resident analysis data

International Nuclear Information System (INIS)

Cranshaw, J; Gieraltowski, J; Malon, D; May, E; Gardner, R W; Mambelli, M

2008-01-01

A Data Skimming Service (DSS) is a site-level service for rapid event filtering and selection from locally resident datasets based on metadata queries to associated 'tag' databases. In US ATLAS, we expect most if not all of the AOD-based datasets to be replicated to each of the five Tier 2 regional facilities in the US Tier 1 'cloud' coordinated by Brookhaven National Laboratory. Entire datasets will consist of on the order of several terabytes of data, and providing easy, quick access to skimmed subsets of these data will be vital to physics working groups. Typically, physicists will be interested in portions of the complete datasets, selected according to event-level attributes (number of jets, missing Et, etc) and content (specific analysis objects for subsequent processing). In this paper we describe methods used to classify data (metadata tag generation) and to store these results in a local database. Next we discuss a general framework which includes methods for accessing this information, defining skims, specifying event output content, accessing locally available storage through a variety of interfaces (SRM, dCache/dccp, gridftp), accessing remote storage elements as specified, and user job submission tools through local or grid schedulers. The advantages of the DSS are the ability to quickly 'browse' datasets and design skims, for example, pre-adjusting cuts to get to a desired skim level with minimal use of compute resources, and to encode these analysis operations in a database for re-analysis and archival purposes. Additionally the framework has provisions to operate autonomously in the event that external, central resources are not available, and to provide, as a reduced package, a minimal skimming service tailored to the needs of small Tier 3 centres or individual users

Public-private partnerships (PPPs) in local services

DEFF Research Database (Denmark)

Carpintero, Samuel; Petersen, Ole Helby

2016-01-01

Local governments are increasingly utilising the public–private partnership (PPP) model as a means of organising service delivery in the public–private domain. This article examines the experiences with construction and operation of 131 PPP wastewater treatment plants in the region of Aragon, Spain...... to the complexity of implementing the projects. The findings contribute to the literature on local service delivery and provide insights regarding risk transfer in long-term PPP contracts for the delivery of local services in general and water services in particular....

Electron Microscopy Facility for Research and Services in the Malaysian Nuclear Agency towards TSO

International Nuclear Information System (INIS)

Nadira Kamarudin; Mohd Bin Harun; Zaiton Selamat

2011-01-01

Scanning Electron Microscope FEI-Quanta 400 (SEM) made in the USA was commissioned in late 2003. This equipment is used in many areas of materials science, metallurgy, engineering, electronics, medicine, agriculture, biology and so on. This facility has helped the researchers in conducting research in their respective fields as well have been providing services to agencies, institutions, industries and local industry. Since 2004, there were 81 projects and 5000 samples analyzed using this facility in Malaysian Nuclear Agency, while 23 companies and 900 samples were from various agencies. In addition, revenue derived from these services has able to provide for the maintenance of this equipment. SEM is an important step in the nuclear material testing process. Nuclear material can be inspected for its performance by getting information from its morphology micrograph by using SEM. It opens up a whole new world that is unseen by the naked eye. (author)

Anesthetic equipment, facilities and services available for pediatric ...

African Journals Online (AJOL)

Background: Facilities and equipment are known to contribute to improved patient care and outcome. Hospitals for sub‑specialized pediatric anesthetic service are routinely available worldwide. In Nigeria, such hospitals now exist. It is therefore relevant to study the facilities and equipment available for pediatric anesthetic ...

Quality of the delivery services in health facilities in Northern Ethiopia.

Science.gov (United States)

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-03-09

Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.

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

OpenAIRE

Paudyal, Manoj; Acharya, Saroj

2015-01-01

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

E-government Facilities Analysis for Public Services in Higher Education

Science.gov (United States)

Astawa, I. P. M.; Dewi, K. C.

2018-01-01

E-Government in higher education can be utilized in order to provide public services to stakeholders both internal and external. The research objectives is to analyze the e-government facilities for public services in higher education. The research began by reviewing the concept of public services and e-government, then continued by analysing e-government facilities based on the E-Government Maturity Level developed by Wirtz and Piehler. The research subject was the e-government website of three universities that ranked the top three of webometrics version (Indonesia country rank), while the research object was e-government facilities for public services. Data collection was done by observing e-government sites via online browsing. The research’s results indicated that all three e-government sites have met four e-government business model and provided e-government services in line with the fourth stage on the e-government development stage. It can concluded that the three universities have achieved e-government maturity at the fourth level.

Evaluating Commercial and Private Cloud Services for Facility-Scale Geodetic Data Access, Analysis, and Services

Science.gov (United States)

Meertens, C. M.; Boler, F. M.; Ertz, D. J.; Mencin, D.; Phillips, D.; Baker, S.

2017-12-01

UNAVCO, in its role as a NSF facility for geodetic infrastructure and data, has succeeded for over two decades using on-premises infrastructure, and while the promise of cloud-based infrastructure is well-established, significant questions about suitability of such infrastructure for facility-scale services remain. Primarily through the GeoSciCloud award from NSF EarthCube, UNAVCO is investigating the costs, advantages, and disadvantages of providing its geodetic data and services in the cloud versus using UNAVCO's on-premises infrastructure. (IRIS is a collaborator on the project and is performing its own suite of investigations). In contrast to the 2-3 year time scale for the research cycle, the time scale of operation and planning for NSF facilities is for a minimum of five years and for some services extends to a decade or more. Planning for on-premises infrastructure is deliberate, and migrations typically take months to years to fully implement. Migrations to a cloud environment can only go forward with similar deliberate planning and understanding of all costs and benefits. The EarthCube GeoSciCloud project is intended to address the uncertainties of facility-level operations in the cloud. Investigations are being performed in a commercial cloud environment (Amazon AWS) during the first year of the project and in a private cloud environment (NSF XSEDE resource at the Texas Advanced Computing Center) during the second year. These investigations are expected to illuminate the potential as well as the limitations of running facility scale production services in the cloud. The work includes running parallel equivalent cloud-based services to on premises services and includes: data serving via ftp from a large data store, operation of a metadata database, production scale processing of multiple months of geodetic data, web services delivery of quality checked data and products, large-scale compute services for event post-processing, and serving real time data

Consumer Response to Gastrointestinal Illness Perceived To Originate from Food Service Facilities.

Science.gov (United States)

Garnett, Erin S; Gretsch, Stephanie R; Null, Clair; Moe, Christine L

2016-10-01

Consumer responses to food product recalls have been documented, but there is little information on how consumers respond to illnesses or outbreaks associated with food service facilities. This study uses an on-line survey of 885 adults conducted in 2012 to determine how respondents changed their dining behavior following personal experiences with and secondhand reports of gastrointestinal illness believed to be associated with food service facilities. In response to personally experiencing gastrointestinal illness that they attributed to a food service facility, 90% of survey participants reported that they avoided the implicated facility for a time following the incident; almost one-half decided to never return to the facility they believed had made them ill. In response to a secondhand report of gastrointestinal illness, 86% of respondents reported they would avoid the implicated facility for a time, and 22% said they would never return to the facility. After both personal experiences of illness and secondhand reports of illness, consumer responses were significantly more severe toward the implicated facility than toward all other food service facilities. Frequent diners avoided facilities for shorter periods of time and were less likely to never go back to a facility than were infrequent diners. The survey results indicate that 24 to 97 fewer meals were purchased per respondent, or a 11 to 20% reduction in meals purchased outside the home, in the year following respondents' illness. Future estimates of the economic burden of foodborne illnesses, including those caused by noroviruses, should consider the impacts on the food service industry attributable to changes in consumer behavior, in addition to health care costs and loss of productivity.

Pricing local distribution services in a competitive market

International Nuclear Information System (INIS)

Duann, D.J.

1995-12-01

Unbundling and restructuring of local distribution services is the focus of the natural gas industry. As a result of regulatory reforms, a competitive local distribution market has emerged, and the validity of traditional cost-based regulation is being questioned. One alternative is to completely unbundle local distribution services and transform the local distribution company into a common carrier for intrastate transportation services. Three kinds of alternative pricing mechanisms are examined. For firm intrastate transportation services, cost-based pricing is the preferred method unless it can be shown that a competitive secondary market can be established and maintained. Pricing interruptible transportation capacity is discussed

Local control unit for ITER-India gyrotron test facility (IIGTF)

Energy Technology Data Exchange (ETDEWEB)

Rathod, Vipal, E-mail: vipal.rathod@iter-india.org; Shah, Ronak; Mandge, Deepak; Parmar, Rajvi; Rao, S.L.

2016-11-15

Highlights: • A dedicated full scale ITER prototype Local Control Unit for ITER-India Gyrotron test facility. • National Instruments® make PXIe system for real time control & data acquisition and Siemens® PLC for sequence control function. • Hardwired FPGA based fast protection interlock system. • High speed analog fiber optical transmission link using V/F and F/V technique. • Software framework based on LabVIEW™ platform and ITER CODAC Core System. - Abstract: Electron Cyclotron system on ITER, is one of the important RF ancillary systems based on high power Gyrotron RF sources, that is used for plasma heating and current drive applications. To operate a Gyrotron source, various auxiliary systems and services such as Super Conducting Magnet set, High Voltage Power Supplies, Auxiliary Power Supplies, Waveguide components, Cooling water system and a Local Control Unit (LCU) are required. The LCU plays a very crucial role for the safe and reliable operation of Gyrotron system. A dedicated full scale ITER prototype LCU is being developed for testing and commissioning of an ITER like Test Gyrotron at ITER-India Gyrotron Test facility (IIGTF). The main functions of LCU include Sequence Control, Local Interlock Protection and Real Time Data Acquisition. PLC based slow controller is used for implementing the Sequence Control & Slow Interlock functions. Critical Protection Interlocks are required to have a response time of <10 μs and are implemented using custom built hardware and PXIe based fast controller. Also PXIe system is used for implementing Real Time Data Acquisition function that is required to have slow and fast acquisition with online visualization and off line analysis facility. A Signal Conditioning Unit (SCU) is used to interface and faithfully transmit the field signals to the remote control systems. Necessary controller hardware is procured and several pre-prototype developments have been taken up to establish the critical subsystems such as

Local control unit for ITER-India gyrotron test facility (IIGTF)

International Nuclear Information System (INIS)

Rathod, Vipal; Shah, Ronak; Mandge, Deepak; Parmar, Rajvi; Rao, S.L.

2016-01-01

Highlights: • A dedicated full scale ITER prototype Local Control Unit for ITER-India Gyrotron test facility. • National Instruments® make PXIe system for real time control & data acquisition and Siemens® PLC for sequence control function. • Hardwired FPGA based fast protection interlock system. • High speed analog fiber optical transmission link using V/F and F/V technique. • Software framework based on LabVIEW™ platform and ITER CODAC Core System. - Abstract: Electron Cyclotron system on ITER, is one of the important RF ancillary systems based on high power Gyrotron RF sources, that is used for plasma heating and current drive applications. To operate a Gyrotron source, various auxiliary systems and services such as Super Conducting Magnet set, High Voltage Power Supplies, Auxiliary Power Supplies, Waveguide components, Cooling water system and a Local Control Unit (LCU) are required. The LCU plays a very crucial role for the safe and reliable operation of Gyrotron system. A dedicated full scale ITER prototype LCU is being developed for testing and commissioning of an ITER like Test Gyrotron at ITER-India Gyrotron Test facility (IIGTF). The main functions of LCU include Sequence Control, Local Interlock Protection and Real Time Data Acquisition. PLC based slow controller is used for implementing the Sequence Control & Slow Interlock functions. Critical Protection Interlocks are required to have a response time of <10 μs and are implemented using custom built hardware and PXIe based fast controller. Also PXIe system is used for implementing Real Time Data Acquisition function that is required to have slow and fast acquisition with online visualization and off line analysis facility. A Signal Conditioning Unit (SCU) is used to interface and faithfully transmit the field signals to the remote control systems. Necessary controller hardware is procured and several pre-prototype developments have been taken up to establish the critical subsystems such as

Advanced satellite servicing facility studies

Science.gov (United States)

Qualls, Garry D.; Ferebee, Melvin J., Jr.

1988-01-01

A NASA-sponsored systems analysis designed to identify and recommend advanced subsystems and technologies specifically for a manned Sun-synchronous platform for satellite management is discussed. An overview of system design, manned and unmanned servicing facilities, and representative mission scenarios are given. Mission areas discussed include facility based satellite assembly, checkout, deployment, refueling, repair, and systems upgrade. The ferrying of materials and consumables to and from manufacturing platforms, deorbit, removal, repositioning, or salvage of satellites and debris, and crew rescue of any other manned vehicles are also examined. Impacted subsytems discussed include guidance navigation and control, propulsion, data management, power, thermal control, structures, life support, and radiation management. In addition, technology issues which would have significant impacts on the system design are discussed.

Primary health care facility infrastructure and services and the ...

African Journals Online (AJOL)

... Research Council ae Currently from Cape Peninsula University of Technology ... Keywords: primary health care facilities; nutritional status; children; caregivers' rural; South Africa ... underlying causes of malnutrition in children, while poor food quality, .... Information on PHC facility infrastructure and services was obtained.

Monte Carlo simulation to analyze the cost-benefit of radioactive seed localization versus wire localization for breast-conserving surgery in fee-for-service health care systems compared with accountable care organizations.

Science.gov (United States)

Loving, Vilert A; Edwards, David B; Roche, Kevin T; Steele, Joseph R; Sapareto, Stephen A; Byrum, Stephanie C; Schomer, Donald F

2014-06-01

In breast-conserving surgery for nonpalpable breast cancers, surgical reexcision rates are lower with radioactive seed localization (RSL) than wire localization. We evaluated the cost-benefit of switching from wire localization to RSL in two competing payment systems: a fee-for-service (FFS) system and a bundled payment system, which is typical for accountable care organizations. A Monte Carlo simulation was developed to compare the cost-benefit of RSL and wire localization. Equipment utilization, procedural workflows, and regulatory overhead differentiate the cost between RSL and wire localization. To define a distribution of possible cost scenarios, the simulation randomly varied cost drivers within fixed ranges determined by hospital data, published literature, and expert input. Each scenario was replicated 1000 times using the pseudorandom number generator within Microsoft Excel, and results were analyzed for convergence. In a bundled payment system, RSL reduced total health care cost per patient relative to wire localization by an average of $115, translating into increased facility margin. In an FFS system, RSL reduced total health care cost per patient relative to wire localization by an average of $595 but resulted in decreased facility margin because of fewer surgeries. In a bundled payment system, RSL results in a modest reduction of cost per patient over wire localization and slightly increased margin. A fee-for-service system suffers moderate loss of revenue per patient with RSL, largely due to lower reexcision rates. The fee-for-service system creates a significant financial disincentive for providers to use RSL, although it improves clinical outcomes and reduces total health care costs.

Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

Science.gov (United States)

Thomas, Kali S; Keohane, Laura; Mor, Vincent

2014-11-01

We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.

Science.gov (United States)

Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

2017-12-01

Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions

49 CFR 1242.25 - Locomotive servicing facilities (account XX-19-27).

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Locomotive servicing facilities (account XX-19-27... Structures § 1242.25 Locomotive servicing facilities (account XX-19-27). Separate common expenses according to distribution of common expenses in the following accounts: Locomotive Fuel (XX-51-67 and XX-52-67...

HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries.

Science.gov (United States)

Mark, Daniella; Armstrong, Alice; Andrade, Catarina; Penazzato, Martina; Hatane, Luann; Taing, Lina; Runciman, Toby; Ferguson, Jane

2017-05-16

In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries. Two hundred and eighteen facilities, responsible for an estimated 80,072 HIV-infected adolescents in care, were surveyed. Sixty per cent of the sample were from PATA's network, with the remaining gathered via local NGO partners and snowball sampling. Data were analysed using descriptive statistics and coding to describe central tendencies and identify themes. Respondents represented three subregions: West and Central Africa ( n  = 59; 27%), East Africa ( n  = 77, 35%) and southern Africa ( n  = 82, 38%). Half (50%) of the facilities were in urban areas, 17% peri-urban and 33% rural settings. Insufficient data disaggregation and outcomes monitoring were critical issues. A quarter of facilities did not have a working definition of adolescence. Facilities reported non-adherence as their key challenge in adolescent service provision, but had insufficient protocols for determining and managing poor adherence and loss to follow-up. Adherence counselling focused on implications of non-adherence rather than its drivers. Facilities recommended peer support as an effective adherence and retention intervention, yet not all offered these services. Almost two-thirds reported attending to adolescents with adults and/or children, and half had no transitioning protocols. Of those with transitioning protocols, 21% moved pregnant adolescents into adult services earlier than their peers. There was limited sexual and reproductive health integration, with 63% of facilities

Integrated social facility location planning for decision support: Accessibility studies provide support to facility location and integration of social service provision

CSIR Research Space (South Africa)

Green, Cheri A

2012-09-01

Full Text Available for two or more facilities to create an integrated plan for development Step 6 Costing of development plan Case Study Access norms and thresholds guidelines in accessibility analysis Appropriate norms/provision guidelines facilitate both service... access norms and threshold standards ?Test the relationship between service demand and the supply (service capacity) of the facility provision points within a defined catchment area ?Promote the ?right?sizing? of facilities relative to the demand...

Restructuring local distribution services: Possibilities and limitations

Energy Technology Data Exchange (ETDEWEB)

Duann, D.J.

1994-08-01

The restructuring of local distribution services is now the focus of the natural gas industry. It is the last major step in the ``reconstitution`` of the natural gas industry and a critical clement in realizing the full benefits of regulatory and market reforms that already have taken place in the wellhead and interstate markets. It could also be the most important regulatory initiative for most end-use customers because they are affected directly by the costs and reliability of distribution services. Several factors contribute to the current emphasis on distribution service restructuring. They include the unbundling and restructuring of upstream markets, a realization of the limitations of supply-side options (such as gas procurement oversight), and the increased diversity and volatility of gas demand facing local distribution companies. Local distribution service is not one but a series of activities that start with commodity gas procurement and extend to transportation, load balancing, storage, and metering and billing of services provided. There are also considerable differences in the economies of scale and scope associated with these various activities. Thus, a mixture of supply arrangements (such as a competitive market or a monopoly) is required for the most efficient delivery of local distribution services. A distinction must be made between the supply of commodity gas and the provision of a bundled distribution service. This distinction and identification of the best supply arrangements for various distribution service components are the most critical factors in developing appropriate restructuring policies. For most state public utility commissions the criteria for service restructuring should include pursuing the economies of scale and scope in gas distribution, differentiating and matching gas service reliability and quality with customer requirements, and controlling costs associated with the search, negotiation, and contracting of gas services.

Research of the Localization of Restaurant Service Robot

Directory of Open Access Journals (Sweden)

Yu Qing-xiao

2010-09-01

Full Text Available This paper designs a restaurant service robot which could be applicable to providing basic service, such as ordering, fetching and sending food, settlement and so on, for the customers in the robot restaurant. In this study, both three landmarks positioning and landmark-based localization algorithms are proposed to localize the mobile robot with rough precision in the restaurant. And Optical Character Recognition (OCR technology is used to distinguish the unique table number of different landmarks. When the high localization precision must be granted around the pantry table, the RFID-based localization algorithm is proposed to localize the mobile robot. Various experiments show that the proposed algorithms could estimate the robot pose reasonably well and could accurately evaluate the localization performance. Finally, the proposed service robot could realize real-time self-localization in the restaurant.

Research of the Localization of Restaurant Service Robot

Directory of Open Access Journals (Sweden)

Yu Qing-xiao

2010-09-01

Full Text Available This paper designs a restaurant service robot which could be applicable to providing basic service, such as ordering, fetching and sending food, settlement and so on, for the customers in the robot restaurant. In this study, both three landmarks positioning and landmark-based localization algorithms are proposed to localize the mobile robot with rough precision in the restaurant. And Optical Character Recognition (OCR technology is used to distinguish the unique table number of different landmarks. When the high localization precision must be granted around the pantry table, the RFID-based localization algorithm is proposed to localize the mobile robot.Various experiments show that the proposed algorithms could estimate the robot pose reasonably well and could accurately evaluate the localization performance. Finally, the proposed service robot could realize real-time self-localization in the restaurant.

EPA Facility Registry Service (FRS): Wastewater Treatment Plants

Data.gov (United States)

U.S. Environmental Protection Agency — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS), EPA's Integrated Compliance Information System (ICIS)...

Space Physics Data Facility Web Services

Science.gov (United States)

Candey, Robert M.; Harris, Bernard T.; Chimiak, Reine A.

2005-01-01

The Space Physics Data Facility (SPDF) Web services provides a distributed programming interface to a portion of the SPDF software. (A general description of Web services is available at http://www.w3.org/ and in many current software-engineering texts and articles focused on distributed programming.) The SPDF Web services distributed programming interface enables additional collaboration and integration of the SPDF software system with other software systems, in furtherance of the SPDF mission to lead collaborative efforts in the collection and utilization of space physics data and mathematical models. This programming interface conforms to all applicable Web services specifications of the World Wide Web Consortium. The interface is specified by a Web Services Description Language (WSDL) file. The SPDF Web services software consists of the following components: 1) A server program for implementation of the Web services; and 2) A software developer s kit that consists of a WSDL file, a less formal description of the interface, a Java class library (which further eases development of Java-based client software), and Java source code for an example client program that illustrates the use of the interface.

Investigating attitudes to hydrogen refuelling facilities and the social cost to local residents

International Nuclear Information System (INIS)

O'Garra, Tanya; Mourato, Susana; Pearson, Peter

2008-01-01

Vehicles fuelled by hydrogen (H 2 ) have attracted increasing attention because of their potentially enhanced environmental profiles. Their penetration into the vehicle stock will be influenced by the spread of refuelling facilities. This study investigates local attitudes towards the proposed installation of H 2 storage facilities at existing refuelling stations throughout London. Using multinomial logit analysis, we identify the determinants of attitudes. Results suggest that residents living very close to a proposed H 2 facility are less likely to be opposed than residents living 200-500 m away. Opposition appears to be determined by a lack of trust in safety regulations, non-environmental attitudes, and concerns about the existing local refuelling station. The social cost to local residents of a local H 2 storage facility was estimated using a method developed by Atkinson et al. [2004. 'Amenity' or 'eyesore'? Negative willingness to pay for options to replace electricity transmission towers. Applied Economics Letters 11(4), 203-208], which elicits the amount of time respondents are willing to commit to oppose a new facility development. Using the leisure rate of time, the social cost is estimated at just under Pounds 14 per local opposed resident. Add to this the WTP to support opposition efforts by a local group, and the value comes to just under Pounds 25 per opposed resident

Use of health services by residents at a seniors-only living facility

Directory of Open Access Journals (Sweden)

Elen Ferraz Teston

2013-10-01

Full Text Available The objective of the study was to compare the use of medical and dental services by seniors residing at a seniors-only living facility and in the general community. It was a quantitative study, among 50 residents of the living facility and 173 in the general community. The data were collected between November 2011 and February 2012 through a questionnaire, and subjected to statistical analysis. Performance of clinical exams and satisfaction with health services was greater among seniors living in the general community; however, physical therapy treatment was more common among those living in the facility. The use of medical and dental services showed a statistically significant difference. The seniors in both groups need oral health monitoring and those living in the facility also require coverage by the Family Health Strategy. The presence of professionals with the right profile to adequately serve residents and the network of available services are determining factors for the success of this new housing policy.

EPA Facility Registry Service (FRS): FRS_ESF10

Data.gov (United States)

U.S. Environmental Protection Agency — This web service contains the following layers: RMP, TRI, FRP, RCRATSD, CERCLIS, TSCA, and E-PLAN facilities and their associated CONTACTS, CHEMICALS, NAIP, SIC, and...

HEPCloud, a New Paradigm for HEP Facilities: CMS Amazon Web Services Investigation

Energy Technology Data Exchange (ETDEWEB)

Holzman, Burt [Fermilab; Bauerdick, Lothar A.T. [Fermilab; Bockelman, Brian [Nebraska U.; Dykstra, Dave [Fermilab; Fisk, Ian [New York U.; Fuess, Stuart [Fermilab; Garzoglio, Gabriele [Fermilab; Girone, Maria [CERN; Gutsche, Oliver [Fermilab; Hufnagel, Dirk [Fermilab; Kim, Hyunwoo [Fermilab; Kennedy, Robert [Fermilab; Magini, Nicolo [Fermilab; Mason, David [Fermilab; Spentzouris, Panagiotis [Fermilab; Tiradani, Anthony [Fermilab; Timm, Steve [Fermilab; Vaandering, Eric W. [Fermilab

2017-09-29

Historically, high energy physics computing has been performed on large purpose-built computing systems. These began as single-site compute facilities, but have evolved into the distributed computing grids used today. Recently, there has been an exponential increase in the capacity and capability of commercial clouds. Cloud resources are highly virtualized and intended to be able to be flexibly deployed for a variety of computing tasks. There is a growing nterest among the cloud providers to demonstrate the capability to perform large-scale scientific computing. In this paper, we discuss results from the CMS experiment using the Fermilab HEPCloud facility, which utilized both local Fermilab resources and virtual machines in the Amazon Web Services Elastic Compute Cloud. We discuss the planning, technical challenges, and lessons learned involved in performing physics workflows on a large-scale set of virtualized resources. In addition, we will discuss the economics and operational efficiencies when executing workflows both in the cloud and on dedicated resources.

Routing Service Quality—Local Driver Behavior Versus Routing Services

DEFF Research Database (Denmark)

Ceikute, Vaida; Jensen, Christian S.

2013-01-01

of the quality of one kind of location-based service, namely routing services. Specifically, the paper presents a framework that enables the comparison of the routes provided by routing services with the actual driving behaviors of local drivers. Comparisons include route length, travel time, and also route...... popularity, which are enabled by common driving behaviors found in available trajectory data. The ability to evaluate the quality of routing services enables service providers to improve the quality of their services and enables users to identify the services that best serve their needs. The paper covers......Mobile location-based services is a very successful class of services that are being used frequently by users with GPS-enabled mobile devices such as smartphones. This paper presents a study of how to exploit GPS trajectory data, which is available in increasing volumes, for the assessment...

Differences between U.S. substance abuse treatment facilities that do and do not offer domestic violence services.

Science.gov (United States)

Cohn, Amy; Najavits, Lisa M

2014-04-01

Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

Facilities for in-service control

International Nuclear Information System (INIS)

Werner, H.

1980-01-01

Up to now the efficiency of in-service control had been limited and dependent on special qualifications of the super-intending personnel and was thus neither exact nor transferable. In the meantime a great number of testing and measuring facilities for special application have been developed. Even novel types of testing methods do not grant absolutely precise statements. In most cases, however, there is a possibility of planning repairs by trend control and of avoiding failures of operation with aggravating consequences. Technical designers from all subject fields should be made familiar with the continually increasing spectrum of in-service inspection techniques so that a better application of modern and well-tried testing methods can be planned. Systematic in-service inspections complete the Rules of Technology which are safety-oriented with regard to the nonlinear wear between regular dates of control which has been ignored so far and its implied risks. Components which are not liable to control can be checked much better by novel type methods. (orig./RW) [de

Liberalization of local public services and modalities of local action in the liberalized sectors

Directory of Open Access Journals (Sweden)

Joaquin Tornos Mas

2017-09-01

Full Text Available In recent years we have witnessed a process of increasing liberalization of public services, which means returning economic activities that had been excluded from the market. This process has been less at the local level, but there have also been cases of liberalization of local public services, such as funeral services. This paper examines these liberalization processes and their consequences, analyzing what powers municipalities can exercise in relation to liberalized services, which, despite their return to the market, remain services of general interest.

42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

Science.gov (United States)

2010-10-01

... institutions for mental diseases. 440.155 Section 440.155 Public Health CENTERS FOR MEDICARE & MEDICAID... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

Environmental Control Plan for the Industrial Hygiene Field Services Facility

International Nuclear Information System (INIS)

Donnelly, J.W.

2000-01-01

This environmental control plan is for the Hanford Site's Industrial Hygiene Field Services Facility, located in the 100-N Area. This facility is used for the maintenance and storage of respirators, respiratory equipment and testing, calibration and testing of industrial hygiene equipment, and asbestos fiber counting

West Valley Demonstration Project facilities utilization plan for the existing facilities at the Western New York Nuclear Service Center

International Nuclear Information System (INIS)

Skillern, C.G.

1986-05-01

In 1980, Congress passed Public Law 96-368, the West Valley Demonstration Project (WVDP) Act. As a primary objective, the Act authorized the US Department of Energy (DOE) to solidify the high-level waste (HLW) stored at the Western New York Nuclear Service Center (WNYNSC) into a form suitable for transportation and disposal in a federal repository. This report will describe how WVDP proposes to use the existing WNYNSC Facilities in an efficient and technically effective manner to comply with Public Law 96-368. In support of the above cited law, the DOE has entered into a ''Cooperative agreement between the United States Department of Energy and the New York State Energy Research and Development Authority on the Western New York Nuclear Service Center at West Valley, New York.'' The state-owned areas turned over to the DOE for use are as follows: Process Plant, Waste Storage, Low-Level Waste Treatment Facility, Service Facilities, Plant Security, and Additional Facilities. The Facilities Utilization Plan (FUP) describes how the state-owned facilities will be utilized to complete the Project; it is divided into five sections as follows: Executive Summary - an overview; Introduction - the WVDP approach to utilizing the WNYNSC Facilities; WVDP Systems - a brief functional description of the system, list of equipment and components to be used and decontamination and decommissioning (D and D) support; WVDP Support Facilities; and Caveats that could effect or change the potential usage of a particular area

Berkeley Low Background Facility

International Nuclear Information System (INIS)

Thomas, K. J.; Norman, E. B.; Smith, A. R.; Poon, A. W. P.; Chan, Y. D.; Lesko, K. T.

2015-01-01

The Berkeley Low Background Facility (BLBF) at Lawrence Berkeley National Laboratory (LBNL) in Berkeley, California provides low background gamma spectroscopy services to a wide array of experiments and projects. The analysis of samples takes place within two unique facilities; locally within a carefully-constructed, low background laboratory on the surface at LBNL and at the Sanford Underground Research Facility (SURF) in Lead, SD. These facilities provide a variety of gamma spectroscopy services to low background experiments primarily in the form of passive material screening for primordial radioisotopes (U, Th, K) or common cosmogenic/anthropogenic products; active screening via neutron activation analysis for U,Th, and K as well as a variety of stable isotopes; and neutron flux/beam characterization measurements through the use of monitors. A general overview of the facilities, services, and sensitivities will be presented. Recent activities and upgrades will also be described including an overview of the recently installed counting system at SURF (recently relocated from Oroville, CA in 2014), the installation of a second underground counting station at SURF in 2015, and future plans. The BLBF is open to any users for counting services or collaboration on a wide variety of experiments and projects

General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh.

Science.gov (United States)

Shawon, Md Shajedur Rahman; Adhikary, Gourab; Ali, Md Wazed; Shamsuzzaman, Md; Ahmed, Shahabuddin; Alam, Nurul; Shackelford, Katya A; Woldeab, Alexander; Lim, Stephen S; Levine, Aubrey; Gakidou, Emmanuela; Uddin, Md Jasim

2018-01-25

Service readiness of health facilities is an integral part of providing comprehensive quality healthcare to the community. Comprehensive assessment of general and service-specific (i.e. child immunization) readiness will help to identify the bottlenecks in healthcare service delivery and gaps in equitable service provision. Assessing healthcare facilities readiness also helps in optimal policymaking and resource allocation. A health facility survey was conducted between March 2015 and December 2015 in two purposively selected divisions in Bangladesh; i.e. Rajshahi division (high performing) and Sylhet division (low performing). A total of 123 health facilities were randomly selected from different levels of service, both public and private, with variation in sizes and patient loads from the list of facilities. Data on various aspects of healthcare facility were collected by interviewing key personnel. General service and child immunization specific service readiness were assessed using the Service Availability and Readiness Assessment (SARA) manual developed by World Health Organization (WHO). The analyses were stratified by division and level of healthcare facilities. The general service readiness index for pharmacies, community clinics, primary care facilities and higher care facilities were 40.6%, 60.5%, 59.8% and 69.5%, respectively in Rajshahi division and 44.3%, 57.8%, 57.5% and 73.4%, respectively in Sylhet division. Facilities at all levels had the highest scores for basic equipment (ranged between 51.7% and 93.7%) and the lowest scores for diagnostic capacity (ranged between 0.0% and 53.7%). Though facilities with vaccine storage capacity had very high levels of service readiness for child immunization, facilities without vaccine storage capacity lacked availability of many tracer items. Regarding readiness for newly introduced pneumococcal conjugate vaccine (PCV) and inactivated polio vaccine (IPV), most of the surveyed facilities reported lack of

Framing the national nuclear legacy at the local level: Implications for the future of federal facilities

International Nuclear Information System (INIS)

Morrone, Michele; Basta, Tania B.; Somerville, Jennifer

2012-01-01

There are several major federal nuclear facilities located in small towns and rural areas of the United States. While many of these facilities were developed in the 1950s to support national defense, in the 1960s and 1970s, some of these shifted their mission to focus on national energy infrastructure. Now, many of these facilities are in a clean-up phase, and local communities are becoming increasingly engaged in influencing decisions about the future of the sites. Communicating with the public in rural communities is challenging when it involves a complicated environmental issue that could have widespread economic impacts. The local media reflect public understanding, so getting a sense of how these media frame issues can be a crucial first step to developing an effective community engagement strategy. A media content analysis of one local newspaper was completed in relation to a major federal nuclear facility. The content analysis is compared to the results of a telephone survey in the region served by the paper and the results suggest that there is a relationship between how the facility is portrayed in local media and public concern. This study has important implications for other nuclear facilities because of the role of local citizens in decision-making. - Highlights: ► Decisions about federal nuclear facilities include local citizen participation. ► Local media can play an important role in public perception of environmental risk. ► Local print media rely on a limited number in of sources for their stories. ► Effective risk communication should begin by understanding local public concerns.

An integrated tiered service delivery model (ITSDM based on local CD4 testing demands can improve turn-around times and save costs whilst ensuring accessible and scalable CD4 services across a national programme.

Directory of Open Access Journals (Sweden)

Deborah K Glencross

Full Text Available The South African National Health Laboratory Service (NHLS responded to HIV treatment initiatives with two-tiered CD4 laboratory services in 2004. Increasing programmatic burden, as more patients access anti-retroviral therapy (ART, has demanded extending CD4 services to meet increasing clinical needs. The aim of this study was to review existing services and develop a service-model that integrated laboratory-based and point-of-care testing (POCT, to extend national coverage, improve local turn-around/(TAT and contain programmatic costs.NHLS Corporate Data Warehouse CD4 data, from 60-70 laboratories and 4756 referring health facilities was reviewed for referral laboratory workload, respective referring facility volumes and related TAT, from 2009-2012.An integrated tiered service delivery model (ITSDM is proposed. Tier-1/POCT delivers CD4 testing at single health-clinics providing ART in hard-to-reach areas (350-1500 tests/day, serving ≥ 200 health-clinics. Tier-6 provides national support for standardisation, harmonization and quality across the organization.The ITSDM offers improved local TAT by extending CD4 services into rural/remote areas with new Tier-3 or Tier-2/POC-Hub services installed in existing community laboratories, most with developed infrastructure. The advantage of lower laboratory CD4 costs and use of existing infrastructure enables subsidization of delivery of more expensive POC services, into hard-to-reach districts without reasonable access to a local CD4 laboratory. Full ITSDM implementation across 5 service tiers (as opposed to widespread implementation of POC testing to extend service can facilitate sustainable 'full service coverage' across South Africa, and save>than R125 million in HIV/AIDS programmatic costs. ITSDM hierarchical parental-support also assures laboratory/POC management, equipment maintenance, quality control and on-going training between tiers.

Quality management standards for facility services in the Italian health care sector.

Science.gov (United States)

Cesarotti, Vittorio; Di Silvio, Bruna

2006-01-01

Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non-core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services--one of the most critical areas. This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service. The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win-win context, it is hoped to continually drive FM services towards organisational excellence. This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts. A systematic method for improving hospital FM services is presented. The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.

77 FR 18272 - Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC...

Science.gov (United States)

2012-03-27

... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC, National Enrichment Facility, Eunice... Louisiana Energy Services (LES), LLC, National enrichment Facility in Eunice, New Mexico, and has verified...

77 FR 65729 - Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC...

Science.gov (United States)

2012-10-30

... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC, National Enrichment Facility, Eunice... Services (LES), LLC, National Enrichment Facility in Eunice, New Mexico, and has verified that cascades...

42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

Science.gov (United States)

2010-10-01

... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment system...

In-service diagnostics of pumping facilities

International Nuclear Information System (INIS)

Jaros, I.

1987-01-01

The potential is discussed of technical diagnostics in increasing operating reliability of pumping facilities of conventional and nuclear power plants, and in rationalizing the system of their maintenance. Attention is focused on the selection of diagnostic parameters in which the so-called subjective expert methodology is applied, and on the diagnostic system design. At this stage, the construction of the respective facility and the analysis of the failure rate of its individual assemblies should be considered. The selection of diagnostic means directly depends on the selection of diagnostic parameters and is conditional on other factors, such as availability, cost, technical service, and operator's training. Briefly characterized are Czechoslovak standards assessing the mechanical condition of rotary machines from the measurement of the effective value of the rate of their oscillations. (Z.M.)

The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya.

Science.gov (United States)

Escamilla, Veronica; Calhoun, Lisa; Winston, Jennifer; Speizer, Ilene S

2018-02-01

Universal access to health care requires service availability and accessibility for those most in need of maternal and child health services. Women often bypass facilities closest to home due to poor quality. Few studies have directly linked individuals to facilities where they sought maternal and child health services and examined the role of distance and quality on this facility choice. Using endline data from a longitudinal survey from a sample of women in five cities in Kenya, we examine the role of distance and quality on facility selection for women using delivery, facility-based contraceptives, and child health services. A survey of public and private facilities offering reproductive health services was also conducted. Distances were measured between household cluster location and both the nearest facility and facility where women sought care. A quality index score representing facility infrastructure, staff, and supply characteristics was assigned to each facility. We use descriptive statistics to compare distance and quality between the nearest available facility and visited facility among women who bypassed the nearest facility. Facility distance and quality comparisons were also stratified by poverty status. Logistic regression models were used to measure associations between the quality and distance to the nearest facility and bypassing for each outcome. The majority of women bypassed the nearest facility regardless of service sought. Women bypassing for delivery traveled the furthest and had the fewest facility options near their residential cluster. Poor women bypassing for delivery traveled 4.5 km further than non-poor women. Among women who bypassed, two thirds seeking delivery and approximately 46% seeking facility-based contraception or child health services bypassed to a public hospital. Both poor and non-poor women bypassed to higher quality facilities. Our findings suggest that women in five cities in Kenya prefer public hospitals and are

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

Science.gov (United States)

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

2017-12-01

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

Study on Customer Satisfaction with Facilities Management Services in Lithuania

Science.gov (United States)

Lepkova, Natalija; Žūkaitė-Jefimovienė, Giedrė

2012-12-01

The article introduces the concept and content of facilities management (FM) services. The paper presents the concept of customer satisfaction and discusses the key factors which influence the opinions of customers and their satisfaction or dissatisfaction with the services provided. The article presents two studies: a brief survey of several FM service providers and a survey of customer satisfaction with FM services in Lithuania. The conclusions are given at the end of the article.

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

Science.gov (United States)

Lang'at, Evaline; Mwanri, Lillian

2015-06-27

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

AECL hot-cell facilities and post-irradiation examination services

International Nuclear Information System (INIS)

Schankula, M.H.; Plaice, E.L.; Woodworth, L.G.

1998-04-01

This paper presents an overview of the post-irradiation examination (PIE) services available at AECL's hot-cell facilities (HCF). The HCFs are used primarily to provide PIE support for operating CANDU power reactors in Canada and abroad, and for the examination of experimental fuel bundles and core components irradiated in research reactors at the Chalk River Laboratories (CRL) and off-shore. A variety of examinations and analyses are performed ranging from non-destructive visual and dimensional inspections to detailed optical and scanning electron microscopic examinations. Several hot cells are dedicated to mechanical property testing of structural materials and to determine the fitness-for-service of reactor core components. Facility upgrades and the development of innovative examination techniques continue to improve AECL's PIE capabilities. (author)

AECL hot-cell facilities and post-irradiation examination services

International Nuclear Information System (INIS)

Schankula, M.H.; Plaice, E.L.; Woodworth, L.G.

1995-01-01

This paper presents an overview of the post-irradiation examination (PIE) services available at AECL's hot-cell facilities (HCF). The HCFs are used primarily to provide PIE support for operating CANDU power reactors in Canada and abroad, and for the examination of experimental fuel bundles and core components irradiated in research reactors at the Chalk River Laboratories (CRL) and off-shore. A variety of examinations and analysis are performed ranging from non-destructive visual and dimensional inspections to detailed optical and scanning electron microscopic examinations. Several hot cells are dedicated to mechanical property testing of structural materials and to determine the fitness-for-service of reactor core components. Facility upgrades and the development of innovative examination techniques continue to improve AECL's PIE capabilities. (author)

Provision of family planning services in Tanzania: a comparative analysis of public and private facilities

NARCIS (Netherlands)

Kakoko, D.C.; Ketting, E.; Kamazima, S.R.; Ruben, R.

2012-01-01

Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based

Wound center facility billing: A retrospective analysis of time, wound size, and acuity scoring for determining facility level of service.

Science.gov (United States)

Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon

2007-01-01

Outpatient wound center facility reimbursement for Medicare beneficiaries can be a challenge to determine and obtain. To compare methods of calculating facility service levels for outpatient wound centers and to demonstrate the advantages of an acuity-based billing system (one that incorporates components of facility work that is non-reimbursable by procedure codes and that represents an activity-based costing approach to medical billing), a retrospective study of 5,098 patient encounters contained in a wound care-specific electronic medical record database was conducted. Approximately 500 patient visits to the outpatient wound center of a Texas regional hospital between April 2003 and November 2004 were categorized by service level in documentation and facility management software. Visits previously billed using a time-based system were compared to the Centers for Medicare and Medicaid Services' proposed three-tiered wound size-based system. The time-based system also was compared to an acuity-based scoring system. The Pearson correlation coefficient between billed level of service by time and estimated level of service by acuity was 0.442 and the majority of follow-up visits were billed as Level 3 and above (on a time level of 1 to 5) , confirming that time is not a surrogate for actual work performed. Wound size also was found to be unrelated to service level (Pearson correlation = 0.017) and 97% of wound areas were billings than extremes; no other method produced this distribution. Hospital-based outpatient wound centers should develop, review, and refine acuity score-based models on which to determine billed level of service.

Analysis of local acceptance of a radioactive waste disposal facility.

Science.gov (United States)

Chung, Ji Bum; Kim, Hong-Kew; Rho, Sam Kew

2008-08-01

Like many other countries in the world, Korea has struggled to site a facility for radioactive waste for almost 30 years because of the strong opposition from local residents. Finally, in 2005, Gyeongju was established as the first Korean site for a radioactive waste facility. The objectives of this research are to verify Gyeongju citizens' average level of risk perception of a radioactive waste disposal facility as compared to other risks, and to explore the best model for predicting respondents' acceptance level using variables related to cost-benefit, risk perception, and political process. For this purpose, a survey is conducted among Gyeongju residents, the results of which are as follows. First, the local residents' risk perception of an accident in a radioactive waste disposal facility is ranked seventh among a total of 13 risks, which implies that nuclear-related risk is not perceived very highly by Gyeongju residents; however, its characteristics are still somewhat negative. Second, the comparative regression analyses show that the cost-benefit and political process models are more suitable for explaining the respondents' level of acceptance than the risk perception model. This may be the result of the current economic depression in Gyeongju, residents' familiarity with the nuclear industry, or cultural characteristics of risk tolerance.

Intra- and Inter-Channel Competition in Local-Service Sectors

NARCIS (Netherlands)

K. Cleeren; M.G. Dekimpe (Marnik); F. Verboven

2005-01-01

textabstractAlthough economically very important, local-service sectors have received little attention in the extensive literature on competitive interactions. Detailed data gathering in these sectors is hard, not only because of the multitude of local players, but also because key service

Contracts for joint provision of local public services

Directory of Open Access Journals (Sweden)

Francisco José Villar Rojas

2017-09-01

Full Text Available This paper studies the way a Local authority can provide a public service of its competence jointly or cooperatively with other public authorities. Specifically, article 12.4 of Directive 2014/24 /EU, on «contracts for the joint provision of public services», is analyzed. Its basis and the conditions that must be fulfilled for its valid use are studied, as it is an exception to the rules on public works contracts. The conclusion is that European law supports and regulates a traditional way of managing local public services.

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

Directory of Open Access Journals (Sweden)

Frank Felix Mosha

2013-03-01

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

42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

Science.gov (United States)

2010-10-01

... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities and home health agencies. 415.204 Section 415.204 Public Health CENTERS FOR MEDICARE & MEDICAID...

Simulation Facilities and Test Beds for Galileo

Science.gov (United States)

Schlarmann, Bernhard Kl.; Leonard, Arian

2002-01-01

Galileo is the European satellite navigation system, financed by the European Space Agency (ESA) and the European Commission (EC). The Galileo System, currently under definition phase, will offer seamless global coverage, providing state-of-the-art positioning and timing services. Galileo services will include a standard service targeted at mass market users, an augmented integrity service, providing integrity warnings when fault occur and Public Regulated Services (ensuring a continuity of service for the public users). Other services are under consideration (SAR and integrated communications). Galileo will be interoperable with GPS, and will be complemented by local elements that will enhance the services for specific local users. In the frame of the Galileo definition phase, several system design and simulation facilities and test beds have been defined and developed for the coming phases of the project, respectively they are currently under development. These are mainly the following tools: Galileo Mission Analysis Simulator to design the Space Segment, especially to support constellation design, deployment and replacement. Galileo Service Volume Simulator to analyse the global performance requirements based on a coverage analysis for different service levels and degrades modes. Galileo System Simulation Facility is a sophisticated end-to-end simulation tool to assess the navigation performances for a complete variety of users under different operating conditions and different modes. Galileo Signal Validation Facility to evaluate signal and message structures for Galileo. Galileo System Test Bed (Version 1) to assess and refine the Orbit Determination &Time Synchronisation and Integrity algorithms, through experiments relying on GPS space infrastructure. This paper presents an overview on the so called "G-Facilities" and describes the use of the different system design tools during the project life cycle in order to design the system with respect to

Environmental Control Plan for the Industrial Hygiene Field Services Facility; TOPICAL

International Nuclear Information System (INIS)

J. W. Donnelly

2001-01-01

This environmental control plan is for the Hanford Site's industrial hygiene field services facility, located in the 100-N Area. The facility is used for the maintenance and storage of respirators, respiratory equipment and testing, calibration and testing of industrial hygiene equipment, and asbestos fiber counting

Operating cost model for local service airlines

Science.gov (United States)

Anderson, J. L.; Andrastek, D. A.

1976-01-01

Several mathematical models now exist which determine the operating economics for a United States trunk airline. These models are valuable in assessing the impact of new aircraft into an airline's fleet. The use of a trunk airline cost model for the local service airline does not result in representative operating costs. A new model is presented which is representative of the operating conditions and resultant costs for the local service airline. The calculated annual direct and indirect operating costs for two multiequipment airlines are compared with their actual operating experience.

A local area network and information management system for a submarine overhaul facility

OpenAIRE

Bushmire, Jeffrey D

1990-01-01

A preliminary design of a local area network for a submarine overhaul facility is developed using System Engineering concepts. SOFLAN, the Submarine Overhaul Facility Local Area Network, is necessary to provide more timely and accurate information to submarine overhaul managers in order to decrease the overhaul time period and become more competitive. The network is a microcomputer based system following the Ethernet and IEEE 802.3 standards with a server .. client architecture. SOFLAN serves...

Car drivers’ knowledge and preferences regarding additional services at parking facilities

NARCIS (Netherlands)

van der Waerden, P.J.H.J.; de Bruin - Verhoeven, M.; Rodrigues da Silva, A.N.

2017-01-01

The paper presents a study on car drivers’ knowledge and preferences regarding additional services at parking facilities. The following eight services are investigated the presence of public toilets, parking spaces for challenged people, lockers, refreshment machines, elevators, charging points for

42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

Science.gov (United States)

2010-10-01

... older (other than services in an institution for mental disease), EPSDT, and family planning services... institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility... institution for mental diseases”, means services that are— (i) Needed on a daily basis and required to be...

The effect of facility-based antiretroviral therapy programs on outpatient services in Kenya and Uganda.

Science.gov (United States)

Wollum, Alexandra; Dansereau, Emily; Fullman, Nancy; Achan, Jane; Bannon, Kelsey A; Burstein, Roy; Conner, Ruben O; DeCenso, Brendan; Gasasira, Anne; Haakenstad, Annie; Hanlon, Michael; Ikilezi, Gloria; Kisia, Caroline; Levine, Aubrey J; Masters, Samuel H; Njuguna, Pamela; Okiro, Emelda A; Odeny, Thomas A; Allen Roberts, D; Gakidou, Emmanuela; Duber, Herbert C

2017-08-16

Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012. We modeled the annual percent change in non-ART OPD visits using hierarchical mixed-effects linear regressions, controlling for a range of facility characteristics. We used four different constructs of ART services to capture the different ways in which the presence, growth, overall, and relative size of ART programs may affect non-ART OPD services. Our final sample included 321 health facilities (140 in Kenya and 181 in Uganda). On average, OPD and ART visits increased steadily in Kenya and Uganda between 2007 and 2012. For facilities where ART services were not offered, the average annual increase in OPD visits was 4·2% in Kenya and 13·5% in Uganda. Among facilities that provided ART services, we found average annual OPD volume increases of 7·2% in Kenya and 5·6% in Uganda, with simultaneous annual increases of 13·7% and 12·5% in ART volumes. We did not find a statistically significant relationship between annual changes in OPD services and the presence, growth, overall, or relative size of ART services. However, in a subgroup analysis, we found that Ugandan hospitals that offered ART services had statistically significantly less growth in OPD visits than Ugandan hospitals that did not provide ART services. Our findings suggest that ART services in Kenya and Uganda did not have a statistically significant deleterious effects on OPD services between 2007 and 2012, although subgroup analyses indicate variation by facility type. Our findings are encouraging, particularly given recent recommendations

Environmental Protection Agency (EPA) Facility Registry Service (FRS) Power Plants

Data.gov (United States)

Department of Homeland Security — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS) and NPDES, along with Clean Watersheds Needs Survey...

77 FR 55843 - Office of Facilities Management and Program Services; Submission for OMB Review; Background...

Science.gov (United States)

2012-09-11

... of Facilities Management and Program Services; Submission for OMB Review; Background Investigations for Child Care Workers AGENCY: Office of Facilities Management and Program Services, Public Building... Act, the Regulatory Secretariat will be submitting to the Office of Management and Budget (OMB) a...

Determinants of facility readiness for integration of family planning with HIV testing and counseling services: evidence from the Tanzania service provision assessment survey, 2014-2015.

Science.gov (United States)

Bintabara, Deogratius; Nakamura, Keiko; Seino, Kaoruko

2017-12-22

Global policy reports, national frameworks, and programmatic tools and guidance emphasize the integration of family planning and HIV testing and counseling services to ensure universal access to reproductive health care and HIV prevention. However, the status of integration between these two services in Tanzanian health facilities is unclear. This study examined determinants of facility readiness for integration of family planning with HIV testing and counseling services in Tanzania. Data from the 2014-2015 Tanzania Service Provision Assessment Survey were analyzed. Facilities were considered ready for integration of family planning with HIV testing and counseling services if they scored ≥ 50% on both family planning and HIV testing and counseling service readiness indices as identified by the World Health Organization. All analyses were adjusted for clustering effects, and estimates were weighted to correct for non-responses and disproportionate sampling. Descriptive, bivariate, and multivariate logistic regression analyses were performed. A total of 1188 health facilities were included in the study. Of all of the health facilities, 915 (77%) reported offering both family planning and HIV testing and counseling services, while only 536 (45%) were considered ready to integrate these two services. Significant determinants of facility readiness for integrating these two services were being government owned [AOR = 3.2; 95%CI, 1.9-5.6], having routine management meetings [AOR = 1.9; 95%CI, 1.1-3.3], availability of guidelines [AOR = 3.8; 95%CI, 2.4-5.8], in-service training of staff [AOR = 2.6; 95%CI, 1.3-5.2], and availability of laboratories for HIV testing [AOR = 17.1; 95%CI, 8.2-35.6]. The proportion of facility readiness for the integration of family planning with HIV testing and counseling in Tanzania is unsatisfactory. The Ministry of Health should distribute and ensure constant availability of guidelines, availability of rapid diagnostic

Environmental Protection Agency (EPA) Facility Registry Service (FRS) Emergency Response (ER) Toxic Substances Control Act (TSCA) Facilities - Oil and Hazardous Materials

Data.gov (United States)

Department of Homeland Security — The purpose of this web feature service is to provide users with access to integrated facility information from FRS, limited to the subset of facilities that link to...

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

Directory of Open Access Journals (Sweden)

Maxwell Ayindenaba Dalaba

2017-11-01

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

Stochastic inventory management at a service facility with a set of ...

African Journals Online (AJOL)

We consider a continuous review perishable inventory system at a service facility with a finite waiting capacity. The maximum inventory level is fixed and the customers arrive according to a Markov arrival process. The life time of each item and the service time are assumed to have independent exponential distributions.

Charging for Local Social Services: the Case of Estonia

Directory of Open Access Journals (Sweden)

Katrin Pihor

2012-12-01

Full Text Available Increasing fiscal pressure has forced local governments to seek new sources of autonomous revenues for financing public services. Charging users of social services has been modest, but with an aging society and growing social costs, this option needs to be reconsidered. This paper combines the results of the survey on the application of user charges on local social services in Estonian local governments (LGs with the official financial and population statistics in order to discover trends and explore factors determining the application of user charges in a small, unitary, highly centralised, post-soviet country. We conclude that user charges are mainly considered as a source of information and additional income to partially cover service costs – the possibilities of increased efficiency and demand control have remained undervalued. The probability of charging users of social services tends to be greater if the income level of inhabitants is higher, reflecting the ‘ability to pay’ principle. Charging users is more probable in the municipalities where the social costs are higher in volume or in proportion to the budget’s expenditures.

Cost-assessment Analysis of Local Vehicle Scrapping Facility

Science.gov (United States)

Grabowski, Lukasz; Gliniak, Maciej; Polek, Daria; Gruca, Maria

2017-12-01

The purpose of the paper was to analyse the costs of recycling vehicles at local vehicle scrapping facility. The article contains regulations concerning vehicle decommissioning, describes the types of recovery, vehicles recycling networks, analyses the structure of a disassembly station, as well as the financial and institutional system in charge of dealing with the recycling of vehicles in Poland. The authors present the number of scrapped vehicles at local recycling company and the level of achieved recovery and recycling. The research presented in the article shows financial situation of the vehicle scrapping industry. In addition, it has been observed that the number of subsidies are directly proportional to the number of scrapped vehicles, and achieved levels of recycling and recovery depends on the percentage of incomplete vehicles.

Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults.

Science.gov (United States)

Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Jacques, Paul; Tennstedt, Sharon

2008-10-01

There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views. One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees' qualifications, and therapeutic nutrition services. Sixty-three percent of experts favored the combination scenario. Dietetics education and experts' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts' personal views exerted a powerful influence. Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities.

76 FR 34103 - In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment Facility); Notice of...

Science.gov (United States)

2011-06-10

.... 10-899-02-ML-BD01] In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment Facility...'' portion of this proceeding regarding the December 2008 application by AREVA Enrichment Services, LLC (AES... gas centrifuge uranium enrichment facility--denoted as the Eagle Rock Enrichment Facility (EREF)--in...

Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

Science.gov (United States)

Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

2015-11-25

The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase

7 CFR 1735.13 - Location of facilities and service for nonrural subscribers.

Science.gov (United States)

2010-01-01

...-TELECOMMUNICATIONS PROGRAM Loan Purposes and Basic Policies § 1735.13 Location of facilities and service for nonrural... times be necessary to provide loan funds to finance telephone facilities which (1) will also serve nonrural subscribers, or (2) are located in nonrural areas. Loans may be approved to finance such...

Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

Science.gov (United States)

Cohn, Amy; Elmasry, Hoda; Niaura, Ray

2017-06-01

Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

User involvement and supporting tools in business-to-business service innovations: Insights from Facility Management services

DEFF Research Database (Denmark)

Nardelli, Giulia

is the generalizability of the findings to other business-to-business service sectors. More research conducted both in FM services and other service sectors would help to shed light on the generalizability of these findings. Originality/value – The study contributes with new and detailed insights into the complexity......Purpose – This article investigates and conceptualizes user involvement in business-to-business service innovations as well as the tools that are used to support interactions in such a service innovation process. Design/methodology/approach – The paper uses a qualitative research approach to answer...... the research question. By following Miles and Huberman (1984)’s this study started with a literature review of studies investigating service innovation, service innovations models, user roles and tools in service innovation in general, to conduct an empirical investigation in facility management (FM) services...

IRLT: Integrating Reputation and Local Trust for Trustworthy Service Recommendation in Service-Oriented Social Networks.

Science.gov (United States)

Liu, Zhiquan; Ma, Jianfeng; Jiang, Zhongyuan; Miao, Yinbin; Gao, Cong

2016-01-01

With the prevalence of Social Networks (SNs) and services, plenty of trust models for Trustworthy Service Recommendation (TSR) in Service-oriented SNs (S-SNs) have been proposed. The reputation-based schemes usually do not contain user preferences and are vulnerable to unfair rating attacks. Meanwhile, the local trust-based schemes generally have low reliability or even fail to work when the trust path is too long or does not exist. Thus it is beneficial to integrate them for TSR in S-SNs. This work improves the state-of-the-art Combining Global and Local Trust (CGLT) scheme and proposes a novel Integrating Reputation and Local Trust (IRLT) model which mainly includes four modules, namely Service Recommendation Interface (SRI) module, Local Trust-based Trust Evaluation (LTTE) module, Reputation-based Trust Evaluation (RTE) module and Aggregation Trust Evaluation (ATE) module. Besides, a synthetic S-SN based on the famous Advogato dataset is deployed and the well-known Discount Cumulative Gain (DCG) metric is employed to measure the service recommendation performance of our IRLT model with comparing to that of the excellent CGLT model. The results illustrate that our IRLT model is slightly superior to the CGLT model in honest environment and significantly outperforms the CGLT model in terms of the robustness against unfair rating attacks.

The nature of innovation processes in Facility Management services

DEFF Research Database (Denmark)

Nardelli, Giulia

Purpose: This work investigates the dynamics of interaction between stakeholders of Facilities Management (FM) innovation and improvement processes. The aim is to understand how the complex value chain of FM services influences innovation processes within this field. Theory: This study combines...... theories on innovation in services with research focused on the empirical field of FM. More specifically, the analytical framework for this study applies the differentiation between reactive and proactive innovation processes by Toivonen and Tuominen (2009) to the value chain identified by Coenen...... has a threefold impact on the nature of innovation processes within this field. Firstly, end-users of FM services are usually not involved in innovation processes, although they might sometimes play a role as initial drivers. Secondly, FM services are intangible but more easily reproducible than other...

76 FR 11523 - Atomic Safety and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility...

Science.gov (United States)

2011-03-02

... and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility); Notice of... Governmental Entities Regarding Environmental Portion of Enrichment Facility Licensing Proceeding February 24.... White. In this 10 CFR part 70 proceeding regarding the request of applicant AREVA Enrichment Services...

Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

Science.gov (United States)

Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

2017-05-01

Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

Fleet servicing facilities for testing and maintaining rail and truck radioactive waste transport systems

International Nuclear Information System (INIS)

Watson, C.D.; Hudson, B.J.; Preston, M.K.; Keith, D.A.; McCreery, P.N.; Knox, W.; Easterling, E.M.; Lamprey, A.S.; Wiedemann, G.

1980-01-01

This paper examines feasibility design concepts and feasibility studies of Fleet Servicing Facilities (FSF). Such facilities are intended to be used for routine servicing, preventive maintenance, and for performing requalification license compliance tests and inspections, minor repairs, and decontamination of both the transportation casks and their associated rail cars or tractor-trailers. None of the waste handling plants in the United States presently receiving radioactive wastes have an onsite FSF, nor is there an existing third party facility providing all of these services. This situation has caused the General Accounting Office to express concern regarding the quality of waste transport system maintenance once the transport system is placed into service. Thus a need is indicated for FSFs or their equivalent at various radioactive materials receiving sites. This paper also compares the respective capital costs and operating characteristics of the following three concepts of a spent fuel cask transportation FSF; integrated FSF, colocated FSF, and independent FSF

42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

Science.gov (United States)

2010-10-01

... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is often...

Decentralization : Local Partnerships for Health Services in the ...

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

Cameroon, like most other sub-Saharan African countries, has adopted laws devolving various responsibilities to local administrations. In the local political discourse, decentralization is seen as bringing essential services closer to the users, especially those in greatest need. However, the national decentralization program ...

Indoor Localization for Optimized Ambient Assisted Living Services

DEFF Research Database (Denmark)

Mitev, Miroslav; Mihovska, Albena Dimitrova; Poulkov, Vladimir

Indoor localization is very critical for the provision of Ambient Assisted Living (AAL) services, such as e-Health, smart home, etc. The success of deploying a real-time localization system depends on selecting the right performance characteristics. Bluetooth Low Energy (BLE) is a technology, which...

Handbook for preservation of local railroad service. Final report

Energy Technology Data Exchange (ETDEWEB)

Patton, E.P.; Langley, C.J. Jr.

1977-01-01

Throughout the United States, there is an accelerating abandonment of redundant and/or unprofitable light-density railroad lines. This abandonment can be economically harmful to both the shippers and the communities that were previously served. Although greater dependence upon truck transportation is a viable alternative in many cases, other situations indicate that the greatest priority should be attached to preserving some form of local railroad service. The objective of this research was to develop a handbook to assist shippers, local and state governments, and rail planners when their Class I rail service is scheduled for abandonment. Two major options are detailed in the handbook. The first regards innovative procedures which may be used by local groups in attempting to preserve service by the existing Class I carrier. The second approach considers the alternative of operating the particular line as an independent railroad.

Environmental Protection Agency (EPA) Facility Registry Service (FRS) Wastewater Treatment Plants

Data.gov (United States)

Department of Homeland Security — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS) and NPDES, along with Clean Watersheds Needs Survey...

Achieving local support for a low-level radioactive waste disposal facility in Illinois

International Nuclear Information System (INIS)

Kerr, T.A.; Seidler, P.E.

1989-01-01

This paper discusses how Illinois is progressing toward the goal of having a new low-level radioactive waste (LLW) disposal facility in operation by the federally mandated milestone of January 1, 1993. To accomplish this task, Illinois has adopted a voluntary siting process. The voluntary siting process will be successful by definition only if a high level of local support can be achieved and sustained. A strong public participation program in conjunction with a comprehensive information and education program is essential to fostering the necessary local support. Many other elements are also needed throughout this process. The Illinois Department of Nuclear Safety (IDNS) has found that making grants to local governments, awarding scholarships for area students, enacting a comprehensive system of legislation and regulations, explaining the site identification and characterization program, describing facility design features, practicing a strong policy of buying and hiring locally, maintaining good relationships with local news media and building trust through personal relationships have all greatly contributed to support for the LLW program in the potential host communities

IRLT: Integrating Reputation and Local Trust for Trustworthy Service Recommendation in Service-Oriented Social Networks.

Directory of Open Access Journals (Sweden)

Zhiquan Liu

Full Text Available With the prevalence of Social Networks (SNs and services, plenty of trust models for Trustworthy Service Recommendation (TSR in Service-oriented SNs (S-SNs have been proposed. The reputation-based schemes usually do not contain user preferences and are vulnerable to unfair rating attacks. Meanwhile, the local trust-based schemes generally have low reliability or even fail to work when the trust path is too long or does not exist. Thus it is beneficial to integrate them for TSR in S-SNs. This work improves the state-of-the-art Combining Global and Local Trust (CGLT scheme and proposes a novel Integrating Reputation and Local Trust (IRLT model which mainly includes four modules, namely Service Recommendation Interface (SRI module, Local Trust-based Trust Evaluation (LTTE module, Reputation-based Trust Evaluation (RTE module and Aggregation Trust Evaluation (ATE module. Besides, a synthetic S-SN based on the famous Advogato dataset is deployed and the well-known Discount Cumulative Gain (DCG metric is employed to measure the service recommendation performance of our IRLT model with comparing to that of the excellent CGLT model. The results illustrate that our IRLT model is slightly superior to the CGLT model in honest environment and significantly outperforms the CGLT model in terms of the robustness against unfair rating attacks.

Facilities management innovation in public-private collaborations: Danish ESCO projects

DEFF Research Database (Denmark)

Nardelli, Giulia; Jensen, Jesper Ole; Nielsen, Susanne Balslev

2015-01-01

The purpose of the article is to investigate how Facilities Management (FM) units navigate Energy Service Company (ESCO) collaborations, here defined as examples of public collaborative innovation within the context of FM. The driving motivation is to inform and inspire internal FM units of local...... institutions on how to navigate and manage collaboration of different, intra- and inter-organisational actors throughout ESCO projects.......The purpose of the article is to investigate how Facilities Management (FM) units navigate Energy Service Company (ESCO) collaborations, here defined as examples of public collaborative innovation within the context of FM. The driving motivation is to inform and inspire internal FM units of local...

Savannah River Plant engineering and design history. Volume 4: 300/700 Areas & general services and facilities

Energy Technology Data Exchange (ETDEWEB)

1957-01-01

The primary function of the 300 Area is the production and preparation of the fuel and target elements required for the 100 Area production reactors. Uranium slugs and lithium-aluminium alloy control and blanket rods are prepared in separate structures. Other facilities include a test pile, a physics assembly laboratory, an office and change house, an electrical substation, and various service facilities such as rail lines, roads, sewers, steam and water distribution lines, etc. The 700 Area contains housing and facilities for plant management, general plant services, and certain technical activities. The technical buildings include the Main Technical Laboratory, the Waste Concentration Building, the Health Physics Headquarters, and the Health Physics Calibration building. Sections of this report describe the following: development of the 300-M Area; selection and description of process; design of main facilities of the 300 Area; development of the 700-A Area; design of the main facilities of the 700 Area; and general services and facilities, including transportation, plant protection, waste disposal and drainage, site work, pilot plants, storage, and furniture and fixtures.

Development of field simulator to test and qualify the gyrotron local control unit for ITER-India Gyrotron Test Facility

International Nuclear Information System (INIS)

Shah, Ronak; Mandge, Deepak; Rathod, Vipal; Parmar, Rajvi; Dilip, E. Sharan; Yadav, Amit; Sharma, Anjali; Rao, S.L.

2017-01-01

High power RF sources such as a Gyrotron system are operated at required output parameter by using various auxiliary power supplies, High voltage power supplies, auxiliary services and a dedicated Local Control Unit (LCU). These sub-systems must be operated in synchronous and safe way to control the gyrotron output parameters. The LCU performs remote, synchronous and safe operation of the all the gyrotron sub-systems. Broadly the LCU functions are operational control, data acquisition, protection and safety of the gyrotron system. At ITER-India gyrotron Test Facility (IIGTF) a local control unit (LCU) is being developed to operate the complete gyrotron system. This paper presents the design, development and various features of the field simulator. It also discuss LCU functionality test cases and results obtained using field simulator

Gaps in perceived quality of facility services between stakeholders in the built learning environment

NARCIS (Netherlands)

Kok, Herman; Mobach, Mark P.; Omta, Onno; Alexander, K.

2013-01-01

Purpose - This paper aims to identify perception gaps on the quality of facility services among different users of educational buildings, and provide possible explanations for these perception gaps, and discussing the consequences regarding Facility Management (FM) governance.

Regulating food service in North Carolina's long-term care facilities.

Science.gov (United States)

DePorter, Cindy H

2005-01-01

Other commentaries in this issue of the North Carolina Medical Journal describe innovative food and dining practices in some of our state's long-term care facilities. Federal and state regulations do not prohibit these innovations, and DFS supports the concept of "enhancements" of the dining experience in these facilities. The Division of Facilities Services, therefore, encourages facilities to assess and operationalize various dining methods, allowing residents to select their foods, dining times, dining partners, and other preferences. The regulations allow facilities to utilize innovative dining approaches, such as buffet lines, or family-style serving options, which allow residents to order at the table as they would in a restaurant. The regulations do not dictate whether facilities should serve food to residents on trays, in buffet lines, or in a family style. While there are many regulations, they leave room for innovative new ideas as long as these ideas do not compromise resident health or safety.. Food consumption and the dining experience are an integral part of the resident's life in a nursing facility. It is important that resident preferences are being honored, and the dining experience is as pleasant and home-like as possible. The facility's responsibility is to provide adequate nutrition and hydration that assures the resident is at his/her highest level of functioning emotionally, functionally, and physically. Meeting the unique needs of each resident in a facility can be a daunting task, but one of immense importance to the quality long-term care.

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

Science.gov (United States)

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

2018-06-01

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

Establishment of a local psychiatric service

DEFF Research Database (Denmark)

Wang, A G

1981-01-01

of senile psychoses. The total increase amounts to 2.4 times the admission rates of psychiatric cases to the General Hospital and 4.4 times the admission rates to the Psychiatric Hospital in Nykøbing in the last years prior to the start of the local service. The outpatient department has grown steadily...... patients were referred to the local General Hospital and about half of the patients in each diagnostic group were sent on the Psychiatric Hospital in Nykøbing on Zealand, Denmark. Since the establishment of the department, admissions have increased in all diagnostic groups, especially in the group...

Establishment of a local psychiatric service

DEFF Research Database (Denmark)

Wang, A G

1981-01-01

patients were referred to the local General Hospital and about half of the patients in each diagnostic group were sent on the Psychiatric Hospital in Nykøbing on Zealand, Denmark. Since the establishment of the department, admissions have increased in all diagnostic groups, especially in the group...... of senile psychoses. The total increase amounts to 2.4 times the admission rates of psychiatric cases to the General Hospital and 4.4 times the admission rates to the Psychiatric Hospital in Nykøbing in the last years prior to the start of the local service. The outpatient department has grown steadily...

Analysis of an M/G/1 Queue with Multiple Vacations, N-policy, Unreliable Service Station and Repair Facility Failures

Directory of Open Access Journals (Sweden)

Wenqing Wu

2014-05-01

Full Text Available This paper studies an M/G/1 repairable queueing system with multiple vacations and N-policy, in which the service station is subject to occasional random breakdowns. When the service station breaks down, it is repaired by a repair facility. Moreover, the repair facility may fail during the repair period of the service station. The failed repair facility resumes repair after completion of its replacement. Under these assumptions, applying a simple method, the probability that the service station is broken, the rate of occurrence of breakdowns of the service station, the probability that the repair facility is being replaced and the rate of occurrence of failures of the repair facility along with other performance measures are obtained. Following the construction of the long-run expected cost function per unit time, the direct search method is implemented for determining the optimum threshold N* that minimises the cost function.

Does a hostel's managing agency determine the access to psychiatric services of its residents?

Science.gov (United States)

Lucas, B; Audini, B; Chisholm, D; Knapp, M; Lelliott, P

1998-10-01

This study examines the effect of managing agency (local authority, private or voluntary) on the use of other health and social care services by residents in mental health hostels and group homes with different levels of staffing in England and Wales. The sample comprised 1323 residents in 275 facilities in eight districts. The measures of service use were number of days in hospital and number of other service contacts. There were highly significant differences between facilities with similar levels of staffing managed by different agencies. Residents in the voluntary sector used fewer community services overall; residents in low-staffed local authority facilities used more services than those in similar facilities managed by other agencies. These differences were not easily explained by differences in the social or clinical characteristics of residents. This suggests that there may be organisational factors, e.g. hostel staff, knowledge of services, which influence access to and use of community services.

Local franchisee PPPS for water services operation

CSIR Research Space (South Africa)

Bhagwan, J

2007-05-01

Full Text Available The paper describes an alternative service delivery institutional concept, viz the franchising of local entrepreneurs, a PPP model especially suited to developing countries. The concept is being developed with the intention of making it available...

77 FR 31017 - Office of Facilities Management and Program Services; Information Collection; Background...

Science.gov (United States)

2012-05-24

... 3090-0287, Background Investigations for Child Care Workers. Instructions: Please submit comments only... request for review and approval for background check investigations of child care workers, form GSA 176C... Child Care Workers AGENCY: Office of Facilities Management and Program Services, Public Building Service...

Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

Science.gov (United States)

Oluoha, Chukwuemeka; Ahaneku, Hycienth

2014-01-01

The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

Location of an electric source facility and local area promotion

International Nuclear Information System (INIS)

Shimohirao, Isao

1999-01-01

Here were described on energy demand and supply, energy policy and local area promotion policy for basic problems important on location of electric source facilities. At present, co-existence business between electricity business and electric source location area is lacking in its activity. It seems to be necessary to enforce some systems to intend to promote it earnestly, and to effort to promote industry promotions such as introduction of some national projects, induction of electricity cost reduction for a means of business invitation, and so forth. And it is necessary to promote them under cooperations with electricity businesses, governments, universities and communities for the industrial promotion and fixation of the youth at local areas. In order to realize such necessities, further larger efforts are expected for national and local governments. (G.K.)

Local and landscape drivers of predation services in urban gardens.

Science.gov (United States)

Philpott, Stacy M; Bichier, Peter

2017-04-01

In agroecosystems, local and landscape features, as well as natural enemy abundance and richness, are significant predictors of predation services that may result in biological control of pests. Despite the increasing importance of urban gardening for provisioning of food to urban populations, most urban gardeners suffer from high pest problems, and have little knowledge about how to manage their plots to increase biological control services. We examined the influence of local, garden scale (i.e., herbaceous and arboreal vegetation abundance and diversity, ground cover) and landscape (i.e., landscape diversity and surrounding land use types) characteristics on predation services provided by naturally occurring predators in 19 urban gardens in the California central coast. We introduced sentinel pests (moth eggs and larvae and pea aphids) onto greenhouse-raised plants taken to gardens and assigned to open or bagged (predator exclosure) treatments. We found high predation rates with between 40% and 90% of prey items removed in open treatments. Predation services varied with local and landscape factors, but significant predictors differed by prey species. Predation of eggs and aphids increased with vegetation complexity in gardens, but larvae predation declined with vegetation complexity. Smaller gardens experienced higher predation services, likely due to increases in predator abundance in smaller gardens. Several ground cover features influenced predation services. In contrast to patterns in rural agricultural landscapes, predation on aphids declined with increases in landscape diversity. In sum, we report the relationships between several local management factors, as well as landscape surroundings, and implications for garden management. © 2017 by the Ecological Society of America.

78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

Science.gov (United States)

2013-06-27

.... The LTC facility regulations clearly specify what services the facility is required to provide to... professional caregivers and are often paid by third-party payers, such as Medicaid. These facilities are... benefit. In regulations at 42 CFR 418.112(c), we specify what must be included in a written agreement...

Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria.

Science.gov (United States)

Ekure, Ekanem N; Sadoh, Wilson E; Bode-Thomas, Fidelia; Orogade, Adeola A; Animasahun, Adeola B; Ogunkunle, Oluwatoyin O; Babaniyi, Iretiola; Anah, Maxwell U; Otaigbe, Barbara E; Olowu, Adebiyi; Okpokowuruk, Frances; Omokhodion, Samuel I; Maduka, Ogechi C; Onakpoya, Uvie U; Adiele, Daberechi K; Sani, Usman M; Asani, Mustapha; Yilgwan, Christopher S; Daniels, Queennette; Uzodimma, Chinyere C; Duru, Chika O; Abdulkadir, Mohammad B; Afolabi, Joseph K; Okeniyi, John A

Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. To evaluate and document the currently available paediatric cardiac services in Nigeria. In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria. Forty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%). Available paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

Forum Guide to Facilities Information Management: A Resource for State and Local Education Agencies. NFES 2012-808

Science.gov (United States)

National Forum on Education Statistics, 2012

2012-01-01

Safe and secure facilities that foster learning are crucial to providing quality education services, and developing and maintaining these facilities requires considerable resources and organization. Facility information systems allow education organizations to collect and manage data that can be used to inform and guide decisionmaking about the…

Local variability in long-term care services: local autonomy, exogenous influences and policy spillovers.

Science.gov (United States)

Fernandez, José-Luis; Forder, Julien

2015-03-01

In many countries, public responsibility over the funding and provision of long-term care services is held at the local level. In such systems, long-term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002-2012, the paper investigates the underlying causes of variation in gross social care expenditure for older people in England. The analysis distinguishes between factors outside the direct control of policy makers, local preferences and local policy spillovers. The results indicate that local demand and supply factors, and to a much lesser extent local political preferences and spatial policy spillovers, explain a large majority of the observed variation in expenditure. Copyright © 2015 John Wiley & Sons, Ltd.

Distribution Pattern of Healthcare Facilities in Osun State, Nigeria ...

African Journals Online (AJOL)

In this paper we employed the use of locational quotient, which is a measure of spatial pattern of services, to examine the distribution pattern of healthcare facilities in the thirty local government areas in Osun State, Nigeria. Twelve indices, representing the totality of healthcare delivery by State and local governments in the ...

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

Science.gov (United States)

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

2016-06-07

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

Delivery of video-on-demand services using local storages within passive optical networks.

Science.gov (United States)

Abeywickrama, Sandu; Wong, Elaine

2013-01-28

At present, distributed storage systems have been widely studied to alleviate Internet traffic build-up caused by high-bandwidth, on-demand applications. Distributed storage arrays located locally within the passive optical network were previously proposed to deliver Video-on-Demand services. As an added feature, a popularity-aware caching algorithm was also proposed to dynamically maintain the most popular videos in the storage arrays of such local storages. In this paper, we present a new dynamic bandwidth allocation algorithm to improve Video-on-Demand services over passive optical networks using local storages. The algorithm exploits the use of standard control packets to reduce the time taken for the initial request communication between the customer and the central office, and to maintain the set of popular movies in the local storage. We conduct packet level simulations to perform a comparative analysis of the Quality-of-Service attributes between two passive optical networks, namely the conventional passive optical network and one that is equipped with a local storage. Results from our analysis highlight that strategic placement of a local storage inside the network enables the services to be delivered with improved Quality-of-Service to the customer. We further formulate power consumption models of both architectures to examine the trade-off between enhanced Quality-of-Service performance versus the increased power requirement from implementing a local storage within the network.

Value Adding Management of buildings and facility services in four steps

DEFF Research Database (Denmark)

van der Voordt, Theo; Jensen, Per Anker; Hoendervanger, Jan Gerard

2016-01-01

This paper presents a new Value Adding Management (VAM) model that aims to support decision makers in identifying appropriate interventions in buildings, other facilities and services that add value to the organisation, to manage its implementation, and to measure the output and outcomes. The pap...

Fleet servicing facilities for servicing, maintaining, and testing rail and truck radioactive waste transport systems: functional requirements, technical design concepts and options cost estimates and comparisons

International Nuclear Information System (INIS)

Watson, C.D.; Hudson, B.J.; Keith, D.A.; Preston, M.K. Jr.; McCreery, P.N.; Knox, W.; Easterling, E.M.; Lamprey, A.S.; Wiedemann, G.

1980-05-01

This is a resource document which examines feasibility design concepts and feasibility studies of a Fleet Servicing Facility (FSF). Such a facility is intended to be used for routine servicing, preventive maintenance, and for performing requalification license compliance tests and inspections, minor repairs, and decontamination of both the transportation casks and their associated rail cars or tractor-trailers. None of the United States' waste handling plants presently receiving radioactive wastes have an on-site FSF, nor is there an existing third party facility providing these services. This situation has caused the General Accounting Office to express concern regarding the quality of waste transport system maintenance once the system is placed into service. Thus, a need is indicated for FSF's, or their equivalent, at various radioactive materials receiving sites. In this report, three forms of FSF's solely for spent fuel transport systems were examined: independent, integrated, and colocated. The independent concept was already the subject of a detailed report and is extensively referenced in this document so that capital cost comparisons of the three concepts could be made. These facilities probably could service high-level, intermediate-level, low-level, or other waste transportation systems with minor modification, but this study did not include any system other than spent fuel. Both the Integrated and Colocated concepts were assumed to be associated with some radioactive materials handling facility such as an AFR repository

The Impact of a Customer Service Intervention and Facility Design on Firm Performance

OpenAIRE

Joanne M. Sulek; Mary R. Lind; Ann S. Marucheck

1995-01-01

The purpose of this research was to investigate the impact of a customer service intervention and store design on store performance within a regional food retailing chain. A longitudinal study examines the organization's implementation of a customer service intervention which utilized new service standards and customer feedback mechanisms. Moreover, the chain provided a natural experiment, since the forty-six stores in this chain represented three levels of facility design ranging from the tr...

Local Social Services in Nordic countries in Times of Disaster

DEFF Research Database (Denmark)

Eydal, Guðný Björk; Ómarsdóttir, Ingibjörg Lilja; Dahlberg, Rasmus

of such disasters is on the rise according to forecasts. In order to enhance resilience and preparedness of those most vulnerable in disasters, the involvement of local social services in the emergency management system is of vital importance. The literature shows how social services can enhance social and human......The project focused on the emergency management systems in the five Nordic countries. It investigated whether local social services have a formal role in the contingency planning of the systems. The project was part of The Nordic Welfare Watch research project during the Icelandic Presidency...... Program in the Nordic Council of Ministers 2014-2016. The council financed the project. The main findings show that Finland, Norway and Sweden specifically address the role of social services in times of disaster in their legal frameworks on emergency management. Finland and Norway also address the role...

[Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

Science.gov (United States)

Kubota, Satoshi; Kawai, Hiromi

2015-01-01

In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

Directory of Open Access Journals (Sweden)

Rajmohan Panda

2013-03-01

Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

Earth Systems Field Work: Service Learning at Local and Global Scales

Science.gov (United States)

Moore, A.; Derry, L. A.

2016-12-01

The Earth & Environmental Systems (EES) Field Program engages students in hands-on exploration along the boundaries of the living earth, solid earth, ocean, and atmosphere. Based on Hawaíi Island, the semester-length program integrates scientific study with environmental stewardship and service learning. Each year EES students contribute 3000 hours of service to their host community. Throughout the semester students engage in different service activities. Most courses includes a service component - for example - study of the role of invasive species in native ecosystems includes an invasive species removal project. Each student completes a 4-week service internship with a local school, NGO, state or federal agency. Finally, the student group works to offset the carbon footprint of the program in collaboration with local conservation projects. This effort sequesters CO2 emissions while at the same time contributing to reforestation of degraded native ecosystems. Students learn that expertise is not confined to "the academy," and that wisdom and inspiration can be found in unexpected venues. Much of the service learning in the EES Program occurs in collaboration with local partners. Service internships require students to identify a partner and to design a tractable project. Students work daily with their sponsor and make a formal presentation of their project at the end of the internship period. This includes speaking to a non-technical community gathering as well as to a scientific audience. For many students the opportunity to work on a real problem, of interest in the real world, is a highlight of the semester. Beyond working in support of local community groups, the EES Prograḿs C-neutral project engages students with work in service to the global commons. Here the outcome is not measurable within the time frame of a semester, yet the intangible result makes the experience even more powerful. Students take responsibility for an important issue that is not

18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

Science.gov (United States)

2010-04-01

... and terminus of all remaining facilities. (d) Exhibit W—Impact on customers whose service will be.... Applicant may use pro forma accounting entries based on estimated amounts, provided that upon consummation... the amount of federal and state income taxes to be allocated to the gain. If no allocation is to be...

A Customer’s Possibilities to Increase the Performance of a Service Provider by Adding Value and Deepening the Partnership in Facility Management Service

Directory of Open Access Journals (Sweden)

Sillanpää Elina

2016-06-01

Full Text Available Reliable and good suppliers are an important competitive advantage for a customer and that is why the development of suppliers, improvement of performance and enhancement of customership are also in the interest of the customer. The purpose of this study is to clarify a customer’s possibilities to increase the performance of a service provider and to develop the service process in FM services and thus help to improve partnership development. This research is a qualitative research. The research complements the existing generic model of supplier development towards partnership development by customer and clarifies the special features that facility management services bring to this model. The data has been gathered from interviews of customers and service providers in the facility management service sector. The result is a model of customers’ possibilities to develop the performance of service providers from the viewpoint of value addition and relationship development and in that way ensure added value to the customer and the development of a long-term relationship. The results can be beneficial to customers when they develop the cooperation between the customer and the service provider toward being more strategic and more partnership focused.

ITALIAN LOCAL PUBLIC SERVICES: SOME GOVERNANCE HIGHLIGHTS FROM THE LARGER CITIES’ EXPERIENCE

Directory of Open Access Journals (Sweden)

DE MATTEIS Fabio

2013-06-01

Full Text Available Entrusting most local public services to local government entities has led to proliferation of public groups and, consistently, to greater complexity of the governance dynamics of local authorities. Differently from Anglo-Saxon countries, the Italian local public services provision has been characterized by a hybrid externalization process where local entities are legally autonomous but owned by the local government. This leads to a peculiar governance complexity source represented by the dual role (stakeholder and customer assumed by the local authority. Considering these elements (hybrid externalization and governance structure, this work tries to investigate some governance issues of public groups, basing on the two most populous Italian municipalities. The empirical findings highlight a gap between the presence of the conditions for defining a group governance structure and the adoption of a group approach by the parent local government. The authors try to suggest how to bridge this gap.

MOVEMENT WITHIN THE LOCAL CIVIL SERVICE SYSTEM

Directory of Open Access Journals (Sweden)

Alen Rajko

2016-01-01

Full Text Available The author analyzes the current Croatian regulation of movement within the local and regional civil service system. This includes the institutes of transfer, promotion, appointment and removal of the heads of administrative bodies, as well as changes in the workplace that may occur in the process of reorganization of the administrative bodies, with additional references to the particularities related to the position of heads of administrative bodies and employees. The procedural context of these issues, related to the implementation of administrative procedure and administrative dispute, is also discussed. The author offers legal interpretation to resolve doubts arising in the practice of implementation of the mentioned civil service institutes.

Assessing STD Partner Services in State and Local Health Departments.

Science.gov (United States)

Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

2018-02-07

State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

A method for studying the development pattern of urban commercial service facilities based on customer reviews from social media

Science.gov (United States)

Wang, Y. D.; Jiang, B. T.; Ye, X. Y.

2016-06-01

Urbanization is one of the most important human social activities in the 21st century (Chaolin et al., 2012). With an increasing number of people visiting cities, the provision of adequate urban service facilities, including public and commercial service facilities, in locations where people live has become an important guarantee of the success of urbanization. Exploring the commercial service facilities in a specific area of a city can help us understand the progress and trends of urban renewal in the area, provide a quantitative basis for evaluating the rationality of planning implementation, and facilitate an analysis of the effects of different factors on the regional development of a city (Schor et al. 2003). In this paper, we proposed a data processing and analysis method for studying the distribution and development pattern of urban commercial facilities based on customer reviews. In addition, based on road network constraints, we explored the patterns contained in customer reviews data, including patterns for the spatial distribution and spatial-temporal evolution of facilities as well as the number of facilities and degree of satisfaction.

A method for studying the development pattern of urban commercial service facilities based on customer reviews from social media

Directory of Open Access Journals (Sweden)

Y. D. Wang

2016-06-01

Full Text Available Urbanization is one of the most important human social activities in the 21st century (Chaolin et al., 2012. With an increasing number of people visiting cities, the provision of adequate urban service facilities, including public and commercial service facilities, in locations where people live has become an important guarantee of the success of urbanization. Exploring the commercial service facilities in a specific area of a city can help us understand the progress and trends of urban renewal in the area, provide a quantitative basis for evaluating the rationality of planning implementation, and facilitate an analysis of the effects of different factors on the regional development of a city (Schor et al. 2003. In this paper, we proposed a data processing and analysis method for studying the distribution and development pattern of urban commercial facilities based on customer reviews. In addition, based on road network constraints, we explored the patterns contained in customer reviews data, including patterns for the spatial distribution and spatial-temporal evolution of facilities as well as the number of facilities and degree of satisfaction.

Value Adding Management (VAM) of buildings and facility services in four steps

NARCIS (Netherlands)

van der Voordt, Theo; Hoendervanger, Jan Gerard; Jensen, Per Anker; Bergsma, Feike

2016-01-01

This paper presents a new Value Adding Management (VAM) model that aims to support decision makers in identifying appropriate interventions in buildings, other facilities and services that add value to the organisation, to manage its implementation, and to measure the output and outcomes. The paper

45 CFR 234.130 - Assistance in the form of institutional services in intermediate care facilities.

Science.gov (United States)

2010-10-01

... facilities as management services, building maintenance and laundry, with other units. (iv) Transfers between... in bathing, dressing, grooming, and management of personal affairs such as shopping. (c) Continuous... properly carried out and recorded; (d) Arrangements for services of a physician in the event of an...

The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

Science.gov (United States)

Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

2018-01-01

Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Small Faith-Related Organizations as Partners in Local Social Service Networks

Directory of Open Access Journals (Sweden)

David Campbell

2016-05-01

Full Text Available Efforts to enlist small faith-related organizations as partners in public service delivery raise many questions. Using community social service networks as the unit of analysis, this paper asks one with broader relevance to nonprofit sector managers: What factors support and constrain effective integration of these organizations into a local service delivery network? The evidence and illustrations come from longitudinal case studies of five faith-related organizations who received their first government contract as part of a California faith-based initiative. By comparing the organizational development and network partnership trajectories of these organizations over more than a decade, the analysis identifies four key variables influencing partnership dynamics and outcomes: organizational niche within the local network; leadership connections and network legitimacy; faith-inspired commitments and persistence; and core organizational competencies and capacities. The evidence supports shifting the focus of faith-based initiatives to emphasize local planning and network development, taking into account how these four variables apply to specific organizations and their community context.

Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria

Science.gov (United States)

Emelumadu, Obiageli F.; Onyeonoro, Ugochukwu Uchenna; Ukegbu, Andrew Ugwunna; Ezeama, Nkiru N.; Ifeadike, Chigozie Ozoemena; Okezie, Obasi Kanu

2014-01-01

Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees’ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4–98.4%) and natal services (92.7%; 95% CI 89.2–95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services. PMID:24791050

The Apology Strategies Used by Customer Service Officers of a Local Bank in Surabaya

OpenAIRE

Ruth, Amelia; Kuntjara, Esther H

2016-01-01

In this study, the writer observed the apology strategies used by ten customer service officers of a local bank. The writer wants to find out what types of apology strategies are used by customer service officers of the local bank. The theory of apology strategy by Trosborg (1995) was used as the main theory of this research. The writer used a qualitative approach. The data were taken by recording interviews with ten customer service officers of the local bank. Then, the writer analyzed the c...

Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

Science.gov (United States)

Coetzee, L M; Cassim, N; Glencross, D K

2015-12-16

The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

Students' Perceived Quality of Library Facilities and Services in Nigerian Private Universities

Science.gov (United States)

Oluwunmi, A. O.; Durodola, O. D.; Ajayi, C. A.

2016-01-01

In a highly competitive academic environment, students are becoming more selective and demanding in their choice of University. Hence, it is essential for educational institutions, particularly privately-owned institutions, to be interested in getting feedback on the quality of their facilities and services. With a focus on four private…

76 FR 387 - Atomic Safety and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility)

Science.gov (United States)

2011-01-04

... and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) December 17, 2010... construction and operation of a gas centrifuge uranium enrichment facility--denoted as the Eagle Rock... site at http://www.nrc.gov/materials/fuel-cycle-fac/arevanc.html . These and other documents relating...

20 CFR 230.5 - Exception concerning service to a local lodge or division.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Exception concerning service to a local lodge... to a local lodge or division. In determining whether an annuity is subject to the provisions of this... lodge or division of a railway-labor-organization employer if the compensation for such service is...

Local authorities and electricity: territories, actors and issues within the local public service in France

International Nuclear Information System (INIS)

Bouvier, G.

2005-06-01

In France, the role of local authorities in the organization of the electricity supply system is largely unknown mainly due to the size of the state-owned utility Electricite de France (EDF). Local authorities and their groupings played a major role in the electrification of the national territory and have kept important prerogatives as conceding authorities of this service of general interest. These groupings also became the tools of the soft power of local actors. The geopolitical analysis of the relationships between local municipalities and electric power stakeholders shows the diversity of actors and opinions. Stuck between market liberalization issues and decentralization to local authorities, these groupings tend to reinforce their competencies. Furthermore, decentralization goes along with a reinforcement of the political involvement in local energy policy and with conflicts on the adequate territorial scale for theses policies. (author)

Low-Income Demand for Local Telephone Service: Effects of Lifeline and Linkup

OpenAIRE

Daniel Ackerberg; Michael Riordan; Gregory Rosston; Bradley Wimmer

2008-01-01

A comprehensive data set on local telephone service prices is used to evaluate the effect of Lifeline and Linkup programs on the telephone penetration rates of low-income households in the United States. Lifeline and Linkup programs respectively subsidize the monthly subscription and initial installation charges of eligible low-income households. Telephone penetration rates are explained by an estimated nonlinear function of local service characteristics (including subsidized prices) and the ...

The impact of market and organizational characteristics on nursing care facility service innovation: a resource dependency perspective.

Science.gov (United States)

Banaszak-Holl, J; Zinn, J S; Mor, V

1996-04-01

Using resource dependency theory as a conceptual framework, this study investigates both the organizational and environmental factors associated with an emerging health care service delivery innovation, the provision of specialty care in designated units in nursing care facilities. We consider two types of specialty units, Alzheimer's Disease and subacute care. The Medicare/Medicaid Automated Certification Survey (MMACS) data file was merged with local market area data obtained from the 1992 Area Resource File and with state level regulatory data. The likelihood of providing Alzheimer's Disease or subacute care in dedicated units was estimated by separate logistic regressions. Results indicate that facilities with fewer Medicare patients are more likely to operate a dedicated Alzheimer's care unit, while facilities located in markets with a large HMO population and greater hospital supply are more likely to operate a subacute care unit. While competition among nursing homes, for the most part, is an incentive to innovate, greater regulatory stringency appears to constrain the development of specialty care units of both types. Finally, organizational characteristics (e.g., size and proprietary status) appear to be important enabling factors influencing the propensity to provide specialty care in dedicated units. Nursing care facilities are moving toward providing specialty care units partly as a response to a growing demand by resource providers and to maintain a competitive edge in tighter markets. Loosening regulation directed at cost containment would further encourage the development of specialty care but should be preceded by some evaluation of population needs for specialty care and the effectiveness of specialty care units.

Effects of Housing Costs and Home Sales on Local Government Revenues and Services

OpenAIRE

Allee, David J.

1991-01-01

The subtitle of this paper should be " How recession and federal devolution have caused local governments to cut services and raise property taxes --now, what should be done in response to the resulting clamor for local government consolidation?" Housing drives local government services. Home sales represent opportunities for more income and more costs. Intergovernmental competition for tax base and the role of state and federal aid to provide equity between jurisdictions are central to the q...

Local authorities and electricity: territories, actors and issues within the local public service in France; Les collectivites locales et l'electricite. Territoires, acteurs et enjeux autour du service public local de l'electricite en france

Energy Technology Data Exchange (ETDEWEB)

Bouvier, G

2005-06-15

In France, the role of local authorities in the organization of the electricity supply system is largely unknown mainly due to the size of the state-owned utility Electricite de France (EDF). Local authorities and their groupings played a major role in the electrification of the national territory and have kept important prerogatives as conceding authorities of this service of general interest. These groupings also became the tools of the soft power of local actors. The geopolitical analysis of the relationships between local municipalities and electric power stakeholders shows the diversity of actors and opinions. Stuck between market liberalization issues and decentralization to local authorities, these groupings tend to reinforce their competencies. Furthermore, decentralization goes along with a reinforcement of the political involvement in local energy policy and with conflicts on the adequate territorial scale for theses policies. (author)

Conceptual aspects of fiscal interactions between local governments and federally-owned, high-level radioactive waste-isolation facilities

International Nuclear Information System (INIS)

Bjornstad, D.J.; Johnson, K.E.

1981-01-01

This paper examines a number of ways to transfer revenues between a federally-owned high level radioactive waste isolation facility (hereafter simply, facility) and local governments. Such payments could be used to lessen fiscal disincentives or to provide fiscal incentives for communities to host waste isolation facilities. Two facility characteristics which necessitate these actions are singled out for attention. First, because the facility is federally owned, it is not liable for state and local taxes and may be viewed by communities as a fiscal liability. Several types of payment plans to correct this deficiency are examined. The major conclusion is that while removal of disincentives or creation of incentives is possible, plans based on cost compensation that fail to consider opportunity costs cannot create incentives and are likely to create disincentives. Second, communities other than that in which the facility is sited may experience costs due to the siting and may, therefore, oppose it. These costs (which also accrue to the host community) arise due to the element of risk which the public generally associates with proximity to the transport and storage of radioactive materials. It is concluded that under certain circumstances compensatory payments are possible, but that measuring these costs will pose difficulty

Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

Science.gov (United States)

Pillay, D; Morroni, C; Pleaner, M; Adeogba, O; Chersich, M; Naidoo, N; Mullick, S; Rees, H

2017-10-01

Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA) in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ), Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities). Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective decision

Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

Directory of Open Access Journals (Sweden)

D Pillay

2017-10-01

Full Text Available Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ, Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities. Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective

Local government energy action in the UK: from service delivery to community leadership

Energy Technology Data Exchange (ETDEWEB)

Wade, Joanne; Pearson, Amanda; Knowland, Rachael [Impetus Consulting (United Kingdom); Flanagan, Brooke [Energy Saving Trust (United Kingdom)

2007-07-01

In October 2006 the UK government published a new Local Government White Paper. This policy statement set the framework for the role of local government in the coming years.The White Paper is one stage in the latest wave of local government reform in the UK. This reform has aimed to refocus attention away from delivery of specific services and towards community leadership, particularly with reference to sustainable development. Climate change is given some emphasis within the White Paper, and should become one of the indicators against which local government performance is measured.This paper examines energy action in local authorities in the past few years, in a situation where most, but not all, were still strongly focused on service delivery. By contrasting this with the results achieved in authorities that have taken a community leadership role, the paper examines the potential of the White Paper. It addresses the following questions: does local government have the capacity to deliver increased local action on climate change? Does the UK policy framework support and encourage development and deployment of this capacity? And do the national and regional bodies that provide support for local authorities need to change the services they offer in light of recent policy developments?.

A study on the service radii and accessibility to health facilities in ...

African Journals Online (AJOL)

Government policies over the years has centered on the provision and delivery of healthcare to all. Spatial distribution of health facilities is subject to a number of social and commercial influences and healthcare needs of the population. The objective of this paper analyzed the service radii and accessibility of health ...

[Provision of building maintenance services in healthcare facilities].

Science.gov (United States)

Amorim, Gláucia Maria; Quintão, Eliana Cardoso Vieira; Martelli Júnior, Hercílio; Bonan, Paulo Rogério Ferreti

2013-01-01

The scope of this paper was to evaluate the provision of building maintenance services in health units, by means of a descriptive, quantitative and cross-sectional study, considering the five types of facilities (Primary Health, Emergency, Specialty, Hospital and Mental Health Units). The research was approved by the Research Ethics Comittee of FHEMIG with the Terms of Agreement signed with the Unified Health System of Betim. Comparative analysis was conducted by checking the requirements of "Physical-Functional Structure Management" of the "Brazilian Hospital Accreditation Manual" of the National Accreditation Organization. Nonconformities were noted in the physical-functional management of the health centers, especially the primary health units. The assessment was important, considering that compliance with formal, technical and structural requirements, welfare activities, according to the service organization and appropriate to the profile and complexity, can collaborate to minimize the risks of users. To improve the quality of health care establishments, it is essential that managers, backed by "top management," prioritize financial, human and material resources in planning to ensure compliance with security requirements of users in buildings.

Comparison of the socioeconomic impacts of international fuel service centers versus dispersed nuclear facilities

International Nuclear Information System (INIS)

Braid, R.B. Jr.

1979-01-01

The paper investigates a variety of community impacts including: public services, fiscal issues, economic matters, land and water use, political and social cohesion, and legal considerations. Comparisons of socioeconomic impacts of colocated versus dispersed sites are made on the basis of the size of the impacted communities, the size and type of nuclear facility, and the facility's construction time frame. The paper concludes that, under similar circumstances, most of the socioeconomic impacts of colocated nuclear facilities would be somewhat less than the sum of the impacts associated with equivalent dispersed sites. While empirical data is non-existent, the paper contends, however, that because the socioeconomic impacts of colocated facilities are so great and readily identifiable to a public unskilled in making comparisons with the dispersed alternative, the facilities will likely generate so much public opposition that IFSCs will probably prove infeasible

Improving water, sanitation and hygiene in health-care facilities, Liberia.

Science.gov (United States)

Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

2017-07-01

The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

Science.gov (United States)

Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

2015-07-01

The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

Towards a New Digital Era: Observing Local E-Government Services Adoption in a Chinese Municipality

Directory of Open Access Journals (Sweden)

Yao Yang

2017-09-01

Full Text Available As electronic government services (e-government evolve, traditional applications such as online portals are encountering challenges in a new digital era in which people thirst for more convenient, diverse channels of communication with their government. Despite the efforts devoted to the promotion of Social Networking Service (SNS use in e-government for the past few years, empirical studies regarding this ongoing trend are still insufficient. In the local administration of China, a special collaboration between local governments and private Internet enterprises is happening: government services are imported into commercial SNS platforms known as WeChat and Weibo. This research conducts a case study of a Chinese municipality premised upon survey data (N = 605 collected in Chongqing. It examines the determinants of e-services adoption in four major local applications: two traditional government-led services “Government website portal” and “Government official app” (traditional government-led services, and two built-in government services on social networking applications “Weibo Government official account” “WeChat Public Services”. The paper aims to provide a closer understanding of current trends in local government e-services, or in this case, an innovative trial of Chinese e-government practices.

A Study on an appropriate operating system of environmental basic facility service industry

Energy Technology Data Exchange (ETDEWEB)

Moon, Hyun Joo [Korea Environment Institute, Seoul (Korea)

1998-12-01

The environmental basic facility service industry is designed to have a structural reorganization of general operating system and the efficient and effective participation of private industry and regulation of industry in connection with the general system. 35 refs., 9 figs., 20 tabs.

Quality assurance requirements for control of procurement items and services for nuclear fuel reprocessing facilities

International Nuclear Information System (INIS)

Anon.

1979-01-01

Requirements and guidelines are provided for the control of activities to be exercised during procurement of items and services which affect the quality of nuclear facilities. These requirements and guidelines apply to procurement activities for items and services such as designing, purchasing, fabricating, handling, shipping, storing, cleaning, constructing, erecting, installing, inspecting, texting, maintaining and modifying

An integrated model to measure service management and physical constraints' effect on food consumption in assisted-living facilities.

Science.gov (United States)

Huang, Hui-Chun; Shanklin, Carol W

2008-05-01

The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated. A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique. A total of 118 residents in five facilities completed both questionnaires and food consumption assessments. Descriptive, multivariate analyses and structural equation modeling techniques were employed. Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction. Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

EDITORIAL Reinvigorating maternal health service delivery in Ethiopia

African Journals Online (AJOL)

kim

awareness, access to services and building the capacity of health facilities. Such measures however ... skilled providers, which is staggering below. 15% (6). This figure may ... health workers and local structures irrespective of their interest?

Clients’ satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya

Science.gov (United States)

2018-01-01

Background This study intended to compare the clients’ satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. Methods This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients’ satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15–49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. Results A higher proportion of clients from private facility 98.1% were attended within 0–30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, psatisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). Conclusion In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from

Clients' satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya.

Directory of Open Access Journals (Sweden)

Clarice Okumu

Full Text Available This study intended to compare the clients' satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours.This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients' satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA between 15-49 years in Tigoni District hospital (public hospital and Limuru Nursing home (private hospital. For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis.A higher proportion of clients from private facility 98.1% were attended within 0-30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001 while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001. Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022.In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from admission

Sustainable Radioactive Waste Management: Reflections on Building a Durable Relationship Between a Facility and the Local Community by Adding Value to Waste Management Projects

International Nuclear Information System (INIS)

Van Hove, Erik

2009-01-01

The appropriate model for radioactive waste management projects is clearly the insertion in the local economy. The author of this paper states that RWM initiatives need a committed and knowledgeable host community over a very long period. This can only be achieved if RWM projects are firmly localised and tied in with the daily life of the host community: RWM projects should go local and bring value to the community in multiple ways. As global economy rules very much dominate the present thinking and norm setting, a durable RWM initiative does not come about spontaneously, explicit value adding measures are required: attention to design (go outside the circle of utilitarian engineering and bring in some creativity and imagination), go for multi-functionality (visitor center, sports facility, etc.), distinctiveness (remarkable architecture, beautiful landscaping, unusual features in the engineering...), meaningful service to society. There are also some preconditions such as sustainable integration of projects in the local community (develop projects in local partnerships) and avoiding the trap of safety-through-adversarial-security

Local control station for development, testing and maintenance of mirror fusion facility subsystem controls

International Nuclear Information System (INIS)

Ables, E.; Kelly, M.F.

1985-01-01

A Local Control Station (LCS) was designed and built to provide a simplified ad easily configurable means of controlling any Mirror Fusion Test Facility (MFTF-B) subsystem for the purpose of development, testing and maintenance of the subsystem. All MFTF-B Subsystems incorporate at least one Local Control Computer (LCC) that is connected to and accepts high level commands from one of the Supervisory Control and Diagnostic System (SCDS) computers. The LCS connects directly to the LCC in place of SCDS. The LCS communicates with the subsystem hardware using the same SCDS commands that the local control computer recognizes and as such requires no special configuration of the LCC

Benefit and Risk Perceptions of Controversial Facilities: A Comparison between Local Officials and the Public in China

Directory of Open Access Journals (Sweden)

Qingduo Mao

2018-04-01

Full Text Available This article investigates the perception biases of local government officials and the general public by comparing their benefit and risk perceptions towards controversial facilities. The analysis framework of Social Judgement Theory (SJT—i.e., (a economic benefits, (b environmental health, and (c social and political factors—was used to design the research. SJT is a widely recognized theoretical framework that includes experimental approaches to the study of cognitive conflicts. An experimental survey was conducted to collect data in order to make a comparison of the weight of different elements. Results demonstrate that there are perception differences between the general public and local officials on controversial facilities. Local officials responsible for endorsing and supervising plants attach more significance to environmental factors than the public, while the public focuses more on social and political factors than officials. There is no significant difference in the cognition of economic benefits. Factors such as demolition compensation and legitimacy may provoke these perception gaps. This paper enriches the current understanding of SJT and policy making for controversial facilities by investigating the perception gaps between officials and the general public.

Estimating preferences for local public services using migration data.

Science.gov (United States)

Dahlberg, Matz; Eklöf, Matias; Fredriksson, Peter; Jofre-Monseny, Jordi

2012-01-01

Using Swedish micro data, the paper examines the impact of local public services on community choice. The choice of community is modelled as a choice between a discrete set of alternatives. It is found that, given taxes, high spending on child care attracts migrants. Less conclusive results are obtained with respect to the role of spending on education and elderly care. High local taxes deter migrants. Relaxing the independence of the irrelevant alternatives assumption, by estimating a mixed logit model, has a significant impact on the results.

75 FR 66054 - Nondiscrimination on the Basis of Disability in State and Local Government Services, Public...

Science.gov (United States)

2010-10-27

... Nondiscrimination on the Basis of Disability in State and Local Government Services, Public Accommodations and in... of Disability; Accessibility of Web Information and Services of State and Local Government Entities and Public Accommodations; Nondiscrimination on the Basis of Disability in State and Local Government...

Facility Effluent Monitoring Plan for the 222-S Laboratory

International Nuclear Information System (INIS)

Robinson, A.V.

1991-11-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems against applicable federal, state, and local requirements. This facility effluent monitoring plan is the first annual report. It shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. The current operation of the 222-S facilities includes the provision of analytical and radiological chemistry services in support of Hanford Site processing plants. The emphasis is on waste management, chemical processing, environmental monitoring effluent programs at B Plant, the Uranium Oxide Plant, Tank Farms, the 242-A Evaporator, the Waste Encapsulation and Storage Facility, the Plutonium-Uranium Extraction Facility, the Plutonium Finishing Plant, process development/impact activities, and essential materials. The laboratory also supplies analytical services in support of ongoing waste tank characterization

Local authorities and electricity: territories, actors and issues within the local public service in France; Les collectivites locales et l'electricite. Territoires, acteurs et enjeux autour du service public local de l'electricite en france

Energy Technology Data Exchange (ETDEWEB)

Bouvier, G

2005-06-15

In France, the role of local authorities in the organization of the electricity supply system is largely unknown mainly due to the size of the state-owned utility Electricite de France (EDF). Local authorities and their groupings played a major role in the electrification of the national territory and have kept important prerogatives as conceding authorities of this service of general interest. These groupings also became the tools of the soft power of local actors. The geopolitical analysis of the relationships between local municipalities and electric power stakeholders shows the diversity of actors and opinions. Stuck between market liberalization issues and decentralization to local authorities, these groupings tend to reinforce their competencies. Furthermore, decentralization goes along with a reinforcement of the political involvement in local energy policy and with conflicts on the adequate territorial scale for theses policies. (author)

EPA Facility Registry Service (FRS): ER_FRP

Data.gov (United States)

U.S. Environmental Protection Agency — This dataset contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link to Facility...

Local Commune Administration as a Regulator of the Local Water Supply and Sewage Disposal Services Market

OpenAIRE

Małysko, Jacek

2012-01-01

In this article the author discusses problems related to the regulation of water and sewage disposal services market. In the beginning he describes the processes of water supply and sewage disposal taken by the local commune administration as a natural monopoly. Next he characterizes the structure of this market in Poland. Then he presents the role of local commune administration as a regulator. The author concludes by evaluating the existing Polish system of regulating wate...

The Influence of Facility and Service Quality towards Customer Satisfaction and its Impact on Customer Loyalty in Borobudur Hotel in Jakarta

Directory of Open Access Journals (Sweden)

Rianto Nurtjahjo

2017-05-01

Full Text Available Hotel developments currently grow very rapidly. The emergence of new hotels increases the competition in the hospitality industry. This research aimed to determine the influence of the facilities, the quality of service to customer satisfaction and its impact on customer loyalty in Borobudur Hotel in Jakarta. Data collection was done by distributing questionnaires directly to 360 customers in Borobudur Hotel in Jakarta. The analysis technique used path analysis. The results of this research indicate that the variables of facilities, service quality and customer satisfaction significantly affect customer loyalty variables simultaneously or partially. In addition, facilities and quality of service variable have a significant effect on customer satisfaction variables.

The politics of service delivery in South Africa: The local government sphere in context

Directory of Open Access Journals (Sweden)

Purshottama S. Reddy

2016-12-01

Full Text Available The post-1994 democratic developmental South African state opted for a strong local government system which has been constitutionalised, in terms of Chapter 7 of the Constitution of the Republic of South Africa Act 108 of 1996. The politicisation of the local bureaucracy was inevitable as the ruling party sought to ensure that the executive leadership of municipalities shared the same political ideology and vision to facilitate local development. This raises the question, where does politicisation commence and end, and what is the ideal local political interface for efficient and effective service delivery and, more importantly, to ensure good governance? These questions have to take cognisance of the fact that South Africa is a ‘struggle democracy’ and development has to take place in historically disadvantaged areas, where services have been poor or non-existent. The historically advantaged areas have to also be maintained and upgraded, as they are key to financial sustainability of the municipalities. The increasing service delivery protests is a matter for concern, if one has to take cognisance of the popular adage highlighted in official literature, ‘if local government fails, South Arica fails’. Given that the struggles for a democratic South Africa were fought at the grassroots level, this has to translate to an improved quality of life for local communities. Consequently, sound political management is key to enhanced municipal service delivery and ultimately good local governance. This paper reviews political trends and developments up to 2016, but excludes any discussion on the recent local government elections.

Dialysis Facility Compare

Data.gov (United States)

U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

The Influence of Brand Image, Price, Service Quality and Facilities on Customer Satisfaction at Aston Hotel Manado

OpenAIRE

Taroreh, Rita N.; Mananeke, Lisbeth; Suwandi, Monica M.

2015-01-01

The economic condition of a country will change the mindset of people, so what happened in Indonesia it determines the public goods and services, in accordance with ability of business players and their business oriented towards the consumer. Consumers free use of money and free compare products or services and factors associated with services like the brand image, price, service quality and facilities. These days, service business in this case of hotel, have a thighter competition. As the ne...

Using Service-Learning in Urban Areas in Semarang Regency to Address Local Knowledge System

Directory of Open Access Journals (Sweden)

Rully Adi Nugroho

2017-08-01

Full Text Available Service-learning has gained substantial recognition as an effective type of pedagogy and has enhanced civic education across the disciplines, however remains a lack of understanding of this type of learning in Indonesia. The goals of the study were (1 to explore the forms of local knowledge systems practiced in Semarang Regency and how they are used in resources conservation using service-learning method, (2 to foster student engagement with the community, and (3 to promote student awareness of community resources that are directly relevant to local knowledge system issues. The success of the service-learning projects in meeting these goals was assessed via qualitative analysis of student reflective papers and classroom presentations. The results indicated there were local knowledges that were still successfully in use, but often only very locally. Furthermore, the results also indicated that the service-learning projects promoted students’ valuable academic skills, including communication, team-building, and critical thinking, built their self-esteem, their awareness of community needs and resources, and demonstrated the relevance of course content to real life.

International trade of health services: global trends and local impact.

Science.gov (United States)

Lautier, Marc

2014-10-01

Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Facilities & Leadership

Data.gov (United States)

Department of Veterans Affairs — The facilities web service provides VA facility information. The VA facilities locator is a feature that is available across the enterprise, on any webpage, for the...

QUALITY GROWTH AND EVALUATION OF PERFORMANCE OF LOCAL PUBLIC SERVICES

Directory of Open Access Journals (Sweden)

Remus Gherman

2015-05-01

Full Text Available Public sector reform aims to increase performance by improving its efficiency and effectiveness by improving the quality of services provided by public service in order to maximize individual welfare of citizens. The purpose of reform is to improve public services because they have to deal with uncertainties and rapid changes that take place in the internal environmental and external pressures. Public administration, in quality of service provider must make a series of efforts to ensure that citizens know their rights and public services on witch they can benefit taking into account the simplification of service delivery, a high quality of its, new administrative procedures for allocating resources in a transparent way and informing the citizens of standards of services and of the methods of compensation in case if the provided quality is different from that promised. Most important is the fact that the local government must realize that effectiveness involves defining objectives that must be achieved simultaneously with the estimation of the results obtained.

9 CFR 203.12 - Statement with respect to providing services and facilities at stockyards on a reasonable and...

Science.gov (United States)

2010-01-01

..., marketing, buying, or selling on a commission basis or otherwise, feeding, watering, holding, delivery..., buying, or selling on a commission basis or otherwise, marketing, feeding, watering, holding, delivery... facilities. Such services and facilities include, but are not limited to, the restaurant, restrooms, drinking...

TownshipNet: A localized hybrid TVWS-WiFi and cloud services network

CSIR Research Space (South Africa)

Hadzic, S

2016-10-01

Full Text Available This paper describes a network architecture to provide low cost last mile access and cloud services for local content sharing in a poorly resourced township environment. We describe how ICT solutions are developed in close partnership with the local...

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities

OpenAIRE

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed u...

Innovations to increase throughput of the multipurpose irradiation facility

Energy Technology Data Exchange (ETDEWEB)

Cabalfin, Estelita G; Lanuza, Luvimina G; Maningas, Aurelio L; Solomon, Haydee M [Irradiation Services Unit, Nuclear Services and Training Division, Philippine Nuclear Research Institute, Quezon City (Philippines)

1998-07-01

With the installation and operation of the PNRI [Philippine Nuclear Research Institute] multipurpose irradiation facility, several local industries are now aware of, and in fact using gamma radiation for sterilization or decontamination of medical and pharmaceutical products, packaging materials and for food preservation. However, the multipurpose irradiation facility has limited capacity and capability, since this was designed as a pilot scale irradiator for research and development. To meet the increasing demand of gamma irradiation service, a new product handling system was locally designed, fabricated and installed. Performance, in terms of total loading and more importantly, radiation dose distribution of the new product handling system, was evaluated. An increase in product throughput was realized effectively with the new product handling system. (Author)

Innovations to increase throughput of the multipurpose irradiation facility

International Nuclear Information System (INIS)

Cabalfin, Estelita G.; Lanuza, Luvimina G.; Maningas, Aurelio L.; Solomon, Haydee M.

1998-01-01

With the installation and operation of the PNRI [Philippine Nuclear Research Institute] multipurpose irradiation facility, several local industries are now aware of, and in fact using gamma radiation for sterilization or decontamination of medical and pharmaceutical products, packaging materials and for food preservation. However, the multipurpose irradiation facility has limited capacity and capability, since this was designed as a pilot scale irradiator for research and development. To meet the increasing demand of gamma irradiation service, a new product handling system was locally designed, fabricated and installed. Performance, in terms of total loading and more importantly, radiation dose distribution of the new product handling system, was evaluated. An increase in product throughput was realized effectively with the new product handling system. (Author)

Testing of Local Velocity Transducer Used at Sodium Thermal Hydraulic Test Facilities

International Nuclear Information System (INIS)

Kim, Tae Joon; Eoh, Jae Hyuk; Hwang, In Koo; Jeong, Ji Young; Kim, Jong Man; Lee, Yong Bum; Kim, Yeong Il

2012-01-01

KAERI (Korea Atomic Energy Research Institute) will perform a test for a thermal hydraulic simulation with STELLA-1 for a Component Performance Test Sodium Loop in the year 2012, and subsequently it will construct for STELLA-2 for a Sodium Thermalhydraulic Experimental Facility in the year 2016. The STELLA-2 consists of a scaled reactor vessel with a core of electric heaters, four IHXs, two PHTS pumps, two DHXs, and two AHXs. In STELLA-2, several kinds of flow measurements exists. In this paper, the local velocity transducer as a prototype tested in IPPE (in Russia), was manufactured as a prototype by a shop in KAERI. This local velocity transducer will be used to measure the flow rate in a pool

Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

Science.gov (United States)

Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

2016-10-06

Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery

75 FR 10525 - In the Matter of: AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) and All Other...

Science.gov (United States)

2010-03-08

...: AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) and All Other Persons Who Seek or Obtain... for the Implementation of a Safeguards Information Program (Effective Immediately) I AREVA Enrichment... it to construct and operate a uranium enrichment facility in Bonneville County, Idaho. AES submitted...

Applied research and service activities at the University of Missouri Research Reactor Facility (MURR)

International Nuclear Information System (INIS)

Alger, D.M.

1987-01-01

The University Of Missouri operates MURR to provide an intense source of neutron and gamma radiation for research and applications by experimenters from its four campuses and by experimenters from other universities, government and industry. The 10 MW reactor, which has been operating an average of 155 hours per week for the past eight years, produces thermal neutron fluxes up to 6-7x10 14 n/cm 2 -s in the central flux trap and beamport source fluxes of up to 1.2x10 14 n/cm 2 -s. The mission of the reactor facility, to promote research, education and service, is the same as the overall mission of the university and therefore, applied research and service supported by industrial firms have been welcomed. The university recognized after a few years of reactor operation that in order to build utilization, it would be necessary to develop in-house research programs including people, equipment and activity so that potential users could more easily and quickly obtain the results needed. Nine research areas have been developed to create a broadly based program to support the level of activity needed to justify the cost of operating the facility. Applied research and service generate financial support for about one-half of the annual budget. The applied and service programs provide strong motivation for university/industry association in addition to the income generated. (author)

Residences Satisfaction Towards Service Quality Provided By Bogor Local Government

OpenAIRE

Setiawan, Budi; Oswari, Teddy; Kuswanto, Adi

2011-01-01

The lowest local government as a frontline government has some crucial duties in­cludes residences administration, village development, residences identity, land ad­ministration, and other duties. Up to present, the performance of the lowest local government is measured based on the regulation, but has never been measured based on the perception of its residences that have had service directly. The objective of the study are(1) to explore whether there is a differences between the perception ...

Long term assurance of supply of back end of fuel cycle facilities and services

International Nuclear Information System (INIS)

1978-01-01

The paper deals with the long-term assurance of supply of the back end of fuel cycle facilities and services. 11 fundamental questions are posed and commented on by representatives of 7 countries. Non-proliferation aspects are not considered as they will be discussed elsewhere

Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

Science.gov (United States)

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-01-01

Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

Science.gov (United States)

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-01-01

Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current

20 CFR 204.7 - Employment relation-service to a local lodge or division of a railway labor organization.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Employment relation-service to a local lodge... relation—service to a local lodge or division of a railway labor organization. Service by an individual to a local lodge or division of a railway labor organization shall be creditable under the Railroad...

Understanding the Collaborative Planning Process in Homeless Services: Networking, Advocacy, and Local Government Support May Reduce Service Gaps.

Science.gov (United States)

Jarpe, Meghan; Mosley, Jennifer E; Smith, Bikki Tran

2018-06-07

The Continuum of Care (CoC) process-a nationwide system of regional collaborative planning networks addressing homelessness-is the chief administrative method utilized by the US Department of Housing and Urban Development to prevent and reduce homelessness in the United States. The objective of this study is to provide a benchmark comprehensive picture of the structure and practices of CoC networks, as well as information about which of those factors are associated with lower service gaps, a key goal of the initiative. A national survey of the complete population of CoCs in the United States was conducted in 2014 (n = 312, 75% response rate). This survey is the first to gather information on all available CoC networks. Ordinary least squares (OLS) regression was used to determine the relationship between internal networking, advocacy frequency, government investment, and degree of service gaps for CoCs of different sizes. United States. Lead contacts for CoCs (n = 312) that responded to the 2014 survey. Severity of regional service gaps for people who are homeless. Descriptive statistics show that CoCs vary considerably in regard to size, leadership, membership, and other organizational characteristics. Several independent variables were associated with reduced regional service gaps: networking for small CoCs (β = -.39, P < .05) and local government support for midsized CoCs (β = -.10, P < .05). For large CoCs, local government support was again significantly associated with lower service gaps, but there was also a significant interaction effect between advocacy and networking (β = .04, P < .05). To reduce service gaps and better serve the homeless, CoCs should consider taking steps to improve networking, particularly when advocacy is out of reach, and cultivate local government investment and support.

The Transfer of Local Authority School Support Services to External Social Enterprises

Science.gov (United States)

Hatcher, Richard

2015-01-01

This paper explores an emerging and largely unresearched sector of the school education market, the transfer of local authority support services to external social enterprises. It locates these new social enterprises as a consequence of government strategies to reduce public spending, shrink local government and create competitive markets in…

25 CFR 170.805 - What are the local, tribal, and BIA roles in transportation facility maintenance?

Science.gov (United States)

2010-04-01

... transportation facility maintenance? 170.805 Section 170.805 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.805 What are the local... Road Maintenance dollars. ...

KNOWLEDGE IS REFERENCE FACILITIES OF SUPPORT OF PROCESSES OF INFORMATIVE ACCOMPANIMENT OF MEDICAL SERVICE OF POPULATION (first report

Directory of Open Access Journals (Sweden)

O. P. Mintser

2012-11-01

Full Text Available Described approaches, models and facilities of forming of the systems of knowledges, by the s purpose of support of grant informatively consultative services at medical practice of doctor. Ontological models, facilities of linguistic analysis and visualization of reflection of objects of medical industry, are determined.

Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

Directory of Open Access Journals (Sweden)

Fisseha G

2017-10-01

Full Text Available Girmatsion Fisseha,1 Yemane Berhane,2 Alemayehu Worku,2,3 Wondwossen Terefe1 1Mekelle University, College of Health Science, School of Public Health, Mekelle, Ethiopia; 2Addis Continental Institute of Public Health, Epidemiology Department, Addis Ababa, Ethiopia; 3Addis Ababa University, School of Public Health, Biostatistics Department, Addis Ababa, Ethiopia Background: Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia.Subjects and methods: A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR and 95% confidence interval (CI.Results: A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71], perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13], experiencing any complication during childbirth, using antenatal care, lower

User involvement in measuring service quality of local authority occupational therapy services: a new approach.

NARCIS (Netherlands)

Sixma, H.J.; Calnan, S.; Calnan, M.; Groenewegen, P.P.

2001-01-01

The aim of this paper is two-fold: (i) to describe the development of a new measuring instrument for quality of care from the perspective of the users of local authority Occupational Therapy (OT) services, and (ii) to evaluate the potential of the new instrument as a standardized approach for the

Biochemistry Facility

Data.gov (United States)

Federal Laboratory Consortium — The Biochemistry Facility provides expert services and consultation in biochemical enzyme assays and protein purification. The facility currently features 1) Liquid...

Local government energy action in the UK: from service delivery to community leadership. Volume 1

Energy Technology Data Exchange (ETDEWEB)

Wade, Joanne; Pearson, Amanda; Knowland, Rachael [Impetus Consulting (United Kingdom); Flanagan, Brooke [Energy Saving Trust (United Kingdom)

2007-07-01

In October 2006 the UK government published a new Local Government White Paper. This policy statement set the framework for the role of local government in the coming years.The White Paper is one stage in the latest wave of local government reform in the UK. This reform has aimed to refocus attention away from delivery of specific services and towards community leadership, particularly with reference to sustainable development. Climate change is given some emphasis within the White Paper, and should become one of the indicators against which local government performance is measured.This paper examines energy action in local authorities in the past few years, in a situation where most, but not all, were still strongly focused on service delivery. By contrasting this with the results achieved in authorities that have taken a community leadership role, the paper examines the potential of the White Paper. It addresses the following questions: does local government have the capacity to deliver increased local action on climate change? Does the UK policy framework support and encourage development and deployment of this capacity? And do the national and regional bodies that provide support for local authorities need to change the services they offer in light of recent policy developments?.

Local government energy action in the UK: from service delivery to community leadership. Volume 1

International Nuclear Information System (INIS)

Wade, Joanne; Pearson, Amanda; Knowland, Rachael; Flanagan, Brooke

2007-01-01

In October 2006 the UK government published a new Local Government White Paper. This policy statement set the framework for the role of local government in the coming years.The White Paper is one stage in the latest wave of local government reform in the UK. This reform has aimed to refocus attention away from delivery of specific services and towards community leadership, particularly with reference to sustainable development. Climate change is given some emphasis within the White Paper, and should become one of the indicators against which local government performance is measured.This paper examines energy action in local authorities in the past few years, in a situation where most, but not all, were still strongly focused on service delivery. By contrasting this with the results achieved in authorities that have taken a community leadership role, the paper examines the potential of the White Paper. It addresses the following questions: does local government have the capacity to deliver increased local action on climate change? Does the UK policy framework support and encourage development and deployment of this capacity? And do the national and regional bodies that provide support for local authorities need to change the services they offer in light of recent policy developments?

Limits to Decentralization in Mozambique: Leadership, Politics and Local Government Capacities for Service Delivery

NARCIS (Netherlands)

A.P.J. Machohe (Antonio)

2011-01-01

textabstractMozambique has been a centralized State since its independence in 1975. During this time, local government has depended on the Central Government and has lacked autonomy in both local policy decisions and resource management in addition to the complete failure of effective local services

Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

Science.gov (United States)

Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

2016-01-01

To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice

Service Quality and Consumer Perception on Retail Banking Facilities and Employees' Courtesy in Malaysia and New Zealand

OpenAIRE

Moha Asri Abdullah; Noor Hazilah Abd Manaf; Kamru Ahsan; Ferdous Azam

2014-01-01

Service quality and consumer perception are the issues being focused solicitously by the business community today. With the expansion of the banking sector and extensive market formation, scopes of different acuity and satisfaction level for consumers seem to impose a mingle game of their perception on service quality especially in retail banking. However, this study is focused on the service quality and consumer perception on retail banking facilities and employees' courtesy in Malaysia and ...

Fiscal pressures and the privatization of local services

OpenAIRE

Yolanda K. Kodrzycki

1998-01-01

The privatization movement appears to have lost some momentum in the United States over the 1990s. Although local governments continue to look for ways to deliver services more efficiently by using private contractors, the pace at which they are issuing contracts has slowed. In part, the trends may reflect political realities. Public employees naturally are concerned about losing their jobs, and they constitute a sizable share of the electorate. The limited role of outside contractors may als...

Health Care Expenditures After Initiating Long-term Services and Supports in the Community Versus in a Nursing Facility.

Science.gov (United States)

Newcomer, Robert J; Ko, Michelle; Kang, Taewoon; Harrington, Charlene; Hulett, Denis; Bindman, Andrew B

2016-03-01

Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs. To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care. Retrospective cohort analysis of California dually eligible adult Medicaid and Medicare beneficiaries who initiated Medicaid LTSS, identified as HCBS or extended nursing facility care, in 2006 or 2007. Propensity score matching for demographic, health, and functional characteristics resulted in a subsample of 34,660 users who initiated Medicaid HCBS versus extended nursing facility use. Those with developmental disabilities or in managed care plans were excluded. Average monthly adjusted acute, postacute, long-term, and total Medicare and Medicaid expenditures for the 12 months following initiation of either HCBS or extended nursing facility care. Those initiating extended nursing facility care had, on average, $2919 higher adjusted total health care expenditures per month compared with those who initiated HCBS. The difference was primarily attributable to spending on LTSS $2855. On average, the monthly LTSS expenditures were higher for Medicare $1501 and for Medicaid $1344 when LTSS was provided in a nursing facility rather than in the community. The higher cost of delivering LTSS in a nursing facility rather than in the community was not offset by lower acute and postacute spending. Medicare and Medicaid contribute similar amounts to the LTSS cost difference and both could benefit financially by redirecting care from institutions to the community.

A hybrid algorithm for stochastic single-source capacitated facility location problem with service level requirements

Directory of Open Access Journals (Sweden)

Hosseinali Salemi

2016-04-01

Full Text Available Facility location models are observed in many diverse areas such as communication networks, transportation, and distribution systems planning. They play significant role in supply chain and operations management and are one of the main well-known topics in strategic agenda of contemporary manufacturing and service companies accompanied by long-lasting effects. We define a new approach for solving stochastic single source capacitated facility location problem (SSSCFLP. Customers with stochastic demand are assigned to set of capacitated facilities that are selected to serve them. It is demonstrated that problem can be transformed to deterministic Single Source Capacitated Facility Location Problem (SSCFLP for Poisson demand distribution. A hybrid algorithm which combines Lagrangian heuristic with adjusted mixture of Ant colony and Genetic optimization is proposed to find lower and upper bounds for this problem. Computational results of various instances with distinct properties indicate that proposed solving approach is efficient.

The Organisation of Local Mental Health Services in Norway: Evidence, Uncertainty and Policy

Science.gov (United States)

Ramsdal, Helge; Hansen, Gunnar Vold

2017-01-01

This article addresses questions about health authorities' recommendations on the local organisation of services for people with mental health disorders in Norway. Analysis is made of the dynamic relationship between different evaluations, national guidelines and other knowledge that influence the organisation of services. The analysis is based…

Facilities Management Service Delivery in Public and Private High Rise Residential Buildings in Nigeria: A case study of Eko Court Complex and Niger Towers

Directory of Open Access Journals (Sweden)

Olanrele O. O.

2014-01-01

Full Text Available This study assessed and compared the delivery of Facilities Management (FM services in public and private high rise residential buildings in Lagos, Nigeria. While some facilities or services may not be available in some public estates, the efficiency of the available ones is inadequate in comparison with the adequacy and efficiency of services provided in private estates. The objectives set for the study include identification of services that are provided in the case studies, service delivery method, and an assessment of the residents’ satisfaction of the services. This study adopted questionnaire survey for collection of data. 127 questionnaires were distributed to the residents of the case studies and 93 were returned. Three of which were discarded for incompleteness, thus 90 were analysed. The study found that most but not all of the facilities services expected in high rise buildings are available in the case studies and the services are outsourced under a standard Service Level Agreement. The service delivery in private high rise residential building is better than the public residential high rise buildings as revealed by the study. The study recommends improved standardization of services, customized services and meeting customer’s expectation for improved service delivery.

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

Science.gov (United States)

Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

2015-03-06

A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

Perceived Barriers to Utilizing Maternal and Neonatal Health Services in Contracted-Out Versus Government-Managed Health Facilities in the Rural Districts of Pakistan

Directory of Open Access Journals (Sweden)

Atif Riaz

2015-05-01

Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.

Australian clinical dosimetry service at ARPANSA

International Nuclear Information System (INIS)

McDonald, Abel; Williams, Ivan

2010-01-01

Full text: Earlier this year, the Australian Health Ministers' Advisory Council accepted the Federal Government's offer to fund the establishment and operation for 3 years of an Australian Clinical Dosimetry Service (ACDS). The service will be located within the Australian Radiation Protection and Nuclear Safety Agency in Yallambie, Victoria and will commence operation at the beginning of 20II. The purpose of the ACDS is to make available independent checks and auditing services to all Australian radiotherapy services. These services will range form postal audits to site visits, and include treatment dose assessments using phantoms (Level III audits). There will be a Clinical Advisory Group to oversee the development of the service, so the ACPSEM and other professional groups will playa key role in developing the ACDS. In consultation with radiotherapy facilities, the ACDS will establish an Audit Panel which will be made up of local staff to assist with on site work and minimise travel costs. The results of all measurements made by the ACDS will be confi dential: only de-identified data would be publicly reported. The service will be free to participating facilities in the first 3 years. An independent review will be conducted in the third year to determine the ongoing arrangements for the service.

Mapping of pedestrian characteristics and level of service for facilities at Universitas Negeri Malang using geographic information system

Science.gov (United States)

Rahayuningsih, Titi; Pranoto, Nindyawati, Umniati, B. Sri; Mardhika, Moch Aqfa Syabahid

2017-09-01

Universitas Negeri Malang (UM) is a university with the second largest academic community in Malang. The activities of the academic community should be supported by adequate facilities, such as pedestrian facilities—crucial yet much neglected matters, so pedestrians to walk along the roadway. As a result, conflicts between pedestrians with motor vehicle users and accidents might occur at any time. This research aimed at: 1) investigating the geometric conditions of pedestrian facilities at UM; 2) identifying the characteristics of pedestrians and the pedestrian facilities at UM; and 3) determining the level of service for pedestrian facilities at UM using Geographic Information System (GIS). The research was conducted through survey of location, survey of geometric conditions, estimation of the number of pedestrians using sidewalk (data were recorded every 15 minutes), measurement of pedestrian speed, and questionnaire about pedestrians' identity, destination, as well as travel time and distance. Data analysis was carried out to identify the pedestrian characteristics, pedestrian flow characteristics, and pedestrian level of service. The research result showed that the percentage of road segments in campus without sidewalks was 52%. The average width of sidewalk was 1.33 m, which was less than the minimum standard of i.e. 2 m. In terms of pedestrian characteristics, the pedestrians consisted of more female (51%) who were mostly students of the Faculty of Letters whose destination was classroom building. The maximum pedestrian flow was at 10.00-13.30 i.e. 4.2018 p/m/min. The average speed of pedestrian was 63.49 m/min. The highest pedestrian density of 0.0609 p/m2 occurred at 10.00-13.30. The largest walking space was 28.0348 m2/p and occurred in the afternoon at 13.30-17.00. The level of service for pedestrian facilities belonged to category A in the morning and afternoon. The level of service at 10.00-13.30 decreased to category B.

Local inpatient units may increase patients’ utilization of outpatient services: a comparative cohort-study in Nordland County, Norway

Science.gov (United States)

Myklebust, Lars Henrik; Sørgaard, Knut; Wynn, Rolf

2015-01-01

Objectives In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care. Methods Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays. Results The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients’ use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized), a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays. Conclusion Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care. PMID:26604843

Local inpatient units may increase patients' utilization of outpatient services: a comparative cohort-study in Nordland County, Norway.

Science.gov (United States)

Myklebust, Lars Henrik; Sørgaard, Knut; Wynn, Rolf

2015-01-01

In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care. Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays. The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients' use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized), a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays. Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care.

Factors determining the concentration and chemical composition of particulate matter in the air of selected service facilities

Science.gov (United States)

Rogula-Kopiec, Patrycja; Pastuszka, Józef; Mathews, Barbara; Widziewicz, Kamila

2018-01-01

The link between increased morbidity and mortality and increasing concentrations of particulate matter (PM) resulted in great attention being paid to the presence and physicochemical properties of PM in closed rooms, where people spends most of their time. The least recognized group of such indoor environments are small service facilities. The aim of this study was to identify factors which determine the concentration, chemical composition and sources of PM in the air of different service facilities: restaurant kitchen, printing office and beauty salon. The average PM concentration measured in the kitchen was 5-fold (PM4, particle fraction ≥ 4 μm) and 5.3-fold (TSP, total PM) greater than the average concentration of these PM fractions over the same period. During the same measurement period in the printing office and in the beauty salon, the mean PM concentration was 10- and 4-fold (PM4) and 8- and 3-fold (TSP) respectively greater than the mean concentration of these PM fractions in outdoor air. In both facilities the main source of PM macro-components, especially organic carbon, were chemicals, which are normally used in such places - solvents, varnishes, paints, etc. The influence of some metals inflow from the outdoor air into indoor environment of those facilities was also recognized.

Health equity issues at the local level: Socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti

Directory of Open Access Journals (Sweden)

Aftab Asma S

2007-08-01

Full Text Available Abstract Background Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. Methods We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. Results We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. Conclusion These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not

Health equity issues at the local level: socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti.

Science.gov (United States)

Perry, Henry B; King-Schultz, Leslie W; Aftab, Asma S; Bryant, John H

2007-08-01

Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS) in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not even greater, levels of health inequities exist. These inequities

Local Government Implementation of Long-Term Stewardship at Two DOE Facilities

Energy Technology Data Exchange (ETDEWEB)

John Pendergrass; Roman Czebiniak; Kelly Mott; Seth Kirshenberg; Audrey Eidelman; Zachary Lamb; Erica Pencak; Wendy Sandoz

2003-08-13

The Department of Energy (DOE) is responsible for cleaning up the radioactive and chemical contamination that resulted from the production of nuclear weapons. At more than one hundred sites throughout the country DOE will leave some contamination in place after the cleanup is complete. In order to protect human health and the environment from the remaining contamination DOE, U.S. Environmental Protection Agency (EPA), state environmental regulatory agencies, local governments, citizens and other entities will need to undertake long-term stewardship of such sites. Long-term stewardship includes a wide range of actions needed to protect human health in the environment for as long as the risk from the contamination remains above acceptable levels, such as barriers, caps, and other engineering controls and land use controls, signs, notices, records, and other institutional controls. In this report the Environmental Law Institute (ELI) and the Energy Communities Alliance (ECA) examine how local governments, state environmental agencies, and real property professionals implement long-term stewardship at two DOE facilities, Losa Alamos National Laboratory and Oak Ridge Reservation.

Transfusion in Haemoglobinopathies: Review and recommendations for local blood banks and transfusion services in Oman

Directory of Open Access Journals (Sweden)

Arwa Z. Al-Riyami

2018-04-01

Full Text Available Sickle cell disease and homozygous β-thalassaemia are common haemoglobinopathies in Oman, with many implications for local healthcare services. The transfusions of such patients take place in many hospitals throughout the country. Indications for blood transfusions require local recommendations and guidelines to ensure standardised levels of care. This article summarises existing transfusion guidelines for this group of patients and provides recommendations for blood banks and transfusion services in Oman. This information is especially pertinent to medical professionals and policy-makers developing required services for the standardised transfusion support of these patients.

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews.

Science.gov (United States)

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-Ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

HIV Services Provided by STD Programs in State and Local Health Departments - United States, 2013-2014.

Science.gov (United States)

Cuffe, Kendra M; Esie, Precious; Leichliter, Jami S; Gift, Thomas L

2017-04-07

The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD

Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.

Science.gov (United States)

Unroe, Kathleen T; Bernard, Brittany; Stump, Timothy E; Tu, Wanzhu; Callahan, Christopher M

2017-07-01

To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. Retrospective cohort study using hospice patient electronic medical record data. Large, national hospice provider. Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed. Descriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings. Minimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months. There are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

Science.gov (United States)

Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

2010-01-01

This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

Measuring disaster preparedness of local emergency medical services agencies

OpenAIRE

Elliott, Ross W.

2010-01-01

CHDS State/Local Approved for public release; distribution is unlimited Emergency Medical Services (EMS) plays a key role in disaster response. Yet, determining how much preparedness is enough to achieve an acceptable level of preparedness is challenging. After conducting an extensive literature review, it is evident no nationally accepted method exists to evaluate an EMS system's level of disaster preparedness systematically. Research was conducted to define the skills and equipmen...

Print Advertising of Educational Services: an investigation on the impact of the pictures facilities and testimonial about attitudes

OpenAIRE

Ayrosa, Eduardo André Teixeira; Facó, Marcos Henrique

2010-01-01

Just like other services organizations, some higher education institutions have invested in printed advertising to attract applicants. The services management literature suggests that using stimuli such as pictures of the facilities and alumni testimonials may help to turn tangible the offer of services so strongly intangible as higher education. In the present work, the impact of two different types of cue on prospects' attitudes is investigated. The cue paradigm (Olson & Jacoby 1972) has be...

Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults

Science.gov (United States)

There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...

Chapter 51: How to Build a Simple Cone Search Service Using a Local Database

Science.gov (United States)

Kent, B. R.; Greene, G. R.

The cone search service protocol will be examined from the server side in this chapter. A simple cone search service will be setup and configured locally using MySQL. Data will be read into a table, and the Java JDBC will be used to connect to the database. Readers will understand the VO cone search specification and how to use it to query a database on their local systems and return an XML/VOTable file based on an input of RA/DEC coordinates and a search radius. The cone search in this example will be deployed as a Java servlet. The resulting cone search can be tested with a verification service. This basic setup can be used with other languages and relational databases.

76 FR 37853 - Arizona Public Service Company; Notice of Consideration of Issuance of Amendment to Facility...

Science.gov (United States)

2011-06-28

...] Arizona Public Service Company; Notice of Consideration of Issuance of Amendment to Facility Operating License, Proposed No Significant Hazards Consideration Determination, and Opportunity for a Hearing AGENCY... consideration. Under the Commission's regulations in Title 10 of the Code of Federal Regulations (10 CFR...

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

Science.gov (United States)

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Purpose Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Conclusion Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings. PMID:29760573

The inner-city Skater Facility - playground or control mechanism?

DEFF Research Database (Denmark)

Gravesen, David Thore

2016-01-01

special Social services, School and Police unit), that observe, mingle and socialize at the facility. The social workers affiliated with the SSP understand and define their role in contradiction to the official agenda. The social workers seek to pull the young people off the street and get them to enroll......The inner-city Skater Facility - playground or control mechanism? In 2013, the municipality in Horsens, a medium-sized provincial town in Denmark, bestowed the city's children and young people a skater facility at the city's central squares. Officially, the municipality donated the facility to give...... local children and young people an opportunity to use their leisure time stimulating their bodies, having a great time with friends and other urban dwellers. The gift is accompanied by a number of (more or less camouflaged) crime prevention- and social education agendas, carried out by the SSP (a...

Lake and wetland ecosystem services measuring water storage and local climate regulation

Science.gov (United States)

Wong, Christina P.; Jiang, Bo; Bohn, Theodore J.; Lee, Kai N.; Lettenmaier, Dennis P.; Ma, Dongchun; Ouyang, Zhiyun

2017-04-01

Developing interdisciplinary methods to measure ecosystem services is a scientific priority, however, progress remains slow in part because we lack ecological production functions (EPFs) to quantitatively link ecohydrological processes to human benefits. In this study, we tested a new approach, combining a process-based model with regression models, to create EPFs to evaluate water storage and local climate regulation from a green infrastructure project on the Yongding River in Beijing, China. Seven artificial lakes and wetlands were established to improve local water storage and human comfort; evapotranspiration (ET) regulates both services. Managers want to minimize the trade-off between water losses and cooling to sustain water supplies while lowering the heat index (HI) to improve human comfort. We selected human benefit indicators using water storage targets and Beijing's HI, and the Variable Infiltration Capacity model to determine the change in ET from the new ecosystems. We created EPFs to quantify the ecosystem services as marginal values [Δfinal ecosystem service/Δecohydrological process]: (1) Δwater loss (lake evaporation/volume)/Δdepth and (2) Δsummer HI/ΔET. We estimate the new ecosystems increased local ET by 0.7 mm/d (20.3 W/m2) on the Yongding River. However, ET rates are causing water storage shortfalls while producing no improvements in human comfort. The shallow lakes/wetlands are vulnerable to drying when inflow rates fluctuate, low depths lead to higher evaporative losses, causing water storage shortfalls with minimal cooling effects. We recommend managers make the lakes deeper to increase water storage, and plant shade trees to improve human comfort in the parks.

Local inpatient units may increase patients' utilization of outpatient services: a comparative cohort-study in Nordland County, Norway

Directory of Open Access Journals (Sweden)

Myklebust LH

2015-10-01

Full Text Available Lars Henrik Myklebust,1 Knut Sørgaard,1,2 Rolf Wynn21Psychiatric Research Centre of North Norway, Nordland Hospital Trust, Bodø, 2Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, NorwayObjectives: In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care.Methods: Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays.Results: The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients' use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized, a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays.Conclusion: Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care.Keywords: psychiatry, hospitalization, decentralization, outpatients, continuity of care, health service research, affective

Facility overview for commercial application of selected Rocky Flats facilities

International Nuclear Information System (INIS)

1996-11-01

The purpose of this Facility Overview is to support the Rocky Flats Local Impacts Initiative's Request for Interest, to solicit interest from commercial corporations for utilizing buildings 865 and 883, and the equipment contained within each building, for a commercial venture. In the following sections, this document describes the Rocky Flats Site, the buildings available for lease, the equipment within these buildings, the site services available to a tenant, the human resources available to support operations in buildings 865 and 883, and the environmental condition of the buildings and property. In addition, a brief description is provided of the work performed to date to explore the potential products that might be manufactured in Buildings 865 and 883, and the markets for these products

Challenges and Opportunities for Biological Mass Spectrometry Core Facilities in the Developing World.

Science.gov (United States)

Bell, Liam; Calder, Bridget; Hiller, Reinhard; Klein, Ashwil; Soares, Nelson C; Stoychev, Stoyan H; Vorster, Barend C; Tabb, David L

2018-04-01

The developing world is seeing rapid growth in the availability of biological mass spectrometry (MS), particularly through core facilities. As proteomics and metabolomics becomes locally feasible for investigators in these nations, application areas associated with high burden in these nations, such as infectious disease, will see greatly increased research output. This article evaluates the rapid growth of MS in South Africa (currently approaching 20 laboratories) as a model for establishing MS core facilities in other nations of the developing world. Facilities should emphasize new services rather than new instruments. The reduction of the delays associated with reagent and other supply acquisition would benefit both facilities and the users who make use of their services. Instrument maintenance and repair, often mediated by an in-country business for an international vendor, is also likely to operate on a slower schedule than in the wealthiest nations. A key challenge to facilities in the developing world is educating potential facility users in how best to design experiments for proteomics and metabolomics, what reagents are most likely to introduce problematic artifacts, and how to interpret results from the facility. Here, we summarize the experience of 6 different institutions to raise the level of biological MS available to researchers in South Africa.

Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Waste Disposal Facility

Energy Technology Data Exchange (ETDEWEB)

Ansley, Shannon Leigh

2002-02-01

The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist.

Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Wastewater Discharge Facility

International Nuclear Information System (INIS)

Ansley, Shannon L.

2002-01-01

The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

Science.gov (United States)

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael

2012-01-01

The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these

Integrated Automatic Workflow for Phylogenetic Tree Analysis Using Public Access and Local Web Services.

Science.gov (United States)

Damkliang, Kasikrit; Tandayya, Pichaya; Sangket, Unitsa; Pasomsub, Ekawat

2016-11-28

At the present, coding sequence (CDS) has been discovered and larger CDS is being revealed frequently. Approaches and related tools have also been developed and upgraded concurrently, especially for phylogenetic tree analysis. This paper proposes an integrated automatic Taverna workflow for the phylogenetic tree inferring analysis using public access web services at European Bioinformatics Institute (EMBL-EBI) and Swiss Institute of Bioinformatics (SIB), and our own deployed local web services. The workflow input is a set of CDS in the Fasta format. The workflow supports 1,000 to 20,000 numbers in bootstrapping replication. The workflow performs the tree inferring such as Parsimony (PARS), Distance Matrix - Neighbor Joining (DIST-NJ), and Maximum Likelihood (ML) algorithms of EMBOSS PHYLIPNEW package based on our proposed Multiple Sequence Alignment (MSA) similarity score. The local web services are implemented and deployed into two types using the Soaplab2 and Apache Axis2 deployment. There are SOAP and Java Web Service (JWS) providing WSDL endpoints to Taverna Workbench, a workflow manager. The workflow has been validated, the performance has been measured, and its results have been verified. Our workflow's execution time is less than ten minutes for inferring a tree with 10,000 replicates of the bootstrapping numbers. This paper proposes a new integrated automatic workflow which will be beneficial to the bioinformaticians with an intermediate level of knowledge and experiences. All local services have been deployed at our portal http://bioservices.sci.psu.ac.th.

Valuing environmental services provided by local stormwater management

Science.gov (United States)

Brent, Daniel A.; Gangadharan, Lata; Lassiter, Allison; Leroux, Anke; Raschky, Paul A.

2017-06-01

The management of stormwater runoff via distributed green infrastructures delivers a number of environmental services that go beyond the reduction of flood risk, which has been the focus of conventional stormwater systems. Not all of these services may be equally valued by the public, however. This paper estimates households' willingness to pay (WTP) for improvements in water security, stream health, recreational and amenity values, as well as reduction in flood risk and urban heat island effect. We use data from nearly 1000 personal interviews with residential homeowners in Melbourne and Sydney, Australia. Our results suggest that the WTP for the highest levels of all environmental services is A799 per household per year. WTP is mainly driven by residents valuing improvements in local stream health, exemptions in water restrictions, the prevention of flash flooding, and decreased peak urban temperatures respectively at A297, A244, A104 and A$65 per year. We further conduct a benefit transfer analysis and find that the WTP and compensating surplus are not significantly different between the study areas. Our findings provide additional support that stormwater management via green infrastructures have large nonmarket benefits and that, under certain conditions, benefit values can be transferred to different locations.

Corporate Statements in the Facilities Industry

DEFF Research Database (Denmark)

Holzweber, Markus

In today’s services business domain, especially in facility services and facilities management (FM), customers are becoming more informed as to the level of choice and competition for their custom. This has led businesses to develop and maintain strategic elements of corporate statements that wil......In today’s services business domain, especially in facility services and facilities management (FM), customers are becoming more informed as to the level of choice and competition for their custom. This has led businesses to develop and maintain strategic elements of corporate statements...... statements from FM organizations was selected and linked to financial data. The article reveals that the FM services industry would benefit from the concept of capability coherence. Findings showed that FM organizations showing higher scores of capability coherence have higher profitability scores....

Women's social networks and use of facility delivery services for uncomplicated births in North West Ethiopia: a community-based case-control study.

Science.gov (United States)

Asrese, Kerebih; Adamek, Margaret E

2017-12-28

High maternal mortality has remained an unmet public health challenge in the developing world. Maternal mortality in Ethiopia is among the highest in the world. Since most maternal deaths occur during labor, delivery, and the immediate postpartum period, facility delivery with skilled birth attendants is recommended to reduce maternal mortality. Nonetheless, the majority of women in Ethiopia give birth at home. Individual attributes and availability and accessibility of services deter service utilization. The role of social networks that may facilitate or constrain service use is not well studied. Community-based case-control study was conducted between February and March 2014 in Jabi Tehinan District, North West Ethiopia. Retrospective data were collected from 134 women who had uncomplicated births at health facilities and 140 women who had uncomplicated births at home within a year preceding the survey. Interviews were held with eight women who had uncomplicated births at health facilities and 11 who had uncomplicated births at home. The quantitative data were entered and analyzed using SPSS for Windows versions 16.0 and hierarchical logistic regression model was used for analysis. The qualitative data were transcribed verbatim and data were used to substantiate the quantitative data. The results indicated that social network variables were significantly associated with the use of health facilities for delivery. Taking social networks into account improved the explanation of facility use for delivery services over women's individual attributes. Women embedded within homogeneous network members (Adjusted OR 2.53; 95% CI: 1.26-5.06) and embedded within high SBA endorsement networks (Adjusted OR 7.97; 95% CI: 4.07-12.16) were more likely to deliver at health facilities than their counterparts. Women living in urban areas (Adjusted OR 3.32; 95% CI: 1.37-8.05) and had better knowledge of obstetric complications (Adjusted OR 3.01; 95% CI: 1.46-6.18) were more likely to

48 CFR 871.208 - Rehabilitation facilities.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation facilities for the rehabilitation services provided under 38 U.S.C. Chapter 31 are paid in the same manner as...

Facility management research in the Netherlands

NARCIS (Netherlands)

Thijssen, Thomas; van der Voordt, Theo; Mobach, Mark P.

This article provides a brief overview of the history and development of facility management research in the Netherlands and indicates future directions. Facility management as a profession has developed from single service to multi-services and integral services over the past 15 years.

Hanford Site near-facility environmental monitoring data report for calendar year 1998

Energy Technology Data Exchange (ETDEWEB)

DIEDIKER, L.P.

1999-07-29

This document summarizes the results of the U.S. Department of Energy's Near-Facility Environmental Monitoring program conducted by Waste Management Federal Services of Hanford, Inc. for Fluor Daniel Hanford, Inc. for 1998 in the 100,200/600, and 300/400 Areas of the Hanford Site, in southcentral Washington State. Surveillance activities included sampling and analyses of ambient air, surface water, groundwater, soil, sediments, and biota. Also, external radiation measurements and radiological surveys were taken at waste disposal sites, radiologically controlled areas, and roads. These activities were conducted to assess and control the effects of nuclear facilities and waste sites on the local environment. In addition, diffuse sources were monitored to determine compliance with federal, state, and/or local regulations. In general, although effects from nuclear facilities can still be observed on the Hanford Site and radiation levels are slightly elevated when compared to offsite locations, the differences are less than in previous years.

Hanford Site near-facility environmental monitoring data report for calendar year 1998

International Nuclear Information System (INIS)

DIEDIKER, L.P.

1999-01-01

This document summarizes the results of the U.S. Department of Energy's Near-Facility Environmental Monitoring program conducted by Waste Management Federal Services of Hanford, Inc. for Fluor Daniel Hanford, Inc. for 1998 in the 100,200/600, and 300/400 Areas of the Hanford Site, in southcentral Washington State. Surveillance activities included sampling and analyses of ambient air, surface water, groundwater, soil, sediments, and biota. Also, external radiation measurements and radiological surveys were taken at waste disposal sites, radiologically controlled areas, and roads. These activities were conducted to assess and control the effects of nuclear facilities and waste sites on the local environment. In addition, diffuse sources were monitored to determine compliance with federal, state, and/or local regulations. In general, although effects from nuclear facilities can still be observed on the Hanford Site and radiation levels are slightly elevated when compared to offsite locations, the differences are less than in previous years

Examining Regionalization Efforts to Develop Lessons Learned and Consideration for Department of Defense Medical Facilities

Science.gov (United States)

2017-03-23

outsourcing effects of military maintenance depots. They found maintenance depots were not working at full capacity and in some cases privatizing the...need to look at the impact of the consolidated departments and if a common goal can be achieved. Funding differences can also affect regionalization...therefore be out of service until fixed. Mitchell & Pasch [5] added that there could be a customer service impact consolidating local facilities into

42 CFR 136.110 - Facilities construction.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Facilities construction. 136.110 Section 136.110..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Grants for Development, Construction, and Operation of Facilities and Services § 136.110 Facilities construction. In addition to other requirements of this subpart...

Does local government staff perceive digital communication with citizens as improved service?

DEFF Research Database (Denmark)

Berger, Jesper Bull; Hertzum, Morten; Schreiber, Trine

2016-01-01

Digital communication between government and citizens is pivotal to e-government. The Danish e-government initiative Digital Post aims to digitize all communications between government and citizens. We surveyed local government staff about how Digital Post affects the service delivered to citizens....... As much as 82% of the 448 respondents considered digital communication with citizens using Digital Post a good idea, yet 47% reported concrete incidents in which they perceived a decrease in service with Digital Post. This result shows the importance of distinguishing between the overall service...... relationship and the concrete incidents of which the service consists. We discuss interactions between the relationship level and the incident level of Digital Post on the basis of a content analysis of the respondents' incident descriptions....

Diagnostic delay amongst tuberculosis patients in Jogjakarta Province, Indonesia is related to the quality of services in DOTS facilities.

Science.gov (United States)

Ahmad, Riris Andono; Mahendradhata, Yodi; Utarini, Adi; de Vlas, Sake J

2011-04-01

To understand determinants of care-seeking patterns and diagnostic delay amongst tuberculosis (TB) patients diagnosed at direct observed treatment short course (DOTS) facilities in Jogjakarta, Indonesia. Cross-sectional survey amongst newly diagnosed TB patients in 89 DOTS facilities whose history of care-seeking was reconstructed through retrospective interviews gathering data on socio-demographic determinants, onset of TB symptoms, type of health facilities visited, duration of each care-seeking action were recorded. Two hundred and fifty-three TB patients were included in the study whose median duration of patients' delay was 1 week and whose total duration of diagnostic delay was 5.4 weeks. The median number of visits was 4. Many of the patients' socio-demographic determinants were not associated with the care-seeking patterns, and no socio-demographic determinants were associated with the duration of diagnostic delay. More than 60% of TB patients started their care-seeking processes outside DOTS facilities, but the number of visits in DOTS facilities was greater during the overall care-seeking process. Surprisingly, patient's immediate visits to a DOTS facility did not correspond to shorter diagnostic delay. Diagnostic delay in Jogjakarta province was not associated with patients' socio demographic factors, but rather with the health system providing DOTS services. This suggests that strengthening the health system and improving diagnostic quality within DOTS services is now a more rational strategy than expanding the TB programme to engage more providers. © 2010 Blackwell Publishing Ltd.

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

Science.gov (United States)

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

[Autonomy for financial management in public and private healthcare facilities in Brazil].

Science.gov (United States)

Santos, Maria Angelica Borges dos; Madeira, Fátima Carvalho; Passos, Sonia Regina Lambert; Bakr, Felipe; Oliveira, Klivia Brayner de; Andreazzi, Marco Antonio Ratzsch de

2014-01-01

Autonomy in financial management is an advantage in public administration. A 2009 National Healthcare Facility Survey showed that 3.9% of Brazil's 52,055 public healthcare facilities had some degree of financial autonomy. Such autonomy was more common in inpatient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for resources in specific areas, relating to small outlays, consumables and capital goods, and outsourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facilities appears to be linked to local political decisions and not necessarily to the facility's specific legal and administrative status. However, legal status displays distinct scopes of autonomy - those under direct government administration tend to be less autonomous, and those under private businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.

STUDY REGARDING THE MANAGEMENT OF LOCAL POLICEMAN CAREER WITHIN THE REŞIŢA LOCAL POLICE DIVISION PUBLIC SERVICE

Directory of Open Access Journals (Sweden)

GHERGHINA LILIANA

2016-10-01

Full Text Available The paper entitled Study regarding the Management of Local Policemen Career within the Reşiţa Local Police Division Public Service aims at highlighting the need for this public service in the Reşiţa municipality community, the importance of the public office in this context, of the public service, of the public servant with special statute and, last but not least, of the managerial act in the administration of this type of human resources, and implicitly this type of career. Starting from the theoretic identifications and their translation into the practice of the field chosen for research we could conclude that in the development of the local policemen career, a special role is played by the human resources management, especially the management of the career of this value-bearing resource. Our investigation was based on the opinion poll-type inquiry, the main instrument being the questionnaire conceived, administered and then valorised and interpreted. The conclusions generated by this research highlighted step by step, along the activities of the analysed human resources management and implicitly their career management, the actual positive or negative aspects and the fact that the management of human resources and implicitly of their career which, we scrutinised – that of police officer or policeman in short – assures with priority: the observance of the legislation specific to the investigated field, support for the development of the local policemen’s career, their prompt availability in due time, the knowledge and fulfilment of the tasks according to the job and position requirements, all this assures the understanding of the employees’ expectations, of the change of employees’ roles within the organisation depending on their experience and solves the conflicts among the employees. Nevertheless, we identified, in a less significant percentage , some cases of discontent and dissatisfaction, cases that could generate ideas for

Centralized vs. decentralized child mental health services.

Science.gov (United States)

Adams, M S

1977-09-01

One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here.

Quick-Reaction Report on the Audit of ReCoupment Actions on Medicine Payments to Uniformed Services Treatment Facilities.

Science.gov (United States)

1993-07-21

OFFICE OF THE INSPECTOR GENERAL QUICK-REACTION REPORT ON THE AUDIT OF RECOUPMENT ACTIONS ON MEDICARE PAYMENTS TO UNIFORMED SERVICES TREATMENT...Quick-Reaction Report on the Audit of Recoupment Actions on Medicare Payments to Uniformed Services Treatment Facilities (Report No. 93-150) We are...Inspectors General will provide a joint report to the congressional committees that requested the audit . The courtesies extended to the audit staff

Towards understanding citizens trust in local government authorities in social service provision: A case of education service in Maswa district Tanzania

Directory of Open Access Journals (Sweden)

Robert Makorere

2012-09-01

Full Text Available The paper stresses on understanding citizens’ trust to local government authorities in the provision of social services, the case of education service in Maswa district. The paper discloses that majority of respondents of 82.2% of total respondents were not involved in full council meetings, although the meetings are supposed to be open to the public and all information that is presented there is public information which includes proposed plans and budgets as well as quarterly progress reports. This shows that there are problems in primary education. Moreover, due to various problems that still exist in primary education in the area under study, they created a sense of distrust between citizens to local government and local leaders to be specific including Village Executive Officers, Ward Executive Officers and councilors since majority of the respondents revealed that they are lazy harass people. This makes people to be reluctant to participate in development activities include refusing to contribute financially in various development initiatives since they do not see importance of their local leaders so they decide to take their own decisions.

Why are babies born before arrival at health facilities in King Sabata Dalindyebo Local Municipality, Eastern Cape, South Africa? A qualitative study

Directory of Open Access Journals (Sweden)

Adeyinka A. Alabi

2015-11-01

Full Text Available Introduction: Babies born before arrival at a health facility have a higher risk of neonatal death and their mothers a higher risk of maternal death compared with those born in-facility. The study explored the reasons for mothers giving birth before arrival (BBA at health facilities and their experiences of BBA. Methods: A qualitative research design was used. Individual and focus group interviews of BBA mothers and of nurses were undertaken at a community health centre and a district hospital in King Sabata Dalindyebo Local Municipality. Results: Reasons for BBA included a lack of transport, a lack of security at night that deterred mothers from travelling, precipitate labour, failure to identify true labour, and a lack of waiting areas at health facilities. Traditional and cultural beliefs favouring childbirth at homeand nurses’ negative attitudes during antenatal care and labour influenced mothers to go to health facilities when in advanced labour. Mothers were aware of possible complications associated with BBA. Conclusion: Socio-economic, individual, cultural and health system factors influence the occurrence of BBA. Relevant parties need to address these factors to ensure that all babies in the King Sabata Dalindyebo Local Municipality are delivered within designated health facilities.

Examining the Potential for Agricultural Benefits from Pollinator Habitat at Solar Facilities in the United States.

Science.gov (United States)

Walston, Leroy; Mishra, Shruti Khadka; Hartmann, Heidi M; Hlohowskyj, Ihor; McCall, James; Macknick, Jordan

2018-05-28

Of the many roles insects serve for ecosystem function, pollination is possibly the most important service directly linked to human well-being. However, land use changes have contributed to the decline of pollinators and their habitats. In agricultural landscapes that also support renewable energy developments such as utility-scale solar energy [USSE] facilities, opportunities may exist to conserve insect pollinators and locally restore their ecosystem services through the implementation of vegetation management approaches that aim to provide and maintain pollinator habitat at USSE facilities. As a first step towards understanding the potential agricultural benefits of solar-pollinator habitat, we identified areas of overlap between USSE facilities and surrounding pollinator-dependent crop types in the United States (U.S.). Using spatial data on solar energy developments and crop types across the U.S, and assuming a pollinator foraging distance of 1.5 km, we identified over 3,500 km2 of agricultural land near existing and planned USSE facilities that may benefit from increased pollination services through the creation of pollinator habitat at the USSE facilities. The following five pollinator-dependent crop types accounted for over 90% of the agriculture near USSE facilities, and these could benefit most from the creation of pollinator habitat at existing and planned USSE facilities: soybeans, alfalfa, cotton, almonds, and citrus. We discuss how our results may be used to understand potential agro-economic implications of solar-pollinator habitat. Our results show that ecosystem service restoration through the creation of pollinator habitat could improve the sustainability of large-scale renewable energy developments in agricultural landscapes.

Challenges for a Local Service Agency to Address Domestic Violence –A Case Study From Rural Indonesia

Science.gov (United States)

Hayati, Elli Nur; Emmelin, Maria; Eriksson, Malin

2014-01-01

Since the launch of a Zero Tolerance Policy in Indonesia, several policies to address domestic violence have been enacted. The obligation of local governments to establish service units for women survivors of domestic violence is one of them. Since domestic violence is a sensitive and complex issue in Indonesia it is important to understand how governmentally regulated services function in practice. This case study aimed to explore challenges faced by a local service agency in managing service provision for women survivors of domestic violence in rural Indonesia. Data from one focus group discussion (12 participants), four individual interviews, six short narratives, two days of participant observation, as well as archive reviews were collected. All data were analyzed using Grounded Theory Situational Analysis. The major challenge faced by the local agency was the low priority that was given them by the local authorities, mirrored also in low involvement by the assigned volunteers in the daily service. The study also identified a gap between the socio-cultural arena and the law & policy arena that needs to be bridged to avoid that the two arenas address domestic violence in a contradictory way. Budget allocation to support the sustainability of the daily routines of service agencies has to be given priority. There is also a need for careful considerations regarding the composition of personnel involved within daily management of service agencies addressing domestic violence. To bridge the gap between the legal systems and traditional cultural values, culturally adjusted alternative justice systems could be developed to increase women’s access to legal support. PMID:25363105

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

Directory of Open Access Journals (Sweden)

Hameed W

2018-05-01

Full Text Available Waqas Hameed, Muhammad Ishaque, Xaher Gul, Junaid-ur-Rehman Siddiqui, Sharmeen Hussain, Wajahat Hussain, Aftab Ahmed, Asma Balal Strategy Department, Marie Stopes Society, Karachi, Sindh, Pakistan Purpose: Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods: A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO clinics, social franchise (SF centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results: Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality and perception-based (satisfaction questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality. Conclusion: Our study indicates signs of courtesy bias and possibly the Hawthorne effect in

A localization property for facility location problems with arbitrary norms

DEFF Research Database (Denmark)

Juel, Henrik; Love, Robert F.

1988-01-01

In an earlier article (1983), the authors showed that, for facilities-location problems characterized by generalized distance norms and any even number of existing facilities, the optimal location of the new facility is at the intersection of the lines joining the pairs of facilities if these lin...

Is it feasible to pool funds for local children's services in England? Evidence from the national evaluation of children's trust pathfinders.

Science.gov (United States)

Lorgelly, Paula; Bachmann, Max; Shreeve, Ann; Reading, Richard; Thorburn, June; Mugford, Miranda; O'Brien, Margaret; Husbands, Chris

2009-01-01

To describe how funds were pooled or otherwise jointly managed by National Health Service (NHS) primary care trusts and local authorities in England. To compare expenditure on local children's services by health, education and social services. We conducted a questionnaire survey of all 35 children's trust pathfinders, six months after they were launched, with a follow-up at 2.5 years. We also undertook an in-depth analysis of local authorities and primary care trusts, within eight pathfinder areas and three non-pathfinder areas, whereby we compared expenditure on children's services, interviewed managers and professionals and examined financial documents. Local authorities and NHS trusts coordinated expenditure in various ways, most commonly through informal agreements and aligning budgets but also by formally pooling budgets. The latter were usually for selected services such as child and adolescent mental health services, though four children's trusts pathfinders pooled (or aligned) their budgets for all children's services. Total expenditure per child was greatest for education, lowest for social services and intermediate for health. However, it was difficult to quantify education expenditure on children with health and social care needs, and health care expenditure on children. Sharing money for local children's services requires shared objectives, trust, and legal and accounting expertise. Several different mechanisms are permitted and many are feasible but programme budgeting for children's services could make them more effective.

Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area.

Science.gov (United States)

Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L

2009-03-01

Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.

Medicare Advantage Members' Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services.

Science.gov (United States)

Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N

2015-06-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.

Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

Science.gov (United States)

Keohane, Laura M.; Grebla, Regina C.; Mor, Vincent; Trivedi, Amal N.

2015-01-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans’ expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. PMID:26056208

Benefits and Barriers of Information and Communication Technologies Adoption in Facilities Management Services Supply Chain

DEFF Research Database (Denmark)

Scupola, Ada

  This paper presents the results of a study of factors impacting information and communication technology (ICT) adoption in the supply chain of facilities management services. The research questions addressed in this study are: What are the key factors that influence adoption and assimilation of...

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

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Helen Killaspy

Full Text Available BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. METHOD: At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. RESULTS: 1750/2495 (70% users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning. A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. CONCLUSIONS: Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care

Evaluating technology service options.

Science.gov (United States)

Blumberg, D F

1997-05-01

Four service and support options are available to healthcare organizations for maintaining their growth arsenals of medical and information technology. These options include maintaining and servicing all equipment using a facility-based biomedical engineering and MIS service department; using a combination of facility-based service and subcontracted service; expanding facility-based biomedical and MIS service departments to provide service to other healthcare organizations to achieve economies of scale; and outsourcing all maintenance, repair, and technical support services. Independent service companies and original equipment manufacturers (OEMs) are offering healthcare organizations a wider array of service and support capabilities than ever before. However, some health systems have successfully developed their own independent service organizations to take care of their own--and other healthcare organizations'--service and support needs.

Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Wastewater Discharge Facility; TOPICAL

International Nuclear Information System (INIS)

Ansley, Shannon L.

2002-01-01

The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist

Nursing home facilities in Malaysia (premise, shared facilities & individual accommodation: Space requirement): A literature review

Science.gov (United States)

Nordin, Nik Muhammad Faris Bin Nik; Hasbollah, Hasif Rafidee bin; Ibrahim, Mohd Asrul Hery Bin; Marican, Nor Dalila bin; Halim, Muhd Hafzal bin Abdul; Rashid, Ahmad Faezi Bin Ab.; Yasin, Nurul Hafizah Binti Mohd

2017-10-01

The numbers of elderly in Malaysia are increased every year. The request towards elderly care services necessitated by the Nursing Home are in demand. However, Nursing Home in Malaysia is lack of standard of facilities in order to cater the care services for the elderly. This paper intends review the minimum standard facilities for the Nursing Homes in globally. The paper also offered insights in developing standard Nursing Home facilities in Malaysia.

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

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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.

The distribution of maternity services across rural and remote Australia: does it reflect population need?

Science.gov (United States)

Rolfe, Margaret I; Donoghue, Deborah Anne; Longman, Jo M; Pilcher, Jennifer; Kildea, Sue; Kruske, Sue; Kornelsen, Jude; Grzybowski, Stefan; Barclay, Lesley; Morgan, Geoffrey Gerard

2017-02-23

-economic status. Our investigation of current birthing services in rural and remote Australia identified disparities in their distribution. Population factors relating to vulnerability and isolation did not increase the likelihood of a local birthing facility, and very remote communities were less likely to have any service. In addition, services are influenced by jurisdictions.

Collaboration, facilities and communities in day care services for older people.

Science.gov (United States)

Adams, John

2001-05-01

Similarities and differences between day hospitals, run by the NHS, and day centres, run by local authorities or charitable organisations, have been widely discussed in the literature of gerontology for many years. The authors of this paper have undertaken a single blind, randomised-controlled trial to compare rehabilitation outcomes in the two settings, which was published in 1999. This research project involved augmenting the staff of day centres by visiting therapists. In addition to quantitative findings, their project also generated much qualitative data from interviews with health service and social service staff which provides the thought-provoking content. The themes identified included the reluctance of some patients to accept referral to a day centre, and the difficulties associated with discharging patients. Positive aspects included the opportunity to share skills, knowledge and resources. 29 references.

Filmless PACS in a multiple facility environment

Science.gov (United States)

Wilson, Dennis L.; Glicksman, Robert A.; Prior, Fred W.; Siu, Kai-Yeung; Goldburgh, Mitchell M.

1996-05-01

A Picture Archiving and Communication System centered on a shared image file server can support a filmless hospital. Systems based on this architecture have proven themselves in over four years of clinical operation. Changes in healthcare delivery are causing radiology groups to support multiple facilities for remote clinic support and consolidation of services. There will be a corresponding need for communicating over a standardized wide area network (WAN). Interactive workflow, a natural extension to the single facility case, requires a means to work effectively and seamlessly across moderate to low speed communication networks. Several schemes for supporting a consortium of medical treatment facilities over a WAN are explored. Both centralized and distributed database approaches are evaluated against several WAN scenarios. Likewise, several architectures for distributing image file servers or buffers over a WAN are explored, along with the caching and distribution strategies that support them. An open system implementation is critical to the success of a wide area system. The role of the Digital Imaging and Communications in Medicine (DICOM) standard in supporting multi- facility and multi-vendor open systems is also addressed. An open system can be achieved by using a DICOM server to provide a view of the system-wide distributed database. The DICOM server interface to a local version of the global database lets a local workstation treat the multiple, distributed data servers as though they were one local server for purposes of examination queries. The query will recover information about the examination that will permit retrieval over the network from the server on which the examination resides. For efficiency reasons, the ability to build cross-facility radiologist worklists and clinician-oriented patient folders is essential. The technologies of the World-Wide-Web can be used to generate worklists and patient folders across facilities. A reliable broadcast

Quality of local authority occupational therapy services: developing an instrument to measure the user's perspective.

NARCIS (Netherlands)

Calnan, S.; Sixma, H.J.; Calnan, M.W.; Groenewegen, P.P.

2000-01-01

The aims of this paper are threefold: (1) to describe the development of an instrument measuring quality of care from the specific perspective of the users of local authority occupational therapy services; (2) to present the results from a survey of users' views about the quality of services offered

Do service innovations influence the adoption of electronic health records in long-term care organizations? Results from the U.S. National Survey of Residential Care Facilities.

Science.gov (United States)

Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P

2014-12-01

Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs. We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs. In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption. Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in

Procedure for the training of workers of facilities of service of the trade retailer.

Directory of Open Access Journals (Sweden)

Tania Ivón Sosa Ibarra

2011-09-01

Full Text Available The benefit of the services transforms quickly. To improve this activity is vital to reach the excellence and a fundamental element is the human factor that should be motivated and highly qualified to satisfy the necessities of the clients, of there the importance of its superación. In this investigation a training procedure is designed for workers of facilities of service of the trade that it facilitates, starting from an appropriate detection of the training necessities, to execute actions to achieve an improvement in the benefit of the services. These transformations in the superación of the workers impact significantly in their conceptions, in order to achieve the formation of a professional of the sector from the much more competent and adjusted services to the demands that it demands the current moment. The procedure is feasible of applying in all the establishments of the commercial net and it contemplates four moments: diagnostic, projection, execution and the control. It constitutes a novel experience, to the being a proposal of change and innovation in the environment of the training and the benefit of the services in the sector of the trade and it can favor the development of work values.

Medicare Provider Payment Data - Skilled Nursing Facilities

Data.gov (United States)

U.S. Department of Health & Human Services — The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare...

Qualitative Study of correspondence between Patient Perception of Service Advertisement and Service Provided from Traditional Health Facilities

Directory of Open Access Journals (Sweden)

Lusi Kristiana

2015-01-01

Full Text Available background: Attractive adses of traditional health services often promises such as certainty of healing, treatment without side effect, experience personnel, exclusive recipes, and testimony of patients who recovered. Ads that this unsubstantiated allegedly played a role in the tendency of people turn to traditional medicine. The aim of the study is to describe the perception of patients about the correspondence between the advertisement and the services provided qualitatively. Methods: The study was conducted in Surabaya for 5 months in 2012. Informants were selected purposively. results: The result shows that most of the information about traditional health services obtained from either advertisement local and national television. Health complaints predominanly degenerative diseases, and most have been treated to modern medicine but because they do not heal, switch to traditional medicine. conclusion: Informants judge ad featuring attractive because advanced equipment, herbal remedies as well as testimonials of patients who have recovered. Much of the promise of the ads is not evident when patients seek treatment, so they seek other traditional treatments. Most of them are less satisfied, but there is a fraction that satisfied because being cured. Traditional health services responsiveness associated with the non-medical aspects assessed either by informants. recomendation:Competent authorities should enforce and socialize media literacy to encourage community.

EPA Facility Registry Service (FRS): CERCLIS

Data.gov (United States)

U.S. Environmental Protection Agency — This data provides location and attribute information on Facilities regulated under the Comprehensive Environmental Responsibility Compensation and Liability...

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.

Remote Internet access to advanced analytical facilities: a new approach with Web-based services.

Science.gov (United States)

Sherry, N; Qin, J; Fuller, M Suominen; Xie, Y; Mola, O; Bauer, M; McIntyre, N S; Maxwell, D; Liu, D; Matias, E; Armstrong, C

2012-09-04

Over the past decade, the increasing availability of the World Wide Web has held out the possibility that the efficiency of scientific measurements could be enhanced in cases where experiments were being conducted at distant facilities. Examples of early successes have included X-ray diffraction (XRD) experimental measurements of protein crystal structures at synchrotrons and access to scanning electron microscopy (SEM) and NMR facilities by users from institutions that do not possess such advanced capabilities. Experimental control, visual contact, and receipt of results has used some form of X forwarding and/or VNC (virtual network computing) software that transfers the screen image of a server at the experimental site to that of the users' home site. A more recent development is a web services platform called Science Studio that provides teams of scientists with secure links to experiments at one or more advanced research facilities. The software provides a widely distributed team with a set of controls and screens to operate, observe, and record essential parts of the experiment. As well, Science Studio provides high speed network access to computing resources to process the large data sets that are often involved in complex experiments. The simple web browser and the rapid transfer of experimental data to a processing site allow efficient use of the facility and assist decision making during the acquisition of the experimental results. The software provides users with a comprehensive overview and record of all parts of the experimental process. A prototype network is described involving X-ray beamlines at two different synchrotrons and an SEM facility. An online parallel processing facility has been developed that analyzes the data in near-real time using stream processing. Science Studio and can be expanded to include many other analytical applications, providing teams of users with rapid access to processed results along with the means for detailed

New CLGF Four-Year Grant to Help Local Government Service Delivery and Boost CLGF’s Research Capacity

Directory of Open Access Journals (Sweden)

Lucy Slack

2012-12-01

Full Text Available The UK Department for International Development (UK AID has agreed £4.5 million funding for a four-year CLGF programme to improve governance and service delivery at local level in several areas of the Commonwealth including Africa and Asia from 2012-16. It will also help to support national policy frameworks for local government service delivery, and increase engagement of local government in regional policy planning and implementation. CLGF will continue to work with its members, UN partners and others to mobilise more resources towards the support of local government in the Commonwealth. The new programme will focus on local government pilot projects in LED, supporting ministries and local government associations in strengthening their national policy making for local government, and establish regional forums to enable local government to engage in and influence regional policy making to reflect the needs and priorities of local government. It will also boost CLGF’s research capacity with targeted research to strengthen CLGF’s policy making and advocacy, including more sustained engagement in international policy debates on key issues affecting local government, such as climate change.

Facility and home based HIV Counseling and Testing: a comparative analysis of uptake of services by rural communities in southwestern Uganda

Directory of Open Access Journals (Sweden)

Guerra Ranieri

2011-03-01

Full Text Available Abstract Background In Uganda, public human immunodeficiency virus (HIV Voluntary Counseling and Testing (VCT services are mainly provided through the facility based model, although the home based approach is being promoted as a strategy for improving access to VCT. However the uptake of VCT varies according to service delivery model and is influenced by a number of factors. The aim of this study therefore, was to compare predictors for uptake of facility and home based VCT in a rural context. Methods A longitudinal study with cross-sectional investigative phases was conducted at two sites (Rugando and Kabingo in southwestern Uganda between November 2007 (baseline and March 2008 (follow up. During the baseline visit, facility based VCT was offered at the main health centre in Rugando while home based VCT was offered at the household level in Kabingo and a mixed survey questionnaire administered to the respondents. The results presented in this paper are derived from only the baseline data. Results Nine hundred ninety four (994 respondents were interviewed, of whom 500 received facility based VCT in Rugando and 494 home based VCT in Kabingo during the baseline visit. The respondents had a mean age of 32.2 years (SD 10.9 and were mainly female (68 percent. Clients who received facility based VCT were less likely to be residents of the more rural households (adjusted Odds Ratio (aOR = 0.14, 95% CI 0.07, 0.22. The clients who received home based VCT were less likely to report having an STI symptom (aOR = 0.63, 95% CI 0.46, 0.86, and more likely to be worried about discrimination if they contracted AIDS (aOR = 1.78, 95% CI 1.22, 2.61. Conclusion The uptake of VCT provided through either the facility or home based models is influenced by client characteristics such as proximity to service delivery points, HIV related symptoms, and fear of discrimination in rural Uganda. Interventions that seek to improve uptake of VCT should provide potential clients

iParking: an intelligent indoor location-based smartphone parking service.

Science.gov (United States)

Liu, Jingbin; Chen, Ruizhi; Chen, Yuwei; Pei, Ling; Chen, Liang

2012-10-31

Indoor positioning technologies have been widely studied with a number of solutions being proposed, yet substantial applications and services are still fairly primitive. Taking advantage of the emerging concept of the connected car, the popularity of smartphones and mobile Internet, and precise indoor locations, this study presents the development of a novel intelligent parking service called iParking. With the iParking service, multiple parties such as users, parking facilities and service providers are connected through Internet in a distributed architecture. The client software is a light-weight application running on a smartphone, and it works essentially based on a precise indoor positioning solution, which fuses Wireless Local Area Network (WLAN) signals and the measurements of the built-in sensors of the smartphones. The positioning accuracy, availability and reliability of the proposed positioning solution are adequate for facilitating the novel parking service. An iParking prototype has been developed and demonstrated in a real parking environment at a shopping mall. The demonstration showed how the iParking service could improve the parking experience and increase the efficiency of parking facilities. The iParking is a novel service in terms of cost- and energy-efficient solution.

iParking: An Intelligent Indoor Location-Based Smartphone Parking Service

Directory of Open Access Journals (Sweden)

Liang Chen

2012-10-01

Full Text Available Indoor positioning technologies have been widely studied with a number of solutions being proposed, yet substantial applications and services are still fairly primitive. Taking advantage of the emerging concept of the connected car, the popularity of smartphones and mobile Internet, and precise indoor locations, this study presents the development of a novel intelligent parking service called iParking. With the iParking service, multiple parties such as users, parking facilities and service providers are connected through Internet in a distributed architecture. The client software is a light-weight application running on a smartphone, and it works essentially based on a precise indoor positioning solution, which fuses Wireless Local Area Network (WLAN signals and the measurements of the built-in sensors of the smartphones. The positioning accuracy, availability and reliability of the proposed positioning solution are adequate for facilitating the novel parking service. An iParking prototype has been developed and demonstrated in a real parking environment at a shopping mall. The demonstration showed how the iParking service could improve the parking experience and increase the efficiency of parking facilities. The iParking is a novel service in terms of cost- and energy-efficient solution.

iParking: An Intelligent Indoor Location-Based Smartphone Parking Service

Science.gov (United States)

Liu, Jingbin; Chen, Ruizhi; Chen, Yuwei; Pei, Ling; Chen, Liang

2012-01-01

Indoor positioning technologies have been widely studied with a number of solutions being proposed, yet substantial applications and services are still fairly primitive. Taking advantage of the emerging concept of the connected car, the popularity of smartphones and mobile Internet, and precise indoor locations, this study presents the development of a novel intelligent parking service called iParking. With the iParking service, multiple parties such as users, parking facilities and service providers are connected through Internet in a distributed architecture. The client software is a light-weight application running on a smartphone, and it works essentially based on a precise indoor positioning solution, which fuses Wireless Local Area Network (WLAN) signals and the measurements of the built-in sensors of the smartphones. The positioning accuracy, availability and reliability of the proposed positioning solution are adequate for facilitating the novel parking service. An iParking prototype has been developed and demonstrated in a real parking environment at a shopping mall. The demonstration showed how the iParking service could improve the parking experience and increase the efficiency of parking facilities. The iParking is a novel service in terms of cost- and energy-efficient solution. PMID:23202179

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

Science.gov (United States)

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

The impact of local public services and geographical cost of living differences on poverty estimates

OpenAIRE

Aaberge, Rolf; Langørgen, Audun; Mogstad, Magne; Østensen, Marit

2008-01-01

Abstract: Despite a broad consensus on the need to account for the value of public services and geographical cost of living differences on the measurement of poverty, there is little reliable evidence on how these factors actually affect poverty estimates. Unlike the standard approach in studies of the distribution of public services, this paper employs a method for valuing sector-specific local public services that accounts for differences between municipalities in the costs and capacity ...

Users' demographic profile and quality attributes of bus services: The perspectives of users, operators and local authorities

Science.gov (United States)

Noh, Nur'Amirah Mhd.; Hamid, Ahmad Hilmy Abd

2017-10-01

Bus services that can help meet almost every bus user's needs are the goals of bus operators. Despite such an idealistic view, the operators themselves, users and even the local authorities have been found to hold different views about the quality of service that the bus should deliver. As the users i.e., customers are considered as important stakeholders, understanding their characteristics, profile and pattern is very crucial. To this end, the present study has attempted to gauge the perspectives of all the above-mentioned stakeholders. For the users, a customer satisfaction survey was employed to look into the relative influence of service attributes. In addition, surveys were also administered to bus operators and local authorities to study their perspectives in relation to this matter. 450 randomly selected respondents were surveyed. Identification of the service level was analyzed through the Likert scale whereas the perspectives of the operators and authorities were dealt with through mean value Analysis. Specifically, this study aims to identify the crucial attributes in determining the quality of the bus services. Findings of the study indicated that different attributes were selected by users, operators and authorities, which clearly enlightened the variations of the important attributes in determining the level of bus service quality. In its attempt to compare the service level attributes from three perspectives, this study has helped advance better improvement and strategies for the urban public bus operators and planners, in addition to the authorities in delivering user-friendly bus services by taking into account the local context, user profile and demographic characteristics.

How can global conventions for biodiversity and ecosystem services guide local conservation actions?

NARCIS (Netherlands)

Geijzendorffer, Ilse R.; van Teeffelen, Astrid; Allison, Hilary; Braun, Daniela; Horgan, K.; Iturrate-Garcia, Maitane; Santos, Maria João; Pellissier, Loïc; Prieur-Richard, Anne-Helene; Quatrini, Simone; Sakai, Shoko; Zuppinger-Dingley, Debra

2017-01-01

With global science-policy conventions for biodiversity and ecosystem services in place, much effort goes into monitoring and reporting on the progress toward policy targets. As conservation actions happen locally, can such global monitoring and reporting efforts effectively guide conservation

Towards understanding the availability of physiotherapy services in rural Australia.

Science.gov (United States)

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2016-01-01

A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services. A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews

Private Capital, Public Goods: Forest Plantations' Investment in Local Infrastructure and Social Services in Rural Tanzania

NARCIS (Netherlands)

Degnet, M.B.; Werf, van der E.; Ingram, V.J.; Wesseler, Justus

2017-01-01

With the rapid expansion of private forest plantations worldwide, their impacts on local development are under scrutiny by NGOs and researchers alike. This study investigates the impacts of private forest plantations on local infrastructure and social services in rural Tanzania. We take a

Use of fees to fund local public health services in Western Massachusetts.

Science.gov (United States)

Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E

2015-01-01

Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.

Intervening in the local health system to improve diabetes care: lessons from a health service experiment in a poor urban neighborhood in India.

Science.gov (United States)

Bhojani, Upendra; Kolsteren, Patrick; Criel, Bart; De Henauw, Stefaan; Beerenahally, Thriveni S; Verstraeten, Roos; Devadasan, Narayanan

2015-01-01

treatment guidelines. Doctors' concerns about the efficacy, quality, availability, and acceptability by patients of generic medications explained limited prescriptions of generic medications. The patients' perception that ailments should be treated through medications limited the use of non-medical management by the doctors in early stages of diabetes. The other reason for the limited use of the standard treatment guidelines was that these doctors mainly provided follow-up care to patients who were previously put on a given treatment plan by specialists. Maintenance: The intervention facilities continued using posters and television monitors for health education after the intervention period. The use of generic medications and standard treatment guidelines for diabetes management remained very limited. Implementing efficacious health service intervention in a real-world resource-constrained setting is challenging and may not prove effective in improving patient outcomes. Interventions need to consider patients' and healthcare providers' experiences and perceptions and how macro-level policies translate into practice within local health systems.

Facility design consequences of different employees’ quality perceptions

NARCIS (Netherlands)

Kok, Herman; Mobach, Mark P.; Omta, Onno

2015-01-01

An important challenge for facility management is to integrate the complex and comprehensive construct of different service processes and physical elements of the service facility into a meaningful and functional facility design. The difficulty of this task is clearly indicated by the present study

Local and regional energy companies offering energy services: Key activities and implications for the business model

International Nuclear Information System (INIS)

Kindström, Daniel; Ottosson, Mikael

2016-01-01

Highlights: • Many companies providing energy services are experiencing difficulties. • This research identifies key activities for the provision of energy services. • Findings are aggregated to the business-model level providing managerial insights. • This research identifies two different business model innovation paths. • Energy companies may need to renew parts of, or the entire, business model. - Abstract: Energy services play a key role in increasing energy efficiency in the industry. The key actors in these services are the local and regional energy companies that are increasingly implementing energy services as part of their market offering and developing service portfolios. Although expectations for energy services have been high, progress has so far been limited, and many companies offering energy services, including energy companies, are experiencing difficulties in implementing energy services and providing them to the market. Overall, this research examines what is needed for local and regional energy companies to successfully implement energy services (and consequently provide them to the market). In doing this, a two-stage process is used: first, we identify key activities for the successful implementation of energy services, and second, we aggregate the findings to the business model level. This research demonstrates that to succeed in implementing energy services, an energy company may need to renew parts or all of its existing product-based business model, formulate a new business model, or develop coexisting multiple business models. By discussing two distinct business model innovation processes, this research demonstrates that there can be different paths to success.

Facility Focus: Food Service.

Science.gov (United States)

College Planning & Management, 2002

2002-01-01

Describes the Hawthorn Court Community Center at Iowa State University, Ames, and the HUB-Robeson Center at Pennsylvania State University. Focuses on the food service offered in these new student-life buildings. Includes photographs. (EV)

18 CFR 260.9 - Reports by natural gas pipeline companies on service interruptions and damage to facilities.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Reports by natural gas..., NATURAL GAS ACT STATEMENTS AND REPORTS (SCHEDULES) § 260.9 Reports by natural gas pipeline companies on service interruptions and damage to facilities. (a)(1) Every natural gas company must report to the...

Local economic impact of nuclear power

International Nuclear Information System (INIS)

Shurcliff, A.W.

1977-01-01

The local economic impact of nuclear installations is examined and the conclusion reached that much of the subsequent area growth may be coincidental to the facility. Nuclear siting criteria favor proximity to a regional power grid, abundant water for cooling, and extensive vacant land with a major access road. These criteria coincide with the characteristics of commuter suburbs, centers for retirement, and recreation areas. Clustering of nuclear units introduces an extraordinary level of new construction, office requirements, and capital. Economic changes will occur at the start and completion of the construction stage and at the time of decommissioning the facility. Past experiences are detailed in terms of employment, payroll, housing, public services, and procurement. When construction is completed, employment falls to a relatively low level. Proximity to the plant offers no advantage in terms of local power rates. While nuclear facilities do not preclude other development in the area, there are restrictions on access, regulatory agencies may reject absorbing the cost of public use as a business expense in the rate structure, and security measures may constrain public use. There is pressure for tax equalization laws to compensate communities for the loss of potential property tax revenues. Some agencies (e.g., the Tennessee Valley Authority) make in-lieu-of-tax payments, while some plants have produced tax benefits large enough to effect significant public improvements. 8 references

EPA Facility Registry System (FRS): NCES

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

EPA Facility Registry System (FRS): NEPT

Data.gov (United States)

U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

MARKET-BASED MECHANISM IN PUBLIC SERVICE DELIVERY IN LOCAL GOVERNMENT IN POLAND – A BRIEF OVERVIEW

Directory of Open Access Journals (Sweden)

Dawid Sześciło

2013-12-01

Full Text Available The reintroduction of local self-government at the level of communes (gminy in 1990 opened the way for an in-depth reform of the local governance framework in Poland. This included not only the legal, organizational and fiscal autonomisation of local communities, but also went in line with general trends concerning the transformation of the public sector. Therefore, among the core elements of the transformation we may identify the extensive privatization of the public service provision schemes. In Poland, this process was not based on the theoretical background of New Public Management, as was the case in a number of Western countries. Instead, it was natural consequence of the rebirth of a market economy with a limited public sector and the intense development of the private market. Those trends were, however, compatible with the NPM programme. The expansion of market-based mechanisms in public service delivery is one of its pillars. This article provides a historical overview of the development of market-based arrangements in public service provision at the most basic level of Polish local government. It is focused mainly on a legal framework, but also includes some observations on the practical side of this process.

Towards improved waste management services by local government – A waste governance perspective

CSIR Research Space (South Africa)

Oelofse, Suzanna HH

2008-11-01

Full Text Available In terms of the South African Constitution (Act 108of 1996), waste management service delivery is a local government function. The Constitution further gives every person the right to an environment that is not harmful to their health or well...

Health services reform in Bangladesh: hearing the views of health workers and their professional bodies.

Science.gov (United States)

Cockcroft, Anne; Milne, Deborah; Oelofsen, Marietjie; Karim, Enamul; Andersson, Neil

2011-12-21

In Bangladesh, widespread dissatisfaction with government health services did not improve during the Health and Population Sector Programme (HPSP) reforms from 1998-2003. A 2003 national household survey documented public and health service users' views and experience. Attitudes and behaviour of health workers are central to quality of health services. To investigate whether the views of health workers influenced the reforms, we surveyed local health workers and held evidence-based discussions with local service managers and professional bodies. Some 1866 government health workers in facilities serving the household survey clusters completed a questionnaire about their views, experience, and problems as workers. Field teams discussed the findings from the household and health workers' surveys with local health service managers in five upazilas (administrative sub-districts) and with the Bangladesh Medical Association (BMA) and Bangladesh Nurses Association (BNA). Nearly one half of the health workers (45%) reported difficulties fulfilling their duties, especially doctors, women, and younger workers. They cited inadequate supplies and infrastructure, bad behaviour of patients, and administrative problems. Many, especially doctors (74%), considered they were badly treated as employees. Nearly all said lack of medicines in government facilities was due to inadequate supply, not improved during the HPSP. Two thirds of doctors and nurses complained of bad behaviour of patients. A quarter of respondents thought quality of service had improved as a result of the HPSP.Local service managers and the BMA and BNA accepted patients had negative views and experiences, blaming inadequate resources, high patient loads, and patients' unrealistic expectations. They said doctors and nurses were demotivated by poor working conditions, unfair treatment, and lack of career progression; private and unqualified practitioners sought to please patients instead of giving medically

Deregulation strategies for local governments and the role/opportunities for energy efficiency services in the utility industry deregulation

International Nuclear Information System (INIS)

Tseng, P.C.

1998-01-01

As the future shape of the electric utility industry continues to unfold and as retail competition becomes a reality, local governments are faced with balancing the need for: (1) economic development; (2) and to avoid the potential impact of cost-shifting among residents and businesses, while ensuring reliable and universal energy services. Furthermore, local governments need to find ways to recoup potential loss of franchise and tax revenues, to ensure fair and adequate energy-efficiency programs, and to continue other social programs for low income families. This paper will address two important issues every local government in the US are facing: (1) the development of viable deregulation strategies before, during and after the promulgation of utility deregulation; (2) opportunities for energy efficiency services in the competitive markets to serve local governments, which typically constitutes the largest market segment in utility's service territory. This paper presents issues and challenges common to all local governments. It documents strategies that several local governments are utilizing to embrace the coming electric utility restructuring and competition challenge to the benefits of their respective communities. This paper presents the results on deregulation work by the City of Portland, Oregon, Barnstable County, Massachusetts, and Montgomery County, Maryland. The research by these local governments was sponsored by the Urban Consortium Energy Task Force and Public Technology, Inc

Deregulation strategies for local governments and the role/opportunities for energy efficiency services in the utility industry deregulation

Energy Technology Data Exchange (ETDEWEB)

Tseng, P.C.

1998-07-01

As the future shape of the electric utility industry continues to unfold and as retail competition becomes a reality, local governments are faced with balancing the need for: (1) economic development; (2) and to avoid the potential impact of cost-shifting among residents and businesses, while ensuring reliable and universal energy services. Furthermore, local governments need to find ways to recoup potential loss of franchise and tax revenues, to ensure fair and adequate energy-efficiency programs, and to continue other social programs for low income families. This paper will address two important issues every local government in the US are facing: (1) the development of viable deregulation strategies before, during and after the promulgation of utility deregulation; (2) opportunities for energy efficiency services in the competitive markets to serve local governments, which typically constitutes the largest market segment in utility's service territory. This paper presents issues and challenges common to all local governments. It documents strategies that several local governments are utilizing to embrace the coming electric utility restructuring and competition challenge to the benefits of their respective communities. This paper presents the results on deregulation work by the City of Portland, Oregon, Barnstable County, Massachusetts, and Montgomery County, Maryland. The research by these local governments was sponsored by the Urban Consortium Energy Task Force and Public Technology, Inc.

Facility effluent monitoring plan for 242-A Evaporator facility

International Nuclear Information System (INIS)

Crummel, G.M.; Gustavson, R.D.

1993-03-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1* for any operations that involve hazardous materials and radioactive substances that could affect employee or public safety or the environment. A facility effluent monitoring plan determination was performed during Calendar Year 1991 and the evaluation showed the need for a facility effluent monitoring plan. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility effluent Monitoring Plans, WHC-EP-0438-1**. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements

Examining the Effects of a Service-Trained Facility Dog on Stress in Children Undergoing Forensic Interview for Allegations of Child Sexual Abuse.

Science.gov (United States)

Krause-Parello, Cheryl A; Thames, Michele; Ray, Colleen M; Kolassa, John

2018-04-01

Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4-16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service-trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present- standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and Immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic blood pressure in the experimental condition (p = .03285) and (p = .04381), respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of child sexual abuse.

20 CFR 416.1023 - Facilities.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Facilities. 416.1023 Section 416.1023... Facilities. (a) Space, equipment, supplies, and other services. Subject to appropriate Federal funding, the... and prompt disability determinations. (b) Location of facilities. Subject to appropriate Federal...

Facility effluent monitoring plan determinations for the 200 Area facilities

International Nuclear Information System (INIS)

Nickels, J.M.

1991-11-01

The following facility effluent monitoring plan determinations document the evaluations conducted for the Westinghouse Hanford Company 200 Area facilities (chemical processing, waste management, 222-S Laboratory, and laundry) on the Hanford Site in south central Washington State. These evaluations determined the need for facility effluent monitoring plans for the 200 Area facilities. The facility effluent monitoring plan determinations have been prepared in accordance with A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438 (WHC 1991). The Plutonium/Uranium Extraction Plant and UO 3 facility effluent monitoring plan determinations were prepared by Los Alamos Technical Associates, Richland, Washington. The Plutonium Finishing Plant, Transuranic Waste Storage and Assay Facility, T Plant, Tank Farms, Low Level Burial Grounds, and 222-S Laboratory determinations were prepared by Science Applications International Corporation of Richland, Washington. The B Plant Facility Effluent Monitoring Plan Determination was prepared by ERCE Environmental Services of Richland, Washington

Compensation for risks: host community benefits in siting locally unwanted facilities

Science.gov (United States)

Himmelberger, Jeffery J.; Ratick, Samuel J.; White, Allen L.

1991-09-01

This article analyzes the recent negotiations connected with siting 24 solid-waste landfills in Wisconsin. We examine the association between the type and amount of compensation paid to host communities by facility developers and the size of facilities, certain facility characteristics, the timing of negotiated agreements, the size of the host community, and the socioeconomic status of the host area. Our findings suggest that the level of compensation after adjusting for landfill capacity is positively associated with the percentage of total facility capacity dedicated to host community use, positively associated with the percentage of people of the host area who are in poverty, and larger for public facilities that accept municipal wastes. Other explanatory variables we examined, whose association with levels of compensation proved statistically insignificant, were facility size, facility status (new vs expansion), facility use (countyonly vs multicounty), timing of negotiation, host community size, and the host area education level, population density, and per capita income. We discuss the policy implications of our principal findings and future research questions in light of the persistent opposition surrounding the siting of solid-waste and other waste-management facilities.

Experiences and Perceptions of Barriers to Health Services for Elderly in Rural Namibia

Directory of Open Access Journals (Sweden)

Gert Van Rooy

2015-07-01

Full Text Available We investigate barriers to accessing health facilities (e.g., transportation and cost of services and health service delivery barriers (e.g., timeliness of services scheduling of appointments, language that the literature suggest are operative. Semistructured interviews were utilized with respondents in three purposefully selected regional research sites in Namibia. All questions were translated into local languages. It is found that although many senior citizens appreciate the use of modern health care and are exempted from paying health care consultation fees, they still prefer to use traditional health medicine because of the long distance to health care facilities, which when they decide to travel translates into high transportation costs. Referrals to hospitals become very expensive. There is a need to consider the unique issues (extended family system affecting access to health care for elderly people in Namibia to achieve equitable access to health care services.

Animal facilities

International Nuclear Information System (INIS)

Fritz, T.E.; Angerman, J.M.; Keenan, W.G.; Linsley, J.G.; Poole, C.M.; Sallese, A.; Simkins, R.C.; Tolle, D.

1981-01-01

The animal facilities in the Division are described. They consist of kennels, animal rooms, service areas, and technical areas (examining rooms, operating rooms, pathology labs, x-ray rooms, and 60 Co exposure facilities). The computer support facility is also described. The advent of the Conversational Monitor System at Argonne has launched a new effort to set up conversational computing and graphics software for users. The existing LS-11 data acquisition systems have been further enhanced and expanded. The divisional radiation facilities include a number of gamma, neutron, and x-ray radiation sources with accompanying areas for related equipment. There are five 60 Co irradiation facilities; a research reactor, Janus, is a source for fission-spectrum neutrons; two other neutron sources in the Chicago area are also available to the staff for cell biology studies. The electron microscope facilities are also described

Using drugs in un/safe spaces: Impact of perceived illegality on an underground supervised injecting facility in the United States.

Science.gov (United States)

Davidson, Peter J; Lopez, Andrea M; Kral, Alex H

2018-03-01

Supervised injection facilities (SIFs) are spaces where people can consume pre-obtained drugs in hygienic circumstances with trained staff in attendance to provide emergency response in the event of an overdose or other medical emergency, and to provide counselling and referral to other social and health services. Over 100 facilities with formal legal sanction exist in ten countries, and extensive research has shown they reduce overdose deaths, increase drug treatment uptake, and reduce social nuisance. No facility with formal legal sanction currently exists in the United States, however one community-based organization has successfully operated an 'underground' facility since September 2014. Twenty three qualitative interviews were conducted with people who used the underground facility, staff, and volunteers to examine the impact of the facility on peoples' lives, including the impact of lack of formal legal sanction on service provision. Participants reported that having a safe space to inject drugs had led to less injections in public spaces, greater ability to practice hygienic injecting practices, and greater protection from fatal overdose. Constructive aspects of being 'underground' included the ability to shape rules and procedures around user need rather than to meet political concerns, and the rapid deployment of the project, based on immediate need. Limitations associated with being underground included restrictions in the size and diversity of the population served by the site, and reduced ability to closely link the service to drug treatment and other health and social services. Unsanctioned supervised injection facilities can provide a rapid and user-driven response to urgent public health needs. This work draws attention to the need to ensure such services remain focused on user-defined need rather than external political concerns in jurisdictions where supervised injection facilities acquire local legal sanction. Copyright © 2017 Elsevier B.V. All

Anesthetic equipment, facilities and services available for pediatric ...

African Journals Online (AJOL)

2011-04-09

Apr 9, 2011 ... standards and increased use of disposable anesthetic equipment. An audit of equipment and facilities for anesthetic care in pediatric patients is important and should be carried out periodically to appraise the situation for upgrading of essential anesthetic facilities and equipment. Appendix A. 18th March, ...

Factors associated with utilization of dental services in a long-term care facility: a descriptive cross-sectional study.

Science.gov (United States)

Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine

2017-03-01

To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

The impacts of nuclear facilities on property values and other factors in the surrounding communities

International Nuclear Information System (INIS)

Bezdek, R.H.; Wendling, R.M.

2006-01-01

This paper addresses the issue of the impact of the siting of nuclear facilities on the adjacent communities. It reviews previous studies on the issue and then empirically examines the impacts of seven major nuclear facilities located throughout the USA on the surrounding communities. The analysis focuses on the effects on local property values, economic growth, tax revenues, public services, community development, jobs and employment, and schools. Using published data, economic and statistical analyses, literature reviews and interviews, it finds that the impacts of these facilities have been largely positive. The findings are placed in perspective, caveats are noted concerning the generalisation of the conclusions derived and recommendations for required further research are provided. (author)

Robots conquering local government services

DEFF Research Database (Denmark)

Nielsen, Jeppe Agger; Andersen, Kim Normann; Sigh, Anne

2016-01-01

labour-intensive services, the public administration research community is short on knowledge of the impact on the work processes carried out in public organizations and how staff and clients react toward robots. This case study investigates the implementation and use of robot vacuum cleaners in Danish......The movement of robots from the production line to the service sector provides a potentially radical solution to innovate and transform public service delivery. Although robots are increasingly being adopted in service delivery (e.g., health- and eldercare) to enhance and in some cases substitute...... eldercare, demonstrating how robot vacuums have proven to have considerable interpretive flexibility with variation in the perceived nature of technology, technology strategy, and technology use between key stakeholders in eldercare....

Challenges for proteomics core facilities.

Science.gov (United States)

Lilley, Kathryn S; Deery, Michael J; Gatto, Laurent

2011-03-01

Many analytical techniques have been executed by core facilities established within academic, pharmaceutical and other industrial institutions. The centralization of such facilities ensures a level of expertise and hardware which often cannot be supported by individual laboratories. The establishment of a core facility thus makes the technology available for multiple researchers in the same institution. Often, the services within the core facility are also opened out to researchers from other institutions, frequently with a fee being levied for the service provided. In the 1990s, with the onset of the age of genomics, there was an abundance of DNA analysis facilities, many of which have since disappeared from institutions and are now available through commercial sources. Ten years on, as proteomics was beginning to be utilized by many researchers, this technology found itself an ideal candidate for being placed within a core facility. We discuss what in our view are the daily challenges of proteomics core facilities. We also examine the potential unmet needs of the proteomics core facility that may also be applicable to proteomics laboratories which do not function as core facilities. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

Directory of Open Access Journals (Sweden)

Hannah H Leslie

2017-12-01

Full Text Available It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs-the structural inputs to care-predicts the clinical quality of care provided to patients.Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC, sick-child care, and (in 2 countries labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania. Facilities with similar

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

Science.gov (United States)

Leslie, Hannah H; Sun, Zeye; Kruk, Margaret E

2017-12-01

It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients. Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores

Public sector effects and social impact assessment of nuclear generating facilities: Information for community mitigation management

International Nuclear Information System (INIS)

Pijawka, K.D.

1984-01-01

One of the major issues in community impact management is the gap between revenues generated by energy projects and expenditures for public facilities and services because of project-induced growth. Of issue is the experience of communities experiencing rapid growth where project revenues are not generated until operations commence and yet, considerable investments are needed to accommodate growth during the construction phase. Such revenue imbalances have resulted in communities demanding ''up-front'' capital investments or revenue prior to and during construction. However, with the construction and operation of nuclear facilities, the few available studies have found substantial revenue gains allocated to local jurisdiction and little adverse expenditure effects. The analyses of twelve nuclear stations found that the demand for new and expanded public facilities and the social services attributable to the plants were generally small, that adverse impacts were controllable and mitigatable, and that utility revenue payments varied substantially amount the host areas

Strategic facility planning improves capital decision making.

Science.gov (United States)

Reeve, J R

2001-03-01

A large, Midwestern IDS undertook a strategic facility-planning process to evaluate its facility portfolio and determine how best to allocate future investments in facility development. The IDS assembled a facility-planning team, which initiated the planning process with a market analysis to determine future market demands and identify service areas that warranted facility expansion. The team then analyzed each of the IDS's facilities from the perspective of uniform capacity measurements, highest and best use compared with needs, building condition and investment-worthiness, and facility growth and site development opportunities. Based on results of the analysis, the strategy adopted entailed, in part, shifting some space from inpatient care to ambulatory care services and demolishing and replacing the 11 percent of facilities deemed to be in the worst condition.