WorldWideScience

Sample records for pickup and delivery service

  1. Single-Commodity Vehicle Routing Problem with Pickup and Delivery Service

    Directory of Open Access Journals (Sweden)

    Goran Martinovic

    2008-01-01

    Full Text Available We present a novel variation of the vehicle routing problem (VRP. Single commodity cargo with pickup and delivery service is considered. Customers are labeled as either cargo sink or cargo source, depending on their pickup or delivery demand. This problem is called a single commodity vehicle routing problem with pickup and delivery service (1-VRPPD. 1-VRPPD deals with multiple vehicles and is the same as the single-commodity traveling salesman problem (1-PDTSP when the number of vehicles is equal to 1. Since 1-VRPPD specializes VRP, it is hard in the strong sense. Iterative modified simulated annealing (IMSA is presented along with greedy random-based initial solution algorithm. IMSA provides a good approximation to the global optimum in a large search space. Experiment is done for the instances with different number of customers and their demands. With respect to average values of IMSA execution times, proposed method is appropriate for practical applications.

  2. 49 CFR 1242.76 - Administration; pickup and delivery, marine line haul, and rail substitute service; loading...

    Science.gov (United States)

    2010-10-01

    ... haul, and rail substitute service; loading, unloading and local marine; protective services; freight... SEPARATION OF COMMON OPERATING EXPENSES BETWEEN FREIGHT SERVICE AND PASSENGER SERVICE FOR RAILROADS 1 Operating Expenses-Transportation § 1242.76 Administration; pickup and delivery, marine line haul, and rail...

  3. Vehicle Routing Problem with Time Windows and Simultaneous Delivery and Pick-Up Service Based on MCPSO

    Directory of Open Access Journals (Sweden)

    Xiaobing Gan

    2012-01-01

    Full Text Available This paper considers two additional factors of the widely researched vehicle routing problem with time windows (VRPTW. The two factors, which are very common characteristics in realworld, are uncertain number of vehicles and simultaneous delivery and pick-up service. Using minimization of the total transport costs as the objective of the extension VRPTW, a mathematic model is constructed. To solve the problem, an efficient multiswarm cooperative particle swarm optimization (MCPSO algorithm is applied. And a new encoding method is proposed for the extension VRPTW. Finally, comparing with genetic algorithm (GA and particle swarm optimization (PSO algorithm, the MCPSO algorithm performs best for solving this problem.

  4. Exact Solutions to the Symmetric and Asymmetric Vehicle Routing Problem with Simultaneous Delivery and Pick-Up

    Directory of Open Access Journals (Sweden)

    Julia Rieck

    2013-05-01

    Full Text Available In reverse logistics networks, products (e.g., bottles or containers have to be transported from a depot to customer locations and, after use, from customer locations back to the depot. In order to operate economically beneficial, companies prefer a simultaneous delivery and pick-up service. The resulting Vehicle Routing Problem with Simultaneous Delivery and Pick-up (VRPSDP is an operational problem, which has to be solved daily by many companies. We present two mixed-integer linear model formulations for the VRPSDP, namely a vehicle-flow and a commodity-flow model. In order to strengthen the models, domain-reducing preprocessing techniques, and effective cutting planes are outlined. Symmetric benchmark instances known from the literature as well as new asymmetric instances derived from real-world problems are solved to optimality using CPLEX 12.1.

  5. A Combination of Meta-heuristic and Heuristic Algorithms for the VRP, OVRP and VRP with Simultaneous Pickup and Delivery

    Directory of Open Access Journals (Sweden)

    Maryam Ashouri

    2017-07-01

    Full Text Available Vehicle routing problem (VRP is a Nondeterministic Polynomial Hard combinatorial optimization problem to serve the consumers from central depots and returned back to the originated depots with given vehicles. Furthermore, two of the most important extensions of the VRPs are the open vehicle routing problem (OVRP and VRP with simultaneous pickup and delivery (VRPSPD. In OVRP, the vehicles have not return to the depot after last visit and in VRPSPD, customers require simultaneous delivery and pick-up service. The aim of this paper is to present a combined effective ant colony optimization (CEACO which includes sweep and several local search algorithms which is different with common ant colony optimization (ACO. An extensive numerical experiment is performed on benchmark problem instances addressed in the literature. The computational result shows that suggested CEACO approach not only presented a very satisfying scalability, but also was competitive with other meta-heuristic algorithms in the literature for solving VRP, OVRP and VRPSPD problems. Keywords: Meta-heuristic algorithms, Vehicle Routing Problem, Open Vehicle Routing Problem, Simultaneously Pickup and Delivery, Ant Colony Optimization.

  6. Branch-and-Cut-and-Price for the Pickup and Delivery Problem with Time Windows

    DEFF Research Database (Denmark)

    Røpke, Stefan; Cordeau, Jean-Francois

    2009-01-01

    In the pickup and delivery problem with time windows (PDPTW), vehicle routes must be designed to satisfy a set of transportation requests, each involving a pickup and a delivery location, under capacity, time window, and precedence constraints. This paper introduces a new branch......-and-cut-and-price algorithm in which lower bounds are computed by solving through column generation the linear programming relaxation of a set partitioning formulation. Two pricing subproblems are considered in the column generation algorithm: an elementary and a non-elementary shortest path problem. Valid inequalities...

  7. GRASP with path-relinking for the selective pickup and delivery problem

    DEFF Research Database (Denmark)

    Ho, Sin C.; Szeto, W. Y.

    2016-01-01

    Bike sharing systems are very popular nowadays. One of the characteristics is that bikes are picked up from some surplus bike stations and transported to all deficit bike stations by a repositioning vehicle with limited capacity to satisfy the demand of deficit bike stations. Motivated by this real...... world bicycle repositioning problem, we study the selective pickup and delivery problem, where demand at every delivery node has to be satisfied by the supply collected from a subset of pickup nodes. The objective is to minimize the total travel cost incurred from visiting the nodes. We present a GRASP...... with path-relinking for solving the described problem. Experimental results show that this simple heuristic improves the existing results in the literature with an average improvement of 5.72% using small computing times. The proposed heuristic can contribute to the development of effective and efficient...

  8. Development of 80- and 100- Mile Work Day Cycles Representative of Commercial Pickup and Delivery Operation

    Energy Technology Data Exchange (ETDEWEB)

    Duran, Adam W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kelly, Kenneth J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kresse, John [Cummins; Li, Ke [Cummins

    2018-04-03

    When developing and designing new technology for integrated vehicle systems deployment, standard cycles have long existed for chassis dynamometer testing and tuning of the powertrain. However, to this day with recent developments and advancements in plug-in hybrid and battery electric vehicle technology, no true 'work day' cycles exist with which to tune and measure energy storage control and thermal management systems. To address these issues and in support of development of a range-extended pickup and delivery Class 6 commercial vehicle, researchers at the National Renewable Energy Laboratory in collaboration with Cummins analyzed 78,000 days of operational data captured from more than 260 vehicles operating across the United States to characterize the typical daily performance requirements associated with Class 6 commercial pickup and delivery operation. In total, over 2.5 million miles of real-world vehicle operation were condensed into a pair of duty cycles, an 80-mile cycle and a 100-mile cycle representative of the daily operation of U.S. class 3-6 commercial pickup and delivery trucks. Using novel machine learning clustering methods combined with mileage-based weighting, these composite representative cycles correspond to 90th and 95th percentiles for daily vehicle miles traveled by the vehicles observed. In addition to including vehicle speed vs time drive cycles, in an effort to better represent the environmental factors encountered by pickup and delivery vehicles operating across the United States, a nationally representative grade profile and key status information were also appended to the speed vs. time profiles to produce a 'work day' cycle that captures the effects of vehicle dynamics, geography, and driver behavior which can be used for future design, development, and validation of technology.

  9. The Multi-commodity One-to-one Pickup-and-delivery Traveling Salesman Problem with Path Duration Limits

    DEFF Research Database (Denmark)

    Plum, Christian Edinger Munk; Pisinger, David; Salazar-González, Juan-José

    2012-01-01

    The design of container shipping networks is an important real world problem, with assets and operational costs in billions of dollars. To guide the optimal deployment of the ships, a single vessel roundtrip is considered by minimizing operational costs and flowing the best paying cargo under...... commercial constraints. Inspiration for formulation and solution method is taken from the rich research done within pickup and delivery problems. The problem, the multicommodity one-toone pickup and delivery traveling salesman problem with path duration limits is, to the best of out knowledge, considered...... for the first time. An arc flow and a path flow model are presented. A Branch and Cut and Price solution method is proposed and implemented....

  10. New formulation and branch-and-cut algorithm for the pickup and delivery traveling salesman problem with multiple stacks: new formulation and branch-and-cut algorithm

    NARCIS (Netherlands)

    Sampaio Oliveira, A.H.; Urrutia, S.

    2017-01-01

    In this paper, we consider the pickup and delivery traveling salesman problem with multiple stacks in which a single vehicle must serve a set of customer requests defined by a pair of pickup and delivery destinations of an item. The vehicle contains a fixed number of stacks, where each item is

  11. An Inventory-Routing Problem with Pickups and Deliveries Arising in the Replenishment of Automated Teller Machines

    NARCIS (Netherlands)

    van Anholt, Roel G.; Coelho, Leandro C.; Laporte, Gilbert; Vis, Iris F. A.

    The purpose of this paper is to introduce, model, and solve a rich multiperiod inventory-routing problem with pickups and deliveries motivated by the replenishment of automated teller machines in the Netherlands. Commodities can be brought to and from the depot, as well as being exchanged among

  12. An inventory-routing problem with pickups and deliveries arising in the replenishment of automated teller machines

    NARCIS (Netherlands)

    Van Anholt, Roel G.; Coelho, Leandro C.; Laporte, Gilbert; Vis, Iris F.A.

    2016-01-01

    The purpose of this paper is to introduce, model, and solve a rich multiperiod inventory-routing problem with pickups and deliveries motivated by the replenishment of automated teller machines in the Netherlands. Commodities can be brought to and from the depot, as well as being exchanged among

  13. An adaptive large neighborhood search heuristic for the pickup and delivery problem with time Windows and scheduled lines

    NARCIS (Netherlands)

    Ghilas, V.; Demir, E.; van Woensel, T.

    2016-01-01

    The Pickup and Delivery Problem with Time Windows and Scheduled Lines (PDPTW-SL) concerns scheduling a set of vehicles to serve freight requests such that a part of the journey can be carried out on a scheduled public transportation line. Due to the complexity of the problem, which is NP-hard, we

  14. Location-Routing Problem with Simultaneous Home Delivery and Customer’s Pickup for City Distribution of Online Shopping Purchases

    Directory of Open Access Journals (Sweden)

    Lin Zhou

    2016-08-01

    Full Text Available With the increasing interest in online shopping, the Last Mile delivery is regarded as one of the most expensive and pollutive—and yet the least efficient—stages of the e-commerce supply chain. To address this challenge, a novel location-routing problem with simultaneous home delivery and customer’s pickup is proposed. This problem aims to build a more effective Last Mile distribution system by providing two kinds of service options when delivering packages to customers. To solve this specific problem, a hybrid evolution search algorithm by combining genetic algorithm (GA and local search (LS is presented. In this approach, a diverse population generation algorithm along with a two-phase solution initialization heuristic is first proposed to give high quality initial population. Then, advantaged solution representation, individual evaluation, crossover and mutation operations are designed to enhance the evolution and search efficiency. Computational experiments based on a large family of instances are conducted, and the results obtained indicate the validity of the proposed model and method.

  15. A Mutualism Quantum Genetic Algorithm to Optimize the Flow Shop Scheduling with Pickup and Delivery Considerations

    Directory of Open Access Journals (Sweden)

    Jinwei Gu

    2015-01-01

    Full Text Available A mutualism quantum genetic algorithm (MQGA is proposed for an integrated supply chain scheduling with the materials pickup, flow shop scheduling, and the finished products delivery. The objective is to minimize the makespan, that is, the arrival time of the last finished product to the customer. In MQGA, a new symbiosis strategy named mutualism is proposed to adjust the size of each population dynamically by regarding the mutual influence relation of the two subpopulations. A hybrid Q-bit coding method and a local speeding-up method are designed to increase the diversity of genes, and a checking routine is carried out to ensure the feasibility of each solution; that is, the total physical space of each delivery batch could not exceed the capacity of the vehicle. Compared with the modified genetic algorithm (MGA and the quantum-inspired genetic algorithm (QGA, the effectiveness and efficiency of the MQGA are validated by numerical experiments.

  16. Ship Routing with Pickup and Delivery for a Maritime Oil Transportation System: MIP Modeland Heuristics

    DEFF Research Database (Denmark)

    Rodrigues, Vinicius Picanco; Morabito, Reinaldo; Yamashita, Denise

    2016-01-01

    This paper examines a ship routing problem with pickup and delivery and time windowsfor maritime oil transportation, motivated by the production and logistics activities of an oil companyoperating in the Brazilian coast. The transportation costs from offshore platforms to coastal terminalsare...... application of two tailor-made MIP heuristics, based on relax-and-fix and timedecomposition procedures. The model minimizes fuel costs of a heterogeneous fleet of oil tankersand costs related to freighting contracts. The model also considers company-specific constraints foroffshore oil transportation....... Computational experiments based on the mathematical models and therelated MIP heuristics are presented for a set of real data provided by the company, which confirmthe potential of optimization-based methods to find good solutions for problems of moderate sizes....

  17. Ship Routing with Pickup and Delivery for a Maritime Oil Transportation System: MIP Model and Heuristics

    Directory of Open Access Journals (Sweden)

    Vinícius P. Rodrigues

    2016-09-01

    Full Text Available This paper examines a ship routing problem with pickup and delivery and time windows for maritime oil transportation, motivated by the production and logistics activities of an oil company operating in the Brazilian coast. The transportation costs from offshore platforms to coastal terminals are an important issue in the search for operational excellence in the oil industry, involving operations that demand agile and effective decision support systems. This paper presents an optimization approach to address this problem, based on a mixed integer programming (MIP model and a novel and exploratory application of two tailor-made MIP heuristics, based on relax-and-fix and time decomposition procedures. The model minimizes fuel costs of a heterogeneous fleet of oil tankers and costs related to freighting contracts. The model also considers company-specific constraints for offshore oil transportation. Computational experiments based on the mathematical models and the related MIP heuristics are presented for a set of real data provided by the company, which confirm the potential of optimization-based methods to find good solutions for problems of moderate sizes.

  18. Dynamic devices - pickups and kickers

    International Nuclear Information System (INIS)

    Lambertson, G.

    1986-08-01

    A given configuration of electrodes may be used either as a pickup or as a kicker; that duality is addressed. Some general relations between longitudinal and transverse effects and between the respones as pickup and as kicker are derived. Dynamic effects are seen to be entirely determined by the longitudinal electric fields in the direction of the beam current when the electrode is excited as a kicker. Response functions that serve as figures of merit are defined. The responses of specific examples of pickups and kickers are analyzed. An approach to the calculation of the transverse variation of coupling over the electrode aperture is preented

  19. Hydrogen pickup and redistribution in alpha-annealed Zircaloy-4

    International Nuclear Information System (INIS)

    Kammenzind, B.F.; Franklin, D.G.; Duffin, W.J.; Peters, H.R.

    1996-01-01

    Zircaloy-4, which is widely used as a core structural material in Pressurized-Water Reactors (PWR), picks up hydrogen during service. Hydrogen solubility in Zircaloy-4 is low and hydrides precipitate after the Zircaloy-4 matrix becomes supersaturated with hydrogen. These hydrides embrittle the Zircaloy-4. To study hydrogen pickup and concentration, a postirradiation nondestructive radiographic technique for measuring hydrogen concentration was developed and qualified. Experiments on hydrogen pickup were conducted in the Advanced Test Reactor (ATR). Ex-reactor tests were conducted to determine the conditions for which hydrogen would dissolve, migrate, and precipitate. Finally, a phenomenological model for hydrogen diffusion was indexed to the data. This presentation describes the equipment and the model, presents the results of experiments, and compares the model predictions to experimental results

  20. AA, stochastic precooling pickup

    CERN Multimedia

    CERN PhotoLab

    1980-01-01

    The freshly injected antiprotons were subjected to fast stochastic "precooling". In this picture of a precooling pickup, the injection orbit is to the left, the stack orbit to the far right. After several seconds of precooling with the system's kickers (in momentum and in the vertical plane), the precooled antiprotons were transferred, by means of RF, to the stack tail, where they were subjected to further stochastic cooling in momentum and in both transverse planes, until they ended up, deeply cooled, in the stack core. During precooling, a shutter near the central orbit shielded the pickups from the signals emanating from the stack-core, whilst the stack-core was shielded from the violent action of the precooling kickers by a shutter on these. All shutters were opened briefly during transfer of the precooled antiprotons to the stack tail. Here, the shutter is not yet mounted. Precooling pickups and kickers had the same design, except that the kickers had cooling circuits and the pickups had none. Peering th...

  1. Controlling service delivery in service triads

    NARCIS (Netherlands)

    Iwaarden, van J.; Valk, van der W.; Aalders, L.; Virolainen, V.-M.

    2010-01-01

    Organizations are increasingly sourcing services that are directly delivered to their (end) customers by external providers. Buying organization, supplier and (end) customer operate in a triadic service relationship. In these triads, the buying organization lacks direct control over service delivery

  2. 20 CFR 628.405 - Service delivery areas.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service delivery areas. 628.405 Section 628... TITLE II OF THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.405 Service delivery... evaluate the degree to which a proposed service delivery area meets criteria established by the Governor...

  3. High-performance pickups for beam diagnostics. Design, analysis, characterization and implementation

    International Nuclear Information System (INIS)

    Angelovski, Aleksandar

    2015-01-01

    This work introduces the design, analysis, characterization and implementation of high-performance pickups for two beam diagnostic instruments, a Bunch Arrival-time Monitor (BAM) and an Energy Beam Position Monitor (EBPM) at the European XFEL. As a part of the BAM the cone-shaped pickups are proposed along with the corresponding RF-frontend. The designed pickups deliver a beam induced signal with a slope steepness of around 400 mV/ps and a bandwidth of 40 GHz. These signal characteristics are well inside the design requirements, i.e., a slope steepness of 300 mV/ps and more than ten times better compared to the signal from the state-of-the-art pickups. The pickups are installed and commissioned at three accelerator facilities, FLASH at DESY, the quasi-CW SRF accelerator ELBE at the Helmholtz-Zentrum Dresden-Rossendorf and the SwissFEL injector test facility at Paul Scherrer Institute. The obtained measurement results from the installed pickups are in good agreement with the simulations. A comparison between the signal measurements with the cone-shaped pickup and the state-of-the-art is performed at ELBE showing an improvement by a factor of ten. The potential of the pickups for sub-10 fs arrival-time measurements for bunch charges of 20 pC is demonstrated at ELBE and at SwissFEL injector test facility. The introduced coneshaped pickups are the first commercially available pickups with a bandwidth of up to 40 GHz. For the EBPM, a modular pickup structure with two types of planar pickups, microstrip transmission line and grounded coplanar waveguide with perpendicular connectors is investigated. The transition region between the connector and the line is optimized for two substrate materials, alumina and glass with a reflection coefficient better than -20 dB up to 6 GHz.

  4. A mixed integer programming model for a continuous move transportation problem with service constraints

    Directory of Open Access Journals (Sweden)

    J. Fabian Lopez

    2010-01-01

    Full Text Available We consider a Pickup and Delivery Vehicle Routing Problem (PDP commonly encountered in real-world logistics operations. The problem involves a set of practical complications that have received little attention in the vehicle routing literature. In this problem, there are multiple vehicle types available to cover a set of pickup and delivery requests, each of which has pickup time windows and delivery time windows. Transportation orders and vehicle types must satisfy a set of compatibility constraints that specify which orders cannot be covered by which vehicle types. In addition we include some dock service capacity constraints as is required on common real world operations. This problem requires to be attended on large scale instances (orders ≥ 500, (vehicles ≥ 150. As a generalization of the traveling salesman problem, clearly this problem is NP-hard. The exact algorithms are too slow for large scale instances. The PDP-TWDS is both a packing problem (assign order to vehicles, and a routing problem (find the best route for each vehicle. We propose to solve the problem in three stages. The first stage constructs initials solutions at aggregate level relaxing some constraints on the original problem. The other two stages imposes time windows and dock service constraints. Our results are favorable finding good quality solutions in relatively short computational times.

  5. Hospital pharmacists' evaluation of drug wholesaler services.

    Science.gov (United States)

    Allen, W O; Ryan, M R; Roberts, K B

    1983-10-01

    Services provided by drug wholesalers were evaluated by hospital pharmacists. A survey was mailed to 1500 randomly selected pharmacy directors. Respondents indicated availability and use of 26 customer services. Pharmacists rated the services that they used on the basis of importance of the service and satisfaction with the service. The 644 returned questionnaires indicated that most services were available to a large majority of respondents. Most services used were rated as important or essential. Most respondents were satisfied with wholesaler services; the service with which the most respondents were dissatisfied was stocking of pharmaceuticals in single-unit packaging. Of other services that were widely used and rated important, prompt crediting for delivery errors, few out-of-stock items, frequent pickup of return merchandise, and stocking of injectable pharmaceuticals received low satisfaction ratings. Same-day delivery service and emergency delivery of prescription items were unavailable to more than 40% of respondents. Hospital pharmacists were generally satisfied with services provided by drug wholesalers. Wholesalers should be aware of the particular service needs of hospital pharmacists, and further studies of these needs should be conducted.

  6. Cost, Emissions, and Customer Service Trade-Off Analysis In Pickup and Delivery Systems.

    Science.gov (United States)

    2011-05-01

    This research offers a novel formulation for including emissions into fleet assignment and vehicle routing, and for the : trade-offs faced by fleet operators between cost, emissions, and service quality. This approach enables evaluation of : the impa...

  7. 77 FR 44306 - Service Delivery Plan

    Science.gov (United States)

    2012-07-27

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0048] Service Delivery Plan AGENCY: Social... input as we develop our Service Delivery Plan (SDP). We recently completed our Agency Strategic Plan... how we plan to provide our services over the next four years and beyond. DATES: To ensure that we...

  8. Menu-based service access and delivery pattern: Towards achieving equatable access to digital services

    CSIR Research Space (South Africa)

    Makitla, I

    2014-11-01

    Full Text Available . This capability is used in basic service such as Short Message Service (SMS) as well as Unstructured Supplementary Service Data (USSD). There is a need for a service access and delivery pattern that can facilitate the delivery of services using common...

  9. Inner Source Pickup Ions Observed by Ulysses

    Science.gov (United States)

    Gloeckler, G.

    2016-12-01

    The existence of an inner source of pickup ions close to the Sun was proposed in order to explain the unexpected discovery of C+ in the high-speed polar solar wind. Here I report on detailed analyses of the composition and the radial and latitudinal variations of inner source pickup ions measured with the Solar Wind Ion Composition Spectrometer on Ulysses from 1991 to 1998, approaching and during solar minimum. We find that the C+ intensity drops off with radial distance R as R-1.53, peaks at mid latitudes and drops to its lowest value in the ecliptic. Not only was C+ observed, but also N+, O+, Ne+, Na+, Mg+, Ar+, S+, K+, CH+, NH+, OH+, H2O+, H3O+, MgH+, HCN+, C2H4+, SO+ and many other singly-charged heavy ions and molecular ions. The measured velocity distributions of inner source pickup C+ and O+ indicate that these inner source pickup ions are most likely produced by charge exchange, photoionization and electron impact ionization of neutrals close to the Sun (within 10 to 30 solar radii). Possible causes for the unexpected latitudinal variations and the neutral source(s) producing the inner source pickup ions as well as plausible production mechanisms for inner source pickup ions will be discussed.

  10. Pick-up ion energization at the termination shock

    Energy Technology Data Exchange (ETDEWEB)

    Gary, S Peter [Los Alamos National Laboratory; Winske, Dan [Los Alamos National Laboratory; Wu, Pin [BOSTON UNIV.; Schwadron, N A [BOSTON UNIV.

    2009-01-01

    One-dimensional hybrid simulations are used to investigate how pickup ions are energized at the perpendicular termination shock. Contrary to previous models based on pickup ion energy gain by repeated crossings of the shock front (shock surfing) or due to a reforming shock front, the present simulations show that pickup ion energy gain involves a gyro-phasedependent interaction with the inhomogeneous motional electric field at the shock. The process operates at all relative concentrations of pickup ion density.

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

    African Journals Online (AJOL)

    dell

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

  12. Five Characteristics of China Made Pickup

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    <正> Compared with imported ones, the domestic-made pick-ups have the characteristics as follows: Technology: over the past several years, along with the fierce market competition, the technologies of over 30 pick-up makers in China seem to be mature. Some makers have possessed a production capacity of 30,000 units every

  13. 'Wagging the dog': supply chain management and service delivery

    CSIR Research Space (South Africa)

    Wall, K

    2013-09-01

    Full Text Available in the appointment of contractors, leading to delays in the delivery of services. The SCM “tail” would appear on those occasions to be “wagging the dog”, namely service delivery....

  14. High frequency permeameter with semi-rigid pick-up coil

    International Nuclear Information System (INIS)

    Shin, Sung-Yong; Shin, Kwang-Ho . E-mail : khshin@star.ks.ac.kr; Kim, Jong-sung; Kim, Young-Hak; Lim, Sang-Ho; Sa-gong, Geon

    2006-01-01

    In this study, we propose the application of semi-rigid cable loop as a single turn shielded loop pick-up coil for the high frequency permeameter. Since the semi-rigid cable pick-up coil has simple structure, it is very easy to make the pick-up coil with bending and conventional soldering. The permeability of cobalt base amorphous ribbon was investigated using the developed permeameter for demonstrating its performance. The permeability of the amorphous ribbon was driven from the S-parameters measured using a network analyzer and permameter having the semi-rigid pick-up coil

  15. Dynamic devices: A primer on pickups and kickers

    International Nuclear Information System (INIS)

    Goldberg, D.A.; Lambertson, G.R.

    1991-11-01

    A charged-particle beam generates electromagnetic fields which in turn interact with the beam's surroundings. These interactions can produce fields which act back on the beam itself, or, if the ''surroundings'' are of suitably designed form (e.g., sensing electrodes with electrical connection to the ''outside world''), can provide information on various properties of the beam; such electrodes are generally known as pickups. Similarly, charged- particle beams respond to the presence of externally imposed electromagnetic fields; devices used to generate such fields are generally known as kickers. As we shall show, the behavior of an electrode system when it functions as a pickup is intimately related to its behavior as a kicker. A number of papers on pickup behavior have appeared in recent years in most of which the primary emphasis has been on beam instrumentation; there have also been several workshops on the subject. There have been several papers which have treated both pickup and kicker behavior of a particular electrode system, but this has been done in the context of discussing a specialized application, such as a stochastic cooling system. The approach in the present paper is similar to that of earlier works by one of the authors, which is to provide a unified treatment of pickup and kicker behavior, and, it is hoped, to give the reader an understanding which is both general and fundamental enough to make the above references easily accessible to him. As implied by the revised title, we have done the re-writing with the non-expert in mind. We have made the introduction both lengthier and more detailed, and done the same with much of the explanatory material and discussion

  16. Dynamic devices: A primer on pickups and kickers

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, D.A.; Lambertson, G.R.

    1991-11-01

    A charged-particle beam generates electromagnetic fields which in turn interact with the beam`s surroundings. These interactions can produce fields which act back on the beam itself, or, if the ``surroundings`` are of suitably designed form (e.g., sensing electrodes with electrical connection to the ``outside world``), can provide information on various properties of the beam; such electrodes are generally known as pickups. Similarly, charged- particle beams respond to the presence of externally imposed electromagnetic fields; devices used to generate such fields are generally known as kickers. As we shall show, the behavior of an electrode system when it functions as a pickup is intimately related to its behavior as a kicker. A number of papers on pickup behavior have appeared in recent years in most of which the primary emphasis has been on beam instrumentation; there have also been several workshops on the subject. There have been several papers which have treated both pickup and kicker behavior of a particular electrode system, but this has been done in the context of discussing a specialized application, such as a stochastic cooling system. The approach in the present paper is similar to that of earlier works by one of the authors, which is to provide a unified treatment of pickup and kicker behavior, and, it is hoped, to give the reader an understanding which is both general and fundamental enough to make the above references easily accessible to him. As implied by the revised title, we have done the re-writing with the non-expert in mind. We have made the introduction both lengthier and more detailed, and done the same with much of the explanatory material and discussion.

  17. Good governance, service delivery and records: the African tragedy ...

    African Journals Online (AJOL)

    A paper tasked to establish the relationship between records, good governance and service delivery, especially in Africa, runs into immediate definitional ambiguities. This is because good governance and service delivery mean different things to different African leaders. Moreover, even the most criminal and tyrannical ...

  18. 78 FR 15797 - Service Delivery Plan

    Science.gov (United States)

    2013-03-12

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0048] Service Delivery Plan AGENCY: Social... input as we finalize our Service Delivery Plan (SDP). We designed our SDP as a roadmap for how we will... Plan. DATES: To ensure that we consider your comments, we must receive them no later than April 11...

  19. Electrostatic pickup station

    CERN Multimedia

    CERN PhotoLab

    1982-01-01

    Electrostatic pickup station, with 4 interleaved electrodes, to measure beam position in the horizontal and vertical plane. This type is used in the transfer lines leaving the PS (TT2, TT70, TTL2). See also 7904075.

  20. Leveraging socially networked mobile ICT platforms for the last-mile delivery problem.

    Science.gov (United States)

    Suh, Kyo; Smith, Timothy; Linhoff, Michelle

    2012-09-04

    Increasing numbers of people are managing their social networks on mobile information and communication technology (ICT) platforms. This study materializes these social relationships by leveraging spatial and networked information for sharing excess capacity to reduce the environmental impacts associated with "last-mile" package delivery systems from online purchases, particularly in low population density settings. Alternative package pickup location systems (PLS), such as a kiosk on a public transit platform or in a grocery store, have been suggested as effective strategies for reducing package travel miles and greenhouse gas emissions, compared to current door-to-door delivery models (CDS). However, our results suggest that a pickup location delivery system operating in a suburban setting may actually increase travel miles and emissions. Only once a social network is employed to assist in package pickup (SPLS) are significant reductions in the last-mile delivery distance and carbon emissions observed across both urban and suburban settings. Implications for logistics management's decades-long focus on improving efficiencies of dedicated distribution systems through specialization, as well as for public policy targeting carbon emissions of the transport sector are discussed.

  1. AA, closed orbit observation pickup

    CERN Multimedia

    1980-01-01

    Electrostatic pickups around the circumference of the AA served for the measurement of the closed orbits across the wide momentum range of +- 3% to either side of central orbit. The pickups were of the "shoebox" type, with diagonal cuts, a horizontal and a vertical one mechanically coupled together. They were located where they would not require extra space. The small ones, like the one we see here, were inserted into the vacuum chamber of the BLG (long and narrow) bending magnets. See also 8001372, 8010042, 8010045

  2. 42 CFR 136a.15 - Health Service Delivery Areas.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas. (b...

  3. MAVEN Pickup Ion Constraints on Mars Neutral Escape

    Science.gov (United States)

    Rahmati, A.; Larson, D. E.; Cravens, T.; Lillis, R. J.; Dunn, P.; Halekas, J. S.; McFadden, J. P.; Mitchell, D. L.; Thiemann, E.; Connerney, J. E. P.; DiBraccio, G. A.; Espley, J. R.; Eparvier, F. G.

    2017-12-01

    Mars is currently losing its atmosphere mainly due to the escape of neutral hydrogen and oxygen. Directly measuring the rate of escaping neutrals is difficult, because the neutral density in the Mars exosphere is dominated, up to several Martian radii, by atoms that are gravitationally bound to the planet. Neutral atoms in the Martian exosphere, however, can get ionized, picked up, and accelerated by the solar wind motional electric field and energized to energies high enough for particle detectors to measure them. The MAVEN SEP instrument detects O+ pickup ions that are created at altitudes where the escaping part of the exosphere is dominant. Fluxes of these ions reflect neutral densities in the distant exosphere of Mars, allowing us to constrain neutral oxygen escape rates. The MAVEN SWIA and STATIC instruments measure pickup H+ and O+ created closer to Mars; comparisons of these data with models can be used to constrain exospheric hot O and thermal H densities and escape rates. In this work, pickup ion measurements from SEP, SWIA, and STATIC, taken during the first 3 Earth years of the MAVEN mission, are compared to the outputs of a pickup ion model to constrain the variability of neutral escape at Mars. The model is based on data from six MAVEN instruments, namely, MAG providing magnetic field used in calculating pickup ion trajectories, SWIA providing solar wind velocity as well as 3D pickup H+ and O+ spectra, SWEA providing solar wind electron spectrum used in electron impact ionization rate calculations, SEP providing pickup O+ spectra, STATIC providing mass resolved 3D pickup H+ and O+ spectra, and EUVM providing solar EUV spectra used in photoionization rate calculations. A variability of less than a factor of two is observed in hot oxygen escape rates, whereas thermal escape of hydrogen varies by an order of magnitude with Mars season. This hydrogen escape variability challenges our understanding of the H cycle at Mars, but is consistent with other

  4. Rethinking the delivery of public services to citizens

    National Research Council Canada - National Science Library

    Seidle, F. Leslie

    1995-01-01

    ... Sector Reform and Service Delivery in the Antipodes New Zealand: Transforming the State Australia: a Concerted Program of Management Reform Conclusion Notes 75 Chapter Four The Canadian Federal Government and Service Delivery Issues Perceptions of Service from the Federal Government The Mulroney Government and Public Service 2000 Special Operati...

  5. Dynamic devices: A primer on pickups and kickers

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, D.A.; Lambertson, G.R.

    1991-11-01

    A charged-particle beam generates electromagnetic fields which in turn interact with the beam's surroundings. These interactions can produce fields which act back on the beam itself, or, if the surroundings'' are of suitably designed form (e.g., sensing electrodes with electrical connection to the outside world''), can provide information on various properties of the beam; such electrodes are generally known as pickups. Similarly, charged- particle beams respond to the presence of externally imposed electromagnetic fields; devices used to generate such fields are generally known as kickers. As we shall show, the behavior of an electrode system when it functions as a pickup is intimately related to its behavior as a kicker. A number of papers on pickup behavior have appeared in recent years in most of which the primary emphasis has been on beam instrumentation; there have also been several workshops on the subject. There have been several papers which have treated both pickup and kicker behavior of a particular electrode system, but this has been done in the context of discussing a specialized application, such as a stochastic cooling system. The approach in the present paper is similar to that of earlier works by one of the authors, which is to provide a unified treatment of pickup and kicker behavior, and, it is hoped, to give the reader an understanding which is both general and fundamental enough to make the above references easily accessible to him. As implied by the revised title, we have done the re-writing with the non-expert in mind. We have made the introduction both lengthier and more detailed, and done the same with much of the explanatory material and discussion.

  6. AA, closed orbit observation pickup

    CERN Multimedia

    CERN PhotoLab

    1980-01-01

    Electrostatic pickups around the circumference of the AA served for the measurement of the closed orbits across the wide momentum range of +- 3% to either side of central orbit. The pickups were of the "shoebox" type, with diagonal cuts, a horizontal and a vertical one mechanically coupled together. They were located where they would not require extra space. The small ones, like the one we see here, were inserted into the vacuum chamber of the BLG (long and narrow) bending magnets. Werner Sax contemplates his achievement. See also 8001383, 8010042, 8010045.

  7. AA, closed orbit observation pickup

    CERN Multimedia

    CERN PhotoLab

    1980-01-01

    Electrostatic pickups around the circumference of the AA served for the measurement of the closed orbits across the wide momentum range of +- 3% to either side of central orbit. The pickups were of the "shoebox" type, with diagonal cuts, a horizontal and a vertical one mechanically coupled together. They were located where they would not require extra space. The wide ones (very wide indeed: 70 cm), like the one we see here, were placed inside the vacuum chamber of the wide quadrupoles QFW, at maximum dispersion. See also 8001372, 8001383, 8010045

  8. AA, closed orbit observation pickup

    CERN Multimedia

    CERN PhotoLab

    1980-01-01

    Electrostatic pickups around the circumference of the AA served for the measurement of the closed orbits across the wide momentum range of +- 3% to either side of central orbit. The pickups were of the "shoebox" type, with diagonal cuts, a horizontal and a vertical one mechanically coupled together. They were located where they would not require extra space. The wide ones (very wide indeed: 70 cm), like the one we see here, were placed inside the vacuum chamber of the wide quadrupoles, QFW, at maximum dispersion. See also 8001372,8001383, 8010042

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

    Directory of Open Access Journals (Sweden)

    Paulin Mbecke

    2014-10-01

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

  10. Electrostatic pickup station

    CERN Multimedia

    CERN PhotoLab

    1979-01-01

    Electrostatic pickup station, with 4 electrodes, to measure beam position in the horizontal and vertical plane. This type is used in the transfer lines leaving the PS (TT2, TTL2, TT70). See also 8206063, where the electrode shapes are clearly visible.

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

    Science.gov (United States)

    Tang, Liyang

    2012-09-14

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

  12. 78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

    Science.gov (United States)

    2013-02-06

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

  13. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Science.gov (United States)

    2013-01-04

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

  14. Bespoke program design for school-aged therapy disability service delivery.

    Science.gov (United States)

    Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi

    2012-01-01

    This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.

  15. PAL-XFEL cavity beam position monitor pick-up design and beam test

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sojeong, E-mail: sojung8681@postech.ac.kr; Park, Young Jung; Kim, Changbum; Kim, Seung Hwan; Shin, Dong Cheol; Han, Jang-Hui; Ko, In Soo

    2016-08-11

    As an X-ray Free Electron Laser, PAL-XFEL is about to start beam commissioning. X-band cavity beam position monitor (BPM) is used in the PAL-XFEL undulator beam line. Prototypes of cavity BPM pick-up were designed and fabricated to test the RF characteristics. Also, the beam test of a cavity BPM pick-up was done in the Injector Test Facility (ITF). In the beam test, the raw signal properties of the cavity BPM pick-up were measured at a 200 pC bunch charge. According to the RF test and beam test results, the prototype cavity BPM pick-up design was confirmed to meet the requirements of the PAL-XFEL cavity BPM system.

  16. Project management: a new service delivery paradigm

    Directory of Open Access Journals (Sweden)

    G. van der Walt

    2007-07-01

    Full Text Available In line with international trends in governance, the South African Government’s initial focus on the development of policy frameworks, structures and systems in order to give effect to the values and principles of the Constitution, shifted to the most critical issue, namely service delivery. The Government became increasingly aware that a significant expansion in the scope and quality of service provision was not possible with traditional delivery settings and approaches. There is growing evidence that there is a need for a significant departure from conventional approaches and that a leap into a new service delivery paradigm is necessary. Increasingly this new paradigm highlights the need to further develop the government’s project management skills and applications with a view to achieving improved delivery capability. In this article the focus will be placed on the changing service delivery paradigm – from an “old” traditional model through the transition to a “new” paradigm. This paradigm is shaped by international and national trends and events in government. The contribution and advantages of project management applications for effective governance are highlighted and the article concludes with an explanation of project management organisational arrangements necessary to support the new paradigm.

  17. Service delivery, community development, and disability.

    Science.gov (United States)

    Murphy, John W

    2010-01-01

    Service delivery has traditionally been based on market forces. When this is the case, the community becomes a silent partner in this process. Services, accordingly, are directed mostly to correcting personal ills and have little to do with community uplift. Another model, based on the work of Amartya Sen, is available that conceptualizes interventions in a very different way. If understood in the context of community development, the focus of services is social change, rather than merely personal rehabilitation. This reorientation is discussed in this article.

  18. Can a Unified Service Delivery Philosophy Be Identified in Aging and Disability Organizations? Exploring Competing Service Delivery Models Through the Voices of the Workforce in These Organizations.

    Science.gov (United States)

    Keefe, Bronwyn

    2018-01-01

    Services for older adults and younger people with disabilities are increasingly merging, as reflected in the creation of Aging and Disability Resource Centers (ADRCs). Using ADRCs to coordinate services is challenging, primarily because these fields have different service delivery philosophies. Independent Living Centers, which serve people with disabilities, have a philosophy that emphasizes consumer control and peer mentoring. However, the aging service delivery philosophy is based in a case management or medical model in which the role of consumers directing their services is less pronounced. Using institutional logics theory and a qualitative research design, this study explored whether a unified service delivery philosophy for ADRCs was emerging. Based on focus groups and questionnaires with staff from ADRCs, findings revealed that competing service delivery models continue to operate in the aging and disability fields.

  19. A Multi-organisational Approach to Service Delivery

    Science.gov (United States)

    Purchase, Valerie; Mills, John; Parry, Glenn

    Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

  20. Human Resources Management and Service Delivery in Nigeria ...

    African Journals Online (AJOL)

    The paper represents essentially an attempt to analyse and comprehend the role of Human Resource Management (HRM) in effective service delivery in Nigeria. The paper advocates that the revamping and transformation of the Nigerian Civil Service to render effective service to the public lies not in the continuous ...

  1. Effects of time-dependent photoionization on interstellar pickup atoms

    International Nuclear Information System (INIS)

    Isenberg, P.A.; Lee, M.A.

    1995-01-01

    We present an analytical model for the density variations of interstellar pickup ions in the solar wind due to a time-dependent variation in the photoionization rate, our model predicts a pickup ion density enhancement lasting for a time of the order of the duration of the increase plus the solar wind convection time to the observation point. If the photoionization rate returns to its initial value, this enhancement is followed by a decreased pickup ion density resulting from a depleted interstellar neutral particle density. In the absence of further variations in the photoionization rate, the pickup ion density recovers on a time which scales as the radial position of the observation point divided by the inflow speed of the neutral particles. Gradual variations in the photoionization rate result in a pickup ion density which tends to track the ionization rate, though the density variations are smoothed and delayed in time due to the solar wind convection of ions picked up at points closer to the Sun. 27 refs., 4 figs

  2. Assessing tether anchor labeling and usability in pickup trucks.

    Science.gov (United States)

    Klinich, Kathleen D; Manary, Miriam A; Malik, Laura A; Flannagan, Carol A; Jermakian, Jessica S

    2018-04-03

    The objective of this study was to investigate vehicle factors associated with child restraint tether use and misuse in pickup trucks and evaluate 4 labeling interventions designed to educate consumers on proper tether use. Volunteer testing was performed with 24 subjects and 4 different pickup trucks. Each subject performed 8 child restraint installations among the 4 pickups using 2 forward-facing restraints: a Britax Marathon G4.1 and an Evenflo Triumph. Vehicles were selected to represent 4 different implementations of tether anchors among pickups: plastic loop routers (Chevrolet Silverado), webbing routers (Ram), back wall anchors (Nissan Frontier), and webbing routers plus metal anchors (Toyota Tundra). Interventions included a diagram label, Quick Response (QR) Code linked to video instruction, coordinating text label, and contrasting text tag. Subjects used the child restraint tether in 93% of trials. However, tether use was completely correct in only 9% of trials. An installation was considered functional if the subject attached the tether to a tether anchor and had a tight installation (ignoring routing and head restraint position); 28% of subjects achieved a functional installation. The most common installation error was attaching the tether hook to the anchor/router directly behind the child restraint (near the top of the seatback) rather than placing the tether through the router and attaching it to the anchor in the adjacent seating position. The Nissan Frontier, with the anchor located on the back wall of the cab, had the highest rate of correct installations but also had the highest rate of attaching the tether to components other than the tether anchor (seat adjustor, child restraint storage hook, around head restraint). None of the labeling interventions had a significant effect on correct installation; not a single subject scanned the QR Code to access the video instruction. Subjects with the most successful installations spent extensive time

  3. Probing the Martian Exosphere and Neutral Escape Using Pickup Ions Measured by MAVEN

    Science.gov (United States)

    Rahmati, A.; Larson, D. E.; Cravens, T.; Halekas, J. S.; Lillis, R. J.; McFadden, J. P.; Mitchell, D. L.; Thiemann, E.; Connerney, J. E. P.; Dunn, P.; DiBraccio, G. A.; Espley, J. R.; Eparvier, F. G.; Jakosky, B. M.

    2016-12-01

    Soon after the MAVEN (Mars Atmosphere and Volatile EvolutioN) spacecraft started orbiting Mars in September 2014, the SEP (Solar Energetic Particle), SWIA (Solar Wind Ion Analyzer), and STATIC (Supra-Thermal and Thermal Ion Composition) instruments onboard the spacecraft started detecting planetary pickup ions. SEP can measure energetic (>50 keV) oxygen pickup ions, the source of which is the extended hot oxygen exosphere of Mars. Model results show that these pickup ions originate from tens of Martian radii upstream of Mars and are energized by the solar wind motional electric field as they gyrate back towards Mars. SEP is blind to pickup hydrogen, as the low energy threshold for detection of hydrogen in SEP is 20 keV; well above the maximum pickup hydrogen energy, which is four times the solar wind proton energy. SWIA and STATIC, on the other hand, can detect both pickup oxygen and pickup hydrogen with energies below 30 keV and created closer to Mars. During the times when MAVEN is outside the Martian bow shock and in the upstream undisturbed solar wind, the solar wind velocity measured by SWIA and the solar wind (or interplanetary) magnetic field measured by the MAG (magnetometer) instrument can be used to model pickup oxygen and hydrogen fluxes near Mars. Solar wind flux measurements of the SWIA instrument are used in calculating charge-exchange frequencies, and data from the EUVM (Extreme Ultraviolet Monitor) and SWEA (Solar Wind Electron Analyzer) instruments are also used in calculating photo-ionization and electron impact frequencies of neutral species in the Martian exosphere. By comparing SEP, SWIA, and STATIC measured pickup ion fluxes with model results, the Martian thermal hydrogen and hot oxygen neutral densities can be probed outside the bow shock, which would place constraints on estimates of oxygen and hydrogen neutral escape rates. We will present model-data comparisons of pickup ions measured outside the Martian bow shock. Our analysis reveals an

  4. 42 CFR 460.98 - Service delivery.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Service delivery. 460.98 Section 460.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., national origin, religion, sex, age, sexual orientation, mental or physical disability, or source of...

  5. The pickup and delivery problem with cross-docking opportunity

    DEFF Research Database (Denmark)

    Petersen, Hanne Løhmann; Røpke, Stefan

    2011-01-01

    delivery by one truck, or by being picked up and transported to the cross-dock by one vehicle, and subsequently delivered at its final destination by another vehicle. Handling times at customers sites and terminal are given. A typical daily instance includes 500-1,000 requests. We solve the problem using...

  6. The delivery of primary care services.

    NARCIS (Netherlands)

    Wilson, A.; Windak, A.; Oleszczyk, M.; Wilm, S.; Hasvold, T.; Kringos, D.

    2015-01-01

    This chapter will be devoted to the dimensions which have been grouped in the framework as “process” and that focus on essential features of service delivery in primary care. In addition to the breadth of services delivered, a comparative overview will be provided of variation in access to services,

  7. Contributing factors to poor service delivery by administrative ...

    African Journals Online (AJOL)

    This article reports on a study that was conducted among non-managerial administrative employees in the public sector in Gauteng. The researchers attempted to determine the effect of specified job factors on the wellbeing and service delivery of these employees. Poor service delivery in the country triggered the research.

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

    African Journals Online (AJOL)

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

  9. Beam-phase monitoring with non-destructive pickup

    International Nuclear Information System (INIS)

    Bogaty, J.; Clifft, B.E.

    1995-01-01

    An intensity and phase-sensitive capacitive pickup was installed at the entrance to the PII linac. This device is based on an extension of the design of the Beam Current Monitor developed as part of the ATLAS radiation safety system. The purpose of the pickup is to allow the arrival phase of the beam from the ECR source at the entrance to the PII linac to be set to a standard which reproduces previous tune conditions and establishes a standard. The new pickups and associated electronics demonstrated sensitivity well below 1 electrical nanoamp but can handle beam currents of many electrical microamps as well. In addition to phase information, beam current is also measured by the units thus providing a continuous, non-intercepting current readout as well. From the very first use of PII, we established a few open-quotes reference tunesclose quotes for the linac and scaled those tunes for any other beam desired. For such scaling to work properly, the velocity and phase of the beam from the ion source must be fixed and reproducible. In last year's FWP the new ATLAS Master Oscillator System was described. The new system has the ability of easily adjusting the beam arrival phase at the entrance to each of the major sections of the facility - PII, Booster, ATLAS. Our present techniques for establishing the beam arrival phase at the entrance of each of the linac sections are cumbersome and, sometimes, intellectually challenging. The installation of these capacitative pickups at the entrance to each of the linac sections will make the determination and setting of the beam arrival phase direct, simple, and dynamic. This should dramatically shorten our setup time for open-quotes old-tuneclose quotes configurations and increase useful operating hours. Permanent electronics for the PII entrance pickup is under construction

  10. planning for gender equitable services delivery in a decentralised ...

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

    Sarah Ssali

    Services Delivery in Uganda. – Services offered. – Participation. – Decision making process. – Actors. – Issues. • Post-Conflict Situations in Uganda. – Challenges from Conflict. – Decentralisation in Post conflict settings. – Planning for gender equitable services delivery. • Recommendations (Policy). • Research Gaps ...

  11. A Rich Vehicle Routing Problem with Multiple Trips and Driver Shifts

    OpenAIRE

    Arda, Yasemin; Crama, Yves; Kucukaydin, Hande; Talla Nobibon, Fabrice

    2012-01-01

    This study is concerned with a rich vehicle routing problem (RVRP) encountered at a Belgian transportation company in charge of servicing supermarkets and hypermarkets belonging to a franchise. The studied problem can be classified as a one-to-many-to-one pick-up and delivery problem, where there is a single depot from which all delivery customers are served and to which every pick-up demand must be carried back (Gutiérrez-Jarpa et al., 2010). The delivery and backhaul customers are considere...

  12. Graduate Student Services: A Study of the Delivery of Services at the Location Where Students Matriculate

    Science.gov (United States)

    Burlison, John G.

    2010-01-01

    This dissertation investigates and explores the best method for the delivery of graduate student services. Essentially, there are two methods for delivery of these services. They can be delivered by virtue of centralization or decentralization. Decentralized delivery, for the purpose of this dissertation is the delivery of graduate student…

  13. Alternative Public Service Delivery Models in Health, Water and ...

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

    The literature on public service delivery alternatives has to date been highly localized, sector specific and lacking in methodological consistency. This project seeks to analyze health, water and electricity delivery models in Africa, Asia and Latin America in order to identify and document successful alternatives to ...

  14. Older adults and the emerging digital service delivery

    DEFF Research Database (Denmark)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were...... associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use...... it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability....

  15. Slot-type pickup/kicker for AA stochastic cooling

    CERN Multimedia

    1979-01-01

    A "slotted transmission line" was used for both pickups and kickers of the stochastic cooling systems of the AA. They served for the cooling of the high-density antiproton stack, in momentum and both transverse planes. In the beginning, in a single band, 1-2 GHz, later in 2 bands, 2-4 and 4-8 GHz. View down the centre of a pickup or kicker. See also 7906189, 7906190, 7906583.

  16. Service delivery innovation architecture: An empirical study of antecedents and outcomes

    Directory of Open Access Journals (Sweden)

    Rajeev Verma

    2014-06-01

    Full Text Available The research examines service delivery innovation architecture and its role in achieving sustainable competitive advantage of firms. The study develops and empirically examines an antecedent based model of service delivery innovation. We collected data from 203 service sector professionals working in Mexican financial and information technology firms, and tested the proposed relationship. Further, the study investigates the moderating role of customer orientation on innovation driven performance outcomes. Results show that customer orientation strengthens the service delivery–performance relationship. This paper aims to contribute to the strategic planning of service firms by guiding their resource allocation to ensure sustainable growth.

  17. Controlling the delivery of outsourced services in asymmetrical supply chains

    NARCIS (Netherlands)

    Iwaarden, van J.; Valk, van der W.; Aalders, L.; Brown, S.W.

    2009-01-01

    Services are increasingly outsourced. When outsourced services are directly delivered to the final customer by the supplier, the buying company lacks direct control over the delivery of the service. The purpose of this study is to expand theory on control over service delivery in supply chains. A

  18. Factors associated with institutional delivery service utilization in Ethiopia

    Directory of Open Access Journals (Sweden)

    Kebede A

    2016-09-01

    Full Text Available Alemi Kebede,1 Kalkidan Hassen,2 Aderajew Nigussie Teklehaymanot1 1Department of Population and Family Health, 2College of Health Sciences, Jimma University, Ethiopia Background: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home.Objective: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia.Methods: The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs and their 95% confidence intervals (CIs were calculated. Heterogeneity of the study was assessed using I2 test.Results: People living in urban areas (OR =13.16, CI =1.24, 3.68, with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively, who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39, and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57 showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization.Conclusion and recommendation: Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available

  19. The quality of free antenatal and delivery services in Northern Sierra Leone.

    Science.gov (United States)

    Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

    2017-07-12

    The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of

  20. Records management and service delivery: the case of Department ...

    African Journals Online (AJOL)

    This article explores the role of records management in the delivery of public service in ... to the Corporate Services Division at the Ministry of Health headquarters. ... delays in access and use of records; lack of a elaborate electronic records ...

  1. Nursing Services Delivery Theory: an open system approach

    Science.gov (United States)

    Meyer, Raquel M; O’Brien-Pallas, Linda L

    2010-01-01

    meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573

  2. Channel integration in governmental service delivery: the effects on citizen behavior and perceptions

    NARCIS (Netherlands)

    Pieterson, Willem Jan; Teerling, Marije; Wimmer, Maria A.; Scholl, Hans J.; Janssen, Marijn; Traunmüller, Roland

    2009-01-01

    Governmental agencies continuously work on the improvement of their service delivery through an array of channels. To improve service satisfaction and to reduce the cost of service delivery, channel integration gets more popular with governmental agencies. In a quasi experimental longitudinal field

  3. Older individuals' experiences during the assistive technology device service delivery process.

    Science.gov (United States)

    Gramstad, Astrid; Storli, Sissel Lisa; Hamran, Torunn

    2014-07-01

    Providing assistive technology devices to older individuals living in their ordinary homes is an important intervention to increase and sustain independence and to enable ageing at home. However, little is known about older individuals' experiences and needs in the assistive technology device (ATD) service delivery process. The purpose of this study was to investigate older individuals' experiences during the service delivery process of ATDs. Nine older individuals were interviewed three times each throughout the ATD service delivery process. The interviews were analysed within a hermeneutical phenomenological perspective. The results show that the service delivery process could be interpreted as an enigmatic journey and described using four themes: "hope and optimistic expectations", "managing after delivery or needing additional help", "having available help versus being abandoned", and "taking charge or putting up". The results emphasize the need for occupational therapists to maintain an individualized approach towards older clients throughout the service delivery process. The experiences of older individuals were diverse and related to expectations that were not necessarily articulated to the occupational therapist. The situation when the ATD is delivered to the client was highlighted by the clients as an important event with the potential to facilitate a successful service delivery process.

  4. Pickup Protons: Comparisons using the Three-Dimensional MHD HHMS-PI model and Ulysses SWICS Measurements

    Science.gov (United States)

    Intriligator, Devrie S.; Detman, Thomas; Gloecker, George; Gloeckler, Christine; Dryer, Murray; Sun, Wei; Intriligator, James; Deehr, Charles

    2012-01-01

    We report the first comparisons of pickup proton simulation results with in situ measurements of pickup protons obtained by the SWICS instrument on Ulysses. Simulations were run using the three dimensional (3D) time-dependent Hybrid Heliospheric Modeling System with Pickup Protons (HHMS-PI). HHMS-PI is an MHD solar wind model, expanded to include the basic physics of pickup protons from neutral hydrogen that drifts into the heliosphere from the local interstellar medium. We use the same model and input data developed by Detman et al. (2011) to now investigate the pickup protons. The simulated interval of 82 days in 2003 2004, includes both quiet solar wind (SW) and also the October November 2003 solar events (the Halloween 2003 solar storms). The HHMS-PI pickup proton simulations generally agree with the SWICS measurements and the HHMS-PI simulated solar wind generally agrees with SWOOPS (also on Ulysses) measurements. Many specific features in the observations are well represented by the model. We simulated twenty specific solar events associated with the Halloween 2003 storm. We give the specific values of the solar input parameters for the HHMS-PI simulations that provide the best combined agreement in the times of arrival of the solar-generated shocks at both ACE and Ulysses. We show graphical comparisons of simulated and observed parameters, and we give quantitative measures of the agreement of simulated with observed parameters. We suggest that some of the variations in the pickup proton density during the Halloween 2003 solar events may be attributed to depletion of the inflowing local interstellar medium (LISM) neutral hydrogen (H) caused by its increased conversion to pickup protons in the immediately preceding shock.

  5. Strategic Promotion And Bank Services Delivery: Operational ...

    African Journals Online (AJOL)

    Chi-square (x2) non-parametric statistical technique was applied in analyzing the primary data so harnessed. The results indicated that Banks services delivery systems are not critically determined by available operational finance. This strategically necessitates budgetary enhancement and focal human capital development ...

  6. 76 FR 4726 - Avaya Global Services, AOS Service Delivery, Worldwide Services Group, Including Workers Whose...

    Science.gov (United States)

    2011-01-26

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

  7. The perceptions and nature of service delivery innovation among government employees: An exploratory study

    Directory of Open Access Journals (Sweden)

    Nico Martins

    2015-11-01

    Full Text Available Innovation has become prominent within the leadership literature as an underlying and important aspect of service delivery. This study set out to determine the perceptions and nature of service delivery innovation among employees of a South African government department, using a sample of 289 participants. Statistical analysis was conducted to analyse the data which indicate that innovation is an important aspect of service delivery. This study suggests that to enhance service delivery employees should be encouraged to be innovative. The implications of the findings are discussed and recommendations for future research are made.

  8. original article predictors of safe delivery service utilization in arsi

    African Journals Online (AJOL)

    Abrham

    There is limited information on the mothers' use of skilled delivery services in the ... edited, cleaned, and entered into a computer and analyzed using SPSS for ... education and communication on safe delivery service utilization, expansion of ...

  9. Invigorating Library Service Delivery through the Adoption of M ...

    African Journals Online (AJOL)

    Invigorating Library Service Delivery through the Adoption of M-Learning by Library Users in Nigeria. ... Nigerian School Library Journal ... so as to be at par with the libraries in the developed nations and to keep abreast Nigerian library users with the recent mobile technologies in the library services delivery in the world.

  10. EPISTEMIC COMMUNITIES AND SERVICE DELIVERY CHOICES IN SPANISH MUNICIPAL ADMINISTRATIONS

    Directory of Open Access Journals (Sweden)

    Miquel SALVADOR

    2015-12-01

    Full Text Available This article contributes to the debate on the use of alternative formulas for public service provision with arguments related to epistemic communities’ influence. Drawing on the literature on models of local public service delivery, the role of internal epistemic communities is discussed and tested through the consideration of two different communities related to specific municipal areas such as personal and urban services. The results demonstrate that the association of urban services’ epistemic communities with alternative formulas for direct provision to deliver services is greater than in the case of personal services’ epistemic community. Those findings contribute to the academic debate not only with arguments and evidence that reinforces the role of variables included in previous research but also by introducing the role of epistemic communities in determining some policy options (as the use of local public-service delivery formulas.

  11. Acoustic emission pickup essentially for waveguide

    International Nuclear Information System (INIS)

    Asty, Michel; Saglio, Robert.

    1979-01-01

    Lambda wave length acoustic emission pickup comprising two juxtaposed piezoelectric capsules of equal lambda/2 thickness and with opposite polarization, separated by an electrically insulating foil, the two opposite sides of the capsules being earthed. The electric signal resulting from the acoustic emission is picked up on the two sides facing both sides of the insulating foil and the assembly of the two piezoelectric capsules is mounted on a base insulating it from the structure on which the acoustic emission is being listened to. Application of this pickup to the surveillance of defects in the steel vessels of nuclear reactors, characterized in that it is placed at the end of a metal ultrasonic wave guide the other end of which is welded directly to the vessel [fr

  12. Techno-Bureaucratic Governance and Public Service Delivery: Indonesia and Nigeria in Perspectives

    Directory of Open Access Journals (Sweden)

    Jacob Olufemi Fatile

    2015-09-01

    Full Text Available Techno-bureaucratic governance is fundamental to contemporary public service. This is because the roles of the bureaucrats and technocrats become more relevant in policy formulation and implementation when the government had to (reinvent its institutions to move from routine administration to that of development planning and management. Utilizing a qualitative approach, the paper notes that techno-bureaucratic ideology values technical expertise itself and its technical experts, efficiency, economic development and effective public service delivery. Adopting comparative perspective, the paper examines techno-bureaucratic governance and public service delivery in Indonesia and Nigeria. The paper takes a cursory look at the similarities and differences between the two countries. The paper notes that the technocracy nurtured by the New Order in Indonesia was cohesive and effective because of its technical expertise and has helped Indonesia to turn oil income into productive investments,whereas in Nigeria the oil income was used for prestigious projects to the detriment of productive investments. The paper therefore recommend among others that developing societies need a new strategy in delivery services in their public service, and this can be achieved through skilled professionals, technocrats and knowledge based actors. It concludes that for public service to deliver effective services, an efficient bureaucracy and technocracy remain invaluable.

  13. Improving the delivery of preventive care services.

    Science.gov (United States)

    Hung, Dorothy Y

    2007-05-01

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

  14. THE WEB SERVICE PROTOTYPE ON DELIVERY SYSTEM IN THE IMPLEMENTATION OF ENTERPRISE SERVICE BUS

    Directory of Open Access Journals (Sweden)

    Ghifari Munawar

    2017-04-01

    Full Text Available The main component of the logistics system is a delivery goods system. It has an enormous role in managing the entire historical shipment data from the start point (origin to the end of delivery (destination. This research aims to implement the Enterprise Service Bus (ESB on delivery systems as a middleware in the integration data process. ESB technology used in this research is NServiceBus. The stages of research using a prototype model to develop a web service that suits with theirs needs. Testing is done by tested two aspects of the exchange messages; the performance aspect and the aspect of independence. The test results show that the performance of the web service with the ESB application is better than the non-ESB user and Web services developed to have a good level of independence (loosely coupling.

  15. The effect of service delivery in public ‘community service centres’: A case of an emerging economy

    OpenAIRE

    Ndabazinhle Ngobese; Roger B. Mason; Mandusha Maharaj

    2017-01-01

    This study investigated public perceptions of the service delivery provided by the Community Service Centres (CSC) of the South African Police Service (SAPS) Durban, South Africa. The study focuses on measuring service quality and service delivery. SERVQUAL was used to compare clients’ perceptions against expectations of service quality. Four hundred respondents were surveyed at three community service centres (previously known as ‘police stations’), with expectations and perceptions being as...

  16. Nursing Services Delivery Theory: an open system approach.

    Science.gov (United States)

    Meyer, Raquel M; O'Brien-Pallas, Linda L

    2010-12-01

    This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a 'black box' that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. A search of CINAHL and Business Source Premier for the years 1980-2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. THE Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. © 2010 Blackwell Publishing Ltd.

  17. Determination of interstellar pickup ion distributions in the solar wind with SOHO and Cluster

    Directory of Open Access Journals (Sweden)

    E. Möbius

    1996-05-01

    Full Text Available Over the last 10 years, the experimental basis for the study of the local interstellar medium has been substantially enhanced by the direct detection of interstellar pickup ions and of interstellar neutral helium within the heliosphere. Pickup ions can be studied for a wide range of interstellar species. However, currently the accuracy of the method to determine the parameters of the interstellar medium, namely neutral density, temperature and relative velocity, is hampered by two problems: (1 In most cases the crucial ionization rates are not available from simultaneous measurements and (2 the transport of the pickup ions in the interplanetary medium substantially modifies the measured spatial distribution of the ions. In this study we will discuss how the enhanced capabilities of the instrumentation on SOHO and Cluster in combination with ongoing efforts to model the pickup ion distributions will lead to a significant improvement over the coming years.

  18. Global Document Delivery, User Studies, and Service Evaluation: The Gateway Experience

    Science.gov (United States)

    Miller, Rush; Xu, Hong; Zou, Xiuying

    2008-01-01

    This study examines user and service data from 2002-2006 at the East Asian Gateway Service for Chinese and Korean Academic Journal Publications (Gateway Service), the University of Pittsburgh. Descriptive statistical analysis reveals that the Gateway Service has been consistently playing the leading role in global document delivery service as well…

  19. Buying results? Contracting for health service delivery in developing countries.

    Science.gov (United States)

    Loevinsohn, Benjamin; Harding, April

    To achieve the health-related Millennium Development Goals, the delivery of health services will need to improve. Contracting with non-state entities, including non-governmental organisations (NGOs), has been proposed as a means for improving health care delivery, and the global experience with such contracts is reviewed here. The ten investigated examples indicate that contracting for the delivery of primary care can be very effective and that improvements can be rapid. These results were achieved in various settings and services. Many of the anticipated difficulties with contracting were either not observed in practice or did not compromise contracting's effectiveness. Seven of the nine cases with sufficient experience (greater than 3 years' elapsed experience) have been sustained and expanded. Provision of a package of basic services by contractors costs between roughly US3 dollars and US6 dollars per head per year in low-income countries. Contracting for health service delivery should be expanded and future efforts must include rigorous evaluations.

  20. Municipal service delivery SET for success

    CSIR Research Space (South Africa)

    Naidoo, S

    2015-10-01

    Full Text Available The application of scientific, engineering and technological solutions by the CSIR to support local government environmental management and service delivery has the potential for significant impact. A case study illustrates the application...

  1. Personalizing knowledge delivery services: a conceptual framework

    Science.gov (United States)

    Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

    2003-01-01

    Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

  2. Quality & timely delivery of products and services

    International Nuclear Information System (INIS)

    Scott, K.; Shabbir, K.

    2015-01-01

    This paper discusses quality and timely delivery of services. The approach is to support our customers, to ensure quality, schedule and cost predictability with no compromise to safety, to avoid optimistic project schedules and conservative cost estimates. It is important to maintain a strategic focus in helping to improve the customer's assets and improve the methodology to improve assets.

  3. Three-dimensional magnetic nanoparticle imaging using small field gradient and multiple pickup coils

    Energy Technology Data Exchange (ETDEWEB)

    Sasayama, Teruyoshi, E-mail: sasayama@sc.kyushu-u.ac.jp; Tsujita, Yuya; Morishita, Manabu; Muta, Masahiro; Yoshida, Takashi; Enpuku, Keiji

    2017-04-01

    We propose a magnetic particle imaging (MPI) method based on third harmonic signal detection using a small field gradient and multiple pickup coils. First, we developed a system using two pickup coils and performed three-dimensional detection of two magnetic nanoparticle (MNP) samples, which were spaced 15 mm apart. In the experiments, an excitation field strength of 1.6 mT was used at an operating frequency of 3 kHz. A DC gradient field with a typical value of 0.2 T/m was also used to produce the so-called field-free line. A third harmonic signal generated by the MNP samples was detected using the two pickup coils, and the samples were then mechanically scanned to obtain field maps. The field maps were subsequently analyzed using the nonnegative least squares method to obtain three-dimensional position information for the MNP samples. The results show that the positions of the two MNP samples were estimated with good accuracy, despite the small field gradient used. Further improvement in MPI performance will be achieved by increasing the number of pickup coils used. - Highlights: • 3D magnetic particle imaging system combining field-free line and two pickup coils. • Imaging method based on third harmonic signal detection and small field gradient. • Nonnegative least squares method for 3D magnetic nanoparticle image reconstruction. • High spatial resolution despite use of small field gradient.

  4. Transforming Health Care Service Delivery and Provider Selection

    OpenAIRE

    Reiner, Bruce I.

    2011-01-01

    Commoditization pressures in medicine have risked transforming service provider selection from “survival of the fittest” to “survival of the cheapest.” Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented per...

  5. 20 CFR 652.208 - How are core services and intensive services related to the methods of service delivery described...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are core services and intensive services related to the methods of service delivery described in § 652.207(b)(2)? 652.208 Section 652.208 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ESTABLISHMENT AND...

  6. The effect of service delivery in public ‘community service centres’: A case of an emerging economy

    Directory of Open Access Journals (Sweden)

    Ndabazinhle Ngobese

    2017-07-01

    Full Text Available This study investigated public perceptions of the service delivery provided by the Community Service Centres (CSC of the South African Police Service (SAPS Durban, South Africa. The study focuses on measuring service quality and service delivery. SERVQUAL was used to compare clients’ perceptions against expectations of service quality. Four hundred respondents were surveyed at three community service centres (previously known as ‘police stations’, with expectations and perceptions being assessed via the dimensions of tangibility, reliability, responsiveness, assurance and empathy. The results indicate that in all five dimensions there is a significant negative quality gap, implying that the quality of service received is below what is expected by clients. Improvements are required in all five dimensions if service delivery is to be improved. Actions needed to improve service quality include regular assessment and monitoring of clients’ experiences, as well as employees’ behaviour

  7. Innovative Mobile Platform Developments for Electronic Services Design and Delivery

    DEFF Research Database (Denmark)

    Scupola, Ada

    In the ever-growing world of technology, it is becoming more important to understand the developments of new electronic services and mobile applications. Innovative Mobile Platform Developments for Electronic Services Design, and Delivery is a comprehensive look at all aspects of production manag...

  8. Exploring Challenges of Municipal Service Delivery in South Africa (1994 - 2013

    Directory of Open Access Journals (Sweden)

    Modimowabarwa Kanyane

    2014-03-01

    Full Text Available This article aims to explore municipal service delivery challenges in South Africa between 1994 and 2013 in order to stimulate debate in addressing problems and challenges confronting municipalities. A fundamental question to be asked stems from the challenges of municipal service delivery. Why, in spite of the existence of regulatory and institutional frameworks, are municipalities still struggling to satisfy basic community needs such as water and electricity amongst others? All of government’s official documents and contemporary literature reviewed, including the summative record of historical facts and narrative data, are evidence of the qualitative research design employed in this study. It is clearly articulated in this article that the existence of a local municipality with poor service delivery is, amongst others, a direct consequence or manifestation of municipal capacity constraints, financial viability problems, service delivery protests, convoluted political process, corruption and poor planning as well as monitoring and evaluation challenges. In the main, the article accounts for why service delivery has failed to meet the expectations of the communities and thereby provide some possible propositions for consideration to attempt to bring a resolve to critical issues raised.

  9. The challenges of government use of cloud services for public service delivery

    NARCIS (Netherlands)

    Irion, K.

    2014-01-01

    Cloud services hold the promise of rendering public service delivery and back-office operations more effective and efficient, by providing ubiquitous, on-demand access to computing resources. Beyond the compelling cost economies, cloud technology is also a promising platform for open government,

  10. Quality & timely delivery of products and services

    Energy Technology Data Exchange (ETDEWEB)

    Scott, K.; Shabbir, K. [WorleyParsons, Toronto, ON (Canada)

    2015-07-01

    This paper discusses quality and timely delivery of services. The approach is to support our customers, to ensure quality, schedule and cost predictability with no compromise to safety, to avoid optimistic project schedules and conservative cost estimates. It is important to maintain a strategic focus in helping to improve the customer's assets and improve the methodology to improve assets.

  11. Charge-pickup of 238U at relativistic energies

    International Nuclear Information System (INIS)

    Rubehn, T.; Bassini, R.; Blaich, T.; Imme, G.; Iori, I.; Kunze, W.D.; Lindenstruth, V.; Lynen, U.; Moehlenkamp, T.; Moretto, L.G.; Ocker, B.; Pochodzalla, J.; Raciti, G.; Schuettauf, A.; Serfling, V.; Trautmann, W.; Trzcinski, A.; Verde, G.; Woerner, A.; Zude, E.; Zwieglinski, B.

    1995-10-01

    Cross sections for the charge-pickup of 238 U projectiles were measured at E/A=600 and 1000 MeV for seven different targets (Be, C, Al, Cu, In, Au and U). Events with two fission fragments with a sum charge of 93 in the exit channel were selected. Due to the significant excitation energy, the dominant part of produced Np nuclei fission instead of decaying to the ground state by evaporation. The observed cross sections can be well reproduced by intranuclear-cascade-plus-evaporation calculations and, therefore, confirm recent results that no exotic processes are needed to explain charge-pickup processes. (orig.)

  12. Investigation of the mediating effects of IT governance-value delivery on service quality and ERP performance

    Science.gov (United States)

    Tsai, Wen-Hsien; Chou, Yu-Wei; Leu, Jun-Der; Chao Chen, Der; Tsaur, Tsen-Shu

    2015-02-01

    This study aimed to explore the mediating effects of IT governance (ITG)-value delivery in the relationships among the quality of vendor service, the quality of consultant services, ITG-value delivery and enterprise resource planning (ERP) performance. The sampling of this research was acquired from a questionnaire survey concerning ERP implementations in Taiwan. In this survey, 4366 questionnaires were sent to manufacturing and service companies listed in the TOP 5000: The Largest Corporations in Taiwan 2009. The results showed that an ERP system will exhibit a decreased error rate and improved performance if ERP system vendors and consultants provide good service quality. The results also demonstrated that significant relationships exist among the quality of vendor service, the quality of consultant services and value delivery. The contribution of this article is twofold. First, it found that value delivery provides an effective measure of ERP performance under an ITG framework. Second, it provides evidence of the partial mediating effects of value delivery between service quality and ERP performance. In other words, if enterprises want to improve ERP performance, they need to consider factors such as value delivery and the quality of a vendor/consultant's service.

  13. The democratisation of meal delivery service in France

    OpenAIRE

    Chen, Szu-Pu

    2017-01-01

    Master's thesis in International hotel and tourism management : Culinary leadership and innovation The purpose of this study was to explore the meal delivery service in French market and the customer’s opinion in the future meal delivery business. In addition, I first did the research basically on the evolution of history and the existing of delivery business in France. Then, I examined the dining habits and behaviours during the weekday of French citizen and their opinions in the futur...

  14. Oxygen Pickup Ions Measured by MAVEN Outside the Martian Bow Shock

    Science.gov (United States)

    Rahmati, A.; Cravens, T.; Larson, D. E.; Lillis, R. J.; Dunn, P.; Halekas, J. S.; Connerney, J. E. P.; Eparvier, F. G.; Thiemann, E.; Mitchell, D. L.; Jakosky, B. M.

    2015-12-01

    The MAVEN (Mars Atmosphere and Volatile EvolutioN) spacecraft entered orbit around Mars on September 21, 2014 and has since been detecting energetic oxygen pickup ions by its SEP (Solar Energetic Particles) and SWIA (Solar Wind Ion Analyzer) instruments. The oxygen pickup ions detected outside the Martian bowshock and in the upstream solar wind are associated with the extended hot oxygen exosphere of Mars, which is created mainly by the dissociative recombination of molecular oxygen ions with electrons in the ionosphere. We use analytic solutions to the equations of motion of pickup ions moving in the undisturbed upstream solar wind magnetic and motional electric fields and calculate the flux of oxygen pickup ions at the location of MAVEN. Our model calculates the ionization rate of oxygen atoms in the exosphere based on the hot oxygen densities predicted by Rahmati et al. (2014), and the sources of ionization include photo-ionization, charge exchange, and electron impact ionization. The photo-ionization frequency is calculated using the FISM (Flare Irradiance Spectral Model) solar flux model, based on MAVEN EUVM (Extreme Ultra-Violet Monitor) measurements. The frequency of charge exchange between a solar wind proton and an oxygen atom is calculated using MAVEN SWIA solar wind proton flux measurements, and the electron impact ionization frequency is calculated based on MAVEN SWEA (Solar Wind Electron Analyzer) solar wind electron flux measurements. The solar wind magnetic field used in the model is from the measurements taken by MAVEN MAG (magnetometer) in the upstream solar wind. The good agreement between our predicted pickup oxygen fluxes and the MAVEN SEP and SWIA measured ones confirms detection of oxygen pickup ions and these model-data comparisons can be used to constrain models of hot oxygen densities and photochemical escape flux.

  15. Innovations in health service delivery: the corporatization of public hospitals

    National Research Council Canada - National Science Library

    Harding, April; Preker, Alexander S

    2003-01-01

    ... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...

  16. Effect of frequency of clinic visits and medication pick-up on antiretroviral treatment outcomes: a systematic literature review and meta-analysis.

    Science.gov (United States)

    Mutasa-Apollo, Tsitsi; Ford, Nathan; Wiens, Matthew; Socias, Maria Eugenia; Negussie, Eyerusalem; Wu, Ping; Popoff, Evan; Park, Jay; Mills, Edward J; Kanters, Steve

    2017-07-21

    Expanding and sustaining antiretroviral therapy (ART) coverage may require simplified HIV service delivery strategies that concomitantly reduce the burden of care on the health system and patients while ensuring optimal outcomes. We conducted a systematic review to assess the impact of reduced frequency of clinic visits and drug dispensing on patient outcomes. As part of the development process of the World Health Organization antiretroviral (ARV) guidelines, we systematically searched medical literature databases for publications up to 30 August 2016. Information was extracted on trial characteristics, patient characteristics and the following outcomes: mortality, morbidity, treatment adherence, retention, patient and provider acceptability, cost and patients exiting the programme. When feasible, conventional pairwise meta-analyses were conducted. Results and discussion Of 6443 identified citations, 21 papers, pertaining to 16 studies, were included in this review, with 11 studies contributing to analyses. Although analyses were feasible, they were limited by the sparse evidence base, despite the importance of the research area, and relatively low quality. Comparative analyses of eight studies reporting on frequency of clinic visits showed that less frequent clinic visits led to higher odds of being retained in care (odds ratio [OR]: 1.90; 95% CI: 1.21-2.99). No differences were found with respect to viral failure, morbidity or mortality; however, most estimates were favourable to reduced clinic visits. Reduced frequency of ARVs pick-ups showed a trend towards better retention (OR: 1.93; 95% CI: 0.62-6.04). Strategies using community support tended to have better outcomes; however, their implementation varied, particularly by location. External validity may be questionable. Our systematic review suggests that reduction of clinical visits (and likely ARVs pick-ups) may improve clinical outcomes, and that they are a viable option to relieve health systems and reduce

  17. Predictors of Safe Delivery Service Utilization in Arsi Zone, South-East Ethiopia

    OpenAIRE

    Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

    2011-01-01

    Background Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilizatio...

  18. The Dilemma of Accountability and Good Governance for Improved Public Service Delivery in Nigeria

    Directory of Open Access Journals (Sweden)

    Kehinde David Adejuwon

    2012-12-01

    Full Text Available The public sector in Nigeria is irrefutably beset with gross  incompetence and ineffective management. Perplexing difficulties endure in the Nigerian public sector in spite of a number of reform programmes that have been designed to enhance efficient and effective service delivery for almost two decades. The fact that public service has failed dismally to achieve its laudable objectives is the reason for the vote of no confidence passed on its administrators by majority of the Nigerian populace. The article examines the dilemma of accountability and good governance in Nigeria and demonstrates that the critical point in achieving meaningful developments in the country intrinsically lay with improved service delivery in the public sector. The basic reason why the public service has become the scorn of the people is because for too long, both the government and public servants have paid lip service to the crucial issue of effective and efficient service delivery. The article argues that improved service delivery will improve both the performance and the image of public service and re-awaken the citizens’ interest and trust in them to do business with public servants. It suggests that  in order to bring sanity back to the Nigerian Public Service,  all unprofessional tendencies such as ethnicity bias and nepotism in appointments and promotions, lack of security of tenure of office, and appointment of non-career public servants into key positions in the public service must stop. Also,  effective service delivery must be tailored to the circumstances of Nigeria. The study made use of secondary data obtained from various sources. It therefore concludes that without a reawakening of the culture of accountability and transparency lost over the years, the trusting relationship needed to forge between the government and the governed for the actualization of good governance will not materialize.

  19. Develop and pilot test smart phone/tablet app for paratransit demand-response passenger pick-up alerts to assist passengers with disabilities and reduce no-shows and dwell times.

    Science.gov (United States)

    2016-12-01

    This research produced an arrival notification system for paratransit passengers with disabilities. Almost all existing curb-to-curb paratransit services have significantly large pick-up time window ranging from 20 to 40 minutes from the scheduled ti...

  20. In-situ electrochemical impedance spectroscopy measurements of zirconium alloy oxide conductivity: Relationship to hydrogen pickup

    International Nuclear Information System (INIS)

    Couet, Adrien; Motta, Arthur T.; Ambard, Antoine; Livigni, Didier

    2017-01-01

    Highlights: • In-situ electrochemistry on zirconium alloys in 360 °C pure water show oxide layer resistivity changes during corrosion. • A linear relationship is observed between oxide resistivity and instantaneous hydrogen pickup fraction. • The resistivity of the oxide layer formed on Zircaloy-4 (and thus its hydrogen pickup fraction) is higher than on Zr-2.5Nb. - Abstract: Hydrogen pickup during nuclear fuel cladding corrosion is a critical life-limiting degradation mechanism for nuclear fuel. Following a program dedicated to zirconium alloys, corrosion, it has been hypothesized that oxide electronic resistivity determines hydrogen pickup. In-situ electrochemical impedance spectroscopy experiments were performed on Zircaloy-4 and Zr-2.5Nb alloys in 360 °C water. The oxide resistivity was measured as function of time. The results show that as the oxide resistivity increases so does the hydrogen pickup fraction. The resistivity of the oxide layer formed on Zircaloy-4 is higher than on Zr-2.5Nb, resulting in a higher hydrogen pickup fraction of Zircaloy-4, compared to Zr-2.5Nb.

  1. Towards a project-based service delivery approach : Uncovering organisational tensions

    OpenAIRE

    12330841 - Van der Waldt, Gerrit

    2009-01-01

    In line with the modernizing, re-inventing and alternative service delivery paradigm, governments increasingly utilise project-based methodologies to improve service delivery. There is general agreement that projects are becoming increasingly important for government institutions to operationalise strategic objectives and policy programmes. This approach is commonly known as ‗Management-by-Projects‘. To adopt this approach requires of public institutions to adjust their existing structures...

  2. Capacitively coupled pickup in MCP-based photodetectors using a conductive metallic anode

    Energy Technology Data Exchange (ETDEWEB)

    Angelico, E.; Seiss, T. [Enrico Fermi Institute, University of Chicago, 5640 S Ellis Ave, Chicago, IL 60637 (United States); Adams, B. [Incom, Inc., 294 SouthBridge Rd, Charlton, Massachusetts 01507 (United States); Elagin, A.; Frisch, H.; Spieglan, E. [Enrico Fermi Institute, University of Chicago, 5640 S Ellis Ave, Chicago, IL 60637 (United States)

    2017-02-21

    We have designed and tested a robust 20×20 cm{sup 2} thin metal film internal anode capacitively coupled to an external array of signal pads or micro-strips for use in fast microchannel plate photodetectors. The internal anode, in this case a 10 nm-thick NiCr film deposited on a 96% pure Al{sub 2}O{sub 3} 3 mm-thick ceramic plate and connected to HV ground, provides the return path for the electron cascade charge. The multi-channel pickup array consists of a printed-circuit card or glass plate with metal signal pickups on one side and the signal ground plane on the other. The pickup can be put in close proximity to the bottom outer surface of the sealed photodetector, with no electrical connections through the photodetector hermetic vacuum package other than a single ground connection to the internal anode. Two pickup patterns were tested using a small commercial MCP-PMT as the signal source: 1) parallel 50 Ω 25-cm-long micro-strips with an analog bandwidth of 1.5 GHz, and 2) a 20×20 cm{sup 2} array of 2-dimensional square ‘pads’ with sides of 1.27 cm or 2.54 cm. The rise-time of the fast input pulse is maintained for both pickup patterns. For the pad pattern, we observe 80% of the directly coupled amplitude. For the strip pattern we measure 34% of the directly coupled amplitude on the central strip of a broadened signal. The physical decoupling of the photodetector from the pickup pattern allows easy customization for different applications while maintaining high analog bandwidth.

  3. Hydraulic Hybrid Vehicles

    Science.gov (United States)

    EPA and the United Parcel Service (UPS) have developed a hydraulic hybrid delivery vehicle to explore and demonstrate the environmental benefits of the hydraulic hybrid for urban pick-up and delivery fleets.

  4. Knowledge and perceptions of antenatal services need and delivery ...

    African Journals Online (AJOL)

    treatment during pregnancy (IPTp) against malaria in Mkuranga and Mufindi districts, Tanzania. Methodology: ... when it comes to utilization of specific health services or interventions .... decision to visit a clinic was the need to be vaccinated .... Health information provided about how to prepare for the delivery. 68 (47.6%).

  5. Ante natal care services utilization, delivery practices and factors affecting them in tribal area of North Maharashtra

    Directory of Open Access Journals (Sweden)

    Sachin S Mumbare

    2011-01-01

    Full Text Available Background: Utilization of Ante natal care (ANC services is poor in the tribal areas, causing increased maternal morbidity and mortality. Objective: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. Design: Cross-sectional study. Materials and Methods: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. Results: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. Conclusion: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.

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

    Science.gov (United States)

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

    2016-10-01

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

  7. ELECTRONIC BANKING ADVANTAGES FOR FINANCIAL SERVICES DELIVERY

    Directory of Open Access Journals (Sweden)

    Paun Dragos

    2010-12-01

    Full Text Available E-banking is a fully automatic service for traditionally banking customers products based on information technology platforms. E-banking services provide customer access to accounts, the ability to move their money between different accounts or making payments via e-channels. The advantages generated by this services have determined an accelerate developing of this industry over the entire world. This paper examines some of the advantages of electronic banking products together with the characteristic management issues generated by the implementation of this new channel for financial services delivery.

  8. An assessment of the waterside corrosion and hydrogen pick-up in the zircaloy-2 pressure tubes of PHWR

    International Nuclear Information System (INIS)

    Sah, D.N.

    1992-01-01

    In view of the deleterious effect of hydriding on the operating life of zircaloy-2 pressure tubes in PHWRs there is an urgent need for the assessment of the status of the pressure tubes with respect to corrosion and hydrogen pick-up in the operating PHWRs. A model has been developed for analysing the waterside corrosion and hydrogen pick-up in the zircaloy-2 pressure tubes under reactor operating conditions. This model predicts the axial profiles of oxide layer thickness and hydrogen pick-up in the pressure tubes as a function of the operating time of the reactor. The prediction of hydrogen pick-up by the model in the F-10 pressure tube of RAPS-I have been found to be in good agreement with the measured value of hydrogen content. This report gives a brief description of the model and its predictions on the present status of hydrogen pick-up in the pressure tubes of lead reactor RAPS-II. (author). 6 refs., 5 figs., 2 tabs

  9. 78 FR 16753 - Service Delivery Plan; Correction

    Science.gov (United States)

    2013-03-18

    ... the first sentence after the words, ``Service Delivery Plan (SDP) insert http://www.ssa.gov/open/SDP... http://ssa.gov/asp/plan-2013-2016.pdf . Paul Kryglik, Director, Office of Regulations, Social Security...

  10. Factors associated with the utilization of institutional delivery services in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A. However, the provision of universal access to reproductive healthcare (MDG-5B and the utilization of maternal healthcare services (MHS such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh.Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011; participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression.According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604, and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437. Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624, and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional

  11. Development of a doorframe-typed swinging seedling pick-up device for automatic field transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Han, H.; Mao, H.; Hu, J.; Tian, K.

    2015-07-01

    A doorframe-typed swing seedling pick-up device for automatic field transplanters was developed and evaluated in a laboratory. The device, consisting of a path manipulator and two grippers, can move the pins slowly to extract seedlings from the tray cells and return quickly to the pick-up point for the next extraction. The path manipulator was constructed with the creative design of type-Ⅱ mechanism combination in series. It consists of an oscillating guide linkage mechanism and a grooved globoidal cam mechanism. The gripper is a pincette-type mechanism using the pick-up pins to penetrate into the root mass for seedling extraction. The dynamic analysis of the designed seedling pick-up device was simulated with ADAMS software. Being the first prototype, various performance tests under local production conditions were conducted to find out the optimal machine operation parameters and transplant production conditions. As the gripper with multiple fine pins was moved by the swing pick-up device, it can effectively complete the transplanting work cycle of extracting, transferring, and discharging a seedling. The laboratory evaluation showed that the pick-up device equipped with two grippers can extract 80 seedlings/min with a 90% success and a 3% failure in discharging seedlings, using 42-day-old tomato plantlets. The quality of extracting seedlings was satisfactory. (Author)

  12. AA precooling pickup

    CERN Multimedia

    CERN PhotoLab

    1980-01-01

    The freshly injected antiprotons, while circulating on the injection orbit, were subjected to fast stochastic "precooling" for several seconds (in momentum and in the vertical plane). This precooling pickup is being readied by Gerard Laurent for installation in its tank. Precooling PUs and kickers were of identical construction (except for the kickers having cooling circuits), with C-shaped ferrites sandwiched between C-shaped metal plates and couplers at the back of the C. For reasons explained in 8002234, they were also equipped with shutters which closed the open side of the C when there was beam on the injection orbit. For more on precooling see 8020234, 8004064.

  13. Mental health service delivery following health system reform in Colombia.

    Science.gov (United States)

    Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

    2003-12-01

    In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a

  14. Solenoid pick-up problem in the CREN-K Triga Mark 2 reactor

    International Nuclear Information System (INIS)

    Malu wa Kalenga; Kobakozete Itono; Diazengwa Mpaka; Mampaka Mana Mouiny; Itio Momba

    1981-01-01

    During a lazy susan forty irradiation tube inspection with the specimen lifting device, the solenoid-operated specimen pick-up tool happened to be locked in the number fourteen position loading tube. The present paper describes the successful experiment which was carried out to solve a potential damaging situation for the safe and useful operation of the reactor. The first step in the investigation process was to ascertain what has indeed occurred in the reactor core to avoid any ill advised step which will worsen the situation. The alternatives were the following: a) The specimen tube was not lined with the loading tube; b) The lazy susan was not working properly due example to the fact that a roll pin in a drive shaft coupling inside the drive shaft tube has been broken; c) The pick-up tool has produced through the cleanout hole in the bottom of the specimen tube and engage the hole; d) The pick-up tool might have slided most of the way between the lazy susan and its housing. By moving up and down the pick-up tool and rotating back and forth the lazy susan it was possible to come to the conclusion that alternative c) was the most likely. It was not possible to release the pick-up tool because its engaging arms could not be activated as was often the case when lifting aluminium container

  15. Solenoid pick-up problem in the CREN-K Triga Mark 2 reactor

    Energy Technology Data Exchange (ETDEWEB)

    Malu wa Kalenga; Kobakozete Itono; Diazengwa Mpaka; Mampaka Mana Mouiny; Itio Momba (Commissariat des Sciences Nucleaires, Kinshasa (Zaire). Centre Regional d' Etudes Nucleaires)

    1981-01-01

    During a lazy susan forty irradiation tube inspection with the specimen lifting device, the solenoid-operated specimen pick-up tool happened to be locked in the number fourteen position loading tube. The present paper describes the successful experiment which was carried out to solve a potential damaging situation for the safe and useful operation of the reactor. The first step in the investigation process was to ascertain what has indeed occurred in the reactor core to avoid any ill advised step which will worsen the situation. The alternatives were the following: a) The specimen tube was not lined with the loading tube; b) The lazy susan was not working properly due example to the fact that a roll pin in a drive shaft coupling inside the drive shaft tube has been broken; c) The pick-up tool has produced through the cleanout hole in the bottom of the specimen tube and engage the hole; d) The pick-up tool might have slided most of the way between the lazy susan and its housing. By moving up and down the pick-up tool and rotating back and forth the lazy susan it was possible to come to the conclusion that alternative c) was the most likely. It was not possible to release the pick-up tool because its engaging arms could not be activated as was often the case when lifting aluminium container.

  16. Assessing family planning service-delivery skills in Kenya.

    Science.gov (United States)

    Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

    1997-06-01

    This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

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

    Science.gov (United States)

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

    2013-07-01

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

  18. Good governance, service delivery and records: the African tragedy

    African Journals Online (AJOL)

    mpho ngoepe

    A transparent and accountable government conducts its business openly ... party to boast about its service delivery record but also to allow international ... members of public and private bodies need strong and explicit ethics to prevent bribery, ... have actually carried out the actions and transactions that they had to execute,.

  19. The role of transformational leadership and organizational culture in service delivery within a public service organization

    Directory of Open Access Journals (Sweden)

    Ophillia Ledimo

    2014-08-01

    Full Text Available Continuous changes in the external environment deriving from legislative, economic and technological factors, puts pressure not only to corporate organizations, but also to public service organizations. These changes have increased pressure on service delivery and calls for accountability in public service organizations. With this increased pressure comes the need for public service organizations to discover how to most effectively enhance their organizational performance. Two of the most effective ways to improve performance are through the organizational leadership and culture. Although many studies were conducted on transformational leadership and organizational culture, there is still a need to investigate the link between these constructs in public service organizations. Hence the objective of this study was to explore the relationship between transformational leadership and organizational culture for service delivery practices. The Leadership Practice Inventory (LPI and Organizational Culture Inventory (OCI were administered to a random sample size of N=238, from a population of 4350 employees working within the public service organization. Descriptive statistics and Pearson’s correlation were conducted to analyse the data. The results of this study indicated a significant positive relationship between transformational leadership and the constructive dimension of organizational culture within a public service organization. In terms of contributions and practical implications, insight gained from the findings may be used in proposing leadership and organizational development interventions and future research

  20. Family-centred care delivery: comparing models of primary care service delivery in Ontario.

    Science.gov (United States)

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-11-01

    To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

  1. Application of social media to library service delivery: Perception of ...

    African Journals Online (AJOL)

    The study revealed that few of the social media identified are rarely relevant to library service delivery. Reference services, current awareness services, and library news postings were the types of library services that social media are applied. Results also indicated that there were benefits derived from using social media in ...

  2. Steering healthcare service delivery: a regulatory perspective.

    Science.gov (United States)

    Prakash, Gyan

    2015-01-01

    The purpose of this paper is to explore regulation in India's healthcare sector and makes recommendations needed for enhancing the healthcare service. The literature was reviewed to understand healthcare's regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS). Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges. This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach). Healthcare pitfalls across the world seem to follow similar follies. India's complexity and experience is useful for emerging and developed economies. The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient's perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

  3. Analytical model of tilted driver–pickup coils for eddy current nondestructive evaluation

    Science.gov (United States)

    Cao, Bing-Hua; Li, Chao; Fan, Meng-Bao; Ye, Bo; Tian, Gui-Yun

    2018-03-01

    A driver-pickup probe possesses better sensitivity and flexibility due to individual optimization of a coil. It is frequently observed in an eddy current (EC) array probe. In this work, a tilted non-coaxial driver-pickup probe above a multilayered conducting plate is analytically modeled with spatial transformation for eddy current nondestructive evaluation. Basically, the core of the formulation is to obtain the projection of magnetic vector potential (MVP) from the driver coil onto the vector along the tilted pickup coil, which is divided into two key steps. The first step is to make a projection of MVP along the pickup coil onto a horizontal plane, and the second one is to build the relationship between the projected MVP and the MVP along the driver coil. Afterwards, an analytical model for the case of a layered plate is established with the reflection and transmission theory of electromagnetic fields. The calculated values from the resulting model indicate good agreement with those from the finite element model (FEM) and experiments, which validates the developed analytical model. Project supported by the National Natural Science Foundation of China (Grant Nos. 61701500, 51677187, and 51465024).

  4. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.; Rosu, D.; Loewenstern, D.; Buco, M. J.; Guo, S.; Lavrado, Rafael Coelho; Gupta, M.; De, P.; Madduri, V.; Singh, J. K.

    2010-01-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21

  5. Challenges in immunisation service delivery for refugees in Australia: A health system perspective.

    Science.gov (United States)

    Mahimbo, A; Seale, H; Smith, M; Heywood, A

    2017-09-12

    Refugees are at risk of being under-immunised in their countries of origin, in transit and post-resettlement in Australia. Whilst studies have focused on identifying barriers to accessibility of health services among refugees, few focus on providers' perspectives on immunisation service delivery to this group. Health service providers are well placed to provide insights into the pragmatic challenges associated with refugee health service delivery, which can be useful in identifying strategies aimed at improving immunisation coverage among this group. A qualitative study involving 30 semi-structured interviews was undertaken with key stakeholders in immunisation service delivery across all States and Territories in Australia between December 2014 and December 2015. Thematic analysis was undertaken. Variability in accessing program funding and vaccines, lack of a national policy for catch-up vaccination, unclear roles and responsibilities for catch-up, a lack of a central immunisation register and insufficient training among general practitioners were seen as the main challenges impacting on immunisation service delivery for refugees. This study provides insight into the challenges that impact on effective immunisation service delivery for refugees. Deliberate strategies such as national funding for relevant vaccines, improved data collection nationally and increased guidance for general practitioners on catch-up immunisation for refugees would help to ensure equitable access across all age groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. The LIFEspan model of transitional rehabilitative care for youth with disabilities: healthcare professionals' perspectives on service delivery.

    Science.gov (United States)

    Hamdani, Yani; Proulx, Meghann; Kingsnorth, Shauna; Lindsay, Sally; Maxwell, Joanne; Colantonio, Angela; Macarthur, Colin; Bayley, Mark

    2014-01-01

    LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities. This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework. Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services. LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.

  7. Privatization of Electricity Service Delivery in Developing Nations: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Olamide Eniola Victor

    2015-09-01

    Full Text Available The provision of public utilities and infrastructures particularly electricity by the public sector (Government especially in the Developing Nations has been heavily criticized. This has been attributed to many reasons including poor electricity supply, poor distribution of service delivery of electricity due to the absence of spatial planning, insufficient government investment into the power industry, ineptitude operation on the part of the technicians, poor administration and managerial control. However, efforts to move away from government ownership, control or participation in this sector of economy towards free enterprise and increased inclusive private sector participation known as privatization, has been adopted as one of the solutions. This paper presents a critical review of privatization practices of alternative Service Delivery approach of selected Asian and African nations. The paper would elicit the common variants of privatization models adopted by these nations and the different implementation strategies which resulted in divergence in effectiveness and efficiency in the service delivery of electricity. The selected Asian countries are; Malaysia, India, and China, while the selected African nations are Nigeria, Cameroun and South Africa. The paper will draw from the literatures the various approaches, concepts adopted, practices, issues and challenges faced by these countries.

  8. Assistive Technology Service Delivery in Rural School Districts

    Science.gov (United States)

    Ault, Melinda Jones; Bausch, Margaret E.; Mclaren, Elizabeth M.

    2013-01-01

    Little is known about the implementation of assistive technology (AT) services for students in rural areas. This study investigated the AT service delivery in 10 rural districts across six states. The results indicated that students use AT across functional areas, but considerably fewer number of devices than do those not living in rural areas. AT…

  9. Situation Analysis of Healthcare Service Delivery using ...

    African Journals Online (AJOL)

    ISML5

    7. No. 1, AARSE 2017 Special Edition, January 2017. 75. Situation Analysis of ... then becomes a major bottleneck to proper planning and policy formulation in healthcare delivery. ... Uganda Annual Health Sector Performance Report for Financial Year 2014/15 ... government's strategy of taking services closer to the people.

  10. Analysis of Pick-Up Development in Punching

    DEFF Research Database (Denmark)

    Olsson, David Dam; Bay, Niels; Andreasen, Jan Lasson

    2002-01-01

    The development of pick-up of work piece material on the punch surface with increasing number of strokes during punching of stainless steel sheet is investigated applying Scanning Electron Microscopy (SEM), 3D roughness mapping and measurements of the backstroke force. It is found that pick...

  11. Pickup protons at quasi-perpendicular shocks: full particle electrodynamic simulations

    Directory of Open Access Journals (Sweden)

    S. Matsukiyo

    2007-02-01

    Full Text Available We have performed 3 one-dimensional full particle electromagnetic simulations of a quasi-perpendicular shock with the same Alfvén Mach number MA~5, shock normal-magnetic field angle ΘBn=87° and ion and electron beta (particle to magnetic field pressure of 0.1. In the first run we used an ion to electron mass ratio close to the physical one (mi/me=1024. As expected from previous high mass ratio simulations the Modified Two-Stream instability develops in the foot of the shock, and the shock periodically reforms itself. We have then self-consistently included in the simulation 10% pickup protons distributed on a shell in velocity space as a third component. In a run with an unrealistically low mass ratios of 200 the shock still reforms itself; reformation is due to accumulation of specularly reflected particles at the upstream edge of the foot. In a third run including pickup protons we used a mass ratio of 1024. The shock reforms periodically as in the low mass ratio run with a somewhat smaller time constant. The specular reflection of pickup protons results in an increase of the shock potential some distance ahead of the shock foot and ramp. The minimum scale of the cross shock potential during reformation is about 7 electron inertial length λe. We do not find any pickup proton acceleration in the ramp or downstream of the shock beyond the energy which specularly reflected ions gain by the motional electric field of the solar wind during their upstream gyration.

  12. A review of technology and trends in document delivery services

    Energy Technology Data Exchange (ETDEWEB)

    Bourne, C P [DIALOG Information Services, Inc., Palo Alto, CA (United States)

    1990-05-01

    This paper reviews the major lines of technical development being pursued to extend or replace traditional inter-library loan and photocopy service and to facilitate the delivery of source documents to individual end users. Examples of technical approaches discussed are: (1) the inclusion of full text and image data in central online systems; (2) image workstations such as the ADONIS and UMI systems; and (3) the use of electronic networks for document ordering and delivery. Some consideration is given to the policy implications for libraries and information systems. (author). 11 tabs.

  13. A review of technology and trends in document delivery services

    International Nuclear Information System (INIS)

    Bourne, C.P.

    1990-05-01

    This paper reviews the major lines of technical development being pursued to extend or replace traditional inter-library loan and photocopy service and to facilitate the delivery of source documents to individual end users. Examples of technical approaches discussed are: 1) the inclusion of full text and image data in central online systems; 2) image workstations such as the ADONIS and UMI systems; and 3) the use of electronic networks for document ordering and delivery. Some consideration is given to the policy implications for libraries and information systems. (author). 11 tabs

  14. Identification of Technical Requirement for Improving Quality of Local Online Food Delivery Service in Yogyakarta

    OpenAIRE

    Elvandari, , Cecilia Desvita Ratna; Sukartiko, Anggoro Cahyo; Nugrahini, Arita Dewi

    2017-01-01

    Increased internet usage and fast-paced consumer’s demands have created business opportunities, including online food delivery services. However, competition with similar national-scale businesses allegedly contributed to the decline in the number of XYZ company orders, one of the food-delivery service providers in Yogyakarta. Therefore, this study aimed to identify the need’s attributes of the daring food delivery service consumers, to find out the service-quality satisfaction level, and to ...

  15. Detection of interstellar pick-up hydrogen in the solar system

    Science.gov (United States)

    Gloeckler, G.; Geiss, J.; Balsiger, H.; Fisk, L. A.; Galvin, A. B.; Ipavich, F. M.; Ogilvie, K. W.; Von Steiger, R.; Wilken, B.

    1993-01-01

    Interstellar hydrogen ionized primarily by the solar wind has been detected by the Solar Wind Ion Composition Spectrometer instrument on the Ulysses spacecraft at a distance of 4.8 AUs from the sun. This 'pick-up' hydrogen is identified by its distinct velocity distribution function, which drops abruptly at twice the local solar wind speed. From the measured fluxes of pick-up protons and singly charged helium, the number densities of neutral hydrogen and helium in the distant regions of the solar system are estimated to be 0.077 +/- 0.015 and 0.013 +/- 0.003 per cu cm, respectively.

  16. Power, Space and Resistance: Foucauldian Reading of "The Pickup"

    Science.gov (United States)

    Babapi, Nasrin; Parvaneh, Farid

    2015-01-01

    The present article is an attempt to read Nadin Gordimer's "The Pickup" from the lens of Foucault. It starts with Foucault's assumption that power is everything and any kind of relation in the world is defined through the discourses of power. It discusses the techniques through which the power dominates its authority over the subjects…

  17. The design & delivery of quality services: A paradigm shift

    Directory of Open Access Journals (Sweden)

    D. B.H. Smith

    2002-12-01

    Full Text Available As result of the increasingly important role information technology (IT is playing in service provision, less person-to-person contact will in future be made during service provision. Highly skilled specialists will make the remaining contact. Emphasis will shift to speed of delivery, with logistics playing an important role. The designers of services must take these factors into account if they wish to design quality services.

  18. Rationale and design: telepsychology service delivery for depressed elderly veterans

    Directory of Open Access Journals (Sweden)

    Richardson Lisa K

    2009-04-01

    Full Text Available Abstract Background Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health" represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1 utility to address existing problematic access to care for rural residents; (2 capacity to reduce stigma associated with traditional mental health care; and (3 utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas. Methods We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology" or traditional face-to-face services ("Same-Room". Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room. Two-hundred twenty-four (224 male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1 clinical outcomes (symptom severity, social functioning; (2 process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout; and (3 economic outcomes (cost and resource use. Discussion Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective

  19. Engineering Consultancy: An Assessment of IT-enabled International Delivery of Services

    DEFF Research Database (Denmark)

    Baark, Erik

    1999-01-01

    The delivery of engineering consultancy services in global markets has been dominated by a small group of firms located in Europe and the US. Like many other service industries, engineering consultants have depended on the movement of highly qualified people and establishment of local affiliates...... services in arms-length transactions across national borders does not appear to have been significantly exploited. Nevertheless, IT-enabled delivery of engineering consultancy services opens up possibilities for business process reengineering that may provide some firms new competitive advantages in global...... markets and lead to further integration of design and construction in partnerships or project consortia, or in the strengthening of design-build approaches in project execution....

  20. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.

    2010-12-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21% of interruptions were caused by human error. We focus on Change Management, the process with the largest risk of human error, and identify the main instances of human errors as the 4 Wrongs: request, time, configuration item, and command. Analysis of change records revealed that the humanerror prevention by partial automation is highly relevant. We propose the HEP Framework, a framework for execution of IT Service Delivery operations that reduces human error by addressing the 4 Wrongs using content integration, contextualization of operation patterns, partial automation of command execution, and controlled access to resources.

  1. Toward a Blueprint for Trauma-Informed Service Delivery in Schools

    Science.gov (United States)

    Chafouleas, Sandra M.; Johnson, Austin H.; Overstreet, Stacy; Santos, Natascha M.

    2016-01-01

    Recognition of the benefits to trauma-informed approaches is expanding, along with commensurate interest in extending delivery within school systems. Although information about trauma-informed approaches has quickly burgeoned, systematic attention to integration within multitiered service delivery frameworks has not occurred yet is essential to…

  2. Fiscal Decentralization and Delivery of Public Services: Evidence from Education Sector in Pakistan

    Directory of Open Access Journals (Sweden)

    Rauf Abdur

    2017-04-01

    Full Text Available Fiscal Decentralization is the devolution of fiscal assignments to lower governments for high growth and better delivery of public services. The current study covering the period from 1972 to 2009 is an attempt to find out the impacts of fiscal decentralization on public services deliveries in Pakistan. Public services are proxy by Gross enrollment at primary school level while fiscal decentralization by fiscal transfer and expenditure sides of devolution. Using time series data, it is found that the individual impacts of fiscal transfer are although insignificant but still support the theoretical proposition regarding fiscal decentralization and public services relationship while delegation of expenditure responsibilities helps in improving the gross enrollment at primary school level. Furthermore the study evident that complete delegation of fiscal responsibilities to lower governments enhance enrollment ratio in Pakistan.

  3. Carbon monoxide poisoning in children riding in the back of pickup trucks.

    Science.gov (United States)

    Hampson, N B; Norkool, D M

    OBJECTIVE - To describe the case characteristics of a series of children poisoned with carbon monoxide while traveling in the back of pickup trucks. DESIGN - Pediatric cases referred for treatment of carbon monoxide poisoning with hyperbaric oxygen between 1986 and 1991 were reviewed. Those cases that occurred during travel in the back of pickup trucks were selected. Clinical follow-up by telephone interview ranged from 2 to 55 months. SETTING - A private, urban, tertiary care center in Seattle, Wash. PATIENTS - Twenty children ranging from 4 to 16 years of age. INTERVENTION - All patients were treated with hyperbaric oxygen. MAIN OUTCOME MEASURES - Characteristics of the poisoning incident and clinical patient outcome. RESULTS - Of 68 pediatric patients treated for accidental carbon monoxide poisoning, 20 cases occurred as children rode in the back of pickup trucks. In 17 of these, the children were riding under a rigid closed canopy on the rear of the truck, while three episodes occurred as children rode beneath a tarpaulin. Average carboxyhemoglobin level on emergency department presentation was 18.2% +/- 2.4% (mean +/- SEM; range, 1.6% to 37.0%). Loss of consciousness occurred in 15 of the 20 children. One child died of cerebral edema, one had permanent neurologic deficits, and 18 had no recognizable sequelae related to the episode. In all cases, the truck exhaust system had a previously known leak or a tail pipe that exited at the rear rather than at the side of the pickup truck. CONCLUSIONS - Carbon monoxide poisoning is a significant hazard for children who ride in the back of pickup trucks. If possible, this practice should be avoided.

  4. Geographic delivery models for radiotherapy services

    International Nuclear Information System (INIS)

    Roberts, G.H.; Dunscombe, P.B.; Samant, R.S.

    2002-01-01

    The study described here was undertaken to quantify the societal cost of radiotherapy in idealized urban and rural populations and, hence, to generate a measure of impediment to access. The costs of centralized, distributed comprehensive and satellite radiotherapy delivery formats were examined by decomposing them into institutional, productivity and geographical components. Our results indicate that centralized radiotherapy imposes the greatest financial burden on the patient population in both urban and rural scenarios. The financial burden faced by patients who must travel for radiotherapy can be interpreted as one component of the overall impediment to access. With advances in remote-monitoring systems, it is possible to maintain technical quality while enhancing patient access. However, the maintenance of professional competence will remain a challenge with a distributed service-delivery format. Copyright (2002) Blackwell Science Pty Ltd

  5. Industrial Perspectives of Work Place Basics and Training Delivery Services.

    Science.gov (United States)

    Logan, Joyce; Byers, Charles

    1991-01-01

    Kentucky employers (249 of 800 surveyed) identified adaptability, teamwork, communication, and problem solving as entry-level and advancement skills. Over 50 percent did no preemployment testing. Responses indicated areas needing change: training focused on workplace basics, accessible training delivery, and preemployment assessment services. (SK)

  6. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia.

    Science.gov (United States)

    Titaley, Christiana R; Hunter, Cynthia L; Dibley, Michael J; Heywood, Peter

    2010-08-11

    Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java

  7. 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.

  8. Expanding services in a shrinking economy: desktop document delivery in a dental school library.

    Science.gov (United States)

    Gushrowski, Barbara A

    2011-07-01

    How can library staff develop and promote a document delivery service and then expand the service to a wide audience? The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated.

  9. Contributing Factors to Poor Service Delivery by Administrative ...

    African Journals Online (AJOL)

    Poor service delivery by local government is crippling South African businesses .... main categories: one focuses on an employee's internal attributes (content ... admitted that their attitude to work was adversely affected by the poor quality.

  10. The role of charge-exchange cross-section for pickup protons and neutrals in the inner heliosheath

    Science.gov (United States)

    Chalov, S. V.

    2018-06-01

    The process of deceleration of the solar wind downstream of the termination shock is studied on the basis of a one-dimensional multi-component model. It is assumed that the solar wind consists of thermal protons, electrons and interstellar pickup protons. The protons interact with interstellar hydrogen atoms by charge-exchange. Two cases are considered. In the first one, the charge-exchange cross-section for thermal protons and hydrogen atoms is the same as for pickup protons and atoms. Under this condition, there is a strong dependence of the solar wind velocity on the downstream temperature of pickup protons. When the proton temperature is close to 10 keV, the change in the velocity with the distance from the termination shock is similar to that measured on the Voyager 1 spacecraft: linear velocity decrease is accompanied by an extended transition region with near-zero velocity. However, with a more careful approach to the choice of the charge-exchange cross-section, the situation changes dramatically. The strong dependence of the solar wind speed on the pickup proton temperature disappears and the transition region in the heliosheath disappears as well, at least at reasonable distances from the TS.

  11. Factors associated with the utilization of institutional delivery services in Bangladesh.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael

    2017-01-01

    Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; pdelivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; pservice utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; pdelivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2

  12. Global fund financing of tuberculosis services delivery in prisons.

    Science.gov (United States)

    Lee, Donna; Lal, S S; Komatsu, Ryuichi; Zumla, Alimuddin; Atun, Rifat

    2012-05-15

    Despite concerted efforts to scale up tuberculosis control with large amounts of international financing in the last 2 decades, tuberculosis continues to be a social issue affecting the world's most marginalized and disadvantaged communities. This includes prisoners, estimated at about 10 million globally, for whom tuberculosis is a leading cause of mortality and morbidity. The Global Fund to Fight AIDS, Tuberculosis and Malaria has emerged as the single largest international donor for tuberculosis control, including funding support in delivering tuberculosis treatment for the confined population. The Global Fund grants database, with an aggregate approved investment of $21.7 billion in 150 countries by the end of 2010, was reviewed to identify tuberculosis and human immunodeficiency virus/tuberculosis grants and activities that monitored the delivery of tuberculosis treatment and support activities in penitentiary settings. The distribution and trend of number of countries with tuberculosis prison support was mapped by year, geographic region, tuberculosis or multidrug-resistant tuberculosis burden, and prison population rate. We examined the types of grant recipients managing program delivery, their performance, and the nature and range of services provided. Fifty-three of the 105 countries (50%) with Global Fund-supported tuberculosis programs delivered services within prison settings. Thirty-two percent (73 of 228) of tuberculosis grants, representing $558 million of all disbursements of Global Fund tuberculosis support by the end of 2010, included output indicators related to tuberculosis services delivered in prisons. Nearly two-thirds (64%) of these grants were implemented by governments, with the remaining by civil society and other partners. In terms of services, half (36 of 73) of grants provided diagnosis and treatment and an additional 27% provided screening and monitoring of tuberculosis for prisoners. The range of services tracked was limited in scope

  13. Interaction of intersteller pick-up ions with the solar wind

    International Nuclear Information System (INIS)

    Mobius, E.; Klecker, B.; Hovestadt, D.; Scholer, M.

    1988-01-01

    The interaction of interstellar pick-up ions with the solar wind is studied by comparing a model for the velocity distribution function of pick-up ions with actual measurements of He + ions in the solar wind. The model includes the effects of pitch-angle diffusion due to interplanetary Alfven waves, adiabatic deceleration in the expanding solar wind and the radial variation of the source function. It is demonstrated that the scattering mean free path is in the range ≤0.1 AU and that energy diffusion can be neglected as compared with adiabatic deceleration. The effects of adiabatic focusing, of the radial variation of the neutral density and of an variation of the solar wind velocity with distance from the Sun are investigated. With the correct choice of these parameters the authors can model the measured energy spectra of the pick-up ions does not vary with the solar wind velocity and the direction of the interplanetary magnetic field for a given local neutral gas density and ionization rate. Therefore, the comparison of the model distributions with the measurements leads to a quantitative determination of the local interstellar gas density

  14. Pickup protons at quasi-perpendicular shocks: full particle electrodynamic simulations

    Directory of Open Access Journals (Sweden)

    S. Matsukiyo

    2007-02-01

    Full Text Available We have performed 3 one-dimensional full particle electromagnetic simulations of a quasi-perpendicular shock with the same Alfvén Mach number MA~5, shock normal-magnetic field angle ΘBn=87° and ion and electron beta (particle to magnetic field pressure of 0.1. In the first run we used an ion to electron mass ratio close to the physical one (mi/me=1024. As expected from previous high mass ratio simulations the Modified Two-Stream instability develops in the foot of the shock, and the shock periodically reforms itself. We have then self-consistently included in the simulation 10% pickup protons distributed on a shell in velocity space as a third component. In a run with an unrealistically low mass ratios of 200 the shock still reforms itself; reformation is due to accumulation of specularly reflected particles at the upstream edge of the foot. In a third run including pickup protons we used a mass ratio of 1024. The shock reforms periodically as in the low mass ratio run with a somewhat smaller time constant. The specular reflection of pickup protons results in an increase of the shock potential some distance ahead of the shock foot and ramp. The minimum scale of the cross shock potential during reformation is about 7 electron inertial length λe. We do not find any pickup proton acceleration in the ramp or downstream of the shock beyond the energy which specularly reflected ions gain by the motional electric field of the solar wind during their upstream gyration.

  15. Cost effectiveness and efficiency in assistive technology service delivery.

    Science.gov (United States)

    Warren, C G

    1993-01-01

    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  16. Modeling and Observation of Interstellar He+ Pickup Ions in the Inner Heliosphere

    Science.gov (United States)

    Chen, Junhong

    Interstellar pickup ions constitute a charged particle population that originates from interstellar neutrals inside the heliosphere. They are produced by photoionization, charge exchange with solar wind ions, and electron impact ionization (EI). Once ionized, they are picked up by the interplanetary magnetic field (IMF) and rapidly swept outward with the solar wind. Typically, pickup ion distributions have been described in terms of a velocity distribution function that evolves through fast pitch angle scattering followed by adiabatic cooling during radial transport in the reference frame of the solar wind [e.g., Vasyliunas & Siscoe, 1976, VS76 hereafter]. In the VS76 model, the slope of the isotropic velocity distributions is controlled by the combination of the ionization rate and the cooling process. Thus far, for the cooling index that relates the slope of the velocity distribution to the radial transport and expansion of the pickup ions a constant value of 3/2 has been widely used. The implicit assumptions to arrive at this value are immediate PUI isotropization due to pitch angle scattering and solar wind expansion with the square of the distance from the Sun. Any experimental determination of the cooling index depends on the knowledge of the ionization rate and its spatial variation, as well as solar wind and interplanetary conditions. In this thesis, we study their influences on the PUI cooling index and separate them by making use of the two complementary helium PUI data sets from SWICS instrument on the ACE spacecraft, and PLASTIC instrument on STEREO spacecraft. We use the pickup ion observations from ACE SIWCS in the last solar cycle to determine the cooling index, and the possible effects of the electron impact ionization on the determination of the cooling index. With pickup ion observations from STEREO PLASTIC, we determine how solar wind expansion patterns affect the cooling index. We find that the cooling index varies substantially with solar

  17. Improving Financial Service Delivery to Communities through Micro ...

    African Journals Online (AJOL)

    ... through Micro-finance Institutions in Uganda; the case of Pride Micro-finance ... This data was analysed qualitatively and the results of the analysis indicated that ... a number of challenges in financial service delivery; like inability to reach out ...

  18. Rural and urban women entrepreneurs: A comparison of service needs and delivery methods priorities

    Directory of Open Access Journals (Sweden)

    Davis, A.

    2011-01-01

    Full Text Available Women entrepreneurs face a wide variety of barriers and challenges throughout the life and growth of their entrepreneurial venture. This study expands the knowledge base on women entrepreneurs’ needs, specifically their needs in terms of service areas and service delivery method preferences. Twenty three “needed” service areas were identified by 95 Manitoba based women entrepreneurs. The first five included: finding new customers, growth benefits and tools, market expansion, general marketing, and networking skills. This study also examined the differences between urban and rural based entrepreneurs. Two service need areas “how to find mentors and role models” and “legal issues” exhibited statistically significant priority differences. Service delivery methods did not produce any statistically significant differences. Overall, this study concludes that regardless of location, women entrepreneurs’ training and support needs are not significantly that different. The effects of entrepreneurial stage and years in business on entrepreneurial support needs are also examined.

  19. Predictors of safe delivery service utilization in arsi zone, South-East ethiopia.

    Science.gov (United States)

    Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

    2011-08-01

    Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilization in Arsi Zone, Southeast Ethiopia. A cross- sectional community based study using quantitative and qualitative methods was conducted from February 15(th) to March 15(th) 2006. A total of 1089 women who had at least one birth one year prior to the study were involved in the study from nine rural and four urban kebeles in three Woredas (Districts) selected using a systematic sampling method from all households in the study area. A pre-tested structured interviewer administered questionnaire was used to collect data. Information on the utilization of safe delivery service and socio-demographic, individual and institutional factors and past obstetric history were collected. Focus Group Discussion guide was used for qualitative data collection. The data were edited, cleaned, and entered into a computer and analyzed using SPSS for windows version 12.0. One thousand seventy four women who had at least one birth were interviewed making a response rate 98.6%. Two hundred seventy one (75.0%) of urban and 373(52.0%) rural women received antenatal care from skilled health professional at least once during their last pregnancy. Thirty-one (4.3%) of rural and 145 (40.4%) of urban women delivered in health institution. In multivariate analysis showed that residential area OR= 8.5, 95%CI; (5.1,13.9), parity OR=0.18, 95%CI; (0.08, 0.42), and ANC service use OR= 4.5, 95%CI; (2.2,8.9), and maternal education OR=4.6, 95%CI; (1.7,12.8), were most significant predictors of safe delivery service use by mothers

  20. Naturalistic drive cycle synthesis for pickup trucks.

    Science.gov (United States)

    Liu, Zifan; Ivanco, Andrej; Filipi, Zoran

    2015-09-01

    Future pick-up trucks are meeting much stricter fuel economy and exhaust emission standards. Design tradeoffs will have to be carefully evaluated to satisfy consumer expectations within the regulatory and cost constraints. Boundary conditions will obviously be critical for decision making: thus, the understanding of how customers are driving in naturalistic settings is indispensable. Federal driving schedules, while critical for certification, do not capture the richness of naturalistic cycles, particularly the aggressive maneuvers that often shape consumer perception of performance. While there are databases with large number of drive cycles, applying all of them directly in the design process is impractical. Therefore, representative drive cycles that capture the essence of the naturalistic driving should be synthesized from naturalistic driving data. Naturalistic drive cycles are firstly categorized by investigating their micro-trip components, defined as driving activities between successive stops. Micro-trips are expected to characterize underlying local traffic conditions, and separate different driving patterns. Next, the transitions from one vehicle state to another vehicle state in each cycle category are captured with Transition Probability Matrix (TPM). Candidate drive cycles can subsequently be synthesized using Markov Chain based on TPMs for each category. Finally, representative synthetic drive cycles are selected through assessment of significant cycle metrics to identify the ones with smallest errors. This paper provides a framework for synthesis of representative drive cycles from naturalistic driving data, which can subsequently be used for efficient optimization of design or control of pick-up truck powertrains. Manufacturers will benefit from representative drive cycles in several aspects, including quick assessments of vehicle performance and energy consumption in simulations, component sizing and design, optimization of control strategies, and

  1. The dynamics of the service delivery process : a value-based approach

    NARCIS (Netherlands)

    Ruyter, de J.C.; Wetzels, M.G.M.; Lemmink, J.G.A.M.; Mattsson, J.

    1997-01-01

    Recent research linking service quality and service satisfaction has raised issues which require conceptual and empirical elaboration. Among these are the formation of satisfaction during the service delivery process and the role of customer value. In this article, the focus is on how different

  2. Can branding by health care provider organizations drive the delivery of higher technical and service quality?

    Science.gov (United States)

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

    2009-01-01

    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  3. IT enabled service delivery innovation from quality perspective

    Directory of Open Access Journals (Sweden)

    Yao-Chin Lin

    2014-03-01

    Full Text Available The objective is to understand how information and service quality to influence of IT enabled service (ITeS, then to enhance service delivery innovation (SDI. This study bases ITeS to elaborate two research questions by adopting Rodosek’s business reference model. Consequently, we conduct a case study approach, by deriving proposals concerning the relationships among two quality perspectives, ITeS, and SDI in a Taiwanese publishing company. In the end, we concluded three related findings. Firstly, the company based on service orientated to provide basic service functions to encourage more users to enjoy their services, as well as facilitating collaborative work via the online discussion area. Secondly, the company adopted advanced service functions to extend their service scopes to end-users, such as download the news into handheld devices. Finally, the company utilized the supporting service functions to assist customers integrating the ideas and plans.

  4. Opening the Black Box: Exploring the Effect of Transformation on Online Service Delivery in Local Governments

    Science.gov (United States)

    van Veenstra, Anne Fleur; Zuurmond, Arre

    To enhance the quality of their online service delivery, many government organizations seek to transform their organization beyond merely setting up a front office. This transformation includes elements such as the formation of service delivery chains, the adoption of a management strategy supporting process orientation and the implementation of enterprise architecture. This paper explores whether undertaking this transformation has a positive effect on the quality of online service delivery, using data gathered from seventy local governments. We found that having an externally oriented management strategy in place, adopting enterprise architecture, aligning information systems to business and sharing activities between processes and departments are positively related to the quality of online service delivery. We recommend that further research should be carried out to find out whether dimensions of organizational development too have an effect on online service delivery in the long term.

  5. A model for hydrogen pickup for BWR cladding materials

    International Nuclear Information System (INIS)

    Hede, G.; Kaiser, U.

    2001-01-01

    It has been observed that rod elongation is driven by the hydrogen pickup but not by corrosion as such. Based on this a non-destructive method to determine clad hydrogen concentration has been developed. The method is based on the observation that there are three different mechanisms behind the rod growth: the effect of neutron irradiation on the Zircaloy microstructure, the volume increase of the cladding as an effect of hydride precipitation and axial pellet-cladding-mechanical-interaction (PCMI). The derived correlation is based on the experience of older cladding materials, inspected at hot-cell laboratories, that obtained high hydrogen levels (above 500 ppm) at lower burnup (assembly burnup below 50 MWd/kgU). Now this experience can be applied, by interpolation, on more modern cladding materials with a burnup beyond 50 MWd/kgU by analysis of the rod growth database of the respective cladding materials. Hence, the method enables an interpolation rather than an extrapolation of present day hydrogen pickup database, which improves the reliability and accuracy. Further, one can get a good estimate of the hydrogen pickup during an ongoing outage based on a non-destructive method. Finally, rod growth measurements are normally performed for a large population of rods, hence giving a good statistics compared to examination of a few rods at a hot cell. (author)

  6. Changing public service delivery: Learning in co-creation

    NARCIS (Netherlands)

    W.H. Voorberg (William); V.J.J.M. Bekkers (Victor); Timeus, K. (Krista); Tonurist, P. (Piret); L.G. Tummers (Lars)

    2017-01-01

    textabstractCo-creation – where citizens and public organizations work together to deal with societal issues – is increasingly considered as a fertile solution for various public service delivery problems. During cocreation, citizens are not mere consumers, but are actively engaged in building

  7. A Universal Design Approach to Government Service Delivery: The Case of ChileAtiende.

    Science.gov (United States)

    Sandoval, Leonardo

    2016-01-01

    A common challenge for government administrations that aim to improve the delivery of information and services to citizens is to go beyond a government-centred approach. By focusing on citizens and the needs of a wide range of citizens, Universal Design (UD) can help to increase the effectiveness, efficiency and satisfaction of government services. This paper examines the case of an internationally recognised Chilean government service delivery programme inspired by UD principles known as ChileAtiende ("ChileService"). A brief account of its creation and current status is provided.

  8. Complaints and compliments assessment in developing service delivery measurement

    Directory of Open Access Journals (Sweden)

    Norshahrizan Nordin

    2018-05-01

    Full Text Available Excellent healthcare services delivered to patients would not necessarily entail an excellent patient service fulfillment, fulfill patient expectations, and attain high satisfaction levels. Hence, patient satisfaction is multifactorial and difficult to measure. Appliance of satisfaction model, service dissatisfaction and satisfaction feedback are able to translate the nonlinear attributes for a more accurate service dissatisfaction and satisfaction feedback assessment. Service recipients of experienced Inpatient and Outpatient (IOPs can be translated into levels of compliments and complaints to describe degrees of patient satisfaction and dissatisfaction, respectively. Compliments and complaints voiced by patients should be taken seriously. As a result, the translation of service satisfaction and service dissatisfaction based on compliments and complaints from patients in the form of satisfaction index SCi and dissatisfaction index SCa introduced a new theoretical concept of concurrent and balance measurement in evaluating customer (VOC or VOPs feedback. In normal practice, the service improvement is usually based on complaints or dissatisfaction aspect, but the compliments or satisfaction aspect on the same service delivery was always neglected. In this study, the formulation which was based on a non-linear assessment, not only amplified the effectiveness in communicating patients’ compliments and complaints in a more receptive manner but also corresponded with Kano model.

  9. Library service delivery, information literacy knowledge: a modelling ...

    African Journals Online (AJOL)

    Knowledge preservation, access to information and dissemination has rapidly changed the way people seek and use information. The study concluded that the application of IT will encourage self sufficiency in food production, good health and rapid development among the citizenry. Keywords: Library service delivery, ...

  10. Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

    Science.gov (United States)

    Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

    2017-05-23

    China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An

  11. Measurement and evaluation of the public administration performance through delivery of electronic services

    Directory of Open Access Journals (Sweden)

    Mirlinda Batalli

    2015-07-01

    Full Text Available The purpose of this paper concerns the relation between delivery of electronic services (e-services and evaluation of public administration performance. Public sector organizations should pay attention and determine the strategies to be followed in order to increase the satisfaction of citizens and businesses in relation to delivery of electronic services. The study aims to review the demands toward progress to the competitiveness, the sustainability, efficiency and effectives in public administration that have rapidly enforced the wide reforms in the public sector, in order to modernize the initiatives to offer better electronic services for the citizens. The article aims to present that the transformation process toward providing electronic services to the citizens should be assessed continuously, in light with challenges, demands and process of globalization, in order to strengthen the capacities of public administration and make it more efficient. In this regard, the regular evaluation and measurement of the public administration performance leads toward the promotion of enhanced public services and higher level of accountability. Through receiving the e-services, citizens can save their time, can reduce the expenses and create an easier access of communication with all levels of the government.

  12. Viability of healthcare service delivery alternatives for the Australian mining sector.

    Science.gov (United States)

    Williams, Patricia A H; Giles, Margaret

    2012-01-01

    The changing and demanding nature of the mining workforce in rural and remote Australia brings unique challenges to the delivery of healthcare services. In an attempt to control costs whilst delivering cost effective and quality healthcare, new models of delivery must be considered. For a workforce that is fly-in/fly-out, the provision of healthcare is problematic given the lack of consistency in location. A cost-benefit framework is analysed comparing three models of service provision using travel to a major location, locum services and remote health monitoring. Ultimately, new models of care must be considered to address the issues of increasing workforce turnover, to cater for rising healthcare costs, and to improve the health of such communities.

  13. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia

    Directory of Open Access Journals (Sweden)

    Titaley Christiana R

    2010-08-01

    Full Text Available Abstract Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and

  14. Changing public service delivery: learning in co-creation

    NARCIS (Netherlands)

    Voorberg, William; Bekkers, Victor; Timeus, Krista; Tonurist, Piret; Tummers, L.G.

    2017-01-01

    Co-creation – where citizens and public organizations work together to deal with societal issues – is increasingly considered as a fertile solution for various public service delivery problems. During co-creation, citizens are not mere consumers, but are actively engaged in building resilient

  15. Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Gladys Reuben Mahiti

    2015-10-01

    Full Text Available Background: Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women's views about the maternal health services (pregnancy, delivery, and postpartum period that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with maternal morbidity and mortality in rural Tanzania. Design: We gathered qualitative data from 15 focus group discussions with women attending a health facility after child birth and transcribed it verbatim. Qualitative content analysis was used for analysis. Results: ‘Three categories emerged that reflected women's perceptions of maternal health care services: “mothers perceive that maternal health services are beneficial,” “barriers to accessing maternal health services” such as availability and use of traditional birth attendants (TBAs and the long distances between some villages, and “ambivalence regarding the quality of maternal health services” reflecting that women had both positive and negative perceptions in relation to quality of health care services offered’. Conclusions: Mothers perceived that maternal health care services are beneficial during pregnancy and delivery, but their awareness of postpartum complications and the role of medical services during that stage were poor. The study revealed an ambivalence regarding the perceived quality of health care services offered, partly due to shortages of material resources. Barriers to accessing maternal health care services, such as the cost of transport and the use of TBAs, were also shown. These findings call for improvement on the services

  16. Engaging children and parents in service design and delivery.

    Science.gov (United States)

    Bedford Russell, A R; Passant, M; Kitt, H

    2014-12-01

    The involvement of all user groups, including children, young people (CYP) and their parents, encourages people to take responsibility for healthier lifestyle behaviours, improves treatment compliance and leads to more appropriate use of healthcare resources. Initiatives to engage CYP in the UK are gathering momentum, but significant improvements are still needed. There is a national drive from the department of health (DH) and NHS England, strategic clinical networks, operational delivery networks (including newborn networks), charities, parent groups and a number of other bodies to embed CYP involvement in service design and delivery. User engagement and patient choice, is underpinned by the NHS outcomes framework, and a myriad of other DH and NHS England policies and practice frameworks. It is now everybody's business. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Feasibility Study of Document Delivery Services in Special Libraries in Tehran

    Directory of Open Access Journals (Sweden)

    Assiyeh Pour- Emam- Ali

    2006-10-01

    Full Text Available The present study investigates the feasibility of establishing document delivery services in special libraries in Tehran. Document delivery services is copyright-cleared hard copy or electronic copy supply to individuals or corporations on a non-profit or for-profit basis. A descriptive survey was conducted over 105 special libraries located within Tehran. Capabilities studied included manual and automated equipments, skilled and motivated manpower, adequate budget and etc. Investigations show that 8.42% of these libraries use web-sites for resource location. 5.43% employ bibliographies. 5.36% of users lodge their requests by phone. 2.32% of the libraries receive requests in person. 3.14% of librarians are familiar with English while 6.28% are familiar with IT. 5.27% of the libraries studied use British library Document Supply Center at Boston Spa as their primary source of Foreign Document acquisition. 5.32% of the libraries consider membership in Interlibrary Cooperative Schemes as appropriate means of meeting patrons’ information needs. Maximum request response time is 3-4 weeks. 3.28% of the requests are for books. 6.88% of the special libraries, lack staff training courses for skill acquisition in the area of document delivery. 8.29% of libraries cite lack of adequate equipment as the main document delivery obstacle. The findings demonstrate the document delivery service among special libraries in Tehran is not appropriate given the existing capabilities.

  18. Tracked "Pick-Up" Ultrasound for Robot-Assisted Minimally Invasive Surgery.

    Science.gov (United States)

    Schneider, Caitlin; Nguan, Christopher; Rohling, Robert; Salcudean, Septimiu

    2016-02-01

    We present a novel "pick-up" ultrasound transducer for intraabdominal robot-assisted minimally invasive surgery. Such a "pick-up" ultrasound transducer is inserted through an abdominal incision at the beginning of the procedure and remains in the abdominal cavity throughout, eliminating the need for a dedicated port or a patient bedside surgical assistant. The transducer has a handle that can be grasped in a repeatable manner using a da Vinci Prograsp tool, allowing the transducer to be accurately manipulated by the surgeon using the da Vinci Robot. This is one way to enable 3-D tracking of the transducer, and, thus, mapping of the vasculature. The 3-D vascular images can be used to register preoperative CT to intraoperative camera images. To demonstrate the feasibility of the approach, we use an ultrasound vessel phantom to register a CT surface model to extracted ultrasound vessel models. The 3-D vascular phantom images are generated by segmenting B-mode images and tracking the pick-up ultrasound transducer with the da Vinci kinematics, internal electromagnetic sensor, or visible fiducials suitable for camera tracking. Reconstruction results using da Vinci kinematics for tracking give a target registration error of 5.4 ± 1.7 mm.

  19. The Cost of Health Services Delivery in Health Houses of Alborz: A Case Study

    Directory of Open Access Journals (Sweden)

    Javad Ghoddousinejad

    2015-07-01

    Full Text Available Background and Objectives : Health houses play an active role to improve health status of rural population.Furthermore, it is important to know the costs of provided services. This research was designed to determine the costs of healthcare delivery in health houses of ALBORZ district. Material and Methods : In this cross-sectional descriptive study, Activity Based Costing (ABC was used to analyze the costs of services. Results : The average Direct Costs (DC of healthcare delivery in health houses was estimated 37033365 Rials. Direct and Indirect Costs (IC of service delivery in health houses were 65.91% and 34.09% of Total Costs (TC respectively. Conclusion : Since human resources play the most important role in determining the costs of health services delivery in healthcare, reforming payment mechanisms would be a suitable solution to reduce extra costs. Moreover, in order to decrease extra costs, it is essential to modify activities and eliminate parallel tasks.

  20. Potentiality of the Usage of Compressed Natural Gas for Competitiveness in Service Delivery Industries

    Directory of Open Access Journals (Sweden)

    Gazi Mohammad Hasan Jamil

    2014-08-01

    Full Text Available Abstract. With the rising costs of gasoline, many vehicle owners are looking for alternatives of it. Compressed natural gas (CNG has been tested for this very purpose in some countries and found as a better alternative so far. CNG comes from country’s natural resources and it is clean and less costly to use. This paper is mainly an analysis of the potential benefits of using natural gas as a transportation fuel by the service delivery industries. It will examine CNG’s potential contribution in reducing delivery and vehicle maintenance cost, saving money in the long run projects, improving fuel efficiency, enhancing physical safety and assuring environment friendly emissions of carbon monoxide or reactive gases for the service delivery industries.Keywords: Compressed natural gas (CNG, Service Delivery, Fossil fuel, Global warming, Competitiveness

  1. Fault Activity Aware Service Delivery in Wireless Sensor Networks for Smart Cities

    Directory of Open Access Journals (Sweden)

    Xiaomei Zhang

    2017-01-01

    Full Text Available Wireless sensor networks (WSNs are increasingly used in smart cities which involve multiple city services having quality of service (QoS requirements. When misbehaving devices exist, the performance of current delivery protocols degrades significantly. Nonetheless, the majority of existing schemes either ignore the faulty behaviors’ variability and time-variance in city environments or focus on homogeneous traffic for traditional data services (simple text messages rather than city services (health care units, traffic monitors, and video surveillance. We consider the problem of fault-aware multiservice delivery, in which the network performs secure routing and rate control in terms of fault activity dynamic metric. To this end, we first design a distributed framework to estimate the fault activity information based on the effects of nondeterministic faulty behaviors and to incorporate these estimates into the service delivery. Then we present a fault activity geographic opportunistic routing (FAGOR algorithm addressing a wide range of misbehaviors. We develop a leaky-hop model and design a fault activity rate-control algorithm for heterogeneous traffic to allocate resources, while guaranteeing utility fairness among multiple city services. Finally, we demonstrate the significant performance of our scheme in routing performance, effective utility, and utility fairness in the presence of misbehaving sensors through extensive simulations.

  2. Decentralisation in Uganda: Prospects for Improved Service Delivery

    African Journals Online (AJOL)

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

  3. The effect of minor alloying elements on oxidation and hydrogen pickup in Zr-2.5Nb

    International Nuclear Information System (INIS)

    Ploc, R.A.

    2002-01-01

    In CANDU reactors, fuel and coolant are contained in horizontal pressure tubes made of Zr-2.5 wt% Nb alloy. In the past decade, the effect of more than 20 impurity elements, in various concentrations, on oxidation and deuterium pickup (at 300 o C, pD = 10.5, Li 2 O) have been investigated in over 70 Zr-2.5Nb alloys. The studies were performed using non-consumable arc-melted alloy logs that were rolled and made into corrosion coupons and corroded in autoclaves. This study represents one of the largest collections of previously unpublished data on the effect of impurity elements on oxide film growth and deuterium pickup in a zirconium alloy. Elements such as Al, Ti, Mn, and Pt, to name but a few, were found to significantly accelerate the corrosion process. Some elements, such as tin, had a positive effect on oxidation (lowers the rate of oxide film development) and a negative effect on hydrogen pickup (increases pickup). Three parameters were important to the corrosion process, namely, microstructure, surface finish, and synergistic interactions between the impurity elements. The above studies culminated in two response surface analyses (RSA). The first was conducted on the effect of C and Fe on oxygen and deuterium pickup in Zr-2.5Nb drop castings corroded at 325 o C in CANDU conditions. The second study was performed in autoclaves at 300 o C on the affect of four impurity elements, C, Fe, Cr, and Si, in Zr-2.5Nb micro-tubes, which possess the same microstructure as full-size pressure tubes. The first RSA revealed a quadratic dependence of corrosion on C and Fe concentrations, with an optimum resistance at about 30 ppm (wt) C and 1100 ppm (wt) Fe. This has been partially confirmed by out-reactor corrosion of Zr-2.5Nb-Fe micro-pressure tubes. Trends in- and out-reactor were similar for oxidation but different in magnitude for deuterium pickup. There is no linear dependence on the Fe concentration in-reactor, implying that Fe and C form a complex. The second RSA

  4. The effect of minor alloying elements on oxidation and hydrogen pickup in Zr-2.5Nb

    International Nuclear Information System (INIS)

    Ploc, R.A.

    2002-01-01

    In CANDU reactors, fuel and coolant are contained in horizontal pressure tubes made of Zr-2.5 wt% Nb alloy. In the past decade, the effect of more than 20 impurity elements, in various concentrations, on oxidation and deuterium pickup (at 300 deg C, pD = 10.5, Li 2 O) have been investigated in over 70 Zr-2.5Nb alloys. The studies were performed using non-consumable arc-melted alloy logs that were rolled and made into corrosion coupons and corroded in autoclaves. This study represents one of the largest collections of previously unpublished data on the effect of impurity elements on oxide film growth and deuterium pickup in a zirconium alloy. Elements such as Al, Ti, Mn, and Pt, to name but a few, were found to significantly accelerate the corrosion process. Some elements, such as tin, had a positive effect on oxidation (lowers the rate of oxide film development) and a negative effect on hydrogen pickup (increases pickup). Three parameters were important to the corrosion process, namely, microstructure, surface finish, and synergistic interactions between the impurity elements. The above studies culminated in two response surface analyses (RSA). The first was conducted on the effect of C and Fe on oxygen and deuterium pickup in Zr-2.5Nb drop castings corroded at 325 deg C in CANDU conditions. The second study was performed in autoclaves at 300 deg C on the affect of four impurity elements, C, Fe, Cr, and Si, in Zr-2.5Nb micro-tubes, which possess the same microstructure as full-size pressure tubes. The first RSA revealed a quadratic dependence of corrosion on C and Fe concentrations, with an optimum resistance at about 30 ppm (wt) C and 1100 ppm (wt) Fe. This has been partially confirmed by out-reactor corrosion of Zr-2.5Nb-Fe micro-pressure tubes. Trends in- and out-reactor were similar for oxidation but different in magnitude for deuterium pickup. There is no linear dependence on the Fe concentration in-reactor, implying that Fe and C form a complex. The second

  5. 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

  6. 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.

  7. Mobile government implementation for government service delivery in developing countries: a South Africa context

    CSIR Research Space (South Africa)

    Ogunleye, OS

    2014-07-01

    Full Text Available an opportunity to use of this platform to provide better service delivery to the citizens of the developing countries. This paper identifies major service delivery issues in South Africa. Various m-government systems that have been implemented in other countries...

  8. Uptake of methanol on mixed HNO3/H2O clusters: An absolute pickup cross section

    Science.gov (United States)

    Pysanenko, A.; Lengyel, J.; Fárník, M.

    2018-04-01

    The uptake of atmospheric oxidized organics on acid clusters is relevant for atmospheric new particle formation. We investigate the pickup of methanol (CH3OH) on mixed nitric acid-water clusters (HNO3)M(H2O)N by a combination of mass spectrometry and cluster velocity measurements in a molecular beam. The mass spectra of the mixed clusters exhibit (HNO3)m(H2O)nH+ series with m = 0-3 and n = 0-12. In addition, CH3OH.(HNO3)m(H2O)nH+ series with very similar patterns appear in the spectra after the methanol pickup. The velocity measurements prove that the undoped (HNO3)m(H2O)nH+ mass peaks in the pickup spectra originate from the neutral (HNO3)M(H2O)N clusters which have not picked up any CH3OH molecule, i.e., methanol has not evaporated upon the ionization. Thus the fraction of the doped clusters can be determined and the mean pickup cross section can be estimated, yielding σs ¯ ≈ 20 Å2. This is compared to the lower estimate of the mean geometrical cross section σg ¯ ≈ 60 Å2 obtained from the theoretical cluster geometries. Thus the "size" of the cluster corresponding to the methanol pickup is at least 3-times smaller than its geometrical size. We have introduced a method which can yield the absolute pickup cross sections relevant to the generation and growth of atmospheric aerosols, as illustrated in the example of methanol and nitric acid clusters.

  9. Analysis and Design Information System Logistics Delivery Service in Pt Repex Wahana

    Directory of Open Access Journals (Sweden)

    Stephanie Surja

    2015-12-01

    Full Text Available Analysis and Design of Logistic Delivery System in PT Repex Wahana aims to analyze company’s need in existing business process of logistic delivery service. This will then be used in the development of an integrated system that can address the problems in the running process of sending and tracking the whereaboutsor status of the delivered goods which are the core business processes in the enterprise. The result then will be used as basis in the development of integrated information system in pursuit of corporate solution for process business automation, delivery process, inventory, and logistic delivery tracking, which is the core of the company business process, and it will be documented using Unified Modeling Language. The information system is meant to simplify the delivery and tracking process in the company, besides will minimize lost and error of data which is often happened because of the manual and unorganized transaction data processing.

  10. Normative values and the effects of age, gender, and handedness on the Moberg Pick-Up Test.

    Science.gov (United States)

    Amirjani, Nasim; Ashworth, Nigel L; Gordon, Tessa; Edwards, David C; Chan, K Ming

    2007-06-01

    The Moberg Pick-Up Test is a standardized test for assessing hand dexterity. Although reduction of sensation in the hand occurs with aging, the effect of age on a subject's performance of the Moberg Pick-Up Test has not been examined. The primary goal of this study was to examine the impact of aging and, secondarily, the impact of gender and handedness, on performance of the Moberg Pick-Up Test in 116 healthy subjects. The average time to complete each of the four subsets of the test was analyzed using the Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-rank tests. The results show that hand dexterity of the subjects was significantly affected by age, with young subjects being the fastest and elderly subjects the slowest. Women accomplished the test faster than men, and task performance with the dominant hand was faster than with the non-dominant hand. Use of normative values established based on age and gender is a valuable objective tool to gauge hand function in patients with different neurologic disorders.

  11. A Service Delivery Model for Addressing Activity and Social Participation Needs of People Living with HIV

    Directory of Open Access Journals (Sweden)

    Gayle Restall

    2017-05-01

    Full Text Available Background: Occupational therapy can contribute to the health and well-being of people with human immunodeficiency virus (HIV who are experiencing health consequences of living long term with this disease. However, there are no comprehensive rehabilitation service delivery models to guide this emerging area of practice. The purpose of this study was to obtain critical feedback about a service delivery model to address the activity and social participation needs of people living with HIV. Method: We developed a service delivery model from a synthesis of the literature. Using a qualitative research design, we conducted individual and focus group interviews with 35 informants from diverse backgrounds and involvement in HIV-related research, service provision, and policymaking to provide critical feedback about the model. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative methods. Results: The informants identified the strengths and limitations of the model and supports and barriers to its implementation. They highlighted the importance of principle-based services, increasing resources for service navigation, building capacity of rehabilitation services to address the needs of people with HIV, and increasing research and program evaluation targeted to achieving activity and social participation outcomes. Conclusions: The model provides a framework for occupational therapists to design and evaluate services for this population.

  12. Enhancing Human Capital Development and Service Delivery in Nigerian Tertiary Institutions through Effective Academic Staff

    Directory of Open Access Journals (Sweden)

    Chinyeaka Igbokwe-Ibeto

    2014-09-01

    Full Text Available Within the framework of bureaucratic and human capital theories, an eclectic approach, the study examines the nexus between academic staff recruitment in Nigerian tertiary institutions and human capital development as well as service delivery with specific reference to universities. It is generally agreed that higher education is a sine-qua-non for human capital development and efficient service delivery. Higher education is a prerequisite for the production of highly competent experts, which in turn, contributes to the development of organizations and the economy at large. For these to be achieved, the right content and academic staff  must be in place to perform this varied function.  However, over the years the quality of human capital coming out of Nigerian universities and its impact on service delivery has become a source of concern to employers of labour and all stakeholders. Inferential opinions have traced the problem to the recruitment of incompetent academic staff. To investigate the issues raised, the study relied heavily on primary and secondary data and multi stage sampling was used to select the sample population. The data collected was presented in pie chart and simple percentage. Similarly, in order to test the hypotheses and establish the degree of dependence or independence of the variables under investigation, the chi-square statistical technique was used. The findings of the study revealed among others, that Nigerian universities do not employ merit, qualification and competency in the academic staff recruitment. It also established that there is a significant relationship between merit, qualification and competency based academic staff recruitment and human capital development and service delivery. To enhance human capital development and service delivery in Nigerian universities, the study recommends among others, that an independent body like the National University Commission (NUC should be given the responsibility of

  13. A study of charge-pickup interactions by (158A GeV) Pb nuclei

    International Nuclear Information System (INIS)

    Sher, G.; Shahzad, M.I.

    2012-01-01

    Study of the relativistic heavy-ion collision is important to focus on probing phase transitions between hadrons and quark-gluon phases in the extreme conditions of temperature and density of nuclear matter formed in the collisions. These states of nuclear matter are expected to be created in relativistic nuclear collisions with large overlap of interacting nuclei, the Lorentz-boosted Coulomb potential Vc proportional to alpha gamma Z/b of a partner with charge Z is very strong, where b is impact parameter and is the fine structure constant. Either one or both nuclei may be disintegrated by the electromagnetic forces in ultra-peripheral collisions at b = R1 + R2, where R1 and R2 are the nuclear radii. This distinct feature of electromagnetic dissociation makes it possible to study the behavior of nuclear matter under electromagnetic fields. The nuclear charge-pickup ( delta Z = +1) by Pb projectiles at energy 158A GeV interacting with targets Bi, Pb, Cu and Al was investigated using CR39 nuclear track detectors. The target-detector stacks were exposed at CERN SPS beam facility. The projectile and fragments charge states have been identified using the etch-cone lengths for charge-pickup at Z = 83 of residual nuclei. Our measured charge-pickup cross sections (delta Z = +1) are shown. It was observed that for the heavy targets the increase in the cross section is anticipated by substantial contribution of electromagnetic dissociation process of production by virtual photons which is almost negligible at 10.6A GeV. In the light target region, our measured cross sections and charge-pickup cross sections reported at energy 10.6A GeV show dominant nuclear contribution and very small contribution of electromagnetic dissociation term. A strong dependence of charge-pickup cross sections on the target mass number was observed particularly in the heavy targets. (orig./A.B.)

  14. Consumer Cooperatives for Delivery of Urban Water and Sanitation Services

    OpenAIRE

    Ruiz-Mier, Fernando; Ginneken, Meike van

    2008-01-01

    To find the optimal delivery model for urban water supply and sanitation (WSS) services, one must look beyond ownership structures to the practices and designs that support good performance. Consumer cooperatives are often attractive institutional models. This note focuses on a Bolivian cooperative that is one of the most successful water cooperatives in Latin America. Successful cooperatives ...

  15. How to move towards community based service delivery?

    NARCIS (Netherlands)

    Meuwissen, L.; Voorham, T.; Bakker, D. de

    2007-01-01

    Aim: Community based primary health care offers in potential the opportunity to tailor health service delivery to the needs and demands of the local population. Up to now, there is no clear cut method to do this. In a pilot benchmark for general practices, data were collected on demand and

  16. Home delivery of medication - the role of a patient information leaflet on maximising service uptake.

    Science.gov (United States)

    Watson, L; Ahmed, N; Mccall, H; Minton, J; Benn, P; Edwards, S; Waters, L

    2014-12-01

    There are currently over 30,000 HIV-positive individuals in London and over 25,000 on anti-retroviral therapy. In 2009/2010, this equated to £170m spent by London's NHS on anti-retroviral drugs. Ways employed to reduce this cost include standardising the drugs patients are on and delivering medication to patients at home. Home delivery (HD) medication is exempt from value-added tax. The savings made from 10 patients using the home delivery service would free up resources to provide anti-retroviral therapy to one further patient. Studies have shown that concerns surrounding potential breaches of confidentiality are a potential barrier to some people using the home delivery service. In order to challenge these concerns, a leaflet was devised highlighting the major benefits to both the patient and the NHS of home delivery and addressing concerns over confidentiality. The leaflet was handed out to patients at the Mortimer Market Centre who were currently on anti-retroviral medication but not on home delivery. They were asked to complete a survey on their views of the service before and after reading the leaflet, whether they had been previously aware of the service and whether their concerns had been addressed. Some 79% felt that the patient information leaflet addressed all of their concerns, and it helped 11% decide whether to consider using home delivery. However, as more patients were opposed to the service after reading the patient information leaflet than those considering it, more work needs to be done to explore patients' concerns and other factors influencing home delivery service uptake. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Revisiting the theory of the evolution of pick-up ion distributions: magnetic or adiabatic cooling?

    Directory of Open Access Journals (Sweden)

    H. J. Fahr

    2007-01-01

    Full Text Available We study the phasespace behaviour of heliospheric pick-up ions after the time of their injection as newly created ions into the solar wind bulk flow from either charge exchange or photoionization of interplanetary neutral atoms. As interaction with the ambient MHD wave fields we allow for rapid pitch angle diffusion, but for the beginning of this paper we shall neglect the effect of quasilinear or nonlinear energy diffusion (Fermi-2 acceleration induced by counterflowing ambient waves. In the up-to-now literature connected with the convection of pick-up ions by the solar wind only adiabatic cooling of these ions is considered which in the solar wind frame takes care of filling the gap between the injection energy and energies of the thermal bulk of solar wind ions. Here we reinvestigate the basics of the theory behind this assumption of adiabatic pick-up ion reactions and correlated predictions derived from it. We then compare it with the new assumption of a pure magnetic cooling of pick-up ions simply resulting from their being convected in an interplanetary magnetic field which decreases in magnitude with increase of solar distance. We compare the results for pick-up ion distribution functions derived along both ways and can point out essential differences of observational and diagnostic relevance. Furthermore we then include stochastic acceleration processes by wave-particle interactions. As we can show, magnetic cooling in conjunction with diffusive acceleration by wave-particle interaction allows for an unbroken power law with the unique power index γ=−5 beginning from lowest velocities up to highest energy particles of about 100 KeV which just marginally can be in resonance with magnetoacoustic turbulences. Consequences for the resulting pick-up ion pressures are also analysed.

  18. Revisiting the theory of the evolution of pick-up ion distributions: magnetic or adiabatic cooling?

    Directory of Open Access Journals (Sweden)

    H. J. Fahr

    2008-01-01

    Full Text Available We study the phasespace behaviour of heliospheric pick-up ions after the time of their injection as newly created ions into the solar wind bulk flow from either charge exchange or photoionization of interplanetary neutral atoms. As interaction with the ambient MHD wave fields we allow for rapid pitch angle diffusion, but for the beginning of this paper we shall neglect the effect of quasilinear or nonlinear energy diffusion (Fermi-2 acceleration induced by counterflowing ambient waves. In the up-to-now literature connected with the convection of pick-up ions by the solar wind only adiabatic cooling of these ions is considered which in the solar wind frame takes care of filling the gap between the injection energy and energies of the thermal bulk of solar wind ions. Here we reinvestigate the basics of the theory behind this assumption of adiabatic pick-up ion reactions and correlated predictions derived from it. We then compare it with the new assumption of a pure magnetic cooling of pick-up ions simply resulting from their being convected in an interplanetary magnetic field which decreases in magnitude with increase of solar distance. We compare the results for pick-up ion distribution functions derived along both ways and can point out essential differences of observational and diagnostic relevance. Furthermore we then include stochastic acceleration processes by wave-particle interactions. As we can show, magnetic cooling in conjunction with diffusive acceleration by wave-particle interaction allows for an unbroken power law with the unique power index γ=−5 beginning from lowest velocities up to highest energy particles of about 100 KeV which just marginally can be in resonance with magnetoacoustic turbulences. Consequences for the resulting pick-up ion pressures are also analysed.

  19. Quality service delivery for the community, by the community: an innovative Eastern Cape infrastructure and job creation success

    CSIR Research Space (South Africa)

    Wall, K

    2013-10-01

    Full Text Available ; and service delivery; through O/&M activities that increase the availability and utility of infrastructure, and the quality and reliability of services. ... of Municipal Engineering of Southern Africa Annual (IMIESA) Conference, Port Elizabeth, October 2013 Quality service delivery for the community, by the community: an innovative Eastern Cape infrastructure and job creation success Wall K, Ive O, Bhagwan J...

  20. Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

    Science.gov (United States)

    Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

    2015-05-28

    Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All

  1. Service requirement for terminal delivery: An empirical study from the perspective of online shoppers

    Directory of Open Access Journals (Sweden)

    Junjie Xu

    2013-09-01

    Full Text Available To investigate customer’s service requirement for parcel delivery, combining with theoretical analysis and empirical test, a measuring model of customer service requirement was proposed for terminal delivery. Based on literature reviews, five potential dimensions with 27 items were initially discussed. Through exploratory factor analysis on samples collected from Taobao networks, four dimensions with 18 measurement items were finally confirmed including service attitude, service reliability, service standardization and service flexibility. By further confirmatory factor analysis, the fitness of this measuring model was proved to be acceptable. The research revealed that online shoppers paid attention to not only service result but also service process, so related suggestions were also proposed for express firms to promote their service management.

  2. Institutional arrangements for decentralized water and health services delivery in rural Tanzania: differences and constraints

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2013-01-01

    In recent years, decentralization has been upheld by governments, donors and policy makers in many developing countries as a means of improving public services although opinion is divided on the link between decentralization and service delivery. This article reviews recent literature and research

  3. Lubricant Film Breakdown and Material Pick-Up in Sheet Forming of Advanced High Strength Steels and Stainless Steels when Using Environmental Friendly Lubricants

    DEFF Research Database (Denmark)

    Ceron, Ermanno; Olsson, M.; Bay, Niels

    2014-01-01

    chemically with the tool and workpiece material forming thin films, which adhere strongly to the surfaces and reduce the tendency to metal-metal contact and material pick-up. Production tests of new, environmentally benign tribo-systems are, however, costly and laboratory tests are preferred as a preliminary...... the tribological performance, i.e. tendency to material pick-up and galling, of the evaluated tribo-systems. Moreover the SEM analysis shows that different workpiece materials result in different types of material pick-up....

  4. Informing resource-poor populations and the delivery of entitled health and social services in rural India: a cluster randomized controlled trial.

    Science.gov (United States)

    Pandey, Priyanka; Sehgal, Ashwini R; Riboud, Michelle; Levine, David; Goyal, Madhav

    2007-10-24

    A lack of awareness about entitled health and social services may contribute to poor delivery of such services in developing countries, especially among individuals of low socioeconomic status. To determine the impact of informing resource-poor rural populations about entitled services. Community-based, cluster randomized controlled trial conducted from May 2004 to May 2005 in 105 randomly selected village clusters in Uttar Pradesh state in India. Households (548 intervention and 497 control) were selected by a systematic sampling design, including both low-caste and mid- to high-caste households. Four to 6 public meetings were held in each intervention village cluster to disseminate information on entitled health services, entitled education services, and village governance requirements. No intervention took place in control village clusters. Visits by nurse midwife; prenatal examinations, tetanus vaccinations, and prenatal supplements received by pregnant women; vaccinations received by infants; excess school fees charged; occurrence of village council meetings; and development work in villages. At baseline, there were no significant differences in self-reported delivery of health and social services. After 1 year, intervention villagers reported better delivery of several services compared with control villagers: in a multivariate analysis, 30% more prenatal examinations (95% confidence interval [CI], 17%-43%; P India about entitled services enhanced the delivery of health and social services among both low- and mid- to high-caste households. Interventions that emphasize educating resource-poor populations about entitled services may improve the delivery of such services. clinicaltrials.gov Identifier: NCT00421291.

  5. Correlates of and Barriers to the Utilization of Health Services for Delivery in South Asia and Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Nai-Peng Tey

    2013-01-01

    Full Text Available The high maternal and neonatal mortality rates in South Asia and Sub-Saharan Africa can be attributed to the lack of access and utilization of health services for delivery. Data from the Demographic and Health Surveys conducted in Bangladesh, India, Pakistan, Kenya, Nigeria, and Tanzania show that more than half of the births in these countries were delivered outside a health facility. Institutional delivery was closely associated with educational level, family wealth, place of residence, and women’s media exposure status, but it was not influenced by women’s work status and their roles in decision-making (with the exception of Nigeria. Controlling for other variables, higher parity and younger women were less likely to use a health facility for delivery. Within each country, the poorer, less educated and rural women had higher unmet need for maternal care services. Service related factors (accessibility in terms of cost and distance and sociocultural factors (e.g., did not perceive the need for the services and objections from husband and family also posed as barriers to institutional delivery. The paper concludes with some suggestions to increase institutional delivery.

  6. Counselling and psychotherapy services in more developed and developing regions in China: a comparative investigation of practitioners and current service delivery.

    Science.gov (United States)

    Qian, Mingyi; Chen, Ruiyun; Chen, Hong; Hu, Sherlyn; Zhong, Jie; Yao, Ping; Yi, Chunli

    2012-09-01

    Counselling and psychotherapy services have taken off with uneven speed across China since the 1980s after several years of stagnation. Researchers have attributed socioeconomic development (or the lack thereof) and regional differences as main barriers to the development in this field. However, little is known today about the status of counselling and psychotherapy services across China. To investigate and compare the current situation of practitioners and service delivery of counselling and psychotherapy in more developed and developing regions across China. Convenience sampling methods from counselling and psychological services organizations in 29 Chinese provinces, municipalities or autonomous regions were used to recruit 1,543 participants to take part in the investigation by completing a 93-item self-designed questionnaire. Organizations in developing and more developed regions in China varied in their current practices and employment situation of their practitioners, and in the quality of service delivery. However, counselling and psychotherapy offered at universities in both types of regions are of similar quality. In China, the level of socioeconomic development significantly influences the development of professional counselling and psychotherapy services. Important progress is evident in the field; however, the lack of systematic training and the scarcity of professional practitioners remain a challenge.

  7. 48 CFR 252.237-7013 - Instruction to offerors (bulk weight).

    Science.gov (United States)

    2010-10-01

    ...) Offers shall be submitted on a unit price per pound of serviced laundry. Unit prices shall include all costs to the Government of providing the service, including pickup and delivery charges. (b) The Contracting Officer will evaluate bids based on the estimated pounds of serviced laundry stated in the...

  8. Corporate municipal governance for effective and efficient public service delivery in South Africa.

    Directory of Open Access Journals (Sweden)

    Paulin Mbecke

    2014-10-01

    Full Text Available This research acknowledges the current service delivery chaos manifested through numerous protests justifying the weakness of the “Batho Pele” good governance principles to facilitate, improve and sustain service delivery by local governments. The success of corporate governance in corporate companies and state owned enterprises is recognised prompting suggestions that local governments should too adopt corporate governance principles or King III to be effective. The research reviews the King III and literature to ascertain the lack of research on corporate governance in local governments in South Africa. Considering the particular set-up of local governments, the research doubts the successful application of King III in local governments. Through critical research theory, the current service delivery crisis in local governments in South Africa is described. The success of corporate governance systems in the United Kingdom and Australian local governments justify the need for a separate corporate municipal governance system as a solution to the crisis. A specific change of legislation and corporate governance guidelines is necessary to address the uniqueness of local governments. Hence, corporate municipal governance should be compulsory and based on ten standardised good governance principles via a code of corporate governance and a corporate governance framework responding to specific prerequisites for success

  9. Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek

    2017-07-01

    The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  10. Customer's Perceptions and Intentions on Online Travel Service Delivery: An Empirical Study in China

    Science.gov (United States)

    Li, Hongxiu; Suomi, Reima

    With the wide adoption of e-commerce in travel and tourism industry, the Internet has become an important travel service delivery channel, and traditional travel agency has been under severe disintermediation threat. This paper reports on a survey conducted to explore the Chinese consumer's current usage of the Internet as the channel to search travel information and to book travel services. It also investigates customer's future intentions on using the Internet to book travel services. This paper aims to examine whether there are difference between different consumer segments in terms of gender and age, and to find the hypothesis of disintermediation or intermediation in travel industry. The results indicates that online travel service delivery has grown as a popular direct distribution channel in travel industry, but more of the customers still turn to the traditional travel agencies, which support both the disintermediation and intermediation in travel industry. The results also reveal that online travel services provided by travel service providers still need to be improved since the number of online bookers is declined. This paper concludes by discussing the limitation of this study and highlighting areas for the future research in online travel service field.

  11. Simulation of robotic courier deliveries in hospital distribution services.

    Science.gov (United States)

    Rossetti, M D; Felder, R A; Kumar, A

    2000-06-01

    Flexible automation in the form of robotic couriers holds the potential for decreasing operating costs while improving delivery performance in hospital delivery systems. This paper discusses the use of simulation modeling to analyze the costs, benefits, and performance tradeoffs related to the installation and use of a fleet of robotic couriers within hospital facilities. The results of this study enable a better understanding of the delivery and transportation requirements of hospitals. Specifically, we examine how a fleet of robotic couriers can meet the performance requirements of the system while maintaining cost efficiency. We show that for clinical laboratory and pharmaceutical deliveries a fleet of six robotic couriers can achieve significant performance gains in terms of turn-around time and delivery variability over the current system of three human couriers per shift or 13 FTEs. Specifically, the simulation results indicate that using robotic couriers to perform both clinical laboratory and pharmaceutical deliveries would result in a 34% decrease in turn-around time, and a 38% decrease in delivery variability. In addition, a break-even analysis indicated that a positive net present value occurs if nine or more FTEs are eliminated with a resulting ROI of 12%. This analysis demonstrates that simulation can be a valuable tool for examining health care distribution services and indicates that a robotic courier system may yield significant benefits over a traditional courier system in this application.

  12. Funding issues and the delivery of public library services in Nigeria ...

    African Journals Online (AJOL)

    This paper examined the impact of government public expenditure on education and the effect of special funding in enhancing the delivery of public library services in Nigeria. secondary data were collected from the websites of the Central Bank of Nigeria (CBN) and Education Trust Fund (ETF.). Results from the regression ...

  13. Pickup Ions in the Plasma Environments of Mars, Comets, and Enceladus

    Science.gov (United States)

    Cravens, T.; Rahmati, A.; Sakai, S.; Madanian, H.; Larson, D. E.; Lillis, R. J.; Halekas, J. S.; Goldstein, R.; Burch, J. L.; Clark, G. B.; Jakosky, B. M.

    2015-12-01

    Ions created within a flowing plasma by ionization of neutrals respond to the electric and magnetic fields associated with the flow becoming what are called pick-up ions (PUI). PUI play an important role in many solar system plasma environments and affect the energy and momentum balance of the plasma flow. PUI have been observed during several recent space missions and PUI data will be compared and interpreted using models. Pick-up oxygen ions were observed in the solar wind upstream of Mars by the Solar Energetic Particle (SEP) and Solar Wind Ion Analyzer (SWIA) instruments on NASA's MAVEN (Mars Atmosphere and Volatile EvolutioN) spacecraft. The pick-up oxygen ions are created when atoms in the hot corona are ionized by solar radiation and charge exchange with solar wind protons. The ion fluxes measured by SEP can constrain the oxygen escape rate from Mars. PUI were also been detected at distances of 10 - 100 km from the nucleus of comet 67P/Churyumov- Gerasimenko (67P/CG) by plasma instruments (IES and ICA) onboard the Rosetta Orbiter when the comet was at 3 AU. The newly-born cometary ions are accelerated by the solar wind motional electric field but remain un-magnetized, as suggested by pre-encounter models (Rubin et al., 2014). The inner magnetosphere of Saturn and the water plume of the icy satellite Enceladus provide a third example of PUI. H2O+ ions created by ionization of neutral water producing ions that are picked-up by the co-rotating magnetospheric plasma flow. These ions then undergo a complex interaction with the plume gas including collisions that convert most H2O+ ions to H3O+, as measured by the Ion and Neutral Mass Spectrometer (INMS) onboard the Cassini spacecraft.

  14. 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

  15. Characteristics of Indigenous primary health care service delivery models: a systematic scoping review.

    Science.gov (United States)

    Harfield, Stephen G; Davy, Carol; McArthur, Alexa; Munn, Zachary; Brown, Alex; Brown, Ngiare

    2018-01-25

    Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified - accessible health services, community

  16. Interplay Wellbeing Framework: Community Perspectives on Working Together for Effective Service Delivery in Remote Aboriginal Communities

    Directory of Open Access Journals (Sweden)

    Eva McRae-Williams

    2018-02-01

    Full Text Available Access to effective services and programs is necessary to improve wellbeing for Aboriginal and Torres Strait Islander people living in remote Australia. Without genuine participation of Aboriginal community members in the design, governance, and delivery of services, desired service delivery outcomes are rarely achieved. Using a "shared space" model, Aboriginal communities, governments, and scientists came together to design and develop the Interplay Wellbeing Framework. This Framework brings together stories and numbers (or qualitative and quantitative data to represent community values for the purpose of informing program and policy agendas. This article unpacks what community members saw as making a service work well and why. The domains of empowerment and community functioning are discussed and their relationship to effective service delivery demonstrated.

  17. Health policies and federative gaps in Brazil: an analysis of regional capacity of services delivery.

    Science.gov (United States)

    Ribeiro, José Mendes; Moreira, Marcelo Rasga; Ouverney, Assis Mafort; Silva, Cosme Marcelo Furtado Passos da

    2017-04-01

    This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.

  18. Local Governance, Urban Poverty and Service Delivery in Namibia

    OpenAIRE

    Fjeldstad, Odd-Helge; Geisler, Gisela; Nangulah, Selma; Nygaard, Knut; Pomuti, Akiser; Shifotoka, Albertina; Van Rooy, Gert

    2005-01-01

    The urbanisation of poverty is one of the most dramatic developments on the African continent, yielding contrasting images of affluent residential and business districts and utter misery in sprawling shantytowns or slums. Namibia has one of Africa’s highest urban growth rates, taking thousands of women, men and children to towns in search of a better life. The large majority of these end up in poverty-stricken informal settlements in urban areas. The current service delivery approach of the g...

  19. Isotopic and velocity distributions of {sub 83}Bi produced in charge-pickup reactions of {sup 208}{sub 82}PB at 1 A GeV

    Energy Technology Data Exchange (ETDEWEB)

    Kelic, A.; Schmidt, K.H.; Enqvist, T. [Gesellschaft fuer Schwerionenforschung mbH, Darmstadt (DE)] [and others

    2004-07-01

    Isotopically resolved cross sections and velocity distributions have been measured in charge-pickup reactions of 1 A GeV {sup 208}Pb with proton, deuterium and titanium target. The total and partial charge-pickup cross sections in the reactions {sup 208}Pb + {sup 1}H and {sup 208}Pb + {sup 2}H are measured to be the same in the limits of the error bars. A weak increase in the total charge-pickup cross section is seen in the reaction of {sup 208}Pb with the titanium target. The measured velocity distributions show different contributions - quasi-elastic scattering and {delta}-resonance excitation - to the charge-pickup production. Data on total and partial charge-pickup cross sections from these three reactions are compared with other existing data and also with model calculations based on the coupling of different intra-nuclear cascade codes and an evaporation code. (orig.)

  20. The Effect of Service Compact (SERVICOM on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    Directory of Open Access Journals (Sweden)

    Jude Kennedy Emejulu

    2014-12-01

    Full Text Available This study examined the effect of service compact (Servicom Service delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that required re-evaluation and attention based on the submissions of every service unit and department, after an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT of each of the service areas. A pre-SERVICOM Charter workshop which was supervised by the Federal Government was held in the various institutions nationwide to enable care providers enumerate their current service capacity and identify their impediments. In the light of the foregoing, some of the recommendations proffered are that the SERVICOM Charter project should be sustained and supervision and control of the SERVICOM Charter project should be intensified in order to ensure that the Nigerian factor of service-fatigue would not supervene in care delivery in the near future.

  1. High-lying neutron hole strengths observed in pick-up reactions

    International Nuclear Information System (INIS)

    Gales, S.

    1980-01-01

    Neutron-hole states in orbits well below the Fermi surface have been observed in a number of medium-heavy nuclei from A=90 to 209 using one nucleon pick-up reactions. The excitation energies, angular distributions of such broad and enhanced structures will be discussed. The fragmentation of the neutron-hole strengths as well as the spreading of such simple mode of excitations into more complex states are compared to recent calculations within the quasiparticle-phonon or the single particle-vibration coupling nuclear models. We report on recent measurements of J for inner-hole states in 89 Zr and 115 Sn 119 Sn using the analyzing power of the (p,d) and (d,t) reactions. Large enhancement of cross-sections are observed at high excitation energy in the study of the (p,t) reactions on Zr, Cd, Sn, Te and Sm isotopes. The systematic features of such high-lying excitation are related to the ones observed in one neutron pick-up experiments. The origin of such concentration of two neutron-hole strengths in Cd and Sn isotopes will be discussed. Preliminary results obtained in the study of the (α, 6 He) reaction at 218 MeV incident energy on 90 Zr, 118 Sn and 208 Pb targets are presented and compared to the (p,t) results. Finally the properties of hole-analog states populated in neutron pick-up reactions (from 90 Zr to 208 Pb) will be presented

  2. Profile of pregnant women using delivery hut services of the Ballabgarh Health and Demographic Surveillance System in rural north India.

    Science.gov (United States)

    Kant, Shashi; Haldar, Partha; Singh, Arvind K; Archana, S; Misra, Puneet; Rai, Sanjay

    2016-08-01

    To describe women who attended two delivery huts in rural Haryana, India. The present observational study assessed routinely collected service provision data from two delivery huts located at primary health centers in the district of Faridabad. Data on sociodemographic characteristics, prenatal care, use of free transport services, and maternal and neonatal indicators at delivery were assessed for all pregnant women who used the delivery hut services from January 2012 to June 2014. During the study period, 1796 deliveries occurred at the delivery huts. The mean age of the mothers was 23.3 ± 3.3 years (95% confidence interval 23.1-23.5). Of 1648 mothers for whom data were available, 1039 (63.0%) had travelled less than 5 km to the delivery hut. The proportion of mothers who belonged to a lower caste increased from 31.0% (193/622) in 2012 to 41.1% (162/394) in 2014. The proportion of mothers who were illiterate also increased, from 8.1% (53/651) in 2012 to 26.4% (104/394) in 2014. Belonging to a disadvantaged social group (in terms of caste or education) was not an obstacle to use of delivery hut services. The delivery huts might have satisfied some unmet needs of community members in rural India. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. California Integrated Service Delivery Evaluation Report. Phase I

    Science.gov (United States)

    Moore, Richard W.; Rossy, Gerard; Roberts, William; Chapman, Kenneth; Sanchez, Urte; Hanley, Chris

    2010-01-01

    This study is a formative evaluation of the OneStop Career Center Integrated Service Delivery (ISD) Model within the California Workforce System. The study was sponsored by the California Workforce Investment Board. The study completed four in-depth case studies of California OneStops to describe how they implemented the ISD model which brings…

  4. 19 CFR 128.1 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... operations must be sufficiently integrated at both ends of the service (i.e., pick-up and delivery) so that... franchise arrangement). (g) Reimbursable. “Reimbursable” means all normal costs incurred at an express...

  5. Vehicle test report: Battronic pickup truck

    Science.gov (United States)

    Price, T. W.; Shain, T. W.; Freeman, R. J.; Pompa, M. F.

    1982-01-01

    An electric pickup truck was tested to characterize certain parameters and to provide baseline data that can be used for the comparison of improved batteries that may be incorporated into the vehicle at a later time. The vehicle tests were concentrated on the electrical drive subsystem; i.e., the batteries, controller, and motor. The tests included coastdowns to characterize the road load and range evaluations for both cyclic and constant speed conditions. A qualitative evaluation of the vehicle's performance was made by comparing its constant speed range performance with other vehicles.

  6. Slot-type pickup/kicker for AA stochastic cooling

    CERN Multimedia

    CERN PhotoLab

    1979-01-01

    A "slotted transmission line" was used for both pickups and kickers of the stochastic cooling systems of the AA. They served for the cooling of the high-density antiproton stack, in momentum and both transverse planes. In the beginning in a single band, 1-2 GHz, later in 2 bands, 2-4 and 4-8 GHz. See also 7906190, 7906193.

  7. “Just-in-Time” Unmediated Document Delivery Service Provides Fast Delivery, Helps Identify Collection Gaps, but Incurs Extra Costs

    Directory of Open Access Journals (Sweden)

    Heather MacDonald

    2017-06-01

    Full Text Available A Review of: Chan, E. K., Mune, C., Wang, Y., & Kendall, S. L. (2016. Three years of unmediated document delivery: An analysis and consideration of collection development priorities. Medical Reference Services Quarterly, 35(1, 42-51. Retrieved from: http://dx.doi.org/10.1080/02763869.2016.1117288 Abstract Objective – Examine the collection development opportunities and challenges of an unmediated document delivery service. Design – Case study. Setting – Large comprehensive public university in the United States of America. Subjects – 11,981 document delivery requests. Methods – This library implemented Copyright Clearance Center’s Get It Now (CCC-GiN service in November 2011 to supplement existing holdings, provide access to embargoed content and help support two new programs. The CCC-GiN service was offered in addition to regular ILL service. Statistical analysis was done using usage data collected for the academic years 2012-2013, 2013-2014, and 2014-2015 (excluding June and July. Usage data included: order date and time, fulfillment date and time, publication name, publication date, article name, article author, publisher name, cost, delivery e-mail address. Taylor and Francis publications were added to the CCC-GiN service in November of 2014. Main Results – The average yearly cost of titles with the largest number of CCC-GiN requests was compared to the annual subscription cost of the same titles. If the annual subscription cost was less than the average yearly cost of CCC-GiN requests, the library purchased a subscription. Patrons ordered older journal content through CCC-GiN requests. This suggested that backfile subscriptions could be cost effective means of providing content. The authors are in the process of analyzing what historical journal content should be purchased. The addition of Taylor and Francis publications resulted in an increase in the average cost per article. Taylor and Francis publications were popular with

  8. Service Delivery and Related Issues at the Trace Research and Development Center.

    Science.gov (United States)

    Smith, R. O.

    The environmental context of the Trace Center is first briefly described as background for a more detailed description of the center's service delivery activities in the field of rehabilitation/education technology. Trace serves four major functions in rehabilitation/education technology. As a nationally funded rehabilitation engineering center,…

  9. Alternate service delivery models in cancer genetic counseling: a mini-review

    Directory of Open Access Journals (Sweden)

    Adam Hudson Buchanan

    2016-05-01

    Full Text Available Demand for cancer genetic counseling has grown rapidly in recent years as germline genomic information has become increasingly incorporated into cancer care and the field has entered the public consciousness through high-profile celebrity publications. Increased demand and existing variability in the availability of trained cancer genetics clinicians place a priority on developing and evaluating alternate service delivery models for genetic counseling. This mini-review summarizes the state of science regarding service delivery models such as telephone counseling, telegenetics and group counseling. Research on comparative effectiveness of these models in traditional individual, in-person genetic counseling has been promising for improving access to care in a manner acceptable to patients. Yet, it has not fully evaluated the short- and long-term patient- and system-level outcomes that will help answer the question of whether these models achieve the same beneficial psychosocial and behavioral outcomes as traditional cancer genetic counseling. We propose a research agenda focused on comparative effectiveness of available service delivery models and how to match models to patients and practice settings. Only through this rigorous research can clinicians and systems find the optimal balance of clinical quality, ready and secure access to care, and financial sustainability. Such research will be integral to achieving the promise of genomic medicine in oncology.

  10. Urban governance and spatial inequality in service delivery: a case study of solid waste management in Abuja, Nigeria.

    Science.gov (United States)

    Adama, Onyanta

    2012-09-01

    Spatial inequality in service delivery is a common feature in African cities. Several factors account for the phenomenon but there is growing attention towards urban governance and the role of the state. Urban governance policies such as privatization serve as key strategies through which the state regulates and (re)produces spatial inequality in service delivery. This study examined how governance practices related to privatization and the regulatory role of the state reinforce spatial inequalities in the delivery of solid waste services in Abuja, Nigeria. It focused primarily on the issue of cost recovery. Privatization became a major focus in Abuja in 2003 when the government launched a pilot scheme. Although it has brought improvements in service delivery, privatization has also increased the gap in the quality of services delivered in different parts of the city. Drawing on empirical data, the study revealed that little sensitivity to income and affordability, and to income differentials between neighbourhoods in the fixing of user charges and in the choice of the billing method is contributing to spatial inequalities in service delivery. Furthermore, the study suggests that these practices are linked to a broader issue, a failure of the government to see the people as partners. It therefore calls for more inclusive governance especially in decision-making processes. The study also emphasizes the need for a policy document on solid waste management, as this would encourage a critical assessment of vital issues including how privatization is to be funded, especially in low-income areas.

  11. The Role of Libraries in eHealth Service Delivery in Australia

    Science.gov (United States)

    Rao, Sarada

    2009-01-01

    eHealth is an emerging service sector which has great potential to improve health care delivery to rural and remote communities, facilitate health surveillance, and promote health education and research. Despite the critical need for eHealth services in Australia based on the challenges of distance and human resources, its utility has yet to be…

  12. Outpatients’ experiences of quality service delivery at a teaching hospital in Gauteng

    Directory of Open Access Journals (Sweden)

    Ebin J Arries

    2008-11-01

    Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack

  13. Design of a multi-vehicles delivery tours satisfying duration constraints

    Energy Technology Data Exchange (ETDEWEB)

    Langevin, A; Soumis, F

    1987-01-01

    The following organization was studied for the letter and parcel pick-up and delivery problem in an urban environment. The day is divided in periods of time in which each vehicle starts from a sorting centre, travels to a very precise area of the region, picks up and delivers letters and parcels, and returns to the depot to have the collected material sorted out for delivery during the following period. The intent of this approach is to have each zone serviced by one vehicle only, in order to facilitate the work of the dispatcher and routing of each vehicle. A method has been developed of partitioning an urban region into zones to be assigned, each one to a specific vehicle, so as to minimize the total number of vehicles used or the total distance travelled by all vehicles. The first part of the method determines the zones and the average number of points to visit. Then, a first refinement of the method takes into account the daily variability of the demand in each zone, whereas a second refinement examines the advantage of allowing some overlapping of zones for the purpose of having an overloaded vehicle relieved by one from an adjacent zone. 17 refs., 11 figs., 2 tabs.

  14. Proposal of a service delivery integration index of home care for older persons: application in several European cities

    Directory of Open Access Journals (Sweden)

    Jean-Claude Henrard

    2006-07-01

    Full Text Available Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method: Items considered as part of both dimensions according to an expert consensus (face validity were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results: Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion: The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity.

  15. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe

    NARCIS (Netherlands)

    Pelone, Ferruccio; Kringos, Dionne S.; Spreeuwenberg, Peter; de Belvis, Antonio G.; Groenewegen, Peter P.

    2013-01-01

    To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment

  16. original article predictors of safe delivery service utilization in arsi

    African Journals Online (AJOL)

    Abrham

    There is limited information on the mothers' use of skilled delivery services in the ... to conditions related to pregnancy and child birth. 99% of .... having favourable attitude towards utilization of ... two injections of Tetanus Toxoid vaccine during.

  17. Assessment of the administration of healthcare service delivery in ...

    African Journals Online (AJOL)

    The study examined the structure and mode of administration in Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria; and also assessed the impact of the structure and mode of administration on the service delivery in the hospital. These were with a view to assessing the administration of healthcare ...

  18. Understanding the queuing theory for improved service delivery: an ...

    African Journals Online (AJOL)

    The methodology adopted in this paper, therefore is to describe queuing theory and its associated terminologies in relation to service delivery. In view of this, the paper presented a simplified exposition of queuing theory and management of waiting lines as it affects entrepreneurial drive for more business growth and ...

  19. Comparative pick-up ion distributions at Mars and Venus: Consequences for atmospheric deposition and escape

    Science.gov (United States)

    Curry, Shannon M.; Luhmann, Janet; Ma, Yingjuan; Liemohn, Michael; Dong, Chuanfei; Hara, Takuya

    2015-09-01

    Without the shielding of a substantial intrinsic dipole magnetic field, the atmospheres of Mars and Venus are particularly susceptible to similar atmospheric ion energization and scavenging processes. However, each planet has different attributes and external conditions controlling its high altitude planetary ion spatial and energy distributions. This paper describes analogous test particle simulations in background MHD fields that allow us to compare the properties and fates, precipitation or escape, of the mainly O+ atmospheric pick-up ions at Mars and Venus. The goal is to illustrate how atmospheric and planetary scales affect the upper atmospheres and space environments of our terrestrial planet neighbors. The results show the expected convection electric field-related hemispheric asymmetries in both precipitation and escape, where the degree of asymmetry at each planet is determined by the planetary scale and local interplanetary field strength. At Venus, the kinetic treatment of O+ reveals a strong nightside source of precipitation while Mars' crustal fields complicate the simple asymmetry in ion precipitation and drive a dayside source of precipitation. The pickup O+ escape pattern at both Venus and Mars exhibits low energy tailward escape, but Mars exhibits a prominent, high energy 'polar plume' feature in the hemisphere of the upward convection electric field while the Venus ion wake shows only a modest poleward concentration. The overall escape is larger at Venus than Mars (2.1 ×1025 and 4.3 ×1024 at solar maximum, respectively), but the efficiency (likelihood) of O+ escaping is 2-3 times higher at Mars. The consequences of these comparisons for pickup ion related atmospheric energy deposition, loss rates, and detection on spacecraft including PVO, VEX, MEX and MAVEN are considered. In particular, both O+ precipitation and escape show electric field controlled asymmetries that grow with energy, while the O+ fluxes and energy spectra at selected spatial

  20. The Velocity Distribution Of Pickup He+ Measured at 0.3 AU by MESSENGER

    Science.gov (United States)

    Gershman, Daniel J.; Fisk, Lennard A.; Gloeckler, George; Raines, Jim M.; Slavin, James A.; Zurbuchen, Thomas H.; Solomon, Sean C.

    2014-06-01

    During its interplanetary trajectory in 2007-2009, the MErcury Surface, Space ENvrionment, GEochemistry, and Ranging (MESSENGER) spacecraft passed through the gravitational focusing cone for interstellar helium multiple times at a heliocentric distance R ≈ 0.3 AU. Observations of He+ interstellar pickup ions made by the Fast Imaging Plasma Spectrometer sensor on MESSENGER during these transits provide a glimpse into the structure of newly formed inner heliospheric pickup-ion distributions. This close to the Sun, these ions are picked up in a nearly radial interplanetary magnetic field. Compared with the near-Earth environment, pickup ions observed near 0.3 AU will not have had sufficient time to be energized substantially. Such an environment results in a nearly pristine velocity distribution function that should depend only on pickup-ion injection velocities (related to the interstellar gas), pitch-angle scattering, and cooling processes. From measured energy-per-charge spectra obtained during multiple spacecraft observational geometries, we have deduced the phase-space density of He+ as a function of magnetic pitch angle. Our measurements are most consistent with a distribution that decreases nearly monotonically with increasing pitch angle, rather than the more commonly modeled isotropic or hemispherically symmetric forms. These results imply that pitch-angle scattering of He+ may not be instantaneous, as is often assumed, and instead may reflect the velocity distribution of initially injected particles. In a slow solar wind stream, we find a parallel-scattering mean free path of λ || ~ 0.1 AU and a He+ production rate of ~0.05 m-3 s-1 within 0.3 AU.

  1. How to achieve optimal organization of primary care service delivery at system level: Lessons from Europe

    NARCIS (Netherlands)

    Pelone, F.; Kringos, D.S.; Spreeuwenberg, P.; de Belvis, A.; Groenewegen, P.P.

    2013-01-01

    OBJECTIVE: To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. DESIGN: Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data

  2. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

    NARCIS (Netherlands)

    Pelone, F.; Kringos, D.S.; Spreeuwenberg, P.; Belvis, A.G. de; Groenewegen, P.P.

    2013-01-01

    Objective: To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Design: Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data

  3. Utilization of institutional delivery service at Wukro and Butajera districts in the Northern and South Central Ethiopia

    Science.gov (United States)

    2014-01-01

    Background Ethiopia has one of the highest maternal mortality in the world. Institutional delivery is the key intervention in reducing maternal mortality and complications. However, the uptake of the service has remained low and the factors which contribute to this low uptake appear to vary widely. Our study aims to determine the magnitude and identify factors affecting delivery at health institution in two districts in Ethiopia. Methods A community based cross sectional household survey was conducted from January to February 2012 in 12 randomly selected villages of Wukro and Butajera districts in the northern and south central parts of Ethiopia, respectively. Data were collected using a pretested questionnaire from 4949 women who delivered in the two years preceding the survey. Results One in four women delivered the index child at a health facility. Among women who delivered at health facility, 16.1% deliveries were in government hospitals and 7.8% were in health centers. The factors that significantly affected institutional delivery in this study were district in which the women lived (AOR: 2.21, 95% CI: 1.28, 3.82), women age at interview (AOR: 1.96, 95% CI: 1.05, 3.62), women’s education (AOR: 3.53, 95% CI: 1.22, 10.20), wealth status (AOR: 16.82, 95% CI: 7.96, 35.54), women’s occupation (AOR: 1.50, 95% CI: 1.01, 2.24), antenatal care (4+) use (AOR: 1.77, 95% CI: 1.42, 2.20), and number of pregnancies (AOR: 0.25, 95% CI: 0.18,0.35). We found that women who were autonomous in decision making about place of delivery were less likely to deliver in health facility (AOR: 0.38, 95% CI: 0.23,0.63). Conclusions Institutional delivery is still low in the Ethiopia. The most important factors that determine use of institutional delivery appear to be women education and household economic status. Women’s autonomy in decision making on place of delivery did not improve health facility delivery in our study population. Actions targeting the disadvantaged, improving

  4. Strength of primary care service delivery: a comparative study of European countries, Australia, New Zealand, and Canada.

    Science.gov (United States)

    Pavlič, Danica R; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor; Vainieri, Milena; Seghieri, Chiara; Maksuti, Alem

    2018-05-01

    AimWe sought to examine strength of primary care service delivery as measured by selected process indicators by general practitioners from 31 European countries plus Australia, Canada, and New Zealand. We explored the relation between strength of service delivery and healthcare expenditures. The strength of a country's primary care is determined by the degree of development of a combination of core primary care dimensions in the context of its healthcare system. This study analyses the strength of service delivery in primary care as measured through process indicators in 31 European countries plus Australia, New Zealand, and Canada. A comparative cross-sectional study design was applied using the QUALICOPC GP database. Data on the strength of primary healthcare were collected using a standardized GP questionnaire, which included 60 questions divided into 10 dimensions related to process, structure, and outcomes. A total of 6734 general practitioners participated. Data on healthcare expenditure were obtained from World Bank statistics. We conducted a correlation analysis to analyse the relationship between strength and healthcare expenditures.FindingsOur findings show that the strength of service delivery parameters is less than optimal in some countries, and there are substantial variations among countries. Continuity and comprehensiveness of care are significantly positively related to national healthcare expenditures; however, coordination of care is not.

  5. The role of value in the delivery process of hospitality services

    NARCIS (Netherlands)

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

    1998-01-01

    In the services marketing literature only scant attention has been paid to the concept of customer value as a basis for evaluative judgment. So far, value has been defined primarily in monetary terms ("value for money"). In this paper the role of customer value in the service delivery process is

  6. Musical instrument pickup based on a laser locked to an optical fiber resonator.

    Science.gov (United States)

    Avino, Saverio; Barnes, Jack A; Gagliardi, Gianluca; Gu, Xijia; Gutstein, David; Mester, James R; Nicholaou, Costa; Loock, Hans-Peter

    2011-12-05

    A low-noise transducer based on a fiber Fabry-Perot (FFP) cavity was used as a pickup for an acoustic guitar. A distributed feedback (DFB) laser was locked to a 25 MHz-wide resonance of the FFP cavity using the Pound-Drever-Hall method. The correction signal was used as the audio output and was preamplified and sampled at up to 96 kHz. The pickup system is largely immune against optical noise sources, exhibits a flat frequency response from the infrasound region to about 25 kHz, and has a distortion-free audio output range of about 50 dB.

  7. Quality Service Delivery as a Competitive Weapon in Corporate ...

    African Journals Online (AJOL)

    The study assessed quality service delivery of Zenith Bank of Nigeria to determine whether it confers competitive advantage on the Bank. A survey research method was adopted. A sample of the Bank's branches in 4 towns in Anambra State was selected. Data were generated from questionnaires, interviews and internet as ...

  8. The health maintenance organization strategy: a corporate takeover of health services delivery.

    Science.gov (United States)

    Salmon, J W

    1975-01-01

    This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

  9. Imprints from the solar cycle on the helium atom and helium pickup ion distributions

    Directory of Open Access Journals (Sweden)

    D. Rucinski

    Full Text Available Neutral interstellar helium atoms penetrate into the solar system almost unaffected by gas–plasma interactions in the heliospheric interface region, and thus can be considered as carriers of original information on the basic parameters (like density, temperature, bulk velocity of the Very Local Interstellar Medium (VLISM. Such information can nowadays be derived from analysis of data obtained from different experimental methods: in situ measurements of He atoms (Ulysses, observations of the solar backscattered He 584 A radiation (EUVE, in situ measurements of He + pickup ions (AMPTE, Ulysses, Wind, SOHO, ACE. In view of the current coordinated international ISSI campaign devoted to the study of the helium focusing cone structure and its evolution, we analyze expected variations of neutral He density, of He + pickup fluxes and of their phase space distributions at various phases of the solar activity cycle based on a realistic time-dependent modelling of the neutral helium and He + pickup ion distributions, which reflect solar cycle-induced variations of the photoionization rate. We show that the neutral helium density values are generally anticorrelated with the solar activity phase and in extreme cases (near the downwind axis the maximum-to-minimum density ratio may even exceed factors of ~ 3 at 1 AU. We also demonstrate that in the upwind hemisphere (at 1 AU and beyond the He + fluxes are correlated with the solar cycle activity, whereas on the downwind side the maximum of the expected flux up to distances of ~ 3 AU occurs around solar minimum epoch, and only further away does the correlation with solar activity become positive. Finally, we present the response of the phase space distribution spectra of He + pickup ions (in the solar wind frame for different epochs of the solar cycle and heliocentric distances from 1 to 5 AU covering the range of Ulysses, Wind and ACE observations.

    Key words. Solar physics, astrophysics and astronomy

  10. Imprints from the solar cycle on the helium atom and helium pickup ion distributions

    Directory of Open Access Journals (Sweden)

    D. Rucinski

    2003-06-01

    Full Text Available Neutral interstellar helium atoms penetrate into the solar system almost unaffected by gas–plasma interactions in the heliospheric interface region, and thus can be considered as carriers of original information on the basic parameters (like density, temperature, bulk velocity of the Very Local Interstellar Medium (VLISM. Such information can nowadays be derived from analysis of data obtained from different experimental methods: in situ measurements of He atoms (Ulysses, observations of the solar backscattered He 584 A radiation (EUVE, in situ measurements of He + pickup ions (AMPTE, Ulysses, Wind, SOHO, ACE. In view of the current coordinated international ISSI campaign devoted to the study of the helium focusing cone structure and its evolution, we analyze expected variations of neutral He density, of He + pickup fluxes and of their phase space distributions at various phases of the solar activity cycle based on a realistic time-dependent modelling of the neutral helium and He + pickup ion distributions, which reflect solar cycle-induced variations of the photoionization rate. We show that the neutral helium density values are generally anticorrelated with the solar activity phase and in extreme cases (near the downwind axis the maximum-to-minimum density ratio may even exceed factors of ~ 3 at 1 AU. We also demonstrate that in the upwind hemisphere (at 1 AU and beyond the He + fluxes are correlated with the solar cycle activity, whereas on the downwind side the maximum of the expected flux up to distances of ~ 3 AU occurs around solar minimum epoch, and only further away does the correlation with solar activity become positive. Finally, we present the response of the phase space distribution spectra of He + pickup ions (in the solar wind frame for different epochs of the solar cycle and heliocentric distances from 1 to 5 AU covering the range of Ulysses, Wind and ACE observations.Key words. Solar physics, astrophysics and astronomy

  11. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa.

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.

  12. New delivery technology for financial services and the changing role of financial intermediaries

    OpenAIRE

    Buhl, Hans Ulrich

    1998-01-01

    New delivery technology for financial services and the changing role of financial intermediaries / H. U. Buhl ; A. Will. - In: Business Information Systems ´98 / W. Abramowicz (ed.). - Poznan : Akad. Ekonomiczna w Poznaniu, 1998. - S. 203-215

  13. A Blockchain Ecosystem for Digital Identity: Improving Service Delivery in Canada’s Public and Private Sectors

    Directory of Open Access Journals (Sweden)

    Greg Wolfond

    2017-10-01

    Full Text Available Blockchain-based solutions have the potential to make government operations more efficient and improve the delivery of services in the public and private sectors. Identity verification and authentication technologies, as one of the applications of blockchain-based solutions – and the focus of our own efforts at SecureKey Technologies – have been critical components in service delivery in both sectors due to their power to increase trust between citizens and the services they access. To convert trust into solid value added, identities must be validated through highly-reliable technologies, such as blockchain, that have the capacity to reduce cost and fraud and to simplify the experience for customers while also keeping out the bad actors. With identities migrating to digital platforms, organizations and citizens need to be able to transact with reduced friction even as more counter-bound services move to online delivery. In this article, drawing on our own experiences with an ecosystem approach to digital identity, we describe the potential value of using blockchain technology to address the present and future challenges of identity verification and authentication within a Canadian context.

  14. Pasundan Delivery Services (PT. Wahana Bumi Raya) Business Strategy Formulation and Implementation to Create Sustain Future Competition

    OpenAIRE

    Haryanto, Iman; Wandebori, Harimukti

    2012-01-01

    Pasundan Delivery Services (PDS) is the delivery services provider using motorcycle provide solutions for visitors and Bandung citizens to effective and efficient their valuable time, run its costumer order through smartphone and social media, lucrative demand leads PDS to formulate its strategy to reach more costumers among existing competitors to win the competition in and as the leader the future. Formulation of strategic management involving small team discussion group as the management o...

  15. Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

    Directory of Open Access Journals (Sweden)

    Wanjira Carol

    2011-05-01

    Full Text Available Abstract Background A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care. Methods A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice. Results Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170 were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170 of the deliveries while in 11.7% (137/1170 of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have Conclusion Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

  16. Perceived service delivery and productivity in the food and beverage sector in Potchefstroom / Adam Herman Viljoen

    OpenAIRE

    Viljoen, Adam Herman

    2012-01-01

    The importance of management in the food and beverage sector as well as managing food and beverage service employees are crucial aspects that influence quality service delivery. The food and beverage sector is a large service orientated segment of the greater tourism industry, and effective management of employees is therefore necessary since employees are regarded as the primary resource through which establishments deliver services. One might further argue that an employee is...

  17. Stoppage - Vat Return and Accounting Practice in Re-Delivery of a Delivery Subject to Stoppage

    Directory of Open Access Journals (Sweden)

    Ahmet Yanık

    2016-12-01

    Full Text Available Value Added Tax (VAT is calculated based on the goods and service delivery costs realized by the corporations. Unless this VAT is subject to stoppage, seller takes the VAT from the purchaser in delivery of goods or services and then the corporate pays this amount to the tax office or sets off through the VAT he paid for his service or goods procurement. However, in some cases, Ministry of Finance holds not those providing the delivery or service but those purchasing or procuring the goods or services responsible partly or fully for the tax calculated based on the delivery or service fee. The purpose of this paper is to reveal VAT stoppage, accounting entries with regards to the corporation accepting the delivery and re-delivering it, VAT set off and VAT return in the re-delivery of a delivery subject to stoppage pursuant to General Communiqué of VAT Serial No 117

  18. The Role of Agro-Veterinary Shops in Animal Health Services, Information and Technology Delivery in Kenya

    International Nuclear Information System (INIS)

    Ngotho, R.N.

    2002-01-01

    With the withdrawal of animal health services by the government of Kenya, 'private' delivery has become increasingly important, especially in urban and per-urban settings. Rural agri- business shops ('dukas') are situated everywhere in the country and areas devoid of veterinarians due to poor establishment of private practice as in the ASALs, they have mushroomed to address the delivery vacuum. Four participatory approaches were used in a study to gauge the perceptions of stakeholders on the role of 'dukas' in delivery of animal health services, technologies and information. Rapid rural appraisals were carried out in three representative districts of Kenya to obtain perceptions in farmers' group settings. Semi-structured interviews of key informants endeavoured to tease out opinions of the professionals on the service and information delivery mode they considered to be most effective and sustainable. Shop exit surveys targeting individual consumers sought to assess what livestock keepers had to say on a one to one basis regarding the agro-veterinary shops. Two consensus-building workshop meetings for stakeholders were held to help crystallise recommendations and develop guidelines and support mechanisms for future duka involvements in AHSD. In this paper, the main stakeholders' perspectives and highlights from stakeholders' consensus-building workshops are also presented. In conclusion the role of the dukas is discussed impartially

  19. Impact of ICT on Agricultural Extension Services Delivery: Evidence from the Catholic Relief Services SMART Skills and Farmbook Project in Kenya

    Science.gov (United States)

    Tata, Joyous S.; McNamara, Paul E.

    2018-01-01

    Purpose: The study was carried out to assess the impact of the Catholic Relief Services (CRS) Skills for Marketing and Rural Transformation (SMART) skills and Farmbook information communication technology (ICT) on agricultural extension service delivery by front-line extension officers in two counties in Kenya. The second objective was to assess…

  20. Improving Government service delivery with private sector intermediaries

    OpenAIRE

    Klievink, B.; Janssen, M.

    2008-01-01

    Government organizations operate a variety of channels to interact with citizens and businesses. Advances in information and communication technology enabled an online presence and more direct interactions. A focus on efficiency makes organizations encourage the use of electronic channels over traditional channels. Also, intermediaries in the service delivery chain are cut out in favor of direct interactions. This strategy of disintermediation finds its rationale in the transaction costs theo...

  1. Position pickup of the PS Booster

    CERN Multimedia

    CERN PhotoLab

    1975-01-01

    The beam position around the 4 rings of the PS Booster (originally 800 MeV, now 1.4 GeV), is measured with electrostatic pickups (PU). They consist of a ceramic cylinder forming part of the vacuum chamber, and, in order to save space, they are located inside the multipole lenses. The inside of the ceramic is coated with a metallic layer, into which the form of the electrodes was cut by computer-controlled micro-sandblasting. Each PU has a pair of horizontal and a pair of vertical electrodes, as well as a separate intensity-sensing circular electrode.

  2. QoC-based Optimization of End-to-End M-Health Data Delivery Services

    NARCIS (Netherlands)

    Widya, I.A.; van Beijnum, Bernhard J.F.; Salden, Alfons

    2006-01-01

    This paper addresses how Quality of Context (QoC) can be used to optimize end-to-end mobile healthcare (m-health) data delivery services in the presence of alternative delivery paths, which is quite common in a pervasive computing and communication environment. We propose min-max-plus based

  3. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-08-11

    Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

  4. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-01-01

    ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

  5. Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.

    Science.gov (United States)

    Lafata, Jennifer Elston; Shay, L Aubree; Brown, Richard; Street, Richard L

    2016-04-01

    The use of physician office-based tools such as electronic health records (EHRs), health risk appraisal (HRA) instruments, and written patient reminder lists is encouraged to support efficient, high-quality, patient-centered care. We evaluate the association of exam room use of EHRs, HRA instruments, and self-generated written patient reminder lists with patient-physician communication behaviors, recommended preventive health service delivery, and visit length. Observational study of 485 office visits with 64 primary care physicians practicing in a health system serving the Detroit metropolitan area. Study data were obtained from patient surveys, direct observation, office visit audio-recordings, and automated health system records. Outcome measures included visit length in minutes, patient use of active communication behaviors, physician use of supportive talk and partnership-building communication behaviors, and percentage of delivered guideline-recommended preventive health services for which patients are eligible and due. Simultaneous linear regression models were used to evaluate associations between tool use and outcomes. Adjusted models controlled for patient characteristics, physician characteristics, characteristics of the relationship between the patient and physician, and characteristics of the environment in which the visit took place. Prior to adjusting for other factors, visits in which the EHR was used on average were significantly (p communication behaviors facilitating patient involvement (2.1 vs. 2.6 occurrences), but more use of active patient communication behaviors (4.4 vs. 2.6). Likewise, HRA use was significantly associated with increased preventive services delivery (62.1 percent vs. 57.0 percent). All relationships remained significant (p > .05) in adjusted models with the exception of that between HRA use and preventive service delivery. Office-based tools intended to facilitate the implementation of desired primary care practice

  6. ENERGETIC NEUTRAL ATOMS: AN ADDITIONAL SOURCE FOR HELIOSPHERIC PICKUP IONS

    International Nuclear Information System (INIS)

    Bochsler, Peter; Moebius, Eberhard

    2010-01-01

    Recently, Schwadron and McComas discussed the possibility of inner source pickup particles originating from the ionization of energetic neutral atoms (ENAs), based on new data from the IBEX mission. This proposition has some interesting features, namely, it might be able to explain why inner source pickup ions (PUIs) have a composition resembling solar abundances and show no indication of overabundance of refractory elements, although this should be expected, if the conventional explanation of solar wind-dust interaction for the origin of this heliospheric component were correct. In this Letter, we explore further consequences for ENA-related PUIs and investigate their velocity distributions. We conclude that this model will not reproduce the observed velocity distributions of inner source PUIs and point out a substantial deviation in their composition. However, it seems likely that the ionization of ENAs as observed with IBEX could contribute a significant amount of heliospheric suprathermal tail ions. Some possible consequences of our investigation for heliospheric particle populations are briefly discussed.

  7. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529

  8. Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

    Science.gov (United States)

    Stelmack, Joan

    2005-05-01

    A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

  9. Ac-loss measurement of coated conductors: The influence of the pick-up coil position

    International Nuclear Information System (INIS)

    Schmidt, Curt

    2008-01-01

    The ac-loss measurement by the magnetization method requires calibration for obtaining absolute values. A convenient way of calibration is the calorimetric measurement which yields, within the measuring accuracy, absolute loss values. In the magnetization measurement the hysteresis loop of sample magnetization which determines the losses is measured via the integration of magnetic flux penetrating a pick-up coil. The ratio of flux integral to magnetization integral and hence the calibration factor is however, for a given pick-up coil geometry, not exactly a constant, but depends on the magnetization current pattern within the sample. Especially for thin tapes in perpendicular external field this effect has to be taken into consideration in order to avoid miss measurements. The relation between measured flux and sample magnetization was calculated for special cases of magnetization current distribution in the sample as a function of the pick-up coil position. Furthermore calibration factors were measured as a function of the ac-field amplitude and the result compared with available theoretical models. A good agreement was found between experiment and theory

  10. Delivery of public services in ethnic minority states: Gender equality ...

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

    Delivery of public services in ethnic minority states: Gender equality and decentralization in Myanmar. In 2017, to sustain Myanmar's democratic transition, IDRC and Global Affairs Canada ... and staff from the University of Toronto's Munk School of Global Affairs (Asia ... Ideas from the global climate change hotspot research.

  11. MgB2 magnetometer with directly coupled pick-up loop

    NARCIS (Netherlands)

    Portesi, C.; Mijatovic, D.; Veldhuis, Dick; Brinkman, Alexander; Monticone, E.; Gonnelli, R.S.

    2006-01-01

    magnetometer with a directly coupled pick-up loop. We used an all in situ technique for fabricating magnesium diboride films, which consists of the co-evaporation of B and Mg by means of an e-gun and a resistive heater respectively. Consequently, we realized the superconducting device, which

  12. Survey of pickup ion signatures in the vicinity of Titan using CAPS/IMS

    Science.gov (United States)

    Regoli, L. H.; Coates, A. J.; Thomsen, M. F.; Jones, G. H.; Roussos, E.; Waite, J. H.; Krupp, N.; Cox, G.

    2016-09-01

    Pickup ion detection at Titan is challenging because ion cyclotron waves are rarely detected in the vicinity of the moon. In this work, signatures left by freshly produced pickup heavy ions (m/q ˜ 16 to m/q ˜ 28) as detected in the plasma data by the Cassini Plasma Spectrometer/Ion Mass Spectrometer (CAPS/IMS) instrument on board Cassini are analyzed. In order to discern whether these correspond to ions of exospheric origin, one of the flybys during which the reported signatures were observed is investigated in detail. For this purpose, ion composition data from time-of-flight measurements and test particle simulations to constrain the ions' origin are used. After being validated, the detection method is applied to all the flybys for which the CAPS/IMS instrument gathered valid data, constraining the region around the moon where the signatures are observed. The results reveal an escape region located in the anti-Saturn direction as expected from the nominal corotation electric field direction. These findings provide new constraints for the area of freshly produced pickup ion escape, giving an approximate escape rate of 3.3-2+3×1023 ions· s-1.

  13. Exploration of the administrative aspects of the delivery of home health care services: a qualitative study.

    Science.gov (United States)

    Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim

    2018-01-01

    Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

  14. Progress in the utilization of antenatal and delivery care services in Bangladesh: where does the equity gap lie?

    Science.gov (United States)

    Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us; Uddin, Jalal; Enemark, Ulrika

    2016-07-29

    Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011. The data of this study came from the Bangladesh Demographic and Health Survey. We employed rate ratio, concentration curve and concentration index to examine the trend in inequity of ANC and delivery care services. We also used logistic regression models to analyse the relationship between socioeconomic factors and maternal health care services. The concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 with a greater decline in urban area. There was almost no change in the concentration index for ANC services from medically trained providers during this period. We also found a decreasing trend in inequity in the utilization of both health facility delivery and skilled birth assistance but this trend was again more pronounced in urban area compared to rural area. The concentration index for C-section delivery decreased by about 33 % over 2004-2011 with a similar rate in both urban and rural areas. Women from the richest households were about 3 times more likely to have 4+ ANC visits, delivery at a health facility and skilled birth assistance compared to women from the poorest households. Women's and their husbands' education were significantly associated with greater use of maternal health care services. In addition, women's exposure to mass media, their involvement in microcredit programs and autonomy in healthcare decision-making appeared as significant predictors of using some of these health care services. Bangladesh faces not only a

  15. Comparison of magnetic and electrostatic Schottky pick-up in the CERN AD

    CERN Document Server

    Federmann, S

    2013-01-01

    The present note is intended to exploit the possibility of using a dedicated electrostatic beam pick-up for Schottky diagnostics in the future ELENA ring. A test setup is described allowing the evaluation of its performance compared to the extra low-noise beam current transformer used successfully in the AD. The results of this experiment are summarized and discussed.

  16. Women veterans' healthcare delivery preferences and use by military service era: findings from the National Survey of Women Veterans.

    Science.gov (United States)

    Washington, Donna L; Bean-Mayberry, Bevanne; Hamilton, Alison B; Cordasco, Kristina M; Yano, Elizabeth M

    2013-07-01

    The number of women Veterans (WVs) utilizing the Veterans Health Administration (VA) has doubled over the past decade, heightening the importance of understanding their healthcare delivery preferences and utilization patterns. Other studies have identified healthcare issues and behaviors of WVs in specific military service eras (e.g., Vietnam), but delivery preferences and utilization have not been examined within and across eras on a population basis. To identify healthcare delivery preferences and healthcare use of WVs by military service era to inform program design and patient-centeredness. Cross-sectional 2008-2009 survey of a nationally representative sample of 3,611 WVs, weighted to the population. Healthcare delivery preferences measured as importance of selected healthcare features; types of healthcare services and number of visits used; use of VA or non-VA; all by military service era. Military service era differences were present in types of healthcare used, with World War II and Korea era WVs using more specialty care, and Vietnam era-to-present WVs using more women's health and mental health care. Operations Enduring Freedom, Iraqi Freedom, New Dawn (OEF/OIF/OND) WVs made more healthcare visits than WVs of earlier military eras. The greatest healthcare delivery concerns were location convenience for Vietnam and earlier WVs, and cost for Gulf War 1 and OEF/OIF/OND WVs. Co-located gynecology with general healthcare was also rated important by a sizable proportion of WVs from all military service eras. Our findings point to the importance of ensuring access to specialty services closer to home for WVs, which may require technology-supported care. Younger WVs' higher mental health care use reinforces the need for integration and coordination of primary care, reproductive health and mental health care.

  17. Slot-type pickup/kicker for AA stochastic cooling

    CERN Multimedia

    CERN PhotoLab

    1979-01-01

    A "slotted transmission line" was used for both pickups and kickers of the cooling systems of the AA. They served for the cooling of the high-density antiproton stack, in momentum and both transverse planes. In the beginning in a single band, 1-2 GHz, later in 2 bands, 2-4 and 4-8 GHz. Here we see the slotted electrodes partly pulled out of the outer casing. See also 7906189, 7906581X, 7896193.

  18. The Changing Political Undercurrents in Health Services Delivery in Sub-Saharan Africa.

    Science.gov (United States)

    Ichoku, H E; Ifelunini, A I

    2017-07-01

    This article reviews the changing political undercurrent in health service delivery in Sub-Saharan Africa, chronicling the ideological shift in orientation toward neoliberalism in the health sector, an ideology crafted and introduced into Sub-Saharan Africa by the International Monetary Fund and the World Bank. The article examines the implication of this neoliberal reform on the efficiency in health care provision and on the quality and accessibility of health services by the poor and vulnerable. Drawing inference from countries like Nigeria, the authors argue that the ascendency of neoliberalism in the health systems of Sub-Saharan Africa has engendered unethical practices and introduced elements of moral hazard in the health sector, reducing the incentive for governments to develop effective service delivery over the long term. The authors therefore advocate for a rejection of neoliberal ideology in favor of a universal coverage principle if an inclusive health system is to be developed.

  19. Costs and outcomes of VCT delivery models in the context of scaling up services in Indonesia

    NARCIS (Netherlands)

    Siregar, A.Y.M.; Komarudin, D.; Wisaksana, R.; Crevel, R. van; Baltussen, R.M.P.M.

    2011-01-01

    OBJECTIVE: To evaluate costs and outcomes of voluntary counselling and testing (VCT) service delivery models in urban Indonesia. METHODS: We collected primary data on utilization, costs and outcomes of VCT services in a hospital clinic (568 clients), HIV community clinic (28 clients), sexually

  20. The role of the document delivery service at an evolving research library in Saudi Arabia

    KAUST Repository

    Vijayakumar, J.K.

    2015-01-01

    Design/methodology/approach – To collect the responses of document delivery service users, an online questionnaire was used with 12 multiple-choice questions and two open-ended questions. The questionnaires were sent only to the users of this service, and the responses were collected anonymously. Two surveys were conducted, in 2010 and 2013, with the same questions. The responses are displayed graphically prepared to compare the results. There were 71 responses in 2010 and 95 in 2013. Findings – In both surveys, the majority of users rated the service, staff behaviour, speed, quality, etc. with a high satisfaction level. Document delivery order statistics are a major decision-making tool, in addition to usage analysis, for developing a better, economical and highly utilized collection in brand new libraries. delivery order statistics are a major decision-making tool, in addition to usage analysis, for developing a better, economical and highly utilized collection in brand new libraries. Originality/value – This is the first published study of user perception of document delivery in Saudi Arabia.

  1. 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.

  2. Ford F250 Dedicated CNG Pickup

    International Nuclear Information System (INIS)

    Eudy, Leslie

    1999-01-01

    The U.S. Department of Energy (DOE) is encouraging the use of alternative fuels and alternative fuel vehicles (AFVs). To support this activity, DOE has directed the National Renewable Energy Laboratory (NREL) to conduct projects to evaluate the performance and acceptability of light-duty AFVs. In this study, we tested a pair of 1998 Ford F-250 pickups: one dedicated compressed natural gas (CNG) model and a gasoline model as closely matched as possible. Each vehicle was run through a series of tests to evaluate acceleration, fuel economy, braking, and cold-start capabilities, as well as more subjective performance indicators such as handling, climate control, and noise

  3. How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

    Science.gov (United States)

    Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

    2017-03-01

    The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

  4. The determinations of remote sensing satellite data delivery service quality: A positivistic case study in Chinese context

    Science.gov (United States)

    Jin, Jiahua; Yan, Xiangbin; Tan, Qiaoqiao; Li, Yijun

    2014-03-01

    With the development of remote sensing technology, remote-sensing satellite has been widely used in many aspects of national construction. Big data with different standards and massive users with different needs, make the satellite data delivery service to be a complex giant system. How to deliver remote-sensing satellite data efficiently and effectively is a big challenge. Based on customer service theory, this paper proposes a hierarchy conceptual model for examining the determinations of remote-sensing satellite data delivery service quality in the Chinese context. Three main dimensions: service expectation, service perception and service environment, and 8 sub-dimensions are included in the model. Large amount of first-hand data on the remote-sensing satellite data delivery service have been obtained through field research, semi-structured questionnaire and focused interview. A positivist case study is conducted to validate and develop the proposed model, as well as to investigate the service status and related influence mechanisms. Findings from the analysis demonstrate the explanatory validity of the model, and provide potentially helpful insights for future practice.

  5. The determinations of remote sensing satellite data delivery service quality: A positivistic case study in Chinese context

    International Nuclear Information System (INIS)

    Jin, Jiahua; Yan, Xiangbin; Tan, Qiaoqiao; Li, Yijun

    2014-01-01

    With the development of remote sensing technology, remote-sensing satellite has been widely used in many aspects of national construction. Big data with different standards and massive users with different needs, make the satellite data delivery service to be a complex giant system. How to deliver remote-sensing satellite data efficiently and effectively is a big challenge. Based on customer service theory, this paper proposes a hierarchy conceptual model for examining the determinations of remote-sensing satellite data delivery service quality in the Chinese context. Three main dimensions: service expectation, service perception and service environment, and 8 sub-dimensions are included in the model. Large amount of first-hand data on the remote-sensing satellite data delivery service have been obtained through field research, semi-structured questionnaire and focused interview. A positivist case study is conducted to validate and develop the proposed model, as well as to investigate the service status and related influence mechanisms. Findings from the analysis demonstrate the explanatory validity of the model, and provide potentially helpful insights for future practice

  6. Relational Analysis for Delivery of Services

    DEFF Research Database (Denmark)

    Nielson, Flemming; Nielson, Hanne Riis; Bauer, Jörg

    2008-01-01

    substantially improves the precision of the results obtained while being able to deal with the full generality of the syntax of processes. The analysis reveals a feasible complexity for practical examples and gives rise to a fast prototype. We use this prototype to automatically prove the correct delivery......Many techniques exist for statically computing properties of the evolution of processes expressed in process algebras. Static analysis has shown how to obtain useful results that can both be checked and computed in polynomial time. In this paper we develop a static analysis in relational form which...... of messages for the implementation of an accident service, which is based on multiplexed communication, a crucial feature of global computing applications....

  7. Cassini CAPS Identification of Pickup Ion Compositions at Rhea

    Science.gov (United States)

    Desai, R. T.; Taylor, S. A.; Regoli, L. H.; Coates, A. J.; Nordheim, T. A.; Cordiner, M. A.; Teolis, B. D.; Thomsen, M. F.; Johnson, R. E.; Jones, G. H.; Cowee, M. M.; Waite, J. H.

    2018-02-01

    Saturn's largest icy moon, Rhea, hosts a tenuous surface-sputtered exosphere composed primarily of molecular oxygen and carbon dioxide. In this Letter, we examine Cassini Plasma Spectrometer velocity space distributions near Rhea and confirm that Cassini detected nongyrotropic fluxes of outflowing CO2+ during both the R1 and R1.5 encounters. Accounting for this nongyrotropy, we show that these possess comparable along-track densities of ˜2 × 10-3 cm-3. Negatively charged pickup ions, also detected during R1, are surprisingly shown as consistent with mass 26 ± 3 u which we suggest are carbon-based compounds, such as CN-, C2H-, C2-, or HCO-, sputtered from carbonaceous material on the moon's surface. The negative ions are calculated to possess along-track densities of ˜5 × 10-4 cm-3 and are suggested to derive from exogenic compounds, a finding consistent with the existence of Rhea's dynamic CO2 exosphere and surprisingly low O2 sputtering yields. These pickup ions provide important context for understanding the exospheric and surface ice composition of Rhea and of other icy moons which exhibit similar characteristics.

  8. Expansion in the private sector provision of institutional delivery services and horizontal equity: evidence from Nepal and Bangladesh.

    Science.gov (United States)

    Hotchkiss, David R; Godha, Deepali; Do, Mai

    2014-07-01

    Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality-Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  9. Addressing Trauma in Schools: Multitiered Service Delivery Options for Practitioners

    Science.gov (United States)

    Reinbergs, Erik J.; Fefer, Sarah A.

    2018-01-01

    Hundreds of thousands of children are confronted with traumatic experiences each year in the United States. As trauma-informed care begins to take hold in schools, school mental health providers (e.g., school psychologists, counselors, and social workers) desire concrete service-delivery options for students affected by trauma. This article…

  10. How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

    Science.gov (United States)

    Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

    2015-01-01

    This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

  11. Background and Pickup Ion Velocity Distribution Dynamics in Titan's Plasma Environment: 3D Hybrid Simulation and Comparison with CAPS T9 Observations

    Science.gov (United States)

    Lipatov, A. S.; Sittler, E. C., Jr.; Hartle, R. E.; Cooper, J. F.; Simpson, D. G.

    2011-01-01

    In this report we discuss the ion velocity distribution dynamics from the 3D hybrid simulation. In our model the background, pickup, and ionospheric ions are considered as a particles, whereas the electrons are described as a fluid. Inhomogeneous photoionization, electron-impact ionization and charge exchange are included in our model. We also take into account the collisions between the ions and neutrals. The current simulation shows that mass loading by pickup ions H(+); H2(+), CH4(+) and N2(+) is stronger than in the previous simulations when O+ ions are introduced into the background plasma. In our hybrid simulations we use Chamberlain profiles for the atmospheric components. We also include a simple ionosphere model with average mass M = 28 amu ions that were generated inside the ionosphere. The moon is considered as a weakly conducting body. Special attention will be paid to comparing the simulated pickup ion velocity distribution with CAPS T9 observations. Our simulation shows an asymmetry of the ion density distribution and the magnetic field, including the formation of the Alfve n wing-like structures. The simulation also shows that the ring-like velocity distribution for pickup ions relaxes to a Maxwellian core and a shell-like halo.

  12. Mapping the ecosystem service delivery chain: Capacity, flow, and demand pertaining to aesthetic experiences in mountain landscapes.

    Science.gov (United States)

    Egarter Vigl, Lukas; Depellegrin, Daniel; Pereira, Paulo; de Groot, Rudolf; Tappeiner, Ulrike

    2017-01-01

    Accounting for the spatial connectivity between the provision of ecosystem services (ES) and their beneficiaries (supply-benefit chain) is fundamental to understanding ecosystem functioning and its management. However, the interrelationships of the specific chain links within ecosystems and the actual benefits that flow from natural landscapes to surrounding land have rarely been analyzed. We present a spatially explicit model for the analysis of one cultural ecosystem service (aesthetic experience), which integrates the complete ecosystem service delivery chain for Puez-Geisler Nature Park (Italy): (1) The potential service stock (ES capacity) relies on an expert-based land use ranking matrix, (2) the actual supply (ES flow) is based on visibility properties of observation points along recreational routes, (3) the beneficiaries of the service (ES demand) are derived from socioeconomic data as a measure of the visitation rate to the recreation location, and (4) the supply-demand relationship (ES budget) addresses the spatially explicit oversupply and undersupply of ES. The results indicate that potential ES stocks are substantially higher in core and buffer zones of protected areas than in surrounding land owing to the specific landscape composition. ES flow maps reveal service delivery to 80% of the total area studied, with the highest actual service supply to locations with long and open vistas. ES beneficiary analyses show the highest demand for aesthetic experiences in all-season tourist destinations like Val Badia and Val Gardena, where both recreational amenity and overnight stays are equally high. ES budget maps identify ES hot and cold spots in terms of ES delivery, and they highlight ES undersupply in nature protection buffer zones although they are characterized by highest ES capacity. We show how decision/policy makers can use the presented methodology to plan landscape protection measures and develop specific regulation strategies for visitors based on

  13. First-Year Wilkinson Microwave Anisotropy Probe (WMAP) Observations: Galactic Signal Contamination from Sidelobe Pickup

    Science.gov (United States)

    Barnes, C.; Hill, R. S.; Hinshaw, G.; Page, L.; Bennett, C. L.; Halpern, M.; Jarosik, N.; Kogut, A.; Limon, M.; Meyer, S. S.; Tucker, G. S.; Wollack, E.; Wright, E. L.

    2003-09-01

    Since the Galactic center is ~1000 times brighter than fluctuations in the cosmic microwave background (CMB), CMB experiments must carefully account for stray Galactic pickup. We present the level of contamination due to sidelobes for the first-year CMB maps produced by the Wilkinson Microwave Anisotropy Probe (WMAP) observatory. For each radiometer, full 4π sr antenna gain patterns are determined from a combination of numerical prediction and ground-based and space-based measurements. These patterns are convolved with the WMAP first-year sky maps and observatory scan pattern to generate the expected sidelobe signal contamination, for both intensity and polarized microwave sky maps. When the main beams are outside of the Galactic plane, we find rms values for the expected sidelobe pickup of 15, 2.1, 2.0, 0.3, and 0.5 μK for the K, Ka, Q, V, and W bands, respectively. Except for at the K band, the rms polarized contamination is the Galactic pickup are presented. WMAP is the result of a partnership between Princeton University and the NASA Goddard Space Flight Center. Scientific guidance is provided by the WMAP Science Team.

  14. Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C Services

    Directory of Open Access Journals (Sweden)

    Jana Cason

    2012-12-01

    Full Text Available Background: Early intervention (EI services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC 2011.  EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA; however, personnel shortages, particularly in rural areas, limit access for children who qualify.  Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community.  Method:  A survey sent by the National Early Childhood Technical Assistance Center (NECTAC to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs.  Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified.  Results:  Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey.  Of these, 30% (n=9 indicated that they are either currently using telehealth as an adjunct service delivery model (n=6 or plan to incorporate telehealth within the next 1-2 years (n=3.  Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH, speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters.  Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance.  Expressed barriers and concerns for

  15. Service quality of delivered care from the perception of women with caesarean section and normal delivery.

    Science.gov (United States)

    Tabrizi, Jafar S; Askari, Samira; Fardiazar, Zahra; Koshavar, Hossein; Gholipour, Kamal

    2014-01-01

    Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 - (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women's perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. "Confidentiality", "autonomy", "choice of care provider" and "communication" achieved scores at the highest level of quality; and "support group", "prompt attention", "prevention and early detection", "continuity of care", "dignity", "safety", "accessibility and "basic amenities" got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008). A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  16. (p, α) reactions: knock-on(out) or pick-up

    International Nuclear Information System (INIS)

    Gadioli, E.

    1983-01-01

    Nothwithstanding the great lot of data collected starting from the beginning of fifties, it cannot be said that a good degree of knowledge about the (p, α) reaction mechanism has been reached. Experimental data are usually interpreted or on the basis of a pure pick-up or knock-on(out) mechanism, though many results suggest the importance of both mechanism

  17. Characterization of BPM pickup designs for the HESR rate at FAIR using simulations and numerical calculations

    Energy Technology Data Exchange (ETDEWEB)

    Halama, Arthur; Kamerdzhiev, Vsevolod; Boehme, Christian; Srinivasan, Sudharsan [Forschungszentrum Juelich, IKP-4 (Germany)

    2016-07-01

    The institute of Nuclear Physics 4(IKP-4) of the Research Center Juelich (FZJ) is in charge of building and commissioning the High Energy Storage Ring (HESR) within the international Facility for Antiproton and Ion Research (FAIR) at Darmstadt. Simulations and numerical calculations were performed to characterize the initial beam position pickup design. Capacitive couplings of the electrodes and the behavior of the electrical equivalent circuit were investigated. This made room for changes to the design and performance increase. A prototype of the BPM pickup was constructed and tested on a dedicated test bench. Preliminary results will be presented. In order to gain higher signal levels and higher sensitivity, another suggested design was characterized as well and put into comparison.

  18. Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study.

    Science.gov (United States)

    Amano, Abdella; Gebeyehu, Abebaw; Birhanu, Zelalem

    2012-10-08

    Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. A community-based cross-sectional survey was conducted from April 1-20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40), women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78), women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97) and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89) were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46) and AOR = 2.77 (95%CI: 1.07, 7.19) respectively. Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended.

  19. Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Amano Abdella

    2012-10-01

    Full Text Available Abstract Background Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. Methods A community-based cross-sectional survey was conducted from April 1–20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Results Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40, women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78, women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97 and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89 were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46 and AOR = 2.77 (95%CI: 1.07, 7.19 respectively. Conclusion Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended.

  20. What Skills and Tactics Are Needed to Play Adult Pick-Up Basketball Games?

    Science.gov (United States)

    Wang, Jianyu; Liu, Wenhao; Moffit, Jeffrey

    2010-01-01

    The purpose of this study was to examine skill levels and performance patterns of regular players of pick-up basketball games. By a survey, 65 participants were identified as regular players and participated in the study. An observational instrument used to analyze game performance of the participants was developed and both content and construct…

  1. The ATLAS beam pick-up based timing system

    International Nuclear Information System (INIS)

    Ohm, C.; Pauly, T.

    2010-01-01

    The ATLAS BPTX stations are composed of electrostatic button pick-up detectors, located 175 m away along the beam pipe on both sides of ATLAS. The pick-ups are installed as a part of the LHC beam instrumentation and used by ATLAS for timing purposes. The usage of the BPTX signals in ATLAS is twofold: they are used both in the trigger system and for LHC beam monitoring. The BPTX signals are discriminated with a constant-fraction discriminator to provide a Level-1 trigger when a bunch passes through ATLAS. Furthermore, the BPTX detectors are used by a stand-alone monitoring system for the LHC bunches and timing signals. The BPTX monitoring system measures the phase between collisions and clock with a precision better than 100 ps in order to guarantee a stable phase relationship for optimal signal sampling in the sub-detector front-end electronics. In addition to monitoring this phase, the properties of the individual bunches are measured and the structure of the beams is determined. On September 10, 2008, the first LHC beams reached the ATLAS experiment. During this period with beam, the ATLAS BPTX system was used extensively to time in the read-out of the sub-detectors. In this paper, we present the performance of the BPTX system and its measurements of the first LHC beams.

  2. Sodium Pick-Up Ion Observations in the Solar Wind Upstream of Mercury

    Science.gov (United States)

    Jasinski, J. M.; Raines, J. M.; Slavin, J. A.; Regoli, L. R.; Murphy, N.

    2018-05-01

    We present the first observations of sodium pick-up ions upstream of Mercury’s magnetosphere. From these observations we infer properties of Mercury’s sodium exosphere and implications for the solar wind interaction with Mercury’s magnetosphere.

  3. Perceptions of International Students on Service Quality Delivery in a Malaysian Public University

    Science.gov (United States)

    Njie, Baboucarr; Asimiran, Soaib; Baki, Roselan

    2012-01-01

    Purpose: The purpose of this study is to explore the perceptions of international students of service quality delivery (SQD) in a Malaysian public university. Design/methodology/approach: The study was limited to the University's immediate physical environment and its associated human and systems-based services. The physical environment in this…

  4. Utilization of clean and safe delivery service package of health services extension program and associated factors in rural kebeles of Kafa Zone, Southwest Ethiopia.

    Science.gov (United States)

    Bayou, Negalign Berhanu; Gacho, Yohannes Haile Michael

    2013-07-01

    In Ethiopia, 94% of births take place at home unattended by trained persons. The government introduced an innovative strategy, Health Services Extension Program in 2003. Clean and safe delivery service is a component of maternal and child healthcare package of the program. However, little is known about the status of uptake of the service. This study thus aimed to assess utilization of clean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia. A community based cross sectional survey was conducted in rural kebeles of Kefa Zone from January 21(st) to February 25(th), 2009 using a sample of 229 mothers. Kafa Zone is located 465 kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structured questionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. Phistory of abortion, knowledge of danger signs and antenatal care attendance. Educating women and improving their knowledge about danger signs of pregnancy and labor is recommended. Health extension workers should consider antenatal care visits as opportunities for this purpose.

  5. PACS and diagnostic imaging service delivery-A UK perspective

    International Nuclear Information System (INIS)

    Sutton, Laurence N.

    2011-01-01

    This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

  6. Innovative health service delivery models in low and middle income countries - what can we learn from the private sector?

    Science.gov (United States)

    Bhattacharyya, Onil; Khor, Sara; McGahan, Anita; Dunne, David; Daar, Abdallah S; Singer, Peter A

    2010-07-15

    The poor in low and middle income countries have limited access to health services due to limited purchasing power, residence in underserved areas, and inadequate health literacy. This produces significant gaps in health care delivery among a population that has a disproportionately large burden of disease. They frequently use the private health sector, due to perceived or actual gaps in public services. A subset of private health organizations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor through innovative health service delivery models. This study aims to characterize these models and identify areas of innovation that have led to effective provision of care for the poor. An environmental scan of peer-reviewed and grey literature was conducted to select exemplars of innovation. A case series of organizations was then purposively sampled to maximize variation. These cases were examined using content analysis and constant comparison to characterize their strategies, focusing on business processes. After an initial sample of 46 studies, 10 case studies of exemplars were developed spanning different geography, disease areas and health service delivery models. These ten organizations had innovations in their marketing, financing, and operating strategies. These included approaches such a social marketing, cross-subsidy, high-volume, low cost models, and process reengineering. They tended to have a narrow clinical focus, which facilitates standardizing processes of care, and experimentation with novel delivery models. Despite being well-known, information on the social impact of these organizations was variable, with more data on availability and affordability and less on quality of care. These private sector organizations demonstrate a range of innovations in health service delivery that have the potential to better serve the poor's health needs and be

  7. Innovative health service delivery models in low and middle income countries - what can we learn from the private sector?

    Directory of Open Access Journals (Sweden)

    Daar Abdallah S

    2010-07-01

    Full Text Available Abstract Background The poor in low and middle income countries have limited access to health services due to limited purchasing power, residence in underserved areas, and inadequate health literacy. This produces significant gaps in health care delivery among a population that has a disproportionately large burden of disease. They frequently use the private health sector, due to perceived or actual gaps in public services. A subset of private health organizations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor through innovative health service delivery models. This study aims to characterize these models and identify areas of innovation that have led to effective provision of care for the poor. Methods An environmental scan of peer-reviewed and grey literature was conducted to select exemplars of innovation. A case series of organizations was then purposively sampled to maximize variation. These cases were examined using content analysis and constant comparison to characterize their strategies, focusing on business processes. Results After an initial sample of 46 studies, 10 case studies of exemplars were developed spanning different geography, disease areas and health service delivery models. These ten organizations had innovations in their marketing, financing, and operating strategies. These included approaches such a social marketing, cross-subsidy, high-volume, low cost models, and process reengineering. They tended to have a narrow clinical focus, which facilitates standardizing processes of care, and experimentation with novel delivery models. Despite being well-known, information on the social impact of these organizations was variable, with more data on availability and affordability and less on quality of care. Conclusions These private sector organizations demonstrate a range of innovations in health service delivery that have

  8. Seasonal variation of Martian pick-up ions: Evidence of breathing exosphere

    Science.gov (United States)

    Yamauchi, M.; Hara, T.; Lundin, R.; Dubinin, E.; Fedorov, A.; Sauvaud, J.-A.; Frahm, R. A.; Ramstad, R.; Futaana, Y.; Holmstrom, M.; Barabash, S.

    2015-12-01

    The Mars Express (MEX) Ion Mass Analyser (IMA) found that the detection rate of the ring-like distribution of protons in the solar wind outside of the bow shock to be quite different between Mars orbital summer (around perihelion) and orbital winter (around aphelion) for four Martian years, while the north-south asymmetry is much smaller than the perihelion-aphelion difference. Further analyses using eight years of MEX/IMA solar wind data between 2005 and 2012 has revealed that the detection frequency of the pick-up ions originating from newly ionized exospheric hydrogen with certain flux strongly correlates with the Sun-Mars distance, which changes approximately every two years. Variation due to the solar cycle phase is not distinguishable partly because this effect is masked by the seasonal variation under the MEX capability of plasma measurements. This finding indicates that the variation in solar UV has a major effect on the formation of the pick-up ions, but this is not the only controlling factor.

  9. Testbeam Studies on Pick-Up in Sensors with Embedded Pitch Adapters

    CERN Document Server

    Rehnisch, Laura; The ATLAS collaboration

    2018-01-01

    Embedded pitch adapters are an alternative solution to external pitch adapters widely used to facilitate the wire-bonding step when connecting silicon strip sensors and readout electronics of different pitch. The pad-pitch adaption can be moved into the sensor fabrication step by implementing a second layer of metal tracks, connected by vias to the primary metal layer of sensor strips. Such a solution, however, might bear the risk of performance losses introduced by various phenomena. One of these effects, the undesired capacitive coupling between the silicon bulk and this second metal layer (pick-up) has been investigated in photon testbeam measurements. For a worst-case embedded pitch adapter design, expected to be maximally susceptible to pick-up, a qualitative analysis has visualized the effect as a function of the location on the second metal layer structure. It was further found that the unwanted effect decreases towards expected values for operating thresholds of the binary readout used. Suggestions fo...

  10. Influence of Students’ Feedback on the Quality of Adult Higher Distance Education Service Delivery

    Directory of Open Access Journals (Sweden)

    Akpovire ODUARAN

    2017-10-01

    Full Text Available The evaluation of a program’s compliance with service delivery and features necessary for the attainment of the programs educational objectives, student outcomes and continuous improvement is an important element in program accreditation and continuous improvement process. The study reported in this paper investigated the possible effects of students’ feedback on the improvement of adult higher education distance learning service quality in a South African rural-based university. The study interrogated the service provision factors that seemingly helped in improving the delivery of the program. Such information are vital for planning, good governance, policy formulation, monitoring and evaluation, and for decision-making. The study used a quantitative descriptive statistics analysis of data generated ranging from 2013-2014. It comprised of overall student satisfaction as the dependent variable and the explanatory variables were given by program management, facilitation, assessment, learner support, systems, resources, program outcomes and subject matter. Analytical results were obtained from the Mann Whitney Test. The population consisted of students enrolled in the Advanced Certificate in Education (ACE program by distance mode. The 313 respondents sampled were randomly selected from a total population of 916 students. Data were collected using a semi-structured questionnaire. The results revealed that service qualities linked to effective management, facilitation, academic support and subject matter delivery were the main qualities that the students recommended for the improvement of the program. It is therefore recommended that adult higher education programs must have a documented systematically utilized and effective process involving program service delivery constituencies like assessment, academic support and resources provided, for the periodic review of the program educational objectives to ensure that the program remains consistent

  11. Going the distance: Service delivery for the Danish National swimming team during the Olympics

    DEFF Research Database (Denmark)

    Larsen, Carsten Hvid

    In this presentation I will outline the service delivery for the Danish National swimming team and provide an example of my work based on mindfulness and acceptance and commitment therapy (ACT) with an individual swimmer during the Olympics. Being part of the Olympics involves a range of stressors...... and distractions such as a tight packed swimming schedule (up to 12 starts across seven days), a lot of media attention, social media, others and own expectations. In my service delivery during the Olympics I tried to create an awareness of these stressors and distractions. On a normal day at the Olympics I had...

  12. Does co-creation impact public service delivery? The importance of state and governance traditions

    NARCIS (Netherlands)

    Voorberg, Willem; Bekkers, Victor; Flemig, Sophie; Timeus, Krista; Tõnurist, Piret; Tummers, L.G.

    2017-01-01

    Co-creation in public service delivery requires partnerships between citizens and civil servants. The authors argue that whether or not these partnerships will be successful depends on state and governance traditions (for example a tradition of authority sharing or consultation). These traditions

  13. The Effect of Service Compact (SERVICOM) on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    OpenAIRE

    Jude Kennedy Emejulu; M. C. Muo; E. E.O. Chukwuemeka

    2014-01-01

    This study examined the effect of service compact (Servicom Service delivery) in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that requir...

  14. Characteristics of Indigenous primary health care models of service delivery: a scoping review protocol.

    Science.gov (United States)

    Harfield, Stephen; Davy, Carol; Kite, Elaine; McArthur, Alexa; Munn, Zachary; Brown, Ngiare; Brown, Alex

    2015-11-01

    The objective of the scoping review is to identify and describe within the existing literature the characteristics (values, principles, components and suggest practical applications) of primary health care models of service delivery for Indigenous people. More specifically, the review question is:What are the characteristics (values, principles, components and suggested practical applications) of primary health care models of service delivery for Indigenous people?Findings from this scoping review will inform two systematic reviews. One of these will explore the acceptability and the other the effectiveness of identified characteristics. The scoping review will follow the JBI Scoping Review methodology as outlined in the 2015 Joanna Briggs Institute Reviewers' Manual. Indigenous populations in colonized countries experience worse health outcomes relative to their non-Indigenous counterparts. In Australia, in the period 2010 to 2012 the estimated gap in life expectancy between Aboriginal and Torres Strait Islander Australians compared to non-Indigenous Australians was 10 years Similar gaps in life expectancy between Indigenous and non-Indigenous have been demonstrated in other countries, such as New Zealand, Canada and the United StatesThe gap in life expectancy and the health disadvantage experienced by Indigenous people is in part the result of mainstream health services not adequately meeting the health needs of Indigenous people and Indigenous people's inability to access mainstream services Part of the solution has been the establishment of primary health care services for and in many cases run by Indigenous people. Indigenous primary health services have been developed to provide culturally appropriate services that meet the needs of local Indigenous communities.In Australia, the first Aboriginal medical service was established in 1971 in Redfern, New South Wales, by "community activists in response to ongoing discrimination against Aboriginal people within

  15. Assessment of pharmacists' delivery of public health services in rural and urban areas in Iowa and North Dakota.

    Science.gov (United States)

    Scott, David M; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists' delivery of public health services. To assess Iowa and North Dakota pharmacists' practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

  16. The value of express delivery services for cross-border e-commerce in European Union markets

    NARCIS (Netherlands)

    T.Y. Kim (Thai Young); R. Dekker (Rommert); C. Heij (Christiaan)

    2016-01-01

    textabstractFurther growth of cross-border e-commerce in the European Union markets requires improved express delivery services. The framework presented in this paper identifies relevant contextual factors that affect express delivery adoption rates in European cross-border e-commerce. This

  17. Service Quality of Delivered Care from the Perception of Women with Caesarean Section and Normal Delivery

    Directory of Open Access Journals (Sweden)

    Jafar S. Tabrizi

    2014-12-01

    Full Text Available Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance based on importance and performance of service quality aspects from the postpartum women‟s perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. Results: “Confidentiality”, “autonomy”, “choice of care provider” and “communication” achieved scores at the highest level of quality; and “support group”, “prompt attention”, “prevention and early detection”, “continuity of care”, “dignity”, “safety”, “accessibility and “basic amenities” got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008. Conclusion: A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  18. Reforming health service delivery at district level in Ghana: the perspective of a district medical officer.

    Science.gov (United States)

    Agyepong, I A

    1999-03-01

    Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper examines aspects of health services delivery, and trends in utilization and coverage, using routine data over time in the Dangme West district of the Greater Accra region of Ghana, from the perspective of a district health manager. Specific interventions through which health services delivery and utilization at district level could be improved are suggested. Suggestions include raising awareness among care providers and health managers that increased resource availability is only a success in so far as it leads to improvements in coverage, utilization and quality; and developing indicators of performance which assess and reward use of resources at the local level to improve coverage, utilization and quality. Also needed are more flexibility in Central Government regulations for resource allocation and use; integration of service delivery at district level with more decentralized planning to make services better responsive to local needs; changes in basic and inservice training strategies; and exploration of how the public and private sectors can effectively collaborate to achieve maximum coverage and quality of care within available resources.

  19. Role Of E-Government In Delivery Of Public Services In Tanzania Electric Supply Company In Ruvuma Region Tanzania

    Directory of Open Access Journals (Sweden)

    Emmanuel Jackson Petro Gunda

    2015-06-01

    Full Text Available ABSTRACT E-government facilitates delivery of public services of relevant government information in electronic form to citizens in a timely manner and better service delivery to citizens. E-government is a kind of governmental administration which is based on Information Communication and Technology Services. Electronic government describes the use of technologies to facilitate the operation of government and disperse of government information and services. The scope of the work was limited to Tanzania Electric Supply Company Limited TANESCO in Ruvuma region. The population of thirty 31 were selected from a total population of 169 public servants use both purposive and stratified random sampling techniques applied. The major findings of study revealed that about 67.7 of response from respondents agree that ICT infrastructures specifically modern computer connected to internet reliable internet speed well organized organization website power availability in public operation contribute to efficient in delivery of services it also noted by respondents to faster decision making speeding up transaction processing and reduce cost. The study greatly recommends that capacity building to public servants on ICT install and strengthening ICT infrastructures to government organizational are inevitable to realise relevant role of e-government in delivery of public services.

  20. An experiment framework to identify community functional components driving ecosystem processes and services delivery.

    NARCIS (Netherlands)

    Dias, A.; Berg, M.P.; de Bello, F.; van Oosten, A.R.; Bila, K.; Moretti, M.

    2013-01-01

    There is a growing consensus that the distribution of species trait values in a community can greatly determine ecosystem processes and services delivery. Two distinct components of community trait composition are hypothesized to chiefly affect ecosystem processes: (i) the average trait value of the

  1. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

    Science.gov (United States)

    Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

    2013-09-01

    To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

  2. Systems modelling and simulation in health service design, delivery and decision making.

    Science.gov (United States)

    Pitt, Martin; Monks, Thomas; Crowe, Sonya; Vasilakis, Christos

    2016-01-01

    The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. 47 CFR 74.431 - Special rules applicable to remote pickup stations.

    Science.gov (United States)

    2010-10-01

    ... occur outside the studio back to studio or production center. The transmitted material shall be intended... system. (b) Remote pickup mobile or base stations may be used for communications related to production..., Hawaii, Puerto Rico, and the Virgin Islands may be used for any purpose related to the programming or...

  4. Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana

    Directory of Open Access Journals (Sweden)

    Abbey Mercy

    2005-12-01

    Full Text Available Abstract Background This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana. Methods Twenty-one individual in-depth interviews and two focus group discussions were conducted with women of reproductive age who had delivered in the past five years in the Greater Accra Region. The study investigated women's perceptions and experiences of care in terms of factors that influenced place of delivery, satisfaction with services, expectations of care and whether they would recommend services. Results One component of care which appeared to be of great importance to women was staff attitudes. This factor had considerable influence on acceptability and utilisation of services. Otherwise, a successful labour outcome and non-medical factors such as cost, perceived quality of care and proximity of services were important. Our findings indicate that women expect humane, professional and courteous treatment from health professionals and a reasonable standard of physical environment. Women will consciously change their place of delivery and recommendations to others if they experience degrading and unacceptable behaviour. Conclusion The findings suggest that inter-personal aspects of care are key to women's expectations, which in turn govern satisfaction. Service improvements which address this aspect of care are likely to have an impact on health seeking behaviour and utilisation. Our findings suggest that user-views are important and warrant further investigation. The views of providers should also be investigated to identify channels by which service improvements, taking into account women's views, could be operationalised. We also recommend that interventions to improve delivery care should not only be directed to the health professional, but also to general health system improvements.

  5. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Mihiretu Alemayehu Arba

    Full Text Available The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones.A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively.Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery.The use of institutional delivery service is

  6. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

    Science.gov (United States)

    Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

    2016-01-01

    The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. The use of institutional delivery service is low in the study

  7. HTS planar gradiometer consisting of SQUID with multi-turn input coil and large pickup coil made of GdBCO coated conductor

    International Nuclear Information System (INIS)

    Tsukamoto, Akira; Adachi, Seiji; Oshikubo, Yasuo; Hato, Tsunehiro; Enpuku, Keiji; Sugisaki, Masaki; Arai, Eiichi; Tanabe, Keiichi

    2013-01-01

    Highlights: ► We fabricated a large HTS gradiometer with 350-mm-long baseline. ► A 6-turn gradiometric planar pickup was made of a HTS coated conductor. ► A 26-turn HTS input coil chip was stacked on a HTS thin film gradiometer chip. ► A mechanical balancing structure was also implemented. ► The fabricated gradiometer showed a gradient field noise of 0.8 fT/cm Hz 1/2 . -- Abstract: We have investigated the fabrication of a high-temperature superconducting (HTS) gradiometer with long baseline for geophysical applications. The proof-of-concept gradiometer using a 1-turn pickup coil made of a GdBa 2 Cu 3 O y coated conductor (GCC) and 5.5-turn input coil integrated on a SQUID was fabricated in our previous work. In this study, we have optimized the device structure to improve the frequency response, gradient field sensitivity and gradiometer balance. The fabricated flux transformer consists of a 6-turn planar gradiometric pickup coil and a 26-turn input coil made of an HTS thin film. A low-melting-point alloy was used to connect polished Ag surfaces of the CGG pickup coil and Au pads of the input coil. An HTS SQUID was formed on another substrate and stacked on the input coil. A mechanical balancing structure using three pieces of GCC as a superconducting shield was also implemented. The fabricated gradiometer showed a gradient field noise of 0.8 fT/cm Hz 1/2 in the white noise regions, a gradiometer balance of 1/142, and a cutoff frequency of 9 Hz corresponding to a 2 mΩ contact resistance between the pickup coil and the input coil

  8. The value of express delivery services for cross-border e-commerce in European Union markets

    OpenAIRE

    Kim, Thai Young; Dekker, Rommert; Heij, Christiaan

    2016-01-01

    textabstractFurther growth of cross-border e-commerce in the European Union markets requires improved express delivery services. The framework presented in this paper identifies relevant contextual factors that affect express delivery adoption rates in European cross-border e-commerce. This framework leads to a set of hypotheses, both on the effects of express deliveries on financial performance indicators (order incidence, order size, and repurchase rate) and on the factors that drive demand...

  9. 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

  10. Addressing service delivery in rural areas through deployment of information and communication technology platforms

    CSIR Research Space (South Africa)

    Foko, Thato E

    2017-05-01

    Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...

  11. Diffusion of electronic service delivery innovations: the case of e-policing

    NARCIS (Netherlands)

    E.H. Korteland (Evelien); V.J.J.M. Bekkers (Victor)

    2009-01-01

    textabstractThis article examines the diffusion and adoption process of an electronic service delivery innovation, which can be seen as an example of e-policing – called SMS-alert – among Dutch police forces. Important is not only to pay attention to the question how an innovation has spread - and

  12. Equity and financing for sexual and reproductive health service delivery: current innovations.

    Science.gov (United States)

    Montagu, Dominic; Graff, Maura

    2009-07-01

    National and international decisions on financing for sexual and reproductive health (SRH) services have profound effects on the type, unit costs and distribution of SRH commodities and services produced, and on their availability and consumption. Much international and national funding is politically driven and is doing little for equity and quality improvement. Financing remains a significant challenge in most developing countries and demands creative responses. While no "one-size-fits-all" solution exists, there are numerous ongoing examples of successful innovations, many of which are focusing on resource pooling and on purchasing or subsidising SRH services. In this article we have used interviews, grey literature and presentations made at a range of recent public fora to identify new and innovative ways of financing SRH services so as to increase equity in developing countries. Because SRH services are often of low value as a personal good but high value as a public good, we summarise the issues from a societal perspective, highlighting the importance of financing and policy decisions for SRH services. We provide a structured overview of what novel approaches to financing appear to have positive effects in a range of developing countries. Targeting, government payment mechanisms, subsidy delivery and co-financing for sustainability are highlighted as showing particular promise. Examples are used throughout the article to illustrate innovative strategies.

  13. Integration and transformation of rural service delivery: The role of management information and decision support systems

    CSIR Research Space (South Africa)

    Mashiri, M

    2005-01-01

    Full Text Available The paper deals with two main themes: 1) the integration and transformation of rural service delivery; and 2) role of management information and decision support systems in this process. Referring specifically to the types of rural areas, conditions...

  14. Preliminary Specifications for the PS Pick-ups Amplifier to be used in the Transverse Damping System

    CERN Document Server

    Belleman, J; CERN. Geneva. AB Department

    2003-01-01

    The pick-up amplification stage to be used for the CODD in the PS is presently under redesign. It appears that the constraints for the circuit are very similar to those of the transverse feedback project. The AB/BDI group and in particular its PI section has kindly agreed to fulfil the RF group constraints so as to obtain a common design with a common control interface. The reliability aspect is not treated here. Nevertheless radiation has been considered. At the locations foreseen for the pick-ups (SS 2, 94, 98), the annual dose measured on the vacuum chamber (ref: CERN-TIS-2002-06-TE) is about 1000 Gray per year. This value is to be compared to the 100 Gy considered as the critical dose for electronic circuits. The radiation problem has been solved for the CODD pick-ups using distance and shield (active circuits 2 meters below the floor composed of concrete slabs). The same lay out will be applied for the dampers with the drawback of the capacitive plates being loaded with a low impedance -5 meters long- ca...

  15. Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

    Science.gov (United States)

    Gudu, William; Addo, Bright

    2017-05-31

    Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great

  16. Delivery through innovation: CSIR research on water services infrastructure operation through franchising

    CSIR Research Space (South Africa)

    Wall, K

    2006-02-01

    Full Text Available There is a great need for institutional innovations aimed at improving access to basic water services in South Africa, and sustaining that improvement. In support of effective delivery, the CSIR, with the support of the Water Research Commission...

  17. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hassen Kebede

    2014-11-01

    Full Text Available Poor livestock health services remain one of the main constraints to livestock production in many developing countries, including Ethiopia. A study was carried out in 11 districts of North Gondar, from December 2011 to September 2012, with the objective of identifying the existing status and constraints of animal health service delivery, and thus recommending possible alternatives for its sustainable improvement. Data were collected by using pre-tested questionnaires and focus group discussion. Findings revealed that 46.34% of the responding farmers had taken their animals to government veterinary clinics after initially trying treatments with local medication. More than 90.00% of the clinical cases were diagnosed solely on clinical signs or even history alone. The antibacterial drugs found in veterinary clinics were procaine penicillin (with or without streptomycin, oxytetracycline and sulphonamides, whilst albendazole, tetramisole and ivermectin were the only anthelmintics. A thermometer was the only clinical aid available in all clinics, whilst only nine (45.00% clinics had a refrigerator. In the private sector, almost 95.00% were retail veterinary pharmacies and only 41.20% fulfilled the requirement criteria set. Professionals working in the government indicated the following problems: lack of incentives (70.00%, poor management and lack of awareness (60.00% and inadequate budget (40.00%. For farmers, the most frequent problems were failure of private practitioners to adhere to ethical procedures (74.00% and lack of knowledge of animal diseases and physical distance from the service centre (50.00%. Of all responding farmers, 58.54% preferred the government service, 21.14% liked both services equally and 20.33% preferred the private service. Farmers’ indiscriminate use of drugs from the black market (23.00% was also mentioned as a problem by private practitioners. Sustainable improvement of animal health service delivery needs increased

  18. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia.

    Science.gov (United States)

    Kebede, Hassen; Melaku, Achenef; Kebede, Elias

    2014-11-12

    Poor livestock health services remain one of the main constraints to livestock production in many developing countries, including Ethiopia. A study was carried out in 11 districts of North Gondar, from December 2011 to September 2012, with the objective of identifying the existing status and constraints of animal health service delivery, and thus recommending possible alternatives for its sustainable improvement. Data were collected by using pre-tested questionnaires and focus group discussion. Findings revealed that 46.34% of the responding farmers had taken their animals to government veterinary clinics after initially trying treatments with local medication. More than 90.00% of the clinical cases were diagnosed solely on clinical signs or even history alone. The antibacterial drugs found in veterinary clinics were procaine penicillin (with or without streptomycin), oxytetracycline and sulphonamides, whilst albendazole, tetramisole and ivermectin were the only anthelmintics. A thermometer was the only clinical aid available in all clinics, whilst only nine (45.00%) clinics had a refrigerator. In the private sector, almost 95.00% were retail veterinary pharmacies and only 41.20% fulfilled the requirement criteria set. Professionals working in the government indicated the following problems: lack of incentives (70.00%), poor management and lack of awareness (60.00%) and inadequate budget (40.00%). For farmers, the most frequent problems were failure of private practitioners to adhere to ethical procedures (74.00%) and lack of knowledge of animal diseases and physical distance from the service centre (50.00%). Of all responding farmers, 58.54% preferred the government service, 21.14% liked both services equally and 20.33% preferred the private service. Farmers' indiscriminate use of drugs from the black market (23.00%) was also mentioned as a problem by private practitioners. Sustainable improvement of animal health service delivery needs increased awareness for all

  19. Organisation and delivery of imaging services: The contributions of ethics and political economy

    International Nuclear Information System (INIS)

    Durand-Zaleski, I.

    2009-01-01

    The objective of this discussion is to explore how theories from other disciplines can contribute to the debate on organisation and delivery of diagnostic and therapeutic exposures. The first part explores how theories of justice suggest that health services should be provided; the second part explores how stakeholders in the field of public health and health care incorporate their own strategies in the deployment of health technologies and health-care programmes. (authors)

  20. A Data-driven Model of the Solar Wind, Interstellar Pickup Ions, and Turbulence Throughout the Interplanetary Space

    Science.gov (United States)

    Kim, T. K.; Kryukov, I.; Pogorelov, N. V.; Elliott, H. A.; Zank, G. P.

    2017-12-01

    The outer heliosphere is an interesting region characterized by the interaction between the solar wind and the interstellar neutral atoms. Having accomplished the mission to Pluto in 2015 and currently on the way to the Kuiper Belt, the New Horizons spacecraft is following the footsteps of the two Voyager spacecraft that previously explored this region lying roughly beyond 30 AU from the Sun. We model the three-dimensional, time-dependent solar wind plasma flow to the outer heliosphere using our own software Multi-Scale Fluid-Kinetic Simulation Suite (MS-FLUKSS), which, in addition to the thermal solar wind plasma, takes into account charge exchange of the solar wind protons with interstellar neutral atoms and treats nonthermal ions (i.e., pickup ions) born during this process as a separate fluid. Additionally, MS-FLUKSS allows us to model turbulence generated by pickup ions. We use MS-FLUKSS to investigate the evolution of plasma and turbulent fluctuations along the trajectory of the New Horizons spacecraft using plasma and turbulence parameters from OMNI data as time-dependent boundary conditions at 1 AU for the Reynolds-averaged MHD equations. We compare the model with in situ plasma observations by New Horizons, Voyager 2, and Ulysses. We also compare the model pickup proton parameters with those derived from the Ulysses-SWICS data.

  1. Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study.

    Science.gov (United States)

    Cottrell, Michelle A; Hill, Anne J; O'Leary, Shaun P; Raymer, Maree E; Russell, Trevor G

    2017-12-01

    The Neurosurgical & Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC&MDS) originated as a complementary, non-surgical pathway for patients referred to public neurosurgical and orthopaedic specialist services. Patient access to the N/OPSC&MDS could potentially be improved with the implementation of telerehabilitation as an additional method of service delivery. To evaluate service provider's views on (1) current barriers to patients' accessing N/OPSC & MD services, and (2) the implementation of telerehabilitation within the N/OPSC&MDS. Qualitative descriptive study design. Healthcare providers (n = 26) were recruited from six N/OPSC&MD services located throughout Queensland, Australia. Semi-structured interviews were conducted to explore service providers' views with respect to existing barriers to patients accessing the N/OPSC&MDS, and if telerehabilitation could be feasibly adopted to address current barriers. Template analysis resulted in six themes: (1) barriers to some patients' accessing current N/OPSC&MD services are complex & multifaceted; (2) telerehabilitation could improve patient access to appropriate management for their musculoskeletal condition; (3) telerehabilitation may have limitations when compared to face-to-face healthcare; (4) the delivery of telerehabilitation needs to be flexible; (5) perceived barriers, and (6) facilitators to the successful implementation of telerehabilitation within the N/OPSC&MDS. This study represents a critical step in determining the readiness of service providers for the implementation of telerehabilitation within the N/OPSC&MDS. Although cautious, service providers are overall accepting of the implementation of telerehabilitation, acknowledging that it could eliminate several current barriers, subsequently achieving more equitable access to the service. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. The morphological /settlement pattern classification of South African settlements based on a settlement catchment approach, to inform facility allocation and service delivery

    CSIR Research Space (South Africa)

    Sogoni, Z

    2016-07-01

    Full Text Available / settlement pattern classification of South African settlements based on a settlement catchment approach, to inform facility allocation and service delivery Zukisa Sogoni Planning Africa Conference 2016 4 July 2Project Focus and Background • CSIR... services. • Purpose is to support application & planning for new investment & prevent “unsustainable” investments / White elephants. 3Outputs • National set of service delivery catchments • Profile information per individual catchment • Ranking...

  3. Pickup design for high bandwidth bunch arrival-time monitors in free-electron lasers

    Energy Technology Data Exchange (ETDEWEB)

    Angelovski, Aleksandar; Penirschke, Andreas; Jakoby, Rolf [TU Darmstadt (Germany). Institut fuer Mikrowellentechnik und Photonik; Kuhl, Alexander; Schnepp, Sascha [TU Darmstadt (Germany). Graduate School of Computational Engineering; Bock, Marie Kristin; Bousonville, Michael; Schlarb, Holger [Deutsches Elektronen-Synchrotron DESY, Hamburg (Germany); Weiland, Thomas [TU Darmstadt (Germany). Institut fuer Theorie Elektromagnetischer Felder

    2012-07-01

    The increased demands for low bunch charge operation mode in the free-electron lasers (FELs) require an upgrade of the existing synchronization equipment. As a part of the laser-based synchronization system, the bunch arrival-time monitors (BAMs) should have a sub-10 femtosecond precision for high and low bunch charge operation. In order to fulfill the resolution demands for both modes of operation, the bandwidth of such a BAM should be increased up to a cutoff frequency of 40 GHz. In this talk, we present the design and the realization of high bandwidth cone-shaped pickup electrodes as a part of the BAM for the FEL in Hamburg (FLASH) and the European X-ray free-electron laser (European XFEL). The proposed pickup was simulated with CST STUDIO SUITE, and a non-hermetic model was built up for radio frequency (rf) measurements.

  4. Using attachment theory to inform the design and delivery of mental health services: a systematic review of the literature.

    Science.gov (United States)

    Bucci, Sandra; Roberts, Nicola H; Danquah, Adam N; Berry, Katherine

    2015-03-01

    The aim of this review was to propose and describe the design and delivery of an attachment-informed general mental health service. We systematically searched the PsycINFO, MEDLINE, Web of Knowledge, COPAC, CINAHL, and Science Direct databases from 1960 to 2013. We also searched reference lists of relevant papers and directly contacted authors in the field. Literature describing attachment theory and its applicability in designing and delivering general mental health services was synthesized using thematic analysis. Papers published in English, books or chapters in edited books that described applying attachment theory in designing and delivering mental health services for adults and adolescents were included in the review. Of the 1,105 articles identified, 14 met inclusion criteria for the review. Eight key themes, and four subthemes, were extracted and organized to reflect the experience of a service user moving through the mental health system. Key themes extracted were as follows: service policy and evaluation; referrals; assessment and formulation; intervention; support for staff; support for carers; moving on; and potential service benefits. Papers reviewed suggested that service users with severe mental health problems have attachment needs that should be met in general mental health services. Attachment theory provides a useful framework to inform the design and delivery of general mental health services. The resource implications for services are discussed, as are limitations of the review and recommendations for future research. Attachment theory should be used to inform the design and delivery of general mental health services. Mental health services should evaluate the extent to which they meet service users' attachment needs. Attachment-informed mental health services should assess outcomes, including cost-effectiveness over time. Papers included in this review focus on long-stay residential care or secure services and there is a limited experimental

  5. Assessment of pharmacists’ delivery of public health services in rural and urban areas in Iowa and North Dakota

    Science.gov (United States)

    Scott, David M.; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking. PMID:28042356

  6. Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study.

    Science.gov (United States)

    Habte, Feleke; Demissie, Meaza

    2015-11-17

    Ethiopia is one of the six countries that contributes' to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia. A community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression. A total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband's attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2(nd) youngest child were found to have statistically significant association with institutional delivery. Institutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service

  7. Predisposing, enabling, and need factors associated with utilization of institutional delivery services: A community-based cross-sectional study in far-western Nepal.

    Science.gov (United States)

    Freidoony, Leila; Ranabhat, Chhabi Lal; Kim, Chun-Bae; Kim, Chang-Soo; Ahn, Dong-Won; Doh, Young Ah

    2018-01-01

    Use of institutional delivery services can be effective in reducing maternal and infant mortality. In Nepal, however, the majority of women deliver at home. Using Andersen's behavioral model of use of health care services, this cross-sectional study aimed to identify factors associated with use of institutional delivery services in four villages and one municipality in Kailali district, Nepal. Mothers (N = 500) who had given birth in the 5 years preceding the survey (conducted between January and February 2015) were randomly selected by cluster sampling and interviewed using a semi-structured questionnaire. Bivariate analyses and multivariate hierarchical logistic regression analyses were performed. Among the women surveyed, 65.6% had used institutional delivery services for their last delivery, a higher proportion than the national average. Primiparity, having a secondary or higher education level, living in the Durgauli village, having husbands with occupations other than agriculture or professional/technical jobs, and having attended four or more antenatal care (ANC) visits had significantly increased use of institutional deliveries. Also, belonging to the richest 20% of the community and having experienced pregnancy complications were marginally significantly associated. These findings demonstrate the need for improving mother's education, encouraging them to attend ANC visits and addressing disparities between different regions.

  8. Heliospheric pick-up ions influencing thermodynamics and dynamics of the distant solar wind

    Directory of Open Access Journals (Sweden)

    H. J. Fahr

    2002-01-01

    Full Text Available Neutral interstellar H-atoms penetrate into the inner heliosphere and upon the event of ionization are converted into pick-up ions (PUIs. The magnetized solar wind flow incorporates these ions into the plasma bulk and enforces their co-motion. By nonlinear interactions with wind-entrained Alfvén waves, these ions are then processed in the comoving velocity space. The complete pick-up process is connected with forces acting back to the original solar wind ion flow, thereby decelerating and heating the solar wind plasma. As we show here, the resulting deceleration cannot be treated as a pure loading effect, but requires adequate consideration of the action of the pressure of PUI-scattered waves operating by the PUI pressure gradient. Hereby, it is important to take into proper account the stochastic acceleration which PUIs suffer from at their convection out of the inner heliosphere by quasi-linear interactions with MHD turbulences. Only then can the presently reported VOYAGER observations of solar wind decelerations and heatings in the outer heliosphere be understood in view of the most likely values of interstellar gas parameters, such as an H-atom density of 0.12 cm-3 . Solar wind protons (SWPs appear to be globally heated in their motion to larger solar distances. Ascribing the needed heat transfer to the action of suprathermal PUIs, which drive MHD waves that are partly absorbed by SWPs, in order to establish the observed SWP polytropy, we can obtain a quantitative expression for the solar wind proton pressure as a function of solar distance. This expression clearly shows the change from an adiabatic to a quasi-polytropic SWP behaviour with a decreasing polytropic index at increasing distances. This also allows one to calculate the average percentage of initial pick-up energy fed into the thermal proton energy. In a first order evaluation of this expression, we can estimate that about 10% of the initial PUI injection energy is eventually

  9. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    Science.gov (United States)

    Mayhew, Susannah H; Ploubidis, George B; Sloggett, Andy; Church, Kathryn; Obure, Carol D; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E; Watts, Charlotte; Vassall, Anna

    2016-01-01

    The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration". These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  10. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    Directory of Open Access Journals (Sweden)

    Susannah H Mayhew

    Full Text Available The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs.Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure and a Functional Integration Index (integrated delivery of services to clients. The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration".These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  11. Improving Service Delivery: Investigating the Role of Information Sharing, Job Characteristics, and Employee Satisfaction

    Science.gov (United States)

    Bontis, Nick; Richards, David; Serenko, Alexander

    2011-01-01

    Purpose: The purpose of this study is to propose and test a model designed to investigate the impact of job characteristics, employee satisfaction, and information sharing on two key indicators of quality service delivery, such as worker perceptions of their efficiency and customer focus. Design/methodology/approach: During the project, 9,060…

  12. Laparoscopic ovum pick-up in spotted paca ( Cuniculus pacas )

    OpenAIRE

    Barros,F.F.P.C.; Teixeira,P.P.M.; Uscategui,R.A.R.; Coutinho,L.N.; Brito,M.B.S.; Kawanami,A.E.; Almeida,V.T.; Mariano,R.S.G.; Nociti,R.P.; Machado,M.R.F.; Vicente,W.R.R.

    2016-01-01

    ABSTRACT The aim of this work is study the laparoscopic ovum pick-up (LapOPU) technique in spotted paca, describing surgery details, complications and oocyte recovery rate. Nine healthy adult non-pregnant captive females were used, in a total of 39 procedures. When the surgical plane of anaesthesia was achieved, the females were positioned at 20º Trendelenburg. Three 6mm trocars were placed on right and left inguinal and hypogastric regions. Abdomen was inflated with CO2 and the intra-abdomin...

  13. Spin polarization of 34Al fragments produced by nucleon pickup at intermediate energies

    International Nuclear Information System (INIS)

    Turzo, K.; Himpe, P.; Borremans, D.; Mallion, S.; Neyens, G.; Vermeulen, N.; Yordanov, D.; Balabanski, D.L.; Belier, G.; Daugas, J.M.; Georgiev, G.; Oliveira de Santos, F.; Matea, I.; Stodel, Ch.; Penionzhkevich, Yu. E.

    2006-01-01

    The polarization of 34 Al fragments, produced by single neutron pickup from a 9 Be target by a 36 S projectile at 77.5 MeV/nucleon, have been observed at GANIL via the detection of resonantly destroyed β-asymmetry. The reaction-induced polarization is deduced using a tentative spin/parity assignment for the 34 Al ground state. A positive polarization was measured near the peak of the 34 Al yield curve. A kinematical model based on the spectator-participant model for projectile fragmentation reactions has been extended in order to take into account the features of pickup reactions, i.e., the picked-up nucleon having an average momentum equal to the Fermi momentum and aligned along the incident beam direction. The trend-line in the observed spin-orientation is very well reproduced by this model

  14. An information technology framework for strengthening telehealthcare service delivery.

    Science.gov (United States)

    Chen, Li-Chin; Chen, Chi-Wen; Weng, Yung-Ching; Shang, Rung-Ji; Yu, Hui-Chu; Chung, Yufang; Lai, Feipei

    2012-10-01

    Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery. The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework. The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive. The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances.

  15. Embodied intersubjective engagement in mother-infant tactile communication: a cross-cultural study of Japanese and Scottish mother-infant behaviors during infant pick-up.

    Science.gov (United States)

    Negayama, Koichi; Delafield-Butt, Jonathan T; Momose, Keiko; Ishijima, Konomi; Kawahara, Noriko; Lux, Erin J; Murphy, Andrew; Kaliarntas, Konstantinos

    2015-01-01

    This study examines the early development of cultural differences in a simple, embodied, and intersubjective engagement between mothers putting down, picking up, and carrying their infants between Japan and Scotland. Eleven Japanese and ten Scottish mothers with their 6- and then 9-month-old infants participated. Video and motion analyses were employed to measure motor patterns of the mothers' approach to their infants, as well as their infants' collaborative responses during put-down, pick-up, and carry phases. Japanese and Scottish mothers approached their infants with different styles and their infants responded differently to the short duration of separation during the trial. A greeting-like behavior of the arms and hands was prevalent in the Scottish mothers' approach, but not in the Japanese mothers' approach. Japanese mothers typically kneeled before making the final reach to pick-up their children, giving a closer, apparently gentler final approach of the torso than Scottish mothers, who bent at the waist with larger movements of the torso. Measures of the gap closure between the mothers' hands to their infants' heads revealed variably longer duration and distance gap closures with greater velocity by the Scottish mothers than by the Japanese mothers. Further, the sequence of Japanese mothers' body actions on approach, contact, pick-up, and hold was more coordinated at 6 months than at 9 months. Scottish mothers were generally more variable on approach. Measures of infant participation and expressivity indicate more active participation in the negotiation during the separation and pick-up phases by Scottish infants. Thus, this paper demonstrates a culturally different onset of development of joint attention in pick-up. These differences reflect cultures of everyday interaction.

  16. Embodied intersubjective engagement in mother–infant tactile communication: a cross-cultural study of Japanese and Scottish mother–infant behaviors during infant pick-up

    Science.gov (United States)

    Negayama, Koichi; Delafield-Butt, Jonathan T.; Momose, Keiko; Ishijima, Konomi; Kawahara, Noriko; Lux, Erin J.; Murphy, Andrew; Kaliarntas, Konstantinos

    2015-01-01

    This study examines the early development of cultural differences in a simple, embodied, and intersubjective engagement between mothers putting down, picking up, and carrying their infants between Japan and Scotland. Eleven Japanese and ten Scottish mothers with their 6- and then 9-month-old infants participated. Video and motion analyses were employed to measure motor patterns of the mothers’ approach to their infants, as well as their infants’ collaborative responses during put-down, pick-up, and carry phases. Japanese and Scottish mothers approached their infants with different styles and their infants responded differently to the short duration of separation during the trial. A greeting-like behavior of the arms and hands was prevalent in the Scottish mothers’ approach, but not in the Japanese mothers’ approach. Japanese mothers typically kneeled before making the final reach to pick-up their children, giving a closer, apparently gentler final approach of the torso than Scottish mothers, who bent at the waist with larger movements of the torso. Measures of the gap closure between the mothers’ hands to their infants’ heads revealed variably longer duration and distance gap closures with greater velocity by the Scottish mothers than by the Japanese mothers. Further, the sequence of Japanese mothers’ body actions on approach, contact, pick-up, and hold was more coordinated at 6 months than at 9 months. Scottish mothers were generally more variable on approach. Measures of infant participation and expressivity indicate more active participation in the negotiation during the separation and pick-up phases by Scottish infants. Thus, this paper demonstrates a culturally different onset of development of joint attention in pick-up. These differences reflect cultures of everyday interaction. PMID:25774139

  17. Distributor pricing approaches enabled in Smart Grid to differentiate delivery service quality

    Directory of Open Access Journals (Sweden)

    Zhongwei Jake Zhang

    2014-12-01

    Full Text Available Industry practitioners who advocate retail competition and Demand-side Participation now look for approaches to link both initiatives through distributor pricing. As distributors incrementally convert more traditional assets into Smart Grid assets, they also need to consider different pricing approaches to recover the investment costs and meet the regulatory business requirements. Small electricity consumers need incentives to take part in these initiatives but their delivery service quality should also be closely guarded. Hence this paper addresses the above needs as a whole and investigates a set of distributor pricing approaches with Smart Grid technologies. Pricing of network and non-network based solutions should follow the incremental basis, such as the long run average incremental cost (LRAIC. The benefit of deferring network investment is calculated and should be passed to consumers as peak pricing rebate. A concept of reliability premium (RP based on load point reliability index is proposed, through which customers can express their preference of service quality and adjust their network tariff payment accordingly. A service delivery model is also proposed to utilize the savings from wholesale market trading to compensate for the downgraded service when loads are controlled. The IEEE 123-node distribution test feeder and the IEEE distribution system for RBTS Bus No. 2 are simulated, and solved using General Algebraic Modeling System (GAMS to demonstrate the proposed distributor pricing approaches in Smart Grid.

  18. Cometary pick-up ions observed near Giacobini-Zinner

    Science.gov (United States)

    Gloeckler, G.; Hovestadt, D.; Ipavich, F. M.; Scholer, M.; Klecker, B.

    1986-01-01

    The number and energy density of cometary water-group ions observed near Comet Giacobini-Zinner are derived using the rest-frame distribution functions. The data reveal that density profiles of inbound and outbound passes and their shape correlate with pick-up ion production model predictions. The lose rate and production rate of water-group cometary molecules calculated from predicted and measured density profiles are 2 x 10 to the -6th/sec and 2.6 x 10 to the 28th/sec respectively. The shapes of the distribution functions are examined to study the solar wind/cometary ions interaction process.

  19. Trends in Rural Water Supply: Towards a Service Delivery Approach

    Directory of Open Access Journals (Sweden)

    Patrick Moriarty

    2013-10-01

    The papers in this special issue argue that tackling these challenges requires a shift in emphasis in rural water supply in developing countries: away from a de-facto focus on the provision of hardware for first-time access towards the proper use of installed hardware as the basis for universal access to rural water services. The outline of the main actions required to achieve this shift are becoming clearer. Chief amongst these are the professionalisation of community management and/or provision of direct support to community service providers; adoption of a wider range of service delivery models than community management alone; and addressing the sustainable financing of all costs with a particular focus on financing capital maintenance (asset management and direct support costs. This introductory paper provides an overview of these issues and a guide to the other articles, which demonstrate these points.

  20. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush

    -zone spread allowing for 24/7 service delivery and access to resources. Based on comprehensive data we show that providers are likely to establish GDM configurations when clients value access to globally distributed talent pools and speed of service delivery, and in particular when services are highly...

  1. High-performance integrated pick-up circuit for SPAD arrays in time-correlated single photon counting

    Science.gov (United States)

    Acconcia, Giulia; Cominelli, Alessandro; Peronio, Pietro; Rech, Ivan; Ghioni, Massimo

    2017-05-01

    The analysis of optical signals by means of Single Photon Avalanche Diodes (SPADs) has been subject to a widespread interest in recent years. The development of multichannel high-performance Time Correlated Single Photon Counting (TCSPC) acquisition systems has undergone a fast trend. Concerning the detector performance, best in class results have been obtained resorting to custom technologies leading also to a strong dependence of the detector timing jitter from the threshold used to determine the onset of the photogenerated current flow. In this scenario, the avalanche current pick-up circuit plays a key role in determining the timing performance of the TCSPC acquisition system, especially with a large array of SPAD detectors because of electrical crosstalk issues. We developed a new current pick-up circuit based on a transimpedance amplifier structure able to extract the timing information from a 50-μm-diameter custom technology SPAD with a state-of-art timing jitter as low as 32ps and suitable to be exploited with SPAD arrays. In this paper we discuss the key features of this structure and we present a new version of the pick-up circuit that also provides quenching capabilities in order to minimize the number of interconnections required, an aspect that becomes more and more crucial in densely integrated systems.

  2. Impact of Affirmative Action on Quality of Service Delivery in the Public Service Sector of Kenya: A Comparative Case Study of the Ministry of State in the Office of the President and Ministry of Higher Education

    Science.gov (United States)

    Kilonzo, Evans Mbuthi; Ikamari, Lawrence

    2015-01-01

    This study was carried out to determine the impact of affirmative action policy on the quality service delivery in the public service sector of Kenya. The study was carried out on the premise that there is a relationship between affirmative Action implementation and the quality of service delivery in the public service sector of Kenya. A lot of…

  3. Hi-Vision telecine system using pickup tube

    Science.gov (United States)

    Iijima, Goro

    1992-08-01

    Hi-Vision broadcasting, offering far more lifelike pictures than those produced by existing television broadcasting systems, has enormous potential in both industrial and commercial fields. The dissemination of the Hi-Vision system will enable vivid, movie theater quality pictures to be readily enjoyed in homes in the near future. To convert motion film pictures into Hi-Vision signals, a telecine system is needed. The Hi-Vision telecine systems currently under development are the "laser telecine," "flying-spot telecine," and "Saticon telecine" systems. This paper provides an overview of the pickup tube type Hi-Vision telecine system (referred to herein as the Saticon telecine system) developed and marketed by Ikegami Tsushinki Co., Ltd.

  4. Performance Analyses in an Assistive Technology Service Delivery Process

    DEFF Research Database (Denmark)

    Petersen, Anne Karin

    Performance Analyses in an Assistive Technology Service Delivery Process.Keywords: process model, occupational performance, assistive technologiesThe Poster is about teaching students, using models and theory in education and practice. It is related to Occupational therapy process and professional...... af top-til-bund, klientcentreret og aktivitetsbaseret interventioner, ERGO/MunksgaardFisher, A. &, Griswold, L. A., 2014. Performance Skills. I: B.Schell red.2014 Occupational Therapy. Willard &Spackman’s occupational therapy. -12th ed., p.249-264Cook A.M., Polgar J.M. (2015) Assistive Technologies...

  5. A MEASUREMENT OF THE ADIABATIC COOLING INDEX FOR INTERSTELLAR HELIUM PICKUP IONS IN THE INNER HELIOSPHERE

    International Nuclear Information System (INIS)

    Saul, Lukas; Wurz, Peter; Kallenbach, Reinald

    2009-01-01

    Interstellar neutral gas enters the inner heliosphere where it is ionized and becomes the pickup ion population of the solar wind. It is often assumed that this population will subsequently cool adiabatically, like an expanding ideal gas due, to the divergent flow of the solar wind. Here, we report the first independent measure of the effective adiabatic cooling index in the inner heliosphere from SOHO CELIAS measurements of singly charged helium taken during times of perpendicular interplanetary magnetic field. We use a simple adiabatic transport model of interstellar pickup helium ions, valid for the upwind region of the inner heliosphere. The time averaged velocity spectrum of helium pickup ions measured by CELIAS/CTOF is fit to this model with a single free parameter which indicates an effective cooling rate with a power-law index of γ = 1.35 ± 0.2. While this average is consistent with the 'ideal-gas' assumption of γ = 1.5, the analysis indicates that such an assumption will not apply in general, and that due to observational constraints further measurements are necessary to constrain the cooling process. Implications are discussed for understanding the transport processes in the inner heliosphere and improving this measurement technique.

  6. Improving consistency and quality of service delivery: implications for the addiction treatment field.

    Science.gov (United States)

    Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

    2008-09-01

    Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

  7. Informal learning processes in support of clinical service delivery in a service-oriented community pharmacy.

    Science.gov (United States)

    Patterson, Brandon J; Bakken, Brianne K; Doucette, William R; Urmie, Julie M; McDonough, Randal P

    The evolving health care system necessitates pharmacy organizations' adjustments by delivering new services and establishing inter-organizational relationships. One approach supporting pharmacy organizations in making changes may be informal learning by technicians, pharmacists, and pharmacy owners. Informal learning is characterized by a four-step cycle including intent to learn, action, feedback, and reflection. This framework helps explain individual and organizational factors that influence learning processes within an organization as well as the individual and organizational outcomes of those learning processes. A case study of an Iowa independent community pharmacy with years of experience in offering patient care services was made. Nine semi-structured interviews with pharmacy personnel revealed initial evidence in support of the informal learning model in practice. Future research could investigate more fully the informal learning model in delivery of patient care services in community pharmacies. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

    Science.gov (United States)

    Fekadu, Melaku; Regassa, Nigatu

    2014-12-01

    Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia. The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression). The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization. The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.

  9. A spatial model to quantify the mortality impact of service delivery in Sub-Saharan Africa: an ecological design utilizing data from South Africa.

    Science.gov (United States)

    Sartorius, Kurt; Sartorius, Benn K D

    2013-02-20

    Sub Saharan Africa is confronted with a wide range of interlinked health and economic problems that include high levels of mortality and poor service delivery. The objective of the paper is to develop a spatial model for Sub-Saharan Africa that can quantify the mortality impact of (poor) service delivery at sub-district level in order to integrate related health and local level policy interventions. In this regard, an expanded composite service delivery index was developed, and the data were analysed using a Bayesian Poisson spatial model. The results indicate significant differences in the risk of mortality and poor service delivery at sub-district level. In particular, the results indicate clusters of high mortality and poor service delivery in two of the bigger, poorer provinces with large rural communities. Conversely, two of the wealthier provinces have lower levels of mortality and higher levels of service delivery, but income inequality is more widespread. The bivariate and multivariate models, moreover, reflect significant positive linkages (p service delivery after adjusting for HIV/AIDS, income inequality, population density and the protective influence of metropolitan areas. Finally, the hypothesized provision of a basket of services reduced the mortality rate in South Africa's 248 sub-districts by an average of 5.3 (0.3-15.4) deaths per 1000. The results indicate that the model can accurately plot mortality and service delivery "hotspots' at sub-district level, as well as explain their associations and causality. A mortality reduction index shows that mortality in the highest risk sub-districts can be reduced by as much as 15.4 deaths per 1000 by providing a range of basic services. The ability to use the model in a wider SSA context and elsewhere is also feasible given the innovative use of available databases. Finally, the paper illustrates the importance of developing policy in SSA that can simultaneously solve both economic and health problems.

  10. Effects of demand-side incentives in improving the utilisation of delivery services in Oyam District in northern Uganda: a quasi-experimental study.

    Science.gov (United States)

    Massavon, William; Wilunda, Calistus; Nannini, Maria; Majwala, Robert Kaos; Agaro, Caroline; De Vivo, Emanuela; Lochoro, Peter; Putoto, Giovanni; Criel, Bart

    2017-12-19

    We evaluated the effects and financial costs of two interventions with respect to utilisation of institutional deliveries and other maternal health services in Oyam District in Uganda. We conducted a quasi-experimental study involving intervention and comparable/control sub-counties in Oyam District for 12 months (January-December 2014). Participants were women receiving antenatal care, delivery and postnatal care services. We evaluated two interventions: the provision of (1) transport vouchers to women receiving antenatal care and delivering at two health centres (level II) in Acaba sub-county, and (2) baby kits to women who delivered at Ngai Health Centre (level III) in Ngai sub-county. The study outcomes included service coverage of institutional deliveries, four antenatal care visits, postnatal care, and the percentage of women 'bypassing' maternal health services inside their resident sub-counties. We calculated the effect of each intervention on study outcomes using the difference in differences analysis. We calculated the cost per institutional delivery and the cost per unit increment in institutional deliveries for each intervention. Overall, transport vouchers had greater effects on all four outcomes, whereas baby kits mainly influenced institutional deliveries. The absolute increase in institutional deliveries attributable to vouchers was 42.9%; the equivalent for baby kits was 30.0%. Additionally, transport vouchers increased the coverage of four antenatal care visits and postnatal care service coverage by 60.0% and 49.2%, respectively. 'Bypassing' was mainly related to transport vouchers and ranged from 7.2% for postnatal care to 11.9% for deliveries. The financial cost of institutional delivery was US$9.4 per transport voucher provided, and US$10.5 per baby kit. The incremental cost per unit increment in institutional deliveries in the transport-voucher system was US$15.9; the equivalent for the baby kit was US$30.6. The transport voucher scheme

  11. The pick-up mechanism in composite particle emission processes

    International Nuclear Information System (INIS)

    Zhang Jingshang; Yan Shiwei; Wang Cuilan

    1992-01-01

    The pick-up mechanism has been included in the exciton model for the light composite particle emissions. Based on the cluster phase space integration method the formation probabilities of α,d,t, 3 He are obtained. The calculation results of (n,t) cross sections indicate that this theoretical method can reproduce the experimental data nicely. For triton emissions in pre-equilibrium reaction processes, the semi-direct reactions are the dominant terms which are just omitted in the previous model calculation

  12. 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.

  13. Skilled delivery service utilization and its association with the establishment of Women's Health Development Army in Yeky district, South West Ethiopia: a multilevel analysis.

    Science.gov (United States)

    Negero, Melese Girmaye; Mitike, Yifru Berhan; Worku, Abebaw Gebeyehu; Abota, Tafesse Lamaro

    2018-01-30

    Because of the unacceptably high maternal and perinatal morbidity and mortality, the government of Ethiopia has established health extension program with a community-based network involving health extension workers (HEWs) and a community level women organization which is known as "Women's Health Development Army" (WHDA). Currently, the HEWs and WHDA network is the approach preferred by the government to register pregnant women and encourage them to link in the healthcare system. However, its association with skilled delivery service utilization is not well known. A community-based cross-sectional study was conducted from January to February 2015. Within 380 clusters of WHDA, a total of 748 reproductive-age women who gave birth in 1 year preceding the study, were included using multistage sampling technique. The data were entered into EPI info version 7 statistical software and exported to STATA version 11 for analysis. Multilevel analysis technique was applied to check for an association of selected variables with a utilization of skilled delivery service. About 45% of women have received skilled delivery care. A significant heterogeneity was observed between "Women's Health Development Teams (clusters)" for skilled delivery care service utilization which explains about 62% of the total variation. Individual-level predictors including urban residence [AOR (95% CI) 35.10 (4.62, 266.52)], previous exposure of complications [AOR (95% CI) 3.81 (1.60, 9.08)], at least four ANC visits [AOR (95% CI) 7.44 (1.48, 37.42)] and preference of skilled personnel [AOR (95% CI) 8.11 (2.61, 25.15)] were significantly associated with skilled delivery service use. Among cluster level variables, the distance of clusters within 2 km radius from the nearest health facility was significantly associated [AOR (95% CI) 6.03 (1.92, 18.93)] with skilled delivery service utilization. In this study, significant variation among clusters of WHDA was observed. Both individual and cluster level

  14. Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

    Science.gov (United States)

    Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

    2012-01-01

    The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to

  15. Evaluation of strip-line pick-up system for the SPS wideband transverse feedback system

    CERN Document Server

    Kotzian, G; Steinhagen, R J; Valuch, D; Wehrle, U

    2017-01-01

    The proposed SPS Wideband Transverse Feedback sys- tem requires a wide-band pick-up system to be able to de- tect intra-bunch motion within the SPS proton bunches, captured and accelerated in a 200 MHz bucket. We present the electro-magnetic design of transverse beam position pick-up options optimised for installation in the SPS and evaluate their performance reach with respect to direct time domain sampling of the intra-bunch motion. The analy- sis also discusses the achieved subsystem responses of the associated cabling with new low dispersion smooth wall coaxial cables, wide-band generation of intensity and posi- tion signals by means of 180 degree RF hybrids as well as passive techniques to electronically suppress the beam off- set signal, needed to optimise the dynamic range and posi- tion resolution of the planned digital intra-bunch feedback system.

  16. Patients’ perception of quality service delivery of public hospitals in Nigeria using analytical hierarchy process

    Directory of Open Access Journals (Sweden)

    Emmanuel Olateju Oyatoye

    2016-07-01

    Full Text Available Introduction: Patients are recently more aware and conscious. This is because of the belief that a high level of quality can translate into patient satisfaction. This is critical for healthcare providers as they deal with life. This recognition by both the service provider and service receivers made the government to establish units of service commission (SERVICOM in each of the governmental agencies including hospitals in Nigeria to monitor the level of quality of service delivery. However, to what extent do patients’ perceptions about health services seem to have been largely recognized remain unclear by health care providers, despite the (SERVICOM units in public institutions in Nigeria? Method: A cross-sectional analytical study using convenient sample method, based on the fact that not every patient of the selected hospitals can be chosen, was performed on 400 patients who received health services at four different public hospitals in Ogun state Nigeria. The selection of these hospitals was based on the zones in the state (Egba, Ijebu, Remo and Yewa area of Ogun-state. The instrument was a valid and reliable analytical hierarchy process based questionnaire containing five service quality dimensions. Data were analyzed using SPSS, Expert choice and Microsoft Excel software to determine the perception of patients towards service quality delivery in pairwise comparison of judgment consistent at less than 10%. Results:The results showed the composite priorities of the patients’ perception with respect to determinants of the patients’ perception towards quality of services delivered in the public hospitals in Nigeria. The most important factor to patients was the reliability dimension with composite priority 0.24 or 24% followed by the responsiveness dimension with 0.22 assurance dimension 0.21, tangibility dimension with 0.21, and the least determinant factor was the empathy dimension with 0.1101. Conclusion: Based on the results, the

  17. Access-technology agnostic delivery platform for ICT4D services

    CSIR Research Space (South Africa)

    Makitla, I

    2012-10-01

    Full Text Available .kashan.co.za] CONTEXT Capitalising on target resource-constrained rural communities? technological capabilities can be considered a critical consideration when delivering Information and Communication Technology for Development (ICT4D) content and services... to these communities. The core approach of this research project, which is informed by the concept of ?digital difference?[1], is to leverage the existing technological infrastructure and capacity (know-how) in a community to enable delivery of ICT4D content...

  18. Split delivery vehicle routing problem with time windows: a case study

    Science.gov (United States)

    Latiffianti, E.; Siswanto, N.; Firmandani, R. A.

    2018-04-01

    This paper aims to implement an extension of VRP so called split delivery vehicle routing problem (SDVRP) with time windows in a case study involving pickups and deliveries of workers from several points of origin and several destinations. Each origin represents a bus stop and the destination represents either site or office location. An integer linear programming of the SDVRP problem is presented. The solution was generated using three stages of defining the starting points, assigning busses, and solving the SDVRP with time windows using an exact method. Although the overall computational time was relatively lengthy, the results indicated that the produced solution was better than the existing routing and scheduling that the firm used. The produced solution was also capable of reducing fuel cost by 9% that was obtained from shorter total distance travelled by the shuttle buses.

  19. Client perspective assessment of women?s satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia

    OpenAIRE

    Dewana, Zeritu; Fikadu, Teshale; G/ Mariam, Abebe; Abdulahi, Misra

    2016-01-01

    Background A woman?s satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women?s satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women?s towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zon...

  20. Customer satisfaction of mobile telecommunication networks in Ghana: service delivery perspective

    OpenAIRE

    A.R. ABDUL-AZIZ; Bashiru I.I. SAEED; Ayogyam ALEXANDER

    2014-01-01

    Organizations, both private and public, in today’s dynamic marketplaces are increasingly leaving antiquated marketing philosophies and strategies to the adoption of more customer driven initiatives that seek to understand, attract, retain and build intimate long term relationship with profitable customers. This article analyzed customer satisfaction with the service delivery of mobile telecommunication networks in Ghana using a binary logistic regression model. Primary data was collected thro...

  1. Impact of Access to Online Databases on Document Delivery Services within Iranian Academic Libraries

    Directory of Open Access Journals (Sweden)

    Zohreh Zahedi

    2007-04-01

    Full Text Available The present study investigates the impact of access to online databases on the document delivery services in Iranian Academic Libraries, within the framework of factors such as number of orders lodged over the years studied and their trends, expenditures made by each university, especially those universities and groups that had the highest number of orders. This investigation was carried out through a survey and by calling on the library document supply unit in universities as well as in-person interview with librarians in charge. The study sample was confined to the universities of Shiraz, Tehran and Tarbiyat Modaress along with their faculties. Findings indicate that the rate of document requests in various universities depends on the target audience, capabilities, students’ familiarity as well as mode of document delivery services..

  2. Coherent detection passive optical access network enabling converged delivery of broadcast and dedicated broadband services

    DEFF Research Database (Denmark)

    Osadchiy, Alexey Vladimirovich; Prince, Kamau; Guerrero Gonzalez, Neil

    2011-01-01

    We propose a passive optical network architecture based on coherent detection for converged delivery of broadcast services from a dedicated remote broadcast server and user-specific services from a local central office. We experimentally demonstrate this architecture with mixed traffic types....... The broadcast channels were transmitted over 78 km of single mode fiber to a central office where they were multiplexed with the unicast channels for further fiber transmission over 34-km to reach the access network. Successful detection of all channels is demonstrated....

  3. Evaluating the Effect of Lead Time on Quality Service Delivery in the Banking Industry in Kumasi Metropolis of Ghana

    Directory of Open Access Journals (Sweden)

    Stephen Okyere

    2015-07-01

    Full Text Available Customers are becoming more attracted to quality service delivery and are being impatience and unsatisfied when they had to be delayed or wait for longer times before they are served.  Hence, Quality Service Delivery is of utmost importance to every service organisation especially financial industry. Most financial institutions focus attention on product innovation at the expense of lead time management which is a major factor in ensuring service quality and customer satisfaction. Consequently, this research looks at evaluating the effect of lead time on quality service delivery in the Banking Industry in Kumasi Metropolis of Ghana. The study relied on Primary data collected through questionnaires, observation and interview instruments, administered to staff and customers of some selected branches of a commercial bank in the study area. The data was analysed qualitatively. The researchers realised that despite the immense importance of lead time on quality service delivery, little attention is given to the concept. It was revealed that, customers were dissatisfied with the commercial bank’s services as a result of the unnecessary delays and queuing at the bank premises. The long lead time was found to be attributable to plant/system failure, skill gap on the part of employees, ATM underutilization and frequent breakdowns, among others. This has consequently resulted into long lead time, waiting, queuing and unnecessary delay at the banking hall. It is recommended that Tellers should be provided with electronic card readers for verification of customer’s data and processing to be faster.

  4. One-nucleon pickup reactions and compound-nuclear decays

    Science.gov (United States)

    Escher, J. E.; Burke, J. T.; Casperson, R. J.; Hughes, R. O.; Scielzo, N. D.

    2018-05-01

    One-nucleon transfer reactions, long used as a tool to study the structure of nuclei, are potentially valuable for determining reaction cross sections indirectly. This is significant, as many reactions of interest to astrophysics and other applications involve short-lived isotopes and cannot be measured directly. We describe a procedure for obtaining constraints for calculations of neutron capture cross sections using observables from experiments with transfer reactions. As a first step toward demonstrating the method, we outline the theory developments used to properly describe the production of the compound nucleus 88Y* via the one-nucleon pickup reaction 89Y(p,d)88Y* and test the description with data from a recent experiment. We indicate how this development can be used to extract the unknown 87Y(n,γ) cross section from 89Y(p,dγ) data. The example illustrates a more generally applicable method for determining unknown cross sections via a combination of theory and transfer (or inelastic scattering) experiments.

  5. VOYAGER OBSERVATIONS OF MAGNETIC WAVES DUE TO NEWBORN INTERSTELLAR PICKUP IONS: 2–6 au

    International Nuclear Information System (INIS)

    Aggarwal, Poornima; Taylor, David K.; Smith, Charles W.; Joyce, Colin J.; Fisher, Meghan K.; Isenberg, Philip A.; Vasquez, Bernard J.; Schwadron, Nathan A.; Cannon, Bradford E.; Richardson, John D.

    2016-01-01

    We report observations by the Voyager 1 and 2 spacecraft of low-frequency magnetic waves excited by newborn interstellar pickup ions H + and He + during 1978–1979 when the spacecraft were in the range from 2 to 6.3 au. The waves have the expected association with the cyclotron frequency of the source ions, are left-hand polarized in the spacecraft frame, and have minimum variance directions that are quasi-parallel to the local mean magnetic field. There is one exception to this in that one wave event that is excited by pickup H + is right-hand polarized in the spacecraft frame, but similar exceptions have been reported by Cannon et al. and remain unexplained. We apply the theory of Lee and Ip that predicts the energy spectrum of the waves and then compare growth rates with turbulent cascade rates under the assumption that turbulence acts to destroy the enhanced wave activity and transport the associated energy to smaller scales where dissipation heats the background plasma. As with Cannon et al., we find that the ability to observe the waves depends on the ambient turbulence being weak when compared with growth rates, thereby allowing sustained wave growth. This analysis implies that the coupled processes of pitch-angle scattering and wave generation are continuously associated with newly ionized pickup ions, despite the fact that the waves themselves may not be directly observable. When waves are not observed, but wave excitation can be argued to be present, the wave energy is simply absorbed by the turbulence at a rate that prevents significant accumulation. In this way, the kinetic process of wave excitation by scattering of newborn ions continues to heat the plasma without producing observable wave energy. These findings support theoretical models that invoke efficient scattering of new pickup ions, leading to turbulent driving in the outer solar wind and in the IBEX ribbon beyond the heliopause.

  6. VOYAGER OBSERVATIONS OF MAGNETIC WAVES DUE TO NEWBORN INTERSTELLAR PICKUP IONS: 2–6 au

    Energy Technology Data Exchange (ETDEWEB)

    Aggarwal, Poornima [Electrical Engineering Department, Cooper Union, New York, NY 10003 (United States); Taylor, David K. [Rensselaer Polytechnic Institute, Troy, NH 12180 (United States); Smith, Charles W.; Joyce, Colin J.; Fisher, Meghan K.; Isenberg, Philip A.; Vasquez, Bernard J.; Schwadron, Nathan A. [Physics Department and Space Science Center, Institute for the Study of Earth, Oceans, and Space, University of New Hampshire, Durham, NH 03824 (United States); Cannon, Bradford E. [Physics Department, Florida State University, Tallahassee, FL 32306 (United States); Richardson, John D., E-mail: neema2000@gmail.com, E-mail: daves@orol.org, E-mail: Charles.Smith@unh.edu, E-mail: cjl46@wildcats.unh.edu, E-mail: mkl54@wildcats.unh.edu, E-mail: Phil.Isenberg@unh.edu, E-mail: Bernie.Vasquez@unh.edu, E-mail: N.Schwadron@unh.edu, E-mail: bc13h@my.fsu.edu, E-mail: jdr@space.mit.edu [Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, 37-655, Cambridge, MA 02139 (United States)

    2016-05-10

    We report observations by the Voyager 1 and 2 spacecraft of low-frequency magnetic waves excited by newborn interstellar pickup ions H{sup +} and He{sup +} during 1978–1979 when the spacecraft were in the range from 2 to 6.3 au. The waves have the expected association with the cyclotron frequency of the source ions, are left-hand polarized in the spacecraft frame, and have minimum variance directions that are quasi-parallel to the local mean magnetic field. There is one exception to this in that one wave event that is excited by pickup H{sup +} is right-hand polarized in the spacecraft frame, but similar exceptions have been reported by Cannon et al. and remain unexplained. We apply the theory of Lee and Ip that predicts the energy spectrum of the waves and then compare growth rates with turbulent cascade rates under the assumption that turbulence acts to destroy the enhanced wave activity and transport the associated energy to smaller scales where dissipation heats the background plasma. As with Cannon et al., we find that the ability to observe the waves depends on the ambient turbulence being weak when compared with growth rates, thereby allowing sustained wave growth. This analysis implies that the coupled processes of pitch-angle scattering and wave generation are continuously associated with newly ionized pickup ions, despite the fact that the waves themselves may not be directly observable. When waves are not observed, but wave excitation can be argued to be present, the wave energy is simply absorbed by the turbulence at a rate that prevents significant accumulation. In this way, the kinetic process of wave excitation by scattering of newborn ions continues to heat the plasma without producing observable wave energy. These findings support theoretical models that invoke efficient scattering of new pickup ions, leading to turbulent driving in the outer solar wind and in the IBEX ribbon beyond the heliopause.

  7. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Larsen, Marcus M.; Bharati, Pratyush

    2013-01-01

    This article examines antecedents and performance implications of global delivery models (GDMs) in global business services. GDMs require geographically distributed operations to exploit both proximity to clients and time-zone spread for efficient service delivery. We propose and empirically show...

  8. On the Effects of Pickup Ion-driven Waves on the Diffusion Tensor of Low-energy Electrons in the Heliosphere

    Energy Technology Data Exchange (ETDEWEB)

    Engelbrecht, N. Eugene, E-mail: n.eugene.engelbrecht@gmail.com [Center for Space Research, North-West University, Potchefstroom, 2522 (South Africa)

    2017-11-01

    The effects of Alfvén cyclotron waves generated due to the formation in the outer heliosphere of pickup ions on the transport coefficients of low-energy electrons is investigated here. To this end, parallel mean free path (MFP) expressions are derived from quasilinear theory, employing the damping model of dynamical turbulence. These are then used as inputs for existing expressions for the perpendicular MFP and turbulence-reduced drift coefficient. Using outputs generated by a two-component turbulence transport model, the resulting diffusion coefficients are compared with those derived using a more typically assumed turbulence spectral form, which neglects the effects of pickup ion-generated waves. It is found that the inclusion of pickup ion effects greatly leads to considerable reductions in the parallel and perpendicular MFPs of 1–10 MeV electrons beyond ∼10 au, which are argued to have significant consequences for studies of the transport of these particles.

  9. Voluntary medical male circumcision scale-up in Nyanza, Kenya: evaluating technical efficiency and productivity of service delivery.

    Science.gov (United States)

    Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2015-01-01

    Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya's context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350-5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959-4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of

  10. Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery

    Science.gov (United States)

    Omondi Aduda, Dickens S.; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2015-01-01

    Background Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya’s context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. Objective To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Design Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Results Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350–5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959–4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Conclusions Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings

  11. Accounting for costs, QALYs, and capacity constraints: using discrete-event simulation to evaluate alternative service delivery and organizational scenarios for hospital-based glaucoma services.

    Science.gov (United States)

    Crane, Glenis J; Kymes, Steven M; Hiller, Janet E; Casson, Robert; Martin, Adam; Karnon, Jonathan D

    2013-11-01

    Decision-analytic models are routinely used as a framework for cost-effectiveness analyses of health care services and technologies; however, these models mostly ignore resource constraints. In this study, we use a discrete-event simulation model to inform a cost-effectiveness analysis of alternative options for the organization and delivery of clinical services in the ophthalmology department of a public hospital. The model is novel, given that it represents both disease outcomes and resource constraints in a routine clinical setting. A 5-year discrete-event simulation model representing glaucoma patient services at the Royal Adelaide Hospital (RAH) was implemented and calibrated to patient-level data. The data were sourced from routinely collected waiting and appointment lists, patient record data, and the published literature. Patient-level costs and quality-adjusted life years were estimated for a range of alternative scenarios, including combinations of alternate follow-up times, booking cycles, and treatment pathways. The model shows that a) extending booking cycle length from 4 to 6 months, b) extending follow-up visit times by 2 to 3 months, and c) using laser in preference to medication are more cost-effective than current practice at the RAH eye clinic. The current simulation model provides a useful tool for informing improvements in the organization and delivery of glaucoma services at a local level (e.g., within a hospital), on the basis of expected effects on costs and health outcomes while accounting for current capacity constraints. Our model may be adapted to represent glaucoma services at other hospitals, whereas the general modeling approach could be applied to many other clinical service areas.

  12. Experimental cross sections for the pickup of electrons by relativistic nuclei

    International Nuclear Information System (INIS)

    Raisbeck, G.M.; Crawford, H.J.; Lindstroem, P.J.; Greiner, D.E.; Beiser, F.S.; Heckman, H.H.

    1977-01-01

    Cross sections for the pickup of electrons in a variety of targets have been measured with beams of 12 C (150, 250, 400 MeV/n), 20 Ne (250, 400, 1050, 2100 MeV/n) and 40 Ar (400, 1050 MeV/n) from the Bevalac accelerator. The interpretation of the results in terms of radiative and non-radiative capture, and the implications for cosmic ray propagation studies are discussed. (author)

  13. Older Adults and Emerging Digital Service Delivery: A Mixed Methods Study on Information and Communications Technology Use, Skills, and Attitudes.

    Science.gov (United States)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability.

  14. Alternative Service Delivery in Africa: The Case for International Regional Organisations

    Directory of Open Access Journals (Sweden)

    Moses N. Kiggundu

    2016-06-01

    Full Text Available Alternative service delivery (ASD is generally confined to the provision opublic services within the boundaries of a single nation state. This paper extends thisconceptualization and practice beyond a single nation state by focusing on services provided  by international regional organizations (IROs, which encompass more than a single country. Recognizing that the regional approach may not be suitable under all circumstances, the papertakes a contingency approach and discusses with illustrations the conditions under which the regional or continental approaches may provide superior public services to the wider population. Three examples from the East African Community (EAC, Africa’s riparian river basins, and cross-border illicit trade of conflict minerals in the Great Lakes region are given as illustrative cases. Noting that Africa’s growing aspirations for inclusive development and rapid transformation call for better governance and quality public services, the paper ends by calling for more scholarly work and field experiments on ASD and other models applicable at local, national, regional and continental levels.

  15. INTERSTELLAR PICKUP ION ACCELERATION IN THE TURBULENT MAGNETIC FIELD AT THE SOLAR WIND TERMINATION SHOCK USING A FOCUSED TRANSPORT APPROACH

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Junye; Roux, Jakobus A. le; Arthur, Aaron D. [Department of Space Science, University of Alabama in Huntsville, Huntsville, AL 35899 (United States)

    2016-08-01

    We study the physics of locally born interstellar pickup proton acceleration at the nearly perpendicular solar wind termination shock (SWTS) in the presence of a random magnetic field spiral angle using a focused transport model. Guided by Voyager 2 observations, the spiral angle is modeled with a q -Gaussian distribution. The spiral angle fluctuations, which are used to generate the perpendicular diffusion of pickup protons across the SWTS, play a key role in enabling efficient injection and rapid diffusive shock acceleration (DSA) when these particles follow field lines. Our simulations suggest that variation of both the shape ( q -value) and the standard deviation ( σ -value) of the q -Gaussian distribution significantly affect the injection speed, pitch-angle anisotropy, radial distribution, and the efficiency of the DSA of pickup protons at the SWTS. For example, increasing q and especially reducing σ enhances the DSA rate.

  16. 20 CFR 662.270 - How are the costs of providing services through the One-Stop delivery system and the operating...

    Science.gov (United States)

    2010-04-01

    ... through the One-Stop delivery system and the operating costs of the system to be funded? 662.270 Section... and the operating costs of the system to be funded? The MOU must describe the particular funding arrangements for services and operating costs of the One-Stop delivery system. Each partner must contribute a...

  17. Efficacy of a process improvement intervention on delivery of HIV services to offenders: a multisite trial.

    Science.gov (United States)

    Pearson, Frank S; Shafer, Michael S; Dembo, Richard; Del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L; Belenko, Steven; Frisman, Linda K; Visher, Christy A; Pich, Michele; Patterson, Yvonne

    2014-12-01

    We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments.

  18. Magnitude of institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district Afar Regional State, Ethiopia.

    Science.gov (United States)

    Assefa, Luelseged; Alemayehu, Mussie; Debie, Ayal

    2018-03-02

    Reduction of maternal mortality is a global priority particularly in developing countries like Ethiopia where maternal mortality ratio is one of the highest in the world. Most deliveries in developing countries occur at home without skilled birth attendants. Therefore, the objective of this study was to assess institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district, Ethiopia. Overall, 35.2% of women delivered at health facilities. Women who had good knowledge AOR = 2.1, 95% CI 1.32, 4.87), Ante Natal Care (ANC) follow up (AOR = 3.2, 95% CI 1.55, 6.63), resided in a place where distance to reach at the nearby health facilities takes delivery place (AOR = 1.9; 95% CI 1.49, 5.07) were more likely to deliver at health facility. Therefore, strengthening ANC services, improving maternal knowledge, involving husbands in decision of delivery place and expanding health facilities in the community would enhance institutional delivery.

  19. Non-communicable diseases and HIV care and treatment: models of integrated service delivery.

    Science.gov (United States)

    Duffy, Malia; Ojikutu, Bisola; Andrian, Soa; Sohng, Elaine; Minior, Thomas; Hirschhorn, Lisa R

    2017-08-01

    Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with human immunodeficiency virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programmes. We describe models of NCD and HIV integration, challenges and lessons learned. A literature review of published articles on integrated NCD and HIV programs in low-income countries and key informant interviews were conducted with leaders of identified integrated NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service delivery integration. Three models of integration were identified as follows: NCD services integrated into centres originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models. Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. Operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policymakers seeking to address all the chronic care needs of their patients. © 2017 John Wiley & Sons Ltd.

  20. Architectural Principles for Orchestration of Cross-Organizational Service Delivery: Case Studies from the Netherlands

    Science.gov (United States)

    van Veenstra, Anne Fleur; Janssen, Marijn

    One of the main challenges for e-government is to create coherent services for citizens and businesses. Realizing Integrated Service Delivery (ISD) requires government agencies to collaborate across their organizational boundaries. The coordination of processes across multiple organizations to realize ISD is called orchestration. One way of achieving orchestration is to formalize processes using architecture. In this chapter we identify architectural principles for orchestration by looking at three case studies of cross-organizational service delivery chain formation in the Netherlands. In total, six generic principles were formulated and subsequently validated in two workshops with experts. These principles are: (i) build an intelligent front office, (ii) give processes a clear starting point and end, (iii) build a central workflow application keeping track of the process, (iv) differentiate between simple and complex processes, (v) ensure that the decision-making responsibility and the overview of the process are not performed by the same process role, and (vi) create a central point where risk profiles are maintained. Further research should focus on how organizations can adapt these principles to their own situation.

  1. Pick-up and impact of flexible bodies

    Science.gov (United States)

    Singh, H.; Hanna, J. A.

    2017-09-01

    Picking up, laying down, colliding, rolling, and peeling are partial-contact interactions involving moving discontinuities. We examine the balances of momentum and energy across a moving discontinuity in a string, with allowance for injection or dissipation by singular supplies. We split the energy dissipation according to its invariance properties, discuss analogies with systems of particles and connections with the literature on shocks and phase transition fronts in various bodies, and derive a compatibility relation between supplies of momentum and translation-invariant energy. For a moving contact discontinuity between a string and a smooth rigid plane in the presence of gravity, we find a surprising asymmetry between the processes of picking up and laying down, such that steady-state kinks in geometry and associated jumps in tension are not admissible during pick-up. This prediction is consistent with experimental observations. We briefly discuss related problems including the falling folded chain, peeling of an adhesive tape, and the "chain fountain". Our approach is applicable to the study of impact and locomotion, and to systems such as moored floating structures and some musical instruments that feature vibrating string and cable elements interacting with a surface.

  2. Weighted log-linear models for service delivery points in Ethiopia: a case of modern contraceptive users at health facilities.

    Science.gov (United States)

    Workie, Demeke Lakew; Zike, Dereje Tesfaye; Fenta, Haile Mekonnen; Mekonnen, Mulusew Admasu

    2018-05-10

    Ethiopia is among countries with low contraceptive usage prevalence rate and resulted in high total fertility rate and unwanted pregnancy which intern affects the maternal and child health status. This study aimed to investigate the major factors that affect the number of modern contraceptive users at service delivery point in Ethiopia. The Performance Monitoring and Accountability2020/Ethiopia data collected between March and April 2016 at round-4 from 461 eligible service delivery points were in this study. The weighted log-linear negative binomial model applied to analyze the service delivery point's data. Fifty percent of service delivery points in Ethiopia given service for 61 modern contraceptive users with the interquartile range of 0.62. The expected log number of modern contraceptive users at rural was 1.05 (95% Wald CI: - 1.42 to - 0.68) lower than the expected log number of modern contraceptive users at urban. In addition, the expected log count of modern contraceptive users at others facility type was 0.58 lower than the expected log count of modern contraceptive users at the health center. The numbers of nurses/midwives were affecting the number of modern contraceptive users. Since, the incidence rate of modern contraceptive users increased by one due to an additional nurse in the delivery point. Among different factors considered in this study, residence, region, facility type, the number of days per week family planning offered, the number of nurses/midwives and number of medical assistants were to be associated with the number of modern contraceptive users. Thus, the Government of Ethiopia would take immediate steps to address causes of the number of modern contraceptive users in Ethiopia.

  3. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, north west of Ethiopia: a community-based cross sectional study.

    Science.gov (United States)

    Teferra, Alemayehu Shimeka; Alemu, Fekadu Mazengia; Woldeyohannes, Solomon Meseret

    2012-07-31

    Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio and improving maternal health is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Amhara Regional State, Ethiopia. Therefore, this study aimed to assess factors affecting institutional delivery service utilization among mothers who gave birth in the last 12 months in Sekela District, Amhara Region, Ethiopia. Community-based cross-sectional study was conducted among mothers with birth in the last 12 months during August, 2010. Multistage sampling technique was used to select 371 participants. A pre tested and structured questionnaire was used to collect data. Bivariate and multivariate data analysis was performed using SPSS version 16.0 software. The study indicated that 12.1% of the mothers delivered in health facilities. Of 87.9% mothers who gave birth at home, 80.0% of them were assisted by family members and relatives. The common reasons for home delivery were closer attention from family members and relatives (60.9%), home delivery is usual practice (57.7%), unexpected labour (33.4%), not being sick or no problem at the time of delivery (21.6%) and family influence (14.4%). Being urban resident (AOR [95% CI] = 4.6 [1.91, 10.9]), ANC visit during last pregnancy (AOR [95% CI] = 4.26 [1.1, 16.4]), maternal education level (AOR [95%CI] =11.98 [3.36, 41.4]) and knowledge of mothers on pregnancy and delivery services (AOR [95% CI] = 2.97[1.1, 8.6]) had significant associations with institutional delivery service utilization. Very low institutional delivery service utilization was observed in the study area. Majority of the births at home were assisted by family members and relatives. ANC visit and lack of knowledge on pregnancy and delivery services were found to

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

    Science.gov (United States)

    2013-01-01

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

  5. Spatial service delivery system for smart licensing & enforcement management

    Science.gov (United States)

    Wahap, N. A.; Ismail, N. M.; Nor, N. M.; Ahmad, N.; Omar, M. F.; Termizi, A. A. A.; Zainal, D.; Noordin, N. M.; Mansor, S.

    2016-06-01

    Spatial information has introduced a new sense of urgency for a better understanding of the public needs in term of what, when and where they need services and through which devices, platform or physical locations they need them. The objective of this project is to value- add existing license management process for business premises which comes under the responsibility of Local Authority (PBT). Manipulation of geospatial and tracing technology via mobile platform allows enforcement officers to work in real-time, use a standardized system, improve service delivery, and optimize operation management. This paper will augment the scope and capabilities of proposed concept namely, Smart Licensing/Enforcement Management (SLEm). It will review the current licensing and enforcement practice of selected PBT in comparison to the enhanced method. As a result, the new enhanced system is expected to offer a total solution for licensing/enforcement management whilst increasing efficiency and transparency for smart city management and governance.

  6. Understanding tradeoffs in the supplier selection process : The role of flexibility, delivery, and value-added services/support

    NARCIS (Netherlands)

    Rhee, van der B.; Verma, R.; Plaschka, G.

    2009-01-01

    In this study, we present, based on econometric choice modeling framework, how manufacturing managers/executives trade-off between cost, delivery, flexibility, and service features in the supplier selection process for commodity raw materials, given acceptable quality. Empirical data for this study

  7. Proposal of a service delivery integration index of home care for older persons: application in several European cities.

    NARCIS (Netherlands)

    Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

    2006-01-01

    PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

  8. Capacity, pressure, demand, and flow: A conceptual framework for analyzing ecosystem service provision and delivery

    Science.gov (United States)

    Villamagna, Amy M.; Angermeier, Paul L.; Bennett, Elena M.

    2013-01-01

    Ecosystem services provide an instinctive way to understand the trade-offs associated with natural resource management. However, despite their apparent usefulness, several hurdles have prevented ecosystem services from becoming deeply embedded in environmental decision-making. Ecosystem service studies vary widely in focal services, geographic extent, and in methods for defining and measuring services. Dissent among scientists on basic terminology and approaches to evaluating ecosystem services create difficulties for those trying to incorporate ecosystem services into decision-making. To facilitate clearer comparison among recent studies, we provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem's capacity to produce services; ecological pressures that interfere with an ecosystem's ability to provide the service; societal demand for the service; and flow of the service to people. We discuss how interpretation and measurement of these four components can differ among provisioning, regulating, and cultural services. Our flexible framework treats service capacity, ecological pressure, demand, and flow as separate but interactive entities to improve our ability to evaluate the sustainability of service provision and to help guide management decisions. We consider ecosystem service provision to be sustainable when demand is met without decreasing capacity for future provision of that service or causing undesirable declines in other services. When ecosystem service demand exceeds ecosystem capacity to provide services, society can choose to enhance natural capacity, decrease demand and/or ecological pressure, or invest in a technological substitute. Because regulating services are frequently overlooked in environmental assessments, we provide a more detailed examination of regulating services and propose a novel method for quantifying the flow of

  9. A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

    Directory of Open Access Journals (Sweden)

    Shamim Haider

    2014-03-01

    Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

  10. A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

    Directory of Open Access Journals (Sweden)

    Shamim Haider

    2014-03-01

    Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

  11. A Study on the Relationship between Customer Satisfaction and Employee Service Delivery at Sutera Sanctuary Lodges’s Front Office Department at Kinabalu Park, Kundasang, Sabah, Malaysia

    Directory of Open Access Journals (Sweden)

    Alaska Adrian Kalasa

    2014-01-01

    Full Text Available The purpose of this study is focused on the customer service delivery by staff of front office department of Sutera Sanctuary Lodges, at Kinabalu Park, Kundasang, and Sabah, Malaysia. It will look into the attitude, skills and knowledge of the staff on customer service delivery and its effect on customer satisfaction. There are gaps that were identified from the findings; the front line staff has English language issues. The low rating for knowledge and skills in their work area are a concern. As a three (3 Orchid rated lodges operation the standard and quality should not be compromised. There is a positive relationship of customer satisfaction and employee service delivery. Rating of poor service delivery has been noted in the survey in anticipating guests need with 1% below expectation, Speed and efficiency of check-in process with 1% rated below expectation, welcoming and greeting with 11% below expectation. This includes courtesy, helpfulness of staff and grooming all rated 4% in below expectation.

  12. Human Trafficking in Ethiopia: A Scoping Review to Identify Gaps in Service Delivery, Research, and Policy.

    Science.gov (United States)

    Beck, Dana C; Choi, Kristen R; Munro-Kramer, Michelle L; Lori, Jody R

    2017-12-01

    The purpose of this review is to integrate evidence on human trafficking in Ethiopia and identify gaps and recommendations for service delivery, research and training, and policy. A scoping literature review approach was used to systematically search nursing, medical, psychological, law, and international databases and synthesize information on a complex, understudied topic. The search yielded 826 articles, and 39 met the predetermined criteria for inclusion in the review. Trafficking in Ethiopia has occurred internally and externally in the form of adult and child labor and sex trafficking. There were also some reports of organ trafficking and other closely related human rights violations, such as child marriage, child soldiering, and exploitative intercountry adoption. Risk factors for trafficking included push factors (poverty, political instability, economic problems, and gender discrimination) and pull factors (demand for cheap labor). Trafficking was associated with poor health and economic outcomes for victims. Key recommendations for service delivery, research and training, and policy are identified, including establishing comprehensive services for survivor rehabilitation and reintegration, conducting quantitative health outcomes research, and reforming policy around migration and trafficking. Implementing the recommendations identified by this review will allow policy makers, researchers, and practitioners to take meaningful steps toward confronting human trafficking in Ethiopia.

  13. 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?.

  14. Modelling of interplanetary pickup ion fluxes and relevance for LISM parameters

    International Nuclear Information System (INIS)

    Fahr, H.J.; Rucinski, D.

    1989-01-01

    It has been known for many years that neutral interstellar atoms enter the solar system from the upwind side and penetrate deep into the inner heliosphere. Helium atoms, in particular, advance towards very small solar distances before they are ionized and then again convected as He - pickup ions outwards with the solar wind. Since these ions were recently detected in space, we concentrate here on calculations of He + production rates and He + fluxes. It is shown that inside 1 a.u., the He - production is essentially determined both by solar e.u.v. photoionization and by electron impact ionization. We calculate He + production rates as a function of space coordinates, taking into account the core-halo structure of the energy distribution of solar wind electrons and their temperature distribution with distance according to relevant solar wind models. For this purpose, a newly developed program to compute He densities was used. In contrast to the production of H + , the He - production rates are found to be higher on the downwind axis than on the upwind axis by a factor of 5. We also determine partial and total He + ion fluxes as a function of solar distance and longitude. It is interesting to note that only the values for total fluxes agree well with the integrated He + fluxes measured by the SULEICA experiment aboard the AMPTE satellite. This indicates that pickup ions under the influence of the intrinsic MHD wave turbulence in the solar wind change their primary seed distribution function by rapid pitch-angle scattering and subsequent adiabatic cooling. To interpret the He + intensity profile along the orbit of the Earth in terms of LISM helium parameters, we point to the need to take into account carefully electron impact ionization in order to prevent misinterpretations. (author)

  15. Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: a qualitative study.

    Science.gov (United States)

    Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery

    2016-05-01

    To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.

  16. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: A community - based cross sectional study

    Directory of Open Access Journals (Sweden)

    Teferra Alemayehu

    2012-07-01

    Full Text Available Abstract Background Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio and improving maternal health is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Amhara Regional State, Ethiopia. Therefore, this study aimed to assess factors affecting institutional delivery service utilization among mothers who gave birth in the last 12 months in Sekela District, Amhara Region, Ethiopia. Methods Community-based cross-sectional study was conducted among mothers with birth in the last 12 months during August, 2010. Multistage sampling technique was used to select 371 participants. A pre tested and structured questionnaire was used to collect data. Bivariate and multivariate data analysis was performed using SPSS version 16.0 software. Results The study indicated that 12.1% of the mothers delivered in health facilities. Of 87.9% mothers who gave birth at home, 80.0% of them were assisted by family members and relatives. The common reasons for home delivery were closer attention from family members and relatives (60.9%, home delivery is usual practice (57.7%, unexpected labour (33.4%, not being sick or no problem at the time of delivery (21.6% and family influence (14.4%. Being urban resident (AOR [95% CI] = 4.6 [1.91, 10.9], ANC visit during last pregnancy (AOR [95% CI] = 4.26 [1.1, 16.4], maternal education level (AOR [95%CI] =11.98 [3.36, 41.4] and knowledge of mothers on pregnancy and delivery services (AOR [95% CI] = 2.97[1.1, 8.6] had significant associations with institutional delivery service utilization. Conclusions Very low institutional delivery service utilization was observed in the study area. Majority of the births at home were assisted by family members and relatives. ANC visit and lack of

  17. Stuttering Intervention in Three Service Delivery Models (Direct, Hybrid, and Telepractice): Two Case Studies

    OpenAIRE

    VALENTINE, DANIEL T.

    2015-01-01

    This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4) was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue) w...

  18. Public Service Delivery in Hybrid Organisations : public management reform and horizontalisation as main challenges for public leaders

    NARCIS (Netherlands)

    Kuitert, L.; Volker, L.

    2016-01-01

    The public sector has been subject to some major movements the last 15 years. In public service delivery a trend called socialisation, leading to the displacement between public and private, is most crucial. A withdrawing government and privatization led to increased collaboration between public and

  19. User involvement in service delivery predicts outcomes of assistive technology use: A cross-sectional study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Borg Johan

    2012-09-01

    Full Text Available Abstract Background Knowledge about the relation between user involvement in the provision of assistive technology and outcomes of assistive technology use is a prerequisite for the development of efficient service delivery strategies. However, current knowledge is limited, particularly from low-income countries where affordability is an issue. The objective was therefore to explore the relation between outcomes of assistive technology use and user involvement in the service delivery process in Bangladesh. Methods Using structured interviews, data from 136 users of hearing aids and 149 users of manual wheelchairs were collected. Outcomes were measured using the International Outcome Inventory for Hearing Aids (IOI-HA, which was adapted for wheelchair users. Predictors of user involvement included preference, measurement and training. Results Users reported outcomes comparable to those found in other high- and low-income countries. User involvement increased the likelihood for reporting better outcomes except for measurement among hearing aid users. Conclusions The findings support the provision of assistive technology as a strategy to improve the participation of people with disabilities in society. They also support current policies and guidelines for user-involvement in the service delivery process. Simplified strategies for provision of hearing aids may be explored.

  20. The effect of Fe and C in modifying deuterium pickup in Zr-2.5Nb: a response surface analysis

    International Nuclear Information System (INIS)

    Ploc, R.A.

    2001-03-01

    A Response Surface Analysis of the effect of iron and carbon in Zr-2.5Nb-Fe/C drop-castings has shown that iron and carbon have at least a quadratic, synergistic relationship on oxidation and deuterium pickup. Tests were performed in the Halden test reactor and associated autoclave for 208 days at 598 K (325 o C). The synergism explains why pressure tube data have limited value when attempting to deduce the effect of impurity elements on pick up. Out- and in-reactor pick up were similar in trend and magnitude except for the in-reactor deuterium pickup, which was about one-quarter of that out-reactor. Minimum in-reactor deuterium ingress is predicted for 30 ppm (wt) carbon and approximately 1,100 ppm (wt) of iron. Out-reactor optimal values are similar but with slightly higher iron values. (author)

  1. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    2016-10-01

    Full Text Available Abstract Background Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider

  2. From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study.

    Science.gov (United States)

    Jacobs, Bart; Thomé, Jean-Marc; Overtoom, Rob; Sam, Sam Oeun; Indermühle, Lorenz; Price, Neil

    2010-05-01

    Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period-notably the development of performance indicators and targets and the performance monitoring.

  3. Who benefits from removing user fees for facility-based delivery services? Evidence on socioeconomic differences from Ghana, Senegal and Sierra Leone.

    Science.gov (United States)

    McKinnon, Britt; Harper, Sam; Kaufman, Jay S

    2015-06-01

    Coverage of skilled delivery care has been increasing across most low-income countries; however, it remains far from universal and is very unequally distributed according to socioeconomic position. In an effort to increase coverage of skilled delivery care and reduce socioeconomic inequalities, governments of several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies and few studies have examined effects on socioeconomic inequalities. This study investigates the impact of recent delivery fee exemption policies in Ghana, Senegal, and Sierra Leone on socioeconomic differences in the use of facility-based delivery services. Using Demographic and Health Survey data from nine sub-Saharan African countries, we evaluated the user fee policy changes using a difference-in-differences approach that accounts for underlying common secular trends and time invariant differences among countries, and allows for differential effects of the policy by socioeconomic position. Removing user fees was consistent with meaningful increases in facility deliveries across all categories of household wealth and maternal education. We found little evidence of differential effects of removing user fees across quartiles of household wealth, with increases of 5.4 facility deliveries per hundred live births (95% CI: 2.1, 8.8) among women in the poorest quartile and 6.8 per hundred live births (95% CI: 4.0, 9.7) for women in the richest quartile. However, our results suggest that educated women benefited more from removing user fees compared to women with no education. For women with at least some secondary education, the estimated effect was 8.6 facility deliveries per hundred live births (95% CI: 5.4, 11.9), but only 4.6 per hundred live births (95% CI: 2.2, 7.0) for women with no education (heterogeneity p-value = 0.04). Thus, while removing fees at the point

  4. Human factors that derail extension services delivery in developing countries: implications for policy

    Directory of Open Access Journals (Sweden)

    E.N. Ajani

    2012-12-01

    Full Text Available The paper examines human factors derailing extension services delivery in developing countries. Poor management of rewards and incentives; quality of work life; poor assessment system; limited quality of human resource; inadequate extension support training materials; inconsistencies of government programmes; inadequate staff training and poor extension programme evaluation were viewed as major constraints. Considering the role of extension to agricultural development, the paper recommends that efforts should be made by the various stakeholders in agricultural extension services to improve the capability of human resources involved in extension services and highlights the need for government agricultural programmes to be consistent to enable the beneficiaries of such programmes derive the benefits that will boost productivity in agriculture.

  5. Electromagnetically-induced nuclear-charge pickup observed in ultra-relativistic Pb collisions

    International Nuclear Information System (INIS)

    Scheidenberger, C.; Aumann, T.; Pshenichnov, I.A.; Russian Academy of Sciences, Moscow

    2002-01-01

    A strong increase of inclusive nuclear-charge pickup cross sections, forming 83 Bi from 158 A GeV 82 Pb ions, is observed in comparison to similar measurements at 10.6 A GeV. From the dependence of these cross sections on target atomic number, this increase is attributed to the electromagnetic process of pion production by equivalent photons. The observed cross sections can be reproduced quantitatively using the recently developed RELDIS code. (orig.)

  6. Methods for the economic evaluation of changes to the organisation and delivery of health services: principal challenges and recommendations.

    Science.gov (United States)

    Meacock, Rachel

    2018-04-20

    There is a requirement for economic evaluation of health technologies seeking public funding across Europe. Changes to the organisation and delivery of health services, including changes to health policy, are not covered by such appraisals. These changes also have consequences for National Health Service (NHS) funds, yet undergo no mandatory cost-effectiveness assessment. The focus on health technologies may have occurred because larger-scale service changes pose more complex challenges to evaluators. This paper discusses the principal challenges faced when performing economic evaluations of changes to the organisation and delivery of health services and provides recommendations for overcoming them. The five principal challenges identified are as follows: undertaking ex-ante evaluation; evaluating impacts in terms of quality-adjusted life years; assessing costs and opportunity costs; accounting for spillover effects; and generalisability. Of these challenges, methods for estimating the impact on costs and quality-adjusted life years are those most in need of development. Methods are available for ex-ante evaluation, assessing opportunity costs and examining generalisability. However, these are rarely applied in practice. The general principles of assessing the cost-effectiveness of interventions should be applied to all NHS spending, not just that involving health technologies. Advancements in this area have the potential to improve the allocation of scarce NHS resources.

  7. Quasi-Experimental Study of the Effectiveness of an Integrated Service Delivery Network for the Frail Elderly

    Science.gov (United States)

    Tourigny, Andre; Durand, Pierre J.; Bonin, Lucie; Hebert, Rejean; Rochette, Louis

    2004-01-01

    The aim of this study was to examine the effectiveness of a new, integrated service delivery (ISD) network of health and social services for frail elderly living in a semi-urban community. A quasi-experimental study was conducted from 1997 to 2000, with measures taken before implementation (T0) and every 12 months after implementation for a 3-year…

  8. Personalizing Knowledge Delivery Services for Emerging Knowledge Processes (EKPs): A Conceptual Framework

    Science.gov (United States)

    Majchrzak, Ann; Chellappa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

    2003-01-01

    The contents include: 1) What do most KMS in use today assume?; 2) Assumptions are violated when KMS is used by EKP workers - Why?; 3) Current State of KMS for EKPs are inadequate; 4) What would an "adequate" KMS for EKPs look like?; 5) "User-as-Consumer" Analogue: Ecommerce/Eem ployee Services; 6) Why is an ideal KMS for EKPs hard to achieve?; 7) So, what type of KMS design would work?; 8) Human-Based KMS for EKP - Proposal Call Managers at R&DLAB; 9) Proposal Call Managers (PCMs); 10) Specific PCM tasks; 11) Why is a R&DLAB PCM a human metaphor for a KMS for EKP?; 12) Data Collection; 13) Finding #1; 14) Finding #2; 15) Finding #3; 16) Factors affecting How/when; 17) Finding #4; 18) Finding #5; 19) Implication#l for a KMS for EKP: From System to Service; 20) Implication #2: From technology or human-centric to Mixed Mode; 21) Implication #3: From Simple User Profiles to Dynamic Delivery Profiles; 22) Implication #4: Maintaining a trustworthy environment; 23) Implication #5: Constructing a dynamic delivery profile; 24) Implications for Research: Model; and 25) Example Research Qs on KMS Support for EKPs.

  9. The Utility of Rural and Underserved Designations in Geospatial Assessments of Distance Traveled to Healthcare Services: Implications for Public Health Research and Practice

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2013-01-01

    Full Text Available Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1 review the different definitions of rurality and their purposes; (2 identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3 describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4 examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

  10. The utility of rural and underserved designations in geospatial assessments of distance traveled to healthcare services: implications for public health research and practice.

    Science.gov (United States)

    Smith, Matthew Lee; Dickerson, Justin B; Wendel, Monica L; Ahn, Sangnam; Pulczinski, Jairus C; Drake, Kelly N; Ory, Marcia G

    2013-01-01

    Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

  11. The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients—innovation in the commissioning of primary dental care service delivery and organisation in the UK

    Science.gov (United States)

    Pavitt, Sue H; Baxter, Paul D; Brunton, Paul A; Douglas, Gail; Edlin, Richard; Gibson, Barry J; Godson, Jenny; Hall, Melanie; Porritt, Jenny; Robinson, Peter G; Vinall, Karen; Hulme, Claire

    2014-01-01

    Introduction In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards ‘blended contracts’ that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. Methods and analysis The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life. Ethics and dissemination The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national

  12. Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in Zambia.

    Science.gov (United States)

    Tuba, Mary; Sandoy, Ingvild F; Bloch, Paul; Byskov, Jens

    2010-11-01

    Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT), a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR) approach to priority setting in Zambia, Tanzania and Kenya. This paper is based on baseline in-depth interviews (IDIs) conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD) with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both planning and delivery. Poor status of the AFR

  13. Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in zambia

    Directory of Open Access Journals (Sweden)

    Bloch Paul

    2010-11-01

    Full Text Available Abstract Background Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT, a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR approach to priority setting in Zambia, Tanzania and Kenya. Methods This paper is based on baseline in-depth interviews (IDIs conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Results Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both

  14. Comparison between Synchronous and Asynchronous Instructional Delivery Method of Training Programme on In-Service Physical Educators' Knowledge

    Science.gov (United States)

    Emmanouilidou, Kyriaki; Derri, Vassiliki; Antoniou, Panagiotis; Kyrgiridis, Pavlos

    2012-01-01

    The purpose of the study was to compare the influences of a training programme's instructional delivery method (synchronous and asynchronous) on Greek in-service physical educators' cognitive understanding on student assessment. Forty nine participants were randomly divided into synchronous, asynchronous, and control group. The experimental groups…

  15. The hands-on project office guaranteeing ROI and on-time delivery

    CERN Document Server

    Kesner, Richard M

    2003-01-01

    THE THREE PILLARS OF IT DELIVERY - PROBLEM RESOLUTION, SERVICE REQUESTS, AND PROJECTSIntroduction The Business Context The Internal Economy for Investing in IT Services and ProjectsThe Three Pillars of IT Delivery Managing Service DeliveryManaging Project Commitments IT Metrics and Reporting Tools THE PROJECT MANAGEMENT OFFICE BUSINESS MODELIntroduction: Revisiting the IT Organization IT Service and Project Delivery RolesThe Role of the Project Management Office: Measuring its ROI The PMO Value Proposition: An Initial ROI Estimate ALIGNMENT AND PLANNING - DOING THE RIGHT THINGS Introduction Ge

  16. Attitudinal orientation of first level managers for improvement of municipal service delivery: Experience of training intervention in Kolkata

    Directory of Open Access Journals (Sweden)

    Uttam Kumar Roy

    2010-07-01

    Full Text Available This paper discusses a program of attitudinal orientation courses provided for functionaries of a large municipal corporation in India. Almost 450 Assistant Managers from the Kolkata Municipal Corporation took part in the training, which was held at the Administrative Training Institute (ATI of the Government of West Bengal, India. Under the 74th Constitutional Amendment Act, Indian Municipalities/Corporations (Urban Local Bodies are empowered and entrusted to perform planning, development and governance for the city/ town and to provide services to the citizens. The change in outlook towards the local government reflected in the Act has highlighted the need for greater awareness and a better attitude amongst municipal staff as well as elected representatives towards service delivery. Good governance can be achieved through the overall performance of officials of an organization, provided they possess the necessary knowledge, skills, attitudes and competencies. For historical reasons, knowledge, skills and attitudes amongst officials of Urban Local Bodies (ULBs in India have been traditionally of a low standard. Willingness to perform better in the role of municipal service delivery is not common. Therein lies the need for training for improvement in service delivery, especially for organizations like large municipal corporations and municipalities.

  17. Decision making at the frontline: Exploring coping with moral conflicts during public service delivery

    NARCIS (Netherlands)

    Vink, E.; Tummers, L.G.; Bekkers, V.J.J.M.; Musheno, M.

    2015-01-01

    Moral conflicts, where a person is confronted with two or more clashing values, norms or responsibilities, are common in public service delivery. Choosing one is realized at the cost of the other(s). Frontline professionals, such as physicians and police officers, often experience clashes over the

  18. Morphological analysis: a method for selecting ICT applications in South African government service delivery

    CSIR Research Space (South Africa)

    Plauché, M

    2010-01-01

    Full Text Available by trial and error, as every attempt counts signi?cantly. 6. Wicked problems do not have an enumerable (or an exhaustively describable) set of potential solutions, nor is there a well-described set of permissible operations that may be incorporated... scheduled clinical visits. Access to information about entitled services alone has been found to improve the delivery of health and social services to resource-poor popula- tions (Pandey, Sehgal, Riboud, Levine, & Goyal, 2007). In South Africa, however...

  19. Beam position pickup for antiprotons to the ISR

    CERN Multimedia

    CERN PhotoLab

    1981-01-01

    The Antiproton Project, launched for proton-antiproton collisions in the SPS (SPS collider), had a side-line for p-pbar collisions in the ISR. A new transfer line, TT6, was constructed to transport antiprotons from the 26 GeV PS to the injection line TT1 of ISR ring 2. Antiprotons were a scarce commodity. For setting up the lines, beam diagnostic devices in the antiproton path had to work reliably and precisely with just a few low-intensity pilot pules: single bunches of about 2x10**9 antiprotons every few hours. Electrostatic pickup electrodes were used to measure beam position. They could be mounted for measurement in the horizontal plane, as in this picture, or at 90 deg, for the vertical plane.

  20. Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya.

    Science.gov (United States)

    Njuguna, John; Kamau, Njoroge; Muruka, Charles

    2017-06-21

    Kenya has a high maternal mortality rate. Provision of skilled delivery plays a major role in reducing maternal mortality. Cost is a hindrance to the utilization of skilled delivery. The Government of Kenya introduced a policy of free delivery services in government facilities beginning June 2013. We sought to determine the impact of this intervention on facility based deliveries in Kenya. We compared deliveries and antenatal attendance in 47 county referral hospitals and 30 low cost private hospitals not participating in the free delivery policy for 2013 and 2014 respectively. The data was extracted from the Kenya Health Information System. Multiple regression was done to assess factors influencing increase in number of deliveries among the county referral hospitals. The number of deliveries and antenatal attendance increased by 26.8% and 16.2% in county referral hospitals and decreased by 11.9% and 5.4% respectively in low cost private hospitals. Increase in deliveries among county referral hospitals was influenced by population size of county and type of county referral hospital. Counties with level 5 hospitals recorded more deliveries compared to those with level 4 hospitals. This intervention increased the number of facility based deliveries. Policy makers may consider incorporating low cost private hospitals so as to increase the coverage of this intervention.

  1. Opportunities and barriers in service delivery through mobile phones (mHealth) for Severe Mental Illnesses in Rajasthan, India: A multi-site study.

    Science.gov (United States)

    Jain, Nikhil; Singh, Harful; Koolwal, Ghanshyam Das; Kumar, Sunil; Gupta, Aditya

    2015-04-01

    Widespread use of mobile technology holds a lot of promise for mental health service delivery in regions where mental health resources are scarce and the treatment gap is large. The felt needs of the clients, and the patterns and barriers of mobile usage must be understood before some intervention can be planned. The study presented in this paper was designed to fill this gap in the region of Rajasthan, India. The study was conducted in three tertiary care hospitals. Clients utilizing services for Severe Mental Illnesses (SMIs) were the participants of the study. Information about ownership, usage patterns and barriers to accessing mobile technology and felt needs in terms of mental health services that could be delivered through mobile phones were sought from the participants. The typical respondents in all three centres were middle-aged, married, Hindu males belonging to lower socio-economic strata from rural background. Seventy two to 92% of participants had access to mobile phone. The most preferred mode of service delivery was through calls. Helpline for crisis resolution and telephonic follow-up of stable patients emerged as the most felt need of the participants. Barriers to mobile phones usage included affordability, lack of necessity, poor signal. In conclusion, the study shows that the access to mobile phones amongst clients receiving services for SMI is widespread and offers new opportunities in service delivery in the region. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. An Exact Method for the Double TSP with Multiple Stacks

    DEFF Research Database (Denmark)

    Lusby, Richard Martin; Larsen, Jesper; Ehrgott, Matthias

    2010-01-01

    The double travelling salesman problem with multiple stacks (DTSPMS) is a pickup and delivery problem in which all pickups must be completed before any deliveries can be made. The problem originates from a real-life application where a 40 foot container (configured as 3 columns of 11 rows) is used...

  3. An Exact Method for the Double TSP with Multiple Stacks

    DEFF Research Database (Denmark)

    Larsen, Jesper; Lusby, Richard Martin; Ehrgott, Matthias

    The double travelling salesman problem with multiple stacks (DTSPMS) is a pickup and delivery problem in which all pickups must be completed before any deliveries can be made. The problem originates from a real-life application where a 40 foot container (configured as 3 columns of 11 rows) is used...

  4. Building Service Delivery Networks: Partnership Evolution Among Children's Behavioral Health Agencies in Response to New Funding.

    Science.gov (United States)

    Bunger, Alicia C; Doogan, Nathan J; Cao, Yiwen

    2014-12-01

    Meeting the complex needs of youth with behavioral health problems requires a coordinated network of community-based agencies. Although fiscal scarcity or retrenchment can limit coordinated services, munificence can stimulate service delivery partnerships as agencies expand programs, hire staff, and spend more time coordinating services. This study examines the 2-year evolution of referral and staff expertise sharing networks in response to substantial new funding for services within a regional network of children's mental health organizations. Quantitative network survey data were collected from directors of 22 nonprofit organizations that receive funding from a county government-based behavioral health service fund. Both referral and staff expertise sharing networks changed over time, but results of a stochastic actor-oriented model of network dynamics suggest the nature of this change varies for these networks. Agencies with higher numbers of referral and staff expertise sharing partners tend to maintain these ties and/or develop new relationships over the 2 years. Agencies tend to refer to agencies they trust, but trust was not associated with staff expertise sharing ties. However, agencies maintain or form staff expertise sharing ties with referral partners, or with organizations that provide similar services. In addition, agencies tend to reciprocate staff expertise sharing, but not referrals. Findings suggest that during periods of resource munificence and service expansion, behavioral health organizations build service delivery partnerships in complex ways that build upon prior collaborative history and coordinate services among similar types of providers. Referral partnerships can pave the way for future information sharing relationships.

  5. Improving family planning services delivery and uptake: experiences from the "Reversing the Stall in Fertility Decline in Western Kenya Project".

    Science.gov (United States)

    Amo-Adjei, Joshua; Mutua, Michael; Athero, Sherine; Izugbara, Chimaraoke; Ezeh, Alex

    2017-10-10

    In this paper, we reflect on our experiences of implementing a multipronged intervention to improve sexual and reproductive health outcomes. The project used family planning as its entry point and was implemented in two high fertility counties-Busia and Siaya in Kenya. The intervention, implemented by a seven-member consortium, involved: family planning services delivery; regular training of service providers to deliver high quality services; monitoring and evaluation; strengthening of commodity chain delivery and forecasting; school-based and out-of-school based sexuality education; and advocacy and stakeholder engagements at the community, county and national levels. Over a 5-year period, the project contributed to raising demand for family planning considerably, evidenced in fertility decline. It also improved the capacity of family planning services providers, increased commitment and awareness of county government and other community stakeholders on the importance of investments in family planning. Our collaborations with organisations interested in sexual and reproductive health issues substantially enhanced the consortium's ability to increase demand for, and supply of family planning commodities. These collaborations are proving useful in the continuity and sustainability of project achievements.

  6. The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2010-01-01

    In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. To investigate in detail the impact of the QOF on practice organisation and service delivery. Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

  7. Determinants of institutional delivery service utilization among pastorals of Liben Zone, Somali Regional State, Ethiopia, 2015

    Directory of Open Access Journals (Sweden)

    Zepro NB

    2016-12-01

    Full Text Available Nejimu Biza Zepro,1 Ahmed Tahir Ahmed2 1College of Health Sciences, Samara University, Samara, Afar, Ethiopia; 2College of Health Science, Jigjiga University, Jigjiga, Somali, Ethiopia Abstract: Maternal health service utilizations are poorly equipped, inaccessible, negligible, and not well documented in the pastoral society. This research describes a quantitative and qualitative study on the determinants of institutional delivery among pastoralists of Liben Zone with special emphasis on Filtu and Deka Suftu woredas of Somali Region, Ethiopia. The study was funded by the project “Fostering health care for refugees and pastoral communities in Somali Region, Ethiopia”. This community-based cross-sectional study was conducted during November 2015. Interviews through a questionnaire and focus group discussions were used to collect the data. Proportional to size allocation followed by systematic sampling technique was used to identify the study units. The major determinants of institutional delivery in the study area were as follows: being apparently healthy, lack of knowledge, long waiting time, poor quality services, cultural beliefs, religious misconception, partner decision, and long travel. Around one-third (133, 34.5% of the women had visited at least once for their pregnancy. More than half (78, 58.6% of the women had visited health facilities due to health problems and only 27 (19.9% women had attended the recommended four antenatal care visits. Majority (268, 69.6% of the pregnant women preferred to give birth at home. Women who attended antenatal care were two times more likely to deliver at health facilities (AOR, 95% confidence interval [CI] =2.38, 1.065–4.96. Women whose family members preferred health facilities had 14 times more probability to give birth in health institutions (AOR, 95% CI =13.79, 5.28–35.8. Women living in proximity to a health facility were 13 times more likely to give birth at health facilities than women

  8. Out-of-hours MRI provision in the UK and models of service delivery

    International Nuclear Information System (INIS)

    Hauptfleisch, J.; Meagher, T.M.; King, D.; López de Heredia, L.; Hughes, R.J.

    2013-01-01

    Aim: To examine current out-of-hours magnetic resonance imaging (MRI) provision through a snapshot survey of National Health Service (NHS) trusts and to assay how radiographer staffing cover was provided for out-of-hours services. Materials and methods: A snapshot postal survey was mailed to heads of service of all 234 trusts in England and Wales. A literature search on the models of service delivery and correlation with the authors' internal MRI rota, which has provided a full on-call service for 20 years was undertaken. Results: The response rate was 45.7% (107 of 234); 14% of responders provided full access to MRI 24 h a day; 63% provided extended weekday service, typically to 20.00 h; and 81% provided a weekend daytime service. The radiographers running the service were typically from the core MRI team. Approximately one-third (29.9%) of trusts provided training in basic brain and spine MRI to non-core MRI team members, but they typically did not participate in out-of-hours provision. Conclusion: There is currently a paucity of information on the provision of out-of-hours MRI in the NHS. However, there is increasing pressure to provide complex imaging out of hours, and in the future, trauma centres may be required to provide MRI to assess spinal injury. The authors describe a system to provide access to MRI at no additional cost to the organization based on 20 years of experience. A minority of surveyed acute NHS trusts have full out-of-hours access to MRI. Demand for MRI provision out of core hours is likely to increase

  9. Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

    OpenAIRE

    Couch, Stephanie; Zieba, Dominique; van der Linde, Jeannie; van der Merwe, Anita

    2015-01-01

    Background: As a professional voice user, it is imperative that a speech-language pathologist’s(SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours,poor vocal hygiene and environmental factors. Objectives: To determine the effect of service delivery on the perceptual and acoustic features of voice. Method: A quasi-experimental., pre-test–post-test research de...

  10. [Methods and Applications to estimate the conversion factor of Resource-Based Relative Value Scale for nurse-midwife's delivery service in the national health insurance].

    Science.gov (United States)

    Kim, Jinhyun; Jung, Yoomi

    2009-08-01

    This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

  11. Operational Criteria for the Design of Front-Office Processes in Multi-Channel Service Delivery Systems

    OpenAIRE

    Sousa, Rui; Amorim, Marlene

    2010-01-01

    This paper identifies relevant operational factors that affect the design of front-office processes in Multi-Channel Service Delivery Systems. Based on two in-depth case studies in banking and telecommunications, we distinguish four operational factors: i) characteristics of the inputs and outputs of the service activities; ii) characteristics of the transformation taking place; iii) the expected utilization; iv) the economics of developing the activities in the channels. Building on these re...

  12. Preventing Elder Abuse: The Texas Plan for a Coordinated Service Delivery System. Collaborative Elder Abuse Prevention Project.

    Science.gov (United States)

    McDaniel, Garry L.

    The Texas Department of Human Services, in collaboration with 13 other public and private organizations, co-sponsored a statewide Collaborative Elder Abuse Prevention project. The goal of this project is to develop a comprehensive, long-range plan for the prevention of elder abuse, a method for achieving a coordinated service delivery system for…

  13. Receivers for processing electron beam pick-up electrode signals

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    There are several methods of determining the transverse position of the electron beam, based upon sensing either the electric field, the magnetic field, or both. At the NSLS the transverse beam position monitors each consist of a set of four circular electrodes. There are 48 sets of pick-up electrodes in the X-ray ring and 24 in the VUV storage ring for determining the electron orbit, and a few extra sets installed for specialized purposes. When the beam passes between the four electrodes, charge is induced on each electrode, the amount depending upon the distance of the beam from that electrode. If V a , V b , V c and V d given by a difference between pairs of electrodes normalized for variations in beam current by dividing by the sum of electrode voltages. The method of processing these signals depends upon their time structure. The electrons circulating around the vacuum chamber are concentrated in short bunches within stability buckets produced by the accelerating voltage in the RF cavities. The charges induced on the pickup electrodes then are narrow pulses, a fraction of a nanosecond long, and would result in a monopolar voltage pulses if it were not for the impedance of the cable connecting the electrode to the processing apparatus. The capacitance between each electrode and the chamber wall is only a few picofarads and is effectively in parallel with the cable impedance (50 ohms). Thus an appreciable amount of the charge flows off the electrode while the bunch is between the electrodes, resulting in potential of opposite sign as the bunch is leaving the vicinity of the electrode. The resulting signal consists of a series of bipolar pulses, each of less than one nanosecond duration

  14. How well are we doing? Families of adolescents or young adults with cerebral palsy share their perceptions of service delivery.

    Science.gov (United States)

    Darrah, J; Magil-Evans, J; Adkins, R

    2002-07-10

    The satisfaction of families of adolescents and young adults with a diagnosis of cerebral palsy with the service delivery they had experienced in the areas of health, education, recreation, employment, housing and transportation was examined. Common themes across the six service areas were identified. Forty-nine adolescents (13-15 years) and 39 young adults (19-23 years) and their families rated their satisfaction with services and then participated in semi-structured interviews to discuss their experiences. Using a constant comparative method of analysis, common themes were identified from the transcribed interviews. Four themes were identified and named: caring and supportive people; fighting and fatigue; communication/information; and disability awareness. Families continue to experience dissatisfaction and frustration with service delivery in the six areas examined. Both bureaucratic structure and attitudes of service providers contribute to their dissatisfaction.

  15. A comparison of rural speech-language pathologists' and residents' access to and attitudes towards the use of technology for speech-language pathology service delivery.

    Science.gov (United States)

    Dunkley, Carolyn; Pattie, Lydelle; Wilson, Linda; McAllister, Lindy

    2010-08-01

    This paper reports results and implications of two related studies which investigated (a) access of residents and speech-language pathologists (SLPs) of rural Australia to information and communication technologies (ICT) and (b) their attitudes towards the use of ICT for delivery of speech-language pathology services. Both studies used mail out questionnaires, followed by interviews with a subset of those who completed the questionnaires. Data were obtained from 43 questionnaires from rural residents and 10 interviews with a subset of those residents, and from questionnaires returned by 49 SLPs and 4 interviews with a subset of those SLPs. Results show a mismatch between rural residents' and SLPs' access to and attitudes towards use of ICT for speech-language pathology service delivery. Rural residents had better access and more positive attitudes to the use of ICT for speech-language pathology service delivery than expected by SLPs. The results of this study have important implications for education and professional development of SLPs and for research into the use of ICT for telespeech-language pathology.

  16. Final version of the pick-up wheels in the Pelletron tandem accelerator at Lund

    International Nuclear Information System (INIS)

    Hakansson, K.; Hellborg, R.

    1993-01-01

    A new type of pick-up wheel has been designed and constructed for the charge transport system of the Lund 3UDH Pelletron tandem accelerator. The major improvements compared with older types are a slender design with only one ball bearing and more robust contact pins with a rubber ring between the pinhead and the wheel nave. (orig.)

  17. Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

    Science.gov (United States)

    Couch, Stephanie; Zieba, Dominique; van der Merwe, Anita

    2015-01-01

    Background As a professional voice user, it is imperative that a speech-language pathologist's (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors. Objectives To determine the effect of service delivery on the perceptual and acoustic features of voice. Method A quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. Results A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Conclusion Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested. PMID:26304213

  18. Health service delivery models for the provision of antiretroviral therapy in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey

    2014-01-01

    OBJECTIVES: In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. METHODS: A systematic lite...

  19. Where to go in the near future: diverging perspectives on online public service delivery

    NARCIS (Netherlands)

    van Deursen, Alexander Johannes Aloysius Maria; Wimmer, Maria A.; Scholl, Jochen; Grönlund, Åke

    2007-01-01

    Although the electronic government is under heavy development, a clear vision doesn’t seem to exist. In this study 20 interviews among leaders in the field of e-government in the Netherlands resulted in different perspectives on the future of electronic public service delivery. The interviews

  20. The Internet of Things in bridging the gap in municipal service delivery in South Africa

    CSIR Research Space (South Africa)

    Dlodlo, N

    2012-05-01

    Full Text Available There continues to be high expectations of the government from the citizens of South Africa to improve the delivery of services , and hence the need to come up with comprehensive measures to alleviate the problem. This paper proposes the adoption...

  1. Structuring front office and back office work in service delivery systems - An empirical study of three design decisions

    NARCIS (Netherlands)

    Zomerdijk, Leonleke G.; de Vries, Jan

    2007-01-01

    Purpose - The aim of this paper is to investigate how the distinction between contact and non-contact activities influences the design of service delivery systems and to identify key design decisions for structuring front office and back office work. Design/methodology/approach - Building on current

  2. The Development of Statewide Policies and Procedures to Implement Telehealth for Part C Service Delivery

    Directory of Open Access Journals (Sweden)

    Beth Cole

    2016-12-01

    Full Text Available The use of telehealth has been discussed nationally as an option to address provider shortages for children, birth through two, enrolled in Part C of the Individuals with Disabilities Education Act (IDEA Early Intervention (EI programs. Telehealth is an evidence-based service delivery model which can be used to remove barriers in providing EI services to children and their families. In 2016, Colorado’s Part C Early Intervention (EI program began allowing the use of telehealth as an option for providers to conduct sessions with children and their caregivers. This article outlines the process taken to develop the necessary requirements and supports for telehealth to be incorporated into EI current practice.

  3. Client perspective assessment of women's satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia.

    Science.gov (United States)

    Dewana, Zeritu; Fikadu, Teshale; G/Mariam, Abebe; Abdulahi, Misra

    2016-02-11

    A woman's satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women's satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women's towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zone, southern Ethiopia. Facility based cross sectional study was conducted among women who gave birth at public health facility. A total 256 women who gave birth during the study period were included in the study. Data was collected using a structured questionnaire. Satisfaction level was measured using a 5 point-Likert scale questions. Data were entered using Epi data version 3.5.1 and analyzed using SPSS 20.0 statistical software. Factor analysis was employed for Likert scale questions to extract factor represented each of the scale which facilitate treatment of variable as continuous for further analysis. Bi-variate and multivariable logistic regression analysis was employed to identify association between women's satisfaction and predicator variables. Statistical significance was declared at P value labour and delivery care. Factors associated with women's satisfaction with labour and delivery care services include: not attending formal education [AOR = 8.00, 95% CI = (1.52, 12.27)] attending antenatal care four times and more [AOR = 5.00, 95% CI = (1.76, 14.20)] waiting below 15 minutes to be seen by health professional [AOR = 3.37, 95% CI = (1.14, 9.97)] and not paying for drugs and supplies [AOR = 6.19, 95% CI = (1.34, 18.59)]. Although majority of women were satisfied with the labour and delivery service they got, their level of satisfaction was influenced by educational status, number of ANC visits, waiting time, and payment for drug and supplies

  4. Large neighborhood search for the double traveling salesman problem with multiple stacks

    Energy Technology Data Exchange (ETDEWEB)

    Bent, Russell W [Los Alamos National Laboratory; Van Hentenryck, Pascal [BROWN UNIV

    2009-01-01

    This paper considers a complex real-life short-haul/long haul pickup and delivery application. The problem can be modeled as double traveling salesman problem (TSP) in which the pickups and the deliveries happen in the first and second TSPs respectively. Moreover, the application features multiple stacks in which the items must be stored and the pickups and deliveries must take place in reserve (LIFO) order for each stack. The goal is to minimize the total travel time satisfying these constraints. This paper presents a large neighborhood search (LNS) algorithm which improves the best-known results on 65% of the available instances and is always within 2% of the best-known solutions.

  5. Families at risk of poor parenting: a model for service delivery, assessment, and intervention.

    Science.gov (United States)

    Ayoub, C; Jacewitz, M M

    1982-01-01

    The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.

  6. Micromanipulation and pick-up system for X-Ray diffraction characterization of micrometer-sized single particles

    International Nuclear Information System (INIS)

    Takeichi, Y; Inami, N; Saito, K; Otori, H; Sagayama, R; Kumai, R; Ono, K; Ueno, T

    2014-01-01

    We describe a micromanipulation and pick-up system for preparing a micrometer-sized single particle for X-ray diffraction characterization. Combining a microgripper based on microelectromechanical systems, piezo-motor-driven linear stages, and a gamepad, the system provides precise and intuitive handling of the object. Single-crystal X-ray diffraction measurements of Sm-Fe-N permanent magnet were performed using this system. We also describe a method to distinguish crystallographically homogeneous particles found in powder-form samples.

  7. The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People

    OpenAIRE

    Knight, Alice; Havard, Alys; Shakeshaft, Anthony; Maple, Myfanwy; Snijder, Mieke; Shakeshaft, Bernie

    2017-01-01

    Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence meas...

  8. The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

    Science.gov (United States)

    Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

    2010-11-01

    Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed

  9. The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

    Directory of Open Access Journals (Sweden)

    Ergin Işıl

    2010-11-01

    Full Text Available Abstract Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006. Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000, number of deliveries and surgical operations (per 10 000 were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1 to Region 6(R6. Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown

  10. Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines.

    Science.gov (United States)

    Hodge, Andrew; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez-Soto, Eliana

    2016-07-06

    Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap. Using national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers' and her partners' education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers' religion and the subjective distance to the health facility were also noteworthy. This study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.

  11. Utilization of institutional delivery service and associated factors in Bench Maji zone, Southwest Ethiopia: community based, cross sectional study.

    Science.gov (United States)

    Tadele, Niguse; Lamaro, Tafesse

    2017-02-01

    At the end of Millennium development goals, Ethiopia was included among 10 countries which constitutes about 59% of maternal deaths due to complications of pregnancy and/or childbirth every year globally. Institutional delivery, which is believed to contribute in reduction of maternal mortality is still low. Hence this study was conducted in order to assess utilization of institutional delivery and related factors in Bench Maji zone, Southwest Ethiopia. Cross sectional study was employed from September 1st - 30th, 2015 in Bench Maji Zone, Southwest Ethiopia where 765 mothers who deliver 2 years preceding the study provided data for this research. Data were collected by enumerators who were trained. In addition to descriptive statistics, binary and multivariate logistic regression analyses were performed. Statistical significance was considered at a p-value delivery which was significant. In Bench Maji Zone institutional delivery was shown to be comparatively good compared to other studies in the region and in Ethiopia in general even though it is below the health sector transformation plan of Ethiopia which aimed to increase deliveries attended by skilled health personnel to 95%. Empowering women, increasing awareness about institutional delivery and proper scaling up of antenatal care services which is an entry point for institutional delivery are recommended.

  12. The Effect of Product Quality and Delivery Service on Online-customer Satisfaction in Zalora Indonesia

    OpenAIRE

    Handoko, Laras Putri

    2016-01-01

    The number of online transaction in Indonesia has increased in recent years with fashion products currently dominate the e-commerce market as the most frequently purchased products. The aims of this study are to analyze the effects of product quality and delivery service on online-customer satisfaction withdrawing taking online fashion retailer Zalora Indonesia as its research object. This research is causal type of research which uses primary data obtained through questionnaires and uses Mul...

  13. Compliance With Legal Age Restrictions on Adolescent Alcohol Sales for Alcohol Home Delivery Services (AHDS)

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; van den Wildenberg, Esther; de Bruijn, Dorien

    2014-01-01

    Purpose: Alcohol availability is an important predictor of alcohol use in adolescents and its negative consequences. Within this study, we zoomed in on availability through alcohol home delivery services (AHDS) by measuring compliance with the legal age limit in this sector. Methods: Two methods

  14. Determination of Route Delivery in the Logistic Service Provider (LSP) by Reviewing the Performance of Street in The City of Malang

    Science.gov (United States)

    Agustin, I. W.; Sumantri, Y.

    2017-03-01

    Malang as the National Activity Centre (PKN) led to increased economic growth and increased the demand for goods both primary and tertiary goods. Demand of goods which is increasing and also diversing will certainly have an impact on the process of transportation of goods involving a freight forwarder. Shipping of goods is part of the supply chain, which handles the flow of goods, distribution and delivery service or commonly called the courier. Fulfilling the request of goods would require Logistics Service Provider (LSP) that distribute goods from point of origin to destination. Delays in the distribution of goods will slow(DOWN) economic growth in Malang, therefore focused studies on the movement of goods which includes the election of the delivery route is needed. The purpose of this study is to get the delivery route for LSP by identifying its patterns of freight transport movement and to analyze the network performance of the road that is passed by freight transportation. Data collection techniques in this research are interviews, questionnaires and observations of moving-car and traffic counting to get the volume of traffic. The study used road’s performance analysis to get the level of service (LOS) of roads which are used by the freight transportation of LSP and Dijkstra’s algorithm analysis to determine the delivery routes. The results showed that the Level of Service of the roads (LOS) is at the level of D to F which indicates that the chosen roads experience instability of traffic flow even reach a critical condition. Therefore by considering delivery routes selection both of existing condition and analysis result as well as the condition of the road network in Malang, then given alternative is by deliverying goods on the chosen routes but not at peak hour.

  15. The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients-innovation in the commissioning of primary dental care service delivery and organisation in the UK.

    Science.gov (United States)

    Pavitt, Sue H; Baxter, Paul D; Brunton, Paul A; Douglas, Gail; Edlin, Richard; Gibson, Barry J; Godson, Jenny; Hall, Melanie; Porritt, Jenny; Robinson, Peter G; Vinall, Karen; Hulme, Claire

    2014-09-17

    In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards 'blended contracts' that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life. The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national and international conferences and in international journals

  16. 45 CFR 61.9 - Reporting civil judgments related to the delivery of a health care item or service.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting civil judgments related to the delivery of a health care item or service. 61.9 Section 61.9 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION...

  17. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    NARCIS (Netherlands)

    M. Chersich (Matthew); S. Luchters (Stanley); I. Ntaganira (Innocent); A. Gerbase (Antonio); Y-R. Lo (Ying-Ru); F. Scorgie (Fiona); R. Steen (Richard)

    2012-01-01

    textabstractIntroduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for

  18. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Science.gov (United States)

    2010-04-01

    ... include: (a) A customer-centered case management approach; (b) The provision of workforce investment... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING...

  19. Delivery of crop pollination services is an insufficient argument for wild pollinator conservation

    Science.gov (United States)

    Kleijn, David; Winfree, Rachael; Bartomeus, Ignasi; Carvalheiro, Luísa G; Henry, Mickaël; Isaacs, Rufus; Klein, Alexandra-Maria; Kremen, Claire; M'Gonigle, Leithen K; Rader, Romina; Ricketts, Taylor H; Williams, Neal M; Lee Adamson, Nancy; Ascher, John S; Báldi, András; Batáry, Péter; Benjamin, Faye; Biesmeijer, Jacobus C; Blitzer, Eleanor J; Bommarco, Riccardo; Brand, Mariëtte R; Bretagnolle, Vincent; Button, Lindsey; Cariveau, Daniel P; Chifflet, Rémy; Colville, Jonathan F; Danforth, Bryan N; Elle, Elizabeth; Garratt, Michael P.D.; Herzog, Felix; Holzschuh, Andrea; Howlett, Brad G; Jauker, Frank; Jha, Shalene; Knop, Eva; Krewenka, Kristin M; Le Féon, Violette; Mandelik, Yael; May, Emily A; Park, Mia G; Pisanty, Gideon; Reemer, Menno; Riedinger, Verena; Rollin, Orianne; Rundlöf, Maj; Sardiñas, Hillary S; Scheper, Jeroen; Sciligo, Amber R; Smith, Henrik G; Steffan-Dewenter, Ingolf; Thorp, Robbin; Tscharntke, Teja; Verhulst, Jort; Viana, Blandina F; Vaissière, Bernard E; Veldtman, Ruan; Westphal, Catrin; Potts, Simon G

    2015-01-01

    There is compelling evidence that more diverse ecosystems deliver greater benefits to people, and these ecosystem services have become a key argument for biodiversity conservation. However, it is unclear how much biodiversity is needed to deliver ecosystem services in a cost-effective way. Here we show that, while the contribution of wild bees to crop production is significant, service delivery is restricted to a limited subset of all known bee species. Across crops, years and biogeographical regions, crop-visiting wild bee communities are dominated by a small number of common species, and threatened species are rarely observed on crops. Dominant crop pollinators persist under agricultural expansion and many are easily enhanced by simple conservation measures, suggesting that cost-effective management strategies to promote crop pollination should target a different set of species than management strategies to promote threatened bees. Conserving the biological diversity of bees therefore requires more than just ecosystem-service-based arguments. PMID:26079893

  20. Health service delivery models for the provision of antiretroviral therapy in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey; Jaffar, Shabbar

    2014-10-01

    In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. A systematic literature search and analysis of studies that compared two or more methods of ART service delivery using either CD4 count or viral load as a primary outcome. Most studies identified in this review were small and non-randomised, with low statistical power. Four of the 30 articles identified by this review conclude that nurse management of ART compares favourably to physician management. Seven provide evidence of the viability of managing ART at lower levels within the health system, and one indicates that vertical and integrated ART programmes can achieve similar outcomes. Five articles show that community/home-based ART management can be as effective as facility-based ART management. Five of seven articles investigating community support link it to better clinical outcomes. The results of four studies suggest that directly observed therapy may not be an important component of ART programmes. Given that the scale-up of antiretroviral therapy represents the most sweeping change in healthcare delivery in sub-Saharan Africa in recent years, it is surprising to not find more evidence from comparative studies to inform implementation strategies. The studies reported on a wide range of service delivery models, making it difficult to draw conclusions about some models. The strongest evidence was related to the feasibility of decentralisation and task-shifting, both of which appear to be effective strategies. © 2014 John Wiley & Sons Ltd.