WorldWideScience

Sample records for providing medical services

  1. Medical service provider networks.

    Science.gov (United States)

    Mougeot, Michel; Naegelen, Florence

    2018-05-17

    In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null. Although all providers join the network under any-willing-provider contracting in the absence of third-party payment, an asymmetric equilibrium may exist when this billing arrangement is implemented. Copyright © 2018 John Wiley & Sons, Ltd.

  2. Email medication counseling services provided by Finnish community pharmacies.

    Science.gov (United States)

    Pohjanoksa-Mäntylä, Marika K; Kulovaara, Heidi; Bell, J Simon; Enäkoski, Marianne; Airaksinen, Marja S

    2008-12-01

    The importance of email as a mode of communication between medication users and pharmacists is likely to increase. However, little is known about the email medication counseling practices of community pharmacies. To determine the prevalence of email medication counseling services in Finland and to assess the accuracy and comprehensiveness of responses by pharmacies providing the opportunity for email medication counseling to inquiries related to use of antidepressants. An inventory was made of all Finnish community pharmacies that provided the opportunity for email medication counseling. Data related to the accuracy and comprehensiveness of responses were collected, using a virtual pseudo-customer method with 3 scenarios related to common concerns of patients on antidepressants. Two inquiries were emailed to each pharmacy that provided the opportunity for email medication counseling in January and February 2005. The responses were content analyzed by 2 researchers, using a prestructured scoring system. Almost one-third (30%, n = 182) of Finnish community pharmacies maintained a working Web site, and 94% of those provided the opportunity for email medication counseling. An online "ask-the-pharmacist" service was offered by 13% (n = 23) of the pharmacies with a Web site. Pharmacies responded to 54% of the email inquiries sent by the virtual pseudo-customers. The response rate and the content score ratio between mean and maximum scores varied among the scenarios. The content score ratio was highest for the scenarios concerning the adverse effects of fluoxetine (0.53, n = 55) and interactions with mirtazapine (0.52, n = 63) and lowest for the scenario related to sexual dysfunction and weight gain associated with citalopram (0.38, n = 52). Community pharmacies are potential providers of email medication counseling services. However, more attention should be directed to responding to consumer inquiries and to the content of these responses.

  3. Hand Washing Practices Among Emergency Medical Services Providers

    Directory of Open Access Journals (Sweden)

    Joshua Bucher

    2015-10-01

    Full Text Available Introduction: Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS workers, respectively. Methods: We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results: There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003. Providers who brought their own sanitizer were more likely to clean their hands. Conclusion: Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

  4. Hand Washing Practices Among Emergency Medical Services Providers.

    Science.gov (United States)

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

    2015-09-01

    Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

  5. Military Medics Insight into Providing Womens Health Services

    Science.gov (United States)

    2015-12-22

    determining a patient’s preference in a provider rather than gender (Buck & Littleton, 2014). Medics, particularly male medics, were keenly aware of...KS, Littleton HL. (2014). Stereotyped beliefs about male and female OB-GYNS: relationship to provider choice and patient satisfaction. Journal of...health care resource during deployment. Male and female IDCs felt obligated to educate women about how to conduct themselves on ship. In a

  6. Emergency medical service providers' experiences with traffic congestion.

    Science.gov (United States)

    Griffin, Russell; McGwin, Gerald

    2013-02-01

    The population's migration from urban to suburban areas has resulted in a more dispersed population and has increased traffic flow, possibly resulting in longer emergency response times. Although studies have examined the effect of response times on time to definitive care and survival, no study has addressed the possible causes of slowed response time from the point of view of emergency medical services (EMS) first responders. To assess the variables most commonly associated with increased emergency response time as described by the opinions and views of EMS first responders. A total of 500 surveys were sent to randomly selected individuals registered as first responders with the Alabama Department of Public Health, and 112 surveys were returned completed. The survey included questions regarding roadway design, response to emergency calls, in-vehicle technology aimed at decreasing travel time, and public education regarding emergency response. Respondents reported traveling on city streets most often during emergency calls, and encountering traffic more often on interstates and national highways. Traffic congestion, on average, resulted in nearly 10min extra response time. Most agreed that the most effective in-vehicle technology for reducing response time was a pre-emptive green light device; however, very few reported availability of this device in their emergency vehicles. Public education regarding how to react to approaching emergency vehicles was stated as having the greatest potential impact on reducing emergency response time. The results of the survey suggest that the best methods for reducing emergency response times are those that are easy to implement (e.g., public education). Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Factors influencing the suicide intervention skills of emergency medical services providers

    OpenAIRE

    Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

    2017-01-01

    ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey asses...

  8. Differences in the use of outsourcing in public and private institutions providing medical services.

    Science.gov (United States)

    Czerw, Aleksandra I; Kowalska, Mariola; Religioni, Urszula

    2014-06-29

    The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed - Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services.

  9. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years.

    Science.gov (United States)

    Barnett, Mitchell J; Frank, Jessica; Wehring, Heidi; Newland, Brand; VonMuenster, Shannon; Kumbera, Patty; Halterman, Tom; Perry, Paul J

    2009-01-01

    Although community pharmacists have historically been paid primarily for drug distribution and dispensing services, medication therapy management (MTM) services evolved in the 1990s as a means for pharmacists and other providers to assist physicians and patients in managing clinical, service, and cost outcomes of drug therapy. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA 2003) and the subsequent implementation of Medicare Part D in January 2006 for the more than 20 million Medicare beneficiaries enrolled in the Part D benefit formalized MTM services for a subset of high-cost patients. Although Medicare Part D has provided a new opportunity for defining the value of pharmacist-provided MTM services in the health care system, few publications exist which quantify changes in the provision of pharmacist-provided MTM services over time. To (a) describe the changes over a 7-year period in the primary types of MTM services provided by community pharmacies that have contracted with drug plan sponsors through an MTM administrative services company, and (b) quantify potential MTM-related cost savings based on pharmacists' self-assessments of the likely effects of their interventions on health care utilization. Medication therapy management claims from a multistate MTM administrative services company were analyzed over the 7-year period from January 1, 2000, through December 31, 2006. Data extracted from each MTM claim included patient demographics (e.g., age and gender), the drug and type that triggered the intervention (e.g., drug therapeutic class and therapy type as either acute, intermittent, or chronic), and specific information about the service provided (e.g., Reason, Action, Result, and Estimated Cost Avoidance [ECA]). ECA values are derived from average national health care utilization costs, which are applied to pharmacist self-assessment of the "reasonable and foreseeable" outcome of the intervention. ECA values are updated

  10. Provision of prehospital emergency medical services in Punjab, Pakistan: Case study of a public sector provider.

    Science.gov (United States)

    Sriram, Veena M; Naseer, Rizwan; Hyder, Adnan A

    2017-12-01

    The availability and quality of emergency medical services in low- and middle-income countries, including Pakistan, are extremely limited. New models for prehospital emergency medical services provision have recently emerged across multiple sectors, and research on these models is urgently needed to inform current and future emergency medical services systems in low-resource settings. The objective of this case study was to provide a comprehensive description of the organizational structure and service delivery model of a public sector provider in the Punjab Province of Pakistan, Rescue 1122, with a focus on operations in Lahore. We used case study methodology to systematically describe the organizational model of Rescue 1122. Qualitative data were collected during an in-person site visit to Lahore in June 2013. Three sources were utilized-semi-structured in-depth interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. Rescue 1122 is based on a legal framework that provides public financing for EMS, resulting in financial stability for the service. The organization has also reportedly taken positive steps in engaging with communities, and in coordinating across EMS, fire and rescue. We noted benefits and challenges in scaling up the service to all districts in Punjab. Finally, some areas of improvement include supply chain management and expanded data utilization. Our case study highlights key components of the model, areas for strengthening, and opportunities for further research. Rescue 1122 provides an example of a government-financed and operated emergency medical system in a low-resource setting. Copyright © 2017. Published by Elsevier Inc.

  11. Using 340B drug discounts to provide a financially sustainable medication discharge service.

    Science.gov (United States)

    Wu, Timothy; Williams, Carla; Vranek, Kathryn; Mattingly, T Joseph

    2018-03-27

    The 340B Drug Pricing Program was intended to stretch federal resources by providing significant discounts to covered entities providing care to underserved populations. Program implementation and evidence of expanding services to higher income patients has brought more scrutiny and calls for elimination of the program. While additional review and reform may be warranted, profitability from 340B discounts enables covered entities to provide additional services that may not be feasible in absence of the program. This case report demonstrates one institution's use of 340B discounts to financially justify providing bedside medication delivery services for patients at the time of discharge from an inpatient admission. A simple financial model was developed using hospital data and inputs from available literature to estimate gross profit and earnings before interest, taxes, depreciation, and amortization (EBITDA) with and without 340B discounts. Without the 340B drug price discounts, the service would operate at a financial loss, and further investigation must be done to determine whether other clinical or economic benefits would warrant discharge medication delivery at the institution. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    OpenAIRE

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-01-01

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 201...

  13. Factors influencing the suicide intervention skills of emergency medical services providers.

    Science.gov (United States)

    Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

    2017-01-01

    Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.

  14. Documentation and billing for services provided by midwives teaching obstetrics and gynecology residents and medical students.

    Science.gov (United States)

    Wilson-Liverman, Angela; Slager, Joan; Wage, Deborah

    2009-01-01

    Certified nurse-midwives are teaching obstetrics and gynecology residents and medical students in major academic institutions across the United States. In these instances, the ability to appropriately document services rendered to support a billable service is paramount. This article explains the difference in requirements for midwives' documentation when working with residents compared with documentation required of an attending obstetrician-gynecologist. It also reviews the teaching physician guidelines developed by the Centers for Medicare and Medicaid Services (CMS) as well as current evaluation and management documentation requirements. Several examples of documentation are provided, as are suggestions for enhancement and simplification of the guidelines to include midwives. An important point to remember is that the CMS rules do not prohibit a certified nurse-midwife from teaching a resident.

  15. Primary Care Providers' experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle

    2012-01-01

    Full Text Available This study explored primary care providers' (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 "MTM is just part of our team approach to the practice of medicine": MTM as an integral part of PCPs' practices; (2 "Frankly it's education for the patient but it's also education for me": MTM services as a source of education; (3 "It's not exactly just the pharmacist that passes out the medicines at the pharmacy": The MTM practitioner is different from the dispensing pharmacist; (4 "So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved": MTM services as preventative health care efforts; (5"I think that time is the big thing": MTM pharmacists spend more time with patients; (6 "There's an access piece, there's an availability piece, there's a finance piece": MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge äóñmedication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients' medications, and their capability to

  16. [Italian physician's needs for medical information. Retrospective analysis of the medical information service provided by Novartis Pharma to clinicians].

    Science.gov (United States)

    Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

    2013-10-01

    The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.

  17. Anaesthesiology as an integral part of Slovene partisan medical services provided during the second world war

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    Aleksander Manohin

    2006-01-01

    Full Text Available Background: The aim of this work was to describe the practice of anaesthesia in partisan military hospitals in Slovenia during the Second World War. The organisation of anaesthetic services delivered as an integral part of partisan medical care was unique in Europe and in the world. Healthcare givers exhibited a high level of professsional knowledge as well as exceptional resourcefulness, adaptability, and willigness to cope with physical and psychological demands of their work.Conclusions: During the Second World War, a number of healthcare facilities for treatment of wounded and severly ill soldiers, run by partisan forces, were established on the territory of Slovenia. The paper deals with the first and most important, Slovene central military partisan hospital in Kočevski Rog, and the best-known, Franja and Pavla Hospitals in Primorska region (Franja was proposed for entry in UNESCO’s list of World Heritage Sites. The authors used a large body of written documentation, as well as the testimony provided by the living witnesses of war events. The main characteristics of partisan fighting were constant movement of troops and absence of hinterland. Therefore, it was not possible to apply the basic principle of war medical services, i. e. to evacuate wounded soldiers to the hinterland through graded units of care. No handbooks on the organization of partisan medical services were available at the time, and there were no hard and fast rules for action. Frequently, healthcare had to be provided before any arrangements for the management of wounded soldiers had been made. The apparently unsolvable problems had to be solved on the spot. The paper gives information not only on anaesthesia but also on general conditions characteristic of that period. It is only in the light of this dramatically different situation that the role of anaesthetic services provided during the war can be understood correctly. The material is illustrated with more, mostly

  18. More than a device: today's medical technology companies provide value through service.

    Science.gov (United States)

    McCoy, Fred

    2003-01-01

    When physicians implant cardiac rhythm management devices, they establish a long-term relationship with those devices and with the manufacturers of those devices. The therapeutic value that each device will provide to its patient is enhanced throughout the life of the device by the services that the manufacturer provides. Services are provided prior to, during and long after implantation. Services include physician and allied health professional training, quality assurance programs, therapy outreach initiatives, on site technical support during device implantation and follow-up, technical service expertise and customer service support. The costs of these services are substantial. When assessed on a per device basis, the service costs may actually exceed the costs of manufacture. Further, the costs of these services are rising. Over the past five years, the number of implanted cardiac rhythm management devices has doubled. Industry field forces have tripled in size. Clearly, industry is dedicated to providing service as a critical element in achieving excellent patient outcomes.

  19. A novel internet-based geriatric education program for emergency medical services providers.

    Science.gov (United States)

    Shah, Manish N; Swanson, Peter A; Nobay, Flavia; Peterson, Lars-Kristofer N; Caprio, Thomas V; Karuza, Jurgis

    2012-09-01

    Despite caring for large numbers of older adults, prehospital emergency medical services (EMS) providers receive minimal geriatrics-specific training while obtaining their certification. Studies have shown that they desire further training to improve their comfort level and knowledge in caring for older adults, but continuing education programs to address these needs must account for each EMS provider's specific needs, consider each provider's learning styles, and provide an engaging, interactive experience. A novel, Internet-based, video podcast-based geriatric continuing education program was developed and implemented for EMS providers, and their perceived value of the program was evaluated. They found this resource to be highly valuable and were strongly supportive of the modality and the specific training provided. Some reported technical challenges and the inability to engage in a discussion to clarify topics as barriers. It was felt that both of these barriers could be addressed through programmatic and technological revisions. This study demonstrates the proof of concept of video podcast training to address deficiencies in EMS education regarding the care of older adults, although further work is needed to demonstrate the educational effect of video podcasts on the knowledge and skills of trainees. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  20. Comprehensive dental services for an underserved and medically compromised population provided through a community partnership and service learning.

    Science.gov (United States)

    Chávez, Elisa M; LaBarre, Eugene; Fredekind, Richard; Isakson, Paul

    2010-01-01

    The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to educate future dentists to provide oral health care for similar populations.

  1. Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

    Science.gov (United States)

    Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

    2015-01-01

    Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi

  2. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    Directory of Open Access Journals (Sweden)

    Sungmin Lee

    2017-02-01

    Full Text Available Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS. Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA were analyzed at the census tract level (n = 264. Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

  3. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers.

    Science.gov (United States)

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-02-08

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

  4. CPI revision provides more accuracy in the medical care services component.

    Science.gov (United States)

    Ford, I K; Sturm, P

    1988-04-01

    This revision, as in the past, enabled the Bureau to update medical care service expenditure weights in the CPI, including a more complete allocation of health insurance premiums. Instead of keeping the portion of premiums that go to benefits under health insurance, the expenditure weight for each benefit category has been added to the appropriate out-of-pocket expense. The unpublished health insurance item represents only the retained earnings portion of premiums paid by households. The specific item categories included in medical care services have also been updated and expanded. A study conducted during the developmental phase of the revision indicated that the Bureau should expand the eligible priced rates for physicians in the CPI to include not only the "self-pay" rate, but also other categories of payment as well. Another study indicated that the direct pricing of health insurance is not feasible because of the difficulty of factoring out from premium changes the effect of utilization levels and modified coverage. In pricing medical care service items, as with other item categories in the CPI, BLS attempts to exclude from price movement the effect of quality changes. However, some quality changes are difficult to assess or are not readily identified, for example, a change in the ratio of nurses to patients, and such changes may be reflected as part of the price change movement in the CPI.

  5. Utilization of day surgery services at Upper hill Medical Centre and the Karen hospital in Nairobi: the influence of medical providers, cost and patient awareness.

    Science.gov (United States)

    Odhiambo, Mildred Adhiambo; Njuguna, Susan; Waireri-Onyango, Rachel; Mulimba, Josephat; Ngugi, Peter Mungai

    2015-01-01

    Health systems face challenges of improving access to health services due to rising health care costs. Innovative services such as day surgery would improve service delivery. Day surgery is a concept where patients are admitted for surgical procedures and discharged the same day. Though used widely in developed countries due to its advantages, utilization in developing countries has been low. This study sought to establish how utilization of day surgery services was influenced by medical providers, patient awareness and cost among other factors. The study design was cross sectional with self administered questionnaires used to collect data. Data analysis was done by using statistical package for social science (SPSS) and presented as frequencies, percentages and Spearman's correlation to establish relationship among variables. Medical providers included doctors, their employees and medical insurance providers. Most doctors were aware of day surgery services but their frequency of utilization was low. Furthermore, medical insurance providers approved only half of the requests for day surgery. Doctors' employees were aware of the services and most of them would recommend it to patients. Although, most patients were not aware of day surgery services those who were aware would prefer day surgery to in patient. Moreover, doctors and medical insurance providers considered day surgery to be cheaper than in patient. The study showed that medical providers and patient awareness had influence over day surgery utilization, though, cost alone did not influence day surgery utilization but as a combination with other factors.

  6. CONSUMER EXPECTATION ON SERVICE QUALITY PROVIDE BY PHARMACIST IN SELF MEDICATION PRACTICES AND ITS ASSOCIATED FACTORS IN BANDUNG, INDONESIA.

    Science.gov (United States)

    Alfian, Sofa D; Sinuraya, Rano K; Kautsar, Angga P; Abdulah, Rizky

    2016-11-01

    Self-medication is the use of medicines for therapeutic intent without a clinician’s advice or prescription. The National Socioeconomic Survey for Indonesia in 2009 found the percentage of the Indonesians engaging in self-medication is increasing. The objectives of this study were to assess consumers’ expectations regarding service quality provide by pharmacist in self-medication practices and determine the factors associated with self-medication in Bandung, Indonesia. We conduct a cross-sectional survey at eight randomly selected community pharmacies during July-November 2012 and purposely sampled 1,200 costumers purchasing medication at those sites. Subjects reported they understood the information about the medicines given by the pharmacist but still wanted more information and time to consult with the pharmacist about their medicines. Factors associated with self-medication were younger age, male gender, greater education and lower income. The intervention is needed to improve appropriate self-medication.

  7. Comparing medical and dental providers of oral health services on early dental caries experience.

    Science.gov (United States)

    Kranz, Ashley M; Rozier, R Gary; Preisser, John S; Stearns, Sally C; Weinberger, Morris; Lee, Jessica Y

    2014-07-01

    Most state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children. We examined the association between who (PCP, dentist, or both) provides these services to Medicaid enrollees before age 3 years and oral health at age 5 years. We linked North Carolina Medicaid claims (1999-2006) to oral health surveillance data (2005-2006). Regression models estimated oral health status (number of decayed, missing, and filled primary teeth) and untreated disease (proportion of untreated decayed teeth), with adjustment for relevant characteristics and by using inverse-probability-of-treatment weights to address confounding. We analyzed data for 5235 children with 2 or more oral health visits from a PCP, dentist, or both. Children with multiple PCP or dentist visits had a similar number of overall mean decayed, missing, and filled primary teeth in kindergarten, whereas children with only PCP visits had a higher proportion of untreated decayed teeth. The setting and provider type did not influence the effectiveness of preventive oral health services on children's overall oral health. However, children having only PCP visits may encounter barriers to obtaining dental treatment.

  8. Examining the Role of Electronic Medical Record Generated Provider Reminders on Provider Offering of Breast Cancer Screening Services

    Science.gov (United States)

    Beverley, Charles St. Clare, Jr.

    2013-01-01

    Introduction: Breast cancer affects the lives of millions of women each year in the United States. Early detection by mammography screening can reduce the risk for advanced stages of breast cancer and improve the probability of long-term survival in women. Electronic medical records (EMRs) have been identified as a successful approach for…

  9. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques.

    Science.gov (United States)

    Chien, Tsair-Wei; Chou, Ming-Ting; Wang, Wen-Chung; Tsai, Li-Shu; Lin, Weir-Sen

    2012-05-15

    Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan's year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. ICCs were generated for Taiwan's year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. We recommend using the ICC to annually assess a nation's year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

  10. Medical Virtual Public Services

    Directory of Open Access Journals (Sweden)

    Iulia SURUGIU

    2008-01-01

    Full Text Available The healthcare enterprises are very disconnected. This paper intends to propose a solution that will provide citizens, businesses and medical enterprises with improved access to medical virtual public services. Referred medical services are based on existing national medical Web services and which support medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures, clinics and hospitals’ services. Requirements and specific rules of these medical services are considered, and personalization of user preferences will to be supported. The architecture is based on adaptable process management technologies, allowing for virtual services which are dynamically combined from existing national medical services. In this way, a comprehensive workflow process is set up, allowing for service-level agreements, an audit trail and explanation of the process to the end user. The process engine operates on top of a virtual repository, providing a high-level semantic view of information retrieved from heterogeneous information sources, such as national sources of medical services. The system relies on a security framework to ensure all high-level security requirements are met. System’s architecture is business oriented: it focuses on Service Oriented Architecture - SOA concepts, asynchronously combining Web services, Business Process Management – BPM rules and BPEL standards.

  11. Diabetes in homeless persons: barriers and enablers to health as perceived by patients, medical, and social service providers.

    Science.gov (United States)

    Elder, Nancy C; Tubb, Matthew R

    2014-01-01

    The ways homelessness and diabetes affect each other is not well known. The authors sought to understand barriers and enablers to health for homeless people with diabetes as perceived by homeless persons and providers. The authors performed semistructured interviews with a sample of participants (seven homeless persons, six social service providers, and five medical providers) in an urban Midwest community. Data analysis was performed with the qualitative editing method. Participants described external factors (chaotic lifestyle, diet/food availability, access to care, and medications) and internal factors (competing demands, substance abuse, stress) that directly affect health. Social service providers were seen as peripheral to diabetes care, although all saw their primary functions as valuable. These factors and relationships are appropriately modeled in a complex adaptive chronic care model, where the framework is bottom up and stresses adaptability, self-organization, and empowerment. Adapting the care of homeless persons with diabetes to include involvement of patients and medical and social service providers must be emergent and responsive to changing needs.

  12. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    2015-01-01

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...

  13. Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use.

    Science.gov (United States)

    Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen; Wells, Kenneth B; Kominski, Gerald; Mays, Vickie M

    2015-12-01

    The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. A total of 2,358 adults, aged 18-64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. We defined "usual provider" as a primary care provider/practice, and "PCMH provider" as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2-13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4-21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7-14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5-15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI

  14. Integrating Medication Therapy Management (MTM Services Provided by Community Pharmacists into a Community-Based Accountable Care Organization (ACO

    Directory of Open Access Journals (Sweden)

    Brian Isetts

    2017-10-01

    Full Text Available (1 Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM services provided by community pharmacists into the clinical care teams and the health information technology (HIT infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO. (2 Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3 Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4 Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.

  15. Complaints against health-care professionals providing police custodial and forensic medical/health-care services and sexual offence examiner services in England, Wales and Northern Ireland.

    Science.gov (United States)

    Kennedy, Kieran M; Green, Peter G; Payne-James, J Jason

    2017-01-01

    Complaints management is an integral component of good clinical governance and an essential contributor to patient safety. Little is known about complaints against health-care professionals (HCPs) in police custodial settings and sexual assault referral centres. This study explored the frequency with which complaints are made against such HCPs working in England, Wales and Northern Ireland. It explored the nature of those complaints and the procedures by which they are investigated. Relevant information was requested from all police services in England, Wales and Northern Ireland; professional regulatory bodies; and the Independent Police Complaints Commission under the Freedom of Information Act (FOIA). Eighty-nine per cent of police services responded to the FOIA request. However, only a minority of these provided detailed information. Many police services cited the provision of health-care services by external providers as the reason for not holding information upon complaints. There was no evidence of any upward trend in the numbers of complaints over the study period. Delayed response to a request for attendance, incivility, medication issues and issues regarding the quality of reports and evidence were amongst the most common types of complaints described. A small number of responders provided copies of the disciplinary procedures used to manage complaints against HCPs. Significant heterogeneity exists in respect of complaints handling procedures across custodial and forensic medical/health-care services and sexual offence examiner services. An opportunity to identify learning for improvement is being missed as a result of the absence of standardised complaints handling procedures.

  16. Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority.

    Science.gov (United States)

    Debenham, Sierra; Fuller, Matthew; Stewart, Matthew; Price, Raymond R

    2017-12-01

    By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks. Debenham S , Fuller M , Stewart M , Price RR . Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593-595.

  17. Provider of Services File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  18. Co-operation of medical and chemical services to provide radiation safety in special zone during Chernobyl' accident response

    International Nuclear Information System (INIS)

    Terent'ev, V.I.

    1990-01-01

    Cooperation of medical and chemical services of the operation group in the special zone during intensive decontamination of the site and neighboring herritories at the Chernobyl NPP are considered. Responsibilities of medical and chemical services, their relations with civie and millitary organizations within the ChNPP region and 30-km zone are reviewed. Cooperation of the services mentioned above consisted in information exchange aimed at overall comprehension of the situation, cooperative activities in the commision and at elaboration of recommendations with an account of radiation safety measures

  19. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

    Science.gov (United States)

    McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L

    2013-09-01

    We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

  20. Factors Affecting Medical Service Quality.

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2014-02-01

    A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

  1. Provider of Services File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The POS file contains data on characteristics of hospitals and other types of healthcare facilities, including the name and address of the facility and the type of...

  2. Emergency Medical Services

    Science.gov (United States)

    ... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

  3. Credential Service Provider (CSP)

    Data.gov (United States)

    Department of Veterans Affairs — Provides a VA operated Level 1 and Level 2 credential for individuals who require access to VA applications, yet cannot obtain a credential from another VA accepted...

  4. Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services.

    Science.gov (United States)

    Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris

    2009-01-01

    To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to

  5. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor.For information, call the Nurses- on Telephone73802- by electronic mailInfirmary.Service@cern.chMarion.Diedrich@cern.chJanet.Doody@cern.chMireille.Vosdey@cern.chMedical Service

  6. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2002-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses: on telephone: 73802 by e-mail: Service.Medical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  7. Reminder from Medical Service

    CERN Multimedia

    Medical Service

    2004-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses on telephone: 73802 by e-mail: Service.Medical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  8. MANAGEMENT OF MEDICAL SERVICES

    Directory of Open Access Journals (Sweden)

    BARBU MARIA-MAGDALENA

    2009-05-01

    Full Text Available The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the

  9. Electronic Medical Record Service

    Data.gov (United States)

    Department of Veterans Affairs — This service provides web services used to obtain clinical data for patients. There are three service methods that allow write functionality signNote, writeNote and...

  10. Ecosystem services provided by waterbirds.

    Science.gov (United States)

    Green, Andy J; Elmberg, Johan

    2014-02-01

    Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation. © 2013 The Authors. Biological Reviews © 2013 Cambridge Philosophical Society.

  11. Ecosystem services provided by bats.

    Science.gov (United States)

    Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H

    2011-03-01

    Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats. © 2011 New York Academy of Sciences.

  12. Find Ryan White HIV/AIDS Medical Care Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Find Ryan White HIV/AIDS Medical Care Providers tool is a locator that helps people living with HIV/AIDS access medical care and related services. Users can...

  13. Medical Service Information

    CERN Multimedia

    GS Department

    2010-01-01

    The Medical Service is pleased to inform you that a psychologist specialising in psychotherapy (member of the Swiss Federation of Psychologists- FSP), Mrs Sigrid Malandain, will be starting work at the CERN on 1 November 2010, in the premises of the Medical Service, Building 57-1-024. Members of CERN personnel can request individual consultations, by appointment, in French or in English, on Tuesdays and Thursdays by calling 78435 (Medical Service secretariat) or sending an e-mail to psychologist-me@cern.ch.

  14. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on telephone: 73802. by electronic mail to: Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch Medical Service

  15. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    2003-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses - on telephone: 73802 - by e-mail:Service.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  16. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    2003-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses - on telephone: 73802 - by e-mail: Service.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  17. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2000-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor.For information, call the Nurses on Telephone: 73802 or by electronic mail:Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.chMedicalService

  18. Reminder from Medical Service

    CERN Multimedia

    2003-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, contact the nurses on telephone: 73802 by e-mail: Service.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  19. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service médical

    2000-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites,be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor.For information, call the Nurseson telephone: 73802.by electronic mail to:Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.chMedicalService

  20. Ancillary Services Provided from DER

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  1. Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

    Science.gov (United States)

    Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

    2012-03-01

    The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  2. TERRITORIAL DISPARITIES REGARDING THE DISTRIBUTION OF HEALTH SERVICE PROVIDERS IN ROMANIA AFTER JOINING THE EUROPEAN UNION STUDY CASE: MEDICAL STAFF WITH TERTIARY LEVEL OF EDUCATION

    Directory of Open Access Journals (Sweden)

    Babucea Ana-Gabriela

    2017-02-01

    Full Text Available In Romania 90ˈs, there was a relatively low level of regional disparities compared with western economies in all fields, but inequalities have emerged and widened rapidly because only certain areas, especially urban areas have benefited from inflows of capital and specialized human resources. Currently, Romania has a low level of development between EU countries, five of the eight NUTS 2 regions being the most underdeveloped in Europe. The aim of this research is a comparative analysis of developments and trends manifested in the public health system in terms of distribution of health services providers at the regional level in Romania. For the analysis of regional disparities, the research seeks to highlight a comprehensive image of the level and dynamics of the Romania territorial inequalities regarding the personnel with tertiary education, which includes physicians, dentists, and pharmaceutical chemists, as professional providers of the health services. Were took into account statistical indicators that describe the distribution of such as healthcare providers, at level of the eight Romanian NUTS2 regions, highlighting inequalities in access to health services for the population. We used available data, accessed from National Institute of Statistics of Romania, regarding Romania, and itˊs eight regions. We appeal also to statistical publications at the national and European level, other data analysis, and experts' opinions expressed in recent articles in the field. In order to identify the factors that can reduce the disparities, and ensure the equity for disadvantaged population, in terms of ensuring the health system of medical services in parallel with a homogeneous distribution of resources and services in this area, we apply specific statistics for territorial analysis and comparisons.

  3. Management systems for service providers

    International Nuclear Information System (INIS)

    Bolokonya, Herbert Chiwalo

    2015-02-01

    In the field of radiation safety and protection there are a number of institutions that are involved in achieving different goals and strategies. These strategies and objectives are achieved based on a number of tools and systems, one of these tools and systems is the use of a management system. This study aimed at reviewing the management system concept for Technical Service Providers in the field of radiation safety and protection. The main focus was on personal monitoring services provided by personal dosimetry laboratories. A number of key issues were found to be prominent to make the management system efficient. These are laboratory accreditation, approval; having a customer driven operating criteria; and controlling of records and good reporting. (au)

  4. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2001-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802. by electronic mail: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  5. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2000-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802. by electronic mail: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  6. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2001-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on telephone: 73802. by electronic mail: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  7. Medical services at a music festival.

    Science.gov (United States)

    Streat, S; McCallum, J A; Boswell, R; Hunton, R

    1975-08-13

    A three-day open air musical festival attended by approximately 20 000 people was held at Ngaruawahia in January 1973. A medical service was provided and staffed mainly by medical students, nurses and young medical graduates. There were 1998 patient visits to the medical area, the five most common complaints being sunburn, headaches, minor foot trauma, gastroenteritis and lacerations which collectively accounted for 75 percent of the diagnoses. The medical services provided are discussed and recommendations for future festivals made.

  8. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Service Médical

    2000-01-01

    iFor medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802. by electronic mail: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  9. REMINDER FROM MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2001-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802 by electronic mail: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch  

  10. Mental Health Providers: Credentials, Services Offered and What to Expect

    Science.gov (United States)

    ... and specific services they offer Treatment approaches and philosophy Which insurance providers they work with Office hours, ... trademarks of Mayo Foundation for Medical Education and Research. © 1998-2018 Mayo Foundation for Medical Education and ...

  11. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

  12. Providing Services to Virtual Patrons.

    Science.gov (United States)

    Hulshof, Robert

    1999-01-01

    Discusses the types of services libraries need to support patrons who access the library via the Internet or e-mail. Highlights include issues in technical support; establishing policies and procedures; tools for technical support, including hardware and software; impacts of technical support on staff; and future possibilities. (LRW)

  13. Electronic word of mouth about medical services

    OpenAIRE

    Hinz, Vera; Drevs, Florian; Wehner, Jürgen

    2012-01-01

    Electronic word of mouth (eWOM) about medical services gains growing popularity from the part of health care users, accompanied with a high reluctance of health care providers towards existing platforms, fearing unqualified, negative reviews driven by motives of vengeance. Purpose of this research is to shed light on the characteristics, content, and motives of eWOM about medical services. Using primary and secondary data of 822 reviews, this study shows that reviews about medical services ar...

  14. Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.

    Science.gov (United States)

    Jay, Melanie; Chintapalli, Sumana; Squires, Allison; Mateo, Katrina F; Sherman, Scott E; Kalet, Adina L

    2015-11-14

    Obesity is highly prevalent among Veterans. In the United States, the Veterans Health Administration (VHA) offers a comprehensive weight management program called MOVE!. Yet, fewer than 10 % of eligible patients ever attend one MOVE! visit. The VHA has a patient-centered medical home (PCMH) model of primary care (PC) called Patient-Aligned Care Teams (PACT) at all Veterans Affairs (VA) Medical Centers. PACT teamlets conduct obesity screening, weight management counseling, and refer to MOVE!. As part of a needs assessment to improve delivery of weight management services, the purpose of this study was to assess PACT teamlet and MOVE! staff: 1) current attitudes and perceptions regarding obesity care; 2) obesity-related counseling practices 3) experiences with the MOVE! program; and 4) targets for interventions to improve implementation of obesity care in the PC setting. We recruited 25 PACT teamlet members from a single VA study site-11 PC physicians, 5 registered nurses, 5 licensed practical nurses, 1 clerical assistant, and 3 MOVE! staff (2 dietitians, 1 psychologist)-for individual interviews using a combination of convenience and snowball sampling. Audio recorded interviews were professionally transcribed and iteratively coded by two independent reviewers. The analytic process was guided by discourse analysis in order to discover how the participants perceived and provided weight management care and what specific attitudes affected their practices, all as bounded within the organization. Emerging themes included: 1) role perceptions, 2) anticipated outcomes of weight management counseling and programs, and 3) communication and information dissemination. Perceived role among PCPs was influenced by training, whereas personal experience with their own weight management impacted role perception among LPNs/RNs. Attitudes about whether or not they could impact patients' weight outcomes via counseling or referral to MOVE! varied. System-level communication about VHA

  15. Attitudes and Perceptions of Healthcare Providers and Medical ...

    African Journals Online (AJOL)

    Purpose: To explore healthcare providers' (HCPs) and medical students' attitudes to, and perceptions of the pharmaceutical services that clinical pharmacists can provide in United Arab Emirates. Methods: A total of 535 participants (265 HCPs and 270 medical students) were asked to complete a questionnaire over a ...

  16. Strategic management of Public Hospitals' medical services.

    Science.gov (United States)

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

  17. Factors Influencing Self Employment Media Service Providers ...

    African Journals Online (AJOL)

    Factors Influencing Self Employment Media Service Providers among Tertiary ... role stereotype and common business practices on media self employment in ... Sex, Psycho-social Characteristics, self Employment, Providing Media Services.

  18. Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro

    2013-11-01

    The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons. Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively. The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons. To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

  19. 28 CFR 549.72 - Services provided without fees.

    Science.gov (United States)

    2010-07-01

    ... care; (f) Diagnosis or treatment of chronic infectious diseases; (g) Mental health care; or (h... Section 549.72 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Fees for Health Care Services § 549.72 Services provided without fees. We will not charge...

  20. Provider Customer Service Program - Performance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is continuously analyzing performance and quality of the Provider Customer Service Programs (PCSPs) of the contractors and will be identifying trends and making...

  1. Health Worker Opinion/Perception of Health Services provided to ...

    African Journals Online (AJOL)

    Nancy Kamau

    VDH Industrial Hygiene CC.PO. Box ... conducted to establish relations of mining activities to human health at Selebi. Phikwe is called for. .... Table 1: Demographic data of health service providers and patients in the study area. Medical ...

  2. Marketing medical services to an aging America.

    Science.gov (United States)

    Mast, L J

    1993-01-01

    Consumers over age 50 currently comprise 40 percent of consumer demand. Medical services provided in the group practice setting must be structured to accommodate the unique needs of their increasing number of elderly patients According to this professional paper, the development of a marketing plan will provide a strategy that will keep the medical group competitive among older consumers.

  3. Modeling Medical Services with Mobile Health Applications

    Directory of Open Access Journals (Sweden)

    Zhenfei Wang

    2018-01-01

    Full Text Available The rapid development of mobile health technology (m-Health provides unprecedented opportunities for improving health services. As the bridge between doctors and patients, mobile health applications enable patients to communicate with doctors through their smartphones, which is becoming more and more popular among people. To evaluate the influence of m-Health applications on the medical service market, we propose a medical service equilibrium model. The model can balance the supply of doctors and demand of patients and reflect possible options for both doctors and patients with or without m-Health applications in the medical service market. In the meantime, we analyze the behavior of patients and the activities of doctors to minimize patients’ full costs of healthcare and doctors’ futility. Then, we provide a resolution algorithm through mathematical reasoning. Lastly, based on artificially generated dataset, experiments are conducted to evaluate the medical services of m-Health applications.

  4. Medical service plans in academic medical centers.

    Science.gov (United States)

    Siegel, B

    1978-10-01

    Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

  5. Emergency Medical Service (EMS) Stations

    Data.gov (United States)

    Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

  6. Reminder from the Medical Service

    CERN Multimedia

    2003-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the nurses - on telephone: 73802 - by e-mail: Service.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  7. Customer assessment of long-term care pharmacy provider services.

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

    Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

  8. Cost Effectiveness and Demand for Medical Services among Rural ...

    African Journals Online (AJOL)

    With daily improvement in science and technology, the demand for modern medical services is becoming increasing. This is because modern medical services provide answers to some medical problems which could not be handled by traditional or other forms of medicine. Regrettably, these medical services receive low ...

  9. Providing Device Independence to Mobile Services

    OpenAIRE

    Nylander, Stina; Bylund, Markus

    2002-01-01

    People want user interfaces to services that are functional and well suited to the device they choose for access. To provide this, services must be able to offer device specific user interfaces for the wide range of devices available today. We propose to combine the two dominant approaches to platform independence, "Write Once, Run Every-where™" and "different version for each device", to create multiple device specific user interfaces for mobile services. This gives possibilities to minimize...

  10. VT Wireless Internet Service Providers 2006

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The VT Wireless Internet Service Provider (ISP) dataset (WISP2006) includes polygons depicting the extent of Vermont's WISP broadband system as of...

  11. VT Wireless Internet Service Providers 2007

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The VT Wireless Internet Service Provider (ISP) dataset (WISP2007) includes polygons depicting the extent of Vermont's WISP broadband system as of...

  12. Logistic service providers and sustainable physical distribution

    Directory of Open Access Journals (Sweden)

    Stef Weijers

    2012-06-01

    Full Text Available Background: Logistic Service Providers main concern was to ensure reliability for a low price (Christopher, 2005. Dutch Logistic Service Providers still have these two aspects at the top of their list, but also have to take in a new aspect: sustainability. 88% Of the investigated Logistic Service Providers have included sustainability in the company's goals. These Logistic Service Providers have developed different strategies to achieve a higher level of sustainability. This paper presents the results of a study into what Logistic Service Providers say what they are doing, or intend to do, to improve sustainability for their transport services. In this way insight is given in the attitude of Dutch Logistic Service Providers towards sustainability and how they intend to translate this into business practise: internal solutions or new methods incorporating external partners. Methods: Various methods of the investigations were used, among which the analysis of the statements about the sustainabilityon the websites of various companies as well as the questionnaire per Internet. The research covered 50 largest logistics companies operating in the Netherlands and 60 companies that competed for the award "Lean and Green" advertised in the Netherlands. In addition, the Internet survey was answered by 41 companies that belong to the network of our university. Results: The investigation has shown that sustainability is handled by the logistics company as an integral part of the corporate strategy. In contrast, shippers depend in the choice of logistics services primarily on such classical aspects as the reliability or the price and the sustainability play a minor role. Conclusions: Trying to find methods to improve the sustainability, Dutch logistics service providers, in the first place, look for solutions that increase the efficiency and therefore the cost reduction potential. Solutions, which require the involvement of clients, were less often

  13. Role Coastumer Service PT. Bank Danamon Provide Service to Customers

    OpenAIRE

    ", NURJANAH; Hardani, Ninda

    2015-01-01

    PT. Bank Danamon Pekanbaru is the bank engaged in banking goods and services that always seeks to prioritize the satisfaction of its customers. The employee on duty and deal directly with the customer in providing services commonly known as customer service that are required to have the ability to serve customers accurately and quickly and have good communication skills. The purpose of this study was to determine the role of customer service as a receptionist, Deskman, salesman, customer rela...

  14. Mitigating Provider Uncertainty in Service Provision Contracts

    Science.gov (United States)

    Smith, Chris; van Moorsel, Aad

    Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

  15. REMINDER FROM THE MEDICAL SERVICE

    CERN Multimedia

    Medical Service

    2000-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, be they staff or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, call the Nurses on Telephone: 73802 by electronic mail: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  16. Calibration services for medical applications of radiation

    Energy Technology Data Exchange (ETDEWEB)

    DeWerd, L.A.

    1993-12-31

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs.

  17. Calibration services for medical applications of radiation

    International Nuclear Information System (INIS)

    DeWerd, L.A.

    1993-01-01

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs

  18. Early abortion services in the United States: a provider survey.

    Science.gov (United States)

    Benson, Janie; Clark, Kathryn Andersen; Gerhardt, Ann; Randall, Lynne; Dudley, Susan

    2003-04-01

    The objective of this study was to describe the availability of early surgical and medical abortion among members of the National Abortion Federation (NAF) and to identify factors affecting the integration of early abortion services into current services. Telephone interviews were conducted with staff at 113 Planned Parenthood affiliates and independent abortion providers between February and April 2000, prior to FDA approval of mifepristone. Early abortion services were available at 59% of sites, and establishing services was less difficult than or about what was anticipated. Sites generally found it easier to begin offering early surgical abortion than early medical abortion. Physician participation was found to be critical to implementing early services. At sites where some but not all providers offered early abortion, variations in service availability resulted. Given the option of reconsidering early services, virtually all sites would make the same decision again. These data suggest that developing mentoring relationships between experienced early abortion providers/sites and those not offering early services, and training physicians and other staff, are likely to be effective approaches to expanding service availability.

  19. Engaging service providers in improving industry performance

    International Nuclear Information System (INIS)

    Oberth, R.

    2012-01-01

    Effective task leadership is the key to achieving results in the nuclear industry and in most other industries. One of the themes of this conference is to discuss how the nuclear industry can undertake Issue-Identification and Definition as a means of 'identifying what needs attention' and then 'defining what needs to be done to make that happen'. I will explore this theme from the perspective of the 'Service Provider' - which by the definition of this conference includes everyone not within an operating utility - meaning 'those involved in everything from inspection and repair to research and plant architecture' - basically the member companies of my association, OCI. Our members take the definition of the roles and responsibilities of the 'Service Provider' community very seriously. In the context of this discussion a key utility function is the early definition of requirements and expectations of Service Providers in supplying to these requirements. Let's explore for a moment the Service Provider role and perspective. Service Providers are by nature pro-active - they seek ways to engage with utilities (and tier one vendors) to solve problems and achieve good outcomes. They come to industry conferences like this one to learn about upcoming utility programs and supply opportunities and how they can improve performance. Service Providers particularly want to hear senior utility people comment on emerging issues even those at the very early identification stage. Some Clarification of Roles is in Order - as that is the focus of this conference: 'Issue-Identification and Definition'. 'Issue-Identification' is the utility's job - it is the utility's role to identify as early as possible 'what needs attention and what their needs and expectations are'. This takes place before service provider engagement. 'Issue-Definition' is more challenging. It means 'determining and prioritizing what needs to be done to deal with the situation at hand'. This typically involves

  20. Integrating advanced practice providers into medical critical care teams.

    Science.gov (United States)

    McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

    2013-03-01

    Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

  1. Transforming Health Care Service Delivery and Provider Selection

    OpenAIRE

    Reiner, Bruce I.

    2011-01-01

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

  2. ACCOUNTING TREATMENTS USED FOR ACCOUNTING SERVICES PROVIDERS

    Directory of Open Access Journals (Sweden)

    ŢOGOE GRETI DANIELA

    2014-08-01

    Full Text Available The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain through a thorough and detailed approach as different sides (conceptual and practical looking projections of accounting issues related to regulatory developments and practices in the field. This paper addresses various concepts, accounting treatments, and books and accounting documents used both freelancers in providing accounting services and legal persons authorized accounting profession. In terms of methodology and research perspective, the whole scientific approach combined with quantitative and qualitative research theoretical perspective (descriptive-conceptual with practice perspective (empirical analyzing the main contributions of various authors (Romanian and foreign to knowledge in the field. Following the survey believe that the amendments to the national legislation will support entities providing accounting services, by cutting red tape on Administrative Burdens, and consequently will increase profitability and increase service quality.

  3. Information from the MEDICAL SERVICE

    CERN Multimedia

    Safety Commission

    2008-01-01

    The CERN infirmary (ground floor, Building 57) is open from 8.00 a.m. to 5.30 p.m. every working day. It is open for emergencies only between 12.30 and 1.30 p.m., to allow the nurses to take their lunch breaks. The Medical Service only gives first-level medical treatment and under no circumstances can it take the place of your family doctor. A list of doctors, dentists and other health professionals in the Pay de Gex and Meyrin can be consulted on the Medical Service’s regularly updated web page: http://sc-me.web.cern.ch/sc-me/ In the event of an emergency on the CERN site, the first number to call is 74444.

  4. Chat reference service in medical libraries: part 2--Trends in medical school libraries.

    Science.gov (United States)

    Dee, Cheryl R

    2003-01-01

    An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

  5. Providing Music Notation Services over Internet

    OpenAIRE

    Solomon , Mike; Fober , Dominique; Orlarey , Yann; Letz , Stéphane

    2014-01-01

    International audience; The GUIDO project gathers a textual format for music representation, a rendering engine operating on this format, and a library providing a high level support for all the services related to the GUIDO format and it's graphic rendering. The project includes now an HTTP server that allows users to access the musical-score-related functions in the API of the GUIDOEngine library via uniform resource identifiers (URIs). This article resumes the core tenants of the REST arch...

  6. ACCOUNTING TREATMENTS USED FOR ACCOUNTING SERVICES PROVIDERS

    OpenAIRE

    ŢOGOE GRETI DANIELA; AVRAM MARIOARA; AVRAM COSTIN DANIEL

    2014-01-01

    The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain thr...

  7. Medical Provider Ballistic Protection at Active Shooter Events.

    Science.gov (United States)

    Stopyra, Jason P; Bozeman, William P; Callaway, David W; Winslow, James; McGinnis, Henderson D; Sempsrott, Justin; Evans-Taylor, Lisa; Alson, Roy L

    2016-01-01

    There is some controversy about whether ballistic protective equipment (body armor) is required for medical responders who may be called to respond to active shooter mass casualty incidents. In this article, we describe the ongoing evolution of recommendations to optimize medical care to injured victims at such an incident. We propose that body armor is not mandatory for medical responders participating in a rapid-response capacity, in keeping with the Hartford Consensus and Arlington Rescue Task Force models. However, we acknowledge that the development and implementation of these programs may benefit from the availability of such equipment as one component of risk mitigation. Many police agencies regularly retire body armor on a defined time schedule before the end of its effective service life. Coordination with law enforcement may allow such retired body armor to be available to other public safety agencies, such as fire and emergency medical services, providing some degree of ballistic protection to medical responders at little or no cost during the rare mass casualty incident. To provide visual demonstration of this concept, we tested three "retired" ballistic vests with ages ranging from 6 to 27 years. The vests were shot at close range using police-issue 9mm, .40 caliber, .45 caliber, and 12-gauge shotgun rounds. Photographs demonstrate that the vests maintained their ballistic protection and defeated all of these rounds. 2016.

  8. Cost Calculation Model for Logistics Service Providers

    Directory of Open Access Journals (Sweden)

    Zoltán Bokor

    2012-11-01

    Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

  9. New year, new Medical Service!

    CERN Multimedia

    2002-01-01

    The Medical Service. From left to right : Nicole De Matos, Dr Etienne Maquet, Marloeke Bol, Françoise Lebrun-Klauser, Katie Thomson, Florence Rabier, Mireille Vosdey and Dr Véronique Fassnacht. Feeling sick at CERN has never been so nice. The medical service has been completely renewed over the last few months, and its team starts 2002 with fresh installations in order to make your state of indisposition less uncomfortable. Those who last visited building 57 six months ago probably won't recognise its new structure. Apart from a creamy colour on the wall, which cheers up the atmosphere, the distribution of the service has completely changed. You may find - as usual - the infirmary downstairs but the laboratory, the secretariat and the doctors on the first floor. Another main change is the reception in both ground floor (emergencies) and first floor. While you wait to be attended to, you can sit in a comfortable waiting room. The faces you'll find won't be familiar either: the nurses Ka...

  10. Ancillary services provided by PV power plants

    Directory of Open Access Journals (Sweden)

    Antonio PIERNO

    2016-07-01

    Full Text Available Renewable energy sources are widely utilized in distributed generation systems, and, recently, they are also considered for providing ancillary services. The paper is focused on PV plants, a survey of the most interesting papers published in the literature in the last decade is reported and the main characteristics of the technical proposals, with their advantages and limits, are evidenced. The results are schematically shown in a table that immediately gives the opportunity to be aware of what was already done, representing a reference tool.

  11. Switching Service Providers: Reasons, Service Types, and Sequences

    African Journals Online (AJOL)

    In Keaveney.s (1995) landmark study on the reasons for switching service providers, data were gathered using critical incident technique (CIT); here the original findings are tested using survey method. Keaveney.s typology of reasons for switching is supported across a range of categories but, in this new study, the reasons ...

  12. Service Provider Revenue Dependence of Offered Number of Service Classes

    Directory of Open Access Journals (Sweden)

    V. S. Aćimović-Raspopović

    2011-06-01

    Full Text Available In this paper possible applications of responsive pricing scheme and Stackelberg game for pricing telecommunication services with service provider as a leader and users acting as followers are analyzed. We have classified users according to an elasticity criterion into inelastic, partially elastic and elastic users. Their preferences are modelled through utility functions, which describe users’ sensitivity to changes in the quality of service and price. In the proposed algorithm a bandwidth management server is responsible for performing automatic optimal bandwidth allocation to each user’s session while maximizing its expected utility and the overall service provider’s revenue. The pricing algorithm is used for congestion control and more efficient network capacity utilization. We have analyzed different scenarios of the proposed usage-based pricing algorithm. Particularly, the influence of the number of service classes on price setting in terms of service provider’s revenue and total users’ utility maximization are discussed. The model is verified through numerous simulations performed by software that we have developed for that purpose.

  13. Contingency management: perspectives of Australian service providers.

    Science.gov (United States)

    Cameron, Jacqui; Ritter, Alison

    2007-03-01

    Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Examples of the use of contingency management provided by key informants demonstrated an over-inclusive definition: all the examples did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study.

  14. Supercomputing Centers and Electricity Service Providers

    DEFF Research Database (Denmark)

    Patki, Tapasya; Bates, Natalie; Ghatikar, Girish

    2016-01-01

    from a detailed, quantitative survey-based analysis and compare the perspectives of the European grid and SCs to the ones of the United States (US). We then show that contrary to the expectation, SCs in the US are more open toward cooperating and developing demand-management strategies with their ESPs......Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates...... this problem. In order to develop a symbiotic relationship between the SCs and their ESPs and to support effective power management at all levels, it is critical to understand and analyze how the existing relationships were formed and how these are expected to evolve. In this paper, we first present results...

  15. New consumer services provided by smart metering

    Directory of Open Access Journals (Sweden)

    Daminov Ildar

    2015-01-01

    Full Text Available This paper focuses on the issues of smart metering market and considers different services provided by smart metering from consumer point of view. Firstly, smart metering deployment challenges emerging and conventional tariffs, which modify a consumer behavior and thus, the entire electric energy market can be optimized since the customer is motivated to consume less energy. Secondly, the authors illustrate changes in electricity quality, which have an impact on consumer relations with utility. Additionally, two main indices of grid resilience – SAIDI and SAIFI – are exemplified to reveal the improvement potential of smart metering implementation in certain regions of Russia that also influence the consumer. Finally, in-home display and privacy problem directly reflect the consumer’s behavior, thus the private life rights should not be violated as they are guaranteed by law.

  16. 75 FR 81832 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-12-29

    ... DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service 7 CFR Part 652 Technical Service... as of Jan. 1, 2010, on page 565, in Sec. 652.2, the first definition for ``Technical service'' is removed. [FR Doc. 2010-32945 Filed 12-28-10; 8:45 am] BILLING CODE 1505-01-D ...

  17. Measuring Prefered Services from Cloud Computing Providers ...

    African Journals Online (AJOL)

    pc

    2018, 10(5S), 207-212. 207. Measuring Prefered Services from ... Published online: 22 March 2018 .... and then introduces a general service selection and ranking model with QoS ..... To facilitate add, remove, and prioritize services in election.

  18. Emergency Medical Service (EMS): Rotorcraft Technology Workshop

    Science.gov (United States)

    Bauchspies, J. S.; Adams, R. J.

    1981-01-01

    A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

  19. Keeley's journey: from service user to service provider.

    Science.gov (United States)

    Cassinello, Keeley; Bramley, Sally

    2012-01-01

    This paper presents the vocational journey of a young British woman, Keeley, who changed her career aspirations to become a mental health worker following an episode of significant mental health difficulties. Keeley's story illustrates the application of the locally developed WORKS framework in conceptualising and supporting Keeley's vocational recovery. A narrative approach highlights the partnerships that developed between Keeley, the Occupational Therapist, Sally, and the User Support and Employment Service. The WORKS framework supported Keeley and Sally to collaboratively develop a successful employment pathway. Strategies, including attention to Keeley's view of her capabilities and aspirations, volunteer placements, support of peers, employer engagement and planning for sustainable employment, assisted Keeley to establish her chosen career. Keeley's journey highlights the leadership role that mental health services can assume by providing paid work for people with experience of mental health difficulties.

  20. Nuclear data services provided by the IAEA

    International Nuclear Information System (INIS)

    Schwerer, O.; Oblozinsky, P.

    2001-01-01

    This paper summarizes the various nuclear data types, libraries and services available free of charge from the IAEA Nuclear Data Section. The databases are collected, maintained and made available within the framework of an international nuclear data center's network. Particular emphasis is given to online services via the Internet. The URL address of the IAEA Nuclear Services is http://www-nds.iaea.or.at. (author)

  1. Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment.

    Science.gov (United States)

    Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun; Cha, Hyo Soung

    2015-10-01

    Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.

  2. Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment

    Science.gov (United States)

    Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun

    2015-01-01

    Objectives Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. Methods This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. Results The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. Conclusions The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical

  3. Educational technology infrastructure and services in North American medical schools.

    Science.gov (United States)

    Kamin, Carol; Souza, Kevin H; Heestand, Diane; Moses, Anna; O'Sullivan, Patricia

    2006-07-01

    To describe the current educational technology infrastructure and services provided by North American allopathic medical schools that are members of the Association of American Medical Colleges (AAMC), to present information needed for institutional benchmarking. A Web-based survey instrument was developed and administered in the fall of 2004 by the authors, sent to representatives of 137 medical schools and completed by representatives of 88, a response rate of 64%. Schools were given scores for infrastructure and services provided. Data were analyzed with one-way analyses of variance, chi-square, and correlation coefficients. There was no difference in the number of infrastructure features or services offered based on region of the country, public versus private schools, or size of graduating class. Schools implemented 3.0 (SD = 1.5) of 6 infrastructure items and offered 11.6 (SD = 4.1) of 22 services. Over 90% of schools had wireless access (97%), used online course materials for undergraduate medical education (97%), course management system for graduate medical education (95%) and online teaching evaluations (90%). Use of services differed across the undergraduate, graduate, and continuing medical education continuum. Outside of e-portfolios for undergraduates, the least-offered services were for services to graduate and continuing medical education. The results of this survey provide a benchmark for the level of services and infrastructure currently supporting educational technology by AAMC-member allopathic medical schools.

  4. Growth Disparity between Medical Research and Medical Services ...

    Indian Academy of Sciences (India)

    Growth Disparity between Medical Research and Medical Services in India. British rulers opened hospitals for modern medicine; medical colleges; nurses schools etc. in the 19th century to the joyous welcome of natives. During the same period, they set up Indian Research Fund Association two years ahead of the MRC of ...

  5. Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

    Science.gov (United States)

    Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

    2013-07-23

    Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and

  6. Developing Cultural Competence in Human Service Providers.

    Science.gov (United States)

    Krajewski-Jaime, Elvia R.; And Others

    Cultural competence assumes greater importance in the United States as international relations shift and the United States changes its own demographic makeup. Hispanics have significant health care needs and cultural beliefs that influence their acceptance of service. As part of an effort to build cultural competence in undergraduate social work…

  7. Effectiveness of Reference Services in Providing Students ...

    African Journals Online (AJOL)

    after spending lots of money due to some reason and the other. .... services include various forms of current awareness and selective dissemination of ... the users. Personal attention is at the very heart of the reference desk, and the goal of the.

  8. Traveling abroad for medical care: U.S. medical tourists' expectations and perceptions of service quality.

    Science.gov (United States)

    Guiry, Michael; Vequist, David G

    2011-01-01

    The SERVQUAL scale has been widely used to measure service quality in the health care industry. This research is the first study that used SERVQUAL to assess U.S. medical tourists' expectations and perceptions of the service quality of health care facilities located outside the United States. Based on a sample of U.S. consumers, who had traveled abroad for medical care, the results indicated that there were significant differences between U.S. medical tourists' perceived level of service provided and their expectations of the service that should be provided for four of the five dimensions of service quality. Reliability had the largest service quality gap followed by assurance, tangibles, and empathy. Responsiveness was the only dimension without a significantly different gap score. The study establishes a foundation for future research on service quality in the rapidly growing medical tourism industry.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  10. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.

    Science.gov (United States)

    Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C

    2013-11-04

    Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs

  11. Medical Service: 40 years of outpatient care

    CERN Multimedia

    2005-01-01

    On 1st June 2005 the Medical Service will be celebrating its fortieth birthday. This will mark forty years of service to the health of CERN's personnel by the Medical Service's small team of doctors, nurses, laboratory assistants and secretaries. Since 1965, 27 280 medical files have been archived and computerised. The Medical Service. From left to right, front row : Mireille Vosdey, Marloeke Bol and Nicole De Matos. From left to right, back row : Katie Warrilow-Thomson, Dr Eric Reymond, Dr Véronique Fassnacht, Isabelle Auvigne and Françoise Lebrun-Klauser. The Medical Service was founded on 1st June 1965, with a staff of four: the doctor, Jean-Paul Diss, a nurse, a laboratory assistant and a secretary. Previously, a private medical practitioner had come to CERN to perform the medical check-ups on the personnel and the Fire Brigade was responsible for first aid. However, in view of increasing staff numbers and the specific needs of a Laboratory like CERN, an on-site Medical Service had become ess...

  12. 25 CFR 20.402 - When are protective services provided?

    Science.gov (United States)

    2010-04-01

    ... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.402 When are protective services provided? Protective services are provided when children or adults: (a) Are deprived temporarily or permanently of needed supervision by responsible adults; (b) Are neglected, abused or exploited...

  13. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers

    Science.gov (United States)

    2013-01-01

    Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff

  14. Practical Theology and providing service: The service through love ...

    African Journals Online (AJOL)

    known sight in society. Despite the larger picture of inadequate service, there are those who serve their fellow humans and society every day. The Mamas Africa utilising the minimum resources available, are examples of people who make a ...

  15. Supercapacitor to Provide Ancillary Services: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Muljadi, Eduard [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gevorgian, Vahan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Luo, Yusheng [Idaho National Laboratory; Mohanpurkar, M. [Idaho National Laboratory; Hovsapian, R. [Idaho National Laboratory; Koritarov, V. [Argonne National Laboratory

    2017-10-09

    Supercapacitor technology has reached a level of maturity as a viable energy storage option available to support a modern electric power system grid; however, its application is still limited because of its energy capacity and the cost of the commercial product. In this paper, we demonstrate transient models of supercapacitor energy storage plants operating in coordination with run-of-the-river (ROR), doubly-fed induction generator hydropower plants (HPP) using a system control concept and architecture developed. A detailed transient model of a supercapacitor energy storage device is coupled with the grid via a three-phase inverter/rectifier and bidirectional DC-DC converter. In addition, we use a version of a 14-bus IEEE test case that includes the models of the supercapacitor energy storage device, ROR HPPs, and synchronous condensers that use the rotating synchronous generators of retired coal-powered plants. The purpose of the synchronous condensers is to enhance the system stability by providing voltage and reactive power control, provide power system oscillations damping, and maintain system inertia at secure levels. The control layer provides coordinated, decentralized operation of distributed ROR HPPs and energy storage as aggregate support to power system operations.

  16. 77 FR 70893 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ... care, nursing home care, domiciliary care, or medical services and who requires medical services to... care, nursing home care, domiciliary care, or medical services, and requires medical services to... may contract for certain hospital care (inpatient care) and medical services (outpatient care) for...

  17. Hand hygiene in emergency medical services.

    Science.gov (United States)

    Teter, Jonathan; Millin, Michael G; Bissell, Rick

    2015-01-01

    Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of

  18. Providing Medical Care in Yekaterynoslav during World War I

    Directory of Open Access Journals (Sweden)

    V.V. Haponov

    2015-04-01

    Full Text Available Providing medical care to the ill and wounded persons during World War I in Yekaterynoslav is described. The history of the creation of field hospitals, military hospitals, Red Cross hospitals and church-monument to the fallen heroes is presented. The selfless work of military medical personnel is shown. Biographical information about a doctor, public figure Yefim Pavlovskyi is provided.

  19. Creative pricing strategies for medical services.

    Science.gov (United States)

    Tellis, G J

    1987-01-01

    This paper discusses the strategic role of the pricing of medical services. Strategic pricing is a creative process that can be a vital means of defining marketing segments, differentiating services, and gaining a competitive advantage. The central issue in strategic pricing is creatively using the principle of cross-subsidies or shared economies over consumer groups, service sets, or competitors. This principle yields a rich set of pricing strategies that can be used in response to various environments.

  20. 28 CFR 92.8 - Providing recruitment services.

    Science.gov (United States)

    2010-07-01

    ... populations to a police department. The recruitment strategies employed may include: (a) A process for... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Providing recruitment services. 92.8... POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.8 Providing recruitment services. The...

  1. Filling Service Gaps: Providing Intensive Treatment Services for Offenders

    Science.gov (United States)

    Young, Douglas W.; Farrell, Jill L.; Henderson, Craig E.; Taxman, Faye S.

    2009-01-01

    Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders. PMID:19261394

  2. Information from the MEDICAL SERVICE

    CERN Document Server

    HR Department

    2008-01-01

    (The English version will be available next week). L’infirmerie du CERN (bâtiment 57-Rdc) est ouverte de 8h00 à 17h30, tous les jours ouvrables. La période de 12h30 à 13h30 est réservée uniquement aux urgences, afin de respecter un moment de pause pour les infirmières. Le service médical délivre des soins de premier secours et ne peut en aucun cas se substituer au médecin traitant. Une liste de médecins, dentistes et d’autres professionnels de santé du pays de Gex et de Meyrin est disponible sur la page web du service médical et mise à jour régulièrement : http://sc-me.web.cern.ch/sc-me/ En cas d’urgence sur le site du CERN, appeler en priorité le 74444.

  3. Security measures effect over performance in service provider network

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... Abstract—network security is defined as a set of policies and actions taken by a ... These threats are linked with the following factors that are ... typically smaller than those in the service provider space. ... Service providers cannot manage to provide ... e the DB performance effect ... r the business needs [10].

  4. Improving Educational Outcomes by Providing Educational Services through Mobile Technology

    OpenAIRE

    Hosam Farouk El-Sofany

    2013-01-01

    The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great co...

  5. Mental Health Service Providers: College Student Perceptions of Helper Effectiveness

    Science.gov (United States)

    Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.

    2014-01-01

    Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…

  6. Note from the CERN Medical Service

    CERN Multimedia

    Medical Service

    2005-01-01

    FLU VACCINATION People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2006. CERN staff aged 50 or over are recommended to have the flu vaccination.  Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious illness or after major surgery . The Medical Service will not administer vaccines for family members or retired staff members, who must contact their usual family doctor. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  7. Medical diagnostic laboratories provisioning of services in India

    Directory of Open Access Journals (Sweden)

    Rahi Jain

    2015-01-01

    Full Text Available Context: Diagnostic services have a very important role to play in medical decision-making, which have an impact on the nation′s health status. The understanding of Indian diagnostic services provisioning has certain literature gaps. Aims: This study focused on understanding the functioning of provision of diagnostic services by Indian diagnostic laboratories. Materials and Methods: Exploratory field visits and literature review were used as tools to understand the Indian health system. Results: Indian diagnostic laboratory can be classified into various categories based on the type of services provided and governance. The difference in their financing, resources, quality assurance of services and patient access to services was found in these different laboratories. Conclusions: It was concluded from the study that patient′s access to laboratory services is affected by the functioning of laboratories in terms of governance, financing, resources, quality assurance of services and patient services.

  8. Ethics in the marketing of medical services.

    Science.gov (United States)

    Latham, Stephen R

    2004-09-01

    This paper deals with the ethics of marketing medical services by physicians, medical groups, hospitals and other mainstream medical caregivers in the United States. It does not deal with pharmaceutical marketing, since that raises a number of special issues, some of them legal and some having to do with the unique culture of pharmaceutical marketing, which really ought to be dealt with separately. Nor does it touch on the little-explored field of marketing alternative and complementary medicine. It begins with a general description of what is included in "the marketing process." It then briefly tours some of the difficulties faced by those who would market medical services ethically, and ends with some comments on the relevance of professionalism to ethical marketing.

  9. Costs of publicly provided maternity services in Rosario, Argentina

    Directory of Open Access Journals (Sweden)

    Borghi Josephine

    2003-01-01

    Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.

  10. Using fuzzy gap analysis to measure service quality of medical tourism in Taiwan.

    Science.gov (United States)

    Ho, Li-Hsing; Feng, Shu-Yun; Yen, Tieh-Min

    2015-01-01

    The purpose of this paper is intended to create a model to measure quality of service, using fuzzy linguistics to analyze the quality of service of medical tourism in Taiwan so as to find the direction for improvement of service quality in medical tourism. The study developed fuzzy questionnaires based on the characteristics of medical tourism quality of service in Taiwan. Questionnaires were delivered and recovered from February to April 2014, using random sampling according to the proportion of medical tourism companies in each region, and 150 effective samples were obtained. The critical quality of service level is found through the fuzzy gap analysis using questionnaires examining expectations and perceptions of customers, as the direction for continuous improvement. From the study, the primary five critical service items that improve the quality of service for medical tourism in Taiwan include, in order: the capability of the service provider to provide committed medical tourism services reliably and accurately, facility service providers in conjunction with the services provided, the cordial and polite attitude of the service provider eliciting a sense of trust from the customer, professional ability of medical (nursing) personnel in hospital and reliability of service provider. The contribution of this study is to create a fuzzy gap analysis to assess the performance of medical tourism service quality, identify key quality characteristics and provide a direction for improvement and development for medical tourism service quality in Taiwan.

  11. MEDICAL SERVICES OR MEDICAL CARE – AN URGENT ISSUE FOR PUBLIC HEALTH INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    E. V. Pesennikova

    2017-01-01

    Full Text Available Purpose. To consider the relationship between the concepts of “medical service” and “medical care” in the work of public medical institutions, based on the analysis of normative legal documents of the modern period.Materials and methods. In the course of the research, more than 18 legal and regulatory documents that were published during the period from 1990 to 2017 were analyzed, an analysis of judicial practice and related literature sources (periodicals was carried out.Results. The analysis made it possible to distinguish the stages in the development of the organizational and legal framework for the provision of paid medical services in the Russian Federation and the dynamics of the relationship between the terms “medical care” and “medical service”. It was revealed that the concept of “medical services” appeared much later and was associated with the development of paid medical services and the need to establish legal aspects of health care. The provision of medical assistance is regulated mainly by public law, and the provision of medical services is governed by private law. The term “medical care” is broader than the “medical service” from the standpoint of the social aspect. At the same time, the concept of “medical service” can be considered more widely than medical care in cases when it is not only about measures aimed at treating the patient, but also about providing additional services to the patient in the process of receiving medical care.Conclusion. Thus, we concluded that the categories of medical care and medical services should not be identified, but also not completely different concepts, but rather enter into a partial intersection relationship. The need to distinguish between the concepts of “medical care” and “medical service” is dictated not only by the category relations or opinion of the population and the medical community, but also by the need for legal support for the process of

  12. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine....515 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine...

  13. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine...

  14. Emergency medical service systems in Japan : Past, present, and future

    OpenAIRE

    Tanigawa, Koichi; Tanaka, Keiichi

    2006-01-01

    Emergency medical services are provided by the fire defense headquarter of the local government in Japan. We have a one-tiered EMS system. The ambulance is staffed by three crews trained in rescue, stabilization, transportation, and advanced care of traumatic and medical emergencies. There are three levels of care provided by ambulance personnel including a basic-level ambulance crew (First Aid Class one, FAC-1), a second level (Standard First Aid Class, SFAC), and the highest level (Emergenc...

  15. Cost associated with stroke: outpatient rehabilitative services and medication.

    Science.gov (United States)

    Godwin, Kyler M; Wasserman, Joan; Ostwald, Sharon K

    2011-10-01

    This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs for services were based on Medicare reimbursement rates. Medicaid reimbursement rates and average wholesale price were used to estimate medication costs. Of the 54 stroke survivors, 40 (74.1%) were categorized as independent, 12 (22.2%) had modified dependence, and 2 (3.7%) were dependent at the time of discharge from inpatient rehabilitation. Average cost for outpatient stroke rehabilitation services and medications the first year post inpatient rehabilitation discharge was $17,081. The corresponding average yearly cost of medication was $5,392, while the average cost of yearly rehabilitation service utilization was $11,689. Cost attributed to medication remained relatively constant throughout the groups. Outpatient rehabilitation service utilization constituted a large portion of cost within each group: 69.7% (dependent), 72.5% (modified dependence), and 66.7% (independent). Stroke survivors continue to incur significant costs associated with their stroke for the first 12 months following discharge from an inpatient rehabilitation setting. Changing public policies affect the cost and availability of care. This study provides a snapshot of outpatient medication and therapy costs prior to the enactment of major changes in federal legislation and serves as a baseline for future studies.

  16. Framing the future: sme logistics service providers and scenario planning

    NARCIS (Netherlands)

    Stef Weijers; Reinder Pieters; Allan Woodburn; Hans-Heinrich Glöckner

    2013-01-01

    In recent years, the transport industry has encountered numerous challenges. It experienced strong growth, but also many uncertainties. In many cases, logistics service providers were forced to change their strategy. So, the question for logistics service providers arises “how to deal best with

  17. Apps and Mobile Support Services in Canadian Academic Medical Libraries

    Directory of Open Access Journals (Sweden)

    Tess Grynoch

    2016-12-01

    Full Text Available Objective: To examine how Canadian academic medical libraries are supporting mobile apps, what apps are currently being provided by these libraries, and what types of promotion are being used. Methods: A survey of the library websites for the 17 medical schools in Canada was completed. For each library website surveyed, the medical apps listed on the website, any services mentioned through this medium, and any type of app promotion events were noted. When Facebook and Twitter accounts were evident, the tweets were searched and the past two years of Facebook posts scanned for mention of medical apps or mobile services/events. Results: All seventeen academic medical libraries had lists of mobile medical apps with a large range in the number of medical relevant apps (average=31, median= 23. A total of 275 different apps were noted and the apps covered a wide range of subjects. Five of the 14 Facebook accounts scanned had posts about medical apps in the past two years while 11 of the 15 Twitter accounts had tweets about medical apps. Social media was only one of the many promotional methods noted. Outside of the app lists and mobile resources guides, Canadian academic medical libraries are providing workshops, presentations, and drop-in sessions for mobile medical apps. Conclusion: While librarians cannot simply compare mobile services and resources between academic medical libraries without factoring in a number of other circumstances, librarians can learn from mobile resources strategies employed at other libraries, such as using research guides to increase medical app literacy.

  18. Low-Value Service Use in Provider Organizations.

    Science.gov (United States)

    Schwartz, Aaron L; Zaslavsky, Alan M; Landon, Bruce E; Chernew, Michael E; McWilliams, J Michael

    2018-02-01

    To assess whether provider organizations exhibit distinct profiles of low-value service provision. 2007-2011 Medicare fee-for-service claims and enrollment data. Use of 31 services that provide minimal clinical benefit was measured for 4,039,733 beneficiaries served by 3,137 provider organizations. Variation across organizations, persistence within organizations over time, and correlations in use of different types of low-value services within organizations were estimated via multilevel modeling, with adjustment for beneficiary sociodemographic and clinical characteristics. Organizations provided 45.6 low-value services per 100 beneficiaries on average, with considerable variation across organizations (90th/10th percentile ratio, 1.78; 95 percent CI, 1.72-1.84), including substantial between-organization variation within hospital referral regions (90th/10th percentile ratio, 1.66; 95 percent CI, 1.60-1.71). Low-value service use within organizations was highly correlated over time (r, 0.98; 95 percent CI, 0.97-0.99) and positively correlated between 13 of 15 pairs of service categories (average r, 0.26; 95 percent CI, 0.24-0.28), with the greatest correlation between low-value imaging and low-value cardiovascular testing and procedures (r, 0.54). Use of low-value services in provider organizations exhibited substantial variation, high persistence, and modest consistency across service types. These findings are consistent with organizations shaping the practice patterns of affiliated physicians. © Health Research and Educational Trust.

  19. Note from the CERN Medical Service

    CERN Multimedia

    Medical Service

    2004-01-01

    FLU VACCINATION People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2004. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  20. Sexual health service providers' perceptions of transgender youth in England.

    Science.gov (United States)

    Lefkowitz, Ayla R F; Mannell, Jenevieve

    2017-05-01

    Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings. © 2017 John Wiley & Sons Ltd.

  1. The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

    Science.gov (United States)

    Faye, M

    2013-01-01

    This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

  2. Homeless health needs: shelter and health service provider perspective.

    Science.gov (United States)

    Hauff, Alicia J; Secor-Turner, Molly

    2014-01-01

    The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.

  3. Twenty-first-century medical microbiology services in the UK.

    Science.gov (United States)

    Duerden, Brian

    2005-12-01

    With infection once again a high priority for the UK National Health Service (NHS), the medical microbiology and infection-control services require increased technology resources and more multidisciplinary staff. Clinical care and health protection need a coordinated network of microbiology services working to consistent standards, provided locally by NHS Trusts and supported by the regional expertise and national reference laboratories of the new Health Protection Agency. Here, I outline my thoughts on the need for these new resources and the ways in which clinical microbiology services in the UK can best meet the demands of the twenty-first century.

  4. Telecommunications: Issues in Providing Cable and Satellite Television Services

    Science.gov (United States)

    2002-10-01

    This report provides information on (1) whether the availability of cable modem Internet access service appears to be affecting the competitiveness of direct broadcast satellite (DBS) companies in the provision of video services, (2) whether cable prices and DBS penetration rates appear to be affected in areas where the DBS companies offer local broadcast channels, and (3) whether the two individual DBS companies are technologically capable of expanding local broadcast channel services into all 210 television markets in the United States.

  5. Conceptual Models of the Individual Public Service Provider

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Pedersen, Lene Holm; Bhatti, Yosef

    are used to gain insight on the motivation of public service providers; namely principal-agent theory, self-determination theory and public service motivation theory. We situate the theoretical discussions in the context of public service providers being transferred to private organizations......Individual public service providers’ motivation can be conceptualized as either extrinsic, autonomous or prosocial, and the question is how we can best theoretically understand this complexity without losing too much coherence and parsimony. Drawing on Allison’s approach (1969), three perspectives...... theoretical – to develop a coherent model of individual public service providers – but the empirical illustration also contributes to our understanding of motivation in the context of public sector outsourcing....

  6. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

    Science.gov (United States)

    Jain, Parul; Slater, Michael D

    2013-01-01

    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.

  7. Privately Provided Accommodation Service Quality and Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Joshua Mugambwa

    2016-04-01

    Full Text Available Privately provided accommodation is a growing service in Uganda’s higher education sector due to education liberalization and demand for education. This research took a case study of Nsamizi Training Institute of Social Development (NTISD to determine the relationship between privately provided accommodation service quality and customer satisfaction. Specifically, the objectives of the study were (a to find out the relationship between security and NTISD students’ satisfaction with privately provided accommodation, and (b to find out the hierarchical level of importance of NTISD student satisfaction of the three service quality dimensions (reliability, security, and tangibles with privately provided accommodation. Using quantitative and qualitative modes of data analysis and a sample of 300 students from 20 private hostels, this study established a strong positive significant relationship between security and satisfaction regarding privately provided accommodation. This implies that accommodation service providers should increase the quality of security so as to increase the satisfaction of students regarding privately provided accommodation. The study established the hierarchical order of importance from the most important service quality dimension, respectively, as follows: reliability, security, and tangibles. Therefore, private accommodation service managers should pay extra attention to the dimensions in the same order.

  8. Personal Perspectives on Providing Services to Foster Youth

    Science.gov (United States)

    Whitman, Kenyon L.

    2018-01-01

    Utilizing an academic capital framework and student perspectives, this chapter provides insight into the ways that programs and services can help students develop the skills needed to succeed in college.

  9. Ecosystem services provided by pacific NW Estuaries: State of knowledge

    Science.gov (United States)

    Coastal regions in the United States are rapidly developing areas, with increasing urbanization and growing populations. Estuarine and nearshore coastal marine waters provide valuable ecosystem services to resident and transient human communities. In the Pacific Northwest (PNW)...

  10. Patients' Evaluations of Gynecologic Services Provided by Nurse Practitioners.

    Science.gov (United States)

    Wagener, J. Mark; Carter, Glenna

    1978-01-01

    The development, operating principles, and users' evaluations of a broad based gynecologic program emphasizing effective birth control on a university campus are discussed. A major feature explored is the use of nurse practitioners as the primary service providers. (JMF)

  11. Strategic information systems planning for health service providers.

    Science.gov (United States)

    Moriarty, D D

    1992-01-01

    There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. This analysis presents some key strategic information systems issues that will enable managers to identify opportunities within their organizations.

  12. The demand for ambulatory mental health services from specialty providers.

    Science.gov (United States)

    Horgan, C M

    1986-01-01

    A two-part model is used to examine the demand for ambulatory mental health services in the specialty sector. In the first equation, the probability of having a mental health visit is estimated. In the second part of the model, variations in levels of use expressed in terms of visits and expenditures are examined in turn, with each of these equations conditional on positive utilization of mental health services. In the second part of the model, users are additionally grouped into those with and without out-of-pocket payment for services. This specification accounts for special characteristics regarding the utilization of ambulatory mental health services: (1) a large part of the population does not use these services; (2) of those who use services, the distribution of use is highly skewed; and (3) a large number of users have zero out-of-pocket expenditures. Cost-sharing does indeed matter in the demand for ambulatory mental health services from specialty providers; however, the decision to use mental health services is affected by the level of cost-sharing to a lesser degree than is the decision regarding the level of use of services. The results also show that price is only one of several important factors in determining the demand for services. The lack of significance of family income and of being female is notable. Evidence is presented for the existence of bandwagon effects. The importance of Medicaid in the probability of use equations is noted. PMID:3721874

  13. Note from the CERN Medical Service

    CERN Multimedia

    2005-01-01

    FLU VACCINATION People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment (preferably between 14:00 and 16:00), but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2005. CERN staff aged 50 or over are recommended to have the flu vaccination. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious illness or after major surgery. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their usual family doctor.

  14. 75 FR 27917 - Emergency Medical Services Week, 2010

    Science.gov (United States)

    2010-05-18

    ... enhancing our country's preparedness and resilience. During Emergency Medical Services Week, we recommit to... physicians. From rural regions of our Nation to our busiest urban centers, EMS teams provide access to... to arrive at the scene of a crisis. These heroic professionals, volunteers, and citizens form a...

  15. Benchmarking online dispatch algorithms for Emergency Medical Services

    NARCIS (Netherlands)

    Jagtenberg, C.J.; Berg, P.L.; van der Mei, R.D.

    2016-01-01

    Providers of Emergency Medical Services (EMS) face the online ambulance dispatch problem, in which they decide which ambulance to send to an incoming incident. Their objective is to minimize the fraction of arrivals later than a target time. Today, the gap between existing solutions and the optimum

  16. Prejudice and discrimination from mental health service providers.

    Science.gov (United States)

    Nemec, Patricia B; Swarbrick, Margaret; Legere, Lyn

    2015-06-01

    This column describes the experience of prejudice and discrimination that some mental health service users encounter in their interactions with service providers and organizations. The intent of this column is to highlight potential action steps to address the negative beliefs and attitudes of service providers that contribute to prejudice and discrimination. This description draws from published material and the authors' experience. If the most effective approaches to reduce public prejudice and discrimination toward people diagnosed with a mental illness are education and contact, then those methods may be useful methods to help mental health service providers view and engage persons served from a strengths-based recovery and wellness orientation. (c) 2015 APA, all rights reserved).

  17. System and Method for Providing a Climate Data Persistence Service

    Science.gov (United States)

    Schnase, John L. (Inventor); Ripley, III, William David (Inventor); Duffy, Daniel Q. (Inventor); Thompson, John H. (Inventor); Strong, Savannah L. (Inventor); McInerney, Mark (Inventor); Sinno, Scott (Inventor); Tamkin, Glenn S. (Inventor); Nadeau, Denis (Inventor)

    2018-01-01

    A system, method and computer-readable storage devices for providing a climate data persistence service. A system configured to provide the service can include a climate data server that performs data and metadata storage and management functions for climate data objects, a compute-storage platform that provides the resources needed to support a climate data server, provisioning software that allows climate data server instances to be deployed as virtual climate data servers in a cloud computing environment, and a service interface, wherein persistence service capabilities are invoked by software applications running on a client device. The climate data objects can be in various formats, such as International Organization for Standards (ISO) Open Archival Information System (OAIS) Reference Model Submission Information Packages, Archive Information Packages, and Dissemination Information Packages. The climate data server can enable scalable, federated storage, management, discovery, and access, and can be tailored for particular use cases.

  18. Employee motivation in Product-Service-System providers

    DEFF Research Database (Denmark)

    Kreye, Melanie

    2016-01-01

    This research investigates how intrinsic and extrinsic motivation factors contribute to employee motivation in providers of Product-Service Systems (PSS). Employee motivation determines the quality of the delivered service and is thus an area of great importance for PSS providers. We present rich...... case-based data collected through semi-structured interviews, a survey and secondary sources. The analysis showed the particularly high importance of intrinsic and individual motivation factors such as the fulfilling nature of the work and skill development showing the ownership and pride service...... employees took in their work. Further, the organisation needs to set the context of high employee motivation by enabling flexibility and performance feedback. Our research contributes to the literature by providing a first empirical study of employee motivation in PSS providers and thus providing important...

  19. Organization and performance evaluation of the regional air medical service

    Directory of Open Access Journals (Sweden)

    A. A. Lobzhanidze

    2016-01-01

    Full Text Available We prove the need to create the regional system of air medical service in St. Petersburg and Leningrad Region.We describe the mechanism of managing the medical service transport system which includes patients’ evacuation both by automobile and aviation. We offer algorithms of assessing the cost effectiveness of air medical service both at the time of treatment and making the patient able to work and during the entire period of hisparticipation in social labor activities. This project is being implemented since 2014. Data in the article are provided on the basis of actually realized flights by helicopter center LLC«Helidrive» which took part in pilot project.

  20. Improving Educational Outcomes by Providing Educational Services through Mobile Technology

    Directory of Open Access Journals (Sweden)

    Hosam Farouk El-Sofany

    2013-01-01

    Full Text Available The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great convenience to those off-campus students who do not always have time to find Internet enabled computers to get the important educational information from their academic institutions. With the mobile or M-educational services, both the students and the instructors can access the services anytime and anywhere they want. This paper discusses those M-educational services that can be moved to the mobile platform and then presents the system prototype and architecture that integrate these services into the mobile technology platform. The paper will conclude with a description of the formative evaluation of the system prototype.

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

    OpenAIRE

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

    2014-01-01

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

  2. The state of the psychology health service provider workforce.

    Science.gov (United States)

    Michalski, Daniel S; Kohout, Jessica L

    2011-12-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of the PsyD degree and the formalization of the predoctoral internship placement system (the APPIC Match) have been well noted, but efforts to gain a complete understanding of professional practice are lacking. Specifically, piecemeal research on the provider workforce has led to the study of specific subpopulations using varying approaches and definitions of those providing direct clinical service. Consequently, estimates of the supply and need for health service providers are distinctly divergent and generate protracted debate in organized psychology. The APA membership directory and the APA Doctorate Employment Surveys have traditionally been relied on for workforce analyses. Yet, these data have become characterized by limited generalizability in recent years because of declining survey response rates and the fact that APA member data may not be as representative of the entire psychology health service provider population as they were previously. The 2008 APA Survey of Psychology Health Service Providers targeted these limitations by including nonmember psychologists in the sampling frame. Results revealed emerging themes in the demographics, work settings, and delivery of health services of the psychology health service provider workforce. Future areas of research for APA and organized psychology to undertake in addressing need and demand are suggested. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  3. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  4. The Defence Medical Library Service and military medicine.

    Science.gov (United States)

    Walker, S B

    2005-01-01

    The Defence Medical Library Service (DMLS) supports the clinical practice and career development of military health professionals across the world. Clinical governance and the need for medical knowledge to be evidence-based means the DMLS has a central role to play in support of defence medicine. The DMLS is important for enabling health professionals to make sense of the evidence-based pyramid and the hierarchy of medical knowledge. The Royal Centre for Defence Medicine (RCDM) in Birmingham is recognised as an international centre of excellence. The information, knowledge and research requirements of the RCDM will provide opportunities for the DMLS to support and engage with the academic community.

  5. Steve Jobs provides lessons for any medical practice.

    Science.gov (United States)

    Ornstein, Hal; Baum, Neil

    2013-01-01

    Steve Jobs is inarguably the greatest inventor and creative genius since Thomas Edison. He provided technology that enhances communication on a global level. Jobs also provided ideas and suggestions that could work in any medical practice regardless of the size of the practice, the location of the practice, or the employment model. His advice can be transferred from a high-tech business that employs thousands to a high-touch medical practice that has only a few employees. This article will list a few of Jobs leadership characteristics and how they might apply to physicians, their teams, and their practices. Wouldn't you like to be the Steve Jobs of healthcare? If so, read on!

  6. GEMSS: grid-infrastructure for medical service provision.

    Science.gov (United States)

    Benkner, S; Berti, G; Engelbrecht, G; Fingberg, J; Kohring, G; Middleton, S E; Schmidt, R

    2005-01-01

    The European GEMSS Project is concerned with the creation of medical Grid service prototypes and their evaluation in a secure service-oriented infrastructure for distributed on demand/supercomputing. Key aspects of the GEMSS Grid middleware include negotiable QoS support for time-critical service provision, flexible support for business models, and security at all levels in order to ensure privacy of patient data as well as compliance to EU law. The GEMSS Grid infrastructure is based on a service-oriented architecture and is being built on top of existing standard Grid and Web technologies. The GEMSS infrastructure offers a generic Grid service provision framework that hides the complexity of transforming existing applications into Grid services. For the development of client-side applications or portals, a pluggable component framework has been developed, providing developers with full control over business processes, service discovery, QoS negotiation, and workflow, while keeping their underlying implementation hidden from view. A first version of the GEMSS Grid infrastructure is operational and has been used for the set-up of a Grid test-bed deploying six medical Grid service prototypes including maxillo-facial surgery simulation, neuro-surgery support, radio-surgery planning, inhaled drug-delivery simulation, cardiovascular simulation and advanced image reconstruction. The GEMSS Grid infrastructure is based on standard Web Services technology with an anticipated future transition path towards the OGSA standard proposed by the Global Grid Forum. GEMSS demonstrates that the Grid can be used to provide medical practitioners and researchers with access to advanced simulation and image processing services for improved preoperative planning and near real-time surgical support.

  7. Customer satisfaction surveys: Methodological recommendations for financial service providers

    Directory of Open Access Journals (Sweden)

    Đorđić Marko

    2010-01-01

    Full Text Available This methodological article investigates practical challenges that emerge when conducting customer satisfaction surveys (CSS for financial service providers such as banks, insurance or leasing companies, and so forth. It displays methodological recommendations in reference with: (a survey design, (b sampling, (c survey method, (d questionnaire design, and (e data acquisition. Article provides appropriate explanations that usage of: two-stage survey design, SRS method, large samples, and rigorous fieldwork preparation can enhance the overall quality of CSS in financial services. Proposed methodological recommendations can primarily be applied to the primary quantitative marketing research in retail financial services. However, majority of them can be successfully applied when conducting primary quantitative marketing research in corporate financial services as well. .

  8. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    Directory of Open Access Journals (Sweden)

    Betsy Sleath

    2014-01-01

    Full Text Available Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients’ visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.

  9. ASMATRA: Rankin g ASs Providing Transit Service to Malware Hosters

    OpenAIRE

    Wagner , Cynthia; François , Jérôme; State , Radu; Dulaunoy , Alexandre; Engel , Thomas; Massen , Gilles

    2013-01-01

    International audience; The Internet has grown into an enormous network offering a variety of services, which are spread over a multitude of domains. BGP-routing and Autonomous Systems (AS) are the key components for maintaining high connectivity in the Internet. Unfortunately, Internet Service Providers (ISPs) operating ASs do not only host normal users and content, but also malicious content used by attackers for spreading malware, hosting phishing web-sites or performing any kind of fraudu...

  10. The Restaurant as Hybrid: Lean Manufacturer and Service Provider

    Directory of Open Access Journals (Sweden)

    Christopher Muller

    2013-01-01

    Full Text Available Uniquely positioned as both consumer service providers and tangible finished goods manufacturers, restaurants sell at retail an inventory that is fabricated from raw materials at the site of consumption. This article illustrates how restaurant managers have historically used the fundamentals of just-in-time and lean manufacturing production, often without understanding the power for efficiency and profit each brings. The goal is to encourage restaurateurs to seek a better understanding of where these principles interface with service management theory.

  11. Public service providers and users in the information society

    Directory of Open Access Journals (Sweden)

    Bernt Krohn Solvang

    2015-03-01

    Full Text Available The issue to be discussed in this article is to what extent does ICT create new challenges for the relationship between public service providers and users? It is important to recognize the concept of social capital because the concept is vital to the understanding of access to the information society and efficient functioning of government in its service to citizens. In this way we see social capital as a mediating “institution” between public authorities and the citizens (users.

  12. Transparency of Mandatory Information Disclosure and Concerns of Health Services Providers and Consumers.

    Science.gov (United States)

    Yan, Yu-Hua; Kung, Chih-Ming; Fang, Shih-Chieh; Chen, Yi

    2017-01-09

    This study analyzed differences between transparency of information disclosure and related demands from the health service consumer's perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384). Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements ( p transparency of information disclosure ( p information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information's applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively.

  13. Factors influencing business of mobile telecommunication service providers in Vietnam

    Directory of Open Access Journals (Sweden)

    Ha Thanh Hai

    2018-05-01

    Full Text Available According to the Ministry of Information and Communications in Vietnam, as of November 2015, the number of mobile subscribers is over 120 million ones, accounting for over 86% of the total number of telephone subscribers. With a total population of over 92 million Vietnam citizens, a stable national economy and a large populations of young consumers in the country, mobile communication industries still have a huge potentials for future development. Telecommunication service providers in Vietnam are facing fierce competition. Subscribers are expecting OTT (Over the Top applications, good quality service and handset subsidy. This study investigated whether legal frameworks, OTT applications, quality of service and handset subsidy are important components of mobile telecommunication service in Vietnam. This study used quantitative method to distribute surveys to mobile subscribers. Findings found that all four factors significantly influence mobile business in Vietnam. Thus, telecommunication service providers in Vietnam must continuously innovate to enhance operational competitiveness, improve business efficiency, expand business scale, and improve its position in the market in order to ensure sustainable development. Moreover, Vietnamese government needs to develop a legal framework to help mobile telecommunication service providers enhance the common interests and benefits of the entire society.

  14. Public health care providers and market competition: the case of Finnish occupational health services.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2011-02-01

    As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.

  15. ContextProvider: Context awareness for medical monitoring applications.

    Science.gov (United States)

    Mitchell, Michael; Meyers, Christopher; Wang, An-I Andy; Tyson, Gary

    2011-01-01

    Smartphones are sensor-rich and Internet-enabled. With their on-board sensors, web services, social media, and external biosensors, smartphones can provide contextual information about the device, user, and environment, thereby enabling the creation of rich, biologically driven applications. We introduce ContextProvider, a framework that offers a unified, query-able interface to contextual data on the device. Unlike other context-based frameworks, ContextProvider offers interactive user feedback, self-adaptive sensor polling, and minimal reliance on third-party infrastructure. ContextProvider also allows for rapid development of new context and bio-aware applications. Evaluation of ContextProvider shows the incorporation of an additional monitoring sensor into the framework with fewer than 100 lines of Java code. With adaptive sensor monitoring, power consumption per sensor can be reduced down to 1% overhead. Finally, through the use of context, accuracy of data interpretation can be improved by up to 80%.

  16. Development of a National Consensus for Tactical Emergency Medical Support (TEMS) Training Programs--Operators and Medical Providers.

    Science.gov (United States)

    Schwartz, Richard; Lerner, Brooke; Llwewllyn, Craig; Pennardt, Andre; Wedmore, Ian; Callaway, David; Wightman, John; Casillas, Raymond; Eastman, Alex; Gerold, Kevin; Giebner, Stephen; Davidson, Robert; Kamin, Richard; Piazza, Gina; Bollard, Glenn; Carmona, Phillip; Sonstrom, Ben; Seifarth, William; Nicely, Barbara; Croushorn, John; Carmona, Richard

    2014-01-01

    Tactical teams are at high risk of sustaining injuries. Caring for these casualties in the field involves unique requirements beyond what is provided by traditional civilian emergency medical services (EMS) systems. Despite this need, the training objectives and competencies are not uniformly agreed to or taught. An expert panel was convened that included members from the Departments of Defense, Homeland Security, Justice, and Health and Human Services, as well as federal, state, and local law-enforcement officers who were recruited through requests to stakeholder agencies and open invitations to individuals involved in Tactical Emergency Medical Services (TEMS) or its oversight. Two face-to-face meetings took place. Using a modified Delphi technique, previously published TEMS competencies were reviewed and updated. The original 17 competency domains were modified and the most significant changes were the addition of Tactical Emergency Casualty Care (TECC), Tactical Familiarization, Legal Aspects of TEMS, and Mass Casualty Triage to the competency domains. Additionally, enabling and terminal learning objectives were developed for each competency domain. This project has developed a minimum set of medical competencies and learning objectives for both tactical medical providers and operators. This work should serve as a platform for ensuring minimum knowledge among providers, which will serve enhance team interoperability and improve the health and safety of tactical teams and the public. 2014.

  17. Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters.

    Science.gov (United States)

    Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting

    2013-01-16

    Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients' perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients' overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a

  18. Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

    Science.gov (United States)

    2013-01-01

    Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly

  19. Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

    Directory of Open Access Journals (Sweden)

    Chang Ching-Sheng

    2013-01-01

    Full Text Available Abstract Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A interpersonal-based medical

  20. Marketing in the business activity of logistics service providers

    Directory of Open Access Journals (Sweden)

    Marcin Świtała

    2013-09-01

    Full Text Available Background: This article is a discussion on the role of marketing in the activity of logistics service providers. The strong competition and changing purchasing preferences should motivate the transport, forwarding and logistics sector managers to apply the marketing approach in practice. Methods: Results of direct research, conducted among a targeted group of 100 companies from the transport, forwarding and logistics sector, constitute the source basis. The sample group was divided into three categories of logistics providers: 2PL, 3PL and 4PL. The statistical analysis was based on three different non-parametric tests (Kruskal-Wallis, Chi-square and V Kramer.  Results and conclusions:  Currently, marketing does not play a key role in the activity of logistics services providers. The prevailing opinion is that importance of marketing in the company is average. The respondents have assessed in a similar way their activity compared to the activities of the competition. However, it was found that with the increase of the level of specialization (2PL-4PL, the awareness of impact of marketing on the logistics services sector also increased. The logistics services providers, who offer a wide range of logistics services, asses their competitive position in a better light.  

  1. The role of medical staff in providing patients rights.

    Science.gov (United States)

    Masic, Izet; Izetbegovic, Sebija

    2014-01-01

    Among the priority basic human rights, without a doubt, are the right to life and health-social protection. The process of implementation of human rights in the everyday life of an ordinary citizen in the post-war recovery of Bosnia and Herzegovina faces huge objective and subjective difficulties. Citizens need to be affordable adequate healthcare facilities that will be open to all on equal terms. The term hospital activity implies a set of measures, activities and procedures that are undertaken for the purpose of treatment, diagnosis and medical rehabilitation of patients in the respective health institutions. Principles of hospital care should include: Comprehensiveness (Hospital care is available to all citizens equally); Continuity (Provided is continuous medical care to all users); Availability (Provided approximately equal protection of rights for all citizens). Education of health professionals: The usual threats to patient safety include medical errors, infections occurred in the hospital, unnecessary exposure to high doses of radiation and the use of the wrong drug. Everyday continuing education in the profession of a doctor is lifelong.

  2. Federated query services provided by the Seamless SAR Archive project

    Science.gov (United States)

    Baker, S.; Bryson, G.; Buechler, B.; Meertens, C. M.; Crosby, C. J.; Fielding, E. J.; Nicoll, J.; Youn, C.; Baru, C.

    2013-12-01

    The NASA Advancing Collaborative Connections for Earth System Science (ACCESS) seamless synthetic aperture radar (SAR) archive (SSARA) project is a 2-year collaboration between UNAVCO, the Alaska Satellite Facility (ASF), the Jet Propulsion Laboratory (JPL), and OpenTopography at the San Diego Supercomputer Center (SDSC) to design and implement a seamless distributed access system for SAR data and derived data products (i.e. interferograms). A major milestone for the first year of the SSARA project was a unified application programming interface (API) for SAR data search and results at ASF and UNAVCO (WInSAR and EarthScope data archives) through the use of simple web services. A federated query service was developed using the unified APIs, providing users a single search interface for both archives (http://www.unavco.org/ws/brokered/ssara/sar/search). A command line client that utilizes this new service is provided as an open source utility for the community on GitHub (https://github.com/bakerunavco/SSARA). Further API development and enhancements added more InSAR specific keywords and quality control parameters (Doppler centroid, faraday rotation, InSAR stack size, and perpendicular baselines). To facilitate InSAR processing, the federated query service incorporated URLs for DEM (from OpenTopography) and tropospheric corrections (from the JPL OSCAR service) in addition to the URLs for SAR data. This federated query service will provide relevant QC metadata for selecting pairs of SAR data for InSAR processing and all the URLs necessary for interferogram generation. Interest from the international community has prompted an effort to incorporate other SAR data archives (the ESA Virtual Archive 4 and the DLR TerraSAR-X_SSC Geohazard Supersites and Natural Laboratories collections) into the federated query service which provide data for researchers outside the US and North America.

  3. Industrial Demand Management Providing Ancillary Services to the Distribution Grid

    DEFF Research Database (Denmark)

    Rahnama, Samira; Green, Torben; Lyhne, Casper

    2017-01-01

    A prominent feature of the future smart grid is the active participation of the consumer side in ancillary service provision. Grid operators procure ancillary services, including regulating power, voltage control, frequency control, and so on, to ensure safe, reliable, and high-quality electricity...... delivery. Consumers' involvement requires new entities and infrastructure. A so-called aggregator has been introduced as a new player to manage the services that are offered by the consumption units. This paper describes an industrial scale experimental setup for evaluating a particular type of aggregator....... The aggregator aims to provide a distribution grid service from industrial thermal loads through a direct control policy. Our specific case studies are a supermarket refrigeration system and an HVac chiller in conjunction with an ice storage, which are virtually connected to the aggregator. Practical results...

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

    Directory of Open Access Journals (Sweden)

    Scheffer Gert J

    2010-03-01

    Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

  5. 77 FR 4252 - Additional Spectrum for the Medical Device Radiocommunication Service

    Science.gov (United States)

    2012-01-27

    ... licensed users in these frequency bands to continue providing service. Medical Micro-Power Networks (MMNs...). Under this approach, medical devices would operate in the band on a shared, non-exclusive basis with...Radio Service rules for devices operating in the 413-457 MHz band. These definitions were for a Medical...

  6. Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

    Science.gov (United States)

    Stanley, Dara A.; Garratt, Michael P. D.; Wickens, Jennifer B.; Wickens, Victoria J.; Potts, Simon G.; Raine, Nigel E.

    2015-12-01

    Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sublethal effects on bees, affecting their foraging behaviour, homing ability and reproductive success. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants, but until now research on pesticide effects has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence to our knowledge that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Bumblebee colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly, these pesticide-exposed colonies produced apples containing fewer seeds, demonstrating a reduced delivery of pollination services. Our results also indicate that reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour, but most likely due to effects at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the functioning of natural ecosystems.

  7. Basics of Compounding: Providing Pharmacy Services to Bariatric Surgery Patients.

    Science.gov (United States)

    McElhiney, Linda F

    2018-01-01

    With the rise in obesity, more individuals are choosing bariatric surgery as a means to successfully lose weight and resolve co-morbidities. These patients need lifelong support from friends, family, and healthcare providers. Pharmacists need to be knowledgeable of the unique needs of these patients in order to provide information and recommendations on drug therapies and supplements. When a patient is wheeled out of the operating room following bariatric surgery, his or her life instantly changes. Like an infant, the patient has to slowly learn how to eat and drink again. Physical activity significantly increases. Taste perception changes. Serious medical problems, such as hypertension, type II diabetes, and hypercholesterolemia completely resolve within a couple of months. The patient has to be disciplined and follow the instructions of the bariatric team and other healthcare providers. Since the patient's gastrointestinal tract has been significantly altered, drug therapies may require some modifications too. Bariatric or weight loss surgery is definitely not the easy way to lose weight, but it is a very powerful tool for the patient. Weight loss, and maintaining that weight loss, is a lifelong journey for the patient that requires support from the bariatric team, healthcare provider(s), co-workers, friends, and family. Pharmacists may also provide support for these patients through counseling about their supplements, medications, and compounding medications to meet their specific needs. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  8. The medical libraries of Vietnam--a service in transition.

    Science.gov (United States)

    Brennen, P W

    1992-07-01

    The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation

  9. The 2017 International Joint Working Group White Paper by INDUSEM, the Emergency Medicine Association and the Academic College of Emergency Experts on Establishing Standardized Regulations, Operational Mechanisms, and Accreditation Pathways for Education and Care Provided by the Prehospital Emergency Medical Service Systems in India.

    Science.gov (United States)

    Sikka, Veronica; Gautam, V; Galwankar, Sagar; Guleria, Randeep; Stawicki, Stanislaw P; Paladino, Lorenzo; Chauhan, Vivek; Menon, Geetha; Shah, Vijay; Srivastava, R P; Rana, B K; Batra, Bipin; Kalra, O P; Aggarwal, P; Bhoi, Sanjeev; Krishnan, S Vimal

    2017-01-01

    The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India.

  10. 29 CFR 1910.151 - Medical services and first aid.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Medical services and first aid. 1910.151 Section 1910.151..., DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Medical and First Aid § 1910.151 Medical services and first aid. (a) The employer shall ensure the ready availability of medical personnel for...

  11. Obesity among health service providers in Nigeria: danger to long ...

    African Journals Online (AJOL)

    Introduction: Obesity is a global epidemic. There are rising rates of obesity and its associated disorders, especially in developing countries, including among Health Service Providers (HSPs). Obesity is associated with early retirement, increased morbidity and mortality. Thus, obesity has the potential of reducing long-term ...

  12. CSRQ Center Report on Education Service Providers: Educator's Summary

    Science.gov (United States)

    Center for Data-Driven Reform in Education (NJ3), 2008

    2008-01-01

    Education service providers (ESPs), or education management organizations, are for-profit or non-profit organizations that contract with new or existing public, charter, or private schools to help them implement comprehensive reforms. Which of these ESPs have evidence that they help children in elementary and secondary school of positive effects…

  13. The State of the Psychology Health Service Provider Workforce

    Science.gov (United States)

    Michalski, Daniel S.; Kohout, Jessica L.

    2011-01-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…

  14. Humanistic Wellness Services for Community Mental Health Providers

    Science.gov (United States)

    Carney, Jolynn V.

    2007-01-01

    The author examines the unique ability of mental health providers to offer humanistic services in a highly competitive atmosphere by using a wellness approach. J. E. Myers and T. J. Sweeney's (2005) 5 second-order factors are offered as a conceptual model. Therapeutic techniques and humanizing benefits for individuals, families, and communities…

  15. Improved Collaborative Transport Planning at Dutch Logistics Service Provider Fritom

    NARCIS (Netherlands)

    Buijs, Paul; Lopez Alvarez, Jose Alejandro; Veenstra, Marjolein; Roodbergen, Kees Jan

    2016-01-01

    We study the collaborative transport planning for two autonomous business units of Fritom, a Dutch logistics service provider. This difficult planning problem does not fit any existing type of vehicle routing problem proposed in the academic literature; therefore, we define a new problem class, the

  16. Medical Services: Medical Record Administration and Health Care Documentation

    Science.gov (United States)

    1999-05-03

    medical condition caused by it. Explain conditions, such as traumatic bursitis, traumatic neuritis, traumatic myositis , or traumatic synovitis, by... histopathologic findings have a direct bearing on diagnosis and treatment (AR 40-31/BUMEDINST 6510.2F/AFR 160-55). In such cases, the attending physician...Armed Forces Institute of Pathology and Armed Forces Histopathology Centers AR 40–35 Preventive Dentistry AR 40–48 Nonphysician Health Care Providers

  17. Under what conditions are provided services in Czech municipalities?

    Directory of Open Access Journals (Sweden)

    Markéta Fantová Šumpíková

    2007-10-01

    Full Text Available The goal of our paper is to present a set of analytical data connected with local services and their delivery arrangements, focusing on contracting out. Brief theoretical part of this paper shortly highlights theoretical issues of local service delivery and new alternative service delivery arrangements. Analytical part provides selected data on forms of delivery and the ways of selection of an external supplier, including comparisons with similar research data from Slovakia. This study uses a positive approach to investigate the research issue. The study analyzes the original collected survey data from own research project No. 402/05/2644 supported by Czech Scientific Foundation. A survey was conducted for each of selected local service to collect data on the structure of forms of delivery of service; the decision-making processes, concerning the selection of the delivery form; and in case of external delivery, the way/system selecting the external supplier and some other selected aspects of the contracting-out. The delivery of local services by external supplier or municipal firm is frequent solution. However, the selection of supplier is realized in many cases without any competition, via the direct award, resulting in non-transparency and bringing inefficiency risks. The final part of our paper summarizes the outcomes and formulates recommendations.

  18. Note from the CERN Medical Service - FLU VACCINATION

    CERN Multimedia

    2007-01-01

    People working on the CERN site who wish to be vaccinated may go to the infirmary (ground-floor, bldg. 57), with their vaccine without a prior appointment. The reimbursement of the vaccine can be done directly with Uniqa providing you attach the receipt and the prescription that you will receive from the medical service the day of your injection at the infirmary. Ideally, the vaccination should take place between 1st October and 30th November 2007 (preferably between 14:00 and 16:00). CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  19. Note from the CERN Medical Service FLU VACCINATION

    CERN Multimedia

    2007-01-01

    People working on the CERN site who wish to be vaccinated may go to the infirmary (ground-floor, bldg. 57), with their vaccine without a prior appointment. The reimbursement of the vaccine can be done directly with Uniqa providing you attach the receipt and the prescription that you will receive from the medical service the day of your injection at the infirmary. Ideally, the vaccination should take place between 1st October and 30th November 2007 (preferably between 14:00 and 16:00). CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  20. Note from the CERN Medical Service FLU VACCINATION

    CERN Multimedia

    2007-01-01

    People working on the CERN site who wish to be vaccinated may go to the infirmary (ground-floor, bldg. 57), with their vaccination without a prior appointment. The reimbursement of the vaccination can be done directly with Uniqa providing you attach the receipt and the prescription that you will receive from the medical service the day of your injection at the infirmary. Ideally, the vaccination should take place between 1st October and 30th November 2007 (preferably between 14:00 and 16:00). CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  1. Loads Providing Ancillary Services: Review of International Experience

    Energy Technology Data Exchange (ETDEWEB)

    Heffner, Grayson; Goldman, Charles; Kintner-Meyer, Michael

    2007-05-01

    In this study, we examine the arrangements for and experiences of end-use loads providing ancillary services (AS) in five electricity markets: Australia, the United Kingdom (UK), the Nordic market, and the ERCOT and PJM markets in the United States. Our objective in undertaking this review of international experience was to identify specific approaches or market designs that have enabled customer loads to effectively deliver various ancillary services (AS) products. We hope that this report will contribute to the ongoing discussion in the U.S. and elsewhere regarding what institutional and technical developments are needed to ensure that customer loads can meaningfully participate in all wholesale electricity markets.

  2. Interrelationships of risks faced by third party logistics service providers

    DEFF Research Database (Denmark)

    Govindan, Kannan; Chaudhuri, Atanu

    2016-01-01

    insights. Results show that arms-length relationship between the customer and the 3PLs has strong influence on other risks and there is a need for collaborative relationships between 3PLs and its customers. Moreover, analysis indicates that the 3PLs need to improve internal processes related to quality......This paper analyses the interrelationships between risks faced by third party logistics service providers (3PLs) in relation to one of its customers using DEMATEL. Novel analysis of both within and between risk categories and generation of threshold value to prioritize risks generate useful...... management, flexibility of its operations and also geographical coverage of their services....

  3. Commercial Building Loads Providing Ancillary Services in PJM

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald, Jason; Kiliccote, Sila; Boch, Jim; Chen, Jonathan; Nawy, Robert

    2014-06-27

    The adoption of low carbon energy technologies such as variable renewable energy and electric vehicles, coupled with the efficacy of energy efficiency to reduce traditional base load has increased the uncertainty inherent in the net load shape. Handling this variability with slower, traditional resources leads to inefficient system dispatch, and in some cases may compromise reliability. Grid operators are looking to future energy technologies, such as automated demand response (DR), to provide capacity-based reliability services as the need for these services increase. While DR resources are expected to have the flexibility characteristics operators are looking for, demonstrations are necessary to build confidence in their capabilities. Additionally, building owners are uncertain of the monetary value and operational burden of providing these services. To address this, the present study demonstrates the ability of demand response resources providing two ancillary services in the PJM territory, synchronous reserve and regulation, using an OpenADR 2.0b signaling architecture. The loads under control include HVAC and lighting at a big box retail store and variable frequency fan loads. The study examines performance characteristics of the resource: the speed of response, communications latencies in the architecture, and accuracy of response. It also examines the frequency and duration of events and the value in the marketplace which can be used to examine if the opportunity is sufficient to entice building owners to participate.

  4. The Medical Service teams up with an external laboratory

    CERN Multimedia

    2015-01-01

    Since January, the CERN Medical Service has been collaborating with Proxilis, a medical testing laboratory in Meyrin, to carry out blood tests.   Sylvie Leprat, a nurse from the Proxilis laboratory, comes to the CERN Medical Service (Building 57, first floor) at 8 a.m. every morning to take blood samples. These samples are then taken from CERN to the Proxilis laboratory, where they are analysed by machines, lab technicians or the team's biologist. The results are first conveyed to CERN doctors over the telephone. Then, at the end of the day, they are incorporated into the patient's medical file for validation and possible comments by CERN doctors, before being e-mailed to the patient. People at CERN who are having blood tests done outside the context of their regular medical check-up receive an e-mail inviting them to choose a day and time for the blood samples to be taken. This provides a flexible service that allows appointments to be arranged according to their availability a...

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

    Science.gov (United States)

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

    2013-01-01

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

  6. 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…

  7. Intelligent Medical Systems for Aerospace Emergency Medical Services

    Science.gov (United States)

    Epler, John; Zimmer, Gary

    2004-01-01

    The purpose of this project is to develop a portable, hands free device for emergency medical decision support to be used in remote or confined settings by non-physician providers. Phase I of the project will entail the development of a voice-activated device that will utilize an intelligent algorithm to provide guidance in establishing an airway in an emergency situation. The interactive, hands free software will process requests for assistance based on verbal prompts and algorithmic decision-making. The device will allow the CMO to attend to the patient while receiving verbal instruction. The software will also feature graphic representations where it is felt helpful in aiding in procedures. We will also develop a training program to orient users to the algorithmic approach, the use of the hardware and specific procedural considerations. We will validate the efficacy of this mode of technology application by testing in the Johns Hopkins Department of Emergency Medicine. Phase I of the project will focus on the validation of the proposed algorithm, testing and validation of the decision making tool and modifications of medical equipment. In Phase 11, we will produce the first generation software for hands-free, interactive medical decision making for use in acute care environments.

  8. Experienced and potential medical tourists' service quality expectations.

    Science.gov (United States)

    Guiry, Michael; Scott, Jeannie J; Vequist, David G

    2013-01-01

    The paper's aim is to compare experienced and potential US medical tourists' foreign health service-quality expectations. Data were collected via an online survey involving 1,588 US consumers engaging or expressing an interest in medical tourism. The sample included 219 experienced and 1,369 potential medical tourists. Respondents completed a SERVQUAL questionnaire. Mann-Whitney U-tests were used to determine significant differences between experienced and potential US medical tourists' service-quality expectations. For all five service-quality dimensions (tangibles, reliability, responsiveness, assurance and empathy) experienced medical tourists had significantly lower expectations than potential medical tourists. Experienced medical tourists also had significantly lower service-quality expectations than potential medical tourists for 11 individual SERVQUAL items. Results suggest using experience level to segment medical tourists. The study also has implications for managing medical tourist service-quality expectations at service delivery point and via external marketing communications. Managing medical tourists' service quality expectations is important since expectations can significantly influence choice processes, their experience and post-consumption behavior. This study is the first to compare experienced and potential US medical tourist service-quality expectations. The study establishes a foundation for future service-quality expectations research in the rapidly growing medical tourism industry.

  9. Evaluating the service quality of third-party logistics service providers using the analytic hierarchy process

    Directory of Open Access Journals (Sweden)

    Soon-hoo So

    2006-12-01

    Full Text Available In this study we apply the analytic hierarchy process (AHP to evaluate the service quality of third-party logistics (3PL service providers. We first conceptualize five dimensions of 3PL service quality (i.e. tangibles, reliability, responsiveness, assurance and empathy. We then apply the AHP method to determine the relative weights of the five service quality dimensions and eventually select the best 3PL service provider. To implement this idea in practice, we conduct an empirical case study on four companies providing 3PL services in Korea. The results indicate that Responsiveness out of the five service quality dimensions is the most important factor in the perception of 3PL customers.

  10. Collaborative business processes for enhancing partnerships among software services providers

    Science.gov (United States)

    Heil Cancian, Maiara; Rabelo, Ricardo; Gresse von Wangenheim, Christiane

    2015-08-01

    Software services have represented a powerful view to support the realisation of the service-oriented architecture (SOA) paradigm. Using open standards and facilitating systems projects, they have increasingly been used as a corporate architectural approach to create interoperable services-based software solutions that can more easily be reused and shared across disparate applications. In the context of software companies, most of them are small firms having enormous difficulties to keep competitive. One strategy to enhance their sustainability is to enlarge partnerships among them at a more valuable level by jointly offering (web) services-based solutions. However, their culture of collaboration is low, and partnerships are usually done with the same companies and sporadically. This article presents an approach to support a more intense collaboration among software companies to attend business opportunities in a more agile way, joining capacities and capabilities which they would not have if they worked alone. This requires, however, some preparedness. From the perspective of business processes, they should understand how to carry out a collaboration more properly. This is essentially what this article is about. It presents a comprehensive list of collaborative business processes and base practices that can also act as a guide for service providers' managers to implement and manage the collaboration along its lifecycle. Processes have been validated and results are discussed.

  11. Data as a service a framework for providing reusable enterprise data services

    CERN Document Server

    Sarkar, Pushpak

    2015-01-01

    Data as a Service shows how organizations can leverage "data as a service" by providing real-life case studies on the various and innovative architectures and related patterns. Comprehensive approach to introducing data as a service in any organization. A re-usable and flexible SOA based architecture framework. Roadmap to introduce 'big data as a service' for potential clients. Presents a thorough description of each component in the DaaS reference architecture so readers can implement solutions.

  12. EXPERIENCE IN DEVELOPMENT MEDICAL KITS FOR MEDICAL SERVICES OF THE RUSSIAN FEDERATION ARMED FORCES

    Directory of Open Access Journals (Sweden)

    E. O. Rodionov

    2016-01-01

    new models of complete-standard issue equipment of the Armed Forces Medical Service, which provides healthcare to a necessary extent and speed of deployment and mobility of medical units formations and military units in the field.

  13. A National Medical Information System for Senegal: Architecture and Services.

    Science.gov (United States)

    Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou

    2016-01-01

    In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.

  14. FIRST TIME ONLINE LEARNERS’ PERCEPTIONS OF SUPPORT SERVICES PROVIDED

    Directory of Open Access Journals (Sweden)

    Stephanie HUNTE

    2012-04-01

    Full Text Available The number of online continuous education and training initiatives continues to increase in Caribbean Small Island Developing States (SIDS and by extension, the number of adult learners who are unfamiliar with the peculiarities of the online teaching and learning environment. The extent to which these learners can derive maximum benefit from these initiatives depends on the rate at which they can adapt to the new circumstances and, as a result, function effectively in this type of teaching and learning environment. To this end, while supporting learners is recognized as a critical success factor little has been explored or documented specific to the Caribbean-SIDS context. The purpose of this study therefore was to describe the support services provided first time online learners in the context of Caribbean-SIDS and examine what if any benefit learners derived from them through their perceptions of these services. The findings reveal that participants’ overall perception of the support services was high. They also reveal that although participants’ awareness of ongoing support services was variable, their rating of the need for and importance of this type of support was also high. The findings suggest that providing support for first time online learners in the context of Caribbean SIDS positively impacts their performance in the online teaching and learning environment.

  15. [Ways of improving medical services for schoolchildren].

    Science.gov (United States)

    Korenev, N M; Novikova, V N; Gaĭdaĭ, V Ia; Bulaga, L P; Komlik, P V

    1990-01-01

    The protection and promotion of schoolchildren's health might be ensured by means of differential approach to the use of different forms of organization of medical provision and its further improvement with due regard for regional conditions. The development of All-union programme "Schoolchildren" is needed which would provide for a scientific base for improving organizational and health-promoting activities at general education schools and boarding schools.

  16. Impact of CRM on the competitiveness level of ICT services in Croatian service providers

    Directory of Open Access Journals (Sweden)

    Dražen Alerić

    2007-07-01

    Full Text Available This paper proves a higher competitiveness of ICT service providers who utilize CRM versus the providers who do not. The study of observed participating ICT service providers in Croatia proves that the value added of the services incorporating CRM is more competitive than the same services but without CRM. There is also stronger demand from clients for the services enriched with CRM. Increased service competitiveness generated by CRM utilization raises the company’s general competitiveness. A systematic application of CRM creates a long-lasting relationship between clients and providers and thus enables high-quality long-term term solutions to client demands. CRM represents the value added that raises the level of service competitiveness and makes the service provider unique and recognizable among numerous competitors. Consequently, the satisfaction of clients with the provider and their preference for the same provider result in higher client loyalty. A service company that incorporates CRM in its practices has a higher success rate in fulfilling its mission and attaining goals in accordance with the marketing philosophy.

  17. Agents for change: nonphysician medical providers and health care quality.

    Science.gov (United States)

    Boucher, Nathan A; Mcmillen, Marvin A; Gould, James S

    2015-01-01

    Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts.

  18. Examination of cultural competence in service providers in an early intervention programme for psychosis in Montreal, Quebec: Perspectives of service users and treatment providers.

    Science.gov (United States)

    Venkataraman, Shruthi; Jordan, Gerald; Pope, Megan A; Iyer, Srividya N

    2018-06-01

    To better understand cultural competence in early intervention for psychosis, we compared service users' and service providers' perceptions of the importance of providers being culturally competent and attentive to aspects of culture. At a Canadian early intervention programme, a validated scale was adapted to assess service user (N = 51) and provider (N = 30) perceptions of service providers' cultural competence and the importance accorded thereto. Analyses of variance revealed that the importance of service providers being culturally competent was rated highest by service providers, followed by visible minority service users, followed by white service users. Providers rated themselves as being more interested in knowing about service users' culture than service users perceived them to be. Service users accorded less import to service providers' cultural competence than providers themselves, owing possibly to varied socialization. A mismatch in users' and providers' views on providers' efforts to know their users' cultures may influence mental healthcare outcomes. © 2017 John Wiley & Sons Australia, Ltd.

  19. Exploring Service-led Growth Trajectories for Analytical Equipment Providers

    DEFF Research Database (Denmark)

    Raja, Jawwad; Frandsen, Thomas; Mouritsen, Jan

    2016-01-01

    This paper examines the dilemmas encountered by advanced analytical equipment providers in developing service-led growth strategies to expand their business in pursuit of more attractive revenue models. It does so by adopting a case based research approach. The findings detail the capabilities...... and solutions-in different contexts, with a view to expanding markets and developing solution based business models, are discussed. It is argued that analytical equipment providers encounter dilemmas as managing these different trajectories implies different needs in terms of the technological sophistication...... of equipment required. This does not necessarily imply that one context is less complex than the other, but rather suggests that the role of integration is qualitatively different and that the relationship between product and service varies when developing solutions in these different arenas....

  20. The Vine Trust's Amazon Hope boats--providing a dental service on the Amazon.

    Science.gov (United States)

    Mason, Shona M C

    2013-01-01

    The Vine Trust's Amazon Hope Project is a medical and dental programme providing healthcare to communities along the Amazon River in Peru. Volunteers from the UK and other countries work alongside Peruvian staff employed by their partner organization, Union Biblica del Peru, to provide a health service from a boat which serves communities on several tributaries who otherwise would have no other access to care. The dental programme involves a basic restorative and extraction service, with scope to develop a preventive programme. Dentists'and DCPs' skills are transferable globally: this article illustrates how one volunteer dental project is working to provide relevant and sustainable dental health care in the Amazon jungle.

  1. A Model for the Growth of Network Service Providers

    Science.gov (United States)

    2011-12-01

    Service Provider O-D Origin-Destination POP Point of Presence UCG Unilateral Connection Game xiv THIS PAGE INTENTIONALLY LEFT BLANK xv EXECUTIVE...xvi We make use of the Abilene dataset as input to the network provisioning model and assume that the NSP is new to the market and is building an...has to decide on the connections to build and the markets to serve in order to maximize its profits. The NSP makes these decisions based on the market

  2. Horizontal cooperations between logistics service providers:motives, structure, performance

    OpenAIRE

    Schmoltzi, Christina; Wallenburg, Carl Marcus

    2011-01-01

    Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich. This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. Purpose – This paper aims to provide a comprehensive overview of the motives, structure and performance attributes of horizontal cooperations between logistics service provi...

  3. Influence of Organizational Culture on Service Provider Selection

    OpenAIRE

    Yılmaz, Mehmet; Yılmaz Börekçi, Dilek; Örnek, Ali

    2017-01-01

    Although Third Party Logistics Service Provider (3PL) selection literature mentions organizational culture’s role in the development as well as in the maintenance of 3PL arrangements, there is a paucity of attempts to underline the significance of organizational culture’s influence on the formation and management of 3PL relationships. In this study, the influence of different organizational cultural orientations in uncertainty avoidance, future orientation, performance orientation and paterna...

  4. Serving some and serving all: how providers navigate the challenges of providing racially targeted health services.

    Science.gov (United States)

    Zhou, Amy

    2017-10-01

    Racially targeted healthcare provides racial minorities with culturally and linguistically appropriate health services. This mandate, however, can conflict with the professional obligation of healthcare providers to serve patients based on their health needs. The dilemma between serving a particular population and serving all is heightened when the patients seeking care are racially diverse. This study examines how providers in a multi-racial context decide whom to include or exclude from health programs. This study draws on 12 months of ethnographic fieldwork at an Asian-specific HIV organization. Fieldwork included participant observation of HIV support groups, community outreach programs, and substance abuse recovery groups, as well as interviews with providers and clients. Providers managed the dilemma in different ways. While some programs in the organization focused on an Asian clientele, others de-emphasized race and served a predominantly Latino and African American clientele. Organizational structures shaped whether services were delivered according to racial categories. When funders examined client documents, providers prioritized finding Asian clients so that their documents reflected program goals to serve the Asian population. In contrast, when funders used qualitative methods, providers could construct an image of a program that targets Asians during evaluations while they included other racial minorities in their everyday practice. Program services were organized more broadly by health needs. Even within racially targeted programs, the meaning of race fluctuates and is contested. Patients' health needs cross cut racial boundaries, and in some circumstances, the boundaries of inclusion can expand beyond specific racial categories to include racial minorities and underserved populations more generally.

  5. Handling of the demilitarized zone using service providers in SAP

    Science.gov (United States)

    Iovan, A.; Robu, R.

    2016-02-01

    External collaboration needs to allow data access from the Internet. In a trusted Internet collaboration scenario where the external user works on the same data like the internal user direct access to the data in the Intranet is required. The paper presents a solution to get access to certain data in the Enterprise Resource Planning system, having the User Interface on a system in the Demilitarized Zone and the database on a system which is located in the trusted area. Using the Service Provider Interface framework, connections between separate systems can be created in different areas of the network. The paper demonstrates how to connect the two systems, one in the Demilitarized Zone and one in the trusted area, using SAP ERP 6.0 with Enhancement Package 7. In order to use the Service Provider Interface SAP Business Suite Foundation component must be installed in both systems. The advantage of using the Service Provider Interface framework is that the external user works on the same data like the internal user (and not on copies). This assures data consistency and less overhead for backup and security systems.

  6. Application of Ethics for Providing Telemedicine Services and Information Technology.

    Science.gov (United States)

    Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali

    2017-10-01

    Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients' personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in

  7. The Economics of Air Force Medical Service Readiness.

    Science.gov (United States)

    Graser, John C; Blum, Daniel; Brancato, Kevin; Burks, James J; Chan, Edward W; Nicosia, Nancy; Neumann, Michael J; Ritschard, Hans V; Mundell, Benjamin F

    2012-01-01

    The prime mission of the Air Force Medical Service (AFMS), like those of the medical departments of its sister services, is to provide medical care during wartime. AFMS currently runs three successful in-theater hospitals that treat severely injured or wounded U.S. personnel from all four services. But this wartime mission depends on capabilities built at home, as critical-care specialists maintain their technical proficiency, as much as peacetime opportunities allow, by meeting health-care needs of Department of Defense beneficiaries at home. These patients have ranged from young, healthy active-duty personnel to aging retirees, historically presenting a broad range of injuries and illnesses for treatment. However, between the demands of deployments creating gaps in staff at home and changes in care plans, some beneficiaries now seek care in the civilian sector. In addition, several AFMS hospitals stateside have been closed, converted to clinics, or combined with those of other services for various reasons. All is problematic for two reasons: First, inpatient workloads in particular represent the best opportunities for critical care providers to prepare for their wartime missions. AFMS will need to increase these opportunities, perhaps working with other services, the Department of Veterans Affairs, or civilian hospitals. Second, AFMS's funding depends, in part, on the workload performed, but current measurement methods do not necessarily do a good job of accounting for the work AFMS practitioners accomplish outside their home stations. Some imminent changes may help resolve this situation, but AFMS should pursue opportunities to create additional workload for its medical personnel and to increase its budgets.

  8. Building capacity in social service agencies to employ peer providers.

    Science.gov (United States)

    Gates, Lauren B; Mandiberg, James M; Akabas, Sheila H

    2010-01-01

    While there is evidence that peer providers are valuable to service delivery teams, the agencies where they work face difficulties in fulfilling the potential of including peers on staff effectively. The purpose of this article is to report findings of a pilot test of a workplace strategy that promoted inclusion of peer providers at social service agencies by building organizational capacity to support people with mental health conditions in peer provider roles. The strategy included training, goal setting and ongoing consultation. Seventy-one peer, non-peer and supervisory staff participated from 6 agencies over a one year period. Goal attainment scaling and data from in-depth interviews about perceptions of differences in the ways in which staff are supported, administered prior to and after the consultation period, were used to assess strategy impact. Most frequently staff set goals to respond to role conflict or a lack of support. Staff that met or exceeded their goals utilized the formal structure of consultation to improve communication among themselves, had leadership that sanctioned changes and felt that their participation was of value to the organization and contributed to their individual development. Strategy participation promoted inclusion by initiating changes to policies and practices that devalued the peer provider role, increased skill sets, and formalized lines of communication for sharing information and understanding related to peer providers. Findings demonstrate that a strategy of training, goal setting and consultation can positively affect perceptions of inclusion, and promote implementation of practices associated with inclusive workplaces.

  9. A Study on Librarian Service Providers' Awareness and Perceptions of Library Services for the Disabled

    Directory of Open Access Journals (Sweden)

    Younghee Noh

    2011-12-01

    Full Text Available The purpose of this study is to improve library promotional marketing for the disabled by identifying requirements of public library disability services. This study aimed to investigate librarian service providers' awareness of library programs for the disabled in order to prepare a systematic plan for promoting such library services. Research methods used are a literature analysis and survey. First, the ratio of respondents with experience promoting activities and services for the disabled was less than 50%. Second, regarding methods for promoting library disability services, the respondents used library homepages, press releases, library user guides, library newsletters, and library pamphlets in that order. Third, when asked what kind of PR media the library disability service providers had experience with and how often they use it, library boards and banners were the most common response. Fourth, suggested improvements to the current design and content of PR materials included: clearer word choice (or greater understandability, more detailed descriptions, simpler layouts, and more interesting or eye-catching content in that order. Fifth, the library disability services which are in the most need of public relations were guide information for library disability services, Library and Information Service (DOI services and search services, using alternative materials and the library collection, and aiding the information search. Overall, when evaluating the promotion of disability services in Korea, the library's public relations for disabled services needs to improve because currently neither librarians nor the disabled community they are targeting has frequent or quality experience with it. Thus, the policy department for the library disability services must develop a variety of promotional strategies adjusted for each type of the disability and distribute PR materials to service providers individually, making sure to utilize effective PR

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

    Science.gov (United States)

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

    2013-06-01

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

  11. Efficient Job Provisioning for a Cloud Service Provider

    Directory of Open Access Journals (Sweden)

    Sharma Dharmvir

    2016-01-01

    Full Text Available Cloud Computing is a very fast emerging technology as every enterprise is moving fast towards this system. Cloud Computing is known as a provider of dynamic services. It optimizes a very large, scalable and virtualized resource. So lots of industries have joined this bandwagon nowadays. One of the major research issues is to maintain good Quality of Service (QoS of a Cloud Service Provider (CSP. The QoS encompasses different parameters, like, smart job allocation strategy, efficient load balancing, response time optimization, reduction in wastage of bandwidth, accountability of the overall system, etc. The efficient allocation strategy of the independent computational jobs among different Virtual Machines (VM in a Data center (DC is a distinguishable challenge in the Cloud Computing domain and finding out an optimal job allocation strategy guided by a good scheduling heuristic for such an environment is a mape-k loop problem. So different heuristic approaches may be used for better result and in this result we paper we implement worst fit in mape-k and evaluated the results.

  12. Liability of German suppliers and service providers for foreign projects

    International Nuclear Information System (INIS)

    Raetzke, Christian

    2017-01-01

    Main topic is the question of the extent to which German plant constructors, suppliers, engineering consultants, experts or operators expose themselves to liability for the delivery of their products and services abroad. In principle, in almost all nuclear power countries, liability is channelled to the operator; suppliers and service providers are exempted from liability. However, there are conceivable cases in which this principle does not apply. This can occur, for example, if a major accident is assumed to have an impact on neighbouring countries of the country of destination; here, depending on the applicable law, the German supplier or service provider could be ordered to pay for damages. The risk of liability remaining in this way can be reduced if necessary by means of an exemption clause in the supply contract. The regulation of the operator's recourse to the contractor, insofar as the latter is responsible for the accident, and the - controversial -question of to what extent damage to the plant itself gives rise to claims for damages by the operator against the contractor are also discussed.

  13. Health service providers in Somalia: their readiness to provide malaria case-management.

    Science.gov (United States)

    Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W

    2009-05-13

    Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of

  14. Health service providers in Somalia: their readiness to provide malaria case-management

    Directory of Open Access Journals (Sweden)

    Moonen Bruno

    2009-05-01

    Full Text Available Abstract Background Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53

  15. Customer satisfaction measurement in emergency medical services.

    Science.gov (United States)

    Kuisma, Markku; Määttä, Teuvo; Hakala, Taisto; Sivula, Tommi; Nousila-Wiik, Maria

    2003-07-01

    The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured. Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction. This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.

  16. Network performance and fault analytics for LTE wireless service providers

    CERN Document Server

    Kakadia, Deepak; Gilgur, Alexander

    2017-01-01

     This book is intended to describe how to leverage emerging technologies big data analytics and SDN, to address challenges specific to LTE and IP network performance and fault management data in order to more efficiently manage and operate an LTE wireless networks. The proposed integrated solutions permit the LTE network service provider to operate entire integrated network, from RAN to Core , from UE to application service, as one unified system and correspondingly collect and align disparate key metrics and data, using an integrated and holistic approach to network analysis. The LTE wireless network performance and fault involves the network performance and management of network elements in EUTRAN, EPC and IP transport components, not only as individual components, but also as nuances of inter-working of these components. The key metrics for EUTRAN include radio access network accessibility, retainability, integrity, availability and mobility. The key metrics for EPC include MME accessibility, mobility and...

  17. IPTV technology for the wireless Internet service provider (WISP

    Directory of Open Access Journals (Sweden)

    Mitchell Vásquez Bermúdez

    2018-02-01

    Full Text Available This article describes the implementation of the IPTV technology through an open source system for the wireless Internet service provider (WISP in the Cerecita site, located in the province of Guayas, Ecuador. The feasibility of implementing the IPTV technology is given through the use of the Emby Server application, in addition to the use of an operating system such as CentOS 7, which are open source and have the necessary requirements for the creation of this service. The analysis of data tra c generated on the WISP network, which will establish the advantages and disadvantages generated by the transmission of this technology, created to VOD multimedia content server that allows the video signal to be sent to users Finally, a feasibility study was carried out to analyze the advantages and disadvantages that exist in the implementation of this IPTV technology.

  18. Ecosystem function and services provided by the deep sea

    Science.gov (United States)

    Thurber, A. R.; Sweetman, A. K.; Narayanaswamy, B. E.; Jones, D. O. B.; Ingels, J.; Hansman, R. L.

    2014-07-01

    The deep sea is often viewed as a vast, dark, remote, and inhospitable environment, yet the deep ocean and seafloor are crucial to our lives through the services that they provide. Our understanding of how the deep sea functions remains limited, but when treated synoptically, a diversity of supporting, provisioning, regulating and cultural services becomes apparent. The biological pump transports carbon from the atmosphere into deep-ocean water masses that are separated over prolonged periods, reducing the impact of anthropogenic carbon release. Microbial oxidation of methane keeps another potent greenhouse gas out of the atmosphere while trapping carbon in authigenic carbonates. Nutrient regeneration by all faunal size classes provides the elements necessary for fueling surface productivity and fisheries, and microbial processes detoxify a diversity of compounds. Each of these processes occur on a very small scale, yet considering the vast area over which they occur they become important for the global functioning of the ocean. The deep sea also provides a wealth of resources, including fish stocks, enormous bioprospecting potential, and elements and energy reserves that are currently being extracted and will be increasingly important in the near future. Society benefits from the intrigue and mystery, the strange life forms, and the great unknown that has acted as a muse for inspiration and imagination since near the beginning of civilization. While many functions occur on the scale of microns to meters and timescales up to years, the derived services that result are only useful after centuries of integrated activity. This vast dark habitat, which covers the majority of the globe, harbors processes that directly impact humans in a variety of ways; however, the same traits that differentiate it from terrestrial or shallow marine systems also result in a greater need for integrated spatial and temporal understanding as it experiences increased use by society. In

  19. Service Learning in Medical Education: Project Description and Evaluation

    Science.gov (United States)

    Borges, Nicole J.; Hartung, Paul J.

    2007-01-01

    Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…

  20. Impact of interventions for patients refusing emergency medical services transport.

    Science.gov (United States)

    Alicandro, J; Hollander, J E; Henry, M C; Sciammarella, J; Stapleton, E; Gentile, D

    1995-06-01

    To evaluate the effect of a documentation checklist and on-line medical control contact on ambulance transport of out-of-hospital patients refusing medical assistance. Consecutive patients served by four suburban ambulance services who initially refused emergency medical services (EMS) transport to the hospital were prospectively enrolled. In phase 1 (control phase), all patients who initially refused medical attention or transport had an identifying data card completed. In phase 2 (documentation phase), out-of-hospital providers completed a similar data card that contained a checklist of high-risk criteria for a poor outcome if not transported. In phase 3 (intervention phase), a data card similar to that used in phase 2 was completed, and on-line medical control was contacted for all patients with high-risk criteria who refused transport. The primary endpoint was the percentage of patients transported to the hospital. A total of 361 patients were enrolled. Transport rate varied by phase: control, 17 of 144 (12%); documentation, 11 of 150 (7%); and intervention, 12 of 67 (18%) (chi-square, p = 0.023). Transport of high-risk patients improved with each intervention: control, two of 60 (3%); documentation, seven of 70 (10%); and intervention, 12 of 34 (35%) (chi-square, p = 0.00003). Transport of patients without high-risk criteria decreased with each intervention: control, 15 of 84 (18%); documentation, four of 80 (5%); and intervention, 0 of 33 (0%) (p = 0.0025). Of the 28 patients for whom medical control was contacted, 12 (43%) were transported to the hospital, and only three of these 12 patients (25%) were released from the ED. Contact with on-line medical control increased the likelihood of transport of high-risk patients who initially refused medical assistance. The appropriateness of the decreased transport rate of patients not meeting high-risk criteria needs further evaluation.

  1. Generating demand for pharmacist-provided medication therapy management: identifying patient-preferred marketing strategies.

    Science.gov (United States)

    Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma

    2009-01-01

    To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.

  2. Evaluating Common Privacy Vulnerabilities in Internet Service Providers

    Science.gov (United States)

    Kotzanikolaou, Panayiotis; Maniatis, Sotirios; Nikolouzou, Eugenia; Stathopoulos, Vassilios

    Privacy in electronic communications receives increased attention in both research and industry forums, stemming from both the users' needs and from legal and regulatory requirements in national or international context. Privacy in internet-based communications heavily relies on the level of security of the Internet Service Providers (ISPs), as well as on the security awareness of the end users. This paper discusses the role of the ISP in the privacy of the communications. Based on real security audits performed in national-wide ISPs, we illustrate privacy-specific threats and vulnerabilities that many providers fail to address when implementing their security policies. We subsequently provide and discuss specific security measures that the ISPs can implement, in order to fine-tune their security policies in the context of privacy protection.

  3. The State of Emergency Medical Services (EMS) Systems in Africa.

    Science.gov (United States)

    Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

    2017-06-01

    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

  4. Quality of health care of the medical units that provide services for Medical Insurance for a New Generation enrollees La calidad de la atención en unidades médicas que proveen servicios para el Seguro Médico para una Nueva Generación

    Directory of Open Access Journals (Sweden)

    Luis Durán-Arenas

    2012-01-01

    Full Text Available OBJECTIVE: In this evaluation we assess the quality of the general and clinical structure in medical units that deliver health services for the Medical Insurance for a New Generation (SMNG enrollees. MATERIALS AND METHODS: The study population included 82 medical units that deliver health services to enrollees of the SMNG in 15 states of Mexico, during 2009. Two indexes: the general structure index and the clinical structure index were created. RESULTS: It was found an unequal quality of the general and clinical structure in the different levels of care. The results suggest that the first level of care lacks both important general and clinical structural items. They also show on average a regular quality in the second level of care and a good quality in the third level of care medical units. CONCLUSIONS: Our results support the main conclusion of the work of Bulatao, "Improving services requires moving beyond policy reform to strengthening implementation of services".OBJETIVO: Se evalúa la calidad de la estructura física y clínica en las unidades médicas que proveen servicios de salud a los afiliados al Seguro Médico para una Nueva Generación (SMNG. MATERIALES Y MÉTODOS: La población de estudio incluyó 82 unidades médicas de los tres niveles de atención del SMNG en 15 estados de México, en 2009. Se elaboraron dos índices: el índice de estructura general y el índice de estructura clínica. RESULTADOS: Se encontró calidad variable en las unidades médicas. Los resultados sugieren que el primer nivel de atención tiene deficiencias en la estructura general y la estructura clínica. También se muestra una calidad regular en unidades de segundo y la mayor calidad en las de tercer nivel. CONCLUSIONES: nuestros resultados están en armonía con la conclusión de Bulatao: "la mejora de los servicios requiere moverse más allá de la reforma de las políticas, hacia la implementación de una estrategia de fortalecimiento de los servicios".

  5. Valuing environmental services provided by local stormwater management

    Science.gov (United States)

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

    2017-06-01

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

  6. The Net Neutrality Debate: Analysis of economic implications of net neutrality on internet service providers, content providers and internet users

    OpenAIRE

    Møinichen, Jørgen

    2014-01-01

    This thesis studies the economic implications of a transition from a neutral to a non-neutral network. A mathematical model with an end to end ecosystem is developed, which includes a backbone internet service provider that provides connectivity for the content providers. The model also includes internet users that pay an access internet service provider for connectivity to interact with the content providers, advertisers that pay the content providers, and access internet service providers t...

  7. Helicopter Emergency Medical Services: effects, costs and benefits

    NARCIS (Netherlands)

    A.N. Ringburg (Akkie)

    2009-01-01

    textabstractAdvanced prehospital medical care with air transport was introduced in the Netherlands in May 1995. The fi rst helicopter Mobile Medical Team, also called Helicopter Emergency Medical Service (HEMS) was a joint venture initiative of the VU Medical Center in Amsterdam and the Algemene

  8. 38 CFR 17.241 - Sharing medical information services.

    Science.gov (United States)

    2010-07-01

    ..., research centers, and individual members of the medical profession, under which medical information and techniques will be freely exchanged and the medical information services of all parties to the agreement will... highly trained and qualified members of the medical profession. (c) Use of electronic equipment. Recent...

  9. Exceptional closure of the Medical Service on 11 October

    CERN Multimedia

    CERN Medical Service

    2016-01-01

    Please note that the Medical Service (infirmary, doctors, psychologist and secretariat) will be closed all day on Tuesday, 11 October 2016.   In the event of a medical emergency, please call 74444 (Fire Brigade). Thank you for your understanding.

  10. IMPLEMENTATION OF THE ABC COSTING IN A SERVICES PROVIDER COMPANY

    Directory of Open Access Journals (Sweden)

    Luiz Ricardo Aguena Jacintho Gil de Castro

    2012-12-01

    Full Text Available This paper describes the implementation of the Activity-Based Cost (ABC method in a company of taxes and accounting services and outlines the positive and negative aspects encountered during implementation. It should be taken into account that this work has been developed in the fiscal area of cost verification. Bibliographical references, internal company documents and interviews with industry officials and the administrator responsible for the company were used. In the evolving of operations, the costs of the fiscal area and their main activities have been described monthly and through this information, drivers have been developed and the ABC (Activity-Based Costing method has been adopted. With the implementation it became clear that the system provides better visualization for the decision making process, it also provided learning for the company, so that the method should be used for an undetermined period of time.

  11. Medication adherence monitoring: implications for patients and providers.

    Science.gov (United States)

    Gheorghiu, Bobby; Nayani, Seema

    2018-05-01

    Non-adherence to medication is a key worldwide issue and can lead to adverse patient outcomes and increased health system costs. Would a process facilitating notification of non-adherence infringe upon the autonomy of individuals or breach expectations of privacy? In contrast, patients who are not taking their medication could unknowingly be putting themselves at risk and all the while prescribers are unaware and without the opportunity to intervene. With the advent of electronic methods of medication adherence monitoring, this ethical dilemma now involves a new layer of complexity. We present two scenarios encountered in clinical practice that reflect issues occurring regularly in the Canadian healthcare system.

  12. A seamless ubiquitous emergency medical service for crisis situations.

    Science.gov (United States)

    Lin, Bor-Shing

    2016-04-01

    In crisis situations, a seamless ubiquitous communication is necessary to provide emergency medical service to save people's lives. An excellent prehospital emergency medicine provides immediate medical care to increase the survival rate of patients. On their way to the hospital, ambulance personnel must transmit real-time and uninterrupted patient information to the hospital to apprise the physician of the situation and provide options to the ambulance personnel. In emergency and crisis situations, many communication channels can be unserviceable because of damage to equipment or loss of power. Thus, data transmission over wireless communication to achieve uninterrupted network services is a major obstacle. This study proposes a mobile middleware for cognitive radio (CR) for improving the wireless communication link. CRs can sense their operating environment and optimize the spectrum usage so that the mobile middleware can integrate the existing wireless communication systems with a seamless communication service in heterogeneous network environments. Eventually, the proposed seamless mobile communication middleware was ported into an embedded system, which is compatible with the actual network environment without the need for changing the original system architecture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Breastfeeding knowledge, attitudes, and practices among providers in a medical home.

    Science.gov (United States)

    Szucs, Kinga A; Miracle, Donna J; Rosenman, Marc B

    2009-03-01

    Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services. We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors. We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission. This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

  14. Attitudes and Perceptions of Healthcare Providers and Medical ...

    African Journals Online (AJOL)

    Erah

    of the healthcare team while 82% believed that clinical pharmacists can help improve the quality of medical care in .... There are few clinical pharmacists working in the public ..... perceptions and expectations of pharmacists' professional ...

  15. Transparency of Mandatory Information Disclosure and Concerns of Health Services Providers and Consumers

    Directory of Open Access Journals (Sweden)

    Yu-Hua Yan

    2017-01-01

    Full Text Available Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384. Results: Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements (p < 0.001. We identified significant differences in health service providers’ and consumers’ awareness regarding the transparency of information disclosure (p < 0.001. Conclusions: It may not be possible for outsiders to properly interpret the information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information’s applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively.

  16. Knowledge, attitudes, and practices of private sector immunization service providers in Gujarat, India.

    Science.gov (United States)

    Hagan, José E; Gaonkar, Narayan; Doshi, Vikas; Patni, Anas; Vyas, Shailee; Mazumdar, Vihang; Kosambiya, J K; Gupta, Satish; Watkins, Margaret

    2018-01-02

    India is responsible for 30% of the annual global cohort of unvaccinated children worldwide. Private practitioners provide an estimated 21% of vaccinations in urban centers of India, and are important partners in achieving high vaccination coverage. We used an in-person questionnaire and on-site observation to assess knowledge, attitudes, and practices of private immunization service providers regarding delivery of immunization services in the urban settings of Surat and Baroda, in Gujarat, India. We constructed a comprehensive sampling frame of all private physician providers of immunization services in Surat and Baroda cities, by consulting vaccine distributors, local branches of physician associations, and published lists of private medical practitioners. All providers were contacted and asked to participate in the study if they provided immunization services. Data were collected using an in-person structured questionnaire and directly observing practices; one provider in each practice setting was interviewed. The response rate was 82% (121/147) in Surat, and 91% (137/151) in Baroda. Of 258 participants 195 (76%) were pediatricians, and 63 (24%) were general practitioners. Practices that were potential missed opportunities for vaccination (MOV) included not strictly following vaccination schedules if there were concerns about ability to pay (45% of practitioners), and not administering more than two injections in the same visit (60%). Only 22% of respondents used a vaccination register to record vaccine doses, and 31% reported vaccine doses administered to the government. Of 237 randomly selected vaccine vials, 18% had expired vaccine vial monitors. Quality of immunization services in Gujarat can be strengthened by providing training and support to private immunization service providers to reduce MOVs and improve quality and safety; other more context specific strategies that should be evaluated may involve giving feedback to providers on quality of services

  17. From manufacturer to service provider; Vom Produzenten zum Dienstleister

    Energy Technology Data Exchange (ETDEWEB)

    Luczak, H. (ed.)

    2004-07-01

    Shrinking time-to-market windows are leading to increasingly tight timeframes available for the planning and realization of factories. At the same time, industrial enterprises as clients for factory planning services may at increasingly later stages specify their requirements on the construction of their new factories or the renovation/conversion of existing ones. This state of affairs generates a series of problems such as growing numbers of alterations and thus interruptions in the factory planning process. In order to avoid this happening, the project described in the following included the drawing up of instruments for planning-service providers and the identification of success factors for optimized work scheduling. (orig/GL) [German] Als Folge von tiefgreifenden Veraenderungsprozessen der volkswirtschaftlichen Strukturen nimmt die Beschaeftigung im Bereich der Produktion und der Verarbeitung kontinuierlich ab waehrend gleichzeitig eine stetige Ausweitung des Dienstleistungssektors zu verzeichnen ist. Auf der gesellschaftlichen Ebene wird dieser s.g. Prozess der Tertiarisierung vielfach diskutiert, im betrieblichen Kontext jedoch bislang noch sehr unzureichend durch empirisch-fundierte Modelle, Konzepte, Vorgehensweisen, Methoden, Erfahrungen, Best Practice und Erfolgsfaktoren hinterlegt und exemplarisch dargestellt. Durch die im Rahmen des Verbundvorhabens MoveOn generierten Forschungsergebnisse konnte diese Luecke durch die Entwicklung und Erprobung eines Modells der betrieblichen Tertiarisierung sowie eines Methoden- und Erfahrungsinstrumentariums zur Unterstuetzung und Begleitung der Entwicklung von Betrieben zu Unternehmen mit einer ausgepraegten Dienstleistungsorientierung und Dienstleistungsmentalitaet geschlossen werden. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Davood Shishebori

    2013-01-01

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

  19. Medical Tourism and the Libyan National Health Services

    Directory of Open Access Journals (Sweden)

    El Taguri A

    2007-01-01

    Full Text Available Medical tourism is a term that is used frequently by the media and travel agencies as a catchall phrase to describe a process where people travel to other countries to obtain medical, dental, and/or surgical care [1,2]. Leisure aspects of traveling are usually included on such a medical travel trip [1]. The term is also used to describe a situation where doctors travel to other places to deliver services to endogenous populations [3].Many factors have led to the recent increase in popularity of medical tourism. Among these factors are the absence of a particular service and the high cost of health care in some countries of origin on one side, and the ease and affordability of international travel, and the improvement of technology and standards of care in host countries on the other side. This phenomenon cannot be separated from globalization and tendency for a more liberal world trade. In countries that operate from a public health-care system, it can take a considerable amount of time to get needed medical care. In Britain and Canada, for example, the waiting period for a hip replacement can be a year or more, while in Bangkok or Bangalore, a patient can be in the operating room the morning after getting off a plane [2]. The post-surgery mortality rate in the 15,000 heart operations done every year in Scots Heart Institute and Research Centre in Delhi and Faridabad is only 0.8%, which is less than half of most major hospitals in the United States or Europe [2]. However, the real attraction is price [2]. The cost of surgery in India, Thailand or South Africa can be one-tenth of the price of comparable treatment in the United States or Western Europe [2]. A heart operation as an example costs €32000 in the United States, €16000 in Europe, but less than €3000 in India. A full facelift that would cost $20,000 in the U.S. runs at about $1,250 in South Africa [2]. In addition, clinics in these countries provide single-patient rooms that

  20. Data Bookkeeping Service 3 - Providing event metadata in CMS

    CERN Document Server

    Giffels, Manuel; Riley, Daniel

    2014-01-01

    The Data Bookkeeping Service 3 provides a catalog of event metadata for Monte Carlo and recorded data of the Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) at CERN, Geneva. It comprises all necessary information for tracking datasets, their processing history and associations between runs, files and datasets, on a large scale of about $200,000$ datasets and more than $40$ million files, which adds up in around $700$ GB of metadata. The DBS is an essential part of the CMS Data Management and Workload Management (DMWM) systems, all kind of data-processing like Monte Carlo production, processing of recorded event data as well as physics analysis done by the users are heavily relying on the information stored in DBS.

  1. Data Bookkeeping Service 3 - Providing Event Metadata in CMS

    Energy Technology Data Exchange (ETDEWEB)

    Giffels, Manuel [CERN; Guo, Y. [Fermilab; Riley, Daniel [Cornell U.

    2014-01-01

    The Data Bookkeeping Service 3 provides a catalog of event metadata for Monte Carlo and recorded data of the Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) at CERN, Geneva. It comprises all necessary information for tracking datasets, their processing history and associations between runs, files and datasets, on a large scale of about 200, 000 datasets and more than 40 million files, which adds up in around 700 GB of metadata. The DBS is an essential part of the CMS Data Management and Workload Management (DMWM) systems [1], all kind of data-processing like Monte Carlo production, processing of recorded event data as well as physics analysis done by the users are heavily relying on the information stored in DBS.

  2. Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014.

    Science.gov (United States)

    Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

    2016-03-01

    Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach's Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors' offices had the highest quality gap of -1.420 ± 0.82 and -1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were -0.883 ± 0.67, -0.882 ± 0.83, and -0.804 ± 0.62, respectively. There was a significant relationship between peoples' perceptions and expectations concerning the quality of health services and their educational levels. The higher gaps in quality in hospitals and in doctors' offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors.

  3. Is environmental sustainability a strategic priority for logistics service providers?

    Science.gov (United States)

    Evangelista, Pietro; Colicchia, Claudia; Creazza, Alessandro

    2017-08-01

    Despite an increasing number of third-party logistics service providers (3PLs) regard environmental sustainability as a key area of management, there is still great uncertainty on how 3PLs implement environmental strategies and on how they translate green efforts into practice. Through a multiple case study analysis, this paper explores the environmental strategies of a sample of medium-sized 3PLs operating in Italy and the UK, in terms of environmental organizational culture, initiatives, and influencing factors. Our analysis shows that, notwithstanding environmental sustainability is generally recognised as a strategic priority, a certain degree of diversity in the deployment of environmental strategies still exists. This paper is original since the extant literature on green strategies of 3PLs provides findings predominantly from a single country perspective and mainly investigates large/multinational organizations. It also provides indications to help managers of medium-sized 3PLs in positioning their business. This is particularly meaningful in the 3PL industry, where medium-sized organizations significantly contribute to the generated turnover and market value. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia.

    Science.gov (United States)

    Tan, Amy Cw; Emmerton, Lynne M; Hattingh, H Laetitia; La Caze, Adam

    2015-06-01

    Many of Australia' s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n =8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40-55 min each, recorded and analysed descriptively. A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes; however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. Participants were unaware of each other's models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models.

  5. Achieving universal health coverage in small island states: could importing health services provide a solution?

    Science.gov (United States)

    Walls, Helen; Smith, Richard

    2018-01-01

    Background Universal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option. Methods Analysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu. Findings Medical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS. Interpretation Our findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control. PMID:29527349

  6. BUSINESS PERFORMANCE OF HEALTH TOURISM SERVICE PROVIDERS IN THE REPUBLIC OF CROATIA.

    Science.gov (United States)

    Vrkljan, Sanela; Hendija, Zvjezdana

    2016-03-01

    Health tourism can be generally divided into medical, health spa and wellness tourism. Health spa tourism services are provided in special hospitals for medical rehabilitation and health resorts, and include under medical supervision controlled use of natural healing factors and physical therapy in order to improve and preserve health. There are 13 special hospitals for medical rehabilitation and health resorts in Croatia. Most of them are financed through the state budget and lesser by sale on the market. More than half of their accommodation capacity is offered for sale on the market while the rest is under contract with the Croatian Health Insurance Fund. Domestic overnights are several times higher than foreign overnights. The aim of this study was to analyze business performance of special hospitals for medical rehabilitation and health resorts in Croatia in relation to the sources of financing and the structure of service users. The assumption was that those who are more market-oriented achieve better business performance. In proving these assumptions, an empirical research was conducted and the assumptions were tested. A positive correlation was proven in tested indicators of business performance of the analyzed service providers of health-spa tourism with a higher amount of overnight stays realized through sales on the market in relation to total overnight stays, with a greater share of foreign overnights in total of overnights and with a higher share of realized revenue on the market out of total revenue. The results of the research show that special hospitals for medical rehabilitation and health resorts that are more market-oriented are more successful in their business performance. These findings are important for planning the health and tourism policies in countries like Croatia.

  7. 29 CFR 1926.50 - Medical services and first aid.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Medical services and first aid. 1926.50 Section 1926.50... Environmental Controls § 1926.50 Medical services and first aid. (a) The employer shall insure the availability... employees, a person who has a valid certificate in first-aid training from the U.S. Bureau of Mines, the...

  8. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa. PR Newton, R Naidoo, P Brysiewicz. Abstract. Introduction. Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high ...

  9. RESEARCH Linking employee burnout to medical aid provider ...

    African Journals Online (AJOL)

    To investigate the connection between employee burnout and medical aid claims and expenditure data in a sample from the ... data connected with each participant were: total insured benefits, general ... increase rapidly during 2010 to 2014.1,2 ... fatigue, concentration issues and low energy), they are distinct and.

  10. The power of management in medical services. Can we manage better for higher quality and more productive medical services?

    Directory of Open Access Journals (Sweden)

    Magdalena BARBU

    2010-06-01

    Full Text Available Medical services are the most important services of all since we all depend on them. Their quality and productivity can assure a wealthy nation and therefore good economical results. The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the “how to” method of obtaining the desired result. The same approach can be applied into our study in order to reach more productive medical services which to prove high quality to all patients. We need to use and to squeeze the entire force of management tools in order to reach our goal: accessible medical services full of quality. The current worldwide crisis situation makes us think that after job and food, even medical services (also a basic thing after all can become a “luxury” although this should never happen. Therefore we must do whatever needed to improve the way medical organizations are driven so that the quality of their medical services will be better and better and the productivity will be at a higher level. Medical management should have as a goal making it possible for patients to be able to solve their health problems as soon as possible and as good as possible.

  11. ESTIMATE MEDICAL SERVICES IN THE NETHERLANDS

    Directory of Open Access Journals (Sweden)

    Norina-Consuela FORNA

    2015-12-01

    Full Text Available One of the many great things about living in the Netherlands is the excellent standard of Dutch healthcare, rated as the best in Europe. The Netherlands tops the list of 34 nations in the 2012 Euro Health Consumer Index (the ‘industry standard’ of modern healthcare and spends 11.9 percent of GDP on health, being the second only after the United States. Plus, almost all the doctors speak excellent English, making healthcare in the Netherlands very accessible to expats. The purpose of the research is to investigate the health sector in the Netherlands and to connect it to the European systems and global requirements. Methods. Conducted research was focused on analysis, comparison, deduction or induction methods. Medicine in the Netherlands is taught differently than in Europe, both in terms of the approach to the subject and timeline to qualification. A visitor to the Netherlands faces no special health risks, as the overall health conditions are excellent. No special inoculations are required. Any necessary immunization is available locally. Although Dutch law is strict about commercial processing, cooking, handling, and serving of foods, consumers are advised to show caution when using eggs and preparing poultry, as salmonella bacteria has been found in these products. Tap water is of excellent quality and safe to drink. Dutch medical care is of high quality and is comparable to the medical care one finds throughout Western Europe. Diagnostic laboratories and specialists in all fields of medicine are available. Hospitals are well-equipped, and maternity hospitals and many clinics are available. Most doctors and dentists speak English. Most medicines are available locally. They may not, however, be the same brand names as those used in the United States and prices are generally higher. Tourists should bring a supply of the medicine that they know they will need whilst abroad and provide proper documentation.

  12. Motivation and reward systems in service provision: exploring motivators for people providing engineering services

    DEFF Research Database (Denmark)

    Kreye, Melanie; Nandrup-Bus, Troels

    2015-01-01

    It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through...... quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being able to take responsibility and accountability for ones work. Service employees were found to feel proud...

  13. Motivation and reward systems in service provision: exploring motivators for people providing engineering services

    OpenAIRE

    Kreye, Melanie; Nandrup-Bus, Troels

    2015-01-01

    It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being ...

  14. Providing frequency regulation reserve services using demand response scheduling

    International Nuclear Information System (INIS)

    Motalleb, Mahdi; Thornton, Matsu; Reihani, Ehsan; Ghorbani, Reza

    2016-01-01

    Highlights: • Proposing a market model for contingency reserve services using demand response. • Considering transient limitations of grid frequency for inverter-based generations. • Price-sensitive scheduling of residential batteries and water heaters using dynamic programming. • Calculating the profits of both generation companies and demand response aggregators. - Abstract: During power grid contingencies, frequency regulation is a primary concern. Historically, frequency regulation during contingency events has been the sole responsibility of the power utility. We present a practical method of using distributed demand response scheduling to provide frequency regulation during contingency events. This paper discusses the implementation of a control system model for the use of distributed energy storage systems such as battery banks and electric water heaters as a source of ancillary services. We present an algorithm which handles the optimization of demand response scheduling for normal operation and during contingency events. We use dynamic programming as an optimization tool. A price signal is developed using optimal power flow calculations to determine the locational marginal price of electricity, while sensor data for water usage is also collected. Using these inputs to dynamic programming, the optimal control signals are given as output. We assume a market model in which distributed demand response resources are sold as a commodity on the open market and profits from demand response aggregators as brokers of distributed demand response resources can be calculated. In considering control decisions for regulation of transient changes in frequency, we focus on IEEE standard 1547 in order to prevent the safety shut-off of inverter-based generation and further exacerbation of frequency droop. This method is applied to IEEE case 118 as a demonstration of the method in practice.

  15. Transparency of Mandatory Information Disclosure and Concerns of Health Services Providers and Consumers

    Science.gov (United States)

    Yan, Yu-Hua; Kung, Chih-Ming; Fang, Shih-Chieh; Chen, Yi

    2017-01-01

    Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384). Results: Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements (p transparency of information disclosure (p < 0.001). Conclusions: It may not be possible for outsiders to properly interpret the information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information’s applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively. PMID:28075362

  16. Global Budgets and Technology-Intensive Medical Services.

    Science.gov (United States)

    Song, Zirui; Fendrick, A Mark; Safran, Dana Gelb; Landon, Bruce; Chernew, Michael E

    2013-06-01

    In 2009-2010, Blue Cross Blue Shield of Massachusetts entered into global payment contracts (the Alternative Quality contract, AQC) with 11 provider organizations. We evaluated the impact of the AQC on spending and utilization of several categories of medical technologies, including one considered high value (colonoscopies) and three that include services that may be overused in some situations (cardiovascular, imaging, and orthopedic services). Approximately 420,000 unique enrollees in 2009 and 180,000 in 2010 were linked to primary care physicians whose organizations joined the AQC. Using three years of pre-intervention data and a large control group, we analyzed changes in utilization and spending associated with the AQC with a propensity-weighted difference-in-differences approach adjusting for enrollee demographics, health status, secular trends, and cost-sharing. In the 2009 AQC cohort, total volume of colonoscopies increased 5.2 percent (p=0.04) in the first two years of the contract relative to control. The contract was associated with varied changes in volume for cardiovascular and imaging services, but total spending on cardiovascular services in the first two years decreased by 7.4% (p=0.02) while total spending on imaging services decreased by 6.1% (pservices, these decreases were also attributable to shifting care to lower-priced providers. No effect was found in orthopedics. As one example of a large-scale global payment initiative, the AQC was associated with higher use of colonoscopies. Among several categories of services whose value may be controversial, the contract generally shifted volume to lower-priced facilities or services.

  17. Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

    National Research Council Canada - National Science Library

    Markot, Peter B

    2007-01-01

    ...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

  18. The Debate on the Moral Responsibilities of Online Service Providers.

    Science.gov (United States)

    Taddeo, Mariarosaria; Floridi, Luciano

    2016-12-01

    Online service providers (OSPs)-such as AOL, Facebook, Google, Microsoft, and Twitter-significantly shape the informational environment (infosphere) and influence users' experiences and interactions within it. There is a general agreement on the centrality of OSPs in information societies, but little consensus about what principles should shape their moral responsibilities and practices. In this article, we analyse the main contributions to the debate on the moral responsibilities of OSPs. By endorsing the method of the levels of abstract (LoAs), we first analyse the moral responsibilities of OSPs in the web (LoA IN ). These concern the management of online information, which includes information filtering, Internet censorship, the circulation of harmful content, and the implementation and fostering of human rights (including privacy). We then consider the moral responsibilities ascribed to OSPs on the web (LoA ON ) and focus on the existing legal regulation of access to users' data. The overall analysis provides an overview of the current state of the debate and highlights two main results. First, topics related to OSPs' public role-especially their gatekeeping function, their corporate social responsibilities, and their role in implementing and fostering human rights-have acquired increasing relevance in the specialised literature. Second, there is a lack of an ethical framework that can (a) define OSPs' responsibilities, and (b) provide the fundamental sharable principles necessary to guide OSPs' conduct within the multicultural and international context in which they operate. This article contributes to the ethical framework necessary to deal with (a) and (b) by endorsing a LoA enabling the definition of the responsibilities of OSPs with respect to the well-being of the infosphere and of the entities inhabiting it (LoA For ).

  19. Health physics, safety and medical services report for 1989

    International Nuclear Information System (INIS)

    Burt, A.K.; Bird, R.W.

    1990-09-01

    The Health Physics, Safety and Medical Services Report for Harwell Laboratory for 1989 includes data on the monitoring of the working environment, personnel monitoring, radiological incidents, disposal of radioactive waste and protection of the public. Work on emergency planning, non-radiological health and safety, occupational hygiene, operations support is also discussed. Finally the medical services available and the medical examinations performed are described. (UK)

  20. Tanzania Telecommunication Company Limited as a Mobile Service Provider

    OpenAIRE

    Ndyamukama, Edna

    2014-01-01

    This bachelor’s thesis was researched and written under the consent and authority of Tanzania Telecommunication Company Limited (TTCL), with the purpose to find out ways of improving sales and profits of its mobile service department. The mobile service department of TTCL is performing poorly as compared to its competitors despite being managed by a strategically positioned and experienced company in tele-communication services. It was also meant to find out the positive contribution of compe...

  1. Providing quality reference services at a special library

    OpenAIRE

    Semertzaki, Eva

    2006-01-01

    The paper deals with the traditional vs. modern reference service and with the reference interview and its value. It analyzes new channels of communication: the virtual reference service. It explores the advantages and disadvantages of face-to-face vs. virtual reference and touches issues of user education, information literacy, user satisfaction and evaluation of reference services. Finally, it highlights the competencies of the reference librarian.

  2. Academic Medical Library Services Contribute to Scholarship in Medical Faculty and Residents

    Directory of Open Access Journals (Sweden)

    Peace Ossom Williamson

    2017-09-01

    Full Text Available A Review of: Quesenberry, A. C., Oelschlegel, S., Earl, M., Leonard, K., & Vaughn, C. J. (2016. The impact of library resources and services on the scholarly activity of medical faculty and residents. Medical Reference Services Quarterly, 35(3, 259-265. http://dx.doi.org/10.1080/02763869.2016.1189778 Abstract Objective – To assess the impact of academic medical library services and resources on information-seeking behaviours during the academic efforts of medical faculty and residents. Design – Value study derived from a 23-item survey. Setting – Public medical residency program and training hospital in Tennessee, USA. Subjects – 433 faculty and residents currently employed by or completing residency in an academic medical centre. Methods – Respondents completed a 23-question survey about their use of library resources and services in preparation for publishing, presenting, and teaching. The library services in the survey included literature searches completed by librarians and document delivery for preparation of publications, presentations, and lecture material. The survey also included questions about how resources were being accessed in preparation for scholarship. The survey sought information on whether respondents published articles or chapters or presented papers or posters in the previous three years. If respondents answered in the affirmative to one of the aforementioned methods of scholarship, they were provided with further questions about how they access library resources and whether they sought mediated literature search and document delivery services in preparation for their recent presentations and publications. The survey also included questions concerning what types of scholarly activity prompt faculty and residents to use online library resources. Main Results – The study was provided to 433 subjects, including 220 faculty and 213 residents, contacted through an email distribution list. The response rate to the

  3. Forging New Service Paths: Institutional Approaches to Providing Research Data Management Services

    Directory of Open Access Journals (Sweden)

    Regina Raboin

    2012-01-01

    Full Text Available Objective: This paper describes three different institutional experiences in developing research data management programs and services, challenges/opportunities and lessons learned.Overview: This paper is based on the Librarian Panel Discussion during the 4th Annual University of Massachusetts and New England Region e-Science Symposium. Librarians representing large public and private research universities presented an overview of service models developed at their respective organizations to bring support for data management and eScience to their communities. The approaches described include two library-based, integrated service models and one collaboratively-staffed, center-based service model.Results: Three institutions describe their experiences in creating the organizational capacity for research data management support services. Although each institutional approach is unique, common challenges include garnering administrative support, managing the integration of services with new or existing staff structures, and continuing to meet researchers needs as they evolve.Conclusions: There is no one way to provide research data management services, but any staff position, committee, or formalized center reflects an overarching organizational commitment to data management support.

  4. A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England

    Directory of Open Access Journals (Sweden)

    Burton Hilary

    2010-05-01

    , including job descriptions and clinical tools. These can be customised for reuse by other services. Conclusions Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions.

  5. A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England.

    Science.gov (United States)

    Bennett, Catherine L; Burke, Sarah E; Burton, Hilary; Farndon, Peter A

    2010-05-14

    be customised for reuse by other services. Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions.

  6. The provision of modern medical services to a nomadic population: a review of medical services to the Bedouins of southern Sinai during Israeli rule 1967-1982.

    Science.gov (United States)

    Romem, Pnina; Reizer, Haya; Romem, Yitzhak; Shvarts, Shifra

    2002-04-01

    Southern Sinai, a mountainous desolated arid area, is inhabited by Bedouin nomad tribes composed of Arabic-speaking Moslems. Until the Six Day War between Egypt and Israel in 1967, healthcare services in the region were based on traditional medicine performed by the Darvish, a local healer. Over the course of Israeli rule (1967-1982) an elaborate healthcare service was established and maintained, providing modern, up to date, comprehensive medical services that were available to all free of charge.

  7. HIV and STD testing in prisons: perspectives of in-prison service providers.

    Science.gov (United States)

    Grinstead, Olga; Seal, David W; Wolitski, Richard; Flanigan, Timothy; Fitzgerald, Christine; Nealey-Moore, Jill; Askew, John

    2003-12-01

    Because individuals at risk for HIV and STDs are concentrated in prisons and jails, incarceration is an opportunity to provide HIV and STD testing. We interviewed 72 service providers working in U.S. prisons in four states about their experiences with and perceptions regarding HIV and STD testing in prison. Providers' job duties represented administration, education, security, counseling, and medical care. Providers' knowledge of prison procedures and programs related to HIV and STD testing was narrowly limited to their specific job duties, resulting in many missed opportunities for prevention counseling and referral. Suggestions include increasing health care and counseling staff so posttest counseling can be provided for those with negative as well as positive test results, providing additional prevention programs for incarcerated persons, improving staff training about HIV and STD testing, and improving communication among in-prison providers as well as between corrections and public health staff.

  8. An exploration of clinical interventions provided by pharmacists within a complex asthma service.

    Science.gov (United States)

    Lemay, Kate S; Saini, Bandana; Bosnic-Anticevich, Sinthia; Smith, Lorraine; Stewart, Kay; Emmerton, Lynne; Burton, Deborah L; Krass, Ines; Armour, Carol L

    2015-01-01

    Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service (interventions) they choose to deliver. To explore the scope and frequency of asthma-related clinical interventions provided by pharmacists to patients in an evidence-based complex asthma service. Pharmacists from 4 states/territories of Australia were trained in asthma management. People with asthma had 3 or 4 visits to the pharmacy. Guided by a structured patient file, the pharmacist assessed the patient's asthma and management and provided interventions where and when considered appropriate, based on their clinical decision making skills. The interventions were recorded in a checklist in the patient file. They were then analysed descriptively and thematically. Pharmacists provided 22,909 clinical pharmacy interventions over the service to 570 patients (398 of whom completed the service). The most frequently delivered interventions were in the themes 'Education on asthma', 'Addressing trigger factors', 'Medications - safe and effective use' and 'Explore patient perspectives'. The patients had a high and ongoing need for interventions. Pharmacists selected interventions based on their assessment of perceived need then revisited and reinforced these interventions. Pharmacists identified a number of areas in which patients required interventions to assist with their asthma management. Many of these were perceived to require continuing reinforcement over the duration of the service. Pharmacists were able to use their clinical judgement to assess patients and provide clinical pharmacy

  9. An exploration of clinical interventions provided by pharmacists within a complex asthma service

    Science.gov (United States)

    Lemay, Kate S.; Saini, Bandana; Bosnic-Anticevich, Sinthia; Smith, Lorraine; Stewart, Kay; Emmerton, Lynne; Burton, Deborah L.; Krass, Ines; Armour, Carol L.

    2014-01-01

    Background: Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service (interventions) they choose to deliver. Objective: To explore the scope and frequency of asthma-related clinical interventions provided by pharmacists to patients in an evidence-based complex asthma service. Methods: Pharmacists from 4 states/territories of Australia were trained in asthma management. People with asthma had 3 or 4 visits to the pharmacy. Guided by a structured patient file, the pharmacist assessed the patient’s asthma and management and provided interventions where and when considered appropriate, based on their clinical decision making skills. The interventions were recorded in a checklist in the patient file. They were then analysed descriptively and thematically. Results: Pharmacists provided 22,909 clinical pharmacy interventions over the service to 570 patients (398 of whom completed the service). The most frequently delivered interventions were in the themes ’Education on asthma’, ’Addressing trigger factors’, ’Medications - safe and effective use’ and ’Explore patient perspectives’. The patients had a high and ongoing need for interventions. Pharmacists selected interventions based on their assessment of perceived need then revisited and reinforced these interventions. Conclusion: Pharmacists identified a number of areas in which patients required interventions to assist with their asthma management. Many of these were perceived to require continuing reinforcement over the duration of the service. Pharmacists were able to use their

  10. An exploration of clinical interventions provided by pharmacists within a complex asthma service

    Directory of Open Access Journals (Sweden)

    LeMay KS

    2015-03-01

    Full Text Available Background: Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service (interventions they choose to deliver. Objective: To explore the scope and frequency of asthma-related clinical interventions provided by pharmacists to patients in an evidence-based complex asthma service. Methods: Pharmacists from 4 states/territories of Australia were trained in asthma management. People with asthma had 3 or 4 visits to the pharmacy. Guided by a structured patient file, the pharmacist assessed the patient’s asthma and management and provided interventions where and when considered appropriate, based on their clinical decision making skills. The interventions were recorded in a checklist in the patient file. They were then analysed descriptively and thematically. Results: Pharmacists provided 22,909 clinical pharmacy interventions over the service to 570 patients (398 of whom completed the service. The most frequently delivered interventions were in the themes ‘Education on asthma’, ‘Addressing trigger factors’, ‘Medications – safe and effective use’ and ‘Explore patient perspectives’. The patients had a high and ongoing need for interventions. Pharmacists selected interventions based on their assessment of perceived need then revisited and reinforced these interventions. Conclusion: Pharmacists identified a number of areas in which patients required interventions to assist with their asthma management. Many of these were perceived to require continuing reinforcement over the duration of the service. Pharmacists were

  11. 76 FR 23479 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Young Adult

    Science.gov (United States)

    2011-04-27

    ... 0720-AB48] Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Young Adult... Year 2011 (NDAA for FY11). It establishes the TRICARE Young Adult (TYA) program to provide an extended.... The TRICARE Young [[Page 23480

  12. [Study on elasticity of medical service demand at the township level in China].

    Science.gov (United States)

    Shi, Hong-xing; Lv, Jun; Xie, Yi-ping; Wang, Ying; Jia, Jin-zhong; Chang, Feng-shui; Duan, Lin; Sun, Mei; Wang, Zhi-feng; Hao, Mo

    2010-06-18

    To find out the economic laws regulating medical service demand in accordance with influencing factors at the township level, thus to provide references for further adjusting the medical service demand reasonably in the future. The model of medical service demand was established to measure the elasticity of demand in 49 township health clinics in 1995, 1999, 2003 and 2007. The price elasticity of outpatient and inpatient demand was stable during the four periods, and the average value was -0.029 and -0.132 respectively; the average value of income elasticity was 0.973 and 0.977, registering a downward trend in general. The medical service demand at the township level is price inelastic, indicating that it is a necessity for rural residents. The downward trend of income elasticity under the influence of some health policies illustrates a lightening in economic burden for medical service demand among rural residents in township health clinics.

  13. Multi-provider architecture for cloud outsourcing of medical imaging repositories.

    Science.gov (United States)

    Godinho, Tiago Marques; Bastião Silva, Luís A; Costa, Carlos; Oliveira, José Luís

    2014-01-01

    Over the last few years, the extended usage of medical imaging procedures has raised the medical community attention towards the optimization of their workflows. More recently, the federation of multiple institutions into a seamless distribution network has brought hope of increased quality healthcare services along with more efficient resource management. As a result, medical institutions are constantly looking for the best infrastructure to deploy their imaging archives. In this scenario, public cloud infrastructures arise as major candidates, as they offer elastic storage space, optimal data availability without great requirements of maintenance costs or IT personnel, in a pay-as-you-go model. However, standard methodologies still do not take full advantage of outsourced archives, namely because their integration with other in-house solutions is troublesome. This document proposes a multi-provider architecture for integration of outsourced archives with in-house PACS resources, taking advantage of foreign providers to store medical imaging studies, without disregarding security. It enables the retrieval of images from multiple archives simultaneously, improving performance, data availability and avoiding the vendor-locking problem. Moreover it enables load balancing and cache techniques.

  14. Status of Medical Library Resources and Services in Teaching Hospitals in Enugu State, Nigeria: implications for quality health care services

    Directory of Open Access Journals (Sweden)

    Oluchi C. Okeke

    2017-06-01

    Full Text Available Considering the need for quality health information and resultant health care services in any society, this study was carried out to look into the status of library and information resources and services provided by medical libraries in Enugu State, Nigeria. The main objective of the study was to find out the information resources and services available for medical library users towards quality health care provision. Five (5 medical libraries of major teaching hospitals were used for the study with 980 registered users as the study population from where 245 users were sampled. Observation checklist was used to collect data on resources while questionnaire was used to collect data from the respondents on the services provided. The Medical Library Association Standard guided the analysis of data from observation while frequency counts and mean scores were used to analyze data from the questionnaire. Major findings showed that even though some of the required resources and services are available and provided the medical libraries, most of the required resources and services are not adequately provided by these libraries.

  15. Sustainable leadership in a Thai healthcare services provider.

    Science.gov (United States)

    Kantabutra, Sooksan

    2011-01-01

    Rhineland leadership practices contrast sharply with the prevailing Anglo/US business model of short-term maximization of profitability, and are said to lead to greater corporate sustainability, at least in highly developed economies. However, the applicability of Rhineland leadership to less developed economies has not yet been demonstrated. This paper sets out to compare the business practices of a social enterprise that delivers healthcare services in Thailand and Avery's 19 sustainable leadership practices derived from Rhineland enterprises. Adopting a case study approach, multi-data collection methods included non-participant observations made during visits to the enterprise, and reference to internal and published documentation and information. Semi-structured interview sessions were held with many stakeholders, including top management, staff, patients and a former consultant. In the Thai healthcare organization studied, evidence was found for compliance with 15 of Avery's 19 sustainable leadership elements, but to varying degrees. The elements were grouped into six core sets of practices: adopting a long-term perspective, staff development, organizational culture, innovation, social responsibility, and ethical behavior. One element was found to be not applicable, and no evidence was found for conformity with Rhineland principles on the remaining three sustainable practices. The paper concludes that Avery's 19 Rhineland practices provide a useful framework for evaluating the corporate sustainability of this Thai enterprise. Healthcare enterprises in Thailand and possibly in other Asian countries that wish to sustain their organizational success could adopt Avery's 19 Sustainable Leadership Grid elements to examine their leadership practices, and adjust them to become more sustainable. The relevance of Rhineland sustainable leadership principles to enterprises in less developed economies remains to be investigated. This study attempts to uncover this unknown.

  16. Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

    Science.gov (United States)

    O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

    2017-12-01

    Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices

  17. [Quality of service provided to heart surgery patients of the Unified Health System-SUS].

    Science.gov (United States)

    Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes

    2010-01-01

    To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (Pquality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.

  18. A systematic review of service-learning in medical education: 1998-2012.

    Science.gov (United States)

    Stewart, Trae; Wubbena, Zane C

    2015-01-01

    PHENOMENON: In the United States, the Affordable Care Act has increased the need for community-centered pedagogy for medical education such as service-learning, wherein students connect academic curriculum and reflections to address a community need. Yet heterogeneity among service-learning programs suggests the need for a framework to understand variations among service-learning programs in medical education. A qualitative systematic review of literature on service-learning and medical education was conducted for the period between 1998 and 2012. A two-stage inclusion criteria process resulted in articles (n = 32) on service-learning and Doctor of Medicine or Doctor of Osteopathic Medicine being included for both coding and analysis. Focused and selective coding were employed to identify recurring themes and subthemes from the literature. The findings of the qualitative thematic analysis of service-learning variation in medical education identified a total of seven themes with subthemes. The themes identified from the analysis were (a) geographic location and setting, (b) program design, (c) funding, (d) participation, (e) program implementation, (f) assessment, and (g) student outcomes. Insights: This systematic review of literature confirmed the existence of program heterogeneity among service-learning program in medical education. However, the findings of this study provide key insights into the nature of service-learning in medical education building a framework for which to organize differences among service-learning programs. A list of recommendations for future areas of inquiry is provided to guide future research.

  19. Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, J. S.; Pesaran, A.

    2013-01-01

    Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but high upfront costs, battery-limited vehicle range, and concern over high battery replacement costs may discourage potential buyers. A subscription model in which a service provider owns the battery and supplies access to battery swapping infrastructure could reduce upfront and replacement costs for batteries with a predictable monthly fee, while expanding BEV range. Assessing the costs and benefits of such a proposal are complicated by many factors, including customer drive patterns, the amount of required infrastructure, battery life, etc. The National Renewable Energy Laboratory has applied its Battery Ownership Model to compare the economics and utility of BEV battery swapping service plan options to more traditional direct ownership options. Our evaluation process followed four steps: (1) identifying drive patterns best suited to battery swapping service plans, (2) modeling service usage statistics for the selected drive patterns, (3) calculating the cost-of-service plan options, and (4) evaluating the economics of individual drivers under realistically priced service plans. A service plan option can be more cost-effective than direct ownership for drivers who wish to operate a BEV as their primary vehicle where alternative options for travel beyond the single-charge range are expensive, and a full-coverage-yet-cost-effective regional infrastructure network can be deployed. However, when assumed cost of gasoline, tax structure, and absence of purchase incentives are factored in, our calculations show the service plan BEV is rarely more cost-effective than direct ownership of a conventional vehicle.

  20. Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, J.; Pesaran, A.

    2013-03-01

    Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but high upfront costs, battery-limited vehicle range, and concern over high battery replacement costs may discourage potential buyers. A subscription model in which a service provider owns the battery and supplies access to battery swapping infrastructure could reduce upfront and replacement costs for batteries with a predictable monthly fee, while expanding BEV range. Assessing the costs and benefits of such a proposal are complicated by many factors, including customer drive patterns, the amount of required infrastructure, battery life, etc. The National Renewable Energy Laboratory has applied its Battery Ownership Model to compare the economics and utility of BEV battery swapping service plan options to more traditional direct ownership options. Our evaluation process followed four steps: (1) identifying drive patterns best suited to battery swapping service plans, (2) modeling service usage statistics for the selected drive patterns, (3) calculating the cost-of-service plan options, and (4) evaluating the economics of individual drivers under realistically priced service plans. A service plan option can be more cost-effective than direct ownership for drivers who wish to operate a BEV as their primary vehicle where alternative options for travel beyond the single-charge range are expensive, and a full-coverage-yet-cost-effective regional infrastructure network can be deployed. However, when assumed cost of gasoline, tax structure, and absence of purchase incentives are factored in, our calculations show the service plan BEV is rarely more cost-effective than direct ownership of a conventional vehicle.

  1. The mobile phone in Africa: Providing services to the masses

    CSIR Research Space (South Africa)

    Botha, Adèle

    2010-08-31

    Full Text Available and operational considerations associated with creating a middleware platform for mobile services. The platform should be able to support different mobile paradigms (voice, text, multimedia, mobile web, applications) using a variety of communications protocols...

  2. THE ECONOMIC APPROACH OF ECOSYSTEM SERVICES PROVIDED BY PROTECTED AREAS

    Directory of Open Access Journals (Sweden)

    Cirnu Maria

    2015-07-01

    Full Text Available As practice shows us, at the present time ecosystem services are recognized by humanity, but unfortunately are undervalued compared to their full potential. Most of planet's ecosystems are degradated by anthropic activity of humankind. It is almost impossible to say that there are no areas affected by human activity, however, the Protected Areas are a good opportunity, so the assessing of ecosystem services in Protected Areas can be a solution to the problem of economic growth. At present, there are few consistent informations on economic value of ecosystem services in Romania, on the basis of which can be adopted some sustainable financing policies of activities in Protected Areas. The premise from which we start is that a proper management of natural capital will allow biodiversity conservation and human well-being if it find appropriate economic instruments. For this reason, studies of economic research on the contribution of those ecosystem services to the communities welfare may constitute credible means for decision-makers, demonstrating the Protected Areas importance. This paper, based on the study of international and national literature, examines the state of knowledge on the economic and environmental valences of ecosystem services. The growing interest of researchers regarding the economic valuation of ecosystem services related to Protected Areas is visible through the many studies carried out at international level. Although national scientific research relating to ecosystem services is at the beginning, concerns researchers economists and ecologists have been directed toward this recess, of ecosystem services. The reason for we should assign an economic value to ecosystem services is to ensure that their value is included actively in decision-making and is not ignored because "is still available". Briefly, the paper start with an overview of the main definition of ecosystem services. From the point of economic value view, the paper

  3. [Medical abortion provided by telemedicine to women in Latin America: complications and their treatment].

    Science.gov (United States)

    Larrea, Sara; Palència, Laia; Perez, Glòria

    2015-01-01

    To analyze reported complications and their treatment after a medical abortion with mifepristone and misoprostol provided by a telemedicine service to women living in Latin America. Observational study based on the registry of consultations in a telemedicine service. A total of 872 women who used the service in 2010 and 2011 participated in the study. The dependent variables were overall complications, hemorrhage, incomplete abortion, overall treatments, surgical evacuation, and antibiotics. Independent variables were age, area of residence, socioeconomic deprivation, previous children, pregnancies and abortions, and week of pregnancy. We fitted Poisson regression models with robust variance to estimate incidence ratios and 95% confidence intervals (95%CI). Complications were reported by 14.6% of the participants: 6.2% reported hemorrhage and 6.8% incomplete abortion. Nearly one-fifth (19.0%) received postabortion treatment: 10.9% had a surgical evacuation and 9.3% took antibiotics. Socioeconomic deprivation increased the risk of complications by 64% (95%CI: 15%-132%), and, among these, the risk of incomplete abortion by 82% (95%CI: 8%-206%) and the risk of surgical intervention by 62% (95%CI: 7%-144%). Previous pregnancies increased the risk of complications and, specifically, the risk of hemorrhage by 2.29 times (95%CI: 1.33-3.95%). Women with a pregnancy of 12 or more weeks had a 2.45 times higher risk of receiving medical treatment and a 2.94 times higher risk of taking antibiotics compared with women with pregnancies of 7 or less weeks. Medical abortion provided by telemedicine seems to be a safe and effective alternative in contexts where it is legally restricted. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  4. PREFER: a European service providing forest fire management support products

    Science.gov (United States)

    Eftychidis, George; Laneve, Giovanni; Ferrucci, Fabrizio; Sebastian Lopez, Ana; Lourenco, Louciano; Clandillon, Stephen; Tampellini, Lucia; Hirn, Barbara; Diagourtas, Dimitris; Leventakis, George

    2015-06-01

    PREFER is a Copernicus project of the EC-FP7 program which aims developing spatial information products that may support fire prevention and burned areas restoration decisions and establish a relevant web-based regional service for making these products available to fire management stakeholders. The service focuses to the Mediterranean region, where fire risk is high and damages from wildfires are quite important, and develop its products for pilot areas located in Spain, Portugal, Italy, France and Greece. PREFER aims to allow fire managers to have access to online resources, which shall facilitate fire prevention measures, fire hazard and risk assessment, estimation of fire impact and damages caused by wildfire as well as support monitoring of post-fire regeneration and vegetation recovery. It makes use of a variety of products delivered by space borne sensors and develop seasonal and daily products using multi-payload, multi-scale and multi-temporal analysis of EO data. The PREFER Service portfolio consists of two main suite of products. The first refers to mapping products for supporting decisions concerning the Preparedness/Prevention Phase (ISP Service). The service delivers Fuel, Hazard and Fire risk maps for this purpose. Furthermore the PREFER portfolio includes Post-fire vegetation recovery, burn scar maps, damage severity and 3D fire damage assessment products in order to support relative assessments required in context of the Recovery/Reconstruction Phase (ISR Service) of fire management.

  5. Preparedness of NGO Health Service Providers in Bangladesh about Distance Based Learning

    Directory of Open Access Journals (Sweden)

    AKM ALAMGIR

    2006-07-01

    Full Text Available This cross-sectional survey was conducted countrywide from 15 January to 01 March 2004 to explore the potentials of health care service providers (physicians, nurses, paramedics etc. for using distance-based learning materials. Face-to-face in-depth interview was taken from 99 randomly selected direct service providers, 45 midlevel clinic mangers/physicians and 06 administrators or policy planners. Quasi-open questionnaire was developed for three different levels. Pre-trained interviewer team assisted data collection at field level. Total procedure was stringently monitored for completeness and consistency to ensure quality data. SPSS software was used to process and analyze both univariate and multivariate multiple responses. Identified need for training areas were- STD/HIV, tuberculosis updates, family planning, treatment of locally endemic diseases, behavioral change communication & marketing and quality management system for managers. About 76.7% clinic managers and 89.1% service providers had primary information about distance-based learning in spite showed interest. About 51.5% desired monthly, 20.6% biweekly and 26.8% wanted bimonthly circulation of the distance-based study materials. About 35.1% expected print materials with regular facilitators while 58.8% demanded stand-by facilitators. The study suggested wide acceptance of distance-based learning methods as supplementary to the continuing medical education among the countrywide health service providers.

  6. [Patient-centered medicine for tuberculosis medical services].

    Science.gov (United States)

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

  7. Targeted Evolution of Embedded Librarian Services: Providing Mobile Reference and Instruction Services Using iPads.

    Science.gov (United States)

    Stellrecht, Elizabeth; Chiarella, Deborah

    2015-01-01

    The University at Buffalo Health Sciences Library provides reference and instructional services to support research, curricular, and clinical programs of the University at Buffalo. With funding from an NN/LM MAR Technology Improvement Award, the University at Buffalo Health Sciences Library (UBHSL) purchased iPads to develop embedded reference and educational services. Usage statistics were collected over a ten-month period to measure the frequency of iPad use for mobile services. While this experiment demonstrates that the iPad can be used to meet the library user's needs outside of the physical library space, this article will also offer advice for others who are considering implementing their own program.

  8. Should doctors provide futile medical treatment if patients or their ...

    African Journals Online (AJOL)

    Ethically and legally doctors are not obliged to provide futile treatment to patients, even if the patient or their proxies are prepared to pay for it. However, it may be justified where such treatment is harmless and has a placebo effect. In deciding about a request for futile treatment, doctors should be guided by the ethical ...

  9. Emergency medical services key performance measurement in Asian cities.

    Science.gov (United States)

    Rahman, Nik Hisamuddin; Tanaka, Hideharu; Shin, Sang Do; Ng, Yih Yng; Piyasuwankul, Thammapad; Lin, Chih-Hao; Ong, Marcus Eng Hock

    2015-01-01

    One of the key principles in the recommended standards is that emergency medical service (EMS) providers should continuously monitor the quality and safety of their services. This requires service providers to implement performance monitoring using appropriate and relevant measures including key performance indicators. In Asia, EMS systems are at different developmental phases and maturity. This will create difficultly in benchmarking or assessing the quality of EMS performance across the region. An attempt was made to compare the EMS performance index based on the structure, process, and outcome analysis. The data was collected from the Pan-Asian Resuscitation Outcome Study (PAROS) data among few Asian cities, namely, Tokyo, Osaka, Singapore, Bangkok, Kuala Lumpur, Taipei, and Seoul. The parameters of inclusions were broadly divided into structure, process, and outcome measurements. The data was collected by the site investigators from each city and keyed into the electronic web-based data form which is secured strictly by username and passwords. Generally, there seems to be a more uniformity for EMS performance parameters among the more developed EMS systems. The major problem with the EMS agencies in the cities of developing countries like Bangkok and Kuala Lumpur is inadequate or unavailable data pertaining to EMS performance. There is non-uniformity in the EMS performance measurement across the Asian cities. This creates difficulty for EMS performance index comparison and benchmarking. Hopefully, in the future, collaborative efforts such as the PAROS networking group will further enhance the standardization in EMS performance reporting across the region.

  10. Reducing chronic obstructive pulmonary disease readmissions: the role of the durable medical equipment provider.

    Science.gov (United States)

    Messenger, Robert W

    2012-01-01

    Exacerbation and frequent rehospitalization in chronic obstructive pulmonary disease exacts a heavy toll on the US health care system. To address these issues, new initiatives have been proposed that are largely based on financial penalties to promote patient education and postdischarge care. However, as laudable as these goals are, improving outcomes in the chronic obstructive pulmonary disease population is more confounding than it may first appear. Chronic hypoxia, cognitive dysfunction, poor nutrition, and economic disadvantage are just a few of the challenges that require creative solutions and ongoing support. Case managers need to utilize all the potential products and services that can assist in improving outcomes for these patients. Durable medical equipment providers are often viewed as purveyors of medical equipment that offer little in the form of clinical support. However, in many cases these providers represent an overlooked resource that provides individualized, highly structured patient education and ongoing support programs. The challenge is in identifying those durable medical equipment providers that offer patients contemporary technology, and have both the resources and the commitment to provide patient support that is amenable to the goals of the hospital. This article reviews many of the confounding issues that contribute to the frequent rehospitalization of chronic obstructive pulmonary disease patients. Recommendations to improve patient education and oxygen therapy outcomes are provided along with suggestions to aid in the vetting of durable medical equipment providers. Acute care hospitals, long-term acute care hospitals, extended care facilities, integrated delivery systems. 1. An understanding of the complex variables that play in the management of chronic obstructive pulmonary disease will help the case manager to plan an effective course of care. 2. Case managers need to ensure that patients receive long-term oxygen technology that

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

    Science.gov (United States)

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

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  12. Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

    Directory of Open Access Journals (Sweden)

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

  13. Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

    Science.gov (United States)

    de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

    2015-03-01

    Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

  14. Enhancing client welfare through better communication of private mental health data between rural service providers

    Directory of Open Access Journals (Sweden)

    Oliver Kisalay Burmeister

    2015-11-01

    Full Text Available Client welfare is detrimentally affected by poor communication of data between rural service providers, which in part is complicated by privacy legislation. A study of service provision involving interviews with mental health professionals, found challenges in communicative processes between agencies were exacerbated by the heavy workloads. Dependence on individual interpretations of legislation, and on manual handling, led to delays that detrimentally affected client welfare. The main recommendation arising from this article is the creation of an ehealth system that is able to negotiate differing levels of access to client data through centralised controls, where the administration of that system ensures that it stays current with changing legislative requirements. The main contribution of the proposed model is to combine two well-known concepts: data integration and generalisation. People with mental illness are amongst the most vulnerable members of society, and current ehealth systems that provide access to medical records inadequately cater to their needs.

  15. 76 FR 72003 - Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2011-11-21

    ... Cosmetic Surgery Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates... recovery from tortiously liable third persons for the cost of outpatient medical, dental, and cosmetic... of the full cost of all services provided. The outpatient medical, dental, and cosmetic surgery...

  16. 78 FR 62709 - Calendar Year 2013 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2013-10-22

    ... Cosmetic Surgery Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates... recovery from tortiously liable third persons for the cost of outpatient medical, dental and cosmetic... of the full cost of all services provided. The CY13 Outpatient Medical, Dental, and Cosmetic Surgery...

  17. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    2015-10-10

    Oct 10, 2015 ... in the eThekwini district of KwaZulu-Natal, South Africa ... Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa ... Emergency medical services (EMS) are sometimes required to respond to cases ...

  18. assessment of emergency medical services in the ashanti region

    African Journals Online (AJOL)

    2015-09-01

    Sep 1, 2015 ... Background: We aimed to assess the structure, func- tion and performance of ... operated Facility-Based Ambulance Service (FBAS).4 ... National Disaster Management Organisation (Kumasi, .... Equipment and Medication. ✓.

  19. Achievements in emergency medical rescue service, North-West ...

    African Journals Online (AJOL)

    2006-08-28

    Aug 28, 2006 ... In North-West province this process of provincialisation took place in ... Emergency Medical Rescue Service, Department of Health, North-West. Victor R .... recovery after CPR treatment should be started as soon as possible ...

  20. International Workshop and Summer School on Medical and Service Robotics

    CERN Document Server

    Bouri, Mohamed; Mondada, Francesco; Pisla, Doina; Rodic, Aleksandar; Helmer, Patrick

    2016-01-01

    Medical and Service Robotics integrate the most recent achievements in mechanics, mechatronics, computer science, haptic and teleoperation devices together with adaptive control algorithms. The book  includes topics such as surgery robotics, assist devices, rehabilitation technology, surgical instrumentation and Brain-Machine Interface (BMI) as examples for medical robotics. Autonomous cleaning, tending, logistics, surveying and rescue robots, and elderly and healthcare robots are typical examples of topics from service robotics. This is the Proceedings of the Third International Workshop on Medical and Service Robots, held in Lausanne, Switzerland in 2014. It presents an overview of current research directions and fields of interest. It is divided into three sections, namely 1) assistive and rehabilitation devices; 2) surgical robotics; and 3) educational and service robotics. Most contributions are strongly anchored on collaborations between technical and medical actors, engineers, surgeons and clinicians....

  1. NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory is a 2005 Wheeled Coach Type III ambulance mounted on a Ford E-450 cut-away van chassis....

  2. 29 CFR 779.388 - Exemption provided for food or beverage service employees.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Exemption provided for food or beverage service employees... Service Establishments Restaurants and Establishments Providing Food and Beverage Service § 779.388 Exemption provided for food or beverage service employees. (a) A special exemption is provided in section 13...

  3. Should Master's Level Training To Provide Rural Services Survive?

    Science.gov (United States)

    Keller, Peter A.

    Despite recent efforts to encourage federal funding of psychological services for underserved populations such as the elderly and residents of rural areas, ample evidence suggests that rural areas are underserved by psychologists. Drawing on data from rural and urban areas in Pennsylvania, this paper argues that master's level training can provide…

  4. Power system services provided by inverter connected distributed energy resources

    DEFF Research Database (Denmark)

    For the last few years there has been a significant increase of DER units in Denmark, of those units more and more are connected to the power system using inverters. These inverter connected units have the potential to support the electrical power system with various power system services. One...

  5. Measuring Perceptual (In) Congruence between Information Service Providers and Users

    Science.gov (United States)

    Boyce, Crystal

    2017-01-01

    Library quality is no longer evaluated solely on the value of its collections, as user perceptions of service quality play an increasingly important role in defining overall library value. This paper presents a retooling of the LibQUAL+ survey instrument, blending the gap measurement model with perceptual congruence model studies from information…

  6. PROVIDING SERVICEABILITY OF STRUCTURAL BEARING TYPES FOR ROADWAY BRIDGES

    Directory of Open Access Journals (Sweden)

    R. I. Polyuga

    2010-03-01

    Full Text Available In the article the description of structural bearing types for roadway bridges and their classification is given. Special attention is paid to effective bearings with elastomeric materials – rubber, pot, spherical ones. Characteristic defects of structural bearings and demands of serviceability are noticed.

  7. Efficiency of municipal service providers in the Republic of Croatia

    Directory of Open Access Journals (Sweden)

    Alemka Šegota

    2017-01-01

    Full Text Available Municipal services, such as the collection, removal and disposal of waste, are just some of the necessary activities carried out by public authorities. Efficient management and utilization of public resources improves the general well-being of a community, and benefits especially the users of municipal services. Hence, the optimal provision of public services is essential. This paper gives a comprehensive overview of municipal services, related primarily to waste collection and disposal, and other related municipal services. The purpose of the paper is to determine the relative cost efficiency of twenty public utility companies that collect household waste in different Croatian cities and surrounding municipalities. The method employed in the study is Data Envelopment Analysis (DEA, using a non-controllable input-oriented model with variable returns to scale. In addition to the relative efficiency results of each utility company, by means of projections on the efficiency frontier, sources and amounts of relative inefficiency were determined, which represent potential improvements for all inefficient utility companies. The results indicate that all inefficient utility companies can improve their efficiency by reducing the corresponding inputs. Thus, company material costs should be drastically reduced, i.e., the relatively inefficient utility company (with the exception of two companies should reduce costs by at least 50%. Considering employee costs, half of the relatively inefficient utility companies should reduce such costs by up to 50%, while the other half should reduce those costs by 58.11% to about 70%. Furthermore, five of the inefficient companies should reduce total assets input by a relatively small amount (up to 38.00%, whereas the remaining seven companies should reduce the company's total assets from 60.96% to 70.99%. This means that management at inefficient companies take into account the obtained results when making decisions in

  8. The Medical Service gets a face-lift

    CERN Multimedia

    2001-01-01

    The Medical Service is to be entirely renovated over the next four months with the aim of rationalising space and thereby facilitating access to treatment. Anyone for musical chairs? Try Building 57 where, over the next four months, the various sections of the Medical Service will be moving around from one room to another. But the eight members of the Medical Service know that all this to-ing and fro-ing is in a good cause, as their workplace is to be entirely refurbished. To ensure as little disruption as possible to the day-to-day services for people working at CERN, the infirmary, secretariat and laboratory will have to move around as the refurbishment work progresses. But there's no way the restoration of the Medical Service can be called a luxury. 'It hasn't chang-ed a jot since 1969,' says Véronique Fassnacht, Head of the Medical Service. But over the past 30 years, medical analysis equipment has been progressively miniaturised, with new, much smaller devices reducing the need for floor space...

  9. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  10. Emergency medical service in the stroke chain of survival.

    Science.gov (United States)

    Chenaitia, Hichem; Lefevre, Oriane; Ho, Vanessa; Squarcioni, Christian; Pradel, Vincent; Fournier, Marc; Toesca, Richard; Michelet, Pierre; Auffray, Jean Pierre

    2013-02-01

    The Emergency Medical Services (EMS) play a primordial role in the early management of adults with acute ischaemic stroke (AIS). The aim of this study was to evaluate the role and effectiveness of the EMS in the stroke chain of survival in Marseille. A retrospective observational study was conducted in patients treated for AIS or transient ischaemic attack in three emergency departments and at the Marseille stroke centre over a period of 12 months. In 2009, of 1034 patients ultimately presenting a diagnosis of AIS or transient ischaemic attack, 74% benefited from EMS activation. Dispatchers correctly diagnosed 57% of stroke patients. The symptoms most frequently reported included limb weakness, speech problems and facial paresis. Elements resulting in misdiagnosis by dispatchers were general discomfort, chest pain, dyspnoea, fall or vertigo. Stroke patients not diagnosed by emergency medical dispatchers but calling within 3 h of symptom onset accounted for 20% of cases. Our study demonstrates that public intervention programmes must stress the urgency of recognizing stroke symptoms and the importance of calling EMS through free telephone numbers. Further efforts are necessary to disseminate guidelines for healthcare providers concerning stroke recognition and the new therapeutic possibilities in order to increase the likelihood of acute stroke patients presenting to a stroke team early enough to be eligible for acute treatment. In addition, EMS dispatchers should receive further training about atypical stroke symptoms, and 'Face Arm Speech Test' tests must be included in the routine questionnaires used in emergency medical calls concerning elderly persons.

  11. The Role of Emergency Medical Service in CBR Incidents

    International Nuclear Information System (INIS)

    Castulik, P.

    2007-01-01

    Majority of Emergency Medical Services (EMS) have daily extensive experience with rescue of casualties having trauma injuries, resulting from conventional incidents. In the case of non-conventional incidents involving chemical, bacteriological or radiological (CBR) hazardous materials operational scene for all responders is begin to be more complicated due contamination of casualties, equipment and environment. Especially EMS personnel and receiving staff at the hospital have to work under very demanding condition due to burden of personal protective equipment (PPE) and awareness to avoiding cross-contamination during handling casualties. Those conditions require significantly different approaches for search and rescue of victims from incident site, through transportation and effective treatment at medical facilities. In cases when chemicals will be major hazard materials, the speed of rescue and treatment of victims is a major challenge. Each minute matter, and any delay of response could seriously complicated saving of lives and successful recovery of exposed victims. Success in rescue victims is finally measured thorough the ability of the first responders to save people... ALIVE..., no matter what surrounding condition is. The presentation is providing a view and suggestions on more rapid immediate medical response during non-conventional incidents. It names basic concept based on preparedness, early identification of CBR hazards through signs and symptoms of casualties, priorities of rescue procedures and care on-site, needs of decontamination, rapid evacuation casualties from a scene and immediate hospital response.(author)

  12. Predicting Perceived Isolation among Midlife and Older LGBT Adults: The Role of Welcoming Aging Service Providers.

    Science.gov (United States)

    Yang, Jie; Chu, Yoosun; Salmon, Mary Anne

    2017-06-16

    Older lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to live alone and less likely to have children compared with their heterosexual counterparts. The lack of immediate family system can render older LGBT adults particularly vulnerable to social isolation and its consequences. The current study utilizes social exclusion theory, which asserts that not only material resources but also engagement with and inclusion into the society are necessary for marginalized people to be integrated into the mainstream. The study examines whether aging service providers (e.g., senior centers, adult day care, transportation, employment services) who are perceived by older LGBT adults as welcoming to LGBT people may reduce this population's perceived isolation. Data were collected through a needs assessment survey designed for the aging LGBT community in North Carolina. Adults aged 45 and over who self-identified as LGBT were recruited at several formal and informal groups. The survey yielded 222 valid responses. The outcome variable was perceived isolation. Key independent variables included having experienced welcoming aging service providers and living alone. After controlling for potential confounders and demographics, logistic regression results showed that having experienced welcoming aging service providers was a protective factor against perceived isolation and it also buffered the negative impact of living alone. The findings provided preliminary evidence for a new direction of intervention research-targeting LGBT cultural competence training for medical and social service providers. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Abortion Services and Military Medical Facilities

    Science.gov (United States)

    2010-12-16

    Graduate Medical Education has directed obstetrical residents should be taught how to perform abortions, unless they have a moral or religious objection...of Violence Act 2004,” below.) Proponents note that such language would recognize the victimization of the child while in utero and afford...Victims of Violence Act of 2004 (Laci and Conner’s Law)” into law.81 Although intended to protect fetuses, this legislation contains a provision that

  14. Medication reconciliation service in Tan Tock Seng Hospital.

    Science.gov (United States)

    Yi, Sia Beng; Shan, Janice Chan Pei; Hong, Goh Lay

    2013-01-01

    Medication reconciliation is integral to every hospital. Approximately 60 percent of all hospital medication errors occur at admission, intra-hospital transfer or discharge. Effectively and consistently performing medication reconciliation at care-interfaces continues to be a challenge. Tan Tock Seng Hospital (TTSH) averages 4,700 admissions monthly. Many patients are elderly (> 65 years old) at risk from poly-pharmacy. As part of a medication safety initiative, pharmacy staff started a medication reconciliation service in 2007, which expanded to include all patients in October 2009. This article aims to describe the TTSH medication reconciliation system and to highlight common medication errors occurring following incomplete medication reconciliation. Where possible, patients admitted into TTSH are seen by pharmacy staff within 24 hours of admission. A form was created to document their medications, which is filed into the case sheets for referencing purposes. Any discrepancies in medicines are brought to doctors' attention. Patients are also counseled about changes to their medications. Errors picked up were captured in an Excel database. The most common medication error was prescribers missing out medications. The second commonest was recording different doses and regimens. The reason was mainly due to doctors transcribing medications inaccurately. This is a descriptive study and no statistical tests were carried out. Data entry was done by different pharmacy staff, and not a dedicated person; hence, data might be under-reported. The findings demonstrate the importance of medication reconciliation on admission. Accurate medication reconciliation can help to reduce transcription errors and improve service quality. The article highlights medication reconciliation's importance and has implications for healthcare professionals in all countries.

  15. Valuation of pollinator forage services provided by Eucalyptus Cladocalyx

    CSIR Research Space (South Africa)

    De Lange, Willem J

    2013-08-01

    Full Text Available legislation does not allow the importation of bees for pollination services from outside the province, the risk of unsecured forage is increased. Pollination replacement option All insect pollinators Managed pollinators Wild pollinators US$ millions...). Furthermore, colony collapse disorder outbreaks along with increases in sightings of predatory Vespula Germanica (German wasp or “yellow jackets”) in the Western Cape not only add to the pressure on the beekeeping industry, but also the wild pollinator...

  16. Ethics in Providing Tourism Services by Travel Agents in Serbia

    OpenAIRE

    Ivana Mišković

    2012-01-01

    This paper attempts to answer the usually neglected ethical questions of the interaction between tourism workers and participants in tourism movements and users of tourism services in general. Contact with numerous people in the work place, dynamic work with customers, continuous phone calls and stress due to constant responsibility, are just some of the conditions which tourism workers encounter on the daily basis and which sometimes make them ask themselves: Am I really able t...

  17. A Flexible Collaborative Innovation Model for SOA Services Providers

    OpenAIRE

    Santanna-Filho , João ,; Rabelo , Ricardo ,; Pereira-Klen , Alexandra ,

    2015-01-01

    Part 5: Innovation Networks; International audience; Software sector plays a very relevant role in current world economy. One of its characteristics is that they are mostly composed of SMEs. SMEs have been pushed to invest in innovation to keep competitive. Service Oriented Architecture (SOA) is a recent and powerful ICT paradigm for more sustainable business models. A SOA product has many differences when compared to manufacturing sector. Besides that, SOA projects are however very complex, ...

  18. Interfunctional Coordination of Service Offering Provided by Manufacturers

    OpenAIRE

    Kanovska, Lucie; Tomaskova, Eva

    2017-01-01

    Interfunctional coordination (IFC) aims to develop cooperation between the different departments of a company. Services offered by companies increase customer orientation of a company and help satisfy its customers. IFC and cus-tomer orientation are the main parts of market orientation. Market orientation is one of many possible ways how to in-crease business performance and competitiveness of companies. The aim of the paper is to describe main findings of the research, which was focused on r...

  19. Residences Satisfaction Towards Service Quality Provided By Bogor Local Government

    OpenAIRE

    Setiawan, Budi; Oswari, Teddy; Kuswanto, Adi

    2011-01-01

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

  20. Research on Logistics Service Providers Selection Based on AHP and VIKOR

    Science.gov (United States)

    Shan, Lu

    The logistics service providers supply a kind of service which is a service product, thus there is a plenty of uncertainty and fuzzy in selecting logistics service providers. AHP is first used to calculate the weights of logistics services providers evaluations and then VIKOR method developed for multi-criteria optimization determining a compromise solution is applied to select the logistics services providers. The latter method provides a maximum "group utility" for the "majority" and minimum of an individual regret for the "opponent". This decision making process of logistics services providers selection is verified to be scientific and feasible through the empirical research.

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

    Directory of Open Access Journals (Sweden)

    Lusi Kristiana

    2015-01-01

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

  2. Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention.

    Science.gov (United States)

    Wang, Shan Huei

    2017-08-02

    Web-based medical service (WBMS), a cooperative relationship between medical service and Internet technology, has been called one of the most innovative services of the 21st century. However, its business promotion and implementation in the medical industry have neither been expected nor executed. Few studies have explored this phenomenon from the viewpoint of inexperienced patients. The primary goal of this study was to explore whether technology attractiveness, medical creditability, and diversified medical information sources could increase users' behavior intention. This study explored the effectiveness of web-based medical service by using three situations to manipulate sources of medical information. A total of 150 questionnaires were collected from people who had never used WBMS before. Hierarchical regression was used to examine the mediation and moderated-mediation effects. Perceived ease of use (P=.002) and perceived usefulness (P=.001) significantly enhance behavior intentions. Medical credibility is a mediator (P=.03), but the relationship does not significantly differ under diverse manipulative information channels (P=.39). Medical credibility could explain the extra variation between technology attractiveness and behavior intention, but not significant under different moderating effect of medical information sources. ©Shan Huei Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.08.2017.

  3. Evidence for Overuse of Medical Services Around the World

    Science.gov (United States)

    Brownlee, Shannon; Chalkidou, Kalipso; Doust, Jenny; Elshaug, Adam G.; Glasziou, Paul; Heath, Iona; Nagpal, Somil; Saini, Vikas; Srivastava, Divya; Chalmers, Kelsey; Korenstein, Deborah

    2017-01-01

    Summary Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a global problem that afflicts rich and poor countries alike. This article reviews the definition of overuse, methods for measuring overuse, harms from overuse, and the evidence for worldwide overuse of many types of services. PMID:28077234

  4. Medical Services - A Significant Component of the Economic Activity

    Directory of Open Access Journals (Sweden)

    Mihalache Patricia

    2017-01-01

    The current consumer of health services is more educated and more concerned with health needs than in the past. The marketing of these services has begun to be viewed from a new perspective, more aggressive and more marketing-oriented and business oriented. The most important methods of promoting medical services refer to advertising in mass media, the Internet, social networks, professional advertising vs. institutional advertising. Private healthcare services are very well promoted in comparison with the health services in the public health system.

  5. Standards - the common element in providing the safety, quality and performance of the medical practice

    Science.gov (United States)

    Greabu, Mihai

    2009-01-01

    Knowing and applying standards is an opportunity of the years 2007-2008 in any kind of field where a successful activity is intended and this assures a certain way towards competence and quality. The most recent German studies highlighted, to the surprise of the specialists, that standardization holds the second place, after the material means, in the row of the elements considered to be decisive for the success of a business. The existence of standards and the concern for their implementation in the activity provides a high technical and quality level of the products services offered to the clients and the increase in the level of competence of the personnel, who will be able to cope with all the challenges. This need comes from the process of Romania’s accession to the European Union. There are a lot of reasons why standards represent a fundamental part of our daily life. Practically, we are surrounded by standards. Everything is „working” well and it is efficient if the standards used as a base for manufacturing „things” have been correctly developed and applied. Standards open communication channels and commercial channels, promote the understanding of technical products, the compatibility of products and services, facilitate mass production and, most importantly, they are the necessary base for the achievement of the objectives in the fields of health and safety and a better quality of life. The transition towards the global market needs an instrument for the removal of the barriers to the application of the latest discoveries in the field of medical instruments, materials and manual labor. Each medical device, equipment and material used in the Dental and General Medicine is standardized, in fact that leads to their better knowing and provides controllable treatment for manual labor with predictable and repeatable results. This presentation intends to make a survey of some general aspects on standardization as well as a review of the standards in

  6. EXPERIENCE IN DEVELOPMENT MEDICAL KITS FOR MEDICAL SERVICES OF THE RUSSIAN FEDERATION ARMED FORCES

    OpenAIRE

    E. O. Rodionov; Yu. V. Miroshnichenko; V. N. Kononov; A. V. Tikhonov; I. V. Klochkova

    2016-01-01

    Introduction. The development of modern, complete-standard issue equipment for the Armed Forces Medical Service is an urgent organizational and management task. First aid kits, medical bags, sets of medical equipment, medical kits and packing existed until recently; no longer meet modern requirements for a number of objective reasons. The aim of the study was the formation of programs of development of modern samples of complete-standard-issue equipment. Materials and methods. The study was c...

  7. 78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-01-04

    ...The NHTSA announces a meeting of NEMSAC to be held in the Metropolitan Washington, DC, area. This notice announces the date, time, and location of the meeting, which will be open to the public. The purpose of NEMSAC, a nationally recognized council of emergency medical services representatives and consumers, is to provide advice and recommendations regarding Emergency Medical Services (EMS) to DOT's NHTSA and to the Federal Interagency Committee on EMS (FICEMS).

  8. Health Physics and Medical Services report for 1986

    International Nuclear Information System (INIS)

    Burt, A.K.; Bird, R.W.

    1987-09-01

    A Health Physics and Medical Services report is presented for Harwell Laboratory for 1986. Health physics aspects covered include safety policy and organisation, monitoring results for the working environment and personnel, an analysis of radiological incidents and radioactive waste disposal, and protection of the public. Other non-radiological aspects of health and safety are briefly considered. The section on Medical Services contains details of the staffing, the types of medical examinations performed, the treatments received, work on the safety of asbestos and manmade mineral fibres and training and education programmes. (UK)

  9. Note from the CERN Medical Service FLU VACCINATION

    CERN Multimedia

    2000-01-01

    CERN Members of personnel who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 16th October and 30th November 2000. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  10. Note from the CERN Medical Service FLU VACCINATION

    CERN Multimedia

    Sylvain Weisz

    2002-01-01

    People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2002. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  11. Note from the CERN Medical Service. FLU VACCINATION

    CERN Multimedia

    2001-01-01

    CERN Members of personnel who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 16th October and 30th November 2000. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  12. Note from the CERN Medical Service FLU VACCINATION

    CERN Multimedia

    2001-01-01

    CERN Members of personnel who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 16th October and 30th November 2000. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  13. NOTE FROM THE CERN MEDICAL SERVICE - FLU VACCINATION

    CERN Multimedia

    2002-01-01

    People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  14. Note from the CERN Medical Service: FLU VACCINATION

    CERN Multimedia

    2001-01-01

    CERN Members of personnel who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 16th October and 30th November 2001. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  15. Note from the CERN Medical Service FLU VACCINATION

    CERN Multimedia

    2003-01-01

    People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2003. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  16. Note from the CERN Medical Service: FLU VACCINATION

    CERN Multimedia

    2003-01-01

    People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2003. CERN staff aged 50 or over are recommended to have influenza vaccinations. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious medical problems or after serious surgical operations. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  17. Home Care Pharmacy Practice in Canada: A Cross-Sectional Survey of Services Provided, Remuneration, Barriers, and Facilitators.

    Science.gov (United States)

    Houle, Sherilyn; MacKeigan, Linda

    2017-01-01

    As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care. A link to a web-based survey was posted in e-newsletters of provincial, territorial, and national pharmacy associations in Canada. In addition, pharmacists known to the researchers as providing in-home clinical services were contacted directly. The survey was open from October to December 2015. Practices or organizations that performed at least one home visit per week for clinical purposes, with documentation of the services provided, were eligible to participate. One response per practice or organization was allowed. Seventeen practices meeting the inclusion criteria were identified, representing community, hospital, and clinic settings. Home visits were most commonly performed for individuals with complex medication regimens or nonadherence to medication therapy. The most common services were conducting medication reconciliation and reviews and counselling patients about medication adherence. No practices or organizations billed patients for these services, yet lack of remuneration was an important barrier identified by many respondents. Although 12 (71%) of the respondents collected data for evaluative purposes, collection of clinical or health system outcome data was rare. Few Canadian pharmacy practices that provide in-home patient care at least once a week could be identified. Data collection suitable to establish an evidence base for this service was infrequently performed by practices and organizations providing

  18. A network system of medical and welfare information service for the patients, their families, hospitals, local governments, and commercial companies in a medical service area.

    Science.gov (United States)

    Matsumura, Kouji; Antoku, Yasuaki; Inoue, Reika; Kobayashi, Mariko; Hanada, Eisuke; Iwasaki, Yasutaka; Kumagai, Yasushi; Iwamoto, Haruya; Tsuchihashi, Saburo; Iwaki, Miho; Kira, Jun-ichi; Nose, Yoshiaki

    2002-06-01

    A service information system using the Internet, which connected the various people who are related to medical treatment and nursing welfare, was constructed. An intractable neurological disease patient who lives in the Onga district, Fukuoka, Japan, and the people who are related to the service were chosen as test users in an experimental model. The communicated service information was divided into open-use data (electronic bulletin board, welfare service, medical care service, and link to private company service home page) and closed-use data (the individual patient's hysterics). The open data server was installed in an Internet service provider The open data could be accessed not only by the patient, but also by the family, information center, companies, hospitals, and nursing commodity store related to patient's nursing and medical treatment. Closed data server was installed in an information center (public health center). Only patient and information center staff can access the closed data. Patients should search and collect the service information of various medical and welfare services by themselves. Therefore, services prepared for the patient are difficult to know, and they cannot be sufficiently utilized. With the use of this information system, all usable service information became accessible, and patients could easily use it. The electronic bulletin board system (BBS) was used by patients for knowing each other or each others' family, and was used as a device for exchange of wisdom. Also, the questions for the specialist, such as doctor, dentist, teacher, physical therapist, care manager, welfare office staff member, and public health nurse, and the answers were shown on the BBS. By arranging data file, a reference of various patients in question and answer, which appeared in this BBS, was made as "advisory hints" and was added to the open data. The advisory hints became the new service information for the patients and their family. This BBS discovered

  19. Predicting Urban Medical Services Demand in China: An Improved Grey Markov Chain Model by Taylor Approximation.

    Science.gov (United States)

    Duan, Jinli; Jiao, Feng; Zhang, Qishan; Lin, Zhibin

    2017-08-06

    The sharp increase of the aging population has raised the pressure on the current limited medical resources in China. To better allocate resources, a more accurate prediction on medical service demand is very urgently needed. This study aims to improve the prediction on medical services demand in China. To achieve this aim, the study combines Taylor Approximation into the Grey Markov Chain model, and develops a new model named Taylor-Markov Chain GM (1,1) (T-MCGM (1,1)). The new model has been tested by adopting the historical data, which includes the medical service on treatment of diabetes, heart disease, and cerebrovascular disease from 1997 to 2015 in China. The model provides a predication on medical service demand of these three types of disease up to 2022. The results reveal an enormous growth of urban medical service demand in the future. The findings provide practical implications for the Health Administrative Department to allocate medical resources, and help hospitals to manage investments on medical facilities.

  20. Role of accrediting bodies in providing education leadership in medical education

    Directory of Open Access Journals (Sweden)

    Sam Leinster

    2014-01-01

    Role of accreditation authorities: If accreditation authorities are to provide leadership in medical education they must undertake regular review of their standards. This should be informed by all stakeholders and include experts in medical education. The format of the standards must provide clear direction to medical schools. Accreditation should take place regularly and should result in the production of a publicly accessible report.

  1. Relationship Between Green Logistics Tendency and Logistics Performance: A Comparative Case Study on Logistics Service Providers

    OpenAIRE

    Ayşenur DOĞRU; Cemile SOLAK FIŞKIN

    2016-01-01

    Increasing concerns related to environmental side effects of the logistics services and competition between the logistics service providers are two pressuring factors on logistics service providers. This study seeks to explore the relation between green logistics tendency and logistic performance from the perspective of logistics service providers. In order to reach this aim, two logistics service providers are investigated by comparative case study method. Findings showed the effects of g...

  2. Estimating the Cost of Providing Foundational Public Health Services.

    Science.gov (United States)

    Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

    2017-12-28

    To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

  3. Medicaid Personal Care Services for Children with Intellectual Disabilities: What Assistance Is Provided? When Is Assistance Provided?

    Science.gov (United States)

    Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.

    2014-01-01

    We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy community.…

  4. Health Providers' Perception towards Safe Abortion Service at ...

    African Journals Online (AJOL)

    In Ethiopia, unsafe abortion accounts up to 32% of maternal deaths. The perception of health providers towards safe abortion provision at selected health facilities in Addis Ababa, Ethiopia was assessed. A stratified random sampling was used to select 431 health providers. A cross-sectional study was conducted from ...

  5. Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.

    Science.gov (United States)

    Gillette, Chris; Blalock, Susan J; Rao, Jaya K; Williams, Dennis; Loughlin, Ceila E; Sleath, Betsy

    2014-08-01

    The objectives of this study were to: (1) describe the extent to which general pediatric providers discuss risks associated with asthma control medications with families, and (2) examine factors that are associated with risk discussions. This study was a cross-sectional secondary analysis of audio taped medical visits involving 35 pediatric providers and 248 children with asthma with their caregivers. Transcripts of the visits were coded for discussions about asthma medication risks. Generalized estimating equations were used to analyze the data. Providers discussed asthma control medication risks during 23% of visits. Risks were more likely to be discussed when the visit was longer and when the provider prescribed a new asthma control medication. When providers discussed asthma control medication risks, they were most likely to ask the family general questions and make general statements. Across all of the visits, caregivers asked a total of 16 questions and made a total of 20 statements about risks associated with asthma medications; children asked a total of 3 questions and made two statements about risks associated with asthma control medications. Providers discussed risks associated with asthma control medications in less than one-quarter of medical visits. Providers should involve families in discussions about risks associated with medications during every visit to assess potential barriers to medication adherence. © 2013 Wiley Periodicals, Inc.

  6. Unified Medical Language System Terminology Services (UTS) API

    Data.gov (United States)

    U.S. Department of Health & Human Services — The UTS API is intended for application developers to perform Web service calls and retrieve UMLS data within their own applications. The UTS API provides the...

  7. The status of occupational safety among health service providers in ...

    African Journals Online (AJOL)

    identify and bring under control at workplaces all health risks; provide ... on the status of occupational safety among hospital workers in Tanzania. ..... The assistance from the IPC/IS. National ... tions of the Healthcare Infection Prevention.

  8. [The main directions of reforming the service of medical statistics in Ukraine].

    Science.gov (United States)

    Golubchykov, Mykhailo V; Orlova, Nataliia M; Bielikova, Inna V

    2018-01-01

    accepted methods for collecting, processing, analyzing and disseminating medical and statistical information; the creation of a medical and statistical service that adapted to the specifics of market relations in health care, flexible and sensitive to changes in international methodologies and standards. Conclusions: The data of medical statistics are the basis for taking managerial decisions by managers at all levels of health care. Reform of Medical Statistics Service of Ukraine should be considered only in the context of the reform of the entire health system. The main directions of the reform of the medical statistics service in Ukraine are: the introduction of information technologies, the improvement of the training of personnel for the service, the improvement of material and technical equipment, the maximum reuse of the data obtained, which provides for the unification of primary data and a system of indicators. The most difficult area is the formation of information funds and the introduction of modern information technologies.

  9. Complexities of Providing Dental Hygiene Services in Community Care Settings.

    Science.gov (United States)

    Zarkowski, Pamela; Aksu, Mert N

    2016-06-01

    Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.' An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The Health Tourists’ Satisfaction Level of Services Provided: A Cross-Sectional Study in Iran

    Science.gov (United States)

    Varzi, Ali Mohammad; Saki, Koroush; Momeni, Khalil; Vasokolaei, Ghasem Rajabi; Khodakaramifard, Zahra; Zouzani, Morteza Arab; Jalilian, Habib

    2016-01-01

    Introduction: Patient satisfaction with provided services is used as an indicator of health care quality. Patient satisfaction is defined as patient perception of provided care compared to expected care. This study was administered to evaluate the health tourists’ satisfaction of provided services in Lorestan University of Medical Sciences affiliated hospitals in 2015. Method: In this descriptive case study, 1800 (696 (54.4%) men and 812 (45.6%) women, 74.5 province native) patients were selected by random sampling from among the patients of Lorestan University of Medical Sciences affiliated hospitals in 2015 spring. The data collection instrument is a semi-structured questionnaire in this study. The questionnaire has 62 general and specific items. Each of the specific items is scaled on four points; satisfied, fairly satisfied, dissatisfied and O.K. In order to analyze the data both descriptive and inferential statistics were used. Results: Poldokhtar Imam Khomeini Hospital had the highest Level of satisfaction of 68 percent in all aspects (hoteling, discharge, paramedical, nurses, medical and admission) among the studied hospitals. Kuhdasht Imam Khomeini hospital had the lowest level of satisfaction of 53 percent. The overall satisfaction level in all hospitals was 61%. Discussion and Conclusion: Despite the shortcomings observed in different areas, the results of the present study are in an intermediate status compared to other studies. While treating patients, patient-centered issue and patients ‘need and preferences should be focused on to enhance health care quality. Considering Patients preferences not only are morally good but also lead to improved care and access to sustainable care practices. Therefore it is needed to drive organizational management approach toward the customer preferences management and needs. PMID:27157181

  11. Ethics in Providing Tourism Services by Travel Agents in Serbia

    Directory of Open Access Journals (Sweden)

    Ivana Mišković

    2012-07-01

    Full Text Available This paper attempts to answer the usually neglected ethical questions of the interaction between tourism workers and participants in tourism movements and users of tourism services in general. Contact with numerous people in the work place, dynamic work with customers, continuous phone calls and stress due to constant responsibility, are just some of the conditions which tourism workers encounter on the daily basis and which sometimes make them ask themselves: Am I really able to do this job? Will their behaviour with each customer be ethical? Will they be able to hide from the customers their stress, nervousness and mental fatigue? Have all the employees in travel agencies attended the training courses in communication with customers, or does everything depend on their own decisions and home upbringing? Is it worth taking risk and putting agency`s reputation at stake? Which moral dilemmas do the tour guides encounter on the journeys? These are just some of the questions which will be put in the spotlight in this paper. The aim of this paper is to indicate the necessity to establish the codes of conduct for all professionals who are in direct contact with tourists

  12. Service providers' perception of the quality of emergency obsteric ...

    African Journals Online (AJOL)

    Facility/staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision. Conclusion The findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were ...

  13. Preparedness of Lithuanian general practitioners to provide mental healthcare services

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas

    2014-01-01

    BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase th...

  14. Mobile phone in Africa: providing services to the masses

    CSIR Research Space (South Africa)

    Botha, Adèle

    2010-08-31

    Full Text Available (SMS, USSD, MMS, Bluetooth, WAP data via GPRS/3 G/HSDPA). This will enable components to be reused, ensure scalability, support multiple access devices (from basic phones to more powerful smart phones, including traditional PCs), provide interoperability...

  15. The marketing-finance interface towards financial services with special reference to the new services provided by futures exchanges

    NARCIS (Netherlands)

    Pennings, J.M.E.; Wetzels, M.G.M.; Meulenberg, M.T.G.

    1999-01-01

    The financial services industry is one of the fastest growing service industries. The financial services industry includes financial derivatives markets such as options and futures markets. In order to ensure survival, firms providing financial services show a rapid product innovation. However, for

  16. The Marketing-Finance Interface Towards Financial Services: with Special Reference to New Services Provided by Futures Exchanges

    NARCIS (Netherlands)

    Pennings, J.M.E.; Wetzels, M.G.M.; Meulenberg, M.T.G.

    1999-01-01

    The financial services industry is one of the fastest growing service industries. The financial services industry includes financial derivatives markets such as options and futures markets. In order to ensure survival, firms providing financial services show a rapid product innovation. However, for

  17. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Science.gov (United States)

    2010-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who is...

  18. Young People's Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment.

    Directory of Open Access Journals (Sweden)

    Christine Michaels-Igbokwe

    Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.

  19. Physiological scoring: an aid to emergency medical services transport decisions?

    Science.gov (United States)

    Challen, Kirsty; Walter, Darren

    2010-01-01

    Attendance at UK emergency departments is rising steadily despite the proliferation of alternative unscheduled care providers. Evidence is mixed on the willingness of emergency medical services (EMS) providers to decline to transport patients and the safety of incorporating such an option into EMS provision. Physiologically based Early Warning Scores are in use in many hospitals and emergency departments, but not yet have been proven to be of benefit in the prehospital arena. The use of a physiological-social scoring system could safely identify patients calling EMS who might be diverted from the emergency department to an alternative, unscheduled, care provider. This was a retrospective, cohort study of patients with a presenting complaint of "shortness of breath" or "difficulty breathing" transported to the emergency department by EMS. Retrospective calculation of a physiological social score (PMEWS) based on first recorded data from EMS records was performed. Outcome measures of hospital admission and need for physiologically stabilizing treatment in the emergency department also were performed. A total of 215 records were analyzed. One hundred thirty-nine (65%) patients were admitted from the emergency department or received physiologically stabilizing treatment in the emergency department. Area Under the Receiver Operating Characteristic Curve (AUROC) for hospital admission was 0.697 and for admission or physiologically stabilizing treatment was 0.710. No patient scoringemergency department to alternative, unscheduled, care providers.

  20. Providing services to trafficking survivors: Understanding practices across the globe.

    Science.gov (United States)

    Steiner, Jordan J; Kynn, Jamie; Stylianou, Amanda M; Postmus, Judy L

    2018-01-01

    Human trafficking is a global issue, with survivors representing all genders, ages, races, ethnicities, religions, and countries. However, little research exists that identifies effective practices in supporting survivors of human trafficking. The research that does exist is Western-centric. To fill this gap in the literature, the goal of this research was to understand practices used throughout the globe with adult human trafficking survivors. A qualitative approach was utilized. Providers from 26 countries, across six different continents, were interviewed to allow for a comprehensive and multi-faceted understanding of practices in working with survivors. Participants identified utilizing an empowerment-based, survivor, and human life-centered approach to working with survivors, emphasized the importance of engaging in community level interventions, and highlighted the importance of government recognition of human trafficking. Findings provide information from the perspective of advocates on best practices in the field that can be used by agencies to enhance human trafficking programming.

  1. Medical students, clinical preventive services, and shared decision-making.

    Science.gov (United States)

    Keefe, Carole W; Thompson, Margaret E; Noel, Mary Margaret

    2002-11-01

    Improving access to preventive care requires addressing patient, provider, and systems barriers. Patients often lack knowledge or are skeptical about the importance of prevention. Physicians feel that they have too little time, are not trained to deliver preventive services, and are concerned about the effectiveness of prevention. We have implemented an educational module in the required family practice clerkship (1) to enhance medical student learning about common clinical preventive services and (2) to teach students how to inform and involve patients in shared decision making about those services. Students are asked to examine available evidence-based information for preventive screening services. They are encouraged to look at the recommendations of various organizations and use such resources as reports from the U.S. Preventive Services Task Force to determine recommendations they want to be knowledgeable about in talking with their patients. For learning shared decision making, students are trained to use a model adapted from Braddock and colleagues(1) to discuss specific screening services and to engage patients in the process of making informed decisions about what is best for their own health. The shared decision making is presented and modeled by faculty, discussed in small groups, and students practice using Web-based cases and simulations. The students are evaluated using formative and summative performance-based assessments as they interact with simulated patients about (1) screening for high blood cholesterol and other lipid abnormalities, (2) screening for colorectal cancer, (3) screening for prostate cancer, and (4) screening for breast cancer. The final student evaluation is a ten-minute, videotaped discussion with a simulated patient about screening for colorectal cancer that is graded against a checklist that focuses primarily on the elements of shared decision making. Our medical students appear quite willing to accept shared decision making as

  2. Antiservice Within the Medical Service Encounter: Lessons for Radiologists Beyond Service Recovery.

    Science.gov (United States)

    Hill, Paul Armstrong; Hill, Ronald Paul

    2015-12-01

    Recent modifications in the metrics for reimbursement have reinforced the importance of radiology service-delivery experiences of patients. Evaluating current radiology practices calls for reflection on the various touch points with patients, as well as their overall satisfaction. If problems occur during encounters, service failure, or lack of satisfactory medical experiences can be transformed through service recovery, whereby patients-as-customers are given chances to voice their concerns, and health care providers across the spectrum can work together to resolve problematic issues. This paper takes a systemic view of the patient experience as embedded in the care continuum, recognizing that different beliefs, attitudes, and behaviors of members of the health care team can negatively affect or sabotage patient satisfaction. Although radiologists are only one of many roles in the care continuum, recommendations are discussed for how they can integrate service satisfaction as a pervasive communal goal among all health care team members. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Petitioning for Involuntary Commitment for Chemical Dependency by Medical Services.

    Science.gov (United States)

    Lamoureux, Ian C; Schutt, Paul E; Rasmussen, Keith G

    2017-09-01

    Patients who have chemical dependency (CD) are commonly encountered on medical and surgical wards, often for illnesses and injuries sustained as a direct result of their substance abuse. When these patients are repeatedly admitted to the hospital in certain states that provide a legal framework to commit chemically dependent persons to a treatment facility, clinicians often wonder whether they should initiate that process. Should consulting psychiatrists choose to initiate the commitment process, they put into motion a resource-intensive, time-consuming mechanism, with uncertain outcomes, both in the courtroom and at the bedside. Petitioning for involuntary commitment to chemical dependency treatment of a patient from medical and surgical services is poorly understood. In this study, we examined a series of patients for whom petitions for judicial commitment in the state of Minnesota were entered over a 12-month period, and evaluated the likelihood of commitment to treatment, the demographics of patients involved, and the outcomes for this series of patients. Three vignettes are presented to illustrate the severity of these patients' illnesses and potential outcomes of the process. We further describe potential limitations of the commitment system and alternatives to CD commitment that could be explored further. © 2017 American Academy of Psychiatry and the Law.

  4. Perception of stroke symptoms and utilization of emergency medical services

    Directory of Open Access Journals (Sweden)

    Maximiliano A. Hawkes

    Full Text Available ABSTRACT Lack of stroke awareness and slow activation of emergency medical services (EMS are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75% arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02. Nineteen patients (20% were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001. Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

  5. Should providers be allowed to extra bill for uncovered services? Debate, resolution, and sequel in Japan.

    Science.gov (United States)

    Ikegami, Naoki

    2006-12-01

    Japan has managed to provide universal coverage at relatively low cost by containing prices and restricting the conditions for which services can be billed in the compulsory social health insurance (SHI) program. However, decline in Japan's economic growth ushered in new actors backed by the prime minister who proposed that the providers should be allowed to extra bill for services not covered by the SHI. In 2004 they took the strategy of drawing the attention of the public to areas where the rigidity of the current prohibition appeared to be unfair and ridiculous. They were opposed by the Ministry of Health, Labor, and Welfare and the Japan Medical Association, who strongly objected on the grounds of safety and equity. The compromise reached by the two ministers in charge led to a clarification of the services that are to be covered and of the process for extending coverage to new procedures and drugs. The prohibition on extra billing has remained essentially unchanged, but the momentum for deregulation has been lost. In 2005 an alternate proposal was made to contain SHI expenditures by introducing a global cap on health expenditures and increasing out-of-pocket payment. Although this proposal was not fully adopted, the gradual decline in SHI benefit levels could lead to a renewed move to allow extra billing.

  6. Opinion On Drug Information Services Provided In A Multi- Specialty Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Vijayakumar TM, Poovi G & Dhanaraju MD

    2011-05-01

    Full Text Available Objective: To evaluate the various drug information queriesreceived, and to access the drug information services providedby the pharmacy practice department.Method: Drug information queries received during wardrounds, direct communication, telephone or internet etc. weredocumented in the drug information request anddocumentation forms prepared by the department over theperiod of January 2010 to June 2010. Various parameters likestatus of enquirer, their specialty, mode of receipt of query,purpose of query, type of query etc. were consider forevaluation.Results: Out of 208 queries received, major 56 (26.9% frommale medical ward. Maximum [82 (39.4 %] queries were fromthe physicians. 73 (35.0 % of the queries were about therecent advances and the updating of the information, It wasfound that mostly the mode of request was during wardrounds 85 (40.9%. Most of the queries [126 (60.6%] wereanswered by written or printout format. Majority of thequeries [195 (93.8 %] were answered directly to theenquirers through direct access. Most of the queries wereanswered through books in the department [86 (41.3 %].Conclusion: Results of the external auditing revealed thatrequestors were generally satisfied with the service provided.The drug information services provided by clinical pharmacistsat the hospital were found to be useful and beneficial to thehealthcare professionals and patients.

  7. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine... Licensing Policy § 597.511 In-kind donations of medicine, medical devices, and medical services. (a... incident to the provision by nongovernmental organizations that are U.S. persons of in-kind donations of...

  8. Reaching out to the forgotten: providing access to medical care for the homeless in Italy.

    Science.gov (United States)

    De Maio, Gianfranco; Van den Bergh, Rafael; Garelli, Silvia; Maccagno, Barbara; Raddi, Freja; Stefanizzi, Alice; Regazzo, Costantina; Zachariah, Rony

    2014-06-01

    A program for outpatient and intermediate inpatient care for the homeless was pioneered by the humanitarian organization Médecins Sans Frontières (MSF) in Milan, Italy, during the winter of 2012-2013. We aimed to document the characteristics and clinical management of inpatients and outpatients seen during this program. A clinic providing outpatient and intermediate inpatient care (24 bed capacity) was set up in an existing homeless hostel. Patients were admitted for post-hospitalization intermediate care or for illnesses not requiring secondary care. This study was a retrospective audit of the routine program data. Four hundred and fifty four individuals presented for outpatient care and 123 patients were admitted to inpatient intermediary care. On average one outpatient consultation was conducted per patient per month, most for acute respiratory tract infections (39.8%; 522/1311). Eleven percent of all outpatients suffered from an underlying chronic condition and 2.98% (38/1311) needed referral to emergency services or secondary care facilities. Most inpatients were ill patients referred through public reception centers (72.3%; 89/123), while 27.6% (34/123) were post-hospitalization patients requiring intermediate care. Out of all inpatients, 41.4% (51/123) required more than 1 week of care and 6.5% (8/123) needed counter-referral to secondary care. The observed service usage, morbidity patterns, relatively long lengths of stay, high referral completion and need for counter-referrals, all reflect the important gap-filling role played by an intermediate care facility for this vulnerable population. We recommend that in similar contexts, medical non-governmental organizations (NGOs) focus on the setup of inpatient intermediary care services; while outpatient services are covered by the public health system. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  9. A cloud system for mobile medical services of traditional Chinese medicine.

    Science.gov (United States)

    Hu, Nian-Ze; Lee, Chia-Ying; Hou, Mark C; Chen, Ying-Ling

    2013-12-01

    Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system

  10. Paralympic medical services for the 2010 paralympic winter games.

    Science.gov (United States)

    Taunton, Jack; Wilkinson, Michael; Celebrini, Rick; Stewart, Robert; Stasyniuk, Treny; Van de Vliet, Peter; Willick, Stuart; Ferrer, Josep Martinez

    2012-01-01

    To present the planning and medical encounters for the 2010 Paralympic Winter Games. Prospective medical encounter study. 2010 Paralympic Winter Games. Athletes, coaches, officials, workforce, volunteers, and media. Sport type: alpine, Nordic, and sledge hockey and curling. Participant type: athlete, workforce, and spectators. Terrain and speed. Medical encounters entered in database at competitive (alpine skiing, biathlon, cross-country skiing, sledge hockey, and curling) and noncompetitive (Whistler and Vancouver Polyclinics, presentation centers, opening and closing ceremonies, media center, Paralympic Family Hotel) venues. Forty-two nations participated with 1350 Paralympic athletes, coaches, and officials. There were 2590 accredited medical encounters (657 athletes, 25.4%; 682 International Federation/National Paralympic Committee officials, 26.3%; 57 IPC, 2.2%; 8 media, 0.3%; 1075 workforce, 41.5%; 111 others, 4.3%) and 127 spectator encounters for a total of 2717 encounters. During the preopening period medical services saw 201 accredited personnel. The busiest venues during the Paralympic Games were the Whistler (1633 encounters) and Vancouver (748 encounters) Polyclinics. Alpine, sledge hockey, and curling were the busiest competitive venues. The majority of medical encounters were musculoskeletal (44.6%, n = 1156). Medical services recorded 1657 therapy treatments, 977 pharmaceutical prescriptions dispensed, 204 dental treatments, 353 imaging examinations (more than 50% from alpine skiing), and 390 laboratory tests. There were 24 ambulance transfers with 7 inpatient hospitalizations for a total of 24 inpatient days and 4 outpatient visits. The mandate to have minimal impact on the health services of Vancouver and the Olympic Corridor while offering excellent medical services to the Games was accomplished. This data will be valuable to future organizing committees.

  11. A study comparing public and medical librarians' perceptions of the role and duties of health information-providing librarians.

    Science.gov (United States)

    Noh, Younghee

    2015-12-01

    This study proposed to define the role and duties of librarians who provide health information service in public and medical libraries. Appropriate education, career experience and starting salary for this position are also presented. This study analysed previous research and job advertisements to understand the current needs for this position. Almost all job advertisements studied were eventually retrieved from Salary.com (US job posting site). Public libraries seeking to fill health informationist positions were even more difficult to find in any of the above locations. Therefore, the researcher attempted to find cases using various search engines, including Google, and noticed that public libraries usually post job advertisements on their website. Finally, 32 job postings were selected as suitable. Fifty-four public and medical librarians were surveyed to validate the results in Korea. Public librarians chose 'health information librarian' as the most appropriate title for this position, while medical librarians answered 'medical librarian'. Therefore, librarians providing health information service in public libraries should be called 'health information librarians', while the position in medical libraries should be called 'medical librarian'. Accordingly, job postings and academic articles will be easily accessible. Both groups marked that the position should require a bachelor's degree in both LIS and a health science field, 2 years library experience and health-related user training. Other requirements included knowledge of health resources and medical terminology, search capabilities and a focus on user-centric service. For required duties, public librarians chose accessing information resources, while medical librarians selected collection management. Health information librarians will play a vital role in the future and must therefore be educated accordingly. © 2015 Health Libraries Group.

  12. Classification and comparison of niche services for developing strategy of medical tourism in Asian countries.

    Science.gov (United States)

    Chen, Hung-chi; Kuo, Hsin-chih; Chung, Kuo-Piao; Chang, Sophia; Su, Syi; Yang, Ming-chin

    2010-01-01

    Medical tourism is a new trend in medical service. It is booming not only in Asian countries but also in European and South American countries. Worldwide competition of medical service is expected in the future, and niche service will be a "trademark" for the promotion of global medicine. Niche service also functions for market segmentation. Niche services are usually surgical procedures. A study was carried out to compare different strategies for developing medical tourism in Asian countries. The role of a niche service is evaluated in the initiation and further development of medical tourism for individual countries. From this study, a general classification was proposed in terms of treatment procedures. It can be used as a useful guideline for additional studies in medical tourism. Niche service plays the following roles in the development of medical tourism: (1) It attracts attention in the mass media and helps in subsequent promotion of business, (2) it exerts pressure on the hospital, which must improve the quality of health care provided in treating foreign patients, especially the niche services, and (3) it is a tool for setting up the business model. E-Da Hospital is an example for developing medical tourism in Taiwan. A side effect is that niche service brings additional foreign patients, which will contribute to the benefit of the hospital, but this leaves less room for treating domestic patients. A niche service is a means of introduction for entry into the market of medical tourism. How to create a successful story is important for the development of a niche service. When a good reputation has been established, the information provided on the Internet can last for a long time and can spread internationally to form a distinguished mark for further development. Niche services can be classified into 3 categories: (1) Low-risk procedures with large price differences and long stay after retirement; (2) high-risk procedures with less of a price difference

  13. 25 CFR 171.305 - Will BIA provide leaching service to me?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Will BIA provide leaching service to me? 171.305 Section... OPERATION AND MAINTENANCE Water Use § 171.305 Will BIA provide leaching service to me? (a) We may provide you leaching service if: (1) You submit a written plan that documents how soil salinity limits your...

  14. 76 FR 42567 - Reporting Requirements for U.S. Providers of International Telecommunications Services

    Science.gov (United States)

    2011-07-19

    ...] Reporting Requirements for U.S. Providers of International Telecommunications Services AGENCY: Federal... international telecommunications traffic for which the burdens on U.S. international service providers outweigh... international reporting requirements for U.S. providers of international telecommunications services. In the...

  15. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Science.gov (United States)

    2010-10-01

    ... or osteopathy as defined by State law; and (2) By or under the personal supervision of an individual licensed under State law to practice medicine or osteopathy. (b) “Medical and surgical services of a...

  16. Providing Assistive Technology Applications as a Service Through Cloud Computing.

    Science.gov (United States)

    Mulfari, Davide; Celesti, Antonio; Villari, Massimo; Puliafito, Antonio

    2015-01-01

    Users with disabilities interact with Personal Computers (PCs) using Assistive Technology (AT) software solutions. Such applications run on a PC that a person with a disability commonly uses. However the configuration of AT applications is not trivial at all, especially whenever the user needs to work on a PC that does not allow him/her to rely on his / her AT tools (e.g., at work, at university, in an Internet point). In this paper, we discuss how cloud computing provides a valid technological solution to enhance such a scenario.With the emergence of cloud computing, many applications are executed on top of virtual machines (VMs). Virtualization allows us to achieve a software implementation of a real computer able to execute a standard operating system and any kind of application. In this paper we propose to build personalized VMs running AT programs and settings. By using the remote desktop technology, our solution enables users to control their customized virtual desktop environment by means of an HTML5-based web interface running on any computer equipped with a browser, whenever they are.

  17. Material efficiency: providing material services with less material production.

    Science.gov (United States)

    Allwood, Julian M; Ashby, Michael F; Gutowski, Timothy G; Worrell, Ernst

    2013-03-13

    Material efficiency, as discussed in this Meeting Issue, entails the pursuit of the technical strategies, business models, consumer preferences and policy instruments that would lead to a substantial reduction in the production of high-volume energy-intensive materials required to deliver human well-being. This paper, which introduces a Discussion Meeting Issue on the topic of material efficiency, aims to give an overview of current thinking on the topic, spanning environmental, engineering, economics, sociology and policy issues. The motivations for material efficiency include reducing energy demand, reducing the emissions and other environmental impacts of industry, and increasing national resource security. There are many technical strategies that might bring it about, and these could mainly be implemented today if preferred by customers or producers. However, current economic structures favour the substitution of material for labour, and consumer preferences for material consumption appear to continue even beyond the point at which increased consumption provides any increase in well-being. Therefore, policy will be required to stimulate material efficiency. A theoretically ideal policy measure, such as a carbon price, would internalize the externality of emissions associated with material production, and thus motivate change directly. However, implementation of such a measure has proved elusive, and instead the adjustment of existing government purchasing policies or existing regulations-- for instance to do with building design, planning or vehicle standards--is likely to have a more immediate effect.

  18. Building capacity in VA to provide emergency gynecology services for women.

    Science.gov (United States)

    Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

    2015-04-01

    Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

  19. Medical Emergency Workload of a Regional UK HEMS Service.

    Science.gov (United States)

    McQueen, Carl; Crombie, Nick; Cormack, Stef; Wheaton, Steve

    2015-01-01

    Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation. A retrospective review of mission data for a regional Air Ambulance Service in England over a two year period. Medical emergencies continue to contribute a large proportion of the overall workload of the service. Requirement for advanced interventions at the scene was rare, with less than 10% of patients attended by HEMS teams having care needs that fall beyond the scope of standard paramedic practice. Dynamic solutions are needed to ensure that HEMS support for cases of medical emergency are appropriately targeted to incidents in which clinical benefit is conferred to the patient. Intelligent tasking of appropriate resources has the potential to improve the HEMS response to medical emergencies while optimizing the availability of resources to respond to other incidents, most notably cases of major trauma. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  20. [Monitoring medication errors in an internal medicine service].

    Science.gov (United States)

    Smith, Ann-Loren M; Ruiz, Inés A; Jirón, Marcela A

    2014-01-01

    Patients admitted to internal medicine services receive multiple drugs and thus are at risk of medication errors. To determine the frequency of medication errors (ME) among patients admitted to an internal medicine service of a high complexity hospital. A prospective observational study conducted in 225 patients admitted to an internal medicine service. Each stage of drug utilization system (prescription, transcription, dispensing, preparation and administration) was directly observed by trained pharmacists not related to hospital staff during three months. ME were described and categorized according to the National Coordinating Council for Medication Error Reporting and Prevention. In each stage of medication use, the frequency of ME and their characteristics were determined. A total of 454 drugs were prescribed to the studied patients. In 138 (30,4%) indications, at least one ME occurred, involving 67 (29,8%) patients. Twenty four percent of detected ME occurred during administration, mainly due to wrong time schedules. Anticoagulants were the therapeutic group with the highest occurrence of ME. At least one ME occurred in approximately one third of patients studied, especially during the administration stage. These errors could affect the medication safety and avoid achieving therapeutic goals. Strategies to improve the quality and safe use of medications can be implemented using this information.

  1. Market competition, ownership, payment systems and the performance of health care providers - a panel study among Finnish occupational health services providers.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2013-10-01

    Many health care reforms rely on competition although health care differs in many respects from the assumptions of perfect competition. Finnish occupational health services provide an opportunity to study empirically competition, ownership and payment systems and the performance of providers. In these markets employers (purchasers) choose the provider and prices are market determined. The price regulation of public providers was abolished in 1995. We had data on providers from 1992, 1995, 1997, 2000 and 2004. The unbalanced panel consisted of 1145 providers and 4059 observations. Our results show that in more competitive markets providers in general offered a higher share of medical care compared to preventive services. The association between unit prices and revenues and market environment varied according to the provider type. For-profit providers had lower prices and revenues in markets with numerous providers. The public providers in more competitive regions were more sensitive to react to the abolishment of their price regulation by raising their prices. Employer governed providers had weaker association between unit prices or revenues and competition. The market share of for-profit providers was negatively associated with productivity, which was the only sign of market spillovers we found in our study.

  2. [The Academy of Trauma Surgery (AUC). Service provider and management organization of the DGU].

    Science.gov (United States)

    Sturm, J A; Hoffmann, R

    2016-02-01

    At the beginning of this century the German Trauma Society (DGU) became extensively active with an initiative on quality promotion, development of quality assurance and transparency regarding treatment of the severely injured. A white book on "Medical care of the severely injured" was published, focusing on the requirements on structural quality and especially procedural quality. The impact of the white book was immense and a trauma network with approved trauma centers, structured and graded for their individual trauma care performance, was developed. In order to monitor and document the required quality of care, a registry was needed. Furthermore, for cooperation within the trauma networks innovative methods for digital transfer of radiological images and patient documents became necessary. Finally, the auditing criteria for trauma centers had and still have to be completed with advanced medical education and training programs. In order to realize the implementation of such a broad spectrum of economically relevant and increasingly complex activities the Academy of Trauma Surgery (AUC) was established as a subsidiary of the DGU in 2004. The AUC currently has four divisions: 1) networks and health care structures, 2) registries and research management, 3) telemedicine, 4) medical education and training, all of which serve the goal of the initiative. The AUC is a full service provider and management organization in compliance with the statutes of the DGU. According to these statutes the business operations of the AUC also cover projects for numerous groups of patients, projects for the joint society the German Society for Orthopedics and Trauma (DGOU) as well as other medical institutions. This article describes the success stories of the trauma network (TraumaNetzwerk DGU®), the TraumaRegister DGU®, the telecooperation platform TKmed®, the new and fast-growing orthogeriatric center initiative (AltersTraumaZentrum DGU®) and the division of medical education and

  3. Personal care services provided to children with special health care needs (CSHCN) and their subsequent use of physician services.

    Science.gov (United States)

    Miller, Thomas R; Elliott, Timothy R; McMaughan, Darcy M; Patnaik, Ashweeta; Naiser, Emily; Dyer, James A; Fournier, Constance J; Hawes, Catherine; Phillips, Charles D

    2013-10-01

    Medicaid Personal Care Services (PCS) help families meet children's needs for assistance with functional tasks. However, PCS may have other effects on a child's well-being, but research has not yet established the existence of such effects. To investigate the relationship between the number of PCS hours a child receives with subsequent visits to physicians for evaluation and management (E&M) services. Assessment data for 2058 CSHCN receiving PCS were collected in 2008 and 2009. Assessment data were matched with Medicaid claims data for the period of 1 year after the assessment. Zero-inflated negative binomial and generalized linear multivariate regression models were used in the analyses. These models included patient demographics, health status, household resources, and use of other medical services. For every 10 additional PCS hours authorized for a child, the odds of having an E&M physician visit in the next year were reduced by 25%. However, the number of PCS hours did not have a significant effect on the number of visits by those children who did have a subsequent E&M visit. A variety of demographic and health status measures also affect physician use. Medicaid PCS for CSHCN may be associated with reduced physician usage because of benefits realized by continuity of care, the early identification of potential health threats, or family and patient education. PCS services may contribute to a child's well-being by providing continuous relationships with the care team that promote good chronic disease management, education, and support for the family. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Medical Tourism and the Libyan National Health Services

    OpenAIRE

    Taguri, Adel El

    2007-01-01

    Medical tourism is a term that is used frequently by the media and travel agencies as a catchall phrase to describe a process where people travel to other countries to obtain medical, dental, and/or surgical care [1,2]. Leisure aspects of traveling are usually included on such a medical travel trip [1]. The term is also used to describe a situation where doctors travel to other places to deliver services to endogenous populations [3].Many factors have led to the recent increase in popularity ...

  5. Positioning patient-perceived medical services to develop a marketing strategy.

    Science.gov (United States)

    Jung, Minsoo; Hong, Myung-Sun

    2012-01-01

    In today's medical market, marketing philosophy is being rapidly transformed from customer searching to patient satisfaction and service improvement. The principal objective of this study was to contribute to the establishment of a desirable medical marketing strategy, through the factors of customer satisfaction and the positioning of patients' perceptions by marketing institutions. The data were collected from 282 students of the College of Public Health and Medicine in Seoul. The survey tools were developed using the SERVQUAL scale. Analysis in this study involved both statistical and network analysis. The former was used to verify the determinants of service satisfaction as perceived by respondents, via factor analysis and multiple regression analysis. The latter was obtained using a positioning map and 2-mode network analysis with the matrix data converted from raw data. The determining factors for patient satisfaction were identified as facilities, accessibility, process, physicians, and medical staff. The regression equation was significant (R = 0.606), and the most influential variable was the service quality of physicians (β = .569). According to multidimensional scaling, the positioning of medical institutions indicated that patients' perceptions were affected by hospital size and specialization. By recognizing and managing patient satisfaction, medical institutions are able to foster customer loyalty and, in turn, to enhance service quality. It is necessary to develop an adequate marketing mix to provide better medical services and to overcome medical competition among institutions.

  6. [Managing digital medical imaging projects in healthcare services: lessons learned].

    Science.gov (United States)

    Rojas de la Escalera, D

    2013-01-01

    Medical imaging is one of the most important diagnostic instruments in clinical practice. The technological development of digital medical imaging has enabled healthcare services to undertake large scale projects that require the participation and collaboration of many professionals of varied backgrounds and interests as well as substantial investments in infrastructures. Rather than focusing on systems for dealing with digital medical images, this article deals with the management of projects for implementing these systems, reviewing various organizational, technological, and human factors that are critical to ensure the success of these projects and to guarantee the compatibility and integration of digital medical imaging systems with other health information systems. To this end, the author relates several lessons learned from a review of the literature and the author's own experience in the technical coordination of digital medical imaging projects. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  7. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)

    Science.gov (United States)

    1991-07-01

    for mental disorders involving sex deviations (e.g., transvestic fetishism), or other similar services, and any supplies provided in connection with...behavior modification, psychotherapy for mental disorders involving sex deviations (e.g., transvestic fetishism), or other similar services, and any...disorders involving sex deviations (e.g., transvestic fetishism), or other similar services, and any supplies provided in connection with therapy for

  8. Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals.

    Science.gov (United States)

    Meng, Runtang; Li, Jingjing; Zhang, Yunquan; Yu, Yong; Luo, Yi; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying; Yu, Chuanhua

    2018-04-17

    Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.

  9. Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals

    Science.gov (United States)

    Li, Jingjing; Yu, Yong; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying

    2018-01-01

    Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation. PMID:29673134

  10. 76 FR 65216 - Beacon Medical Services, LLC, Aurora, CO; Notice of Negative Determination Regarding Application...

    Science.gov (United States)

    2011-10-20

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,219] Beacon Medical Services... workers and former workers of Beacon Medical Services, LLC, Aurora, Colorado (Beacon Medical Services... published in the Federal Register on July 8, 2011 (76 FR 40401). The workers of Beacon Medical Services are...

  11. 42 CFR 412.88 - Additional payment for new medical service or technology.

    Science.gov (United States)

    2010-10-01

    ... for new medical service or technology. (a) For discharges involving new medical services or... medical service or technology. [66 FR 46924, Sept. 7, 2001, as amended at 67 FR 50111, Aug. 1, 2002; 69 FR... 42 Public Health 2 2010-10-01 2010-10-01 false Additional payment for new medical service or...

  12. A cloud medication safety support system using QR code and Web services for elderly outpatients.

    Science.gov (United States)

    Tseng, Ming-Hseng; Wu, Hui-Ching

    2014-01-01

    Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

  13. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Directory of Open Access Journals (Sweden)

    Sheila Cyril

    Full Text Available Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services.We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia.Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers.This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD

  14. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N

    2016-01-01

    Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services. We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure

  15. Breastfeeding after Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk.

    Science.gov (United States)

    Cobb, Benjamin; Liu, Renyu; Valentine, Elizabeth; Onuoha, Onyi

    Doctors, nurses, and midwives often inform mothers to "pump and dump" their breast milk for 24 hours after receiving anesthesia to avoid passing medications to the infant. This advice, though cautious, is probably outdated. This review highlights the more recent literature regarding common anesthesia medications, their passage into breast milk, and medication effects observed in breastfed infants. We suggest continuing breastfeeding after anesthesia when the mother is awake, alert, and able to hold her infant. We recommend multiple types of medications for pain relief while minimizing sedating medications. Few medications can have sedating effects to the infant, but those medications are specifically outlined. For additional safety, anesthesia providers and patients may screen medications using the National Institute of Health' LactMed database.

  16. Helicopter emergency medical service patient transport safe at night?

    NARCIS (Netherlands)

    Peters, J.H.; Wageningen, B. van; Hoogerwerf, N.; Biert, J.

    2014-01-01

    OBJECTIVE: Dutch helicopter emergency medical services are available 24/7. Working without daylight brings additional challenges, both in patient care and in-flight operation. We retrospectively evaluated the safety of this nighttime helicopter transportation of patients. METHODS: Our helicopter

  17. Three Types of Memory in Emergency Medical Services Communication

    Science.gov (United States)

    Angeli, Elizabeth L.

    2015-01-01

    This article examines memory and distributed cognition involved in the writing practices of emergency medical services (EMS) professionals. Results from a 16-month study indicate that EMS professionals rely on distributed cognition and three kinds of memory: individual, collaborative, and professional. Distributed cognition and the three types of…

  18. 20 CFR 416.1024 - Medical and other purchased services.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical and other purchased services. 416.1024 Section 416.1024 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determinations of Disability Administrative Responsibilities and...

  19. 20 CFR 404.1624 - Medical and other purchased services.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical and other purchased services. 404.1624 Section 404.1624 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determinations of Disability Administrative Responsibilities and Requirements...

  20. [The first and foremost tasks of the medical service].

    Science.gov (United States)

    Chizh, I M

    1997-07-01

    Now in connection with common situation in Russian Federation the problem of reinforcements of army and fleet by healthy personnel, scare of a call-up quota and its poor quality are the main problems of the Armed Forces at the state level. The uniform complex program of medico-social maintenance of the citizens during preparation for military service is necessary. The modern situation is difficult due to many infectious diseases, so the role and the place of military-medical service grows. In last years structure of quota, served by the military doctors, and number of other parameters have greatly changed, that require revision of some priorities. A problem of reinforcements of the Armed Forces by medical service officers remains actual, for decision of which a full-bodied admission on military medical faculty is required, as well as admission of the officers under contract and calling-up of reserve officers. In article the main lessons, received by the medical service during combat actions in Republic of Chechnya are also formulated.

  1. Assessment of emergency medical services in the Ashanti region of ...

    African Journals Online (AJOL)

    Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. Conclusions: The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for ...

  2. 78 FR 30727 - Emergency Medical Services Week, 2013

    Science.gov (United States)

    2013-05-22

    .... During Emergency Medical Services Week, we pause to offer our gratitude to these remarkable men and women, whose dedication is fundamental to our society's well-being. In recent weeks, we have again seen the... thousand thirteen, and of the Independence of the United States of America the two hundred and thirty...

  3. International Space Station Medical Projects - Full Services to Mars

    Science.gov (United States)

    Pietrzyk, R. A.; Primeaux, L. L.; Wood, S. J.; Vessay, W. B.; Platts, S. H.

    2018-01-01

    The International Space Station Medical Projects (ISSMP) Element provides planning, integration, and implementation services for HRP research studies for both spaceflight and flight analog research. Through the implementation of these two efforts, ISSMP offers an innovative way of guiding research decisions to meet the unique challenges of understanding the human risks to space exploration. Flight services provided by ISSMP include leading informed consent briefings, developing and validating in-flight crew procedures, providing ISS crew and ground-controller training, real-time experiment monitoring, on-orbit experiment and hardware operations and facilitating data transfer to investigators. For analog studies at the NASA Human Exploration Research Analog (HERA), the ISSMP team provides subject recruitment and screening, science requirements integration, data collection schedules, data sharing agreements, mission scenarios and facilities to support investigators. The ISSMP also serves as the HRP interface to external analog providers including the :envihab bed rest facility (Cologne, Germany), NEK isolation chamber (Moscow, Russia) and the Antarctica research stations. Investigators working in either spaceflight or analog environments requires a coordinated effort between NASA and the investigators. The interdisciplinary nature of both flight and analog research requires investigators to be aware of concurrent research studies and take into account potential confounding factors that may impact their research objectives. Investigators must define clear research requirements, participate in Investigator Working Group meetings, obtain human use approvals, and provide study-specific training, sample and data collection and procedures all while adhering to schedule deadlines. These science requirements define the technical, functional and performance operations to meet the research objectives. The ISSMP maintains an expert team of professionals with the knowledge and

  4. Human Trafficking Identification and Service Provision in the Medical and Social Service Sectors.

    Science.gov (United States)

    Schwarz, Corinne; Unruh, Erik; Cronin, Katie; Evans-Simpson, Sarah; Britton, Hannah; Ramaswamy, Megha

    2016-06-01

    The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital's emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims.

  5. Compression-based aggregation model for medical web services.

    Science.gov (United States)

    Al-Shammary, Dhiah; Khalil, Ibrahim

    2010-01-01

    Many organizations such as hospitals have adopted Cloud Web services in applying their network services to avoid investing heavily computing infrastructure. SOAP (Simple Object Access Protocol) is the basic communication protocol of Cloud Web services that is XML based protocol. Generally,Web services often suffer congestions and bottlenecks as a result of the high network traffic that is caused by the large XML overhead size. At the same time, the massive load on Cloud Web services in terms of the large demand of client requests has resulted in the same problem. In this paper, two XML-aware aggregation techniques that are based on exploiting the compression concepts are proposed in order to aggregate the medical Web messages and achieve higher message size reduction.

  6. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  7. Note from the CERN Medical Service - FLU VACCINATIONs

    CERN Multimedia

    SC Unit

    2008-01-01

    People working on the CERN site who wish to be vaccinated may go to the Infirmary (ground-floor, Bldg. 57) with their vaccine without a prior appointment. Claims for reimbursement should be sent directly to UNIQA, accompanied by the receipt for the vaccine and the prescription you will receive from the Medical Service on the day of your injection at the Infirmary. Ideally, the vaccination should take place before the end of November 2008 (preferably between 14:00 and 16:00). Influenza vaccinations are recommended for all CERN staff aged 50 or over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems or diabetics and for those recovering from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their normal family doctor.

  8. Note from the CERN Medical Service - Flu vaccinations

    CERN Multimedia

    SC Unit

    2008-01-01

    People working on the CERN site who wish to be vaccinated may go to the Infirmary (ground-floor, Bldg. 57) with their vaccine without a prior appointment. Claims for reimbursement should be sent directly to UNIQA, accompanied by the receipt for the vaccine and the prescription you will receive from the Medical Service on the day of your injection at the Infirmary. Ideally, the vaccination should take place before the end of November 2008 (preferably between 14:00 and 16:00). Influenza vaccinations are recommended for all CERN staff aged 50 or over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems or diabetics and for those recovering from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their normal family doctor.

  9. Note from the CERN Medical Service - FLU VACCINATIONs

    CERN Multimedia

    SC Unit

    2008-01-01

    People working on the CERN site who wish to be vaccinated may go to the Infirmary (ground-floor, Bldg. 57) with their vaccine without a prior appointment. Claims for reimbursement should be sent directly to UNIQA, accompanied by the receipt for the vaccine and the prescription you will receive from the Medical Service on the day of your injection at the Infirmary. Ideally, the vaccination should take place before the end of November 2008 (preferably between 2.00 p.m. and 4.00 p.m.). Influenza vaccinations are recommended for all CERN staff aged 50 or over. Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems or diabetes and for those recovering from serious medical problems or major surgery. The Medical Service will not administer vaccines to family members or retired staff members, who must contact their normal family doctor.

  10. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health

  11. Information sharing for effective IT incident resolving in IT service provider networks: A financial service case study

    NARCIS (Netherlands)

    Vlietland, J.; Vliet, J.C.

    2015-01-01

    Information technology (IT)-enabled financial services are typically delivered by a network of interdependent IT service providers. Such networks need information to resolve IT incidents in their delivered IT services. The objective of this research is to identify the set of information that needs

  12. Collaborative service innovation : A study on the collaboration between designers and service providers in dervice disigne projects

    NARCIS (Netherlands)

    Berit Kari Godfroij

    2011-01-01

    Designers move more and more in the direction of Service Design, in which frequently a participatory or co-design approach is used to involve service providers in the design process. The designerprovider relationship in such Service Design processes differs in four aspects from

  13. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Science.gov (United States)

    2011-11-21

    ... concerning the billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing... to ``RIN 2900-AN98--Payment for home health and services and hospice care by non-VA providers...

  14. 42 CFR 54a.8 - Right to services from an alternative provider.

    Science.gov (United States)

    2010-10-01

    ... ABUSE PREVENTION AND TREATMENT SERVICES § 54a.8 Right to services from an alternative provider. (a... 42 Public Health 1 2010-10-01 2010-10-01 false Right to services from an alternative provider. 54a... date of such objection, such program beneficiary shall have rights to notice, referral, and alternative...

  15. Offshoring of healthcare services: the case of US-India trade in medical transcription services.

    Science.gov (United States)

    Kshetri, Nir; Dholakia, Nikhilesh

    2011-01-01

    - The issue of offshore outsourcing of healthcare services is a critical but little-examined problem in healthcare research. The purpose of this study is to contribute to filling this void. A library-based study was carried out of the development of the Indian medical transcription offshoring industry. Findings- Cost-saving potential and the degree of outsourceability are higher for medical transcription compared with most services. Offshoring experience, typically in a low-value BPO, helps to enhance productivity and international linkages required for the success of medical transcription. Research limitations/implications - An important area of future research concerns comparing India's factor endowments in medical transcription outsourcing with other services. Further research is also needed to examine how India differs from its regional competitors in terms of factors endowments associated with these services. Another extension would be to investigate the drivers of offshoring of higher value services such as radiological readings. Practical implications - ICT infrastructures needed for outsourcing require much less investment compared with leading capital-intensive industries. The development patterns of the Indian medical and offshoring industries indicate that India may attract higher skilled medical functions in the future. The Indian offshoring industry is shifting its focus from BPO to knowledge process outsourcing (KPO). Developing countries need to shift to greater automation and greater levels of skill training to retain and reinforce their comparative advantages. This paper's greatest value stems from the fact that it examines the drivers of a new but rapidly growing healthcare industry.

  16. British Coal Corporation Medical Service annual report 1988-89

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    This annual report reviews the work of British Coal's Medical Service over the period 1988-89. Recruitment was at a lower level resulting in a reduction in the number of pre-employment medical examinations. Statistics are given for these, and for consultations during the year. The work of the rescue service is described. Results of surveys on the prevalence of pneumoconiosis in coal miners from 1961 to 1988 are presented in detail. The fall in prevalence continued. Continued attention has been paid to compliance with COSHH regulations, to encouraging the use of physiotherapy and to educating workers in lifting and handling methods. Following an incidence of Legionnaires Disease an investigation was carried out to identify the source of infection in an underground refrigeration plant. Studies on the mortality of coke workers have progressed. Reports are given on first aid and nursing services and on the administration of pethridine to injured miners.

  17. 75 FR 62348 - Reimbursement Offsets for Medical Care or Services

    Science.gov (United States)

    2010-10-08

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN55 Reimbursement Offsets for Medical Care... Veterans Affairs (VA) proposes to amend its regulations concerning the reimbursement of medical care and... situations where third-party payers are required to reimburse VA for costs related to care provided by VA to...

  18. Medical services at the first Winter Youth Olympic Games 2012 in Innsbruck/Austria.

    Science.gov (United States)

    Blank, Cornelia; Schamasch, Patrick; Engebretsen, Lars; Haslinger, Simon; Ruedl, Gerhard; Fink, Christian; Schobersberger, Wolfgang

    2012-12-01

    The Youth Olympic Games (YOG) are a new format designed by the International Olympic Committee. So far no reference data are available regarding the organisation or implementation of the medical services that were needed for the Winter Youth Olympic Games that took place for the first time in Innsbruck 9-24 January 2012. (1) To provide insight into what is needed to prepare for such a complex high level sporting event from a medical perspective, (2) to provide data on medical services for future organising committees and (3) to provide information on different National Olympic Committee (NOC) delegation structures and the consequences of registering a National Olympic Committee Team Physician. A medical information system in the form of a patient data-management system was developed with all involved parties to standardise data collection. All medical encounters occurring at any IYOGOC medical service centre (including physiotherapy and psychology facilities) were tracked and collected in daily reports. Data evaluation was prepared based on different interest groups (Athletes, National Olympic Committees, Workforce, International Olympic Committee and Media) and analysed. 327 medical encounters (42.8% athletes; out of these, 57.9% were accounted to athletes with own NOC team physician) were seen during the YOG 2012. The total number of hospital transports was 27.3%, of which 8.9% were hospitalised with an average length of 1.9 nights. Physiotherapy usage was low with only 19 medical encounters resulting in a referral to physiotherapy accounting for 67 treatments during the entire YOG. Psychological care service was not used at all. The main reason for illnesses was disorders of the respiratory system (28.8%), injuries mostly affected upper extremities (49.6%) and were mostly diagnosed with lacerations and contusions (26.2%). Injury (70.7%) and illness (29.3%) incidences in athletes were slightly lower than previous studies showed. 40.0% of NOC delegations

  19. Perceptions of school nurses and principals towards nurse role in providing school health services in Qatar.

    Science.gov (United States)

    A L-Dahnaim, Layla; Said, Hana; Salama, Rasha; Bella, Hassan; Malo, Denise

    2013-04-01

    The school nurse plays a crucial role in the provision of comprehensive health services to students. This role encompasses both health and educational goals. The perception of the school nurse's role and its relation to health promotion is fundamental to the development of school nursing. This study aimed to determine the perception of school nurses and principals toward the role of school nurses in providing school health services in Qatar. A cross-sectional study was carried out among all school nurses (n=159) and principals (n=159) of governmental schools in Qatar. The participants were assessed for their perception toward the role of the school nurse in the school using 19-Likert-type scaled items Questionnaire. The response rates were 100% for nurses and 94% for principals. The most commonly perceived roles of the school nurse by both nurses and principals were 'following up of chronically ill students', 'providing first aid', and 'referral of students with health problems', whereas most of the roles that were not perceived as school nurse roles were related to student academic achievements. School nurses and principals agreed on the clinical/medical aspects of nurses' role within schools, but disagreed on nurses' involvement in issues related to the school performance of students. The study recommends raising awareness of school principals on the school nursing role, especially in issues related to the school performance of students.

  20. Providing information regarding exposures in pregnancy: a survey of North American Teratology Information Services.

    Science.gov (United States)

    Hancock, Rebecca L; Ungar, Wendy J; Einarson, Adrienne; Goodstadt, Michael; Koren, Gideon

    2008-04-01

    Teratology Information Services (TIS) provide information on exposures during pregnancy and breast-feeding. Maintaining ongoing funding is a challenge. The purpose was to gather descriptive information on current TIS operations. All North American TIS (16 American, 2 Canadian) completed a detailed survey. Service goal ranked as most important was correction of risk misperceptions. Inquiries were primarily for medications (mean 43.5%, S.D. 14.1), lactation exposures, and workplace exposures. Median employees per TIS: three (range 1-12.5). Two TIS only counsel health care professionals (HCPs). Main callers to remaining TIS were pregnant women (mean 46.8%, S.D. 22.8), physicians, and nurses. Calls per week varied (median 20, range 4-600). Median annual budget: US dollars 69,000 (range dollars 3000-335,000). Seventeen TIS collect patient data for research. This survey was the first to document TIS operations in North America and demonstrates a spectrum of clinical and research activities, and provides data for a future cost-benefit analysis of TIS.

  1. [A web information system for enhancing management and improving special care services provided to dependent persons].

    Science.gov (United States)

    Alvarez-Bermejo, J A; Hernández-Capel, D M; Belmonte-Ureña, L J; Roca-Piera, J

    2009-01-01

    Ensuring the quality of services provided in centres where dependent persons are seen by specialist services, by improving and enhancing how information -salary, control of tasks, patients' records, etc.- is shared between staff and carers. A web information system has been developed and experimentally deployed to accomplish this. The accuracy of the system was evaluated by assessing how confident the employees were with it rather than relying on statistical data. It was experimentally deployed since January 2009 in Asociación de Personas con Discapacidad "El Saliente" that manages several day centres in Almeria, for dependent persons over 65 years old, particularly those affected by Alzheimer' disease. Incidence data was collected during the experimental period. A total of 84% of the employees thought that the system helped to manage documents, administrative duties, etc., and 92.4% said they could attend to really important tasks because the system was responsible for alerting them of every task, such as medication timetables, checking all patients were present (to prevent an Alzheimer affected person leaving the centre) etc. During this period the incidences reported were reduced by about a 30%, although data is still partially representative. As the life expectancy of the population gets longer, these centres will increase. Providing systems such as the one presented here would be of great help for administrative duties (sensitive data protection...) as well as ensuring high quality care and attention.

  2. [Design and piloting of a structured service medication dispensing process].

    Science.gov (United States)

    Abaurre, Raquel; García-Delgado, Pilar; Maurandi, M Dolores; Arrebola, Cristóbal; Gastelurrutia, Miguel Ángel; Martínez-Martínez, Fernando

    2015-01-01

    The aim of this article is to design and pilot a protocol for the dispensing of medications service. Using the requirements proposed in the Ministry of Health Pharmaceutical Care Consensus, a literature search was made applying qualitative consensus techniques. An observational, cross-sectional study was conducted from March to June 2009. A total of 53 community pharmacies from 24 Spanish counties. Patients who requested one or more particular medications with or without medical prescription for their own use or for someone in their care. The personalised medication information (IPM), the problems associated with the medications (PRM), and the negative results associated with the medication (RNM), detected by the pharmacist each time medication was dispensed, as well as the perception of the pharmacist on the operability of the protocol were recorded. A total of 870 medications were dispensed, with 423 (48.6%) cases of lack of personalised medication information (IPM) being detected. PRM were detected in 10.11% of the dispensed medications, as well as 68 (7.81%) suspected RNM: safety (n = 35; 51.5%), effectiveness (n = 29; 42.6%) and necessity (n = 4; 5.8%). Almost two-thirds (65.21%) of the pharmacists said that the protocol is in operation. The designed protocol helped to detect deficiencies in the information to the patients about their medications, as well as the PRM and RNM, and is shown to be tool that is easy to use and apply. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  3. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Science.gov (United States)

    2012-01-01

    Background Dental general anaesthesia (DGA) is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS) and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age (periodontics, surgical procedures and miscellaneous. The reasons for DGA and the treatments provided varied according to age, immigration, previous sedation and DGA and medical background. The logistic regression model showed that previous sedation (OR 2.3; 95%CI 1.3-4.1; p=0.005) and extreme non-cooperation (OR 1.7; 95%CI 0.9-3.2; p=0.103) were most indicative of preventive measures given. Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA. PMID:23102205

  4. Brand Medications and Medicare Part D: How Eye Care Providers' Prescribing Patterns Influence Costs.

    Science.gov (United States)

    Newman-Casey, Paula Anne; Woodward, Maria A; Niziol, Leslie M; Lee, Paul P; De Lott, Lindsey B

    2018-03-01

    To quantify costs of eye care providers' Medicare Part D prescribing patterns for ophthalmic medications and to estimate the potential savings of generic or therapeutic drug substitutions and price negotiation. Retrospective cross-sectional study. Eye care providers prescribing medications through Medicare Part D in 2013. Medicare Part D 2013 prescriber public use file and summary file were used to calculate medication costs by physician specialty and drug. Savings from generic or therapeutic drug substitutions were estimated for brand drugs. The potential savings from price negotiation was estimated using drug prices negotiated by the United States Veterans Administration (USVA). Total cost of brand and generic medications prescribed by eye care providers. Eye care providers accounted for $2.4 billion in total Medicare part D prescription drug costs and generated the highest percentage of brand name medication claims compared with all other providers. Brand medications accounted for a significantly higher proportion of monthly supplies by volume, and therefore, also by total cost for eye care providers compared with all other providers (38% vs. 23% by volume, P total cost, P total cost attributable to eye care providers is driven by glaucoma medications, accounting for $1.2 billion (54% of total cost; 72% of total volume). The second costliest category, dry eye medications, was attributable mostly to a single medication, cyclosporine ophthalmic emulsion (Restasis, Allergan, Irvine, CA), which has no generic alternative, accounting for $371 million (17% of total cost; 4% of total volume). If generic medications were substituted for brand medications when available, $148 million would be saved (7% savings); if generic and therapeutic substitutions were made, $882 million would be saved (42% savings). If Medicare negotiated the prices for ophthalmic medications at USVA rates, $1.09 billion would be saved (53% savings). Eye care providers prescribe more brand

  5. Home Visit Services Provided for Elderly Dwellers in Isfahan Province: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Zamane Vafaei

    2015-06-01

    Conclusion: As the home visit services might be effective for providing health care for the aged people and increasing their quality of life, policymaking to spread these services seems to be crucial especially for Iran.

  6. Subcontracting in electronics : from contract manufacturers to providers of electronic manufacturing services (EMS)

    OpenAIRE

    Liemt van, Gijsbert

    2007-01-01

    Discusses how the top contract manufacturers in the electronics industry try to become providers of electronic manufacturing services by deepening and broadening the rage of services that they offer and by diversifying into markets other than computing and telecommunications.

  7. Barriers to Rural Induced Abortion Services in Canada: Findings of the British Columbia Abortion Providers Survey (BCAPS)

    Science.gov (United States)

    Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer

    2013-01-01

    Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578

  8. The Effects of Korean Medical Service Quality and Satisfaction on Revisit Intention of the United Arab Emirates Government Sponsored Patients.

    Science.gov (United States)

    Lee, Seoyoung; Kim, Eun-Kyung

    2017-06-01

    The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals. Copyright © 2017. Published by Elsevier B.V.

  9. Audit of annual medical appraisal and revalidation activity across the UK Defence Medical Services 2013-2014.

    Science.gov (United States)

    Morris, Louisa E; Withnall, Rdj

    2017-02-01

    To provide the first annual audit of Defence Medical Services (DMS) medical appraisal and revalidation activity. A questionnaire-based survey of appraisal and revalidation activity within the 2013-2014 appraisal year (1 April 2013 - 1 March 2014) across the Royal Navy (RN), Army, Royal Air Force (RAF) and Ministry of Defence (MOD) and Defence Postgraduate Medical Deanery (DPMD) Designated Bodies (DBs). Mandatory annual medical appraisal of all DMS doctors was introduced in 2002. The General Medical Council (GMC) introduced licences to practise in November 2011. Revalidation went live in December 2012. In the 2013-2014 appraisal year, there were 1379 DMS doctors. The Responsible Officers (ROs) of the RN, Army, RAF, MOD and Defence Postgraduate Medical Deanery (DPMD) provide appraisal and revalidation services for doctors within their DBs. In the 2013-2014 appraisal year, 82% of DMS doctors completed an annual appraisal. ROs provided positive revalidation recommendations for 90% of DMS doctors without the need for additional supporting information. Additional supporting evidence was required for 10% of DMS trained doctors, but ultimately 100% of DMS doctors due revalidation in the 2013-2014 appraisal year received a positive recommendation. To assist DMS compliance with GMC quality assurance requirements, HQ Surgeon General now maintains a central database of appraisal and revalidation data across the five DMS DBs. Appropriately targeted appraiser training and 'revalidation ready top-up' training should be provided to ensure the demand for military appraisers is met, and that DMS appraisers appropriately maintain their skills. MOD now maintains a central live database for ongoing appraisal and revalidation monitoring. 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/.

  10. Cloud Service Provider Methods for Managing Insider Threats: Analysis Phase 1

    Science.gov (United States)

    2013-11-01

    of Standards and Technology (NIST) Special Publication 800-145 (NIST SP 800-145) defines three types of cloud services : Software as a Service ( SaaS ...among these three models. NIST SP 800-145 describes the three service models as follows: SaaS —The capability provided to the consumer is to use the...Cloud Service Provider Methods for Managing Insider Threats: Analysis Phase I Greg Porter November 2013 TECHNICAL NOTE CMU/SEI-2013-TN-020

  11. Emergency Medical Services Professionals’ Attitudes About Community Paramedic Programs

    Directory of Open Access Journals (Sweden)

    Robert J. Steeps

    2017-05-01

    Full Text Available Introduction: The number of community paramedic (CP programs has expanded to mitigate the impact of increased patient usage on emergency services. However, it has not been determined to what extent emergency medical services (EMS professionals would be willing to participate in this model of care. With this project, we sought to evaluate the perceptions of EMS professionals toward the concept of a CP program. Methods: We used a cross-sectional study method to evaluate the perceptions of participating EMS professionals with regard to their understanding of and willingness to participate in a CP program. Approximately 350 licensed EMS professionals currently working for an EMS service that provides coverage to four states (Missouri, Arkansas, Kansas, and Oklahoma were invited to participate in an electronic survey regarding their perceptions toward a CP program. We analyzed interval data using the Mann-Whitney U test, Kruskal-Wallis one-way analysis of variance, and Pearson correlation as appropriate. Multivariate logistic regression was performed to examine the impact of participant characteristics on their willingness to perform CP duties. Statistical significance was established at p ≤ 0.05. Results: Of the 350 EMS professionals receiving an invitation, 283 (81% participated. Of those participants, 165 (70% indicated that they understood what a CP program entails. One hundred thirty-five (58% stated they were likely to attend additional education in order to become a CP, 152 (66% were willing to perform CP duties, and 175 (75% felt that their respective communities would be in favor of a local CP program. Using logistic regression with regard to willingness to perform CP duties, we found that females were more willing than males (OR = 4.65; p = 0.03 and that those participants without any perceived time on shift to commit to CP duties were less willing than those who believed their work shifts could accommodate additional duties (OR = 0.20; p

  12. The financial value of services provided by a rural community health fair.

    Science.gov (United States)

    Dulin, Mary Katherine; Olive, Kenneth E; Florence, Joseph A; Sliger, Carolyn

    2006-11-01

    There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.

  13. What to provide and how to provide it? : - a study on small companies' demand for audit and alternative services

    OpenAIRE

    Franzén, Liza

    2010-01-01

    The 1st of July 2010 is the statutory audit going to be abolished in Sweden. After the abolition 96 % of the limited companies do not have to conduct an audit.  This research will therefore study the small companies’ demand for audit and alternative services, and how the services shall be provided to best align with the clients’ demands. This study will be conducted with a positivistic perception of knowledge, since the aim is to explain what factors that affect the companies’ demand. With st...

  14. Initiation of a medical toxicology consult service at a tertiary care children's hospital.

    Science.gov (United States)

    Wang, George Sam; Monte, Andrew; Hatten, Benjamin; Brent, Jeffrey; Buchanan, Jennie; Heard, Kennon J

    2015-05-01

    Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children toxicology consultation is not common at children's hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children's hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8-16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship.

  15. [Medical services on an inspection ship in the north Atlantic].

    Science.gov (United States)

    Kjaer, A

    1990-10-29

    The Danish Naval Inspection Ships sail in the North Atlantic waters with a doctor on board. The object of this investigation was to illustrate the medical services on board and to elucidate the significance of various factors to predict seeking medical advice. During a period of three months, all of the medical services and certain basic factors were registered. The crew was interviewed about consumption of alcohol and tobacco, previous life at sea and family background. A total of 305 consultations were used by the crew of 72 men. This figure is five times the anticipated figure in general practice. Low rank and low age were predictors for frequent medical consultations. The diagnosis groups of traumata/injuries, dermatological conditions and disease in the nervous system or organs of sense were relatively overrepresented. A series of factors may possibly have influenced the pattern of seeking medical help so that this differs from general practice. It is concluded that the dangerous working environment and poor possibilities for good hygiene are important factors whereas the mental stress is of lesser significance.

  16. When the visit to the emergency department is medically nonurgent: provider ideologies and patient advice.

    Science.gov (United States)

    Guttman, N; Nelson, M S; Zimmerman, D R

    2001-03-01

    It is estimated that more than half of pediatric hospital emergency department (ED) visits are medically nonurgent. Anecdotal impressions suggest that ED providers castigate medically nonurgent visits, yet studies on such visits are scarce. This study explored the perspectives of 26 providers working in the EDs of two urban hospitals regarding medically nonurgent pediatric ED visits and advising parents or guardians on appropriate ED use. Three provider ideologies regarding the appropriateness of medically nonurgent ED use were identified and found to be linked to particular communication strategies that providers employed with ED users: restrictive, pragmatic, and all-inclusive. The analysis resulted in the development of a typology of provider ideological orientations toward ED use, distinguished according to different orientations toward professional dominance.

  17. Mapping ecosystem services provided by benthic habitats in the European North Atlantic Ocean

    Directory of Open Access Journals (Sweden)

    Ibon eGalparsoro

    2014-07-01

    Full Text Available Mapping and assessing the ecosystem services provided by benthic habitats are a highly valuable source of information for understanding their current and potential benefits to society. The main objective of this investigation is to assess and map the ecosystem services provided by benthic habitats of the European North Atlantic Ocean, in the context of Mapping and Assessment of Ecosystems and their Services (MAES programme, the European Biodiversity Strategy and the implementation of the Marine Strategy Framework Directive. In total, 62 habitats have been analysed in relation to 12 ecosystem services over 1.7 million km2. Results indicated that more than 90% of the mapped area provides biodiversity maintenance and food provision services; meanwhile grounds providing reproduction and nursery services are limited to half of the mapped area. Benthic habitats generally provide more services closer to shore than offshore and in shallower waters. This gradient is likely to be explained by difficult access (i.e. distance and depth and lack of scientific knowledge for most of the services provided by distant benthic habitats. This research has provided a first assessment of the benthic ecosystem services at Atlantic European scale, with the provision of ecosystem services maps and their general spatial distribution patterns. Related to the objectives of this research, the conclusions are: (i benthic habitats provide a diverse set of ecosystem services, being the food provision and biodiversity maintenance services the ones that are more extensively represented. In addition, other regulating and cultural services are provided in a more limited area; and (ii the ecosystem services assessment categories are significantly related to the distance to the coast and with depth (higher near the coast and in shallow waters.

  18. Health Physics, Safety and Medical Services report for 1988

    International Nuclear Information System (INIS)

    Burt, A.K.; Bird, R.W.

    1989-08-01

    This annual report summarizes Health Physics and Medical Services activities at Harwell Laboratory. Topics covered include liaison with emergency authorities, organization, policy, training and staffing problems, major changes to plant and the decommissioning projects. Monitoring of the working environment and that surrounding the Laboratory are discussed, together with surface contamination and waste disposal. Summaries of doses for 1988, and cumulative doses in selected buildings for Harwell staff and contractors are presented in tabular form and a summary of attendance for medical treatment is also given. (UK)

  19. The Role of the Medical Provider in the Evaluation of Sexually Abused Children and Adolescents

    Science.gov (United States)

    Newton, Alice Whittier; Vandeven, Andrea Marie

    2010-01-01

    It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…

  20. [New possibilities in emergency medical transportation and emergency services of Polish Medical Air Rescue].

    Science.gov (United States)

    Gałazkowski, Robert

    2010-01-01

    In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.

  1. Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management Oversight

    Science.gov (United States)

    2016-04-28

    Treasury for collection when the debts are delinquent more than 120 days.9 Further, UBOs can transfer debt to the Defense Finance and Accounting ...Comptroller); • Defense Finance and Accounting Service; • MEDCOM; • RHCE; and • LRMC. During the site visits to LRMC and MEDCOM, we observed daily...Uniform Business Office Manual,” November 2006; and • MEDCOM Finance and Accounting Division Standard Operating Procedures Medical Services Account

  2. 47 CFR 64.707 - Public dissemination of information by providers of operator services.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Public dissemination of information by providers of operator services. 64.707 Section 64.707 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... § 64.707 Public dissemination of information by providers of operator services. Providers of operator...

  3. Who wants to deliver public service? Do institutional antecedents of public service motivation provide an answer?

    NARCIS (Netherlands)

    Vandenabeele, W.V.

    2011-01-01

    Public service motivation has rapidly become one of the important concepts in contemporary public administration research. However, until now, research has mainly focused on its measurement and its consequences, whereas relatively ignoring its origins. This study investigates where the antecedents

  4. Retrospective financial analysis of medication therapy management services from the pharmacy's perspective.

    Science.gov (United States)

    McDonough, Randal P; Harthan, Aaron A; McLeese, Kelly E; Doucette, William R

    2010-01-01

    To determine the net financial gain or loss for medication therapy management (MTM) services provided to patients by an independent community pharmacy during 16 months of operation. Retrospective study. Independent community pharmacy in Iowa City, IA, from September 1, 2006, to December 31, 2007. Patients receiving MTM services during the specified period who had proper documentation of reimbursement for the services. MTM services were provided to the patient and documented by the pharmacist or student pharmacist. Net financial gains or losses for providing MTM services. Sensitivity analyses included costs that might be incurred under various conditions of operation. 103 initial and 88 follow-up MTM visits were conducted during a 16-month time period. The total cost for these services to the pharmacy was $11,191.72. Total revenue from these services was $11,195.00; therefore, the pharmacy experienced a net financial gain of $3.28. Sensitivity analyses were conducted, revealing the net gain/loss to the pharmacy if a student pharmacist was used and the net gain/loss if the pharmacist needed extra training to provide the services. Using a student pharmacist resulted in a net gain of $6,308.48, while extra training for the pharmacist resulted in a net loss of $1,602.72. The MTM service programs showed a positive financial gain after 16 months of operation, which should encourage pharmacists to incorporate these services into their practice.

  5. New joints: Private providers and rising demand in the English National Health Service

    OpenAIRE

    Kelly, Elaine; Stoye, George

    2015-01-01

    Reforms to public services have extended consumer choice by allowing for the entry of private providers. The aim is to generate competitive pressure to improve quality when consumers choose between providers. However, for many services new entrants could also affect whether a consumer demands the service at all. We explore this issue by considering how demand for elective surgery responds following the entry of private providers into the market for publicly funded health care in England. For ...

  6. FACTORS INFLUENCING CUSTOMERS’ BEHAVIOUR TOWARDS TRUSTED SERVICE PROVIDERS: AN INVESTIGATION OF FOUR SERVICE SETTINGS

    Directory of Open Access Journals (Sweden)

    Gurau Calin

    2013-07-01

    20 minutes, and the respondents being randomly selected from the waiting areas of five UK supermarkets. The collected data has been analysed with the SPSS software, using the Chi Square and Pearson’s two-tailed correlation tests. The results indicate a complex relationship between various categories of factors and the level of customer loyalty, which varies in relation to specific service settings. The findings have been integrated into a synthetic model, developed for four different types of services.

  7. National Coal Board Medical Service annual report 1980-1981

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    Sections report on: medical examinations and consultations; protection from health hazards such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in the blood of miners, Legionaires' disease, Perthe's disease, rehabilitation and physiotherapy, chemical hazards, public health and hygiene, noise, and the use of visual display units; diseases from coal products such as in coke and tar manufacture; first aid services, morphia, and nursing service; and back pain in the mining industry. A list of staff and their publications is also included.

  8. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Directory of Open Access Journals (Sweden)

    Savanheimo Nora

    2012-10-01

    Full Text Available Abstract Background Dental general anaesthesia (DGA is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age ( Results The DGA patients (n=349 were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA.

  9. Medical tourism services available to residents of the United States.

    Science.gov (United States)

    Alleman, Brandon W; Luger, Tana; Reisinger, Heather Schacht; Martin, Rene; Horowitz, Michael D; Cram, Peter

    2011-05-01

    There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited. To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered. DESIGN, PARTICIPANTS, AND OUTCOMES: Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected. We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US--most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports. The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical

  10. Talking about Sexuality and Intimacy with Women Spousal Caregivers: Perspectives of Service Providers.

    Science.gov (United States)

    Brotman, Shari; Drummond, Jennifer; Silverman, Marjorie; Sussman, Tamara; Orzeck, Pam; Barylak, Lucy; Wallach, Isabelle; Billette, Veronique

    2016-11-20

    This article reports the findings of an exploratory study examining service provider perceptions and experiences of addressing sexuality and intimacy with women spousal caregivers. The caregiver-provider encounter is examined, and challenges faced by service providers in addressing sexuality are considered. Themes identified include ambivalence and discomfort, personal and institutional barriers, meanings attributed to sexuality and intimacy, and lack of opportunities to discuss experiences. Strategies to overcome silence and invisibility on the part of service providers in the health and social services system are considered. © 2016 National Association of Social Workers.

  11. Preliminary construction of a service provider--informed domestic violence research agenda.

    Science.gov (United States)

    Murray, Christine E; Welch, Metoka L

    2010-12-01

    This article presents the results of a statewide survey of domestic violence (DV) service providers that focused on the needs, background characteristics, and opinions of service providers related to research. The survey included an examination of service providers' motivation for working in the field, research background and training, and perceptions of research as well as the topics they believe are important for researchers to study, the resources they consult to learn about DV, and their suggestions to help researchers learn more about the nature of their work. The results are integrated into a preliminary agenda for future DV research that accounts for the needs and insight of service providers.

  12. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Science.gov (United States)

    2010-10-01

    ... payment for new medical services and technologies: General provisions. (a) Basis. Sections 412.87 and 412... establish a mechanism to recognize the costs of new medical services and technologies under the hospital... that are new medical services and technologies, if the following conditions are met: (1) A new medical...

  13. Effects of a Patient-Provider, Collaborative, Medication-Planning Tool: A Randomized, Controlled Trial

    Directory of Open Access Journals (Sweden)

    James F. Graumlich

    2016-01-01

    Full Text Available Among patients with various levels of health literacy, the effects of collaborative, patient-provider, medication-planning tools on outcomes relevant to self-management are uncertain. Objective. Among adult patients with type II diabetes mellitus, we tested the effectiveness of a medication-planning tool (Medtable™ implemented via an electronic medical record to improve patients’ medication knowledge, adherence, and glycemic control compared to usual care. Design. A multicenter, randomized controlled trial in outpatient primary care clinics. 674 patients received either the Medtable tool or usual care and were followed up for up to 12 months. Results. Patients who received Medtable had greater knowledge about indications for medications in their regimens and were more satisfied with the information about their medications. Patients’ knowledge of drug indication improved with Medtable regardless of their literacy status. However, Medtable did not improve patients’ demonstrated medication use, regimen adherence, or glycemic control (HbA1c. Conclusion. The Medtable tool supported provider/patient collaboration related to medication use, as reflected in patient satisfaction with communication, but had limited impact on patient medication knowledge, adherence, and HbA1c outcomes. This trial is registered with ClinicalTrials.gov NCT01296633.

  14. 50 CFR 260.97 - Conditions for providing fishery products inspection service at official establishments.

    Science.gov (United States)

    2010-10-01

    ... processed foods and/or components thereof; (10) Furnish and provide laundry service, as required by NMFS... inspection service at official establishments. 260.97 Section 260.97 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE PROCESSED FISHERY...

  15. 17 CFR 248.13 - Exception to opt out requirements for service providers and joint marketing.

    Science.gov (United States)

    2010-04-01

    ... include marketing of your own products or services or marketing of financial products or services offered... requirements for service providers and joint marketing. 248.13 Section 248.13 Commodity and Securities... Consumer Financial Information and Safeguarding Personal Information Exceptions § 248.13 Exception to opt...

  16. System and Method for Providing a Climate Data Analytic Services Application Programming Interface Distribution Package

    Science.gov (United States)

    Schnase, John L. (Inventor); Duffy, Daniel Q. (Inventor); Tamkin, Glenn S. (Inventor)

    2016-01-01

    A system, method and computer-readable storage devices for providing a climate data analytic services application programming interface distribution package. The example system can provide various components. The system provides a climate data analytic services application programming interface library that enables software applications running on a client device to invoke the capabilities of a climate data analytic service. The system provides a command-line interface that provides a means of interacting with a climate data analytic service by issuing commands directly to the system's server interface. The system provides sample programs that call on the capabilities of the application programming interface library and can be used as templates for the construction of new client applications. The system can also provide test utilities, build utilities, service integration utilities, and documentation.

  17. Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?

    Science.gov (United States)

    Rayner, Clive; Ragan, Michael R

    2018-05-01

    Efficient responses to emergencies in the oral and maxillofacial surgery office require preparation, communication, and thorough documentation of the event and response. The concept of team anesthesia is showcased with these efforts. Emergency medical services training and response times vary greatly. The oral and maxillofacial surgery office should be prepared to manage the patient for at least 15 minutes after making the call to 911. Patient outcomes are optimized when providers work together to manage and transport the patient. Oral and maxillofacial surgery offices should develop and rehearse emergency plans and coordinate these protocols with local Emergency medical services teams. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. National Coal Board Medical Service annual report 1981-82

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    Sections report on: medical examinations and consultations; protection from health hazards, such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in miners' blood, Legionnaires' disease, rehabilitation and physiotherapy, high pressure injection injuries, pump packing; National Coal Board (Coal Products) Ltd.; injuries and treatment; and nursing service. A list of staff and their publications and a supplement on occupational toxicology are included.

  19. [Organisation of scientific and research work of Navy medical service].

    Science.gov (United States)

    Gavrilov, V V; Myznikov, I L; Kuz'minov, O V; Shmelev, S V; Oparin, M Iu

    2013-03-01

    The main issues of organization of scientific and research work of medical service in the North Fleet are considered in the present article. Analysis of some paragraphs of documents, regulating this work at army level is given. The authors give an example of successful experience of such work in the North Fleet, table some suggestions which allow to improve the administration of scientific and research work in the navy and also on the district scale.

  20. Measuring disaster preparedness of local emergency medical services agencies

    OpenAIRE

    Elliott, Ross W.

    2010-01-01

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