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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. 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.

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

    DEFF Research Database (Denmark)

    Petersen, Hanne Løhmann; Røpke, Stefan

    2011-01-01

    In this paper, we consider the pickup and delivery problem with cross-docking opportunity (PDPCD). The problem arises from an industry application, and includes pickup requests, delivery requests, and pickup-and-delivery requests. Each pickup-and-delivery request can be served either as direct...... 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...

  4. Strategies for Handling Temporal Uncertainty in Pickup and Delivery Problems with Time Windows

    NARCIS (Netherlands)

    F. Jordan Srour (F.); N.A.H. Agatz (Niels); J. Oppen (Johan)

    2014-01-01

    textabstractIn many real-life routing problems there is more uncertainty with respect to the required timing of the service than with respect to the service locations. We focus on a pickup and delivery problem with time windows in which the pickup and drop-off locations of the service requests are

  5. Finding optimal solutions for vehicle routing problem with pickup and delivery services with time windows: A dynamic programming approach based on state-space-time network representations

    OpenAIRE

    2015-01-01

    Optimization of on-demand transportation systems and ride-sharing services involves solving a class of complex vehicle routing problems with pickup and delivery with time windows (VRPPDTW). This paper first proposes a new time-discretized multi-commodity network flow model for the VRPPDTW based on the integration of vehicles carrying states within space-time transportation networks, so as to allow a joint optimization of passenger-to-vehicle assignment and turn-by-turn routing in congested tr...

  6. Look-ahead strategies for dynamic pickup and delivery problems

    NARCIS (Netherlands)

    Mes, Martijn R.K.; van der Heijden, Matthijs C.; Schuur, Peter

    2010-01-01

    In this paper we consider a dynamic full truckload pickup and delivery problem with time-windows. Jobs arrive over time and are offered in a second-price auction. Individual vehicles bid on these jobs and maintain a schedule of the jobs they have won. We propose a pricing and scheduling strategy

  7. The pickup and delivery traveling salesman problem with handling costs

    NARCIS (Netherlands)

    Veenstra, Marjolein; Roodbergen, Kees Jan; Vis, Iris F.A.; Coelho, Leandro

    2017-01-01

    This paper introduces the pickup and delivery traveling salesman problem with handling costs (PDTSPH). In the PDTSPH, a single vehicle has to transport loads from origins to destinations. Loading and unloading of the vehicle is operated in a last-in-first-out (LIFO) fashion. However, if a load must

  8. Pickup and delivery selection with compulsory requests

    OpenAIRE

    Ramaekers, Katrien; CARIS, An; Janssens, Gerrit; Maes, Tabitha

    2015-01-01

    The operational planning decisions of a carrier consist of accepting transport requests of customers and constructing daily vehicle routes. Several customers may have less-than-truckload requests to be transported between two specified locations: these customers are consolidated into vehicle tours by the carrier. However, a carrier has only a limited capacity within his own vehicle fleet. Therefore he can only serve a selection of clients. Transport requests of clients are only accepted if th...

  9. An approximation algorithm for the pickup and delivery vehicle routing problem on trees

    OpenAIRE

    Katoh, Naoki; Yano, Taihei

    2006-01-01

    This paper presents an approximation algorithm for a vehicle routing problem on a tree-shaped network with a single depot where there are two types of demands, pickup demand and delivery demand. Customers are located on nodes of the tree, and each customer has a positive demand of pickup and/or delivery. Demands of customers are served by a fleet of identical vehicles with unit capacity. Each vehicle can serve pickup and delivery demands. It is assumed that the demand of a customer is splitta...

  10. Multi-depot Vehicle Routing Problem with Pickup and Delivery Requests

    Science.gov (United States)

    Sombuntham, Pandhapon; Kachitvichyanukul, Voratas

    2010-10-01

    This paper considers a multi-depot vehicle routing problem with pickup and delivery requests. In the problem of interest, each location may have goods for both pickup and delivery with multiple delivery locations that may not be the depots. These characteristics are quite common in industrial practice. A particle swarm optimization algorithm with multiple social learning structures is proposed for solving the practical case of multi-depot vehicle routing problem with simultaneous pickup and delivery and time window. A new decoding procedure is implemented using the PSO class provided in the ETLib object library. Computational experiments are carried out using the test instances for the pickup and delivery problem with time windows (PDPTW) as well as a newly generated instance. The preliminary results show that the proposed algorithm is able to provide good solutions to most of the test problems.

  11. 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

    -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......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...

  12. A branch-and-cut-and-price approach for the pickup and delivery problem with shuttle routes

    DEFF Research Database (Denmark)

    Masson, Renaud; Røpke, Stefan; Lehuédé, Fabien

    2014-01-01

    The Pickup and Delivery Problem with Shuttle routes (PDPS) is a special case of the Pickup and Delivery Problem with Time Windows (PDPTW) where the trips between the pickup points and the delivery points can be decomposed into two legs. The first leg visits only pickup points and ends at some...... delivery point. The second leg is a direct trip – called a shuttle – between two delivery points. This optimization problem has practical applications in the transportation of people between a large set of pickup points and a restricted set of delivery points.This paper proposes three mathematical models...... the quality of linear relaxations. The method is evaluated on generated and real-world instances containing up to 193 transportation requests. Instances with up to 87 customers are solved to optimality within a computation time of one hour....

  13. 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...

  14. The Value of Inaccurate Advance Time Window Information in a Pick-up and Delivery Problem

    NARCIS (Netherlands)

    F.J. Srour (Jordan); N.A.H. Agatz (Niels); J. Oppen (Johan)

    2014-01-01

    textabstractWe examine different routing strategies to cope with inaccurate time window in- formation in the context of a dynamic pick-up and delivery problem with time windows. Our experiments show that advance information, even if inaccurate, can provide benefits from a planning perspective. We

  15. 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.

  16. 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.

  17. Pickup and Delivery Problem with Stochastic Travel Times for Semiconductor Supply Chains

    Science.gov (United States)

    Lai, Chun-Mei

    2011-11-01

    As the supply chain has been constructed comprehensively, the pickup and delivery activities between supply-chain members are very complicated. In semiconductor factories, highly capacity utilization and efficiently production scheduling are essential due to the intensive capital investment. Because of travel time uncertainty, requests may fail to arrive within time window and may result in capacity idle and even deferral delivery when ignoring randomness of travel times. Therefore, taking the travel time uncertainty and time windows into account is of great importance when planning vehicle routes and schedules. Furthermore, in the fleet, some vehicles are with special facilities dedicated to carry 8" wafers, some are dedicated for 12" wafers, while other vehicles are open for carrying all products. When assigning requests to vehicles, the product/vehicle compatibility must be taken into account. In this study, we consider the pickup and delivery problem for semiconductor supply chains (PDPSSC), which involves constraints on stochastic travel times, time windows, product/vehicle compatibility, pickup and delivery, and vehicle capacity constraints. We describe the PDPSSC and formulate a chance constrained programming model to minimize total travel distances under two kinds of chance constraints, time windows and driver duration, hold with prescribed probabilities. By the implementation of the proposed model, the vehicle routing problem in semiconductor supply chain can be more integrated and applicable for the real-world applications.

  18. Inventory-routing problem with pickups and deliveries of RTI in closed-loop supply chain

    OpenAIRE

    Limbourg, Sabine

    2014-01-01

    Reducing environmental impact, related regulations and potential for operational benefits are the main reasons why companies share their Returnable Transport Items (RTIs) among different partners of a closed-loop supply chain. This research deals with an inventory-routing problem with pickups and deliveries of RTIs. A mixed-integer linear program is developed and tested on small instances. To handle realistic large size problems, a clustering algorithm is coupled with a simulation model. This...

  19. 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

    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....

  20. Exactly solving the Split Pickup and Split Delivery Vehicle Routing Problem on a bike-sharing system

    OpenAIRE

    Casazza, Marco

    2016-01-01

    We propose an exact methodology to solve the Split Pickup and Split Delivery Vehicle Routing Problem arising in bike-sharing systems: a bike-sharing system is a public service in which bicycles are stored in rack stations and made available for shared use to individuals on a short term basis. However, during peak hours, flows along particular direction are registered, leading to high risk of empty racks in departure stations, and full racks at destination. One of the solutions chosen by many ...

  1. 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...

  2. A Genetic Algorithm for the Multi-Pickup and Delivery Problem with time windows

    CERN Document Server

    Dridi, Imen Harbaoui; Ksouri, Mekki; Borne, Pierre

    2010-01-01

    In This paper we present a genetic algorithm for the multi-pickup and delivery problem with time windows (m-PDPTW). The m-PDPTW is an optimization vehicles routing problem which must meet requests for transport between suppliers and customers satisfying precedence, capacity and time constraints. This paper purposes a brief literature review of the PDPTW, present our approach based on genetic algorithms to minimizing the total travel distance and thereafter the total travel cost, by showing that an encoding represents the parameters of each individual.

  3. A Hybrid Genetic Algorithm for the Traveling Salesman Problem with Pickup and Delivery

    Institute of Scientific and Technical Information of China (English)

    Fang-Geng Zhao; Jiang-Sheng Sun; Su-Jian Li; Wei-Min Liu

    2009-01-01

    In this paper,a hybrid genetic algorithm (CA) is proposed for the traveling salesman problem (TSP) with pickup and delivery (TSPPD).In our algorithm,a novel pheromone-based crossover operator is advanced that utilizes both local and global information to construct offspring.In addition,a local search procedure is integrated into the GA to accelerate convergence.The proposed GA has been tested on benchmark instances,and the computational results show that it gives better convergence than existing heuristics.

  4. Application of Hybrid Encoding Genetic Algorithm on Pickup and Delivery Traveling Salesman Problem with Traffic Conditions

    Directory of Open Access Journals (Sweden)

    S. Patvichaichod

    2011-01-01

    Full Text Available Problem statement: This study deals with the pickup and delivery traveling salesman problem with traffic conditions (PDTSPTW, an extension of the pickup and delivery traveling salesman problem (PDTSP where each customer to be served is associated with two quantities of product to be collected and delivered. Almost PDTSP problems uses distance between each point of customers as Euclidean Distance and are not concerned with other parameters to find minimal cost. Approach: The PDTSPTC concerns more parameters, such as street network and vehicle speed, which results it closer to the real world condition. The study also proposes the developed genetic algorithm called “Hybrid Encoding Genetic Algorithm (HEGA”. The concept is to combine binary encoding and integer encoding together, causing the in complexity of the algorithm structure and the ease of implementation. Results: the HEGA can save the travel cost about 26-57%. It is obviously seen that HEGA in the PDTSPTC test problems result the fast convergence that is about 12-43% and in all, the computational time is under 6 seconds. Conclusion: The HEGA performs quite well when testing a test problem. Computation times are small in all case. The PDTSPTC is closer to real-world conditions than PDTSP. This problem can be applied in logistics immediately if the distance of streets, traffic conditions (average vehicle speed in each street and vehicle conditions (fuel consumption rate and vehicle capacity are known.

  5. A two-stage heuristic method for vehicle routing problem with split deliveries and pickups

    Institute of Scientific and Technical Information of China (English)

    Yong WANG; Xiao-lei MA; Yun-teng LAO; Hai-yan YU; Yong LIU

    2014-01-01

    The vehicle routing problem (VRP) is a well-known combinatorial optimization issue in transportation and logistics network systems. There exist several limitations associated with the traditional VRP. Releasing the restricted conditions of traditional VRP has become a research focus in the past few decades. The vehicle routing problem with split deliveries and pickups (VRPSPDP) is particularly proposed to release the constraints on the visiting times per customer and vehicle capacity, that is, to allow the deliveries and pickups for each customer to be simultaneously split more than once. Few studies have focused on the VRPSPDP problem. In this paper we propose a two-stage heuristic method integrating the initial heuristic algorithm and hybrid heuristic algorithm to study the VRPSPDP problem. To validate the proposed algorithm, Solomon benchmark datasets and extended Solomon benchmark datasets were modified to compare with three other popular algorithms. A total of 18 datasets were used to evaluate the effectiveness of the proposed method. The computational results indicated that the proposed algorithm is superior to these three algorithms for VRPSPDP in terms of total travel cost and average loading rate.

  6. 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.

  7. Multiobjective Vehicle Routing Problems With Simultaneous Delivery and Pickup and Time Windows: Formulation, Instances, and Algorithms.

    Science.gov (United States)

    Wang, Jiahai; Zhou, Ying; Wang, Yong; Zhang, Jun; Chen, C L Philip; Zheng, Zibin

    2016-03-01

    This paper investigates a practical variant of the vehicle routing problem (VRP), called VRP with simultaneous delivery and pickup and time windows (VRPSDPTW), in the logistics industry. VRPSDPTW is an important logistics problem in closed-loop supply chain network optimization. VRPSDPTW exhibits multiobjective properties in real-world applications. In this paper, a general multiobjective VRPSDPTW (MO-VRPSDPTW) with five objectives is first defined, and then a set of MO-VRPSDPTW instances based on data from the real-world are introduced. These instances represent more realistic multiobjective nature and more challenging MO-VRPSDPTW cases. Finally, two algorithms, multiobjective local search (MOLS) and multiobjective memetic algorithm (MOMA), are designed, implemented and compared for solving MO-VRPSDPTW. The simulation results on the proposed real-world instances and traditional instances show that MOLS outperforms MOMA in most of instances. However, the superiority of MOLS over MOMA in real-world instances is not so obvious as in traditional instances.

  8. 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 cust

  9. Multi-objective Optimization For The Dynamic Multi-Pickup and Delivery Problem with Time Windows

    CERN Document Server

    Dridi, Imen Harbaoui; Borne, Pierre; Ksouri, Mekki

    2011-01-01

    The PDPTW is an optimization vehicles routing problem which must meet requests for transport between suppliers and customers satisfying precedence, capacity and time constraints. We present, in this paper, a genetic algorithm for multi-objective optimization of a dynamic multi pickup and delivery problem with time windows (Dynamic m-PDPTW). We propose a brief literature review of the PDPTW, present our approach based on Pareto dominance method and lower bounds, to give a satisfying solution to the Dynamic m-PDPTW minimizing the compromise between total travel cost and total tardiness time. Computational results indicate that the proposed algorithm gives good results with a total tardiness equal to zero with a tolerable cost.

  10. Penerapan Algoritma Differential Evolution untuk Penyelesaian Permasalahan Vehicle Routing Problem with Delivery and Pick-up

    Directory of Open Access Journals (Sweden)

    Ika Ayu Fajarwati

    2012-09-01

    Full Text Available Vehicle Routing Problem (VRP merupakan permasalahan optimasi kombinatorial kompleks yang memiliki peranan penting dalam manajemen sistem distribusi dengan tujuan meminimalkan biaya yang diperlukan, dimana penentuan biaya berkaitan dengan jarak dari rute yang ditempuh oleh armada distribusi. Ciri dari VRP yaitu penggunaan armada dengan kapasitas tertentu dan kegiatannya berpusat pada satu titik depot untuk melayani pelanggan pada titik-titik tertentu dengan jumlah permintaan yang diketahui. Kasus distribusi yang menggabungkan aktifitas pengiriman dan pengambilan produk termasuk dalam salah satu jenis VRP yaitu Vehicle Routing Problem Delivery and Pick-Up (VRP-DP. Banyak metode yang dapat digunakan untuk menyelesaikan permasalahan VRP-DP, salah satunya adalah metode optimasi metaheuristik yaitu Algoritma Differential Evolution yang akan diperkenalkan dalam penelitian ini. Hasil yang diharapkan nantinya adalah rute distribusi optimal untuk armada perusahaan sehingga menghasilkan jarak tempuh dan tentunya total biaya yang minimal dalam memenuhi semua permintaan pelanggan

  11. Crowdsourced Delivery: A Dynamic Pickup and Delivery Problem with Ad-hoc Drivers

    NARCIS (Netherlands)

    A.M. Arslan (Alp); N.A.H. Agatz (Niels); L.G. Kroon (Leo); R.A. Zuidwijk (Rob)

    2016-01-01

    textabstractThe trend towards shorter delivery lead-times reduces operational efficiency and increases transportation costs for internet retailers. Mobile technology, however, creates new opportunities to organize the last-mile. In this paper, we study the concept of crowdsourced delivery that aims

  12. 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.

  13. 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.

  14. An Adaptive Tabu Search Heuristic for the Location Routing Pickup and Delivery Problem with Time Windows with a Theater Distribution Application

    Science.gov (United States)

    2006-08-01

    1992. Fisher, M., Huang, J., & Tang, B. "Scheduling Bulk-Pickup-Delivery Vehicles in Shanghai”, (1986). Fraleigh , J. A first course in abstract...Acknowledgements I would like to express my sincere appreciation to my faculty advisor, Dr. James Moore, for his guidance and support throughout the course of...division support activity ETDD early time definite delivery FIFO first - in first -out GTTS group theoretic tabu search GVRP generalized

  15. Genetic Algorithm for Mulicriteria Optimization of a Multi-Pickup and Delivery Problem with Time Windows

    CERN Document Server

    Dridi, Imen Harbaoui; Ksouri, Mekki; Borne, Pierre

    2010-01-01

    In This paper we present a genetic algorithm for mulicriteria optimization of a multipickup and delivery problem with time windows (m-PDPTW). The m-PDPTW is an optimization vehicles routing problem which must meet requests for transport between suppliers and customers satisfying precedence, capacity and time constraints. This paper purposes a brief literature review of the PDPTW, present an approach based on genetic algorithms and Pareto dominance method to give a set of satisfying solutions to the m-PDPTW minimizing total travel cost, total tardiness time and the vehicles number.

  16. Embedding Assignment Routing Constraints through Multi Dimensional Network Construction for Solving the Multi Vehicle Routing Problem with Pickup and Delivery with Time Windows

    OpenAIRE

    2016-01-01

    The multi Vehicle Routing Problem with Pickup and Delivery with Time Windows is a challenging version of the Vehicle Routing Problem. In this paper, by embedding many complex assignment routing constraints through constructing a multi dimensional network, we intend to reach optimality for local clusters derived from a reasonably large set of passengers on real world transportation networks. More specifically, we introduce a multi vehicle state space time network representation in which only t...

  17. Pick-Up and Delivery Problem: Models and Single Vehicle Exact Procedures,

    Science.gov (United States)

    1985-06-01

    appropriate Lagrangian ascent procedures (for example, see Bazaraa and Goode 18)). IMI 22 U r! ,.~ 4. A BRANCH AND BOUND ALGORITHM FOR THE SINGLE VEHICLE...B&B phase. For this purpose a subgradient optimization procedure, suggested by Bazaraa and Goode for the TSP, was utilized to improve the * value of F...Analysed by a Routing Heuristic", Working Paper #81-006, University of Maryland (February). 8 Bazaraa , M. and J. Goode (1977). "The Travelling Salesman

  18. DELIVERY AND PICK-UP PROBLEM TRANSPORTATION - MILK RUN AND CONVENTIONAL SYSTEMS

    Directory of Open Access Journals (Sweden)

    Delmo Alves de Moura

    2016-09-01

    Full Text Available This paper examines the role of inventory and transportation in the supply system of parts adopted by most of the Brazilian automotive companies to feed their assembly lines. It is a system for programmed collection of pieces called Milk Run that aims, within a window of time, to collect parts from suppliers, fulfilling established routes in order to minimize the cost of transport operations and reducing inventory in the supply chain. Milk Run, a scheduled collection system of parts can be carried out by automotive industry itself: the automaker manage the best route for its collector vehicle, determining the quantity of parts required to collect at each supplier within a given route, aiming to best utilize the capacity of the vehicle. Another way to work within the Milk Run system is the automaker to find the best routing and determines the amount of parts needed to be collected from each supplier on each trip. The collection, however, is held by a third carrier. As a third way of working, the assembler can determine the quantity of parts to collect and when it will require them. A logistics carrier determines the best routing for the collection of pieces in order to meet the production plan so that there is not a lack of parts or components on the assembly line, which would lead to a stop. In this case, the logistics carrier transports parts on its own fleet of vehicles or transfer the transport operation to a carrier.

  19. Vehicle Minimization for the Multimodal Pickup and Delivery Problem with Time Windows

    Science.gov (United States)

    2013-03-01

    problems for parallel machines. The VRP solved is subject to time windows and capacity constraints on vehicles and offloading. The VRP is multimodal. The...addresses a special case of the VRP . The VRP considered is multimodal with time constraints. It is also subject to capacity constraints, both on...Consequently, the problem can also be considered to be a special case of the Fleet Size and Mix Problem. The primary issue in solving any VRP is

  20. Service Delivery Platforms Developing and Deploying Converged Multimedia Services

    CERN Document Server

    Ahson, Syed A

    2011-01-01

    In the telecommunications industry, it is becoming increasingly important for operators to quickly provide a service delivery platform. This book discusses the fundamental requirements of service delivery platforms, evaluating their basic functions and feasibility. Starting with content and media in modern networks, the text presents the entire user experience, including requirements for the user terminal, supporting systems, broadcasting, and networks. Expert contributors explore the evolving role of service delivery platforms, explaining various applications and delivery mechanisms, providin

  1. Interlinking Service Delivery Innovation And Service Quality: A Conceptual Framework

    National Research Council Canada - National Science Library

    Arif Mohammad Arshad; Qin Su

    2015-01-01

      The purpose of writing this paper is to present the relationship between service delivery innovation and service quality in service organizations and to establish a research conceptual framework about this relationship...

  2. 大型铁路客运站车底取送作业模型研究%RESEARCH ON CARRIAGES PICKUP AND DELIVERY OPERATIONS MODEL IN LARGE-SCALE RAILWAY PASSENGER STATION

    Institute of Scientific and Technical Information of China (English)

    刘新花; 张静芳; 刘胜元

    2015-01-01

    Railway carriages pickup and delivery operations in passenger train stations have the relations with the departure and arrival trains in their beginning and finishing time when occupying the arrival-departure lines and the passenger technology lines.Whether or not to be able to plan the carriages pickup and delivery operations rapidly and reasonably will directly affect the operation efficiency of railway passenger stations.By taking into account the factors of the impacts of the application of passenger technology line and the cross interference in throat area on carriage pickup and delivery operations plan,we considered to make those departure trains behind of the schedule be able to depart as in normal ways by ensuring a minimum number of these delayed trains while controlling the delay time of these trains within the acceptable range.We proposed the method to control the delay time of the trains to a reasonable range.Based on calculating the time window of carriages entering and exiting garages,we used time windows of garage entering and of garage exiting as the constraint condition to determine the time of carriages in and out the garage.In order to achieve the goal of reasonably arrange the plan of carriages pickup and delivery operations,relative parameters were added to relax the hard constraints.The carriages pickup and delivery operations model was built using the method that taking it as the target to minimise the total number of those passenger trains departing late after being completed their services,and the simulated annealing algorithm was employed to solve the model.The instance demonstrated that the proposed model and algorithm could formulate the carriages pickup and delivery operations plan quickly and reasonably.%客运站旅客列车车底取送作业关系着始发、终到列车占用到发线、客技线的起止时间,能否快速、合理地制定旅客列车车底取送作业计划,直接影响着铁路客运站

  3. 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.

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

    National Research Council Canada - National Science Library

    Maryam Ashouri; Majid Yousefikhoshbakht

    2017-01-01

    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...

  5. 77 FR 10033 - Advisory Committee International Postal and Delivery Services

    Science.gov (United States)

    2012-02-21

    ... Committee International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... related to international postal and delivery services of interest to Advisory Committee members and...

  6. 75 FR 1681 - Advisory Committee International Postal and Delivery Services

    Science.gov (United States)

    2010-01-12

    ... Committee International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... International Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of... international postal and delivery services of interest to Advisory Committee members and the public....

  7. 77 FR 24758 - Advisory Committee International Postal and Delivery Services

    Science.gov (United States)

    2012-04-25

    ... Committee International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... postal and delivery services of interest to Advisory Committee members and the public. For...

  8. Penerapan Algoritma Genetika Untuk Penyelesaian Vehicle Routing Problem With Delivery And Pick-Up (VRP-DP)

    OpenAIRE

    Simanullang, Herlin

    2013-01-01

    Vehicle Routing Problem (VRP) is a problem of combinatorial optimization complexeses that has essential role in management distribution system which is aimed to minimize the needed cost, the cost is determined in relationship with the distance of route which is taken by the distribution vehicle. The characteristic from VRP is the use of vehicle in certain capacity and its activity is centralized in one depot to serve the customer on certain locations with certain known demand. ...

  9. Satisfaction with health facility delivery care services and ssociated ...

    African Journals Online (AJOL)

    Satisfaction with health facility delivery care services and ssociated factors: The ... of care ranging from 30% reporting to be satisfied with management of labour pains ... women comfortable and satisfied with the process of delivery elsewhere.

  10. Service Delivery Reviews in Canada and the U.K.

    OpenAIRE

    World Bank

    2009-01-01

    This brief describes in detail Canada's policy on alternative service delivery and service delivery reviews in the UK, such as the prior options reviews, better quality services and best value reviews, market testing, and fundamental expenditure reviews. Links are provided to relevant documents and case studies.

  11. Strengthening Public Revenue and Expenditure Management to Enhance Service Delivery

    OpenAIRE

    2013-01-01

    To achieve higher growth and reduce poverty and inequality, Mexico needs to improve public service delivery. Mexico is a middle-income country with continuing high levels of poverty (46.2 percent of the population). To improve public sector service delivery, Mexico needs to ensure sufficient financial and human resources relative to the needs of the population, and effective and efficient ...

  12. Customer participation in service production and delivery system

    OpenAIRE

    Sridhar, M. S.

    1998-01-01

    Highlights significance of designing service delivery system, explains the integral role of customer in service production process, stresses the importance of customer-organisation interface, lists important ingredients of service package to be considered while designing customer interface, enumerates various dimensions of customer interface which can be positively made use of in design of service production and delivery system, discusses various ways and means of inducing and enhancing custo...

  13. Simultaneous delivery and pickup vehicle routing problem with three-dimension ;loading constraints%同时取送货的三维装载约束下车辆路径问题

    Institute of Scientific and Technical Information of China (English)

    彭碧涛; 周世平

    2016-01-01

    同时取货和送货的三维装载约束下车辆路径问题(3L-VRPSDP)是经典车辆路径问题(VRP)的一个扩展,在3L-VRPSDP中,顾客可能要求同时取货和送货,而且货物装载要考虑其三维大小、先进后出、底面支撑等装载特性。针对这类问题,提出了基于左底优先和最大接触面优先的装载算法,在装载时要考虑其配送特征;在此基础上,设计了对应的禁忌搜索算法对初始结果进行优化,通过实验验证了算法的有效性。%The Simultaneous Delivery and Pickup Vehicle Routing Problem with Three-Dimension Loading Constraints (3L-VRPSDP)is a variant of the classical Vehicle Routing Problem(VRP)where clients may require simultaneous pickups and deliveries, at the same time, cargo must consider its three dimensional size, first in last out, bottom support constraints. Considering the distribution characteristics, the loading algorithms based on Left Bottom(LB)and Maximum Contact Area (MCA)are proposed, and the corresponding tabu search algorithms are designed. Experiments are given to prove the validity of the algorithms.

  14. 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...

  15. 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

    ... related to the methods of service delivery described in § 652.207(b)(2)? 652.208 Section 652.208... FUNCTIONING OF STATE EMPLOYMENT SERVICES Wagner-Peyser Act Services in a One-Stop Delivery System Environment § 652.208 How are core services and intensive services related to the methods of service...

  16. 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...... management, delivery and consumption of e-services, self services, and mobile communication including business-to-business, business-to-consumer, government-to-business, government-to-consumer, and consumer-to-consumer e-services. This volume is perfect for the interest of professionals, academic educators...

  17. Service Delivery and Customer Satisfaction in Nigerian Banks

    OpenAIRE

    FARAYIBI, Adesoji

    2016-01-01

    The study examined the impact of the quality of service delivery on customer satisfaction in the Nigerian banks using Ordinary Least Square (OLS) methodology. The study established a relationship between better banks performance in service delivery and customer satisfaction through effective customer relationship management (CRM). Findings revealed that increase in the number of working days and number of bank branches led to better levels of customer satisfaction. Empirical evidence also rev...

  18. Pick-up, impact, and peeling

    Science.gov (United States)

    Singh, Harmeet; Hanna, James

    We consider a class of problems involving a one-dimensional, inextensible body with a propagating discontinuity (shock) associated with partial contact with a rigid obstacle providing steric, frictional, or adhesive forces. This class includes the pick-up and impact of an axially flowing string or cable, and the peeling of an adhesive tape. The dynamics are derived by applying an action principle to a non-material volume. The resulting boundary conditions provide momentum and energy jump conditions at the shock. These are combined with kinematic conditions on velocities and accelerations to obtain families of steady-state solutions parameterized by the shock velocity and momentum and energy sources. We find relationships between the jump in stress, injection of momentum, and dissipation of energy, which we apply to specific cases, and compare with other results in the literature on chain fountains, falling folded chains, and impulsively loaded cables. Time permitting, we will briefly discuss the possibility of using kinematic conditions and information about accelerating or otherwise unsteady forms of the adjoining bulk solutions to construct an equation of motion of the shock.

  19. 76 FR 24339 - Streamlining Service Delivery and Improving Customer Service

    Science.gov (United States)

    2011-05-02

    ... standards and expectations, including, where appropriate, performance goals for customer service required by...; and (f) identifying ways to use innovative technologies to accomplish the customer service activities... Office of Science and Technology Policy shall assist and support agencies in developing customer service...

  20. 带有次序限制的装卸一体化车辆路径问题研究%The Study for Vehicle Routing Problem with Simultaneous Delivery and Pickup and Order limit

    Institute of Scientific and Technical Information of China (English)

    黄秋爱; 李珍萍

    2014-01-01

    The vehicle routing problem with simultaneous delivery and pickup is studied in this paper. According to the practical case, the constraint of order limit is added. Then the mathematical model aiming at finding out the minimum distance is established. At the same time, an improved genetic algorithm based on the best selection method is designed and used to solve this model. Finally, the validity of the model and algorithm are tested by practical example.%研究了装卸一体化的车辆路径问题,根据问题的实际情况,增加了带有次序限制条件,并以总行驶路线最短为目标,建立了数学模型,并根据模型的特点,用改进的遗传算法进行求解。最后,通过具体实例验证了模型及算法的有效性。

  1. Advanced content delivery, streaming, and cloud services

    CERN Document Server

    Sitaraman, Ramesh Kumar; Robinson, Dom

    2014-01-01

    While other books on the market provide limited coverage of advanced CDNs and streaming technologies, concentrating solely on the fundamentals, this book provides an up-to-date comprehensive coverage of the state-of-the-art advancements in CDNs, with a special focus on Cloud-based CDNs. The book includes CDN and media streaming basics, performance models, practical applications, and business analysis. It features industry case studies, CDN applications, and open research issues to aid practitioners and researchers, and a market analysis to provide a reference point for commercial entities. The book covers Adaptive Bitrate Streaming (ABR), Content Delivery Cloud (CDC), Web Acceleration, Front End Optimization (FEO), Transparent Caching, Next Generation CDNs, CDN Business Intelligence and more.

  2. 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 ...

  3. 求解异车型同时集送问题的多属性标签算法%A heuristic algorithm for vehicle routing problem with heterogeneous fleet, simultaneous pickup and delivery

    Institute of Scientific and Technical Information of China (English)

    田宇; 伍炜勤

    2015-01-01

    针对实际运输中顾客对不同车型、同时集送货物的多样化需求,文章建立了异车型同时集送车辆路径模型(vehicle routing problem with heterogeneous fleet,simultaneous pickup and delivery,VRPHSPD),并构建了基于多属性标签的蚁群系统算法(multi-label based ant colony system,MLACS)进行求解.该算法利用面向对象理念,分别对客户、车辆及其行驶路径构建多属性标签,首先用近邻法生成初始路径,再通过蚁群算法的搜索规则对客户和车辆标签进行匹配,从而得优化的结果.通过公开算例、实际应用案例的验证表明,MLACS算法能成功求解VRPHSPD问题,具有较高的求解质量、运算效率以及实际应用意义.

  4. 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...

  5. 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.

  6. Privatization and 'Agentification' of Public Services Delivery in Africa ...

    African Journals Online (AJOL)

    seriane.camara

    2009-05-14

    May 14, 2009 ... Council for the Development of Social Science Research in Africa, 2008 .... between public and private sector organizations in public services delivery .... assets. Land survey. Municipal land. Sanitation. Town cleaning .... depending on circumstance and may include executive share ..... DOL Contract No.

  7. 同时送取货车辆路径问题算法研究综述%Algorithm review of vehicle routing problem with simultaneous delivery and pickup

    Institute of Scientific and Technical Information of China (English)

    王科峰; 叶春明; 李永林

    2013-01-01

    针对同时送取货车辆路径问题的研究算法进行了评述.将该问题的求解方法分为精确算法、构造型启发式、现代启发式以及并行算法四个大类.从算法的原理、性能、适用环境,以及算法之间差异性等方面对各类算法进行了较为全面的介绍.最后,说明了VRPSDP算法研究在节点具有双重需求车辆路径问题理论研究方面的意义,并提出未来VRPSDP算法研究的两个发展方向,即适合多处理器上运行的并行现代启发式算法,以及有效的混合算法如量子行为粒子群算法.%This paper gave a review about the algorithms for the vehicle routing problem with simultaneous delivery and pickup (VRPSDP). It divided the solving methods into four main classes; exact algorithm, constructive heuristics algorithm, meta-heuristics algorithm, and parallel algorithm. It also gave the detail introductions of the algorithms from the principle, performance, application environment, and the differences between them. In the end, it introduced the significance of the algorithm research of VRPSDP in the theory development of the vehicle routing problem with node having double demands. After that, it proposed two research directions in the future, which were parallel metaheuristics based on multiple processors, and the effec-tive hybrid algorithm such as quantum-behaved particle swarm optimization.

  8. The Vehicle Routing Problem with Simultaneous Pickup and Delivery Considering Customer Satisfaction%考虑客户满意度的同时收发车辆路径问题

    Institute of Scientific and Technical Information of China (English)

    范静

    2011-01-01

    当客户要求车辆一次性完成发送以及收集货物的任务时, 只需考虑车辆的路径安排即可.但若客户进一步提出在时间窗内完成的话,就必须考虑客户的等待时间--客户的满意度的衡量标准,等待时间越短满意度越高.因此问题的目标为最小化车辆路径总长度、最小化所有客户等待时间之和.本文通过加权转变为单目标函数,由最邻近法及最廉价插入法得到初始解后经过禁忌搜索算法可得到改进算法,解并通过实例对不同权参数的情况进行了比较.%When customers require the vehicles to pickup and delivery goods simultaneous, we just consider how to arrange the path of every vehicle.However, if costomers further propose the vehicles to complete within time windows, costumers' waiting time which is regarded as the criterion of customers satisfaction must be considered, that is, the shorter, the higher the satisfaction.Therefore the goal is to minimize the total length of vehicles' paths, and to minimize the sum of all customers' waiting time.In this paper, combining into a single objective function by weight, initial solution, obtained by the nearest neighbor method and the cheapest insertion method, can be improved by tabu search algorithm.Finally solutions of different parameters are compared.

  9. INTRAOPERATIYE OVUM PICK-UP AND ULTRASONICGUIDED TRANSVAGINAL OVUM RETRIEVAL IN AN IVF PROGRAM

    Institute of Scientific and Technical Information of China (English)

    ZHANGLi-Zhu; CHENGui-An; ZHAOWen-Xin; WANGZe-Mi; LIMei-Zhi; LIUPing; WANGXiu-Yun; ZHAOYun-Fen

    1989-01-01

    Methods of ovum pick-up in an IVF program From January to November, 1988, were reported. In the initial stages of the program, transabdominal intraopcrative ovum pick-up was used, which resulte, d in two cases of clinical pregnancy in 1987 with full term delivery

  10. Electronic Mediated Administration and Public Service Delivery in Nigeria

    Directory of Open Access Journals (Sweden)

    Samuel Oni

    2015-12-01

    Full Text Available The public service of any country is a major pillar in determining the development and stability of such country. This is because the public service is the engine for the processing of the vastly acquired and expanded government responsibilities of executing public policies and projects and rendering essential services to the people. In Nigeria, various governmental regimes have attempted repositioning the public sector for effective and efficient service delivery through various reforms. In spite of all these efforts, the Nigeria Public Service remains inefficient and incapable of delivering its responsibility. This paper adopts descriptive and analytical approach with data collected from secondary sources. By interrogating the exponential growth, usage and acceptance of Information Communication Technology (ICT in Nigeria, it argues for a paradigm shift from the traditional approach to electronic administration to enhance the delivery of public goods and services which are considered necessary for the sustainable development of the country. ICT enabled administration has the potentials of revolutionizing the quality of services delivered to the citizens by ushering in transparency, accountability and efficiency which are the bane of the Nigeria’s public sector.

  11. Detailed simulation of morphodynamics: 2. Sediment pickup, transport, and deposition

    NARCIS (Netherlands)

    Nabi, M.; De Vriend, H.J.; Mosselman, E.; Sloff, C.J.; Shimizu, Y.

    2013-01-01

    The paper describes a numerical model for simulating sediment transport with eddy-resolving 3-D models. This sediment model consists of four submodels: pickup, transport over the bed, transport in the water column and deposition, all based on a turbulent flow model using large-eddy simulation. The

  12. Detailed simulation of morphodynamics: 2. Sediment pickup, transport, and deposition

    NARCIS (Netherlands)

    Nabi, M.; De Vriend, H.J.; Mosselman, E.; Sloff, C.J.; Shimizu, Y.

    2013-01-01

    The paper describes a numerical model for simulating sediment transport with eddy-resolving 3-D models. This sediment model consists of four submodels: pickup, transport over the bed, transport in the water column and deposition, all based on a turbulent flow model using large-eddy simulation. The s

  13. 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…

  14. Document delivery services contrasting views

    CERN Document Server

    1999-01-01

    Design and maintain document delivery services that are ideal for academic patrons! In Document Delivery Services: Contrasting Views, you'll visit four university library systems to discover the considerations and challenges each library faced in bringing document delivery to its clientele. This book examines the questions about document delivery that are most pressing in the profession of library science. Despite their own unique experiences, you'll find common practices among all four?including planning, implementation of service, and evaluation of either user satisfaction and/or vendor per

  15. Chemical Abstracts' Document Delivery Service.

    Science.gov (United States)

    Rollins, Stephen

    1984-01-01

    The Document Delivery Service offered by Chemical Abstracts is described in terms of the DIALORDER option on the Dialog information retrieval system, mail requests, and requests transmitted through OCLC's Interlibrary Loan system. Transmission costs, success rates, delivery rates, and other considerations in utilizing the service are included.…

  16. Service Provider Combinations and the Delivery of Early Intervention Services to Children and Families

    Science.gov (United States)

    Raspa, Melissa; Hebbeler, Kathleen; Bailey, Donald B., Jr.; Scarborough, Anita A.

    2010-01-01

    Using data from the National Early Intervention Longitudinal Study, this study provides a framework for characterizing the delivery of early intervention services based on the combinations of service providers who work with infants and toddlers with disabilities and their families. Five groups of providers were identified. Results showed that the…

  17. Service Provider Combinations and the Delivery of Early Intervention Services to Children and Families

    Science.gov (United States)

    Raspa, Melissa; Hebbeler, Kathleen; Bailey, Donald B., Jr.; Scarborough, Anita A.

    2010-01-01

    Using data from the National Early Intervention Longitudinal Study, this study provides a framework for characterizing the delivery of early intervention services based on the combinations of service providers who work with infants and toddlers with disabilities and their families. Five groups of providers were identified. Results showed that the…

  18. Towards improving service delivery in screening and intervention services in community pharmacies: a case study of an alcohol IBA service.

    Science.gov (United States)

    Mackridge, A J; Krska, J; Stokes, E C; Heim, D

    2016-03-01

    Previous studies have demonstrated positive outcomes from a range of pharmacy public health services, but barriers to delivery remain. This paper explores the processes of delivering an alcohol screening and intervention service, with a view to improving service delivery. A mixed-methods, multi-perspective approach was used, comprising in-pharmacy observations and recording of service provision, follow-up interviews with service users and interactive feedback sessions with service providers. Observations and recordings indicate that staff missed opportunities to offer the service and that both availability and delivery of the service were inconsistent, partly owing to unavailability of trained staff and service restrictions. Most service users gave positive accounts of the service and considered pharmacies to be appropriate places for this service. Respondents also described positive impacts, ranging from thinking more about alcohol consumption generally to substantial reductions in consumption. Key facilitators to service provision included building staff confidence and service champions. Barriers included commissioning issues and staff perception of alcohol as a sensitive topic. Findings support expansion of pharmacies' role in delivering public health services and highlight benefits of providing feedback to pharmacy staff on their service provision as a possible avenue for service improvement. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Downgrading Financial Service Delivery and Institutional ...

    African Journals Online (AJOL)

    2014-05-01

    May 1, 2014 ... Empirical evidence on impact of mimicry on institutional sustainability can ... statements and returns to the central bank between 1996 and 2005. ... is fraught with risk, none of which augurs well for long term financial self-sufficiency of .... collection concept as one of its saving mobilisation /credit products to ...

  20. Lunar and martian meteorite delivery services

    Science.gov (United States)

    Warren, Paul H.

    1994-01-01

    Launch mechanisms for lunar and martian meteorites have been investigated, by integrating physical modeling constraints, geochemical cosmic-ray exposure (CRE) constraints, and petrologic constraints. The potential source region for lunar meteorites is remarkably small compared to the final crater volume. CRE constraints indicate that most launches start at depths of less than or equal to 3.2 m, and cratering theory implies derivation of suitably accelerated objects from a subvolume with diameter only about 0.3 x the final crater diameter. The shallow depth provenance is probably related to shock-wave interference, enhanced by the lunar regolith's extremely low compressional wave velocity. CRE constraints alone imply that four to five separate launch events are represented among the eight well-studied lunar meteorites. Most of the lunar meteorites are regolith breccias, which tend to show only limited compositional diversity within any kilometer-scale region of the Moon. Several others are polymict breccias, which also show relatively subdued compositional diversity, compared to igneous rocks. The observed diversity among these samples in terms of abundances of mare basalt and KREEP, and in Mg/(Mg + Fe) ratio, implies that among eight well-studied lunar meteorites only two potential source craters pairings are plausible: between Asuka-881757 + Y-793169 (most probable) and between Y-793274 + EET875721. Altogether, these eight lunar meteorites apparently represent at least six separate source craters, including three in the past 10(exp 5) years and five in the past 10(exp 6) years. CRE constraints imply that SNC meteorites are launched from systematically greater than lunar meteorites. SNCs are also systematically bigger, and all nine well-studied SNCs are uncommonly young (by martian standards) mafic igneous rocks. Comparison between Viking and Apollo results reveals that rocks the size of common meteorites are remarkably scarce in the martian regolith, probably due

  1. Lunar and martian meteorite delivery services

    Science.gov (United States)

    Warren, Paul H.

    1994-10-01

    Launch mechanisms for lunar and martian meteorites have been investigated, by integrating physical modeling constraints, geochemical cosmic-ray exposure (CRE) constraints, and petrologic constraints. The potential source region for lunar meteorites is remarkably small compared to the final crater volume. CRE constraints indicate that most launches start at depths of less than or equal to 3.2 m, and cratering theory implies derivation of suitably accelerated objects from a subvolume with diameter only about 0.3 x the final crater diameter. The shallow depth provenance is probably related to shock-wave interference, enhanced by the lunar regolith's extremely low compressional wave velocity. CRE constraints alone imply that four to five separate launch events are represented among the eight well-studied lunar meteorites. Most of the lunar meteorites are regolith breccias, which tend to show only limited compositional diversity within any kilometer-scale region of the Moon. Several others are polymict breccias, which also show relatively subdued compositional diversity, compared to igneous rocks. The observed diversity among these samples in terms of abundances of mare basalt and KREEP, and in Mg/(Mg + Fe) ratio, implies that among eight well-studied lunar meteorites only two potential source craters pairings are plausible: between Asuka-881757 + Y-793169 (most probable) and between Y-793274 + EET875721. Altogether, these eight lunar meteorites apparently represent at least six separate source craters, including three in the past 105 years and five in the past 106 years. CRE constraints imply that SNC meteorites are launched from systematically greater than lunar meteorites. SNCs are also systematically bigger, and all nine well-studied SNCs are uncommonly young (by martian standards) mafic igneous rocks. Comparison between Viking and Apollo results reveals that rocks the size of common meteorites are remarkably scarce in the martian regolith, probably due to pervasive

  2. 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.

  3. 76 FR 59768 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2011-09-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Advisory Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice... the meeting of the Advisory Committee on International Postal and Delivery Services scheduled...

  4. 75 FR 57102 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2010-09-17

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... related to international postal and delivery services of interest to Advisory Committee members and...

  5. 78 FR 8683 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2013-02-06

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... postal and delivery services of interest to Advisory Committee members and the public. For...

  6. 76 FR 15028 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2011-03-18

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... related to international postal and delivery services of interest to Advisory Committee members and...

  7. 75 FR 8425 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2010-02-24

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... international postal and delivery services of interest to Advisory Committee members and the public....

  8. 78 FR 57671 - Advisory Committee on International Postal and Delivery Services; Membership Renewals

    Science.gov (United States)

    2013-09-19

    ... Committee on International Postal and Delivery Services; Membership Renewals AGENCY: Department of State... international postal and private-sector delivery services. The Advisory Committee on International Postal and Delivery Services was created in accordance with the Federal Advisory Committee Act (Pub. L. 92-463)....

  9. 77 FR 41877 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2012-07-16

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice, FACA... Postal and Delivery Services (the Advisory Committee). This Committee has been formed in fulfillment of... International Postal and Delivery Services, Bureau of International Organization Affairs, Department of...

  10. 78 FR 55773 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2013-09-11

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... delivery services of interest to Advisory Committee members and the public. FOR FURTHER INFORMATION...

  11. 76 FR 54829 - Advisory Committee On International Postal and Delivery Services

    Science.gov (United States)

    2011-09-02

    ... Committee On International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice... International Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of... related to international postal and delivery services that are of interest to Advisory Committee...

  12. Simulation and measurement of the resonant Schottky pickup

    Institute of Scientific and Technical Information of China (English)

    ZANG Yong-Dong; XIAO Guo-Qing; F.Nolden; P.Hülsmann; Yu. A. Litvinov; C. Peschke; P.Petri; M.S.Sanjari; M. Steck; WU Jun-Xia; ZHAO Tie-Cheng; ZHANG Sheng-Hu; MAO Rui-Shi; XU Hu-Shan; SUN Zhi-Yu; MA Xin-Wen; TU Xiao-Lin

    2011-01-01

    A resonant Schottky pickup with high sensitivity,built by GSI,will be used for nuclear mass and lifetime measurement at CSRe.The basic concepts of Schottky noise signals,a brief introduction of the geometry of the detector,the transient response of the detector,and MAFIA simulated and perturbation measured results of characteristics are presented in this paper.The resonant frequency of the pickup is about 243 MHz and can be slightly changed at a range of 3 MHz.The unloaded quality factor is about 1072 and the shunt impedance is 76 kΩ.The measured results of the characteristics are in agreement with the MAFIA simulations.

  13. 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.

  14. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Angelovski, Aleksandar

    2015-07-01

    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.

  16. Three-Dimensional Magnetohydrodynamic Modeling of the Solar Wind Including Pickup Protons and Turbulence Transport

    Science.gov (United States)

    Usmanov, Arcadi V.; Goldstein, Melvyn L.; Matthaeus, William H.

    2012-01-01

    To study the effects of interstellar pickup protons and turbulence on the structure and dynamics of the solar wind, we have developed a fully three-dimensional magnetohydrodynamic solar wind model that treats interstellar pickup protons as a separate fluid and incorporates the transport of turbulence and turbulent heating. The governing system of equations combines the mean-field equations for the solar wind plasma, magnetic field, and pickup protons and the turbulence transport equations for the turbulent energy, normalized cross-helicity, and correlation length. The model equations account for photoionization of interstellar hydrogen atoms and their charge exchange with solar wind protons, energy transfer from pickup protons to solar wind protons, and plasma heating by turbulent dissipation. Separate mass and energy equations are used for the solar wind and pickup protons, though a single momentum equation is employed under the assumption that the pickup protons are comoving with the solar wind protons.We compute the global structure of the solar wind plasma, magnetic field, and turbulence in the region from 0.3 to 100 AU for a source magnetic dipole on the Sun tilted by 0 deg - .90 deg and compare our results with Voyager 2 observations. The results computed with and without pickup protons are superposed to evaluate quantitatively the deceleration and heating effects of pickup protons, the overall compression of the magnetic field in the outer heliosphere caused by deceleration, and the weakening of corotating interaction regions by the thermal pressure of pickup protons.

  17. Measurements and Modeling of the Nonlinear Behavior of a Guitar Pickup at Low Frequencies †

    Directory of Open Access Journals (Sweden)

    Antonin Novak

    2017-01-01

    Full Text Available Description of the physical behavior of electric guitars is still not very widespread in the scientific literature. In particular, the physical models describing a nonlinear behavior of pickups still requires some refinements. The study presented in this paper is focused on nonlinear modeling of the pickups. Two main issues are raised. First, is the currently most used nonlinear model (a Hammerstein model sufficient for the complex nonlinear behavior of the pickup? In other words, would a more complex model, such as a Generalized Hammerstein that can deal better with the nonlinear memory, yield better results? The second troublesome issue is how to measure the nonlinear behavior of a pickup correctly. A specific experimental set-up allowing for driving the pickup in a controlled way (string displacement perpendicular to the pickup and to separate the nonlinear model of the pickup from other nonlinearities in the measurement chain is proposed. Thanks to this experimental set-up, a Generalized Hammerstein model of the pickup is estimated for frequency range 15–500 Hz and the results are compared with a simple Hammerstein model. A comparison with experimental results shows that both models succeed in describing the pickup when used in realistic conditions.

  18. 77 FR 2340 - Advisory Committee on International Postal and Delivery Services

    Science.gov (United States)

    2012-01-17

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice of... the renewal of the charter of the Advisory Committee on International Postal and Delivery Services in... oversight of foreign policy related to international postal services and other international...

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

    Energy Technology Data Exchange (ETDEWEB)

    Sutton, Laurence N., E-mail: lasusu@laurencesutton.co.uk [Diagnostic Imaging Department, Main X-Ray, Calderdale Royal Hospital, Calderdale and Huddersfield NHS Foundation Trust, Salterhebble, Halifax, West Yorkshire, HX3 0PW (United Kingdom)

    2011-05-15

    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.

  20. 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…

  1. Lytle S. Adams, DDS (1883-1970): Nonstop Airmail Pick-up inventor.

    Science.gov (United States)

    Christen, Arden G; Christen, Joan A

    2005-11-01

    Between 1923 and 1940, a restless, optimistic, self-styled, inventor, Lytle S. Adams, DDS (1883-1970) was tirelessly working to develop a nonstop, airmail delivery and pick-up system. He believed that his invention would enable air postal services to serve those smaller, more isolated communities that would otherwise be bypassed due to economic and operational reasons. For 17 years, Adams vigorously promoted his pick-up system in both public and private arenas, and he even obtained congressional support for his ideas. However, he was unable to arrange for long-term, hardheaded financial and engineering support. Consequently, the once promising Adams Nonstop Airmail Pick-up System had only temporary and limited success. His endeavor, like others which came before and after, initially appeared to be a sound idea in search of inspired realization.

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

    Science.gov (United States)

    2011-01-26

    ... Employment and Training Administration Avaya Global Services, AOS Service Delivery, Worldwide Services Group... Assistance on October 20, 2010, applicable to workers of Avaya Global Services, AOS Service Delivery... Avaya Global Services, AOS Service Delivery had their wages reported through a separate...

  3. Pickup ions at Dione and Enceladus: Cassini Plasma Spectrometer simulations

    Science.gov (United States)

    Sittler, Ed C.; Johnson, R. E.; Jurac, S.; Richardson, J. D.; McGrath, M.; Crary, F.; Young, D. T.; Nordholt, J. E.

    2004-01-01

    Voyager images of the icy satellites of Saturn, Dione and Enceladus, suggest that they may have been geologically active and are not only composed of ice. Recent observations by the Hubble Space Telescope have shown the presence of ozone at both Dione and Rhea, which also implies the presence of molecular oxygen at these bodies. Observations of Ariel, Europa, Ganymede, and Callisto indicate the presence of CO2, so its presence on the Saturnian satellites is also expected. The Cassini Plasma Spectrometer (CAPS) will provide the capability to determine the global composition of these bodies by measuring the pickup ions produced by the ionization of their sputter-produced atmospheres. We will present a model of these atmospheres and associated pickup ions and demonstrate CAPS ability to distinguish the freshly produced picked up ions from the ambient plasma. Such ions are expected to form a ring distribution that will have a uniquely different energy-angle dependence than the ambient plasma ions. In the case of Dione we expect the potential for a moderate strength interaction for which both Voyager 1 and Pioneer 11 spacecraft measured ion cyclotron waves centered on the Dione L shell and near the equatorial plane. SKR radio emissions also displayed emissions occurring at the orbital period of Dione which could indicate some intrinsic activity due to Dione. So again, something interesting may be going on at Dione. Since Enceladus, or material in orbit near Enceladus, may be the source of the E-ring, some surprises may be encountered during its close encounter with the Cassini spacecraft. In the case of Dione we will show that a wake pass at 500 km altitude is more than an order of magnitude better than an upstream pass at 500 km altitude. Pickup ion detection for minor ion species such as NH3+ is possible for 500 km altitude wake pass but not for ≈500 km altitude upstream pass at closest approach. For navigation reasons a 100 km pass is not allowed. Therefore it is

  4. The Whole PIC Catalog: Organization, Planning and Service Delivery Options under JTPA.

    Science.gov (United States)

    National Alliance of Business, Inc., Washington, DC.

    This handbook illustrates and discusses organizational options for the delivery of employment and training services within service delivery areas (SDAs) mandated by the Job Training Partnership Act (JTPA) of 1982. Addressed primarily to members of private industry councils (PICs), representatives of local governments, and employment and training…

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

    African Journals Online (AJOL)

    access health services for disease control, a study was conducted to assess knowledge, ... and other essential service supplies, existence of user-fees in health facilities, and pregnant ... In the area of antenatal care (ANC) services, medical and ... The government .... making some women to miss IPTp in the recommended.

  6. Pick-up and impact of flexible bodies

    CERN Document Server

    Singh, H

    2016-01-01

    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, peeli...

  7. The Ghana community-based health planning and services initiative for scaling up service delivery innovation.

    Science.gov (United States)

    Nyonator, Frank K; Awoonor-Williams, J Koku; Phillips, James F; Jones, Tanya C; Miller, Robert A

    2005-01-01

    Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.

  8. Interstellar Pickup Ion Production in the Global Heliosphere and Heliosheath

    CERN Document Server

    Wu, Yihong; Guo, Xiaocheng

    2016-01-01

    Interstellar Pickup ions (PUIs) play a significant part in mediating the solar wind (SW) interaction with the interstellar medium. In this paper, we examine the details of spatial variation of the PUI velocity distribution function (VDF) in the SW by solving the PUI transport equation. We assume the PUI distribution is isotropic resulting from strong pitch-angle scattering by wave-particle interaction. A three-dimensional model combining the MHD treatment of the background SW and neutrals with a kinetic treatment of PUIs throughout the heliosphere and the surrounding local interstellar medium (LISM) has been developed. The model generates PUI power law tails via second-order Fermi process. We analyze how PUIs transform across the heliospheric termination shock (TS) and obtain the PUI phase space distribution in the inner heliosheath including continuing velocity diffusion. Our simulated PUI spectra are compared with observations made by New Horizons, Ulysses, Voyager 1, 2 and Cassini, and a satisfactory agree...

  9. Structure-modification and oil pick-up ability of PHBV as oil sorbent materials

    Institute of Scientific and Technical Information of China (English)

    Xuwen He; Dayi Qian; Bing Wu; Tong Wang

    2003-01-01

    The PHBV (β-hydroxybutyrate-co-β-hydroxyvalerate) foams as oil sorbent materials, which were prepared by salting out method based on PHBV and chloroform additive and their oil pick-up abilities were investigated. And the oil pick-up abilities of different PHBV foams as oil sorbent materials were compared. The results show that with the amount of chloroform additive and sodium chloride increasing, the oil pick-up rates, the oil-keeping rates and the second oil pick-up rates of PHBV foams can increase to different extent. When the amount of sodium chloride was 92%, the ratio of PHBV to chloroform was 1 (g): 14 (mL), the oil pick-up ability of the PHBV foam was optimal. And their oil pick-up ratios can reach 25.51 (26℃) and 27.51 g/g (17℃) in raw oil, which were 4-5 times more than those of PHBV powder. In addition, the structure-modified PHBV as oil sorbent materials also has some advantages, such as three-dimension structure, bio-degradability and good oil pick-up ability, so this kind of green oil sorbent materials will have great perspective in the future.

  10. 22 CFR 228.55 - Delivery services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Delivery services. 228.55 Section 228.55... COMMODITIES AND SERVICES FINANCED BY USAID Waivers § 228.55 Delivery services. (a) Ocean transportation. A... case of bulk cargoes and large cargoes carried by liners; (2) Eligible vessels provide liner...

  11. ASSESSMENT OF CUSTOMER EXPECTATION AND PERCEPTION OF SERVICE QUALITY DELIVERY IN GHANA COMMERCIAL BANK

    Directory of Open Access Journals (Sweden)

    Otu William

    2016-02-01

    Full Text Available The study is to determine customers’ expectations and perception of quality of servicedelivery of Ghana Commercial Banks Limited. The study also aims at determining thegap between customers’ expectation and perception of service quality delivery(customer satisfaction /dissatisfaction of the banks. To achieve the main aim of thestudy, the following specific objectives have been set out; determine customers’expectations of the quality of service delivery of GCB, measure customers’ perceptionof the quality of service delivery of GCB, determine the gap (customer satisfaction ordissatisfaction between customers’ perception and expectation of service qualitydelivery of the bank.

  12. An overview of current document delivery and interlibrary loan services of Chinese libraries

    Institute of Scientific and Technical Information of China (English)

    JIA; Ping

    2008-01-01

    In this article,the author introduces the basic information and the historical development of document delivery and interlibrary loan services conducted by Chinese libraries at different organizational levels and in different geographical areas.It compares and analyzes the commonalities,peculiarities and service-effectiveness of three most important systems of document delivery and interlibrary loan currently available in China.The author also discusses the developing trend of such services in the future.

  13. Observations of Interstellar Pickup Ions and their Suprathermal Tails in Interplanetary Space and in the Heliosheath

    Science.gov (United States)

    Gloeckler, George; Fisk, Len

    2014-10-01

    Since the invention of space-borne time-of-flight mass spectrometers in the late 1990s, distribution functions of singly charged interstellar pickup ions, produced primarily by charge exchange with the solar wind and by photoionization of the interstellar neutral gas, have been observed from 1 to ~5 AU in interplanetary space. Here we summarize observed characteristics of pickup ion spectra (primarily of H+ and He+) as well as of the pickup ion tails that are readily produced in Local Acceleration Regions in space, both at 1 AU and in the heliosheath, and briefly discuss the most likely mechanisms for producing interstellar pickup ions as well as their tails that in the heliosheath extend to high (~10 MeV/nuc) energies.

  14. 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.

  15. A Relational Goal-Oriented Model of Optimal Service Delivery to Children and Families

    Science.gov (United States)

    King, Gillian

    2009-01-01

    This article presents a Relational Goal-Oriented Model of Service Delivery to Children with physical or mental health difficulties and their families. This research-informed and practice-relevant model provides a broad understanding of what effective service provision entails and requires from practitioners and service organizations. The model…

  16. 76 FR 77483 - Nationwide Change in Postal Delivery Service Standards

    Science.gov (United States)

    2011-12-13

    ... Nationwide Change in Postal Delivery Service Standards AGENCY: Postal Regulatory Commission. ACTION: Notice... pair service standards would be modified to move overnight delivery to 2-day delivery, and to move a portion of 2-day delivery to 3-day delivery. Id. at 1. Although changes to service standards...

  17. 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...

  18. Development, Implementation, and Evaluation of the Apollo Model of Pediatric Rehabilitation Service Delivery

    Science.gov (United States)

    Camden, Chantal; Swaine, Bonnie; Tetreault, Sylvie; Bergeron, Sophie; Lambert, Carole

    2013-01-01

    This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical…

  19. 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.

  20. ION-PICKUP MECHANISM AND TWO-STREAM INSTABILITY IN COMET

    Institute of Scientific and Technical Information of China (English)

    Pang Yongjiang; Li Zhongyuan; Liu Yuan

    2000-01-01

    In this paper, we adopted a reasonable particle distribution function and used a simplified judgement to analyze the possibility of the ion-pickup caused by two-stream instibility in cometary tail. On calculation, we get an energy limitation(ΔE1, ΔE2) between the solar wind particles and the cometary particles .When the energy diffference is between ΔE1 and ΔE2, the pickup of ions in the cometary tail is more effective.

  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. Chiropractor perceptions and practices regarding interprofessional service delivery in the Danish primary care context

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Christensen, Henrik Wulff; Fogh-Schultz, Anders Lyck

    2014-01-01

    in practice alongside chiropractors, these being massage therapists (82%), physiotherapists (58%) and acupuncturists (37%). Interestingly only 11% considered a medical practitioner to be an active participant in their current interprofessional service delivery. Danish chiropractors consider interprofessional...

  3. Drivers of Prenatal Care Quality and Uptake of Supervised Delivery Services in Ghana

    OpenAIRE

    Atinga, RA; Baku, AA; Adongo, PB

    2014-01-01

    Background: In spite of the introduction of free maternal healthcare in Ghana, utilization of supervised delivery services continues to be low due partly to poor quality of antenatal care (ANC). Aim: The study sought to identify the determinants of perceived quality of ANC and uptake of skilled delivery services. Subjects and Methods: A total of 363 expectant mothers were randomly selected in urban health facilities for interview. Logistic regression models were computed to examine the relati...

  4. ASSESSMENT OF CUSTOMER EXPECTATION AND PERCEPTION OF SERVICE QUALITY DELIVERY IN GHANA COMMERCIAL BANK

    OpenAIRE

    Otu William; Emma Eyison Appiah; Emmanuel Addo Botchway.

    2016-01-01

    The study is to determine customers’ expectations and perception of quality of servicedelivery of Ghana Commercial Banks Limited. The study also aims at determining thegap between customers’ expectation and perception of service quality delivery(customer satisfaction /dissatisfaction) of the banks. To achieve the main aim of thestudy, the following specific objectives have been set out; determine customers’expectations of the quality of service delivery of GCB, measure customers’ perceptionof...

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

    African Journals Online (AJOL)

    Ngulup

    classification scheme, electronic records management system; and. Development of ...... Workshop for Enhancing the Performance of the African Public Service Commission‟s and. Other Appointing ... Wescott, C. 1999. Guiding principle on ...

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

    CSIR Research Space (South Africa)

    Wall, K

    2013-09-01

    Full Text Available SUPPLY CHAIN management (SCM) regulations for public sector procurement of goods and services have greatly improved the transparency of procurement procedures, increased the opportunities for alternative suppliers and reduced the potential...

  7. Utilization of Antenatal Care and Delivery Services in Sagamu ...

    African Journals Online (AJOL)

    Objective:We conducted a community based study in South Western Nigeria to ... Higher educational status and higher level of income positively affected the pattern ... institutions will encourage women to use the available maternity services.

  8. 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.

  9. Pickup ion production in the global heliosphere and heliosheath

    Science.gov (United States)

    Wu, Yihong

    Pickup ions (PUIs) play a significant part in mediating the solar wind (SW) interaction with the interstellar medium. In this dissertation, I examine the details of spatial variation of the PUI velocity distribution function (VDF) in the SW by solving the PUI transport equation. I assume the PUI distribution is isotropic resulting from strong pitch-angle scattering by wave-particle interation. I take into account the effects of convection with the SW, adiabatic cooling, second-order Fermi process and production of PUIs. I analyze how PUIs transform across the heliospheric termination shock (TS) and obtain the PUI phase space distribution in the inner heliosheath including continuing velocity diffusion. A 3D model combining the MHD treatment of the background SW and neutrals with a kinetic treatment of PUIs throughout the heliosphere and the surrounding local interstellar medium (LISM) has been developed. It gives us the PUI and SW characteristics, such as phase space densities, spatial distribution maps, etc., from close to the sun to the heliopause. My simulated PUI spectra are compared with observations made by New Horizons, Ulysses, Voyager 1, 2 and Cassini, and a satisfactory agreement is demonstrated. Some specific features in the observations, for example, a cutoff of PUI VDF at v = VSW in the reference frame of the SW, are well represented by the model. The compressed SW and PUIs behind the TS can create energetic neutral atoms (ENAs) via charge exchange. ENAs with energies high enough to overcome the outward flow speed can be detected back at Earth. I calculate ENA fluxes at 1 AU. Based on my PUI model, I compare my simulation results with the Interstellar Boundary EXplorer (IBEX) distributed ENA sky maps and the line of sight (LOS) spectra. This brings us closer to understanding the properties of distributed ENA flux observations.

  10. Simulating Negative Pickup Ions and Ion Cyclotron Wave Generation at Europa (Invited)

    Science.gov (United States)

    Desai, R. T.; Cowee, M.; Gary, S. P.; Wei, H.; Coates, A. J.; Kataria, D. O.; Fu, X.

    2015-12-01

    The mass loading of space environments through the ionisation of planetary atmospheres is a fundamental process governing the plasma interactions and long term evolution of celestial bodies across the solar system. Regions containing significant pickup ion populations have been observed to exhibit a rich variety of electromagnetic plasma wave phenomena, the characteristics and properties of which can be used to infer the ion species present, their spatial and temporal distributions, and the global ionisation rates of the neutral material. In this study we present hybrid (kinetic ion, massless fluid electron) simulations of ion pickup and Ion Cyclotron (IC) waves observed in the Jovian magnetosphere and draw comparisons to sub-alfvénic pickup observed by Cassini in the Saturnian system, and also to supra-alfvénic pickup at planetary bodies immersed directly in the solar wind. At Jupiter, Europa has been identified as the secondary mass loader in the magnetosphere, orbiting within a neutral gas torus at ~9.38 Rj. Near Europa, Galileo magnetometer observations displayed bursty IC wave characteristics at the gyrofrequency of a number of species including SO2, K, Cl, O2, and Na, suggesting a complex mass loading environment. A particular deduction from the dataset was the presence of both positively and negatively charged pickup ions, inferred from the left and right hand polarisations of the transverse waves. Using hybrid simulations for both positively and negatively charged Cl pickup ions we are able to self-consistently reproduce the growth of both right and left hand near-circularly polarised waves in agreement with linear theory and, using the observed wave amplitudes, estimate Cl pickup ion densities at Europa.

  11. 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.

  12. 22 CFR 201.32 - Suppliers of delivery services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Suppliers of delivery services. 201.32 Section... services. (a) Performance of the service contract. The supplier of delivery services financed by USAID shall comply with the terms and conditions of its contract to supply delivery services. (b)...

  13. 22 CFR 228.24 - Other delivery services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Other delivery services. 228.24 Section 228.24... for USAID Financing § 228.24 Other delivery services. No source or nationality rules apply to other delivery services, such as export packing, loading, commodity inspection services, and services of...

  14. Commercial Document Delivery Services "Challenged" as EBSCO Drops Service.

    Science.gov (United States)

    Machovec, George S.

    1998-01-01

    Discusses the EBSCO decision to stop its traditional commercial document delivery business. High prices for copyright clearance, government subsidized services, electronic formats available on the Internet, Web-based services, and consortium-based licensing activities are discussed as influencing the market for document delivery. (LRW)

  15. Commercial Document Delivery Services "Challenged" as EBSCO Drops Service.

    Science.gov (United States)

    Machovec, George S.

    1998-01-01

    Discusses the EBSCO decision to stop its traditional commercial document delivery business. High prices for copyright clearance, government subsidized services, electronic formats available on the Internet, Web-based services, and consortium-based licensing activities are discussed as influencing the market for document delivery. (LRW)

  16. 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.

  17. Local level service delivery, decentralisation and governance: A comparative study of Uganda, Kenya and Tanzania

    Directory of Open Access Journals (Sweden)

    Per Tidemand

    2009-05-01

    Full Text Available This paper summarises key findings from a comprehensive analysis commissioned by the Japan International Cooperation Agency (JICA of the nature of decentralisation in the three East African countries: Kenya, Uganda and Tanzania. The specific objectives of the study were: • Provide a basic comparative analysis of the forms and processes of decentralisation reforms in the three countries • Analyse the specific modalities in the three countries for local service delivery planning and provision within the three sectors of basic education, primary health care and agricultural extension, with a particular emphasis on rural areas. TIDEMAND: Local level service delivery, decentralisation and governance: A comparative study of Uganda, Kenya and Tanzania CJLG May 2009 145 • Explore the impact of the specific forms of decentralisation and local level service delivery arrangements in terms of efficiency, accountability (transparency and democratic process (participation.

  18. PHYSICAL EVIDENCE AND QUALITY SERVICE DELIVERY IN PUBLIC HOSPITALS IN GHANA

    Directory of Open Access Journals (Sweden)

    Edem Max Azila-Gbettor

    2013-09-01

    Full Text Available This study examines the value of physical environment in the delivering of quality healthcare or service in public hospitals in Ghana. Twelve set of self-administered questions were designed using Baker’s (1987 typology of servicescape. A descriptive univariate analysis was applied for the study. Based on 233 usable questionnaires retrieved from respondents, the study indicates a strong link between physical environment and quality healthcare delivery and the choice of healthcare facility. It is there by recommended that improvement in quality service delivery may be better served and improved by improving the servicescape/physical element in the services mix.

  19. 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...

  20. A study of pickup and signal processing for HLS-Ⅱ bunch current measurement system

    Institute of Scientific and Technical Information of China (English)

    YANG Yong-Liang; MA Tian-Ji; SUN Bao-Gen; WANG Ji-Gang; ZOU Jun-Ying; CHENG Chao-Cai; LU Ping

    2013-01-01

    For the HLS-Ⅱ bunch current measurement system,in order to obtain the absolute value of bunch current,the calibration factor should be determined by using DCCT.At the HLS storage ring,the stretch effect of bunch length is observed and the change rate is about 19% when the bunch current decays over time and this will affect the performance of bunch current detection.To overcome the bunch stretch influence in the HLS-Ⅱ bunch current measurement,an evaluation about pickup type and signal processing is carried out.Strip-line pickup and button pickup are selectable,and the theoretical analysis and demonstration experiment are performed to find out an acceptable solution for the bunch current measurement system at HLS-Ⅱ.The experimental data analysis shows that the normalized calibration factor will change by about 27% when the bunch length changes by about 19% if using the button pickup and processing by peak value of bunch signal; the influence will be reduced to 2% less if adopting the strip-line pickup and integral.

  1. Magnetometer utilizing SQUID pico-voltmeter and cooled normal pickup coil

    Energy Technology Data Exchange (ETDEWEB)

    Yang, T.Q. [Research Institute of Superconductor Science and Systems, Kyushu University, Higashi-ku, Hakozaki 6-10-1, Fukuoka 812-8581 (Japan); Yao, Kenichiro [Research Institute of Superconductor Science and Systems, Kyushu University, Higashi-ku, Hakozaki 6-10-1, Fukuoka 812-8581 (Japan); Yamasaki, Daisuke [Research Institute of Superconductor Science and Systems, Kyushu University, Higashi-ku, Hakozaki 6-10-1, Fukuoka 812-8581 (Japan); Enpuku, Keiji [Research Institute of Superconductor Science and Systems, Kyushu University, Higashi-ku, Hakozaki 6-10-1, Fukuoka 812-8581 (Japan)]. E-mail: enpuku@sc.kyushu-u.ac.jp

    2005-10-01

    Magnetometer utilizing a high-T {sub c} SQUID pico-voltometer and cooled normal pickup coil has been developed. The pickup coil was made of copper wire, and cooled to T = 77 K in order to decrease thermal noise from resistance. Total voltage noise of the SQUID pico-voltmeter with a cooled pickup coil was 124 pV/Hz{sup 1/2} and 96 pV/Hz{sup 1/2} at 100 Hz and 1 kHz, respectively, when resistance of the coil was 1.5 {omega}. The magnetic field noise of the magnetometer was 130 pT/Hz{sup 1/2} and 10 pT/Hz{sup 1/2} at 100 Hz and 1 kHz for the pickup coil with 4.4 mm diameter, respectively. Application of the magnetometer to non-destructive evaluation was presented. It is shown that small crack inside Cu plate can be detected with this system in unshielded environment. It was also shown that scanning of the pickup coil in unshielded environment is possible without degradation of the system performance.

  2. Rural Psychiatry: Special Issues and Models of Service Delivery

    OpenAIRE

    Fiona Judd; Caitlin Fraser; Margaret Grigg; Joseph Scopelliti; Gene Hodgins; Adrian Donoghue; John Humphreys

    2002-01-01

    The commonly occurring psychiatric disorders, anxiety and depression, have a combined community prevalence rate of 15-30% and are associated with significant clinical and economic cost. Although a number of effective pharmacological and psychological treatments are available for the management of these disorders, many people do not have access to, or do not receive, these treatments. An important factor associated with the lower rates of use of specialist services is rural, particularly remot...

  3. A preliminary model of wheelchair service delivery.

    Science.gov (United States)

    Eggers, Sara L; Myaskovsky, Larissa; Burkitt, Kelly H; Tolerico, Michelle; Switzer, Galen E; Fine, Michael J; Boninger, Michael L

    2009-06-01

    To integrate and expand on previously published models of wheelchair service delivery, and provide a preliminary framework for developing more comprehensive, descriptive models of wheelchair service delivery for adults with spinal cord injury within the U.S. health care system. Literature review and a qualitative analysis of in-depth interviews. Not applicable. Ten academic, clinical, regulatory, and industry experts (Department of Veterans Affairs [VA] and non-VA) in wheelchair service delivery. Not applicable. Interviewees were asked to discuss the full range of variables and stakeholders involved in wheelchair service delivery, and to limit their scope to the provision of primary subsequent or replacement chairs (not backup chairs) to adults within the United States. Most experts we interviewed stressed that clients who require a wheelchair play a central role in the wheelchair service delivery process. Providers (including clinicians, rehabilitation engineers, and rehabilitation counselors) are also critical stakeholders. More so than in other health care settings, suppliers play an integral role in the provision of wheelchairs to clients and may significantly influence the appropriateness of the wheelchair provided. Suppliers often have a direct role in wheelchair service delivery through their interactions with the clinician and/or client. This model also identified a number of system-level factors (including facility administration and standards, policies, and regulations) that influence wheelchair service delivery and ultimately the appropriateness of the wheelchair provided. We developed a detailed, descriptive model of wheelchair service delivery that integrates the delivery process and device outcomes, and includes the patient-level, provider-level, and system-level factors that may directly influence those processes and outcomes. We believe that this detailed model can help clinicians and researchers describe and consider the complexities of wheelchair

  4. Delivery Commitments in Stochastic Service Networks: Case of Automobile Service

    OpenAIRE

    Sandeep Dulluri; Ganesh Muthusamy

    2013-01-01

    Service firms have become highly competitive in terms of providing the delivery. The delivery quality in terms of delivery commitments. Delivery commitments impact the customer in deciding for the service. Computing the delivery commitments in stochastic service systems is a real challenge. Delivery commitment forms a key parameter in formulating the service level agreements in B2B markets. In our current work we propose a queuing theoretic approach for computing the delivery commitments. The...

  5. Delivery Commitments in Stochastic Service Networks: Case of Automobile Service

    OpenAIRE

    Sandeep Dulluri; Ganesh Muthusamy

    2013-01-01

    Service firms have become highly competitive in terms of providing the delivery. The delivery quality in terms of delivery commitments. Delivery commitments impact the customer in deciding for the service. Computing the delivery commitments in stochastic service systems is a real challenge. Delivery commitment forms a key parameter in formulating the service level agreements in B2B markets. In our current work we propose a queuing theoretic approach for computing the delivery commitments. The...

  6. Use of antenatal services and delivery care in Entebbe, Uganda: a community survey

    Directory of Open Access Journals (Sweden)

    Muwanga Moses

    2007-10-01

    Full Text Available Abstract Background Disparities in perinatal health care occur worldwide. If the UN Millennium Development Goals in maternal and child health are to be met, this needs to be addressed. This study was conducted to facilitate our understanding of the changing use of maternity care services in a semi-urban community in Entebbe Uganda and to examine the range of antenatal and delivery services received in health care facilities and at home. Methods We conducted a retrospective community survey among women using structured questionnaires to describe the use of antenatal services and delivery care. Results In total 413 women reported on their most recent pregnancy. Antenatal care attendance was high with 96% attending once, and 69% the recommended four times. Blood pressure monitoring (95% and tetanus vaccination (91% were the services most frequently reported and HIV testing (47%, haematinics (58% and presumptive treatment for malaria (66% least frequently. Hospital clinics significantly outperformed public clinics in the quality of antenatal service. A significant improvement in the reported quality of antenatal services received was observed by year (p Conclusion Although antenatal services were well utilised, the quality of services varied. Women were able and willing to travel to a facility providing a good service. Access to essential skilled birth attendants remains difficult especially for less educated, poorer women, commonly mediated by financial and transport difficulties and several simple post delivery practices were commonly neglected. These factors need to be addressed to ensure that high quality care reaches the most vulnerable women and infants.

  7. Fiscal decentralization and the challenges of public ecological services delivery

    Directory of Open Access Journals (Sweden)

    N.V. Kotenko

    2015-06-01

    Full Text Available The aim of the article. The aim of the article is to define and propose the directions to solve the recent problems of financing public ecological services in the conditions of fiscal decentralization. The results of the analysis. This paper analyzes the decentralization reform impact on the possibilities of local authorities to finance the public ecological services in Ukraine. Advantages and threats of decentralizing reform are defined on the basis of theoretical vision of fiscal federalism in different state structures. The authors assessed basic central government documents in which the strategy and tactic of development. The lack of particular measures that are directed to the sustainable nature use on state level is defined. In practice, this means transference of financing powers from central to local government. Such process needs to be conducted with respective changes of financial flows directions and establishing effective forming and distributive tools. Traditionally, one of such tools, which are most appropriate to accumulate public environmental funds, is ecological tax. The study revealed that the enhancement of general fund of local budget revenues by local tax make the Local Environmental foundations' work impossible. Another initiative of central government is to transfer more than half revenues from the tax to the regional level. Such decision will be practicable only if impartial, formula based mechanism of subsequent allocation of funds between basic local authorities is developed. Scale projects now are funded by regional authorities. Authors proved that the better way to finance public ecological services on complementary basis is the local authorities’ cooperation. One of the advantages of such cooperation is the considering of the opportunities of self-taxation. This voluntary fiscal tool in Ukrainian European future must be stable source for financing of public ecological services. Decentralization reform also

  8. 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.

  9. 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,

  10. Painted Pickup.

    Science.gov (United States)

    Wheeler, Kimberly

    2001-01-01

    Discusses a six week art class project for elementary school children that lasted for six weeks. Explains that the students painted sunflowers in the style of Vincent van Gogh over the rust spots of a pickup truck. Reports that the painting served as great publicity for the art classes. (CMK)

  11. Time scales for formation and spreading of velocity shells of pickup ions in the solar wind

    Science.gov (United States)

    Gaffey, J. D., Jr.; Wu, C. S.; Winske, D.

    1988-01-01

    This paper discusses the process of assimilation (pickup) by the solar wind of newly ionized atoms and molecules. Generally, the pickup process is considered to evolve in three stages: (1) the initial interaction of newly created ions with the interplanetary magnetic field to form the ring-beam distribution; (2) pitch angle scattering of the ring beam to form a hollow shell; and (3) slower velocity diffusion to form a partially filled-in shell distribution. Using numerical simulations of turbulence such as would occur naturally in the solar wind and such as would be encountered near cometary bow shocks, the processes of shell formation and evolution are studied, and the results are used to estimate the time scales for shell formation and diffusion in several situations of recent observational interest, the interstellar He data obtained by AMPTE and cometary ion pickup distributions obtained by various spacecraft at comets Giacobini-Zinner and Halley.

  12. 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....

  13. 78 FR 32612 - Collect on Delivery (COD)-Service Features

    Science.gov (United States)

    2013-05-31

    ... 111 Collect on Delivery (COD)--Service Features AGENCY: Postal Service\\TM\\. ACTION: Proposed rule... * * * * * 503 Extra Services * * * * * 13.0 Collect on Delivery (COD) * * * * * 13.2 Basic Information 13.2.1... collect on delivery (COD) service to mail an article for which the mailer has not been paid and have...

  14. 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...

  15. Designing, formalizing and evaluating a flexible architecture for integrated service delivery: combining event-driven and service-oriented architectures

    NARCIS (Netherlands)

    Overbeek, S.J.; Janssen, M.F.W.H.A.; Van Bommel, P.

    2012-01-01

    An influx of service providers collaborate in networks to meet their clients’ demands. Integrated service delivery (ISD) is a way to let networked service providers offer services to their clients by bundling selected services offered by each provider so that clients do not have to deal with each sin

  16. Designing, formalizing and evaluating a flexible architecture for integrated service delivery: combining event-driven and service-oriented architectures

    NARCIS (Netherlands)

    Overbeek, S.J.; Janssen, M.F.W.H.A.; Van Bommel, P.

    2012-01-01

    An influx of service providers collaborate in networks to meet their clients’ demands. Integrated service delivery (ISD) is a way to let networked service providers offer services to their clients by bundling selected services offered by each provider so that clients do not have to deal with each

  17. Safety of labour and delivery following closures of obstetric services in small community hospitals.

    Science.gov (United States)

    Hutcheon, Jennifer A; Riddell, Corinne A; Strumpf, Erin C; Lee, Lily; Harper, Sam

    2017-03-20

    In recent decades, many smaller hospitals in British Columbia, Canada, have stopped providing planned obstetric services. We examined the effect of these service closures on the labour and delivery outcomes of pregnant women living in affected communities. We used maternal postal codes to identify delivery records (1998-2014) of women residing in a community affected by service closure. The records were obtained from the British Columbia Perinatal Data Registry. We examined the effect of the closures using a within-communities fixed-effects framework and included similar-sized communities without service closures to control for underlying time trends. The primary outcome was a previously published composite measure of labour and delivery safety, the Adverse Outcome Index, which includes adverse events such as birth injury and unanticipated operative procedures, and includes weights for severity of adverse events. Secondary outcomes included maternal or newborn transfer, and use of obstetric interventions. We found little evidence that closure of planned obstetric services affected the risk of composite adverse maternal-newborn outcome (-0.4 excess adverse events per 100 deliveries, 95% confidence interval [CI] -2.0 to 1.1), or most other secondary outcomes. The severity of composite outcome events decreased following the closures (rate ratio 0.58, 95% CI 0.36 to 0.89). Closures were associated with increases in use of epidural analgesia (3.4 excess events per 100 deliveries, 95% CI 0.4 to 6.3) and length of antepartum stay (0.6 h, 95% CI 0.1 to 1.0 h). Closure of planned obstetric services in low-volume hospitals was not associated with an increase or decrease in frequency of adverse events during labour and delivery. © 2017 Canadian Medical Association or its licensors.

  18. Modelling healthcare internal service supply chains for the analysis of medication delivery errors and amplification effects

    Directory of Open Access Journals (Sweden)

    Banafsheh Behzad

    2011-12-01

    Full Text Available Purpose: Healthcare is a universally used service that hugely affects economies and the quality of life. The research of service supply chains has found a significant role in the past decade. The main research goal of this paper is to model and simulate the internal service supply chains of a healthcare system to study the effects of different parameters on the outputs and capability measures of the processes. The specific objectives are to analyse medication delivery errors in a community hospital based on the results of the models and to explore the presence of bullwhip effect in the internal service supply chains of the hospital.Design/methodology/approach: System dynamics which is an approach for understanding the behaviour of complex systems, used as a methodology to model two internal service supply chains of the hospital with a sub-model created to simulate medication delivery errors in the hospital. The models are validated using the actual data of the hospital and the results are analyzed based on experimental design techniques.Findings: It is observed that the bullwhip effect may not occur in a hospital’s internal service supply chains. Furthermore the paper points out the conditions for reducing the medication delivery error in a hospital.Research limitations/implications: Because of the community hospital’s data availability the type of service supply chains modelled in this paper, are small service supply chains, representing only the tasks which are done inside the hospital. To better observe the bullwhip effect in healthcare service supply chains, the chains should be modelled more generally.Originality/value: The original system dynamics modelling of the internal service supply chains of a community hospital, with a sub-model simulating the medication delivery error.

  19. Managing Customer Participation and Customer Interactions in Service Delivery: the Case of Museums and Educational Services

    National Research Council Canada - National Science Library

    Marlene Amorim; Maria João Rosa; Sandra Santos

    2014-01-01

      Background and Purpose - In this study we investigate determinants of customers' quality perceptions in service processes which involve customer participation and customer to customer interaction (CCI...

  20. Concentration of interstellar pickup H(+) and He(+) in the solar wind

    Science.gov (United States)

    Gloeckler, G.; Jokipii, J. R.; Giacalone, J.; Geiss, J.

    1994-01-01

    We present observations of interstellar pickup hydrogen and helium in the solar wind which show large, highly-correlated fluctuations in flux which are not correlated significantly with the solar-wind hydrogen flux. The correlation of the fluctuations in the two species implies that the fluctuations are caused by transport after ionization. The lack of correlation with the thermal flux means they are not caused by compressions of the wind. We present a new model which can naturally produce the observed fluctuations in the pickup ions.

  1. Quasi-Markets and Service Delivery Flexibility Following a Decade of Employment Assistance Reform in Australia

    DEFF Research Database (Denmark)

    Considine, Mark; Lewis, Jenny; O’Sullivan, S

    2011-01-01

    In 1998, we were witnessing major changes in frontline social service delivery across the OECD and this was theorised as the emergence of a post-Fordist welfare state. Changes in public management thinking, known as New Public Management (NPM), informed this shift, as did public choice theory....... A 1998 study of Australia's then partially privatised employment assistance sector provided an ideal place to test the impact of such changes upon actual service delivery. The study concluded that frontline staff behaviour did not meet all the expectations of a post-Fordist welfare state and NPM...

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

    OpenAIRE

    Scott DM; Strand M; Undem T; Anderson G; Clarens A; liu X.

    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 al...

  4. Ecosystem-Based Management and the Sustainable Delivery of Marine Ecosystem Services

    Science.gov (United States)

    Fogarty, M.; Schwing, F. B.

    2016-12-01

    Ecosystem-Based Management can provide an essential framework for the sustainable delivery of a broad spectrum of marine Ecosystem Services (ES) essential to human well being. Key elements of the approach involve the specification of clearly articulated goals for EBM; the development of an accompanying Marine Ecosystem Services Assessment (MESA) designed to evaluate the status of delivery of these services; and strategies for the implementation of management options designed to achieve the stated goals of the program. The specification of goals is the purview of managers. In the United States under the provisions of the National Ocean Policy, Regional Planning Bodies are charged with the responsibility of articulating goals and developing strategies to meet these goals. Government agencies, in concert with the broader scientific community, hold the responsibility for assessing the status of the delivery of ecosystem services in relation to designated objectives and advising on appropriate management strategies. In this presentation, I will illustrate the specification of a MESA for the Northwest U.S Continental Shelf Large Marine Ecosystem (NES LME). The approach focuses on the evaluation of ES indicators and additional metrics related to threats and impacts to the sustainable delivery of these services. Results are combined into an overall index of status of the NES LME.

  5. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    Science.gov (United States)

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  6. Meta-service Design and Implementation for Content Delivery Network Cloud Environments

    Directory of Open Access Journals (Sweden)

    Weitong Huang

    2012-11-01

    Full Text Available Storage has emerged as a typical kind of service in the cloud environment as the content delivery network (CDN emerges and becomes widely-used. In this paper, we conducted a research on the management issues for such applications, and implemented some meta-services upon the underlying cloud services. The architecture of the system was described in detailed and the detailed design of four types of meta-services was further discussed. The implementation of the key components was presented one by one, depicting the functionalities of these meta-services. Experimental results show that the implemented prototype can work effectively and meaningful suggestions could be given according to users’ requests, and thus exhibit the advantages of employing the proposed meta-services. Moreover, by presenting a special case study, the feasibility and usability of meta-services in the CDN is further illustrated.

  7. 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.

  8. A Collaborative Naturalistic Service Delivery Program for Enhancing Pragmatic Language and Participation in Preschoolers

    Science.gov (United States)

    Demchick, Barbara B.; Day, Karen H.

    2016-01-01

    We describe a speech-language pathology and occupational therapy service delivery program for preschoolers with developmental delays and communication and related impairments. Key features included interprofessional collaboration; parent professional partnerships; naturalistic environment; opportunities for choice and control; use of a…

  9. Causes of neonatal and maternal deaths in Dhaka slums: Implications for service delivery

    Directory of Open Access Journals (Sweden)

    Khatun Fatema

    2012-01-01

    Full Text Available Abstract Background Bangladesh has about 5.7 million people living in urban slums that are characterized by adverse living conditions, poor access to healthcare services and health outcomes. In an attempt to ensure safe maternal, neonatal and child health services in the slums BRAC started a programme, MANOSHI, in 2007. This paper reports the causes of maternal and neonatal deaths in slums and discusses the implications of those deaths for Maternal Neonatal and Child Health service delivery. Methods Slums in three areas of Dhaka city were selected purposively. Data on causes of deaths were collected during 2008-2009 using verbal autopsy form. Two trained physicians independently assigned the cause of deaths. Results A total of 260 newborn and 38 maternal deaths were identified between 2008 and 2009. The majority (75% of neonatal deaths occurred during 0-7 days. The main causes of deaths were birth asphyxia (42%, sepsis (20% and birth trauma (7%. Post partum hemorrhage (37% and eclampsia (16% were the major direct causes and hepatic failure due to viral hepatitis was the most prevalent indirect cause (11% of maternal deaths. Conclusion Delivery at a health facility with child assessment within a day of delivery and appropriate treatment could reduce neonatal deaths. Maternal mortality is unlikely to reduce without delivering at facilities with basic Emergency Obstetric Care (EOC and arrangements for timely referral to EOC. There is a need for a comprehensive package of services that includes control of infectious diseases during pregnancy, EOC and adequate after delivery care.

  10. 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…

  11. Program Intensity and Service Delivery Models in the Schools: SLP Survey Results

    Science.gov (United States)

    Brandel, Jayne; Loeb, Diane Frome

    2011-01-01

    Purpose: School-based speech-language pathologists (SLPs) routinely work with team members to make recommendations regarding an intervention program's intensity and method of service delivery for children with speech and language impairments. In this study, student, SLP, and workplace characteristics that may influence SLPs' recommendations were…

  12. 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…

  13. Health services delivery networks: what do we know and where should we be headed?

    Science.gov (United States)

    Provan, Keith G; Milward, H Brinton

    2006-01-01

    Networks of collaborating organizations have become critical mechanisms for the effective delivery of healthcare and related human services. Despite their importance, there is much about health networks that is not understood. The article by Huerta, Casebeer and VanderPlaat is an effort to discuss the importance of health services delivery networks and to point out ways in which such networks might best be studied. Their article offers a number of useful and interesting ideas for both practice and research. Many of these ideas are not, however, well organized, integrated or fully developed. This commentary provides a critique of their work, while offering some of our own suggestions about how the study of health delivery networks might be advanced.

  14. 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…

  15. 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

  16. Numbers That Count: Exploring Special Education and Paraprofessional Service Delivery in Inclusion-Oriented Schools

    Science.gov (United States)

    Suter, Jesse C.; Giangreco, Michael F.

    2009-01-01

    This study explores key indicators of special education service delivery based on responses from 92 special educators and 36 administrators in 19 Vermont schools. Special educators reported on their work, the work of paraprofessionals they supervised, and 103 students with disabilities who were receiving one-to-one paraprofessional supports within…

  17. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Science.gov (United States)

    2013-01-04

    ... Employment and Training Administration Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial Reporting Group, Hartford, CT; Notice of Affirmative... workers of Hartford Financial Services Group, Inc., Commercial/ Actuarial/Information Delivery...

  18. 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

  19. Speech-Language Pathologist and General Educator Collaboration: A Model for Tier 2 Service Delivery

    Science.gov (United States)

    Watson, Gina D.; Bellon-Harn, Monica L.

    2014-01-01

    Tier 2 supplemental instruction within a response to intervention framework provides a unique opportunity for developing partnerships between speech-language pathologists and classroom teachers. Speech-language pathologists may participate in Tier 2 instruction via a consultative or collaborative service delivery model depending on district needs.…

  20. Moral, Legal, and Functional Dimensions of Inclusive Service Delivery in Catholic Schools

    Science.gov (United States)

    Scanlan, Martin

    2009-01-01

    Catholic school educators are morally compelled by Catholic social teaching to foster inclusive service delivery for students who have traditionally been marginalized in schools, including students in poverty, students of color, English language learners, and students with special needs. This article applies this moral context to analyze the legal…

  1. Current Practices in Special Education Service Delivery and Differences between Instructional Settings

    Science.gov (United States)

    Platt, Marguerite D.

    2013-01-01

    Despite nationwide advances in special education service delivery practices, disparities exist between the educational outcomes of students with disabilities versus students without disabilities. There is often disparity in teachers' roles and instructional practices in coteaching classrooms, as well as in their pullout resource classroom…

  2. Contribution of Professional School Counselors' Values and Leadership Practices to Their Programmatic Service Delivery

    Science.gov (United States)

    Shillingford, M. Ann; Lambie, Glenn W.

    2010-01-01

    School counselors are called to be leaders to support the development of all students. The study in this article investigated the contributions of the values (Schwartz, 1992) and leadership practices (Posner & Kouzes, 1988) of 163 school counselors to their programmatic service delivery (Scarborough, 2005). Leadership practices made…

  3. Our natural capital: Ecosystem service delivery

    CSIR Research Space (South Africa)

    Dziba, L

    2012-10-01

    Full Text Available In this presentation the author focuses on ecosystem service delivery for national development planning. He shares new tools for improved decision-making to assess trade-offs and development choice impacts on ecosystem services. He also highlights...

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

    Science.gov (United States)

    Sasayama, Teruyoshi; 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.

  5. Perturbations of the solar wind flow by radial and latitudinal pick-up ion pressure gradients

    Directory of Open Access Journals (Sweden)

    H. J. Fahr

    2004-06-01

    Full Text Available It has been found that pick-up ions at their dynamical incorporation into the solar wind modify the original conditions of the asymptotic solar wind plasma flow. In this respect, it has meanwhile been revealed in many papers that these type of solar wind modifications, i.e. deceleration and decrease of effective Mach number, are not only due to the pick-up ion loading effects, but also to the action of pick-up ion pressure gradients. Up to now only the effects of radial pick-up ion pressure gradients were considered, however, analogously but latitudinal pressure gradients also appear to be important. Here we study the effects of radial and latitudinal pick-up ion pressure gradients, occurring especially during solar minimum conditions at mid-latitude regions where slow solar wind streams change to fast solar wind streams. First, we give estimates of the latitudinal wind components connected with these gradients, and then after revealing its importance, present a more quantitative calculation of solar wind velocity and density perturbations resulting from these pressure forces. It is shown that the relative density perturbations near and in the ecliptic increase with radial distance and thus may well explain the measured non-spherically symmetric density decrease with distance. We also show that the solar wind decelerations actually seen with Voyager-1/2 are in conciliation with interstellar hydrogen densities of nH∞≥0.1cm-3, in contrast to earlier claims for nH∞=0.05cm-3.

  6. University Educational Service Delivery Strategy in a Changing World: Implications for Ethical Values and Leadership Integrity in Nigeria

    Science.gov (United States)

    Akintayo, D. I.

    2008-01-01

    This paper examined university educational service delivery strategy in a changing world as it affects ethical values and leadership integrity in Nigeria. This was for the purpose of determining appropriate strategies for improving the quality of service delivery system in Nigerian universities. The paper submits that the quality and quantity of…

  7. 78 FR 15797 - Service Delivery Plan

    Science.gov (United States)

    2013-03-12

    ... ADMINISTRATION Service Delivery Plan AGENCY: Social Security Administration (SSA). ACTION: Notice; request for comments. SUMMARY: We are requesting public input as we finalize our Service Delivery Plan (SDP). We... Nation's economy. Today, the challenge of service delivery is greater than at any other point in...

  8. Satellite delivery of B-ISDN services

    Science.gov (United States)

    Kwan, R. K.; Price, K. M.; Chitre, D. M.; White, L. W.; Henderson, T. R.

    1992-01-01

    This paper will address the role of technology in the satellite delivery of B-ISDN services. Satellites excel in serving remote users and in providing multicast and broadcast services. Benefits to potential users employing these satellite broadband services will be examined together with their respective network architecture. Two application requirements are then proposed. The critical technologies needed in the realization of these architectures will be identified.

  9. Single liner shipping service design

    DEFF Research Database (Denmark)

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

    2014-01-01

    demand under commercially driven constraints. This paper introduces the Single Liner Shipping Service Design Problem. Arc-flow and path-flow models are presented using state-of-the-art elements from the wide literature on pickup and delivery problems. A Branch-and-Cut-and-Price algorithm is proposed...

  10. Using networks to enhance health services delivery: perspectives, paradoxes and propositions.

    Science.gov (United States)

    Huerta, Timothy R; Casebeer, Ann; Vanderplaat, Madine

    2006-01-01

    There is a growing need to better understand and address the consequences of an increasing reliance on networks used to enhance health services delivery. Networks seem to have emerged as the definitive solution for tackling complex healthcare problems together that we have not been able to adequately address separately. Emphasizing the collective and the collaborative, networks are assumed to address healthcare issues in ways that are superior to previous service-delivery models. While this assumption would appear to be sound theoretically, we have little empirical information available to actually understand what networks are, what they do and whether they achieve their stated goals--truly making a difference in the delivery of care and the maintenance of health. With a diversity of networks within Canada focused on health services delivery, this paper offers a multi-dimensional framework for conceptualizing how these complex inter-organizational relationships generate both challenges and opportunities. We identify six paradoxes that the networks create when used to enhance the delivery of health services and posit several propositions concerning the evaluative work that needs to be done to enhance our understanding of and confidence in this inter-organizational form. Unless these paradoxes are adequately recognized and addressed, the value and costs associated with developing and using networks in healthcare contexts will remain unclear at best. Given the broad interest in and use of networks proliferating in health-related arenas, it is time to amass the evidence and than align the perspectives. Are networks here to stay in healthcare because they make a difference or because we got tired of talking about the need for greater collaboration and so gave it a new name and frame? At the very least, it will be important to build on what we have already learned through research into collaboration in healthcare and related fields, and even more critical to be mindful

  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. 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.

  13. 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.

  14. The impact of racism on the delivery of health care and mental health services.

    Science.gov (United States)

    Hollar, M C

    2001-01-01

    This article presents research findings useful in formulating a Best Practices Model for the delivery of mental health services to underserved minority populations. Aspects of the role of racism in health care delivery and public health planning are explored. An argument is made for inclusion of the legacy of the slavery experience and the history of racism in America in understanding the current health care crisis in the African-American population. The development of an outline in APA DSM IV for the use of cultural formulations in psychiatric diagnosis is discussed.

  15. 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.

  16. 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.

  17. 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.

  18. Converting Student Support Services to Online Delivery

    Directory of Open Access Journals (Sweden)

    David E. Brigham

    2001-01-01

    Full Text Available This case study describes how Regents College (soon to be Excelsior College, an accredited, private, distance education institution with administrative offices in Albany, New York addressed the structural, management, and resource issues that came into play when converting distance education programs from print-based and telephone delivery to online delivery. The study uses a systems framework to describe and analyze the circumstances and issues surrounding the creation of six student support services: electronic advising, an electronic peer network, an online database of distance courses, an online bookstore, a virtual library, and an alumni services website.

  19. Making Decisions about Service Delivery in Early Childhood Programs

    Science.gov (United States)

    Case-Smith, Jane; Holland, Terri

    2009-01-01

    Purpose: This article presents a rationale for specialized services personnel to use fluid models of service delivery and explains how specialized services personnel make decisions about the blend of service delivery methods that will best serve a child. Method: The literature on occupational therapy, physical therapy, and speech-language…

  20. 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.

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

    African Journals Online (AJOL)

    dell

    not done on time and this resulted in serious disciplinary problems on the students' side. ... three areas (1) problem solving and planning cycles of the ... interpersonal communication skills are essential since ..... workplace: Newelhi. PP1-17.

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

    Directory of Open Access Journals (Sweden)

    Hassen Kebede

    2014-02-01

    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

  3. 44 ICT's, Service Delivery and Operational Performance in Nigerian ...

    African Journals Online (AJOL)

    User

    2011-07-21

    Jul 21, 2011 ... tool for gaining competitive advantage in the corporate world and as such it has become .... acquisition, storage, manipulation, management, movement ... Nigeria emerged as a distinct country in 1914 with the merger of the.

  4. Institutional dynamics and health service delivery in regional referral ...

    African Journals Online (AJOL)

    ... referral hospitals in Uganda: What lessons from a case of Jinja Regional Hospital? ... supplies, physical infrastructure and the availability of medical equipment. ... perhaps not seriously affected by lack of drugs but by inadequate facilities.

  5. Procurement and Delivery of Joint Service Armor Protected Vehicles

    Science.gov (United States)

    2009-01-29

    vehicles should not ha ve bcen compared to each othcr 0 1’ to a singlc IG E. F8Jl 8FFISMb l!IS6 8PlbY 29 An M S orti eial stated that thc IGCE was based...in thi s casc. Adcquate competition can be cxpccted to result in fail’ and rcasonable contract prices. However, an M S orti cial statcd that they...it comments concerning the fa ir and reasonable con tract price determination from the Ortiee of Defense Procurement Acq ui sit ion Po li cy (D PAP

  6. 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.

  7. AA, stochastic precooling pickup

    CERN Multimedia

    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...

  8. Addressing health system barriers to access to and use of skilled delivery services: perspectives from Ghana.

    Science.gov (United States)

    Ganle, John Kuumuori; Fitzpatrick, Raymond; Otupiri, Easmon; Parker, Michael

    2016-10-01

    Poor access to and use of skilled delivery services have been identified as a major contributory factor to poor maternal and newborn health in sub-Saharan African countries, including Ghana. However, many previous studies that examine norms of childbirth and care-seeking behaviours have focused on identifying the norms of non-use of services, rather than factors, that can promote service use. Based on primary qualitative research with a total of 185 expectant and lactating mothers, and 20 healthcare providers in six communities in Ghana, this paper reports on strategies that can be used to overcome health system barriers to the use of skilled delivery services. The strategies identified include expansion and redistribution of existing maternal health resources and infrastructure, training of more skilled maternity caregivers, instituting special programmes to target women most in need, improving the quality of maternity care services provided, improving doctor-patient relationships in maternity wards, promotion of choice, protecting privacy and patient dignity in maternity wards and building partnerships with traditional birth attendants and other non-state actors. The findings suggest the need for structural changes to maternity clinics and routine nursing practices, including an emphasis on those doctor-patient relational practices that positively influence women's healthcare-seeking behaviours. Copyright © 2015 John Wiley & Sons, Ltd.

  9. 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.

  10. 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.

  11. 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.

  12. Pickup impact on high-voltage multifinger LDMOS-SCR with low trigger voltage and high failure current

    Science.gov (United States)

    Yang, Liu; Jin, Xiangliang; Wang, Yang; Zhou, Acheng

    2015-12-01

    The impact of inserting P+ pickup on high-voltage multi-finger laterally diffused metal-oxide-semiconductor-silicon-controlled rectifier (LDMOS-SCR) has been studied in this article. Four-finger LDMOS-SCR structures with finger length of 50 μm using 0.5 μm 18 V complementarily diffused metal oxide semiconductor (CDMOS) process were fabricated and tested. Theoretical analysis is carried out to make detailed comparisons between LDMOS-SCR with and without P+ pickup. It verifies that the multi-finger LDMOS-SCR with P+ pickup has greater electrostatic discharge (ESD) robustness and effectiveness. Furthermore, transmission line pulse (TLP) test has been done and the results show that the trigger voltage (Vt1) of the LDMOS-SCR with P+ pickup remarkably decreases from 46.19 to 35.39 V and the second breakdown current (It2) effectively increases from 8.13 to 10.08 A.

  13. Pick-up Ion Sputtering of Mars' Atmosphere: Analysis of MAVEN Data and Simulations

    Science.gov (United States)

    Williamson, Hayley N.; Leclercq, Ludivine; Johnson, Robert E.; Curry, Shannon; Elrod, Meredith K.; Luhmann, Janet; Leblanc, Francois

    2016-10-01

    One of the ways hot oxygen escapes the exosphere of Mars is through sputtering caused by the precipitation of, primarily, O+ pickup ions. This process is thought to have been particularly important early in martian history, as it is correlated with increased solar activity (Luhmann 1992). With ion precipitation data from the MAVEN mission for a variety of solar conditions (Leblanc 2015), we can potentially see the effect of atmospheric sputtering. To determine if this process is apparent in MAVEN data, we first model the thermosphere and exosphere with an O and CO2 Direct Simulation Monte Carlo model. We then introduce a heat flux representative of the energy deposited by pickup ions for a variety solar conditions and look for the resulting signatures in the in situ neutral and ion atmospheric data from the NGIMS instrument available on the PDS. Preliminary simulations and data analysis are suggestive. Analysis of the simulations and the data analysis will be presented.

  14. 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…

  15. Instabilities Driven by a Pickup Ion Velocity Ring in the Heliosphere: Linear Theory and PIC Simulations

    Science.gov (United States)

    Liu, K.; Min, K.; Gary, S. P.; Wang, X.

    2016-12-01

    Linear dispersion analyses and two-dimensional electromagnetic particle-in-cell simulations are performed to study the kinetic plasma instabilities driven by a proton velocity ring with parameters (e.g., ring speed 10vA where vA is the Alfvén speed) relevant to the pickup ions in the distant solar wind. The results show that, besides the commonly expected Alfvén cyclotron instability with maximum growth at parallel propagation, mirror mode and ion Bernstein modes at oblique propagations are also unstable. While the enhanced waves from the Alfvén cyclotron instability mainly lead to pitch angle scattering of the ring protons, the other modes scatter the protons differently. The results also have implications for the pickup ions in the outer heliosheath.

  16. 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

  17. Injection to the pick-up ion regime from high energies and induced ion power laws

    CERN Document Server

    Fahr, H -J; Verscharen, D

    2008-01-01

    Though pick-up ions (PUIs) are a well known phenomenon in the inner heliosphere, their phase-space distribution nevertheless is a theoretically unsettled problem. Especially the question of how pick-up ions form their suprathermal tails, extending to far above their injection energies, still now is unsatistactorily answered. Though Fermi-2 velocity diffusion theories have revealed that such tails are populated, they nevertheless show that resulting population densities are much less than seen in observations showing power-laws with a velocity index of ``-5''. We first investigate here, whether or not observationally suggested power-laws can be the result of a quasi-equilibrium state between suprathermal ions and magnetohydrodynamic turbulences in energy exchange with eachother. We demonstrate that such an equilibrium cannot be established. We furthermore show that Fermi-2 type energy diffusion in the outer heliosphere is too inefficient to determine the shape of the distribution function there. As we can show...

  18. 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.

  19. SAFE DELIVERY SERVICE UTILIZATION IN METEKEL ZONE,

    African Journals Online (AJOL)

    The objective of this study was to assess the status of safe delivery service utilization and ..... headache, 73(7%) severe abdominal pain, 32(3.1%) drowsiness and 28(2.7%) ..... In line with reports from Pakistan (12), mothers' knowledge about ...

  20. 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.

  1. Coproduction without Experts: A Study of People Involved in Community Health and Well-Being Service Delivery

    Science.gov (United States)

    Ledger, Alison; Slade, Bonnie

    2015-01-01

    Coproduction (equal professional-public involvement in service delivery) has been widely promoted as a means of revolutionising health and social care. Service providers/professionals are tasked with working more in partnership with service users/clients, recognising their experiences and knowledge as critical to the success of the interaction.…

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

    OpenAIRE

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

    2010-01-01

    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 ...

  3. Design of planar pick-ups for beam position monitor in the bunch compressor at FLASH and XFEL

    Energy Technology Data Exchange (ETDEWEB)

    Angelovski, Aleksandar; Penirschke, Andreas; Jakoby, Rolf [Institut fuer Mikrowellentechnik und Photonik, TU Darmstadt (Germany); Sydlo, Cezary; Mavric, Uros; Gerth, Christopher [DESY, Hamburg (Germany)

    2013-07-01

    For obtaining ultra short electron bunches at the Free Electron Laser at DESY (FLASH) the beam is compressed in magnetic chicanes. During the compression process the precise knowledge of the energy of the bunches is essential for the longitudinal dynamics control. The measurement of the beam position in the chicane allows for non-destructive measurements of the energy. For that purpose, two stripline pick-ups perpendicular to the beam direction are installed in the chicane at FLASH as a part of the Beam Position Monitor. The recent upgrade in the electronics as well as the increased aperture and length of the beam pipe (for the European XFEL) requires the design of new pick-ups which will fulfill the new demands. Namely, the pick-ups should have maximum signal at 3 GHz with minimum reflections. In this talk, we will present the design of planar transmission line pick-ups for FLASH and XFEL. The planar design of the pick-ups can provide for a proper impedance matching to the subsequent electronics as well as sufficient mechanical stability along the aperture when using alumina substrate. A prototype of the pick-ups was build and installed in a non-hermetic body. The measured S parameters are compared to the simulation.

  4. 32 CFR 700.822 - Delivery of personnel to civil authorities and service of subpoena or other process.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Delivery of personnel to civil authorities and service of subpoena or other process. 700.822 Section 700.822 National Defense Department of Defense... REGULATIONS AND OFFICIAL RECORDS The Commanding Officer Commanding Officers in General § 700.822 Delivery...

  5. Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care.

    Science.gov (United States)

    MacPherson, Peter; Munthali, Chigomezgo; Ferguson, Jane; Armstrong, Alice; Kranzer, Katharina; Ferrand, Rashida A; Ross, David A

    2015-08-01

    Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle-Ottawa Scale. Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent-friendliness of clinics. Most studies were of low to moderate methodological quality. This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent-tailored services appear promising interventions and warrant further investigation. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  6. 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

    2016-03-31

    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.

  7. Outplacement Services for Displaced Employees: Attitudes of Human Resource Managers Based on Differences in Internal and External Delivery

    Science.gov (United States)

    Kilcrease, Kelly M.

    2013-01-01

    The results from a survey of 238 human resources executives from organizations that offer outplacement counseling (OPC) internally and 168 that offer it externally suggest that internal OPC delivery is inferior to external OPC delivery. The author found that most internal OPC organizations did not offer the 13 traditional OPC services, even when…

  8. Outplacement Services for Displaced Employees: Attitudes of Human Resource Managers Based on Differences in Internal and External Delivery

    Science.gov (United States)

    Kilcrease, Kelly M.

    2013-01-01

    The results from a survey of 238 human resources executives from organizations that offer outplacement counseling (OPC) internally and 168 that offer it externally suggest that internal OPC delivery is inferior to external OPC delivery. The author found that most internal OPC organizations did not offer the 13 traditional OPC services, even when…

  9. 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.

  10. Trends in health surveillance and joint service delivery for pastoralists in West and Central Africa.

    Science.gov (United States)

    Abakar, M F; Schelling, E; Béchir, M; Ngandolo, B N; Pfister, K; Alfaroukh, I O; Hassane, H M; Zinsstag, J

    2016-11-01

    In most sub-Saharan African countries, pastoralism represents an important economic resource and contributes significantly to national growth; however, challenges remain, particularly in providing social services to pastoralists (especially health and education) and in avoiding conflict with local sedentary communities and local authorities. All of this takes place while pastoralists try to maintain their mobile lifestyle within a rapidly changing ecosystem. Transdisciplinary approaches, such as 'One Health', which covers both human and animal health, have proven effective in delivering services and reaching mobile pastoralists in remote areas. The pastoralist way of life could be described as being linked to both their livestock and their environment, which makes social science an important element when researching the delivery and adaptation of social services to pastoralists. Early or pre-diagnostic detection of emerging and endemic infectious disease remains a vital aspect of health surveillance targeted at preventing further transmission and spread. Community-based syndromic surveillance, coupled with visual mobile phone technology, adapted to the high levels of illiteracy among nomads, could offer an alternative to existing health surveillance systems. Such an approach could contribute to accelerated reporting, which could in turn lead to targeted intervention among mobile pastoralists in sub-Saharan Africa. Although considerable efforts have been made towards integrating mobile pastoralists into social services, obstacles remain to the adoption of a clear, specific and sustainable policy on pastoralism in sub-Saharan Africa.

  11. 78 FR 16753 - Service Delivery Plan; Correction

    Science.gov (United States)

    2013-03-18

    ... ADMINISTRATION Service Delivery Plan; Correction AGENCY: Social Security Administration. ACTION: Notice; request... SUMMARY caption insert the following hyper-links. In the first sentence after the words, ``Service Delivery Plan (SDP) insert http://www.ssa.gov/open/SDP . In ] addition, in the third sentence after...

  12. Development of a Power Receiving Pickup for the Scalable Inductive Power Transfer Platform(Asia-Pacific Symposium on Applied Electromagnetics and Mechanics(APSAEM10))

    OpenAIRE

    N. L., Mohd Kamal; D., Kacprzak; Department of Electrical and Computer Engineering, The University of Auckland

    2011-01-01

    This publication presents an outline of the strategies and steps involved in designing a pickup for 2D inductive power transfer platform with selectively powered hexagonal coils. The design of the pickup coil takes advantage of the horizontal component of the magnetic field produced by the platform and is intended to transfer power from the poorly uniform magnetic field produced by the single layer platform. 3D simulations of pickup coils are made and verified using the finite element method ...

  13. Pickup protons and pressure-balanced structures from 39 to 43 AU: Voyager 2 observations during 1993 and 1994

    Science.gov (United States)

    Burlaga, L. F.; Ness, N. F.; Belcher, J. W.; Whang, Y. C.

    1996-07-01

    The pressure of interstellar pickup protons in the distant heliosphere can be determined by analyzing pressure-balanced structures, observed on a scale of a few hundredths of an AU. This paper extends the earlier work of L. F. Burlaga et al. (Journal of Geophysical Research, 99, 21, 511, 1994) by analyzing pressure-balanced structures observed by Voyager 2 from 39.3 to 40.6 AU in 1993 and from 42.6 to 43.2 AU during 1994. The pickup proton temperature is high in the region of the distant heliosphere that we considered: (5.4+/-0.1)×106 K at 39-41 AU and (6.0+/-0.4)×106 K at ~43 AU. The density of the pickup protons is (1.6+/-0.3)×10-4 cm-3 at 39-41 AU and (1.2+/-0.2)×10-4 cm-3 at ~43 AU. The ratio of the pickup proton density to the solar wind proton density (Ni/N) is small, only 0.03+/-0.01 during both 1993 and 1994. Nevertheless, the pickup proton pressures are relatively high because of their high temperatures. The pickup proton pressure was (11+/-2)×10-14 ergcm-3 at 39-41 AU and (9+/-1)×10-14 ergcm-3 at 43 AU. There is a possible decrease in Pi with increasing distance from the Sun. The pickup proton pressure is an order of magnitude greater than the solar wind proton pressure: Pi/Pswp=10+/-2 at 39-41 AU and 8+/-2 at 43 AU. Our results support the hypothesis of Burlaga et al. that the pickup proton pressure is more important than the solar wind thermal pressure in the dynamics of the distant heliosphere. The ratio of the pickup ion pressure to the magnetic pressure is Pi/(B2/8π)=1.7+/-0.3 at 39-41 AU and 1.7+/-0.72 at ~43 AU. These results are compared with a model.

  14. 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.

  15. Issues and principles in service delivery to communicatively impaired minority bilingual adults in neurorehabilitation.

    Science.gov (United States)

    Centeno, José G

    2009-08-01

    Demographic and epidemiological trends coupled with health-care needs in minority populations highlight the imperative need to develop effective, culturally appropriate clinical approaches for minority adults with communication impairments. The steady increase in linguistic and cultural diversity in the country includes a large number of bilingual adults, which is estimated to continue. Because strokes are quite prevalent in racial/ethnic minorities, the number of bilingual adults with acquired communication disorders will similarly increase. However, members of minority groups presently confront disparities in health-care services compared with the general population that translates into reduced health outcomes. This article discusses the current clinical needs and complexities in service delivery to communicatively impaired minority adults, with a special focus on bilingual adults with aphasia.

  16. Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes

    Science.gov (United States)

    Ponnusamy, Vellapandian; Grove, J. Robert

    2014-01-01

    Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key points Consultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services. Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values. Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach. Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year. PMID:25177193

  17. Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes.

    Science.gov (United States)

    Ponnusamy, Vellapandian; Grove, J Robert

    2014-09-01

    Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key pointsConsultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services.Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values.Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach.Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year.

  18. Delivery of high quality stroke and vision care: experiences of UK services.

    Science.gov (United States)

    Rowe, Fiona; Walker, Marion; Rockliffe, Janet; Pollock, Alex; Noonan, Carmel; Howard, Claire; Currie, Jim

    2015-07-02

    We sought to identify exemplars of high quality care provision from established stroke vision services. We identified areas of high quality services across the UK, judged as having integrated stroke/vision care provision for stroke survivors. Healthcare professionals were selected to participate in 1:1 interviews or focus groups. A strengths-weaknesses-opportunities-threats (SWOT) framework was used to lead the discussion in a semi-structured format. Thematic analysis was undertaken. Interviewees (n = 24) from 14 NHS Trusts included eye clinic managers, nurses, orthoptists, occupational therapists and physiotherapists. Identified strengths of their services included established communication, training provision for stroke team staff, "open access" for referrals, use of standardised screening/referral forms, provision of lay summaries and information sheets, patients assessed on the stroke unit with continued follow-up and initial visual assessments made within 1 week of stroke onset. Weaknesses included lack of funding, insufficient orthoptic cover, and time consuming retraining of stroke staff because of staff rotation and changes. Opportunities included increasing the number (or length) of orthoptic sessions and training of stroke staff. Perceived threats related to funding and increased appointment waiting times. Practical elements for improved stroke and vision care provision are highlighted which can be implemented with relatively little financial inputs. Implications for Rehabilitation Integrated vision services within stroke units can improve the detection of visual problems in stroke survivors leading to earlier visual rehabilitation. Orthoptists within core stroke teams are beneficial to the delivery of a high quality service. This study illustrates clear practical elements to support the provision of high quality integrated stroke and vision services. Relatively little financial inputs are required to fund such services but with larger potential to

  19. Service delivery for e-Health applications.

    Science.gov (United States)

    Staemmler, Martin

    2011-01-01

    E-Health applications have to take the business perspective into account. This is achieved by adding a fourth layer reflecting organizational and business processes to an existing three layer model for IT-system functionality and management. This approach is used for designing a state-wide e-Health service delivery allowing for distributed responsibilities: clinical organizations act on the fourth layer and have established mutual cooperation in this state-wide approach based on collectively outsourced IT-system services. As a result, no clinical organization can take a dominant role based on operating the IT-system infrastructure. The implementation relies on a central infrastructure with extended means to guarantee service delivery: (i) established redundancy within the system architecture, (ii) actively controlled network and application availability, (iii) automated routine performance tests fulfilling regulatory requirements and (iv) hub-to-spoke and end-to-end authentication. As a result, about half of the hospitals and some practices of the state have signed-up to the services and guarantee long-term sustainability by sharing the infrastructural costs. Collaboration takes place for more than 1000 patients per month based on second opinion, online consultation and proxy services for weekend and night shifts.

  20. 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.

  1. Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

    Directory of Open Access Journals (Sweden)

    Stephanie Couch

    2015-02-01

    Full Text Available 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 wasused 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.

  2. Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: perceptions of health and social services professionals.

    Science.gov (United States)

    McNeil, Ryan; Guirguis-Younger, Manal

    2012-06-01

    Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the challenges of end-of-life care services to homeless illicit drug users based on data collected during a national study on end-of-life care services delivery to homeless persons in Canada. The authors conducted qualitative interviews with 50 health and social services professionals involved in health services delivery to homeless persons in five cities. Interviews were transcribed verbatim and analysed thematically. Themes were organised into two domains. First, barriers preventing homeless illicit drug users from accessing end-of-life care services, such as competing priorities (e.g. withdrawal management), lack of trust in healthcare providers and discrimination. Second, challenges to end-of-life care services delivery to this population in health and social care settings, including non-disclosure of illicit drug use, pain and symptom management, interruptions in care, and lack of experience with addictions. The authors identify a need for increased research on the role of harm reduction in end-of-life care settings to address these challenges.

  3. 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...... of messages for the implementation of an accident service, which is based on multiplexed communication, a crucial feature of global computing applications....

  4. 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.

  5. 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

  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. Stellar wind interaction and pick-up ion escape of the Kepler-11 "super-Earths"

    Science.gov (United States)

    Kislyakova, Kristina; Johnstone, Colin; Odert, Petra; Erkaev, Nikolai; Lammer, Helmut; Lüftinger, Theresa; Holmstöm, Mats; Khodachenko, Maxim; Güdel, Manuel

    2014-05-01

    We present the results of modeling of the interactions between stellar wind and the extended hydrogen-dominated upper atmospheres of planets and estimate the resulting escape of planetary pick-up ions from the 5 «super-Earths» in the compact Kepler-11 system. We compare the escape rates with the efficiency of the thermal escape of neutral hydrogen atoms. Assuming the stellar wind of Kepler-11 is similar to the solar wind, we used a polytropic 1D hydrodynamic wind model to estimate the wind properties at the planetary orbits. We applied a Direct Simulation Monte Carlo Model to model the hydrogen coronae and the stellar wind plasma interaction around Kepler-11b-f planets within a realistic expected heating efficiency range of 15-40%. The same model was used to estimate the ion pick-up escape from the XUV heated and hydrodynamically extended upper atmospheres of Kepler-11b-f. Modeling clarifies the influence of possible magnetic moments on escape processes and allows to estimate the charge exchange and photoionization production rates of planetary ions as well as the loss rates of pick-up H+ ions for all five planets. This study presents also the comparison of the results between the five 'super-Earths' and in a more general sense also with the thermal escape rates of the neutral planetary hydrogen atoms. Our results show that for all Kepler-11b-f exoplanets, a huge neutral hydrogen corona is formed around the planet. The non-symmetric form of the corona changes from planet to planet and is defined mostly by radiation pressure, charge-exchange and gravitational effects. According to our estimates, nonthermal escape rates of pick-up ionized hydrogen atoms for Kepler-11 «super-Earths» vary between ~ 6.4 × 1030 s-1 and ~ 4.1 × 1031 s-1 depending on the planet's orbital location and assumed heating efficiency. These values correspond to non-thermal mass loss rates of ~ 1.07 × 107 g·s-1 and ~ 6.8 × 107 g·s-1 respectively, which is a few percent of the thermal

  8. The effectiveness of the PRISMA integrated service delivery network: preliminary report on methods and baseline data.

    Science.gov (United States)

    Hébert, Réjean; Dubois, Marie-France; Raîche, Michel; Dubuc, Nicole

    2008-02-14

    The PRISMA study analyzes an innovative coordination-type integrated service delivery (ISD) system developed to improve continuity and increase the effectiveness and efficiency of services, especially for older and disabled populations. The objective of the PRISMA study is to evaluate the effectiveness of this system to improve health, empowerment and satisfaction of frail older people, modify their health and social services utilization, without increasing the burden of informal caregivers. The objective of this paper is to present the methodology and give baseline data on the study participants. A quasi-experimental study with pre-test, multiple post-tests, and a comparison group was used to evaluate the impact of PRISMA ISD. Elders at risk of functional decline (501 experimental, 419 control) participated in the study. At entry, the two groups were comparable for most variables. Over the first year, when the implementation rate was low (32%), participants from the control group used fewer services than those from the experimental group. After the first year, no significant statistical difference was observed for functional decline and changes in the other outcome variables. This first year must be considered a baseline year, showing the situation without significant implementation of PRISMA ISD systems. Results for the following years will have to be examined with consideration of these baseline results.

  9. The effectiveness of the PRISMA integrated service delivery network: preliminary report on methods and baseline data

    Directory of Open Access Journals (Sweden)

    Réjean Hébert

    2008-02-01

    Full Text Available Purpose: The PRISMA study analyzes an innovative coordination-type integrated service delivery (ISD system developed to improve continuity and increase the effectiveness and efficiency of services, especially for older and disabled populations. The objective of the PRISMA study is to evaluate the effectiveness of this system to improve health, empowerment and satisfaction of frail older people, modify their health and social services utilization, without increasing the burden of informal caregivers. The objective of this paper is to present the methodology and give baseline data on the study participants. Methods: A quasi-experimental study with pre-test, multiple post-tests, and a comparison group was used to evaluate the impact of PRISMA ISD. Elders at risk of functional decline (501 experimental, 419 control participated in the study. Results: At entry, the two groups were comparable for most variables. Over the first year, when the implementation rate was low (32%, participants from the control group used fewer services than those from the experimental group. After the first year, no significant statistical difference was observed for functional decline and changes in the other outcome variables. Conclusion: This first year must be considered a baseline year, showing the situation without significant implementation of PRISMA ISD systems. Results for the following years will have to be examined with consideration of these baseline results.

  10. Life Cycle Thinking and Integrated Product Deliveries in renovation projects: Extending the concept of Integrated Product Deliveries with Product Service Systems

    DEFF Research Database (Denmark)

    Schipull Kauschen, Jan

    2012-01-01

    INTRODUCTION The term “Integrated product deliveries (IPD)” encompasses complex building solutions, that not only include building materials and components but also different necessary services linked directly to them, as design and planning tasks, production, assembly, delivery and construction...... work. Furthermore, IPDs are produced in an industrial context, allowing higher quality products at competitive costs. Expanding the term to also include services during the components use phase and continued responsibility for the end-of-life, offers new possibilities for enhancing the sustainability...... on renovation projects from Denmark, using different forms of IPDs for façade renovation and discusses the different stakeholder’s perspectives on life cycle thinking and their interests and values regarding sustainable building. Furthermore is the concept of Product Service Systems (PSS) as a valuable...

  11. Security in Cloud Computing For Service Delivery Models: Challenges and Solutions

    Directory of Open Access Journals (Sweden)

    Preeti Barrow

    2016-04-01

    Full Text Available Cloud computing, undoubtedly, is a path to expand the limits or add powerful capabilities on-demand with almost no investment in new framework, training new staff, or authorizing new software. Though today everyone is talking about cloud but, organizations are still in dilemma whether it’s safe to deploy their business on cloud. The reason behind it; is nothing but Security. No cloud service provider provides 100% security assurance to its customers and therefore, businesses are hesitant to accept cloud and the vast benefits that come along with it. The absence of proper security controls delimits the benefits of cloud. In this paper, a review on different cloud service models and a survey of the different security challenges and issues while providing services in cloud is presented .The paper focuses on the security issues specific to service delivery model (SaaS, IaaS and PaaS of cloud environment. This paper also explores the various security solutions currently being applied to protect cloud from various kinds of intruders

  12. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Science.gov (United States)

    2010-04-01

    ... service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING... the basic components of an NFJP service delivery strategy? The NFJP service delivery strategy must... Investment Boards for the delivery of the services available through the One-Stop system to MSFW's; and...

  13. Leadership Dynamics Promoting Systemic Reform for Inclusive Service Delivery

    Science.gov (United States)

    Scanlan, Martin

    2009-01-01

    This article presents a multicase study of two systems of schools striving to reform service delivery systems for students with special needs. Considering these systems as institutional actors, the study examines what promotes the understanding and implementation of special education service delivery within a system of schools in a manner that…

  14. 78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

    Science.gov (United States)

    2013-02-06

    .../ Information Delivery Services (IDS)/Corporate & Financial Reporting Group, Hartford, CT; Notice of Negative... Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS)/Corporate & Financial... Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services...

  15. Stellar wind interaction and pick-up ion escape of the Kepler-11 "super-Earths"

    CERN Document Server

    Kislyakova, K G; Odert, P; Erkaev, N V; Lammer, H; üftinger, T L; Holmström, M; Khodachenko, M L; üdel, M G

    2013-01-01

    We study the interactions between stellar wind and the extended hydrogen-dominated upper atmospheres of planets and the resulting escape of planetary pick-up ions from the 5 "super-Earths" in the compact Kepler-11 system and compare the escape rates with the efficiency of the thermal escape of neutral hydrogen atoms. Assuming the stellar wind of Kepler-11 is similar to the solar wind, we use a polytropic 1D hydrodynamic wind model to estimate the wind properties at the planetary orbits. We apply a Direct Simulation Monte Carlo Model to model the hydrogen coronae and the stellar wind plasma interaction around Kepler-11b-f within a realistic expected heating efficiency range of 15-40%. The same model is used to estimate the ion pick-up escape from the XUV heated and hydrodynamically extended upper atmospheres of Kepler-11b-f. From the interaction model we study the influence of possible magnetic moments, calculate the charge exchange and photoionization production rates of planetary ions and estimate the loss r...

  16. Thermalization of Na+ Pickup Ions in Mercury's Magnetosheath and Magnetosphere via Hybrid Simulation

    Science.gov (United States)

    Boardsen, S. A.; Omidi, N.; Slavin, J. A.

    2007-12-01

    In previous studies it has been suggested that the incorporation of Na+ pickup ions into Mercury's magnetosphere could have a significant impact on various magnetospheric processes. Test particle simulations indicate that freshly created Na+ ions are rapidly energized and lost from the system. In order to incorporate these ions into the bulk magnetospheric plasma they must be thermalized. A recent study that used linear theory suggests that the wavelengths of electromagnetic ion cyclotron waves may be to large and may not grow to sufficient amplitudes to thermalize these ions and concluded that global thermalization of these ions is not possible. However, under certain solar wind and IMF conditions such thermalization might take place in limited regions of Mercury's magnetosphere, primarily in the sub-solar magnetosheath. Due the small scale size of Mercury's magnetosphere compared to the gyro-radii of these heavy ions and their associated wave modes, hybrid simulation with a kinetic treatment for the ions and a fluid treatment for the electrons may be the only way to study if thermalization of Na+ can occur. Preliminary results of a hybrid simulation that incorporates the Na+ pickup ions in its kinetic treatment will be presented.

  17. 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…

  18. Utilization of Service Delivery Insurance (Jampersal for Maternal and Child Health Services in 12 Districts/Cities: Eliminate the Socio-cultural Obstacle on Safe Delivery

    Directory of Open Access Journals (Sweden)

    Lestari Handayani

    2014-08-01

    Full Text Available Background: The Government launched Jampersal as one of efforts to suppress the number of Maternal and Infant Mortality Ratio (MMR & IMR as well as a booster to achieve the MDGs by 2015. Delivery assistance seek are influencedby many factors including a socio-cultural factor. This research aimed to provide a study on the socio-cultural role inimproving the utilization of Service Delivery Insurance (Jampersal. Methods: Data about Jampersal was collected throughin-depth interviews, focus group discussion to community leaders, traditional birth attendants, midwives and head of thehealth center. In addition, as a supporting data, a quantitative survey to mothers who gave birth in the last year was alsoconducted. The research was located in 6 province in Indonesia. Each covered one health center in a rural area and one in a urban area. Results: The result of this research showed a strong evidence that rituals or traditions were still mostlyconducted. So the role of traditional birth attendants were still needed. Lack of transportation was to be the main obstacleto acces health facilities. Mean while, social interaction in rural area and a well-developed infrastructure in urban areawere important to enable the accessibility to access health facilities. Midwives were well-accepted by the people who hada good knowledge on health despite having less formal education both in rural or urban area. Labor financing by utilizingJampersal are good but not maximized or tend to be low in certain urban areas. Conclusions: People prefered to chosemidwives as birth attendants financed by Jampersal although some delivered at home. TBAs are still needed for maternal and baby care as well as to assist the implementation of rituals. Midwife-TBAs partnerships already on the right track butthe labor financing by Jampersal only support health care practitioner. Recommendation: Jampersal also support social and cultural-related financing, such as honorarium for TBAs who

  19. Are the sungrazing comets the inner source of pickup ions and energetic neutral atoms?

    CERN Document Server

    Bzowski, M

    2004-01-01

    We show arguments that at least part of the inner source of pickup ions and energetic neutral atoms (~ 1 keV) might be the material released by sungrazing comets.Based on the monthly apparition statistics we postulate that the actual number of sungrazing comets may be even higher than observed. We point out that an overwhelming majority of the observed sungrazers belong to the Kreutz group of comets which follow tightly clumped orbits and break up at $\\sim 40 - 4$ solar radii in a well defined region. The material released from these comets should be (after ionization) at least an important portion of the inner source of pickup ions. We suggest that PUI from the cometary source should be accompanied by an increased level of ENA of similar energy. We indicate time intervals during the year when the cometary PUI should be observed from a spacecraft at Earth's orbit (basically, from the end of July till the end of the year) and show three time intervals, when they should be observable by Ulysses (since launch ti...

  20. Speech and language therapy service delivery: overcoming limited provision for children.

    Science.gov (United States)

    Jesus, L M T; Martinez, J; Valente, A R; Costa, M C

    2017-10-01

    To test an alternative Speech and Language Therapy (SLT) service delivery model based on partnerships between a University and local schools and charities, and to report on the impact and feasibility of intervention based on long-term outcome measures and three case studies with individual analysis of Reliable Change. The following six-step model was tested: 1-establishing partnerships; 2-flagging children; 3-pre-treatment SLT assessment; 4-reporting and discussion with parents and teachers; 5-treatment; 6-post-treatment assessment. Case studies are presented. A partnership was established with one kindergarten in a pre-test and a total of 25 kindergartens during the second phase of the process. A group of 139 children were then flagged and assessed. The following long-term outcomes (18 months post-therapy) were investigated: phonetic-phonological standardised test percentiles and raw scores; receptive and expressive language percentiles and raw scores according to a standardised language test; percentage of syllables stuttered; duration of stuttering moments; academic achievement in norm-tests' core areas (mathematics, Portuguese language and social studies). Case studies and a 95% credible interval analysis to assess Reliable Change are presented. Seventy five (54%) children needed SLT support. Fifty (67%) of those children returned to the clinic for long-term assessments and the analysis of all outcome measures showed significant improvements in their performance, 18 months post-therapy. Case Studies Reliable Change analysis revealed a statistically significant improvement, which also clearly shows the feasibility and the positive impact of the intervention. This specialised and differentiated care network constitutes an alternative delivery system of SLT services that addresses the lack of support currently experienced by children and their families. The long-term outcome measures and the 95% credible interval analysis are reliable methods to determine the

  1. 'Trust and teamwork matter': community health workers' experiences in integrated service delivery in India.

    Science.gov (United States)

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011-2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive 'teamwork' and 'building trust with the community' (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology - which the health workers espouse - is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration.

  2. Stuttering Intervention in Three Service Delivery Models (Direct, Hybrid, and Telepractice: Two Case Studies

    Directory of Open Access Journals (Sweden)

    Daniel T. Valentine

    2015-01-01

    Full Text Available 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 were obtained in each of the 10-week intervention periods. In addition, the Communication Attitudes Test-Revised was used to assess the children’s attitudes toward speaking. Following the telepractice period, parents and children completed a questionnaire concerning the therapy experience via telepractice. Both children continued to improve fluency as measured by the weekly fluency samples. SSI-4 severity ratings improved for one child and remained consistent for the other. These outcomes appear to demonstrate that telepractice is viable for improving and maintaining fluency.

  3. 20 CFR 664.700 - What is the connection between the youth program and the One-Stop service delivery system?

    Science.gov (United States)

    2010-04-01

    ... program and the One-Stop service delivery system? 664.700 Section 664.700 Employees' Benefits EMPLOYMENT... INVESTMENT ACT One-Stop Services to Youth § 664.700 What is the connection between the youth program and the One-Stop service delivery system? (a) The chief elected official (or designee, under WIA section...

  4. Home care and the new economy. Creating a new model for service delivery.

    Science.gov (United States)

    Sobolewski, S; Marren, J

    2000-01-01

    The strategy undertaken by the VNSNY for its survival has been to create a new service delivery model. The design of the SDM is based on a study of organizations, within and outside of health care, that face common challenges in the home health industry today: increased competition, declining reimbursement with escalating costs, and demands for improved outcomes and customer satisfaction. The model that emerged contained several important strategies in its design, including the alignment of team goals with organizational strategic objectives, restructuring teams as multidisciplinary units, redefining the work of teams to include practice improvement and supporting team learning, increasing members' accountability for team not individual performance. The SDM continues to evolve and improve during the process of implementation as lessons emerge from our experience with teams. Preliminary results indicate that the efforts have begun to show improvements in outcomes.

  5. Labor and delivery service use: indigenous women's preference and the health sector response in the Chiapas Highlands of Mexico.

    Science.gov (United States)

    Ibáñez-Cuevas, Midiam; Heredia-Pi, Ileana B; Meneses-Navarro, Sergio; Pelcastre-Villafuerte, Blanca; González-Block, Miguel A

    2015-12-23

    Mexico has undertaken important efforts to decrease maternal mortality. Health authorities have introduced intercultural innovations to address barriersfaced by indigenous women accessing professional maternal and delivery services. This study examines, from the perspective of indigenous women, the barriers andfacilitators of labor and delivery care services in a context of intercultural and allopathic innovations. This is an exploratory study using a qualitative approach of discourse analysis with grounded theory techniques. Twenty-five semi-structured interviews were undertaken with users and non-users of the labor and delivery services, as well as with traditional birth attendants (TBAs) in San Andrés Larráinzar, Chiapas in 2012. The interviewees identified barriers in the availability of medical personnel and restrictive hours for health services. Additionally, they referred to barriers to access (economic, geographic, linguistic and cultural) to health services, as well as invasive and offensive hospital practices enacted by health system personnel, which limited the quality of care they can provide. Traditional birth attendants participating in intercultural settings expressed the lack of autonomy and exclusion they experience by hospital personnel, as a result of not being considered part of the care team. As facilitators, users point to the importance of having their traditional birth attendants and families present during childbirth, to allow them to use their clothing during the attention, that the staff of health care is of the female sex and speaking the language of the community. As limiting condition users referred the different medical maneuvers practiced in the attention of the delivery (vaginal examination, episiotomy, administration of oxytocin, etc.). Evidence from the study suggests the presence of important barriers to the utilization of institutional labor and delivery services in indigenous communities, in spite of the intercultural

  6. User satisfaction survey and usage of an electronic desktop document delivery service at an academic medical library.

    Science.gov (United States)

    Sayed, Ellen N; Murray, Sarah D

    2003-01-01

    In June 2000, the Biomedical Library at the University of South Alabama introduced Prospero, an electronic desktop document delivery service. From June 2000 to November 2002, Prospero delivered 28% of interlibrary loan requests and 72% of document delivery requests. In November 2002, the library conducted a user satisfaction survey of the Prospero service. Forty-two surveys were used. Fifteen responses were received from affiliated faculty, staff, and students, who generally expressed satisfaction with the service. Twenty-seven responses were received from unaffiliated users, comprised of medical libraries, individual users, and businesses. Based on the survey results, the library deemed the Prospero service a success. To better support users, the library's Web page was updated to include hardware and software requirements for successful use of the Prospero service, as well as screen shots of the Prospero process.

  7. Titan's atmospheric sputtering and neutral torus produced by magnetospheric and pick-up ions

    Science.gov (United States)

    Michael, M.; Smith, H. T.; Johnson, R. E.; Shematovich, V.; Leblanc, F.; Ledvina, S.; Luhmann, J. H.

    As Titan does not possess an intrinsic magnetic field, Kronian magnetospheric ions can penetrate Titan's exobase as can locally produced pick-up ions (e.g. Shematovich et al. 2003). This can cause atmospheric loss and heating of the exobase region. Penetration by slowed and deflected magnetospheric ions and by the pick-up ions is described here using a 3-D Monte Carlo model (Michael et al. 2004). The incident ions can lead to the production of fast neutrals that collide with other atmospheric neutrals producing the ejection of both atomic and molecular nitrogen and heating. The recently calculated dissociation cross sections of N2 are used in the present model (Tully and Johnson 2002). The incident flux of slowed magnetospheric N+ ions and pick-up C2H5+ ions is estimated from the work of Brecht et al. (2000). These ions, which have energies less than 1.2 keV, were shown to be more efficient in ejecting material from Titan's atmosphere than the non-deflected co-rotating ions used earlier (Lammer et al. 1993). The loss rates are comparable or larger than those produced by photo-dissociation. Exobse heating rates are given and the loss rates of N and N2 are then used as a source of nitrogen for the Titan neutral torus. If atmospheric sputtering is important this torus will contain both atomic and molecular nitrogen and, therefore, will provide a distributed source of both atomic and molecular nitrogen ions that will be readily detected by Cassini (Smith et al. 2004) Acknowledgment: This work is supported by NASA's Planetary Atmospheres Program and by the CAPS-Cassini Instrument. Brecht, S.H., J.G. Luhmann, and D.J. Larson, J. Geophys. Res., 105, 13119, 2000. Lammer, H., and S.J. Bauer,. Planet. Space Sci., 41, 657, 1993. Shematovich, V.I.,et al, J. Geophys. Res., 108, 5086, 10.1029/2003JE002096, 2003. Michael, M. et al., submitted, Icarus, 2004. Smith, H.T., et al., Titan Aeronomy Workshop, Paris, January 7-9, 2004. Tully, C., R.E. Johnson, J. Chem. Phys. 117, 6556

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

    Directory of Open Access Journals (Sweden)

    Scott DM

    2016-12-01

    Full Text Available 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 (P<0.05. For some public health services, pharmacists in rural areas reported higher frequency of delivery than did pharmacists in urban areas (P < .05 that included: medication therapy management, immunizations, tobacco counseling, and medication take-back programs. For some essential services, pharmacists (particularly independents in rural areas reported more frequent delivery than did pharmacists in urban areas (P < .05, these included: evaluate the services the pharmacy provides, partner with the community to identify and help solve health problems, and conduct needs assessments to identify health risks in my community. Conclusion: Rural pharmacists more frequently deliver public health services than urban in both Iowa and North Dakota. 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.

  9. 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.

  10. 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

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

    Directory of Open Access Journals (Sweden)

    Tsitsi Mutasa-Apollo

    2017-07-01

    Conclusions: 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 burden of care for PLHIV. Strategies aimed at reducing clinic visits or drug refill services should focus on stable patients who are virally suppressed, tolerant to their drug regimen and fully adherent. These strategies may be critical to the current changes taking place in HIV treatment policy; thus, due to the data limitations, further high quality research is needed to inform policy and programmatic interventions.

  12. Analyzing IT Service Delivery in an ISP from Nicaragua

    Science.gov (United States)

    Flores, Johnny; Rusu, Lazar; Johanneson, Paul

    This paper presents a method for analyzing IT service delivery and its application in an Internet Service Provider (ISP). The method proposed is based on ITIL-processes and case study technique; it includes questionnaires for gathering information, semi-structured interviews, focus groups and documents as sources of information for recognition of factual information. The method application allows to the ISP determines its practices and limitations of the IT Service Delivery.

  13. Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

    Directory of Open Access Journals (Sweden)

    Jessica C. Wedgworth

    2014-07-01

    Full Text Available Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure and general aesthetic characteristics (taste, odor and color, providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets and as-delivered from the distribution network (from outside flame-sterilized taps, if available, where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color. Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts.

  14. Associations between perceptions of drinking water service delivery and measured drinking water quality in rural Alabama.

    Science.gov (United States)

    Wedgworth, Jessica C; Brown, Joe; Johnson, Pauline; Olson, Julie B; Elliott, Mark; Forehand, Rick; Stauber, Christine E

    2014-07-18

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure-a risk factor for contamination-may be relatively reliable and therefore useful in future monitoring efforts.

  15. Impact and economic evaluation of a novel HIV service delivery model in rural Malawi.

    Science.gov (United States)

    McBain, Ryan K; Petersen, Elizabeth; Tophof, Nora; Dunbar, Elizabeth L; Kalanga, Noel; Nazimera, Lawrence; Mganga, Andrew; Dullie, Luckson; Mukherjee, Joia; Wroe, Emily B

    2017-09-10

    We performed an impact and cost-effectiveness analysis of a novel HIV service delivery model in a high prevalence, remote district of Malawi with a population of 143 800 people. A population-based retrospective analysis of 1-year survival rates among newly enrolled HIV-positive patients at 682 health facilities throughout Malawi, comparing facilities implementing the service delivery model (n = 13) and those implementing care-as-usual (n = 669). Through district-level health surveillance data, we evaluated 1-year survival rates among HIV patients newly enrolled between July 2013 and June 2014 - representing 129 938 patients in care across 682 health facilities - using a multilevel modeling framework. The model, focused on social determinants of health, was implemented throughout Neno District at 13 facilities and compared with facilities in all other districts. Activity-based costing was used to annualize financial and economic costs from a societal perspective. Incremental cost-effectiveness ratios were expressed as quality-adjusted life-years gained. The national average 1-year survival rate for newly enrolled antiretroviral therapy clients was 78.9%: this rate was 87.9% in Neno District, compared with 78.8% across all other districts in Malawi (P cost of receiving care in Neno district (n = 6541 patients) was $317/patient/year, compared with an estimated $219/patient in other districts. This translated to $906 per quality-adjusted life-year gained. Neno District's comprehensive model of care, featuring a strong focus on the community, is $98 more expensive per capita per annum but demonstrates superior 1-year survival rates, despite its remote location. Moreover, it should be considered cost-effective by traditional international standards.

  16. Life Cycle Thinking and Integrated Product Deliveries in renovation projects: Extending the concept of Integrated Product Deliveries with Product Service Systems

    DEFF Research Database (Denmark)

    Schipull Kauschen, Jan

    2012-01-01

    material-focused approach in product development in the construction sector, as building materials usually have relatively low values and - in general – seem not to be dependent on yet-scarce resources. Sustainable IPDs can be categorized into two main streams – “sustainable by design” and “sustainable......INTRODUCTION The term “Integrated product deliveries (IPD)” encompasses complex building solutions, that not only include building materials and components but also different necessary services linked directly to them, as design and planning tasks, production, assembly, delivery and construction...... work. Furthermore, IPDs are produced in an industrial context, allowing higher quality products at competitive costs. Expanding the term to also include services during the components use phase and continued responsibility for the end-of-life, offers new possibilities for enhancing the sustainability...

  17. 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

    2014-01-01

    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. PMID:25012794

  18. 75 FR 60141 - International Business Machines (IBM), Global Technology Services Delivery Division, Including On...

    Science.gov (United States)

    2010-09-29

    ... Employment and Training Administration International Business Machines (IBM), Global Technology Services... of International Business Machines (IBM), Global Technology Services Delivery Division, Greenville... International Business Machines (IBM), Global Technology Services Delivery Division, including on-site...

  19. All-planar SQUIDs and pickup coils for combined MEG and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Luomahaara, J; Kiviranta, M; Groenberg, L; Hassel, J [VTT Technical Research Centre of Finland, PO BOX 1000, 02044 VTT (Finland); Vesanen, P T; Nieminen, J O; Dabek, J; Zevenhoven, C J; Ilmoniemi, R J [Department of Biomedical Engineering and Computational Science, Aalto University, PO BOX 12200, 00076 Aalto (Finland); Penttilae, J [Aivon Oy, Tietotie 3, 02150 Espoo (Finland); Simola, J, E-mail: juho.luomahaara@vtt.fi [Elekta Oy, PO Box 34, 00531 Helsinki (Finland)

    2011-07-15

    Flux trapping and random flux movement are common problems in superconducting thin-film devices. Ultrasensitive magnetic field sensors based on superconducting quantum interference devices (SQUIDs) coupled to large pickup coils are especially vulnerable to strong external fields. The issue has become particularly relevant with the introduction of SQUID-based ultra-low-field (ULF) nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) techniques. In this paper, we study the constraints of thin-film-based magnetometers and gradiometers as exposed to magnetic field sequences of ULF MRI. In particular, we address issues such as response recovery, transient noise, magnetization and behaviour under shielded room conditions after prepolarization. As a result, we demonstrate sensors that are suitable for a combined multi-channel magnetoencephalography (MEG) and MRI imaging system.

  20. Improving health service delivery organisational performance in health systems: a taxonomy of strategy areas and conceptual framework for strategy selection.

    Science.gov (United States)

    Pallas, Sarah W; Curry, Leslie; Bashyal, Chhitij; Berman, Peter; Bradley, Elizabeth H

    2012-03-01

    Health systems strengthening (HSS) is a priority for global health funders, policy-makers and practitioners. Although many HSS efforts have focused on policy levers such as financing approaches, payment schemes or regulatory reforms, less attention has been directed to targeting the organisations that deliver health services such as hospitals, health centres and clinics. Evidence suggests that the impact of organisation-level interventions varies by context; however, we lack a general framework for integrating organisational context into performance improvement strategies for health service delivery organisations. Drawing on open systems theories from organisational behaviour and management as well as a review of 181 empirical studies of health service delivery organisations in low- and middle-income countries, we propose a taxonomy of seven strategy areas for improving organisational performance as well as a multistage conceptual framework for selecting among them. We propose that the choice of strategy for improving health service delivery organisational performance should be informed by: (i) the root cause of the organisation's performance gap; (ii) the environmental conditions facing the organisation; and (iii) the implementation capability of the organisation. We also highlight conditions under which different strategy areas may be expected to be optimally effective. The approaches presented in this paper offer a way for health system decision-makers and researchers to systematically assess and incorporate organisational context in the process of developing strategies to improve the performance of health service delivery organisations and, ultimately, of health systems.

  1. Aligning goals, intents, and performance indicators in family planning service delivery.

    Science.gov (United States)

    RamaRao, Saumya; Jain, Anrudh K

    2015-03-01

    A flurry of policy initiatives in the fields of both population and development and reproductive health, many addressing the provision of family planning services, are currently underway: FP2020, the ICPD Beyond 2014, and the post-2015 development agenda, among others. This is an opportune time, therefore, to reflect upon and take into consideration what five decades of family planning programs can teach us about ensuring that policies and programs integrate their underlying intents, concrete goals, and performance indicators. The family planning field has encountered instances in its history when inconsistencies between goals, intents, and indicators arose and adversely affected the delivery of services. This commentary presents our observations concerning potential misalignments that may arise within the many promising initiatives underway. We examine the relationship between the intent, goal, and indicators of FP2020 as a case study highlighting the need for ensuring a tight alignment. We offer suggestions for ensuring that this and other initiatives use carefully calibrated indicators to guide the achievement of explicit program goals without undermining their underlying intent--namely, promoting well-being and reproductive rights.

  2. AA precooling pickup

    CERN Multimedia

    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.

  3. User-centric Service Composition - Towards Personalised Service Composition and Delivery

    NARCIS (Netherlands)

    Goncalves da Silva, Eduardo

    2011-01-01

    With computing devices and the Internet becoming ubiquitous, users can make use of network-based software applications in different places and situations. Mobile devices with Internet connectivity are a good example of this trend. Network-based software applications are being exposed to users as web

  4. How does context influence collaborative decision-making for health services planning, delivery and evaluation?

    Science.gov (United States)

    Gagliardi, Anna R; Webster, Fiona; Brouwers, Melissa C; Baxter, Nancy N; Finelli, Antonio; Gallinger, Steven

    2014-11-19

    Collaboration among researchers (clinician, non-clinician) and decision makers (managers, policy-makers, clinicians), referred to as integrated knowledge translation (IKT), enhances the relevance and use of research, leading to improved decision-making, policies, practice, and health care outcomes. However IKT is not widely practiced due to numerous challenges. This research explored how context influenced IKT as a means of identifying how IKT could be strengthened. This research investigated IKT in three health services programs for colon cancer screening, prostate cancer diagnosis, and the treatment of pancreatic cancer. Qualitative methods were used to explore contextual factors that influenced how IKT occurred, and its impact. Data were collected between September 1, 2012 and May 15, 2013 from relevant documents, observation of meetings, and interviews with researchers and decision-makers, analyzed using qualitative methods, and integrated. Data were analyzed from 39 documents, observation of 6 meetings, and 36 interviews. IKT included interaction at meetings, joint undertaking of research, and development of guidelines. IKT was most prevalent in one program with leadership, clear goals, dedicated funding and other infrastructural resources, and an embedded researcher responsible for, and actively engaged in IKT. This program achieved a variety of social, research and health service outcomes despite mixed individual views about the value of IKT and the absence of a programmatic culture of IKT. Participants noted numerous challenges including lack of time and incentives, and recommendations to support IKT. A conceptual framework of factors that influence IKT and associated outcomes was generated, and can be used by others to plan or evaluate IKT. The findings can be applied by researchers, clinicians, managers or policy-makers to plan or improve collaborative decision-making for health services planning, delivery, evaluation or quality improvement. Further

  5. A management information system to plan and monitor the delivery of health-care services in government hospitals in India.

    Science.gov (United States)

    Ramani, K V

    2004-01-01

    Governments all over the world are getting increasingly concerned about their ability to meet their social obligations in the health sector. In this paper, we discuss the design and development of a management information system (MIS) to plan and monitor the delivery of healthcare services in government hospitals in India. Our MIS design is based on an understanding of the working of several municipal, district, and state government hospitals. In order to understand the magnitude and complexity of various issues faced by the government hospitals, we analyze the working of three large tertiary care hospitals administered by the Ahmedabad Municipal Corporation. The hospital managers are very concerned about the lack of hospital infrastructure and resources to provide a satisfactory level of service. Equally concerned are the government administrators who have limited financial resources to offer healthcare services at subsidized rates. A comprehensive hospital MIS is thus necessary to plan and monitor the delivery of hospital services efficiently and effectively.

  6. Rural development NGOS and service delivery to the very poor: An empirical analysis of a training center in rural Cameroon

    Directory of Open Access Journals (Sweden)

    Balgah Roland Azibo

    2015-04-01

    Full Text Available The role of development nongovernmental organizations (DNGOs in driving change, servicing the very poor and reducing poverty especially in rural areas in developing countries has been generally affirmed in the rural economics literature. This romantic image accounts to a large extent for the exponential numeric growth observed in the sector, and for burgeoning research on the subject by rural development economists. However, not enough empirical evidence exists on the extent to which such organizations actually service the very poor. This paper uses the example of a rural development NGO in the administrative unit of North West Cameroon to assess the extent to which the very poor actually benefit from DNGO services. A relative poverty approach is applied, allowing for the use of individual indicators and computed poverty indices to compare beneficiaries and non-beneficiaries of the DNGO service delivery based on cross sectional data. The results indicate that the DNGO serviced mainly poor communities. However, a disproportionately higher share of the benefits (60% went to groups that were already well off before service delivery, than to the very poor. The paper then emphasizes the need for DNGOs to carry out poverty analysis prior to service delivery, as a prerequisite to effectively reach out to the very poor, particularly in rural areas in Cameroon.

  7. 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 (Pindependents) in rural areas reported more frequent delivery than did pharmacists in urban areas (P pharmacy provides, partner with the community to identify and help solve health problems, and conduct needs assessments to identify health risks in my community. Rural pharmacists more frequently deliver public health services than urban in both Iowa and North Dakota. 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.

  8. User/consumer involvement in mental health service delivery.

    Science.gov (United States)

    Chamberlin, Judi

    2005-01-01

    The involvement of mental health service users in service delivery is a new and growing phenomenon. Such involvement is complex, given the history of paternalism in the mental health system, the power differential between service providers and service users, and the very differing views each group holds on multiple issues. Unless such differences are addressed, there can be no meaningful involvement. Service user involvement needs to apply to all aspects of the service delivery system, including professional training, service design, delivery, evaluation, and research. User/survivors, and their organizations, have developed a body of experience and knowledge that needs to be recognized and respected. Unless there are multiple opportunities for ongoing and open dialogue on these many difficult issues, real user involvement will not occur.

  9. How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study.

    Science.gov (United States)

    Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

    2017-02-23

    Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. 4 DAPs at 2 teaching and 2 community hospitals in Canada. 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural-remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes

  10. Service delivery and coverage in primary healthcare in a community-health project in Ibadan, Nigeria

    Directory of Open Access Journals (Sweden)

    Kabiru K. Salami

    2014-01-01

    Full Text Available Background: Standard health-service delivery aimed toward improving maternal and childhealth status remains elusive in Nigeria because of inaccuracies in data documentation leading to a lack of relatively stable evidence.Objectives: Through a community-health project, this study tested the accuracy of record keeping in primary healthcare services in nine clinics run in Ibadan, Nigeria.Methods: A validation exercise was performed through a sample of the 10 most recent names extracted from three registers maintained by each clinic.Results: A review of the register covering a period of four years showed a steady increase in: fully-immunised children, registration for antenatal care during the first trimester of pregnancy, the number of women who attended antenatal care at least three times, the overall number of women who booked for antenatal care and women who delivered in Eniosa Community-Health Project facilities over the four-year period. It was possible to trace 86% of those selected from the antenatal care register, 88.9% of those from the birth register and 81.1%of those from the immunisation register. Four women who should have been included for antenatal care, seven who had delivered (but were not in the register and 13 who reportedlyreceived immunisation but were not listed were found during the validation exercise.Conclusion: This study concludes that the names appearing in the register are likely to represent valid events, but that the registers did not capture all such events in the community.

  11. 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

  12. Seeing Beyond Service - Redefining the Problem of Water and Sanitation Service Delivery in Resource-Limited Settings to Enable Effective Solutions

    OpenAIRE

    Strock, Christopher Moore

    2010-01-01

    The purpose of this study was to examine the effectiveness of water and sanitation service delivery in resource-limited settings using two different social theories (modernization and world system). Understanding that barriers to effectiveness are rooted in global structures that tend to present at local levels helps redefine the problem leading to comprehensive policies and practices. The guiding research questions included an identification of an effectiveness gap in services delivered in d...

  13. 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...

  14. 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

  15. An Expanded Role for Public Schools: Community-Based Delivery of Comprehensive Health and Mental Health Services.

    Science.gov (United States)

    Mallory, Bruce L.; Cottom, Carolyn

    This paper proposes that local public schools assume the locus of responsibility for providing comprehensive health and mental health services for children and their families. Among the advantages of school based delivery systems are the universality of public education, the availability of physical and human resources, established funding…

  16. The Student Profile, Service Delivery Model, and Support Practices of Four Early Childhood Intervention Environments in Singapore

    Science.gov (United States)

    Poon, Kenneth K.; Yang, Xueyan

    2016-01-01

    The student profile, model of service delivery, and support practices for young children with disabilities receiving early childhood intervention (ECI) in Singapore is reported and contrasted in this study. The supervisors/managers/principals of eight Early Intervention Programme for Infants and Children (EIPIC) centres, eight Integrated Child…

  17. Mechanistic models as a transferable framework for projecting effects of habitat change on production and delivery of ecosystem services

    Science.gov (United States)

    Drawing a link between habitat change and the production and delivery of ecosystem services is a priority in coastal estuarine ecosystems. Mechanistic modeling tools are highly functional for exploring this link because they allow for the synthesis of multiple ecological and beh...

  18. The Pickup Ion Composition Spectrometer

    Science.gov (United States)

    Gilbert, Jason A.; Zurbuchen, Thomas H.; Battel, Steven

    2016-06-01

    Observations of newly ionized atoms that are picked up by the magnetic field in the expanding solar wind contain crucial information about the gas or dust compositions of their origins. The pickup ions (PUIs) are collected by plasma mass spectrometers and analyzed for their density, composition, and velocity distribution. In addition to measurements of PUIs from planetary sources, in situ measurements of interstellar gas have been made possible by spectrometers capable of differentiating between heavy ions of solar and interstellar origin. While important research has been done on these often singly charged ions, the instruments that have detected many of them were designed for the energy range and ionic charge states of the solar wind and energized particle populations, and not for pickup ions. An instrument optimized for the complete energy and time-of-flight characterization of pickup ions will unlock a wealth of data on these hitherto unobserved or unresolved PUI species. The Pickup Ion Composition Spectrometer (PICSpec) is one such instrument and can enable the next generation of pickup ion and isotopic mass composition measurements. By combining a large-gap time-of-flight-energy sensor with a -100 kV high-voltage power supply for ion acceleration, PUIs will not only be above the detection threshold of traditional solid-state energy detectors but also be resolved sufficiently in time of flight that isotopic composition can be determined. This technology will lead to a new generation of space composition instruments, optimized for measurements of both heliospheric and planetary pickup ions.

  19. Pickup ion-mediated plasma physics of the outer heliosphere and very local interstellar medium

    Science.gov (United States)

    Zank, G. P.

    2016-12-01

    Observations of plasma and turbulence in the outer heliosphere (the distant supersonic solar wind and the subsonic solar wind beyond the heliospheric termination shock) made by the Voyager Interstellar Mission and the energetic neutral atom observations made by the IBEX spacecraft have revealed that the underlying plasma in the outer heliosphere and very local interstellar medium (VLISM) comprises distinct thermal proton and electron and suprathermal pickup ion (PUI) populations. Estimates of the appropriate collisional frequencies show that the multi-component plasma is not collisionally equilibrated in either the outer heliosphere or VLISM. Furthermore, suprathermal PUIs in these regions form a thermodynamically dominant component. We review briefly a subset of the observations that led to the realization that the solar wind-VLISM interaction region is described by a non-equilibrated multi-component plasma and summarizes the derivation of suitable plasma models that describe a PUI-mediated plasma.

  20. On the Anisotropy of the He+, C+, O+, and Ne+ Pickup Ion Velocity Distribution Function: STEREO PLASTIC Observations

    Science.gov (United States)

    Taut, A.; Drews, C.; Berger, L.; Peleikis, T.; Wimmer-Schweingruber, R. F.

    2015-12-01

    PickUp Ions (PUIs) are typically characterized by (1) their almost exclusively single charge state, (2) a highly non-thermal and anisotropic Velocity Distribution Function (VDF) [Drews et al., 2015], and (3) an extended source population of neutral atoms somewhere between the observer and the Sun. The origin of pickup ions ranges from sources only several solar radii away from the Sun, the so-called inner-source of pickup ions, up to a distance of several hundreds of astronomical units, the local interstellar medium. Their continuous production inside the heliosphere and complex interactions with the magnetized solar wind plasma leads to the development of non-thermal, anisotropic features of both the solar wind and pickup ion velocity distribution functions. In this study, we present observations of the VDF of He+, C+, N+, O+ and Ne+ pickup ions with PLASTIC on STEREO A. We have found a PUI flux increase during perpendicular configurations of the local magnetic field that is generally linked to the existence of a so-called torus-distribution [Drews et al., 2015] which is attributed to the production of PUIs close to the observer. A comparison of the PUI VDF between radial and perpendicular configurations of the local magnetic field vector is used to quantify the anisotropy of the PUI VDF and thereby enables us to estimate the mean free path for pitch-angle scattering of He, C, N, O and Ne pickup ions without the necessity of an over-simplified heliospheric model to describe the PUI phase space transport. Our results show a clear signature of a C+ torus signature at 1 AU as well as significant differences between the anisotropies of the He+ and O+ VDF. We will discuss our results in the light of recent studies about the nature of the inner-source of PUIs [Berger et al., 2015] and observations of the 2D VDF of He+[Drews et al., 2015]. Figure Caption: Velocity space diagrams of a pickup ion torus distribution as a (vx-vy)-projection (top left panel) and in the vz = 0

  1. 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

  2. Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services.

    Science.gov (United States)

    Silver, Julie K; Raj, Vishwa S; Fu, Jack B; Wisotzky, Eric M; Smith, Sean Robinson; Kirch, Rebecca A

    2015-12-01

    Palliative care and rehabilitation practitioners are important collaborative referral sources for each other who can work together to improve the lives of cancer patients, survivors, and caregivers by improving both quality of care and quality of life. Cancer rehabilitation and palliative care involve the delivery of important but underutilized medical services to oncology patients by interdisciplinary teams. These subspecialties are similar in many respects, including their focus on improving cancer-related symptoms or cancer treatment-related side effects, improving health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision-making. They also aim to improve healthcare efficiencies and minimize costs by means such as reducing hospital lengths of stay and unanticipated readmissions. Although their goals are often aligned, different specialized skills and approaches are used in the delivery of care. For example, while each specialty prioritizes goal-concordant care through identification of patient and family preferences and values, palliative care teams typically focus extensively on using patient and family communication to determine their goals of care, while also tending to comfort issues such as symptom management and spiritual concerns. Rehabilitation clinicians may tend to focus more specifically on functional issues such as identifying and treating deficits in physical, psychological, or cognitive impairments and any resulting disability and negative impact on quality of life. Additionally, although palliative care and rehabilitation practitioners are trained to diagnose and treat medically complex patients, rehabilitation clinicians also treat many patients with a single impairment and a low symptom burden. In these cases, the goal is often cure of the underlying neurologic or musculoskeletal condition. This report defines and describes cancer rehabilitation and palliative care, delineates their

  3. Investigation of Planar Pick-up and Kicker Electrodes for Stochastic Cooling

    CERN Document Server

    Balk, M; Weiland, T; Nolden, F; Caspers, Friedhelm

    2002-01-01

    The success of stochastic cooling crucially depends on the interaction between the beam and high frequency devices for detection (pick-up electrodes) and deflection (kicker electrodes). This contribution shows the theoretical investigation of a planar electrode to be used for stochastic cooling of secondary particles with a beta of 0.83. The coupling to the beam is realised by a slot line. Transition networks are added to extract the signal. The detailed investigation is performed via a numerical electromagnetic field analysis. The longitudinal kick of the deflectors is calculated as a function of the beam position and scaled to the applied voltage. According to the Panofsky-Wenzel theorem the transverse kick is obtained simultaneously. The electromagnetic properties of the discussed electrode are compared to existing ones as currently in use in the ESR storage ring (GSI, Darmstadt).

  4. 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.

  5. How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study

    Science.gov (United States)

    Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

    2017-01-01

    Objectives Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. Design A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. Setting 4 DAPs at 2 teaching and 2 community hospitals in Canada. Participants 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Results Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural–remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. Conclusions This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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

  13. Water service delivery challenges in a small South African municipality

    African Journals Online (AJOL)

    Water service delivery challenges in a small South African municipality: Identifying and .... improve integrated water resource management processes in South Africa. .... Grahamstown West comprises the town's central business district and ...

  14. A practical guide to ethical and effective delivery of geoscience for the service of society

    Science.gov (United States)

    Allington, Ruth

    2017-04-01

    Competence, integrity, accountability and high ethical standards - judged peer-to-peer - are the hallmarks of what it means to be a professional and part of a professional community. The geoscience profession is no different and professionalism is relevant in all of its constituent communities - academia, industry, government etc There are three propositions that illustrate the importance of professionalism in the delivery of geoscience across the board. The first: Without understanding the skills and expertise needed by 'industry', how can educators prepare students for the workplace? Most of those graduating in geoscience will not stay in universities - do we not owe it to them to develop a realistic idea of what a non-academic career might look like? This is done very well in some institutions and not at all in others and the author's impression is that the latter is the norm. The second: Without understanding societal needs, how can researchers design research which is truly relevant to those needs? A more connected geoscience community that is, in turn, more connected to the needs and wants of Society will develop research agendas that are truly relevant. And finally…… Without access to high quality graduates and excellent underpinning fundamental and applied research, how can geoscientists in 'industry' or public service deliver their expertise effectively? This contribution, which draws on ideas set out in the author's plenary speech at 35IGC, will consider the practical skills, experience, ethical and behavioural regulatory frameworks, codes and norms that underpin success in meeting these challenges.

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

    African Journals Online (AJOL)

    Improving Financial Service Delivery to Communities through Micro-finance ... This study examined the design of a target Enterprise Architecture (EA) that can ... business processes, information/data, applications, actors, and technological ...

  16. Integrative Review: Delivery of Healthcare Services to Adolescents and Young Adults During and After Foster Care.

    Science.gov (United States)

    Collins, Jennifer L

    The purpose of this integrative review is to summarize evidence describing delivery of healthcare services to adolescents while in foster care and to young adults after they exit foster care. The long-term, deleterious effect of abuse and/or neglect by caregivers among youth who have been placed in foster care is grounded in empirical evidence demonstrating the relationship between long-term health needs and exposure to trauma in childhood. Evidence is needed to provide culturally-specific care and also to identify knowledge gaps in the care of adolescents and young adults who have been in the foster care system. Peer-reviewed research studies published between 2004 and 2014 that include samples of youth 12 to 30 years of age are included in the review. Eighteen studies met inclusion criteria for the review. Physical and behavioral healthcare needs among youth with foster care experience are significant. The ability to adequately meet health needs are inextricable from the ability to negotiate resources and to successfully interact with adults. Challenges that youth with foster care histories experience when transitioning into young adulthood are comparable to other populations of vulnerable youth not in foster care. Nurses must use each healthcare encounter to assess how the social determinants of health facilitate or impede optimal health among youth with foster care experience. The development of integrated intervention strategies to inform best practice models is a priority for current and former foster care youth as they transition into young adulthood. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 41 CFR 60-300.84 - Responsibilities of appropriate employment service delivery system.

    Science.gov (United States)

    2010-07-01

    ... appropriate employment service delivery system. 60-300.84 Section 60-300.84 Public Contracts and Property... of appropriate employment service delivery system. By statute, appropriate employment service... referrals. The employment service delivery systems shall provide OFCCP, upon request, information...

  18. Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions.

    Science.gov (United States)

    Walker, Elizabeth A; Spratford, Meredith; Ambrose, Sophie E; Holte, Lenore; Oleson, Jacob

    2017-03-01

    This study investigates clinical practice patterns and parent perception of intervention for children with mild hearing loss (HL). Ages at and delays between service delivery steps (first diagnostic evaluation, confirmation of HL, hearing aid [HA] fitting, entry into early intervention) were investigated for 113 children with mild HL. Comparisons were made to children with moderate-to-severe HL. Parents of children with mild HL reported reasons for delays and their perceptions of intervention and amplification for their children. Seventy-four percent of children with mild HL were identified through the newborn hearing screen; 26% were identified later due to passing or not receiving a newborn hearing screen. Ninety-four percent of children with mild HL were fit with HAs, albeit at significantly later ages than children with moderate-to-severe HL. Most parents indicated that their children benefited from HA use, but some parents expressed ambivalence toward the amount of benefit. Audiologists appear to be moving toward regularly providing amplification for children with mild HL. However, delays in HA fittings indicate that further educating professionals and parents about the benefits of early amplification and intervention is warranted to encourage timely fitting and consistent use of HAs.

  19. Factors Influencing the Choice of Child Delivery Location among Women Attending Antenatal Care Services and Immunization Clinic in Southeastern Nigeria.

    Science.gov (United States)

    Egharevba, Johnbull; Pharr, Jennifer; van Wyk, Brian; Ezeanolue, Echezona

    2017-01-01

    In Nigeria, most deliveries take place at home or with traditional birth attendants (TBAs). This study examined the factors that influenced or determined utilization of healthcare facility delivery services among women who attended antenatal care (ANC) services. A cross-sectional survey was conducted with 220 women who registered for ANC at a hospital and delivered within 18 months. Associations between independent variables and choice of healthcare facility delivery were analyzed. Multiple logistic regression was also used to identify the predictors of choice of delivery among women. Of the 220 women who registered for ANC, 75% delivered at a healthcare facility while 15% delivered with a TBA or at home. In the final model, number of children, having planned to deliver at a hospital, labor occurring at night, and labor allowing time for transportation were significant predictors of child delivery location among the women. Utilization of the health facilities for childbirth may increase if pregnant women are encouraged to book early for ANC and if during ANC, pregnant women were counseled to detect labor signs early. In addition to focused and intensified counseling for women with more children, support should be provided that includes financial provisions for transportation to the healthcare facility.

  20. Documentation of and satisfaction with the service delivery process of electric powered scooters among adult users in different national contexts

    DEFF Research Database (Denmark)

    Sund, Terje; Iwarsson, Susanne; Andersen, Mette C

    2013-01-01

    PURPOSE: The purpose of this study was to investigate how different service delivery systems for assistive devices were associated with the service delivery process (SDP) and user satisfaction in two national contexts when electric powered scooters were provided. METHOD: The study had a follow......-up design based on a consecutive inclusion of 50 Danish and 86 Norwegian adults as they were about to be provided a scooter. A study-specific structured questionnaire for documentation of the SDP was administered. The Satisfaction with Assistive Technology Services was used for documenting user satisfaction...... with the SDP. Besides descriptive statistics, regression analysis was used to identify contributors of variance and predictors of user satisfaction. RESULTS: The various steps of the SDP were carried out to a various degree. Significantly more total time was spent in the SDP in the Danish sample (p

  1. Policies and practices in the delivery of HIV services in correctional agencies and facilities: results from a multisite survey.

    Science.gov (United States)

    Belenko, Steven; Hiller, Matthew; Visher, Christy; Copenhaver, Michael; O'Connell, Daniel; Burdon, William; Pankow, Jennifer; Clarke, Jennifer; Oser, Carrie

    2013-10-01

    HIV risk is disproportionately high among incarcerated individuals. Corrections agencies have been slow to implement evidence-based guidelines and interventions for HIV prevention, testing, and treatment. The emerging field of implementation science focuses on organizational interventions to facilitate adoption and implementation of evidence-based practices. A survey of correctional agency partners from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) revealed that HIV policies and practices in prevention, detection, and medical care varied widely, with some corrections agencies and facilities closely matching national guidelines and/or implementing evidence-based interventions. Others, principally attributed to limited resources, had numerous gaps in delivery of best HIV service practices. A brief overview is provided of a new CJ-DATS cooperative research protocol, informed by the survey findings, to test an organization-level intervention to reduce HIV service delivery gaps in corrections.

  2. 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.

  3. Contracting for Management: Assessing Management Capacity under Alternative Service Delivery Arrangements

    Science.gov (United States)

    Brown, Trevor; Potoski, Matt

    2006-01-01

    Contracting critics suggest that when governments outsource, they reduce their capacity to produce services and manage service delivery. In this paper, we decompose the service delivery decision into service production and service management components. When governments contract for service production, they may also choose to contract for a…

  4. 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.

  5. 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.

  6. Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Hamidi S

    2015-02-01

    Full Text Available Samer Hamidi School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates Introduction: A national health account (NHA provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD. Methods: The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA. Results: In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE. Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita, compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion: The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of

  7. Structure, Content, Delivery, Service, and Outcomes: Quality e-Learning in higher education

    Directory of Open Access Journals (Sweden)

    Colla J. MacDonald

    2005-07-01

    Full Text Available This paper addresses the need for quality e-Learning experiences. We used the Demand-Driven Learning Model (MacDonald, Stodel, Farres, Breithaupt, and Gabriel, 2001 to evaluate an online Masters in Education course. Multiple data collection methods were used to understand the experiences of stakeholders in this case study: the learners, design team, and facilitators. We found that all five dimensions of the model (structure, content, delivery, service, and outcomes must work in concert to implement a quality e-Learning course. Key themes include evolving learner needs, the search for connection, becoming an able e-participant, valued interactions, social construction of content, integration of delivery partners, and mindful weighing of benefits and trade-offs. By sharing insights into what is needed to design and deliver an e-Learning experience, our findings add to the growing knowledge of online learning. Using this model to evaluate perceptions of quality by key stakeholders has led to insights and recommendations on the Demand Driven Learning Model itself which may be useful for researchers in this area and strengthen the model. Quality has been defined in terms of the design of the e-Learning experience, the contextualized experience of learners, and evidence of learning outcomes (Carr and Carr, 2000; Jung 2000; Salmon, 2000. Quality and design of e-Learning courses, however, are sometimes compromised in an “ . . . effort to simply get something up and running��� in response to pressing consumer demands (Dick, 1996, p. 59. Educators and researchers have voiced concern over the lack of rigorous evaluation studies of e-Learning programs (e.g., Arbaugh, 2000; Howell, Saba, Lindsay, and Williams, 2004; Lockyer, Patterson, and Harper, 1999; Robinson, 2001. McGorry (2003 adds, “although the number of courses being delivered via the Internet is increasing rapidly, our knowledge of what makes these courses effective learning experiences

  8. Advanced Audiovisual Rendering, Gesture-Based Interaction and Distributed Delivery for Immersive and Interactive Media Services

    NARCIS (Netherlands)

    Niamut, O.A.; Kochale, A.; Ruiz Hidalgo, J.; Macq, J-F.; Kienast, G.

    2011-01-01

    The media industry is currently being pulled in the often-opposing directions of increased realism (high resolution, stereoscopic, large screen) and personalisation (selection and control of content, availability on many devices). A capture, production, delivery and rendering system capable of

  9. Trust Building in PPPs for Service Delivery

    DEFF Research Database (Denmark)

    Schulze, Christiane

    for service delivery in Denmark leads to two main findings. First, despite the existence of rather formalized procedures trust based on the perception of the other managers’ competence is already important before the contract is entered. Second, this trust is not automatically transferred onto the next...

  10. Scaling service delivery in a failed state

    NARCIS (Netherlands)

    Muilerman, Sander; Vellema, Sietze

    2016-01-01

    The increased use of sustainability standards in the international trade in cocoa challenges companies to find effective modes of service delivery to large numbers of small-scale farmers. A case study of the Sustainable Tree Crops Program targeting the small-scale cocoa producers in Côte d’Ivoire

  11. Scaling service delivery in a failed state

    NARCIS (Netherlands)

    Muilerman, Sander; Vellema, Sietze

    2017-01-01

    The increased use of sustainability standards in the international trade in cocoa challenges companies to find effective modes of service delivery to large numbers of small-scale farmers. A case study of the Sustainable Tree Crops Program targeting the small-scale cocoa producers in Côte d’Ivoire

  12. Time, costs and farmers’ perceptions: The case of livestock service delivery in tamilnadu

    Directory of Open Access Journals (Sweden)

    G kathiravan

    2011-10-01

    Full Text Available A study was undertaken in southern peninsular State of India, the Tamil Nadu State, (i to ascertain the time costs of animal health care and bovine breeding services, and (ii to comprehend the perceptions of farmers on the livestock services rendered by different service providers. The districts of the state were categorized as 'Livestock Developed' (LD and 'Livestock Under Developed' (LUD based on initial base line developed. Travel, waiting and service time were among the primary non-price factors that affected service quality. Average travel time was highest for visiting the public veterinary centre in both LUD (23.05 min. and LD (21.32 min. districts. Waiting time with regard to veterinarians providing home services in LUD districts was highest (23.01 min., followed by public veterinary centre services at LUD districts (22.35 min., home services by para-veterinarians (22.01 min. and public veterinary centre services at LD districts (20.10 min.. Both travel and waiting time were much higher in case of breeding services compared to curative services, which could be due to the fact that the farmers preferred Artificial Insemination (AI over its close substitute, the natural service. However, the service time was relatively less in case of insemination services vis-à-vis curative services both in LUD and LD districts. The quality perceptions of farmers on livestock services revealed that the home services rendered by veterinarians as the best one (0.83, followed by private veterinary clinics (0.75, home services by para-veterinarians (0.74, public veterinary centres (0.64 and co-operative veterinary centres (0.48. [Vet. World 2011; 4(5.000: 209-212

  13. The economics of the delivery of veterinary services.

    Science.gov (United States)

    Holden, S

    1999-08-01

    Low livestock productivity in many developing countries is commonly considered to reflect, among other factors, the inadequate supply of services to control disease. Veterinary services have traditionally been provided by the state, but public finance constraints have limited the availability and effectiveness of public services. The author explains how economic theory can be used to identify alternative delivery systems (beyond the state) for providing animal health care and proposes new roles for the state and private sector in service delivery. The author highlights a number of barriers that currently limit the potential contribution of the private sector to service delivery, and describes a variety of approaches that have been used by the state to create an enabling environment for the private sector.

  14. The leadership of communities in HIV service delivery.

    Science.gov (United States)

    Barr, David; Odetoyinbo, Morolake; Mworeko, Lillian; Greenberg, Julia

    2015-07-01

    HIV treatment and prevention strategies are life-long endeavours, requiring not only comprehensive, high-quality, consistent and equitable medical services but also appropriate political and cultural milieus to be effective. Communities directly affected by HIV offer a unique expertise and understanding in developing services to meet the needs of people seeking out and utilizing HIV treatment, prevention and support services. Through their organizations and networks, and through partnerships with health systems, these communities provide leadership, services and advocacy to ensure the delivery of high-quality, comprehensive services to meet the needs of diverse populations affected by HIV. This article describes integrated approaches to service delivery in which affected communities play a key role in the development and implementation of HIV programmes. Further scale-up of these approaches to care can improve overall quality, reduce stigma and discrimination, increase demand for services and improve retention in care.

  15. 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.

  16. 39 CFR 761.6 - Delivery of Postal Service securities.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Delivery of Postal Service securities. 761.6... POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.6 Delivery of Postal Service securities. A Reserve Bank... obligations under this part by the delivery of Postal Service securities in definitive form to its...

  17. 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

  18. The Role of Public Relations in the Delivery of Forestry Services in Ghana

    National Research Council Canada - National Science Library

    Kofi Ampadu Boateng; Petra Hlaváčková

    2017-01-01

    .... There are, however, few researches relating to public relations and delivery of forestry services. The aim of this study was to examine the role public relations play in the delivery of forestry services with Ghana as case study...

  19. Enhancing Experiment Central Service Reliability: from delivery to security and virtualization

    CERN Document Server

    Donno, Flavia; Buzykaev, Alexey; Saiz Santos, Maria Dolores

    2011-01-01

    The four LHC experiments rely on experiment specific services running on machines mainly located at CERN. Some of these services have been rated by the experiments as very critical: any loss or degradation of performance has a major impact on the experiment's production and analysis activities. It is therefore important to provide a reliable and robust operational environment. In this work we describe the strategy based on service deployment, security and virtualization adopted to enhance the reliability of ATLAS and CMS central services.

  20. Service Delivery to Persons with Communication Disorders in Micronesia.

    Science.gov (United States)

    Stewart, Jean L.; Martinez, Velma A.

    1986-01-01

    Summarizes factors which make delivery of human services extremely difficult in Micronesia, noting problems of geographic distance and isolation and cultural and linguistic diversity. Presents a plan for providing services to persons with communication disorders using a speech-language pathologist and an audiologist with doctorates to supervise…

  1. Horizontal Cooperation in Dial-a-Ride Services

    OpenAIRE

    2016-01-01

    A dial-a-ride system is an application of demand-dependent, collective people transportation. Each user requests a trip between an origin and a destination of choice, to which a number of service level requirements are linked. The service provider attempts to develop efficient vehicle routes and time schedules, respecting these requirements and the technical constraints of a pickup and delivery problem. A frequent objective is to minimize operational costs subject to full demand satisfaction ...

  2. United Parcel Service Evaluates Hybrid Electric Delivery Vans (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2010-02-01

    This fact sheet describes how the National Renewable Energy Laboratory's Fleet Test and Evaluation team evaluated the 12-month, in-service performance of six Class 4 hybrid electric delivery vans - fueled by regular diesel - and six comparable conventional diesel vans operated by the United Parcel Service.

  3. Analysis of Hearth Roller Pickup Occurred Inside Annealing Furnace and Countermeasures%带钢热处理炉辊结瘤分析及对策

    Institute of Scientific and Technical Information of China (English)

    付建辉; 杨柏松

    2013-01-01

    阐述了带钢热处理退火炉炉辊结瘤的原因,分析认为防止带钢打滑和涂层是解决炉辊结瘤的有效手段,同时针对高强板MnO结瘤进行了论证,并提出了DPC74涂层是防止该种结瘤的一种有效手段.%The reasons of hearth roller pickup occurred inside annealing furnace are described.It is thought that avoiding strip slip from the hearth roller and coating for hearth roller are the effective measures to prevent hearth roller pickup.MnO hearth roller pickup of high strength plate is demonstrated,and it is pointed that the coating DPC74 is an effective way to prevent this kind of pickup from occurring.

  4. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  5. Clinical Issues in Mental Health Service Delivery to Refugees.

    Science.gov (United States)

    Gong-Guy, Elizabeth; And Others

    1991-01-01

    Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process: fragmentation, instability, language barriers, culturally inappropriate treatment methods, and severe staff shortages. Suggested improvements for refugee mental health services emphasize outreach, prevention, treatment approaches,…

  6. Large scale stochastic inventory routing problems with split delivery and service level constraints

    NARCIS (Netherlands)

    Y. Yu (Yugang); C. Chu (Chengbin); H.X. Chen (Haoxun); F. Chu (Feng)

    2010-01-01

    textabstractA stochastic inventory routing problem (SIRP) is typically the combination of stochastic inventory control problems and NP-hard vehicle routing problems, which determines delivery volumes to the customers that the depot serves in each period, and vehicle routes to deliver the volumes. Th

  7. Large scale stochastic inventory routing problems with split delivery and service level constraints

    NARCIS (Netherlands)

    Y. Yu (Yugang); C. Chu (Chengbin); H.X. Chen (Haoxun); F. Chu (Feng)

    2012-01-01

    textabstractA stochastic inventory routing problem (SIRP) is typically the combination of stochastic inventory control problems and NP-hard vehicle routing problems, which determines delivery volumes to the customers that the depot serves in each period, and vehicle routes to deliver the volumes. Th

  8. Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys.

    Science.gov (United States)

    Kosec, Katrina; Avula, Rasmi; Holtemeyer, Brian; Tyagi, Parul; Hausladen, Stephanie; Menon, Purnima

    2015-06-17

    In Bihar, India, coverage of essential health and nutrition interventions is low. These interventions are provided by 2 national programs--the Integrated Child Development Services (ICDS) and Health/National Rural Health Mission (NRHM)--through Anganwadi workers (AWWs) and Accredited Social Health Activists (ASHAs), respectively. Little is known, however, about factors that predict effective service delivery by these frontline workers (FLWs) or receipt of services by households. This study examined the predictors of use of 4 services: (1) immunization information and services, (2) food supplements, (3) pregnancy care information, and (4) general nutrition information. Data are from a 2012 cross-sectional survey of 6,002 households in 400 randomly selected villages in 1 district of Bihar state, as well as an integrated survey of 377 AWWs and 382 ASHAs from the same villages. For each of the 4 service delivery outcomes, logistic regression models were specified using a combination of variables hypothesized to be supply- and demand-side drivers of service utilization. About 35% of households reported receiving any of the 4 services. Monetary immunization incentives for AWWs (OR = 1.55, CI = 1.02-2.36) and above-median household head education (OR = 1.39, CI = 1.05-1.82) were statistically significant predictors of household receipt of immunization services. Higher household socioeconomic status was associated with significantly lower odds of receiving food supplements (OR = 0.87, CI = 0.79-0.96). ASHAs receiving incentives for institutional delivery (OR = 1.52, CI = 0.99-2.33) was marginally associated with higher odds of receiving pregnancy care information, and ASHAs who maintained records of pregnant women was significantly associated with households receiving such information (OR = 2.25, CI = 1.07-4.74). AWWs receiving immunization incentives was associated with significantly higher odds of households receiving general

  9. Repeated Ovum Pick-Up and In-vitro Embryo Production in Buffalo

    Directory of Open Access Journals (Sweden)

    C. Yang

    2010-02-01

    Full Text Available Transvaginal ultrasound-guided ovum pick-up (OPU was performed on 40 Nili-Ravi and Murrah buffaloes for consecutive 3 times each, at an interval of 3 days. A total of 936 follicles were aspirated, 643 oocytes were retrieved and 456 oocytes of them were usable. The recovery rate was 68.77% (643/935 and the percentage of usable oocytes was 70.92% (456/643, with an average of 3.80±0.23 oocytes usable per buffalo. The number of usable oocytes for the first, second and third OPU was 3.82±0.50;3.82±0.35; 4.05±0.43, respectively, and the difference among them was not significant (P<0.05. After in-vitro maturation (IVM, in-vitro fertilization (IVF and co-incubation with single layer of granular cells, the cleavage rate was 56.36% - 257/456, blastocyst formation rate was 20.39% (93/456 The result proved the feasibility of consecutive OPU at an interval of 3d and produce buffalo embryo via OPU-IVF. Further studies are needed to improve the efficiency of OPU-IVF.

  10. Comparison of dietetics service delivery (demand and determinants within two Australian Medical Assessment and Planning Units

    Directory of Open Access Journals (Sweden)

    Angela P Vivanti

    2017-03-01

    Full Text Available Aims Assessment and Planning Units have increased globally however, models of care literature is limited. With high malnutrition prevalence amongst ageing populations, this case report identifies demands for dietetic services. Methods Descriptive data compared and contrasted two service including medical models, eligibility criteria, malnutrition screening, dietetic services, clinical follow-up, and team composition. Results High malnutrition prevalence (17 per cent, 31 per cent was evident with different screening approaches successfully implemented. Both units favoured rapid assessment and intervention. Conclusion Dietetic expertise was required for malnutrition assessment, and ongoing management in acute or community setting as determined by differing health-care system arrangements

  11. Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

    Science.gov (United States)

    Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

    2015-06-01

    Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings.

  12. Factors associated with institutional delivery service utilization in Ethiopia.

    Science.gov (United States)

    Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

    2016-01-01

    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. The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. 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 I (2) test. 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. 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 communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended.

  13. 7 CFR 652.6 - Department delivery of technical services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Department delivery of technical services. 652.6... General Provisions § 652.6 Department delivery of technical services. (a) The Department may enter into a... technical assistance services that accelerate conservation program delivery. Related technical...

  14. Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.

    Science.gov (United States)

    Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana

    2015-03-01

    While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas.

  15. Delivery of eye and vision services in Aboriginal and Torres Strait Islander primary health care centres

    Directory of Open Access Journals (Sweden)

    Anthea M Burnett

    2016-12-01

    Full Text Available Background: Routine eye and vision assessments are vital for the detection and subsequent management of vision loss, which is particularly important for Aboriginal and Torres Strait Islander people, who face higher rates of vision loss than other Australians. In order to guide improvements, this paper will describe patterns, variations and gaps in these eye and vision assessments for Aboriginal and Torres Strait Islander people. Methods: Clinical audits from 124 primary health care centres (sample size 15,175 from five Australian States and Territories were conducted during 2005-2012. Main outcome measure was adherence to current guidelines for delivery of eye and vision assessments to adults with diabetes, those without a diagnosed major chronic disease and children attending primary health care centres. Results: Overall delivery of recommended eye and vision assessments varied widely between health centres. Of the adults with diabetes, 45% had a visual acuity assessment recorded within the previous 12 months (health centre range 0-88%, and 33% had a retinal examination recorded (health centre range 0-73%. Of the adults with no diagnosed major chronic disease, 31% had a visual acuity assessment recorded within the previous two years (health centre range 0-30%, and 13% had received an examination for trichiasis (health centre range 0-40%. In children, 49% had a record of a vision assessment (health centre range 0-97%, and 25% had a record of an examination for trachoma within the previous 12 months (health centre range 0-63%. Conclusions: There was considerable range, and variation in the recorded delivery of scheduled eye and vision assessments across health centres. Sharing the successful strategies of the better-performing health centres to support focused improvements in key areas of need may increase overall rates of eye examinations – important for the timely detection, referral and treatment of eye conditions affecting Aboriginal and

  16. Challenges and conflicts in the delivery of mental health services to ultra-orthodox Jews.

    Science.gov (United States)

    Greenberg, David; Witztum, Eliezer

    2013-02-01

    Ultra-orthodox Jews are a religious group that lives apart, valuing its separateness and ascribing sanctity to its life style. Community members are reticent to seek help from mental health services, especially if provided by professionals from outside the community. Therapeutic interventions should be explained in terms meaningful to the patient's explanatory model. Community members may face stigmatic attitudes of service providers. Situations are presented of the challenges and conflicts that confront ultra-orthodox Jews and mental health service providers concerning seeking help, understanding idioms of distress, providing appropriate rehabilitation services and negotiating arranged matches for marriage (shidduchim).

  17. 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.

  18. Factors impacting the use of antenatal care and hospital child delivery services: a case study of rural residents in the Enshi Autonomous Prefecture, Hubei Province, China.

    Science.gov (United States)

    Zhang, Yin; Chen, Minxing; Lu, Jun; Hao, Mo; Zhang, Changli; Sun, Mei; Li, Xiaohong; Chang, Fengshui

    2015-01-01

    This study was undertaken to understand the factors that impact whether rural women obtain antenatal care (ANC) and choose to use hospital delivery services in central and western China. We chose to conduct field research with the rural residents in Hubei Province through a combination of random sampling and purposive sampling methods. A mixed method approach was taken to analyze the factors impacting the use of ANC and hospital delivery services from the perspective of the villagers. Our results indicate that the quality of the available ANC services is poor. In particular, women who have special circumstances and unplanned pregnancies or who become pregnant prior to marriage are confronted with inadequate ANC and hospital child delivery services. The factors that impact whether women use or not use ANC and hospital delivery services and that cause women to choose hospital or home delivery can be understood at three levels: macro, middle, and micro. We strongly suggest that the policies and projects that promote maternal healthcare in rural areas be sustained with an added focus on including women with special circumstances. Village doctors can be enlisted to regularly visit pregnant women at home and to provide extra explanation about the ANC services available and the purpose of maternal healthcare. These findings and suggestions can be used by local health providers and decision-makers to improve the quality of ANC and hospital delivery services.

  19. Testing OGC Web Feature and Coverage Service performance: Towards efficient delivery of geospatial data

    Directory of Open Access Journals (Sweden)

    Gregory Giuliani

    2013-12-01

    Full Text Available OGC Web Feature Service (WFS and Web Coverage Service (WCS specifications allow interoperable access to distributed geospatial data made available through spatial data infrastructures (SDIs. To ensure that a service is sufficiently responsive to fulfill users’ expectations and requirements, performance of services must be measured and monitored to track latencies, bottlenecks, and errors that may negatively influence its over- all quality. Despite the importance of data retrieval and access, little research has been published on this topic and mostly concentrates on the usability of services when integrating distributed data sources. Considering these issues, this paper extends and validates the FOSS4G approach to measure the server-side performance of different WFS and WCS services provided by various software implementations; and provides guidance to data providers looking to improve the quality of their services. Our results show that performance of tested implementations is generally satisfactory and memory tuning/data and storage optimization are essential to handle increased efficiency and reliability of services.

  20. 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...

  1. Proposing a competitive intelligence (CI framework for Public Service departments to enhance service delivery

    Directory of Open Access Journals (Sweden)

    Nisha Sewdass

    2012-02-01

    Full Text Available Background: The aim of public service departments in South Africa is to improve service delivery through the transformation and improvement of human resources and the improvement of service delivery practices. Furthermore, it is important for the public service sector in South Africa to improve the quality of its service delivery, not only by comparing its performance with other sectors within South Africa but also by positioning itself amongst the best in the world. This can be achieved by benchmarking with other global industries and by implementing the most recent competitive intelligence strategies, tools and techniques. The environment of the public service organisations consists of competitive forces that impact the functioning of these organisations.Objectives: This article focuses on proposing competitive intelligence-related strategies, tools and techniques for gathering and analysing information in the public service departments in South Africa in order to enhance service delivery.Method: The study was qualitative in nature and was divided into two components, namely, (1 theoretical – through an extensive review of the literature and (2 empirical – an ethnographic study at the chosen public service department, the Department of Home Affairs (DHA. Ethnographic interviews with management-level staff, focus groups and document analysis were used to obtain adequate information to determine the current state of public service delivery in South Africa.Results: The results of the study was the development of a new competitive intelligencerelated framework for gathering and analysing information, and it represents a formal and systematic process of informing managers in public service departments about critical issues that these departments face or are likely to experience in future.Conclusion: The strategic planning tools and techniques of this framework will fill the gap that exists in public service departments. Once this framework has

  2. Features of the Maintenance Agreement (Contract) for the Delivery of Goods, Works and Services for State and Municipal Needs

    OpenAIRE

    Evgeniya V. Loginova

    2015-01-01

    Article analyzes main features of the agreement (contract) for the delivery of goods, works and services for state and municipal needs. It is shown that civil-legal nature of this agreement, which aims to meet the public interest. It is emphasized that this agreement is the special subject composition. Features of this type of contract, which is manifested in the use of special methods of placing state and municipal orders are shown. It is proved that for the public contract subject of the co...

  3. Setting Customer Expectation in Service Delivery: An Integrated Marketing-Operations Perspective

    OpenAIRE

    Teck H. Ho; Yu-Sheng Zheng

    2004-01-01

    Service firms have increasingly been competing for market share on the basis of delivery time. Many firms now choose to set customer expectation by announcing their maximal delivery time. Customers will be satisfied if their perceived delivery times are shorter than their expectations. This gap model of service quality is used in this paper to study how a firm might choose a delivery-time commitment to influence its customer expectation, and delivery quality in order to maximize its market sh...

  4. Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review

    Directory of Open Access Journals (Sweden)

    Jamie Bartram

    2013-10-01

    Full Text Available Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.

  5. Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review

    Science.gov (United States)

    Kayser, Georgia L.; Moriarty, Patrick; Fonseca, Catarina; Bartram, Jamie

    2013-01-01

    Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled. PMID:24157507

  6. A Comparison of Speech Sound Intervention Delivered by Telepractice and Side-by-Side Service Delivery Models

    Science.gov (United States)

    Grogan-Johnson, Sue; Schmidt, Anna Marie; Schenker, Jason; Alvares, Robin; Rowan, Lynne E.; Taylor, Jacquelyn

    2013-01-01

    Telepractice has the potential to provide greater access to speech-language intervention services for children with communication impairments. Substantiation of this delivery model is necessary for telepractice to become an accepted alternative delivery model. This study investigated the progress made by school-age children with speech sound…

  7. Converting Student Support Services to Online Delivery

    OpenAIRE

    David E. Brigham

    2001-01-01

    This case study describes how Regents College (soon to be Excelsior College), an accredited, private, distance education institution with administrative offices in Albany, New York addressed the structural, management, and resource issues that came into play when converting distance education programs from print-based and telephone delivery to online delivery. The study uses a systems framework to describe and analyze the circumstances and issues surrounding the creation of six student suppor...

  8. Coping during public service delivery: A conceptualization and systematic review of the literature

    NARCIS (Netherlands)

    Tummers, L.G.; Bekkers, V.J.J.M.; Vink, E.; Musheno, M.

    2015-01-01

    Frontline workers, such as teachers and social workers, often experience stress when delivering public services to clients, for instance because of high workloads. They adapt by coping, using such practices as breaking or bending rules for clients, or rationing services. Although coping is recognize

  9. Four ways geographic information systems can help to enhance health service planning and delivery for infectious diseases in low-income countries.

    Science.gov (United States)

    Brijnath, Bianca; Ansariadi; de Souza, Dziedzom K

    2012-11-01

    Focusing specifically on infectious diseases in low-income countries, this paper discusses four ways Geographic Information Systems (GIS) can facilitate health service planning and delivery: (1) deeper insight into where health care services should be located; (2) improved health surveillance and real-time planning for disease control and population health; (3) stronger accountability and evidence-informed dialogue between funders and the service providers and; (4) greater opportunities to translate complex data into more accessible formats which policymakers can quickly interpret and act on. Taking its use beyond just a research instrument, GIS is a way to undertake multidisciplinary work and improve health service planning and delivery.

  10. Students' community health service delivery: experiences of involved parties.

    Science.gov (United States)

    Greeff, M; van der Walt, E; Strydom, C; Wessels, C; Schutte, P J

    2009-03-01

    For several years the School of Nursing Science and the School of Psychosocial Behavioural Science, of a specific university, have been offering health care services in response to some of the health needs of a disadvantaged community as part of their students' experiential learning. However, these health care services were rendered independently by these two schools, implying that no feedback system existed to evaluate the worth and quality of these student-rendered health care services. The objectives of this research were to explore and describe the experiences of senior nursing and social work students, the experiences of health service delivery organisations concerned and the experiences of the disadvantaged community members receiving such health care services, as well as to investigate which communication models were apparent with regard to the major factors within health communication. An exploratory descriptive qualitative research design was used. Focus group discussions were held, interviews were conducted and field notes taken. Focus group discussions and interviews were transcribed and analysed by the research team to determine themes and sub-themes using the open coding technique. The results of the three groups showed similarities. The health service delivery organisations also identified a communication barrier, although the students were prepared to bridge it. The health service delivery organisations and the community felt positive towards the students and what they offered to the organisations and to the patients. A greater need for multi-disciplinary team work was recognised by al parties concerned. Recommendations focus on improved student accompaniment by lecturers; extending health care delivery to include a multi-disciplinary team approach by students; as well as improving the delivery of health care services.

  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

    OpenAIRE

    Alaska Adrian Kalasa; Supain Cyril Christopher

    2014-01-01

    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...

  12. Wheeled mobility (wheelchair) service delivery: scope of the evidence.

    Science.gov (United States)

    Greer, Nancy; Brasure, Michelle; Wilt, Timothy J

    2012-01-17

    Identifying the appropriate wheelchair for a person who needs one has implications for both disabled persons and society. For someone with severe locomotive problems, the right wheelchair can affect mobility and quality of life. However, policymakers are concerned about the increasing demand for unnecessarily elaborate chairs. The Office of Inspector General, U.S. Department of Health and Human Services, issued 4 reports between 2009 and 2011 detailing fraud and misapplication of Medicare funds for powered wheelchairs, more than a decade after similar concerns were first raised by 4 contractors who process claims for durable medical equipment. Subsequent concerns have arisen about whether some impaired persons who need wheeled mobility devices may now be inappropriately denied coverage. A transparent, evidence-based approach to wheeled mobility service delivery (the matching of mobility-impaired persons to appropriate devices and supporting services) might lessen these concerns. This review describes the process of wheeled mobility service delivery for long-term wheelchair users with complex rehabilitation needs and presents findings from a survey of the literature (published and gray) and interviews with key informants. Recommended steps in the delivery process were identified in textbooks, guidelines, and published literature. Delivery processes shared many commonalities; however, no research supports the recommended approaches. A search of bibliographic databases through March 2011 identified 24 studies that evaluated aspects of wheeled mobility service delivery. Most were observational, exploratory studies designed to determine consumer use of and satisfaction with the process. The evidence base for the effectiveness of approaches to wheeled mobility service delivery is insufficient, and additional research is needed to develop standards and guidelines.

  13. Expected Impact of Health Care Reform on the Organization and Service Delivery of Publicly Funded Addiction Health Services.

    Science.gov (United States)

    Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence

    2017-07-01

    Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.

  14. Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Allison J Carter

    2013-01-01

    Full Text Available Introduction: The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. Methods: A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL, augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. Results and discussion: The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1 creating an atmosphere of safety, respect and acceptance; (2 facilitating communication and interaction among peers; (3 involving women in the planning, delivery and evaluation of services; (4 providing self-determination opportunities; (5 providing tailored programming for women; (6 facilitating meaningful access to care through the provision of social and supportive services; (7 facilitating access to women-specific and culturally sensitive information; (8 considering family as the unit of intervention; (9 providing multidisciplinary integration and coordination of a comprehensive array of services; (10 meeting women “where they are”; (11 providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12 conducting gendered HIV/AIDS research. Conclusions: This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and

  15. Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS

    Science.gov (United States)

    Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

    2013-01-01

    Introduction The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. Methods A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. Results and discussion The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women “where they are”; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. Conclusions This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately

  16. Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

    Directory of Open Access Journals (Sweden)

    Kathryn Schnippel

    Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

  17. Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

    Science.gov (United States)

    Schnippel, Kathryn; Lince-Deroche, Naomi; van den Handel, Theo; Molefi, Seithati; Bruce, Suann; Firnhaber, Cynthia

    2015-01-01

    Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model. The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district) and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs), breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD. Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts); the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost. Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to health care

  18. Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS.

    Science.gov (United States)

    Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

    2013-01-11

    The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women "where they are"; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately assess the effectiveness of women-specific services on HIV

  19. Quantification, morphology, and viability of equine preantral follicles obtained via the Biopsy Pick-Up method.

    Science.gov (United States)

    Haag, K T; Magalhães-Padilha, D M; Fonseca, G R; Wischral, A; Gastal, M O; King, S S; Jones, K L; Figueiredo, J R; Gastal, E L

    2013-03-01

    A Biopsy Pick-Up (BPU) method was tested to determine the feasibility of retrieving preantral follicles from mare ovaries in vivo. A total of 33 ovarian biopsy procedures were performed on 18 mares during the breeding season. Mares were 5 to 21 years old and biopsies were performed during the estrous and/or diestrous phase, as confirmed by transrectal ultrasonography. Follicles were mechanically isolated using a tissue chopper, counted, and classified as normal or abnormal and primordial or primary. Viability of isolated follicles was determined by Trypan Blue dye. A total of 256 biopsy attempts were made resulting in 185 successful tissue sample collections (72% success rate). The mean weight of ovarian tissue collected per procedure was 25.0 ± 1.6 mg. Overall, 620 preantral follicles were collected and isolated (95% primordial and 5% primary). The mean (±SEM) number of follicles isolated per biopsy procedure was 18.8 ± 1.9. Primordial and primary follicles had an average diameter of 31.3 ± 6.2 and 41.1 ± 6.6 μm, respectively. Viability rate was higher (P 0.05) according to phase of the estrous cycle. Younger mares (5 to 7 years old) had more (P 0.05) by any biopsy procedure, and there were no adverse effects on cyclicity or general reproductive health. In conclusion, the BPU method provided large numbers of normal and viable preantral follicles for the study of early follicular development in mares. The BPU method might be used in the future to obtain preantral follicles for in vitro culture to enable the use of numerous oocytes present within the equine ovary. This could allow for the preservation of genetic material or large-scale embryo production.

  20. Household cost of antenatal care and delivery services in a rural community of Kaduna state, northwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Mohd Nasiq Sambo

    2013-01-01

    Full Text Available Background: Maternal mortality remains a leading cause of death among women of reproductive age. While Nigeria has only two percent of the global population, it contributes 10% to the global maternal mortality burden. Antenatal care (ANC reduces the incidence of maternal mortality. However, financial capability affects access to antenatal care. Thus, the rural poor are at a higher risk of maternal mortality. Materials and Methods: A cross-sectional descriptive study involving 135 women (pregnant women and those who are 6 weeks postpartum. Structured interviewer-administered questionnaires were used for data collection. Data analysis was carried out using statistical package for social sciences software (version 17. Results: The average amount spent on booking and initial laboratory investigations were N77 (half a dollar and N316 ($2, respectively. Per ANC visit, average amount spent on drugs and transportation were N229 ($1.5 and N139 ($0.9 respectively. For delivery, the average amount spent was N1500 ($9.6. On an average, ANC plus delivery cost about N3,365.00 ($22. There was a statistically significant association between husband′s income and ANC attendance (X 2 = 2.451, df = 2, P = 0.048. Conclusion: Cost of Antenatal care and delivery services were not catastrophic but were a barrier to accessing antenatal care and facility-based delivery services in the study area. ANC attendance was associated with the income of household heads. Pro-poor policies and actions are needed to address this problem, as it will go a long way in reducing maternal mortality in this part of the country.

  1. Improving service delivery of water, sanitation, and hygiene in primary schools: a cluster-randomized trial in western Kenya.

    Science.gov (United States)

    Alexander, Kelly T; Dreibelbis, Robert; Freeman, Matthew C; Ojeny, Betty; Rheingans, Richard

    2013-09-01

    Water, sanitation, and hygiene (WASH) programs in schools have been shown to improve health and reduce absence. In resource-poor settings, barriers such as inadequate budgets, lack of oversight, and competing priorities limit effective and sustained WASH service delivery in schools. We employed a cluster-randomized trial to examine if schools could improve WASH conditions within existing administrative structures. Seventy schools were divided into a control group and three intervention groups. All intervention schools received a budget for purchasing WASH-related items. One group received no further intervention. A second group received additional funding for hiring a WASH attendant and making repairs to WASH infrastructure, and a third group was given guides for student and community monitoring of conditions. Intervention schools made significant improvements in provision of soap and handwashing water, treated drinking water, and clean latrines compared with controls. Teachers reported benefits of monitoring, repairs, and a WASH attendant, but quantitative data of WASH conditions did not determine whether expanded interventions out-performed our budget-only intervention. Providing schools with budgets for WASH operational costs improved access to necessary supplies, but did not ensure consistent service delivery to students. Further work is needed to clarify how schools can provide WASH services daily.

  2. Features of the Maintenance Agreement (Contract for the Delivery of Goods, Works and Services for State and Municipal Needs

    Directory of Open Access Journals (Sweden)

    Evgeniya V. Loginova

    2015-12-01

    Full Text Available Article analyzes main features of the agreement (contract for the delivery of goods, works and services for state and municipal needs. It is shown that civil-legal nature of this agreement, which aims to meet the public interest. It is emphasized that this agreement is the special subject composition. Features of this type of contract, which is manifested in the use of special methods of placing state and municipal orders are shown. It is proved that for the public contract subject of the contract will depend on the considered whether the supply agreement or service contract. Existing in the modern civil law doctrine approaches to understanding the essential terms of the contract are analyzed. Features of pricing in this agreement is shown. It was concluded that, in contrast to other types of civil contracts, state contract has a wide range of essential conditions.

  3. IT-Mediated customer service content and delivery in electronic governments : An empirical investigation of the antecedents of service quality

    NARCIS (Netherlands)

    Tan, C.W.; Benbasat, I.; Cenfetelli, R.

    2013-01-01

    Despite extensive deliberations in contemporary literature, the design of citizen-centric e-government websites remains an unresolved theoretical and pragmatic conundrum. Operationalizing e-government service quality to investigate and improve the design of e-government websites has been a much soug

  4. IT-Mediated customer service content and delivery in electronic governments : An empirical investigation of the antecedents of service quality

    NARCIS (Netherlands)

    Tan, C.W.; Benbasat, I.; Cenfetelli, R.

    Despite extensive deliberations in contemporary literature, the design of citizen-centric e-government websites remains an unresolved theoretical and pragmatic conundrum. Operationalizing e-government service quality to investigate and improve the design of e-government websites has been a much

  5. 78 FR 41305 - Collect on Delivery (COD)-Service Features

    Science.gov (United States)

    2013-07-10

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE 39 CFR Part 111 Collect on Delivery (COD)--Service Features AGENCY: Postal Service TM . ACTION: Final rule... proposed rule were received, the Postal Service will adopt the proposed changes to Collect on Delivery (COD...

  6. Water services and franchising partnership principles flowing together for improved delivery

    CSIR Research Space (South Africa)

    Wall, K

    2008-08-01

    Full Text Available Water Research Commission (WRC) of South Africa studies have found that franchising partnerships could alleviate and address many challenges in the operation and maintenance of water services infrastructure. Franchising brings appropriate training...

  7. Sustaining and improving an international service-learning partnership: Evaluation of an evidence-based service delivery model.

    Science.gov (United States)

    Hayward, Lorna M; Li, Li

    2017-06-01

    International service learning (ISL) is an instructional method used by physical therapist educators in the United States (US) to prepare students for rendering culturally competent care. ISL is a faculty led student learning opportunity that includes academic instruction and community service in an international context. Research exists that explores student experiences with ISL, but studies that evaluate ISL partnerships and include global stakeholder feedback are lacking. The purposes of this study were to: 1) integrate a partnership evaluation component into an existing curriculum-based ISL model and 2) through evaluation identify benefits, drawbacks, and suggestions for improving and sustaining the academic-community partnership. Community-based participatory research design using a mixed methods approach was used to evaluate a ISL partnership between a US-based physical therapy program and a service site in Ecuador. Participants were 31 staff working at the global service site. Over three years, 11 interviews were conducted and 26 surveys were administered to global partner staff. Data were analyzed using qualitative thematic content analysis and descriptive statistics. Partnership benefits included the following: continuity of ISL team leadership, targeted rehabilitative efforts, sensitivity to cultural norms, respectful communication, and interaction with local community. Drawbacks were as follows: deficits in cultural awareness, language barriers, and poor treatment carryover. Suggestions for sustaining the relationship incorporated: additional pre-trip communication, education of staff, and improved language skills. As more US teams deliver clinical services abroad, intentional evaluation approaches must include the global stakeholder in the planning, implementation, and evaluation phases to maximize partnerships benefits.

  8. Forest biodiversity and the delivery of ecosystem goods and services: translating science into policy

    Science.gov (United States)

    Ian Thompson; Kimiko Okabe; Jason Tylianakis; Pushpam Kumar; Eckehard G. Brockerhoff; Nancy Schellhorn; John A. Parrotta; Robert. Nasi

    2011-01-01

    Biodiversity is integral to almost all ecosystem processes, with some species playing key functional roles that are essential for maintaining the value of ecosystems to humans. However, many ecosystem services remain nonvalued, and decisionmakers rarely consider biodiversity in policy development, in part because the relationships between biodiversity and the provision...

  9. Evidence for the effectiveness of different service delivery models in early intervention services.

    Science.gov (United States)

    Kingsley, Karrie; Mailloux, Zoe

    2013-01-01

    Consideration of the evidence for all aspects of service delivery is a growing relevant concern of occupational therapists, including those providing early intervention to children and families. We conducted a review of the literature to uncover what evidence existed for determining the effectiveness of different service delivery models and methods used to improve occupational performance for children and families who receive early intervention services. Through a comprehensive search, we reviewed and synthesized studies, finding common themes of family-centered and routine-based approaches, service setting, and the inclusion of parent participation and training. Families consistently reported positive perceptions of family-centered and routine-based approaches. Parent participation and training resulted in positive outcomes. No specific setting or method of service delivery was identified as clearly most effective, with most studies reporting combined approaches and environments for interventions.

  10. Opportunities in Delivery of Preventive Services in Retail Settings

    CERN Document Server

    Bar-Yam, Yaneer; Nesbitt, Keith; Lim, May; Smith, Suzanne; Perkins, Bradley A

    2012-01-01

    Recommended clinical preventive services are not being delivered despite well-documented benefits. Here we show that transferring simple and repetitive preventive services to nurse-staffed retail clinics provides an opportunity for dramatically improving their delivery. For each of 35 high-benefit, cost-effective preventive services, we identify required training, number of repetitions, and time and cost for full coverage in the US. We determine that full delivery through physician-based practices would require an unrealistic 400,000 full-time personnel. We estimate the efficiency gains from implementation at nurse-staffed clinics at retail locations for 28 services. Widespread adoption would result in a five-fold reduction in variable costs and three-fold reduction in personnel. By elevating the benefit-to-cost ratio, retail implementation can expedite widespread prevention coverage and help transform US healthcare.

  11. STI service delivery in British Columbia, Canada; providers' views of their services to youth

    Directory of Open Access Journals (Sweden)

    Masaro Cindy L

    2012-08-01

    Full Text Available Abstract Background Little is known about service providers’ knowledge, attitudes, and experiences in relation to the assessment, diagnosis, and treatment of individuals seeking care for sexually transmitted infections (STIs, and how they influence the delivery of services. The purpose of this study was to explore the perceptions of STI care providers and the ways they approached their practice. Methods We used a qualitative approach drawing on methods used in thematic analysis. Individual semi-structured in-depth interviews were conducted with 21 service providers delivering STI services in youth clinics, STI clinics, reproductive health clinics, and community public health units in British Columbia (BC, Canada. Results Service providers’ descriptions of their activities and roles were shaped by a number of themes including specialization, scarcity, and maintaining the status quo. The analysis suggests that service providers perceive, at times, the delivery of STI care to be inefficient and inadequate. Conclusion Findings from this study identify deficits in the delivery of STI services in BC. To understand these deficits, more research is needed to examine the larger health care structure within which service providers work, and how this structure not only informs and influences the delivery of services, but also how particular structural barriers impinge on and/or restrict practice.

  12. Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes

    Directory of Open Access Journals (Sweden)

    Vellapandian Ponnusamy, J. Robert Grove

    2014-09-01

    Full Text Available Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217. The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures.

  13. Training and development as a tool for improving basic service delivery: the case of a selected municipality

    Directory of Open Access Journals (Sweden)

    Mthokozisi Mpofu

    2015-12-01

    Full Text Available Municipal employees have come under fire for poor performance and conduct in their work as some engage in corruption and others are not qualified enough to discharge their duties to the required levels. Employee training and development has become one of the key aspects in improving employee performance in organisations, thus leading to improved organizational performance and growth. The study investigated the relationship between the quality of employee training and development on service delivery in a selected municipality with data collected from 150 employees. The results indicated the need for effective employee training and development systems and processes to achieve improved employee performance thus improved provision of basic services to the communities.

  14. 42 CFR 460.98 - Service delivery.

    Science.gov (United States)

    2010-10-01

    ... services. (3) Restorative therapies, including physical therapy and occupational therapy. (4) Personal care... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... furnished in at least the PACE center, the home, and inpatient facilities. (3) The PACE organization may not...

  15. Conscientious objection and reproductive health service delivery in sub-Saharan Africa.

    Science.gov (United States)

    Lema, V M

    2012-03-01

    Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in sub-Saharan Africa (SSA). This is partly due to a shortage of qualified and experienced health care providers. However conscientious objection amongst the available few is a hitherto undocumented potential factor influencing access to health care in SSA. Provision of certain reproductive health services goes counter to some individual's religious and moral beliefs and practices. Health providers sometimes refuse to participate in or provide such services to clients/patients on moral and/or religious grounds. While the rights to do so are protected by the principles of freedom of religion, among other documents, their refusal exposes clients/patients to the risk of reproductive health morbidity as well as mortality. Such providers are required to refer the clients/patients to other equally qualified and experienced providers who do not hold similar conscientious objection. Access to high quality and evidence-based reproductive health services by all in need is critical to attaining MDG5. In addressing factors contributing to delay in attaining MDG5 in SSA it is instructive to consider the role of conscientious objection in influencing access to quality reproductive health care services and strategies to address it.

  16. Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery.

    Science.gov (United States)

    Ó Mír, M; O'Sullivan, C

    2017-05-06

    One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.

  17. Solar cycle variation of interstellar neutral He, Ne, O density and pick-up ions along the Earth's orbit

    OpenAIRE

    Sokół, Justyna M.; Bzowski, Maciej; Kubiak, Marzena A.; Möbius, Eberhard

    2016-01-01

    We simulated the modulation of the interstellar neutral (ISN) He, Ne, and O density and pick-up ion (PUI) production rate and count rate along the Earth's orbit over the solar cycle from 2002 to 2013 to verify if solar cycle-related effects may modify the inferred ecliptic longitude of the ISN inflow direction. We adopted the classical PUI model with isotropic distribution function and adiabatic cooling, modified by time- and heliolatitude-dependent ionization rates and non-zero injection spe...

  18. Lessons Learned from a Tiered Service Delivery Implementation Project

    Science.gov (United States)

    Johnson, Evelyn S.; Pool, Juli L.; Carter, Deborah R.

    2012-01-01

    Tiered models of service delivery for both academics and behavior are being increasingly adopted across the nation, and discussions of how to implement these models effectively and simultaneously are growing. In this article, the authors share some lessons learned from a 2-year implementation project to implement a comprehensive (both academic and…

  19. 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

  20. Challenges, solutions, and best practices in telemental health service delivery across the pacific rim-a summary.

    Science.gov (United States)

    Doarn, Charles R; Shore, Jay; Ferguson, Stewart; Jordan, Patricia J; Saiki, Stanley; Poropatich, Ronald K

    2012-10-01

    The Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Materiel Command, in conjunction with the American Telemedicine Association's Annual Mid-Year Meeting, conducted a 1-day workshop on how maturing and emerging processes and applications in the field of telemental health (TMH) can be expanded to enhance access to behavioral health services in the Pacific Rim. The purpose of the workshop was to bring together experts in the field of TMH from the military, federal agencies, academia, and regional healthcare organizations serving populations in the Pacific Rim. The workshop reviewed current technologies and systems to better understand their current and potential applications to regional challenges, including the Department of Defense and other federal organizations. The meeting was attended by approximately 100 participants, representing military, government, academia, healthcare centers, and tribal organizations. It was organized into four sessions focusing on the following topic areas: (1) Remote Screening and Assessment; (2) Post-Deployment Adjustment Mental Health Treatment; (3) Suicide Prevention and Management; and (4) Delivery of Training, Education, and Mental Health Work Force Development. The meeting's goal was to discuss challenges, gaps, and collaborative opportunities in this area to enhance existing or create new opportunities for collaborations in the delivery of TMH services to the populations of the Pacific Rim. A set of recommendations for collaboration are presented.

  1. The Effect of Leadership on Service Delivery in Universities

    Science.gov (United States)

    Zvavahera, Promise

    2013-01-01

    This study was aimed at assessing leadership effectiveness on service delivery at the University of Namibia and all its campuses throughout the country. The study was carried out during the month of February 2013. The methodology consisted of document analysis, interviews through face to face, video and tele-conferencing. Purposive sampling was…

  2. 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.

  3. Quantification of rolling circle amplified DNA using magnetic nanobeads and a Blu-ray optical pick-up unit

    DEFF Research Database (Denmark)

    Donolato, Marco; Antunes, Paula Soares Martins; Gómez del a Torre, Teresa Zardán

    2015-01-01

    We present the first implementation of a Blu-ray optical pickup unit (OPU) for the high-performance low-cost readout of a homogeneous assay in a multichamber microfluidic disc with a chamber thickness of 600 μm. The assay relies on optical measurements of the dynamics of magnetic nanobeads...... the optimum magnetic bead concentration to 0.1 mg/mL and have measured the response vs. concentration of DNA coils formed from Escherichia Coli. We have found a limit of detection of 10 pM and a dynamic range of about two orders of magnitude, which is comparable to the performance obtained using costly...

  4. Patient satisfaction with HIV/AIDS care and treatment in the decentralization of services delivery in Vietnam.

    Directory of Open Access Journals (Sweden)

    Bach Xuan Tran

    Full Text Available OBJECTIVE: We evaluated the patient satisfaction with HIV/AIDS care and treatment and its determinants across levels of health service administration in Vietnam. METHODS: We interviewed 1016 patients at 7 hospitals and health centers in three epicenters, including Hanoi, Hai Phong, and Ho Chi Minh City. The Satisfaction with HIV/AIDS Treatment Interview Scale (SATIS was developed, and 3 dimensions were constructed using factor analysis, namely "Quality and Convenience"; "Availability and Responsiveness"; and "Competence of health care workers". RESULTS: In a band score of (0; 10, the mean scores of all domains were large; it was the highest in "Competence of health workers" (9.34±0.84, and the lowest in "Quality and Convenience" (9.03±1.04. The percentages of respondents completely satisfied with overall service quality and treatment outcomes were 42.4% and 18.8%, respectively. In multivariate analysis, factors related to higher satisfaction included female sex, older age, and living with spouses or partners. Meanwhile, lower satisfaction was found among patients who were attending provincial and district clinics; in the richest group; had higher CD4 count; and drug users. CONCLUSION: This study highlights the importance of improving the quality of HIV/AIDS services at the provincial and district clinics. Potential strategies include capacity building for health workers, integrative service delivery, engagements of family members in treatment supports, and additional attention and comprehensive care for drug users with HIV/AIDS.

  5. The organization and delivery of craniofacial health services: the state of the art.

    Science.gov (United States)

    Strauss, R P

    1999-05-01

    The dominant organizational structure providing care for cleft palate and other craniofacial conditions is the health care team. Various types of health care team organization are profiled, including intradisciplinary, multidisciplinary, and interdisciplinary teams. Effective team-based care delivery has the ability to address the fragmentation and dehumanization that can result when a variety of specialists and disciplines are required to provide assessment and technical care. A team's leadership and its hierarchy of professional authority can be expected to affect its ability to function effectively. Health reform and managed care are considered for their impact on the team and on the doctor-patient relationship. Trends in team regionalization, quality assurance, outcomes research, and consumer advocacy are reviewed. The cleft palate and craniofacial team is profiled as an organizational model that is being affected by the forces of health system change.

  6. Use of antenatal services and delivery care among women in rural western Kenya: a community based survey

    Directory of Open Access Journals (Sweden)

    Rosen Daniel H

    2006-04-01

    Full Text Available Abstract Background Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care. Methods Population-based cross-sectional survey among women who had recently delivered. Results Of 635 participants, 90% visited the antenatal clinic (ANC at least once during their last pregnancy (median number of visits 4. Most women (64% first visited the ANC in the third trimester; a perceived lack of quality in the ANC was associated with a late first ANC visit (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0–2.4. Women who did not visit an ANC were more likely to have 90%, but provision of other services was low, e.g. malaria prevention (21%, iron (53% and folate (44% supplementation, syphilis testing (19.4% and health talks (14.4%. Eighty percent of women delivered outside a health facility; among these, traditional birth attendants assisted 42%, laypersons assisted 36%, while 22% received no assistance. Factors significantly associated with giving birth outside a health facility included: age ≥ 30 years, parity ≥ 5, low SES, 1 hour walking distance from the health facility. Women who delivered unassisted were more likely to be of parity ≥ 5 (AOR 5.7, 95% CI 2.8–11.6. Conclusion In this rural area, usage of the ANC was high, but this opportunity to deliver important health services was not fully utilized. Use of professional delivery services was low, and almost 1 out of 5 women delivered unassisted. There is an urgent need to improve this dangerous situation.

  7. The Status of Technology-Enhanced Education and Service Delivery in Rehabilitation Counselor Education

    Science.gov (United States)

    Oswald, Gina R.; Huber, Mary J.; Wilson, Josephine F.; Embree, Jared

    2015-01-01

    Purpose: The purpose of this article is to discuss the upsurge of technology-enhanced rehabilitation education programs and telerehabilitation services, to provide examples of these advancements, and to discuss the implications of this technology for education and the field including the unique advantage to developing technological skills through…

  8. Rethinking place and the social work office in the delivery of children's social work services.

    Science.gov (United States)

    Stanley, Nicky; Larkins, Cath; Austerberry, Helen; Farrelly, Nicola; Manthorpe, Jill; Ridley, Julie

    2016-01-01

    Limited attention has been given to the concept of place in social work research and practice. This paper draws on the national evaluation of social work practices (SWPs) in England undertaken between 2009 and 2012. SWPs were pilot organisations providing independent social work services for children in out-of-home care in five sites. One factor distinguishing some of these pilots was their attention to place. The evaluation employed a mixed methods approach and we use data from interviews with 121 children and young people in out-of-home care, 19 birth parents and 31 interviews with SWP staff which explored their views and experiences of the SWP offices. Children and young people were alert to the stigma which could attach to social work premises and appreciated offices which were planned and furnished to appear less institutional and more 'normal'. Daily interactions with staff which conveyed a sense of recognition and value to service users also contributed to a view of some SWP offices as accessible and welcoming places. Both children and parents appreciated offices that provided fun activities that positioned them as active rather than passive. Staff valued opportunities for influencing planning decisions about offices and place was seen to confer a value on them as well as on service users. However, not all the SWPs were able to achieve these aspects of place, and engaging children and families in place was less likely when the service user population was widely dispersed. Recognising the importance of place and how place is constructed through relationships between people as well as through the physical environment appeared to be key to creating offices that combated the stigma attached to out-of-home care. Those leading and managing children's services should explore ways of involving local communities in planning social work offices and turn attention to making these offices accessible, welcoming, places.

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

    NARCIS (Netherlands)

    A.P.J. Machohe (Antonio)

    2011-01-01

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

  10. Business drivers and design choices for multilingual IVRs : A government service delivery case study

    CSIR Research Space (South Africa)

    Calteaux, K

    2012-05-01

    Full Text Available and salient design decisions pertaining to these markets. In this paper we analyze the business drivers and design issues for a voice service (the School Meals Line) piloted in the public sector. We find that cost saving, increased customer satisfaction...

  11. Re-Framing Pacific Regional Service Delivery: Opportunity Spaces for "Together" and "Apart"

    Science.gov (United States)

    Sanga, Kabini

    2011-01-01

    Regionalism is a common development strategy in the Pacific region. Through it, numerous services are delivered to countries, communities and organisations. While some see regionalism as an effective and efficient strategy for the Pacific region, others point to its dismal performance. Using the experience of the Rethinking Pacific Education…

  12. Re-Framing Pacific Regional Service Delivery: Opportunity Spaces for "Together" and "Apart"

    Science.gov (United States)

    Sanga, Kabini

    2011-01-01

    Regionalism is a common development strategy in the Pacific region. Through it, numerous services are delivered to countries, communities and organisations. While some see regionalism as an effective and efficient strategy for the Pacific region, others point to its dismal performance. Using the experience of the Rethinking Pacific Education…

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

    NARCIS (Netherlands)

    A.P.J. Machohe (Antonio)

    2011-01-01

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

  14. A service-oriented medical framework for fast and adaptive information delivery in mobile environment.

    Science.gov (United States)

    Park, Eunjeong; Nam, Hyo Suk

    2009-11-01

    The need for fast treatment of patients in critical conditions motivates the use of mobile devices to provide prompt and consistent communication between hospitals and physicians. We propose a framework that supports ubiquitous access to medical systems using personalized mobile services and integrated medical systems. The proposed service-oriented medical framework provides dynamically composed services that are adapted to contextual variables such as the user's role, the network bandwidth, and resources available at mobile devices while supporting task allocation in distributed servers for massive resource-consuming services. It also manages accurate patient data by integrating local medical systems using medical information standards such as Digital Imaging and Communications in Medicine and Health Level 7. We have demonstrated the effectiveness of our framework by building a prototype of context-based adaptation of computerized tomography image retrieval for acute stroke treatments, which allows images to be viewed on mobile devices with WiMax wireless network. The proposed medical framework reduces hospital delays of patients and facilitates treatments in the absence of medical specialists.

  15. 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, int

  16. Using and understanding consumer satisfaction to effect an improvement in mental health service delivery.

    Science.gov (United States)

    Brunero, S; Lamont, S; Fairbrother, G

    2009-04-01

    Consumer satisfaction is today, widely accepted as a measure of the level and quality of service received by consumers. The aim of this survey-based study is to explore consumer satisfaction with quality of care, staff, environment and discharge in a south eastern Sydney adult acute inpatient mental health unit. A cross-sectional analysis is pursued in order to identify aspects of the patient stay, which form an associative relationship with an overall rating of consumer satisfaction on a 10-point scale. During the survey period, there were 182 discharges. Seventy questionnaires (38.5%) were returned from this group. The survey results highlight a number of areas of identified need, enabling the service to prioritize organizational systems around meeting these needs. Multiple regression analysis identified three items in the survey, which were independently significant associates of overall consumer satisfaction. They included being happy with the service provided by the consumer support worker, having support for services on discharge and feeling safe and secure on the ward. The model containing these three items accounted for 50% of the variation in overall satisfaction. Two primary interventions have been developed because survey administration which, it is hoped, will address issues raised in the survey. The interventions were the development of an admission and discharge pathway and a ward-based psychosocial intervention programme, which includes the involvement of consumer support workers.

  17. 基于逐渐覆盖的自提点选址模型与算法研究%Research on pickup point location model and algorithm in presence of gradual coverage

    Institute of Scientific and Technical Information of China (English)

    陈义友; 陈以衡

    2016-01-01

    Social practices show that the pickup point’s type and covering distance affect consumer satisfaction level on pic-kup service.In order to solve consumer satisfaction location problem,this paper used convex and concave function to depict consumer satisfaction level,then based on the gradual coverage theory,proposed the pickup point location model in the pres-ence of gradual coverage.According to the attributes of the model,it proposed a Lagrangian relaxation algorithm.Finally,it cal-culated a large number of random examples and compared with the location results of traditional covering model.The numerical examples show that the proposed model and algorithm have the effectiveness in pickup point location decision.%实践表明自提点类型和自提点覆盖距离影响消费者对自提服务的满意度。为解决消费者满意度选址问题,基于逐渐覆盖理论,用凹凸函数刻画消费者的满意度,构建了基于逐渐覆盖的自提点选址模型;根据模型的特点,设计了相应的拉格朗日松弛算法;最后,运用大量的随机算例进行计算,并与传统覆盖模型的选址结果进行了比较。算例分析结果揭示了所构建的模型和算法在自提点选址决策中的有效性。

  18. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    Directory of Open Access Journals (Sweden)

    Matthew F Chersich

    2013-03-01

    Full Text Available Introduction: 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 reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed and non-indexed journals were searched for studies with quantitative study outcomes. Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART, but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions: There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers

  19. A Framework to Enhance Quality of Service for Content Delivery Network Using Web Services: A Review

    Directory of Open Access Journals (Sweden)

    K.Manivannan

    2011-09-01

    Full Text Available Content Delivery Networks (CDNs is anticipated to provide better performance delivery of content in internet through worldwide coverage, which would be a fence for new content delivery network providers. The appearance of Web as a omnipresent media for sharing content and services has led to the rapid growth of the Internet. At the same time, the number of users accessing Web-based content and services are growing exponentially. This has placed a heavy demand on Internet bandwidth and Web systems hosting content and application services. As a result, many Web sites are unable to manage this demand and offer their services in a timely manner. Content Delivery Networks (CDNs have emerged to overcome these limitations by offering infrastructure and mechanisms to deliver content and services in a scalable manner, and enhancing users Web experience. The planned research provides a framework designed to enhance QoS of Web service processes for real time servicing. QoS parameters of various domains can be combined to provide differentiated services, and allocating dynamically available resources in the midst of customers while delivering high-quality real time multimedia content. While accessing the service by a customer, it is possible to adapt real time streams to vastly changeable network conditions to give suitable quality in spite of factors upsetting Quality of service. To reach these intentions, adaptive web service processes to supply more information for determining the quality and size of the delivered object. The framework includes a section for QoS monitoring and adaptation and QoS faults prediction possibility and convalesce actions in case of failure. The aim of this research is to encourage research about quality of composite services in service-oriented architectures with security measures.

  20. 76 FR 35181 - Wireless Backhaul; Further Inquiry Into Fixed Service Sharing of the 6875-7125 and 12700-13200...

    Science.gov (United States)

    2011-06-16

    ... electronic news-gathering operations using TV pickup stations from interference due to FS operations, and... (FWCC) reports that BAS and CARS path and channel licensing, respectively, in the 13 GHz band have... its path within the service area of a co-channel TV pickup station. Additionally, the Commission...

  1. 试论图书馆电子文献传递服务%On Library Electronic Document Delivery Service

    Institute of Scientific and Technical Information of China (English)

    丁根度

    2001-01-01

    This essay discusses the impetus of modern information technology to document delivery service, introduces the electronic document delivery mode in Australia, and elaborates the importance, necessity and feasibility of building up electronic document delivery systems in the libraries in China.

  2. Resonant pickups for non-destructive single-particle detection in heavy-ion storage rings and first experimental results

    Energy Technology Data Exchange (ETDEWEB)

    Sanjari, Mohammad Shahab

    2013-04-26

    Nuclear astrophysics studies on highly charged radionuclides benefit from accelerator facilities with storage rings, where exotic nuclides produced with small yields can be efficiently investigated. Currently there are two accelerator facilities capable of storing highly charged heavy ions, GSI in Darmstadt and IMP in Lanzhou. Non-destructive detection methods are often used for in-flight measurements based on frequency analysis. The sensitivity of such detection systems are of primary importance specially when number of stored ions is small. Furthermore, since the exotic nuclides of interest are as a rule short-lived, the detectors must be fast. One common form of such detectors are parallel plate SCHOTTKY monitors, on which particles induce a mirror charge at each passage. This method has been successfully used at ESR experimental storage ring of GSI since 1991. In this work we describe a new resonant SCHOTTKY pickup operating as a high sensitive cavity current monitor which was mounted and commissioned in the ESR early 2010. It was successfully used in several storage ring experiments. A very similar pickup was mounted in CSRe at IMP Lanzhou in 2011. First in-ring tests have been performed and new experimental results are pending. The spectral analysis of acquired signals by the new detector has enabled a broad range of new physics experiments. The theory of operation and first experimental results and future perspectives are presented in this thesis.

  3. Serving transgender people: clinical care considerations and service delivery models in transgender health.

    Science.gov (United States)

    Wylie, Kevan; Knudson, Gail; Khan, Sharful Islam; Bonierbale, Mireille; Watanyusakul, Suporn; Baral, Stefan

    2016-07-23

    The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people.

  4. Potential ecosystem service delivery by endemic plants in New Zealand vineyards: successes and prospects

    Directory of Open Access Journals (Sweden)

    Morgan W. Shields

    2016-06-01

    Full Text Available Vineyards worldwide occupy over 7 million hectares and are typically virtual monocultures, with high and costly inputs of water and agro-chemicals. Understanding and enhancing ecosystem services can reduce inputs and their costs and help satisfy market demands for evidence of more sustainable practices. In this New Zealand work, low-growing, endemic plant species were evaluated for their potential benefits as Service Providing Units (SPUs or Ecosystem Service Providers (ESPs. The services provided were weed suppression, conservation of beneficial invertebrates, soil moisture retention and microbial activity. The potential Ecosystem Dis-services (EDS from the selected plant species by hosting the larvae of a key vine moth pest, the light-brown apple moth (Epiphyas postvittana, was also quantified. Questionnaires were used to evaluate winegrowers’ perceptions of the value of and problems associated with such endemic plant species in their vineyards. Growth and survival rates of the 14 plant species, in eight families, were evaluated, with Leptinella dioica (Asteraceae and Acaena inermis ‘purpurea’ (Rosaceae having the highest growth rates in terms of area covered and the highest survival rate after 12 months. All 14 plant species suppressed weeds, with Leptinella squalida, Geranium sessiliforum (Geraniaceae, Hebe chathamica (Plantaginaceae, Scleranthus uniflorus (Caryophyllaceae and L. dioica, each reducing weed cover by >95%. Plant species also differed in the diversity of arthropods that they supported, with the Shannon Wiener diversity index (H′ for these taxa ranging from 0 to 1.3. G. sessiliforum and Muehlenbeckia axillaris (Polygonaceae had the highest invertebrate diversity. Density of spiders was correlated with arthropod diversity and G. sessiliflorum and H. chathamica had the highest densities of these arthropods. Several plant species associated with higher soil moisture content than in control plots. The best performing species

  5. 34 CFR 303.525 - Delivery of services in a timely manner.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Delivery of services in a timely manner. 303.525... Matters § 303.525 Delivery of services in a timely manner. Each lead agency is responsible for the... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM...

  6. Compact Optical Discs and the World Wide Web: Two Mediums in Digitized Information Delivery Services

    Directory of Open Access Journals (Sweden)

    Ziyu Lin

    1999-10-01

    Full Text Available

    頁次:40-52

    Compact optical discs (CDs and the World Wide Web (the Web are two mechanisms that contemporary libraries extensively use for digitized information storage, dissemination, and retrieval. The Web features an unparalleled global accessibility free from many previously known temporal and spatial restrictions. Its real-time update capability is impossible for CDs. Web-based information delivery can reduce the cost in hardware and software ownership and management of a local library, and provide one-to-one zcustomization to better serve library's clients. The current limitations of the Web include inadequate speed in data transmission, particularly for multimedia applications, and its insufficient reliability, search capabilities, and security. In comparison, speed, quality, portability, and reliability are the current advantages of CDs over the Web. These features, together with the trend in the PC industry and market, suggest that CDs will exist and continue to develop. CD/Web hybrids can combine the best of both developing mechanisms and offer optimal results. Through a comparison of CDs and the Web, it is argued that the functionality and unique features of a technology determine its future.

  7. Analytical and numerical calculation of the second-order moment of the beam using a capacitive pickup

    Directory of Open Access Journals (Sweden)

    Joel Alain Tsemo Kamga

    2016-04-01

    Full Text Available Beam emittance has particular importance in particle physics, because it provides information about the quality of the particle beam. There are many techniques for measuring the beam emittance, such as that proposed by Miller et al. [Report No. SLAC-PUB-3186, (A (1983]. This technique is based on determining the emittance by measuring the second-order moment of the beam using quadrupole pickups consisting of four symmetrical electrodes placed around the beam pipe at 90° intervals, respectively. Based on Miller’s approach, two signal processing methods are generally used to get the quadrupole moment of the beam, namely the difference over sum and the log ratio [P. Li et al., IEEE Nuclear Science Symposium Conference Record, N24-404, 2007, pp. 1675–1678] methods. However, these traditional methods provide results with a good accuracy only for a well centered beam. The method presented in this paper, which starts with Miller’s approach, considerably reduces the impact of the dipole signal on the quadrupole moment measurement for both small and large values of the beam position. Furthermore, a methodology for the numerical determination of the sensitivity of quadrupole pickups will be presented.

  8. The nursing contribution to chronic disease management: a whole systems approach: Report for the National Institute for Health Research Service Delivery and Organisation programme

    OpenAIRE

    Kendall , Sally; Wilson, Patricia M.; Procter, Susan; Brooks, Fiona; Bunn, Frances; Gage, Heather; McNeilly, Elaine

    2010-01-01

    Background Transforming the delivery of care for people with Long Term Conditions (LTCs) requires understanding about how health care policies in England and historical patterns of service delivery have led to different models of chronic disease management (CDM). It is also essential in this transformation to analyse and critique the models that have emerged to provide a more detailed evidence base for future decision making and better patient care. Nurses have made, and continue to make, ...

  9. Auditing Information System : Delivery Product Service

    Directory of Open Access Journals (Sweden)

    Purwoko Purwoko

    2011-05-01

    Full Text Available Purpose of the research is to ensure the securities of information system asset and to ensure if informa-tion system support the operational and data collected was valid. Research method that used in this research were library studies and field studies. Field studies such an observation, questioner, and inter-view. the expected result are founding the weakness of security management control, operational man-agement control, input control, and output control of risk happened in the company. Conclusion of this research are the system on the company work good and there’s no potential risk happened and make an impact to the delivery process of information system.Index Terms - Auditing Information system, Delivery product process.

  10. Service delivery: Focus on Dipaleseng local municipality: Mpumalanga

    Directory of Open Access Journals (Sweden)

    S'bonisile Zama

    2013-12-01

    Full Text Available The supply or lack of services impacts on people's quality of life, and so the Constitution of South Africa and other strategy documents emphasise the provision of services to all South African citizens irrespective of colour or creed. The services are vast and the responsibility for provision is divided between national, provincial and local authorities. This paper focuses on the delivery of services whose responsibility and accountability lies with the local municipalities, including: water; electricity; sanitation and refuse removal. The paper also explores the background to the recent unrest in the country with a focus on Dipaleseng Municipality, looking at its socio-economic situation, and challenges which include poverty, economic stability and provision of basic services. Sources of data include the South African media, journal articles, relevant documents, websites and databases.

  11. Service delivery and pharmacotherapy for alcohol use disorder in the era of health reform: Data from a national sample of treatment organizations

    Science.gov (United States)

    Knudsen, Hannah K.; Roman, Paul M.

    2015-01-01

    Background Although there is a growing literature examining organizational characteristics and medication adoption, little is known about service delivery differences between specialty treatment organizations that have and have not adopted pharmacotherapy for alcohol use disorder (AUD). This study compares adopters and non-adopters across a range of treatment services, including levels of care, availability of tailored services for specific populations, treatment philosophy and counseling orientations, and adoption of comprehensive wraparound services. Methods In-person interviews were conducted with program leaders from a national sample of 372 organizations that deliver AUD treatment services in the US. Results About 23.6% of organizations had adopted at least one AUD medication. Organizations offering pharmacotherapy were similar to non-adopters across many measures of levels of care, tailored services, treatment philosophy, and social services. The primary area of difference between the two groups was for services related to health problems other than AUD. Pharmacotherapy adopters were more likely to offer primary medical care, medications for smoking cessation, and services to address co-occurring psychiatric conditions. Conclusions Service delivery differences were modest between adopters and non-adopters of AUD pharmacotherapy, with the exception of health-related services. However, the greater adoption of health-related services by organizations offering AUD pharmacotherapy represents greater medicalization of treatment, which may mean these programs are more strongly positioned to respond to opportunities for integration under health reform. PMID:25893539

  12. 77 FR 44306 - Service Delivery Plan

    Science.gov (United States)

    2012-07-27

    ...) Deliver quality disability decisions and services; (2) provide quality service to the public; (3) preserve... significantly to the Nation's economy. As we develop our plan, we are interested in hearing from you, our... responding to requests for verifying benefit amounts and assisting people with claims for other Federal...

  13. Document Delivery Services around the World

    Directory of Open Access Journals (Sweden)

    Ashrafosadat Foladi

    2008-04-01

    Full Text Available Given the importance of information access versus collection, the present study identified and investigated ten most important document delivery websites which had the highest frequency of citations in online directories and printed sources. The evaluation was based on the indicators and policies of Iranian Scientific Information and Documentation Center (IRANDOC. These included document diversity, document request mechanisms, document delivery options, response time, payment options, costs, and copy right clearance. The findings were then processed statistically using SPSS. It was found that based on document diversity BLDSC, LHL and DocDeliver are the frontrunners. On the account of subject comprehensiveness, Doc Deliver, BLDSC, Infotrieve, Ingenta, ISI and UMI are at the same level. All ten sites studied covered basic sciences. BL is strong with respect to diversity of document delivery options, payment options and response time. ISI is most suitable when diversity in request options is required. Ingenta is suitable when diversity in payment options are required. NTIS is in the lead when special documents such as technical reports are required, while UMI is most suitable for Dissertations and rare books

  14. Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates.

    Science.gov (United States)

    Hamidi, Samer

    2015-01-01

    A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers.

  15. Collaborative Service Delivery: From Instruction to Implementation

    Science.gov (United States)

    Lundblom, Erin Elizabeth Gill

    2012-01-01

    Legal mandates, educational reform, and professional policy changes, have emphasized the need to promote the integration of services for students with communication impairments within the general education curriculum. However, speech-language pathologists (SLPs) continue to report the provision of primarily pull-out services with intervention…

  16. Converting Student Support Services to Online Delivery.

    Science.gov (United States)

    Brigham, David E.

    2001-01-01

    Uses a systems framework to analyze the creation of student support services for distance education at Regents College: electronic advising, electronic peer network, online course database, online bookstore, virtual library, and alumni services website. Addresses the issues involved in converting distance education programs from print-based and…

  17. A cross-sectional study of migrant women with reference to their antenatal care services utilization and delivery practices in an urban slum of Mumbai

    Directory of Open Access Journals (Sweden)

    Vijay Loknath Badge

    2016-01-01

    Full Text Available Introduction: Migrant is a vulnerable population. They face several barriers in accessing health services. The immigration status presents various challenges for maternity services utilization. So this study was conducted (1 to estimate proportion of women utilizing full ANC package and to find out reasons for its nonutilization (2 to estimate the proportion of institutional deliveries and reasons for home deliveries. Methods: A cross-sectional community based study was conducted among migrant women in reproductive age group in an urban slum. The sample size was 120. Multistage simple random sampling was done. Results: Maximum numbers of migrants (71.7% were from Uttar Pradesh. Sixty two percent married before the age of 18 years. Full ANC package was received by only 18% migrants. Proportion of home deliveries was 12%, and all were conducted by Untrained Dai. Lack of transport facility and availability of Dai (local birth attendant were the reasons mentioned for home delivery. For nonutilization of full ANC package, far location of health center (30%; it is not necessary (25.8%; and family did not allow them to visit health center (21.8% were the reasons mentioned. Religion and type of family were significantly associated with nonutilization of full ANC package. Conclusion: The present study revealed low utilization of ANC services and high proportion of home deliveries among the migrant women even after availability of health facilities for providing ANC care and to conduct deliveries in urban area.

  18. The post-2015 delivery of universal and sustainable access to infrastructure services. Working Paper

    Energy Technology Data Exchange (ETDEWEB)

    Doczi, Julian, Dorr, Tobias; Mason, Nathaniel; Scott, Andrew

    2013-06-15

    In this new working paper, the authors focus specifically on what would be necessary to achieve High Level Panel-style goals and targets for water, energy and transport, if these were to be eventually adopted by world leaders. In all three cases, much of the advocacy - and the proposed High Level Panel goals - have emphasized the need to strive for universal and sustainable access to at least basic levels of services from these sectors. Many of the proposals for post-2015 goals and targets appear ambitious, but what would it take to achieve them? This paper assesses what is needed to achieve goals for universal and sustainable access to infrastructure, specifically water, energy and transport. Using illustrative goals and targets, the paper reviews the development challenges in each sector, and what will be necessary to overcome the barriers to universal and sustainable access to water, energy and transport infrastructure services, in the areas of governance, finance, capacity development and environmental protection. The paper ends with general conclusions about infrastructure in the post-2015 development agenda.

  19. Comparing Service Delivery Models for Children with Developmental Delays in Canada: Adaptive and Maladaptive Behaviours, Parental Perceptions of Stress and of Care

    Science.gov (United States)

    Sladeczek, Ingrid E.; Fontil, Laura; Miodrag, Nancy; Karagiannakis, Anastasia; Amar, Daniel; Amos, Janet

    2017-01-01

    This study compares two service delivery models (community-based and centre-based), examining them in light of children's adaptive and maladaptive behaviours, and parental perceptions of stress and of care. More specifically, parents of 96 children with developmental delays assessed their children's adaptive and maladaptive behaviours and rated…

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

    DEFF Research Database (Denmark)

    Leedo, Eva; Gade, Josephine; Granov, Sabrina

    2017-01-01

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

  1. Systematic review of pathways for the delivery of allergy services

    Science.gov (United States)

    Cummins, Carole; Lilford, Richard; Roberts, Tracy

    2017-01-01

    Objectives The incidence and prevalence of allergies worldwide has been increasing and allergy services globally are unable to keep up with this increase in demand. This systematic review aims to understand the delivery of allergy services worldwide, challenges faced and future directions for service delivery. Methods A systematic scoping review of Ovid, EMBASE, HMIC, CINAHL, Cochrane, DARE, NHS EED and INAHTA databases was carried out using predefined inclusion and exclusion criteria. Data on the geographical region, study design and treatment pathways described were collected, and the findings were narratively reported. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results 205 publications were screened and 27 selected for review. Only 3 were prospective studies, and none included a control group. There were no eligible publications identified from North America, Africa, Australia and most parts of Asia. Most publications relate to allergy services in the UK. In general, allergy services globally appear not to have kept pace with increasing demand. The review suggests that primary care practitioners are not being adequately trained in allergy and that there is a paucity of appropriately trained specialists, especially in paediatric allergy. There appear to be considerable barriers to service improvement, including lack of political will and reluctance to allocate funds from local budgets. Conclusions Demand for allergy services appears to have significantly outpaced supply. Primary and secondary care pathways in allergy seem inadequate leading to poor referral practices, delays in patient management and consequently poor outcomes. Improvement of services requires strong public and political engagement. There is a need for well-planned, prospective studies in this area and a few are currently underway. There is no evidence to suggest that any given pathway of service provision is better than

  2. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

    Science.gov (United States)

    Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

    2017-01-05

    Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. 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. Centers for independent living and secondary transition collaboration: characteristics for enhanced service delivery for adolescents in the United States.

    Science.gov (United States)

    Plotner, Anthony J; Shogren, Karrie A; Shaw, Leslie A; VanHorn Stinnett, Chelsea; Seo, Hyojeong

    2017-06-01

    Research involving secondary transition practices indicates a growing implementation of interagency collaboration to maximize service delivery to support students transitioning from school to adult life. Centers for Independent Living (CILs) are often excluded from collaborative partnerships and denied the opportunity to contribute as a valued stakeholder in the transition process. A total of 189 CIL professionals representing represented 38 states completed the online survey to (a) identify to what degree does the factor structure of Thompson's Collaboration Survey holds for CIL professionals and (b) explore what specific CIL professional and agency characteristics predict greater collaboration between CILs and local education agencies (LEAs). Additionally (c) researchers sought to determine the degrees to which greater self-reported collaboration predicts more frequent transition services provided to transition-age youth by CIL professionals. Results indicated that the factor structure proposed by Thompson was confirmed in a sample of CIL professionals. None of the agency or individual characteristics (i.e., number of high schools partnered with, number of students served, amount of training in transition services, and importance of collaboration between high schools and agencies for transition) predicted greater collaboration with LEAS. When analyzing the effects of degree of collaboration on the services provided, high ratings on three of the five collaborative dimensions predicted a higher likelihood of providing services to transition-age youth. This study suggests that more training and experience of CIL professionals does not necessarily lead to greater collaboration. Additionally, the findings suggest that collaborative team structure is more important than social capital collaborative dimensions in leading to frequent services from CILs to transition-age youth. Implications for rehabilitation Extant literature suggests that secondary transition

  4. Pickup Ion Production in the Global Heliosphere and Heliosheath and Their Diagnostics by Fluxes of Energetic Neutral Atoms

    Science.gov (United States)

    Wu, Y.

    2015-12-01

    An anisotropic particle transport model, based on an expansion of a focused transport equation in Legendre polynomials, is used here as a tool to analyze the distributions of pickup ions (PUIs) in the heliosphere and heliosheath. A three-dimensional, MHD-kinetic model for flows of a thermal plasma, neutral atoms and PUIs has been developed. The preliminary results from our model are in qualitative agreement with observations made by New Horizons, Ulysses, Voyager 1 and 2. All-sky maps of energetic neutral atoms (ENA) fluxes with energies of about 0.2-6 keV based on our current PUI model are qualitatively similar to IBEX-Hi distributed ENA maps. Also, simulated spectra of ENA fluxes nearly match IBEX-Hi spectra of distributed ENA fluxes. It is demonstrated that preserving some pitch-angle information of the PUI distribution is important for correctly interpreting the data.

  5. Delivery of satellite based broadband services

    Science.gov (United States)

    Chandrasekhar, M. G.; Venugopal, D.

    2007-06-01

    Availability of speedy communication links to individuals and organizations is essential to keep pace with the business and social requirements of this modern age. While the PCs have been continuously growing in processing speed and memory capabilities, the availability of broadband communication links still has not been satisfactory in many parts of the world. Recognizing the need to give fillip to the growth of broadband services and improve the broadband penetration, the telecom policies of different counties have placed special emphasis on the same. While emphasis is on the use of fiber optic and copper in local loop, satellite communications systems will play an important role in quickly establishing these services in areas where fiber and other communication systems are not available and are not likely to be available for a long time to come. To make satellite communication systems attractive for the wide spread of these services in a cost effective way special emphasis has to be given on factors affecting the cost of the bandwidth and the equipment. As broadband services are bandwidth demanding, use of bandwidth efficient modulation technique and suitable system architecture are some of the important aspects that need to be examined. Further there is a need to re-look on how information services are provided keeping in view the user requirements and broadcast capability of satellite systems over wide areas. This paper addresses some of the aspects of delivering broadband services via satellite taking Indian requirement as an example.

  6. QoE aware Service delivery in distributed environment

    OpenAIRE

    LAGHARI, Khalil Ur Rehman; Crespi, Noel; MOLINA, Benjamin; Palau, Carlos E.

    2011-01-01

    International audience; Service delivery and customer satisfaction are strongly related items for a correct commercial management platform. Technical aspects targeting this issue relate to QoS parameters that can be handled by the platform, at least partially. Subjective psychological issues and human cognitive aspects are typically unconsidered aspects and they directly determine the Quality of Experience (QoE). These factors finally have to be considered as key input for a successful busine...

  7. Ensuring 3es and Responsiveness in the Delivery of Educational Services in the Autonomous Region in Muslim Mindanao, Philippines

    Directory of Open Access Journals (Sweden)

    Sapia Moalam Abdulrachman

    2013-08-01

    Full Text Available The Autonomous Region in Muslim Mindanao (ARMM is a public organization in the Philippines located in between the national government and the local governments. It performs unique functions quite distinct from other public organizations in the coun-try, as it performs both political and administrative functions. Using unobtrusive research design, as it relies on mostly secondary data, this paper analyzes the educational system in the region and proposes strategies in attaining administrative efficiency, economy, effectiveness and responsiveness. The paper starts with the introduction which consist of the background and statement of the problem. It is followed by a review of theoretical perspective and then by the research methodology. The fourth part portrays the findings of the study which include: DepEd ARMM resources; the management of DepEd ARMM, and the management outputs such as: net enrollment ratio, achievement rate and literacy rate. The fifth part of the paper deals with the analyses and conclusion. The paper concludes that in addition to certain structural innovation, inculcation of appropriate work ethics in accordance with the Ethi-cal Standards Act, the Anti-Corruption Law, the Civil Service Rules and Regulations as well as the Islamic Practices on Employment must be enshrined in the reform agenda. Finally, among other things that could facilitate the attainment of 3Es and R in the delivery of educational services is a strategy that requires the joint collaboration and teamwork between the civil society, non-government organizations and government organizations in the region.

  8. Administrative Coordination in Non-Profit Human Service Delivery Networks: The Role of Competition and Trust.

    Science.gov (United States)

    Bunger, Alicia C

    2013-12-01

    Non-profit human service organizations operating within the same regional network are often faced with dual pressure to compete as well as coordinate administrative operations (by sharing funding, staff or space) to enhance efficiency. Emerging evidence has demonstrated that competing organizations coordinate, despite the risks. Trust, or perceived trustworthiness between two organizations may mitigate the negative influence of competition on coordination, however there have been few explicit tests of this hypothesis among non-profit organizations. Drawing on quantitative data collected from a network of 36 non-profit children's behavioral health organizations, this paper empirically tests how competition and perceived trustworthiness interact to influence administrative coordination. Results support the hypothesis that trustworthiness moderates the influence of competition on administrative coordination. Findings suggest that as competing non-profit leaders build trust, the more their agencies coordinate their administrative functions. This study highlights the importance of leaders' perceptions for organizational strategy.

  9. Clinical issues in mental health service delivery to refugees.

    Science.gov (United States)

    Gong-Guy, E; Cravens, R B; Patterson, T E

    1991-06-01

    Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.

  10. 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

  11. The Leadership Role in Transitioning an Urban Secondary School from a Traditional Service Delivery Model to a Co-Teaching Service Delivery Model for Students with Disabilities: A Phenomenological Case Study

    Science.gov (United States)

    McDonald, Ginni E.

    2013-01-01

    This research studies the leadership role in transitioning from a traditional service delivery model to a co-teaching service delivery model for students with disabilities. While there is an abundant amount of information on the service delivery model of co-teaching, sustaining co-teaching programs, and effective co-teaching programs for students…

  12. Integration of agglutination assay for protein detection in microfluidic disc using Blu-ray optical pickup unit and optical fluid scanning

    DEFF Research Database (Denmark)

    Uddin, Rokon; Burger, Robert; Donolato, Marco;

    2015-01-01

    We present a novel strategy for thrombin detection by combining a magnetic bead based agglutination assay and low-cost microfluidic disc. The detection method is based on an optomagnetic readout system implemented using a Blu-ray optical pickup unit (OPU) as main optoelectronic component. The assay...

  13. Integration of agglutination assay for protein detection in microfluidic disc using Blu-ray optical pickup unit and optical fluid scanning

    DEFF Research Database (Denmark)

    Uddin, Rokon; Burger, Robert; Donolato, Marco;

    2015-01-01

    We present a novel strategy for thrombin detection by combining a magnetic bead based agglutination assay and low-cost microfluidic disc. The detection method is based on an optomagnetic readout system implemented using a Blu-ray optical pickup unit (OPU) as main optoelectronic component. The ass...

  14. Institutional Change in Delivery of Dental Services: A Marketing Perspective

    Science.gov (United States)

    Capon, Noel

    1982-01-01

    The recent appearance and growth of new delivery systems for dental services is examined from a marketing perspective. Analysis reveals that the growth of low priced, high throughput operations is consistent not only with marketing principles, but with the development of American retail institutions in general. Options for independent dentists in the face of this new competitive environment are discussed. (Am J Public Health 1982; 72:679-683.) PMID:7091457

  15. 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.

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

    Science.gov (United States)

    Gushrowski, Barbara A

    2011-01-01

    Question: How can library staff develop and promote a document delivery service and then expand the service to a wide audience? Setting: The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. Method: 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. Main results: 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. Conclusion: 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. PMID:21753911

  17. Pediatric Tape: Accuracy and Medication Delivery in the National Park Service

    Directory of Open Access Journals (Sweden)

    Danielle D. Campagne

    2015-10-01

    Full Text Available Introduction: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape. Methods: This study was a two-period, two-treatment crossover trial using simulated pediatric patients in the prehospital setting. Each participant was presented with two emergent scenarios; participants were randomized to which case they encountered first, and to which case used the National Park Service (NPS emergency medical services (EMS length-based pediatric emergency resuscitation tape. In the control (without tape case, providers used standard methods to determine medication dosing (e.g. asking parents to estimate the patient’s weight; in the intervention (with tape case, they used the NPS EMS length-based pediatric emergency resuscitation tape. Each scenario required dosing two medications (Case 1 [febrile seizure] required midazolam and acetaminophen; Case 2 [anaphylactic reaction] required epinephrine and diphenhydramine. Twenty NPS EMS providers, trained at the Parkmedic/Advanced Emergency Medical Technician level, served as study participants. Results: The only medication errors that occurred were in the control (no tape group (without tape: 5 vs. with tape: 0, p=0.024. Time to determination of medication dose was significantly shorter in the intervention (with tape group than the control (without tape group, for three of the four medications used. In case 1, time to both midazolam and acetaminophen was significantly faster in the intervention (with tape group (midazolam: 8.3 vs. 28.9 seconds, p=0.005; acetaminophen: 28.6 seconds vs. 50.6 seconds, p=0.036. In case 2, time to epinephrine did not differ (23.3 seconds vs. 22.9 seconds, p=0.96, while time to diphenhydramine was significantly shorter in the intervention (with tape group (13 seconds vs. 37.5 seconds, p<0.05. Conclusion: Use of a length-based pediatric emergency

  18. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Directory of Open Access Journals (Sweden)

    Aggarwal R

    2015-11-01

    Full Text Available Reena Aggarwal,1,2 Tim Swanwick2 1Women's Health, Whittington Health, London, UK; 2Health Education England, North Central and East London, London, UK Abstract: Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline. Keywords: National Health Service, junior doctors, quality improvement, management, health care

  19. Uninsured immigrant and refugee children presenting to Canadian paediatric emergency departments: Disparities in help-seeking and service delivery.

    Science.gov (United States)

    Rousseau, Cécile; Laurin-Lamothe, Audrey; Rummens, Joanna Anneke; Meloni, Francesca; Steinmetz, Nicolas; Alvarez, Fernando

    2013-11-01

    Access to health care for medically uninsured immigrant and refugee children is a public health concern due to the consequences of delayed or substandard care for child development and health. To explore possible differences in help-seeking and service delivery across migratory statuses, institutions and provinces. A review was undertaken of 2035 emergency files of immigrant, refugee and undocumented children without provincial health care coverage who sought care at three major paediatric hospitals in Montreal (Quebec) and Toronto (Ontario) during 2008 and 2009. Refugee claimant children with Interim Federal Health Program benefits consulted for less urgent problems than the overall hospital population, except in one hospital that had a multicultural paediatric ambulatory clinic. Undocumented children and new permanent resident immigrant children within the three-month waiting period for provincial health care coverage were over-represented in the very urgent triage category and presented more often for injuries, trauma and mental health problems than did refugee claimant children. Wide interhospital differences suggest that the predicament of limited access to health care of these groups of vulnerable medically uninsured children needs to be addressed through further research to inform policies and develop training.

  20. Poor linkages in maternal health care services-evidence on antenatal care and institutional delivery from a community-based longitudinal study in Tigray region, Ethiopia.

    Science.gov (United States)

    Melaku, Yohannes Adama; Weldearegawi, Berhe; Tesfay, Fisaha Haile; Abera, Semaw Ferede; Abraham, Loko; Aregay, Alemseged; Ashebir, Yemane; Eshetu, Friehiwot; Haile, Ashenafi; Lakew, Yihunie; Kinsman, John

    2014-12-19

    Progress towards attaining the maternal mortality and maternal health targets set by Millennium Development Goal 5 has been slow in most African countries. Assessing antenatal care and institutional delivery service utilization and their determinants is an important step towards improving maternal health care services. Data were drawn from the longitudinal database of Kilite-Awlaelo Health and Demographic Surveillance System. A total of 2361 mothers who were pregnant and who gave birth between September 2009 and August 2013 were included in the analysis. Potential variables to explain antenatal care and institutional delivery service utilization were extracted, and descriptive statistics and logistic regression were used to determine the magnitude of maternal health care service utilization and associated factors, respectively. More than three-quarters, 76% [95% CI: 74.8%-78.2%] (n = 1806), of mothers had undergone at least one antenatal care visit during their previous pregnancy. However, only 27% [95% CI: 25.3%-28.9%] (n = 639) of mothers gave birth at a health institution. Older mothers, urban residents, mothers with higher education attainment, and farmer mothers were more likely to use antenatal care. Institutional delivery services were more likely to be used among older mothers, urban residents, women with secondary education, mothers who visited antenatal care, and mothers with lower parity. Despite a relatively high proportion of mothers attending antenatal care services at least once, we found low levels of institutional delivery service utilization. Health service providers in Kilite-Awlaelo should be particularly vigilant regarding the additional maternal health needs of rural and less educated women with high parity.

  1. Observations of Low-Frequency Magnetic Waves due to Newborn Interstellar Pickup Ions Using ACE, Ulysses, and Voyager Data

    Science.gov (United States)

    Smith, Charles W.; Aggarwal, Poornima; Argall, Matthew R.; Burlaga, Leonard F.; Bzowski, Maciej; Cannon, Bradford E.; Gary, S. Peter; Fisher, Meghan K.; Gilbert, Jason A.; Hollick, Sophia J.; Isenberg, Philip A.; Joyce, Colin J.; Murphy, Neil; Nuno, Raquel G.; Pine, Zackary B.; Richardson, John D.; Schwadron, Nathan A.; Skoug, Ruth M.; Sokół, Justyna M.; Taylor, David K.; Vasquez, Bernard J.

    2017-09-01

    Wave excitation by newborn interstellar pickup ions (PUIs) plays a significant role in theories that attempt to describe IBEX and Voyager observations in the solar wind and heliosheath. The same dynamic processes can be far-reaching and extend into the inner heliosphere to at least 1AU and likely to smaller heliocentric distances. While the high-resolution magnetic field measurements required to study these waves are not yet available in the heliosheath, we have studied a range of available observations and found evidence of waves due to interstellar PUIs using ACE (1998–2015 at 1 AU), Ulysses (1996–2006 at 2 to 5 AU, high and low latitudes) and Voyager (1978–1979 and 2 to 6 AU) observations. Efforts to extend the Voyager observations to 35 AU are ongoing. We have examined these data sets and report on observations of low-frequency waves that result from newborn interstellar pickup H+ and He+ ions. Although not as common as theory originally predicted, we presently have identified 524 independent occurrences. Our conclusion from studying these waves is that they are seen only when the ambient turbulence is sufficiently weak. The instability that generates these waves requires a slow accumulation of wave energy over several to tens of hours to achieve observable wave amplitudes. In regions where the turbulence is moderate to strong, the turbulence absorbs the wave energy before it can reach observable levels and transports the energy to the dissipation scales where it heats the background thermal particles. Only intervals with the weakest turbulence will permit energy accumulation over this time scale. These conditions are most often, but not exclusively, achieved in solar wind rarefaction regions.

  2. Knowledge and perception of extension workers towards ict utilization in agricultural extension service delivery in Gazipur district of Bangladesh

    Directory of Open Access Journals (Sweden)

    F.A. Prodhan

    2014-12-01

    Full Text Available The primary purpose of the study was to assess the extent of knowledge and perception of extension workers towards ICT utilization and to determine the relationship between the selected characteristics of the respondents and knowledge and perception of extension workers towards ICT utilization in extension service delivery. The study was conducted in Gazipur district and comprised proportionate random sample of 90 extension workers from five upazila of Gazipur district. A pre-tested interview schedule was used to collect data from the respondents. To measure the knowledge on ICT utilization 35 statements were selected regarding 7 ICT with five possible answer of each tools and a score of one was given to the right answer and zero to the wrong answer alternatively to measure the perception of the respondents rated each of 10 statements ICT utilization in agriculture on a 5-point Likert type scale and the total of these ratings formed perception index. The result of the study showed that out of seven ICT tools the knowledge of extension workers was highest in case of MS Word this was followed by internet/ web service and the lowest knowledge was found in case of Geographical Information System. It is observed that an overwhelming majority (88.9% of agricultural extension workers in the study area had low to medium knowledge towards ICT utilization. Findings reveal that the respondents had top most perception on the ICT utilization in respect of ‘Extension work can be greatly enhanced by ICT’ followed by on ‘The benefits of ICT use outweigh the financial burden involved’. The result also indicated that more than fourth-fifth (84.4% of the respondents had medium to high perception towards ICT utilization. There were significant relationship between service experience and use of the information sources of the respondents with their knowledge towards ICT utilization conversely innovativeness, cosmopoliteness and job satisfaction of the

  3. Sputtering of the Europa surface by thermal ions from the torus and pickup ions in a diverted flow

    Science.gov (United States)

    Dols, Vincent J.; Cassidy, Timothy A.; Bagenal, Fran; Crary, Frank; Delamere, Peter A.

    2016-10-01

    Europa's atmosphere is very tenuous and is mainly composed of O2. It is thought to be produced by ion bombardment of its icy surface. Several ion populations may contribute to this sputtering:1) The thermal plasma of the torus (~ 1keV including ram velocity), which may be partially diverted around the moon by the ionospheric currents2) The energetic sulfur and hydrogen ions (~10 keV-MeV), which diffuse inward toward Europa's orbit3) and possibly the newly ionized O2 molecules that are picked up by the torus flow and hit the surface.The relative contribution of each sputtering ion population has been debated for more than three decades with estimated O2 sputtering rates varying by ~2 order of magnitude. Modelers have historically focused on a single piece of the puzzle: plasma modelers assume a static atmosphere and tend not to check that their sources and losses are consistent with their prescribed atmosphere; while atmospheric modelers neglect the electro-dynamic interaction that diverts torus plasma around the moon, and limits the ion flux to the surface.In this work, we present a first step to compute self-consistently the atmospheric production by the bombardment of the thermal plasma and pickup O2+ ions.1) We calculate the plasma flow around Europa with a MHD model2) We use this flow in a multi-species physical chemistry model of the plasma-atmosphere interaction to compute the ion fluxes into Europa's surface.3) We compute the production rate of O2 resulting from the ice sputtering by thermal and pickup ions and compare the resulting atmospheric source rate to previously published results.

  4. Water service delivery - the weakest link

    CSIR Research Space (South Africa)

    Wall, K

    2009-05-01

    Full Text Available and operators • There are ~ 2000 plumbers and other water service men in local government, but ~ 1100 vacancies. Plus more posts required – largely for maintenance • The majority of the 3 000 to 5 000 operators working in the 2 000+ water and wastewater... and systems (e.g. procurement processes) that could enable more assistance than they do; – poor operation and maintenance: the services have been delivered, yes, in the sense that the pipe is in the ground -- but operation and maintenance...

  5. Improving the delivery of veterinary services in Africa: insights from the empirical application of transaction costs theory in Uganda and Kenya.

    Science.gov (United States)

    Ilukor, J

    2017-04-01

    This paper presents a summary of findings from a research project that examined institutional arrangements for providing animal health services in Uganda and Kenya. Given the need to find solutions to the pervasive governance challenges encountered in the delivery of veterinary services in Africa, the study applied transaction economics theory to generate recommendations on how to improve the delivery of these services and minimise livestock production risks, including those that pose a risk to human health, e.g. zoonoses. The most notable recommendations are as follows: i) lower- and middle-income countries should invest in creating an enabling environment that supports the relationship between professional veterinarians and para-professionals, to ensure the timely reporting, treatment and control of animal diseases; ii) the provision of veterinary extension services should not focus solely on household 'heads', but also on other household members, such as wives and children, and on herdsmen; iii) strong government engagement is required in the provision of veterinary services for pastoral or extensive livestock production systems, because normal market forces have failed to attract professional veterinarians and trained para-professionals from the private sector to work in these sectors; iv) farmers must be empowered to hold service providers accountable, by the development and trialling of tools that would enable them to measure the quality of services that they receive and to verify the qualifications of different service providers; v) investment in veterinary education is vital, to ensure that enough qualified veterinary staff are available to offer veterinary services to farmers.

  6. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis

    Science.gov (United States)

    Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

    2017-01-01

    Objective Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. Setting The study focused on all 72 health districts of Zambia. Methods We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Results Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. Conclusions With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. PMID:28057650

  7. The anatomy of a service delivery disaster: how the UK’s tax agency goofed up. And what it means to one of their ‘customers'\\ud

    OpenAIRE

    Dunleavy, Patrick

    2010-01-01

    As a country Britain has spent billions of pounds on modernizing its public services, but often with very poor results. Patrick Dunleavy looks at the current debacle at Her Majesty’s Revenue and Customs over massive amounts of uncollected tax. Examining a single case in detail, he shows how the crisis of service delivery was entirely of the department’s own making, reflecting long-run problems of organizational culture and management\\ud \\ud

  8. Evaluating the Magnitude and Duration of Cold Load Pick-up on Residential Distribution Feeders Using Multi-State Load Models

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Kevin P.; Sortomme, Eric; Venkata, S. S.; Miller, Melanie T.; Ponder, Leslie

    2016-09-01

    The increased level of demand that is associated with the restoration of service after an outage, Cold Load Pick-Up (CLPU), can be significantly higher than pre-outage levels, even exceeding the normal distribution feeder peak demand. These high levels of demand can delay restoration efforts and in extreme cases damage equipment. The negative impacts of CLPU can be mitigated with strategies that restore the feeder in sections, minimizing the load current. The challenge for utilities is to manage the current level on critical equipment while minimizing the time to restore service to all customers. Accurately modeling CLPU events is the first step in developing improved restoration strategies that minimize restoration times. This paper presents a new method for evaluating the magnitude of the CLPU peak, and its duration, using multi-state load models. The use of multi-state load models allows for a more accurate representation of the end-use loads that are present on residential distribution feeders.

  9. Client satisfaction with service delivery of assistive technology for outdoor mobility

    NARCIS (Netherlands)

    Jedeloo, S; De Witte, LP; Linssen, BAJ; Schrijvers, AJP

    2002-01-01

    Purpose: In the decentralized Dutch service delivery system, client satisfaction levels for the provision of assistive technology (AT) for outdoor mobility for elderly and disabled persons was measured to investigate whether or not differences exist between local service delivery systems and if so,

  10. Client satisfaction with service delivery of assistive technology for outdoor mobility

    NARCIS (Netherlands)

    Jedeloo, S; De Witte, LP; Linssen, BAJ; Schrijvers, AJP

    Purpose: In the decentralized Dutch service delivery system, client satisfaction levels for the provision of assistive technology (AT) for outdoor mobility for elderly and disabled persons was measured to investigate whether or not differences exist between local service delivery systems and if so,

  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. 20 CFR 617.20 - Responsibilities for the delivery of reemployment services.

    Science.gov (United States)

    2010-04-01

    ... § 617.20 Responsibilities for the delivery of reemployment services. (a) State agency referral... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Responsibilities for the delivery of reemployment services. 617.20 Section 617.20 Employees' Benefits EMPLOYMENT AND TRAINING...

  13. 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

  14. 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

  15. Is there any role for community involvement in the community-based health planning and services skilled delivery program in rural Ghana?

    Science.gov (United States)

    Sakeah, Evelyn; McCloskey, Lois; Bernstein, Judith; Yeboah-Antwi, Kojo; Mills, Samuel; Doctor, Henry V

    2014-08-11

    In Ghana, between 1,400 and 3,900 women and girls die annually due to pregnancy related complications and an estimated two-thirds of these deaths occur in late pregnancy through to 48 hours after delivery. The Ghana Health Service piloted a strategy that involved training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). CHO-midwives collaborated with community members to provide skilled delivery services in rural areas. This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. We employed an intrinsic case study design with a qualitative methodology. We conducted 29 in-depth interviews with health professionals and community stakeholders. We used a random sampling technique to select the CHO-midwives in three Community-based Health Planning and Services (CHPS) zones for the interviews and a purposive sampling technique to identify and interview District Directors of Health Services from the three districts, the Regional Coordinator of the CHPS program and community stakeholders. Community members play a significant role in promoting skilled delivery care in CHPS zones in Ghana. We found that community health volunteers and traditional birth attendants (TBAs) helped to provide health education on skilled delivery care, and they also referred or accompanied their clients for skilled attendants at birth. The political authorities, traditional leaders, and community members provide resources to promote the skilled delivery program. Both volunteers and TBAs are given financial and non-financial incentives for referring their clients for skilled delivery. However, inadequate transportation, infrequent supply of drugs, attitude of nurses remains as challenges, hindering women accessing maternity services in rural areas. Mutual

  16. 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

  17. Healthcare service delivery: a literature review

    CSIR Research Space (South Africa)

    Arhete, LE

    2016-05-01

    Full Text Available fourteen year period, and intended to ensure that everyone, irrespective of race, gender, geographic location and socio-economic status, have unrestricted access to quality healthcare services, and as well protect them from any financial adversity...:162; Coovadia et al., 2009:828; Holtz & Elsawy, 2013:76-80): Persistent and deepening disparities, inequalities, and inequities in healthcare: Decades after the end of Apartheid dispensation, deep and deepening disparities, inequalities, and inequities...

  18. Breaking the Glass Ceiling: Increasing the Meaningful Involvement of Women Living With HIV/AIDS (MIWA) in the Design and Delivery of HIV/AIDS Services.

    Science.gov (United States)

    Carter, Allison; Greene, Saara; Nicholson, Valerie; O'Brien, Nadia; Sanchez, Margarite; de Pokomandy, Alexandra; Loutfy, Mona; Kaida, Angela

    2015-01-01

    The meaningful involvement of women living with HIV/AIDS (MIWA) is a key feature of women-centred HIV care, yet little is known about transforming MIWA from principle to practice. Drawing on focus group data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), we explored HIV-positive women's meaningful involvement in the design and delivery of HIV/AIDS services in British Columbia, Canada. In this article, we highlight the benefits and tensions that emerge as women traverse multiple roles as service users and service providers within their care communities, and the impact this has on their access to care and overall health.

  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. 77 FR 56652 - Notice of Service Delivery Area Designation for the Mashpee Wampanoag Indian Tribe

    Science.gov (United States)

    2012-09-13

    ...\\ Cow Creek Band of Umpqua Indians of Coos, OR \\14\\, Deshutes, OR, Oregon. Douglas, OR, Jackson, OR...-56658] [FR Doc No: 2012-22593] DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Notice of Service Delivery Area Designation for the Mashpee Wampanoag Indian Tribe AGENCY: Indian Health Service...

  1. Innovative Service Delivery for Secondary Prevention of PTSD in At-Risk OIF-OEF Service Men and Women

    Science.gov (United States)

    2015-02-01

    psychosocial domains. Exposure techniques are typically trauma -focused; thus, these techniques may not ameliorate depressive symptoms that bear more direct...efficiency (> .70), and robust psychometrics with a variety of trauma populations. Beck Depression Inventory-II (BDI): The BDI-II is a 21-item, 4...preliminary investigation. Psychological Trauma : Theory, Research, Practice, and Policy, 5(1): 93-100. PMID: 23869250. 12. Strachan, M.K., Gros, D.F

  2. Technological Challenges and Opportunities in the United States Education Information Network Collaboration and Service Delivery.

    Science.gov (United States)

    Ely, Donald P.

    The definition, role, and functions of "library" are changing. The National Library of Education (NLE) is in transition from a traditional library to a virtual library encompassing "one stop [any stop] shopping" through conventional and digital means. To adequately plan for the transition, the customer and potential customers…

  3. HIV and tuberculosis co-infection in Uganda: clinical management, immune reconstitution and health service delivery

    NARCIS (Netherlands)

    Hermans, S.M.

    2012-01-01

    Background In HIV-infected patients, tuberculosis (TB) occurs 20 to 30 times more often and is a leading cause of death. Triple combination antiretroviral therapy (cART) reduces mortality and risk of TB in HIV-infected patients. Uganda is a high-burden country of both HIV and TB; more than half of

  4. HIV and tuberculosis co-infection in Uganda: clinical management, immune reconstitution and health service delivery

    NARCIS (Netherlands)

    Hermans, S.M.

    2012-01-01

    Background In HIV-infected patients, tuberculosis (TB) occurs 20 to 30 times more often and is a leading cause of death. Triple combination antiretroviral therapy (cART) reduces mortality and risk of TB in HIV-infected patients. Uganda is a high-burden country of both HIV and TB; more than half of T

  5. Quality of caesarean delivery services and documentation in first-line referral facilities in Afghanistan: a chart review

    Directory of Open Access Journals (Sweden)

    Kim Young-Mi

    2012-03-01

    Full Text Available Abstract Background Increasing appropriate use and documentation of caesarean section (CS has the potential to decrease maternal and perinatal mortality in settings with low CS rates. We analyzed data collected as part of a comprehensive needs assessment of emergency obstetric and newborn care (EmONC facilities in Afghanistan to gain a greater understanding of the clinical indications, timeliness, and outcomes of CS deliveries. Methods Records were reviewed at 78 government health facilities expected to function as EmONC providers that were located in secure areas of the country. Information was collected on the three most recent CS deliveries in the preceding 12 months at facilities with at least one CS delivery in the preceding three months. After excluding 16 facilities with no recent CS deliveries, the sample includes 173 CS deliveries at 62 facilities. Results No CS deliveries were performed in the previous three months at 21% of facilities surveyed; all of these were lower-level facilities. Most CS deliveries (88% were classified as emergencies, and only 12% were referrals from another facility. General anesthesia was used in 62% of cases, and spinal or epidural anesthesia in 34%. Only 28% of cases were managed with a partograph. Surgery began less than one hour after the decision for a CS delivery in just 30% of emergency cases. Among the 173 cases, 27 maternal deaths, 28 stillbirths, and 3 early neonatal deaths were documented. In cases of maternal and fetal death, the most common indications for CS delivery were placenta praevia or abruption and malpresentation. In 62% of maternal deaths, the fetus was stillborn or died shortly after birth. In 48% of stillbirths, the fetus had a normal heart rate at the last check. Information on partograph use was missing in 38% of cases, information on parity missing in 23% of cases and indications for cesareans missing in 9%. Conclusions Timely referral within and to EmONC facilities would decrease

  6. New Zealand's health system: national policy goals and decentralized service planning and delivery.

    Science.gov (United States)

    Gauld, Robin

    2007-01-01

    To inaugurate the fifth year of its publication, The American Heart Hospital Journal (AHHJ) focused its Winter 2007 issue on health care systems from around the world, with 8 articles contributed by national leaders in their respective countries. Due to the interest and wide range of expertise in the international cardiac community, we will continue to publish Special Reports throughout 2007 on this topic. We invite members of the international community to share with readers of the AHHJ, their insights on the strengths and weaknesses of their respective health care and cardiac care systems, as well as their ideas and aspirations for future change.

  7. Study on the Prefecture-level Library’s Interlibrary Service and Document Delivery Service%地市级公共图书馆的馆际互借与文献传递服务研究

    Institute of Scientific and Technical Information of China (English)

    叶颖

    2016-01-01

    This paper expounds the current status of and problems in prefecture-level library’s ic library interlibrary service and document delivery service, analyzes the factors influencing prefecture-level library’s interlibrary service and document delivery service, and puts forward some methods for prefecture-level library to break through the dilemma.%阐述了地市级公共图书馆馆际互借/文献传递服务的现状与问题,分析了影响地市级公共图书馆馆际互借/文献传递服务的因素,提出了地市级公共图书馆走出困境的方法。

  8. Policies and Practices in the Delivery of HIV Services in Correctional Agencies and Facilities: Results from a Multi-Site Survey

    Science.gov (United States)

    Belenko, Steven; Hiller, Matthew; Visher, Christy; Copenhaver, Michael; O’Connell, Daniel; Burdon, William; Pankow, Jennifer; Clarke, Jennifer; Oser, Carrie

    2013-01-01

    HIV risk is disproportionately high among incarcerated individuals. Corrections agencies have been slow to implement evidence-based guidelines and interventions for HIV prevention, testing, and treatment. The emerging field of implementation science focuses on organizational interventions to facilitate adoption and implementation of evidence-based practices. A survey of among CJ-DATS correctional agency partners revealed that HIV policies and practices in prevention, detection and medical care varied widely, with some corrections agencies and facilities closely matching national guidelines and/or implementing evidence-based interventions. Others, principally attributed to limited resources, had numerous gaps in delivery of best HIV service practices. A brief overview is provided of a new CJ-DATS cooperative research protocol, informed by the survey findings, to test an organization-level intervention to reduce HIV service delivery gaps in corrections. PMID:24078624

  9. 78 FR 55731 - Notice of Service Delivery Area Designation for the Wilton Rancheria

    Science.gov (United States)

    2013-09-11

    ... HUMAN SERVICES Indian Health Service Notice of Service Delivery Area Designation for the Wilton... Indian Health Service (IHS) proposes the geographic boundaries of the Service Delivery Area (SDA) for the... Contract Health Service Delivery Area (CHSDA), for the purpose of operating a Contract Health Service...

  10. 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.

  11. Waste management service delivery to all

    CSIR Research Space (South Africa)

    Afrika, M

    2010-10-01

    Full Text Available One of the major challenges facing municipalities in South Africa is ensuring that all households within their areas of jurisdiction are provided with a basic level of waste service (DEAT, 2007). Huge waste service backlogs still exists...

  12. Clinic Attendance for Antiretroviral Pills Pick-Up among HIV-Positive People in Nepal: Roles of Perceived Family Support and Associated Factors.

    Directory of Open Access Journals (Sweden)

    Rakesh Ayer

    Full Text Available HIV-positive people's clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal.A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance.Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92, participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82, and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99. In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93, when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44, good (AOR = 0.14, 95% CI = 0.04, 0.46, and fair (AOR = 0.21, 95% CI = 0.06, 0.70.HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings. Service providers should also

  13. Asking the right questions: Scoping studies in the commissioning of research on the organisation and delivery of health services

    Directory of Open Access Journals (Sweden)

    Peckham Stephen

    2008-07-01

    Full Text Available Abstract Scoping studies have been used across a range of disciplines for a wide variety of purposes. However, their value is increasingly limited by a lack of definition and clarity of purpose. The UK's Service Delivery and Organisation Research Programme (SDO has extensive experience of commissioning and using such studies; twenty four have now been completed. This review article has four objectives; to describe the nature of the scoping studies that have been commissioned by the SDO Programme; to consider the impact of and uses made of such studies; to provide definitions for the different elements that may constitute a scoping study; and to describe the lessons learnt by the SDO Programme in commissioning scoping studies. Scoping studies are imprecisely defined but usually consist of one or more discrete components; most commonly they are non-systematic reviews of the literature, but other important elements are literature mapping, conceptual mapping and policy mapping. Some scoping studies also involve consultations with stakeholders including the end users of research. Scoping studies have been used for a wide variety of purposes, although a common feature is to identify questions and topics for future research. The reports of scoping studies often have an impact that extends beyond informing research commissioners about future research areas; some have been published in peer reviewed journals, and others have been published in research summaries aimed at a broader audience of health service managers and policymakers. Key lessons from the SDO experience are the need to relate scoping studies to a particular health service context; the need for scoping teams to be multi-disciplinary and to be given enough time to integrate diverse findings; and the need for the research commissioners to be explicit not only about the aims of scoping studies but also about their intended uses. This necessitates regular contact between researchers and

  14. Reforming delivery of urban services in developing countries: Evidence from a case study in India.

    OpenAIRE

    Sridhar, Kala Seetharam

    2006-01-01

    Given the importance of urban public services in attracting firm location, increasing employment and facilitating economic growth, in this paper, we examine the following questions: Is there a need for reforming public service delivery in Ludhiana (which is a city chosen under India's leading urban initiative), when judged against national benchmarks? Is there a relationship between the city's financial performance and its delivery of urban services? We develop several hypotheses. Next, we ex...

  15. Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

    Science.gov (United States)

    Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

    2014-12-01

    Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. 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.

  16. Differences in male and female injury severities in sport-utility vehicle, minivan, pickup and passenger car accidents.

    Science.gov (United States)

    Ulfarsson, Gudmundur F; Mannering, Fred L

    2004-03-01

    This research explores differences in injury severity between male and female drivers in single and two-vehicle accidents involving passenger cars, pickups, sport-utility vehicles (SUVs), and minivans. Separate multivariate multinomial logit models of injury severity are estimated for male and female drivers. The models predict the probability of four injury severity outcomes: no injury (property damage only), possible injury, evident injury, and fatal/disabling injury. The models are conditioned on driver gender and the number and type of vehicles involved in the accident. The conditional structure avoids bias caused by men and women's different reporting rates, choices of vehicle type, and their different rates of participation as drivers, which would affect a joint model of all crashes. We found variables that have opposite effects for the genders, such as striking a barrier or a guardrail, and crashing while starting a vehicle. The results suggest there are important behavioral and physiological differences between male and female drivers that must be explored further and addressed in vehicle and roadway design.

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

    Directory of Open Access Journals (Sweden)

    Deborah K Glencross

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

  18. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  19. An Information Technology Framework for Strengthening Telehealthcare Service Delivery

    Science.gov (United States)

    Chen, Chi-Wen; Weng, Yung-Ching; Shang, Rung-Ji; Yu, Hui-Chu; Chung, Yufang; Lai, Feipei

    2012-01-01

    Abstract Objective: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. PMID:23061641

  20. Measuring the Delivery of Special Education Services in a Large Urban District: Lessons from the Los Angeles Unified School District

    Science.gov (United States)

    Harr, Jenifer J.; Oliver, Deborah F.; Ramanathan, Arun; Socias, Miguel

    2008-01-01

    Special education service delivery is often the source of disputes between parents and districts and an issue in special education class-action lawsuits. Despite these controversies, there has been little large-scale research on the delivery of services. This study represents a large-scale assessment of the delivery of special education services…