WorldWideScience

Sample records for providing medical services

  1. Medical Services: Nonphysician Health Care Providers

    Science.gov (United States)

    2000-11-07

    medical supervisors will be dictated by the specialty of the patient population involved (for example, chief, pediatric service for well child physical...of osteopathy ). (2) PAs may write routine orders on inpatients, using DA Form 4256 (Doctor’s Orders). (3) When required, inpatient treatment...which FAP clients may be located. (2) FAP personnel are the primary source of care for clients involved in alleged/substantiated child /spouse abuse

  2. Emergency Medical Services Provider Experiences of Hospice Care.

    Science.gov (United States)

    Barnette Donnelly, Cassandra; Armstrong, Karen Andrea; Perkins, Molly M; Moulia, Danielle; Quest, Tammie E; Yancey, Arthur H

    2017-12-04

    Growing numbers of emergency medical services (EMS) providers respond to patients who receive hospice care. The objective of this investigation was to assess the knowledge, attitudes, and experiences of EMS providers in the care of patients enrolled in hospice care. We conducted a survey study of EMS providers regarding hospice care. We collected quantitative and qualitative data on EMS provider's knowledge, attitudes, and experiences in responding to the care needs of patients in hospice care. We used Chi-squared tests to compare EMS provider's responses by credential (Emergency Medical Technician [EMT] vs. Paramedic) and years of experience (0-5 vs. 5+). We conducted a thematic analysis to examine open-ended responses to qualitative questions. Of the 182 EMS providers who completed the survey (100% response rate), 84.1% had cared for a hospice patient one or more times. Respondents included 86 (47.3%) EMTs with Intermediate and Advanced training and 96 (52.7%) Paramedics. Respondent's years of experience ranged from 0-10+ years, with 99 (54.3%) providers having 0-5 years of experience and 83 (45.7%) providers having 5+ years of experience. There were no significant differences between EMTs and Paramedics in their knowledge of the care of these patients, nor were there significant differences (p education on the care of hospice patients. A total of 36% respondents felt that patients in hospice care required a DNR order. In EMS providers' open-ended responses on challenges in responding to the care needs of hospice patients, common themes were family-related challenges, and the need for more education. While the majority of EMS providers have responded to patients enrolled in hospice care, few providers received formal training on how to care for this population. EMS providers have expressed a need for a formal curriculum on the care of the patient receiving hospice.

  3. Hand Washing Practices Among Emergency Medical Services Providers

    National Research Council Canada - National Science Library

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

    2015-01-01

    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...

  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

    sexually transmitted diseases (STDs), pregnancy, and routine pelvic examination. This list of diagnoses the medics described is not unlike what the...medics were bacterial vaginosis, dysmenorrhea, urinary tract infection, urinary incontinence, dehydration, sexually transmitted diseases (STDs), and...conditions, especially when it came to sexually transmitted infections. The medics related to the young women and used vernacular understood by younger

  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. Medical abortion service in rural areas of Henan Province, China: a provider survey.

    Science.gov (United States)

    Ji, Ning; Zhou, You; Zhang, Ying; He, Dian; Pang, Cheng; Xi, Maomao; Cheng, Yimin

    2013-03-01

    The aim of this study was to explore the knowledge, attitudes and practices on medical abortion of abortion service providers in rural areas of China. A cross-sectional study via self-administered questionnaire was conducted among 362 abortion service providers from family planning service centers (FPSC) and hospitals in rural areas of Henan Province, China, between November 2009 and May 2010. Most of the providers were female (99.4%) and obstetricians/gynecologists (63.3%). The knowledge score achieved ranged from 9.4 to 78.1 points, with both the median and the mode of 56.3 points. Of the 52.2% (189/362) of providers having a preference on abortion method, 30.2% (57/189) preferred medical abortion, while 69.8% (132/189) preferred surgical abortion. In total, 50.7% (174/343) of the providers indicated the provision of medical abortion should be expanded, with the three biggest challenges in its further expansion being increased complications/failures, poor client knowledge/awareness, and problems with drug/equipment supplies. Of all the providers, 81.7% and 92.2% reported they had experience in providing medical abortion and surgical abortion, respectively. Medical abortion providers were mainly experienced in misoprostol with oral (81.8%)/vaginal (79.6%) prostaglandin (misoprostol/gemeprost). Knowledge on medical abortion of providers working in rural China was at a moderate level. Providers preferred surgical abortion to medical abortion. Providers have more experience in providing surgical abortion than medical abortion. Efforts should be made to overcome the perceived challenges in future expansion of medical abortion. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  8. Provider Perception of Pharmacy Services in the Patient-Centered Medical Home.

    Science.gov (United States)

    Albanese, Nicole P; Pignato, Alyssa M; Monte, Scott V

    2017-12-01

    Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group. The survey response rate was 78%. Top-tier clinical services were identified as medication counseling, reconciliation, adherence assessment, polypharmacy assessment, and drug information. Formulary review was the only top-tier cost- or access-related service. Top-tier educational services included new black-boxed warnings, drug market withdrawals, and new drug reviews. Ninety-one percent of providers were comfortable referring to a pharmacist for diabetes medication selection and dose titration, but no other disease state eclipsed 75%. More than twice as many providers found the pharmacy service to be very or extremely valuable when the pharmacist is physically located in the office versus virtual interactions (70% vs 34%). Top-tier clinical, cost/access, and educational services considered worthwhile by providers in a PCMH have been identified. In addition to these services, when developing or evaluating a pharmacy service, special attention should be paid to provider preference for physical location in the office and perceived barriers to the pharmacist availability, concern over complex disease management competency and patient confusion as to the role of the pharmacist.

  9. Effects of Medication Reconciliation Service Provided by Student Pharmacists in a Tertiary Care Emergency Department

    Directory of Open Access Journals (Sweden)

    Arinzechukwu Nkemdirim Okere

    2013-01-01

    Full Text Available Objective: The primary objective of this case study was to evaluate the impact of a medication reconciliation service (MRS provided by student pharmacists in an emergency department (ED. Methods: Eligible patients were assigned to two groups, MRS or non-MRS. Patients in the MRS group were seen by student pharmacists while the non-MRS group followed usual care. As part of the services provided by the student pharmacists, medication reconciliation was provided under the supervision of a clinical pharmacist. At the conclusion of their ED visit, patients were asked to complete a survey addressing knowledge of medications, confidence in medication taking and patient satisfaction. To evaluate the impact of provision of MRS by student pharmacists on readmission rates in the ED, the electronic health records of the institution were queried for subsequent inpatient hospitalizations and ED visits. Results: Based on the study, patients in MRS group were more likely to be satisfied with the education provided to them in the ED (p=0.016 and had greater confidence in taking their medications (p=0.03. Sixty days post ED visit MRS group readmissions were significantly lower compared to non-MRS group (P= 0.047. Conclusions: Students' participation in the provision of medication reconciliation led to reduction of readmission in the tertiary care ED, improved patient satisfaction and confidence in medication use.   Type: Case Study

  10. Effects of Medication Reconciliation Service Provided by Student Pharmacists in a Tertiary Care Emergency Department

    Directory of Open Access Journals (Sweden)

    Michael Swanoski, PharmD

    2013-01-01

    Full Text Available Objective: The primary objective of this case study was to evaluate the impact of a medication reconciliation service (MRS provided by student pharmacists in an emergency department (ED.Methods: Eligible patients were assigned to two groups, MRS or non-MRS. Patients in the MRS group were seen by student pharmacists while the non-MRS group followed usual care. As part of the services provided by the student pharmacists, medication reconciliation was provided under the supervision of a clinical pharmacist. At the conclusion of their ED visit, patients were asked to complete a survey addressing knowledge of medications, confidence in medication taking and patient satisfaction. To evaluate the impact of provision of MRS by student pharmacists on readmission rates in the ED, the electronic health records of the institution were queried for subsequent inpatient hospitalizations and ED visits.Results: Based on the study, patients in MRS group were more likely to be satisfied with the education provided to them in the ED (p=0.016 and had greater confidence in taking their medications (p=0.03. Sixty days post ED visit MRS group readmissions were significantly lower compared to non-MRS group (P= 0.047.Conclusions: Students’ participation in the provision of medication reconciliation led to reduction of readmission in the tertiary care ED, improved patient satisfaction and confidence in medication use.

  11. Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget

    Science.gov (United States)

    Wham, George S.; Saunders, Ruth; Mensch, James

    2010-01-01

    Abstract Context: Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. Objective: To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Design: Cross-sectional study. Setting: Mailed and e-mailed survey. Patients or Other Participants: One hundred sixty-six South Carolina high schools. Intervention(s): The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r  =  0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. Main Outcome Measure(s): The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Results: Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P sports medicine supply budget. Conclusions: The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for

  12. Key factors for providing appropriate medical care in secondary school athletics: athletic training services and budget.

    Science.gov (United States)

    Wham, George S; Saunders, Ruth; Mensch, James

    2010-01-01

    Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Cross-sectional study. Mailed and e-mailed survey. One hundred sixty-six South Carolina high schools. The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P athletic trainer and the size of the sports medicine supply budget. The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.

  13. 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...

  14. 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.

  15. 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.

  16. How do women seeking abortion choose between surgical and medical abortion? Perspectives from abortion service providers.

    Science.gov (United States)

    Newton, Danielle; Bayly, Chris; McNamee, Kathleen; Hardiman, Annarella; Bismark, Marie; Webster, Amy; Keogh, Louise

    2016-10-01

    Depending on availability, many Australian women seeking an abortion will be faced with the choice between surgical or medical abortion. Little is known about the factors that influence Australian women's choice of method. Through the perspectives of abortion service providers, this study aimed to explore the factors that contribute to Australian women's decision to have a surgical or medical abortion. In 2015, in-depth interviews were conducted with fifteen Victorian-based key informants (KIs) directly providing or working within a service offering medical abortion. Ten KIs were working at a service that also provided surgical abortion. Interviews were semi-structured, conducted face-to-face or over the telephone, transcribed verbatim and analysed thematically. KIs described varying levels of awareness of medical abortion, with poorer awareness in regional areas. When it comes to accessing information, women were informed by: their own research (often online); their own experiences and the experiences of others; and advice from health professionals. Women's reasons for choosing surgical or medical abortion range from the pragmatic (timing and location of the method, support at home) to the subjective (perceived risk, emotional impact, privacy, control, and physical ability). Women benefit from an alternative to surgical abortion and are well-placed to choose between the two methods, however, challenges remain to ensure that all women are enabled to make an informed choice. KIs identify the need to: promote the availability of medical abortion; address misconceptions about this method; and increase general practitioner involvement in the provision of medical abortion. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  17. 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

  18. Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study.

    Science.gov (United States)

    Brown, Seth A; Hayden, Theresa C; Randell, Kimberly A; Rappaport, Lara; Stevenson, Michelle D; Kim, In K

    2017-02-01

    Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data. Forty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements. Focus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care. Brown SA , Hayden TC , Randell KA , Rappaport L , Stevenson MD , Kim IK . Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20-26.

  19. 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.

  20. Emergency medical services and "psych calls": Examining the work of urban EMS providers.

    Science.gov (United States)

    Prener, Christopher; Lincoln, Alisa K

    2015-11-01

    Emergency medical technicians and paramedics form the backbone of the United States' Emergency Medical Service (EMS) system. Despite the frequent involvement of EMS with people with mental health and substance abuse problems, the nature and content of this work, as well as how EMS providers think about this work, have not been fully explored. Using data obtained through observations and interviews with providers at an urban American EMS agency, this paper provides an analysis of the ways in which EMS providers interact with people with mental illness and substance abuse problems, as well as providers' experiences with the mental health care system. Results demonstrate that EMS providers share common beliefs and frustrations about "psych calls" and the types of calls that involve people with behavioral health problems. In addition, providers described their understandings of the ways in which people with mental health and substance use problems "abuse the system" and the consequences of this abuse. Finally, EMS providers discuss the system-level factors that impact their work and specific barriers and challenges to care. These results suggest that additional work is needed to expand our understanding of the role of EMS providers in the care of people with behavioral health problems and that mental health practitioners and policy makers should include consideration of the important role of EMS and prehospital care in providing community-based supports for people with behavioral health needs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  1. Emergency medical service, nursing, and physician providers' perspectives on delirium identification and management.

    Science.gov (United States)

    LaMantia, Michael A; Messina, Frank C; Jhanji, Shola; Nazir, Arif; Maina, Mungai; McGuire, Siobhan; Hobgood, Cherri D; Miller, Douglas K

    2017-04-01

    Purpose of the study The study objective was to understand providers' perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient's home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms

  2. Challenges and Opportunities to Engaging Emergency Medical Service Providers in Substance Use Research: A Qualitative Study.

    Science.gov (United States)

    Maragh-Bass, Allysha C; Fields, Julie C; McWilliams, Junette; Knowlton, Amy R

    2017-04-01

    Introduction Research suggests Emergency Medical Services (EMS) over-use in urban cities is partly due to substance users with limited access to medical/social services. Recent efforts to deliver brief, motivational messages to encourage these individuals to enter treatment have not considered EMS providers. Problem Little research has been done with EMS providers who serve substance-using patients. The EMS providers were interviewed about participating in a pilot program where they would be trained to screen their patients for substance abuse and encourage them to enter drug treatment. Qualitative interviews were conducted with Baltimore City Fire Department (BCFD; Baltimore, Maryland USA) EMS providers (N=22). Topics included EMS misuse, work demands, and views on participating in the pilot program. Interviews were transcribed and analyzed using grounded theory and constant-comparison. Participants were mostly white (68.1%); male (68.2%); with Advanced Life Skills training (90.9%). Mean age was 37.5 years. Providers described the "frequent flyer problem" (eg, EMS over-use by a few repeat non-emergent cases). Providers expressed disappointment with local health delivery due to resource limitations and being excluded from decision making within their administration, leading to reduced team morale and burnout. Nonetheless, providers acknowledged they are well-positioned to intervene with substance-using patients because they are in direct contact and have built rapport with them. They noted patients might be most receptive to motivational messages immediately after overdose revival, which several called "hitting their bottom." Several stated that involvement with the proposed study would be facilitated by direct incorporation into EMS providers' current workflow. Many recommended that research team members accompany EMS providers while on-call to observe their day-to-day work. Barriers identified by the providers included time constraints to intervene, limited

  3. Health care providers' requests to Teratogen Information Services on medication use during pregnancy and lactation.

    Science.gov (United States)

    Gendron, Marie-Pierre; Martin, Brigitte; Oraichi, Driss; Bérard, Anick

    2009-05-01

    Medication use during pregnancy and lactation is prevalent. However, current knowledge of the risks and benefits of medication use during pregnancy and lactation is incomplete as the best available evidence has been obtained from cohort studies of inadvertent exposures and registries. This situation may partly explain health care providers' (HCP) risk perceptions and thus the increasing number of calls to Teratogen Information Services (TIS). The objectives of this study were (1) to identify the medication classes for which HCP are seeking counseling from the IMAGe center, a Quebec TIS; (2) to identify the medical conditions for which medication classes were used during pregnancy and lactation; (3) to identify and quantify predictors of medication information requests during pregnancy and lactation. A retrospective analysis of data was conducted within the population served by the IMAGe center, a TIS based at CHU Ste-Justine in Montreal, Quebec, Canada, that serves the French population of Canada. To be included, calls had to be received between January 1, 2004 and April 30, 2007, and the subject of the call had to be directly associated with the exposure, or not, of a pregnant or breastfeeding woman to medication. Multivariate generalized estimating equation (GEE) regression models were performed to identify the predictors of medication requests. A total of 11, 076 requests regarding medication exposure during pregnancy, 12 055 requests regarding pregnant women before the exposure took place, and 13, 364 requests regarding lactation were included for analyses. Pregnant women were most frequently exposed to antidepressants (17.3), antibiotics (6.3%), and benzodiazepines (5.3%). Prior to drug exposure, the most frequent inquiries by HCP were on antibiotics (11.0%), anti-inflammatory drugs (6.0%), and antiemetics (5.1%). Inquiries concerning lactating women most frequently requested information on the drug classes of antidepressants (10.8%), antibiotics (9.1%), and

  4. Emergency medical service provider decision-making in out of hospital cardiac arrest: an exploratory study.

    Science.gov (United States)

    Brandling, J; Kirby, K; Black, S; Voss, S; Benger, J

    2017-07-25

    There are approximately 60,000 out-of-hospital cardiac arrests (OHCA) in the United Kingdom (UK) each year. Within the UK there are well-established clinical practice guidelines that define when resuscitation should be commenced in OHCA, and when resuscitation should cease. Background literature indicates that decision-making in the commencement and cessation of resuscitation efforts in OHCA is complex, and not comprehensively understood. No relevant research from the UK has been published to date and this research study seeks to explore the influences on UK Emergency Medical Service (EMS) provider decision-making when commencing and ceasing resuscitation attempts in OHCA. The aim of this research to explore the influences on UK Emergency Medical Services provider decision-making when commencing and ceasing resuscitation attempts in OHCA. Four focus groups were convened with 16 clinically active EMS providers. Four case vignettes were discussed to explore decision-making within the focus groups. Thematic analysis was used to analyse transcripts. This research found that there are three stages in the decision-making process when EMS providers consider whether to commence or cease resuscitation attempts in OHCA. These stages are: the call; arrival on scene; the protocol. Influential factors present at each of the three stages can lead to different decisions and variability in practice. These influences are: factual information available to the EMS provider; structural factors such as protocol, guidance and research; cultural beliefs and values; interpersonal factors; risk factors; personal values and beliefs. An improved understanding of the circumstantial, individual and interpersonal factors that mediate the decision-making process in clinical practice could inform the development of more effective clinical guidelines, education and clinical decision support in OHCA. These changes have the potential to lead to greater consistency. and EMS provider confidence, with

  5. Association between poor sleep, fatigue, and safety outcomes in emergency medical services providers.

    Science.gov (United States)

    Patterson, P Daniel; Weaver, Matthew D; Frank, Rachel C; Warner, Charles W; Martin-Gill, Christian; Guyette, Francis X; Fairbanks, Rollin J; Hubble, Michael W; Songer, Thomas J; Callaway, Clifton W; Kelsey, Sheryl F; Hostler, David

    2012-01-01

    To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among emergency medical services (EMS) workers. We used convenience sampling of EMS agencies and a cross-sectional survey design. We administered the 19-item Pittsburgh Sleep Quality Index (PSQI), 11-item Chalder Fatigue Questionnaire (CFQ), and 44-item EMS Safety Inventory (EMS-SI) to measure sleep quality, fatigue, and safety outcomes, respectively. We used a consensus process to develop the EMS-SI, which was designed to capture three composite measurements of EMS worker injury, medical errors and adverse events (AEs), and safety-compromising behaviors. We used hierarchical logistic regression to test the association between poor sleep quality, fatigue, and three composite measures of EMS worker safety outcomes. We received 547 surveys from 30 EMS agencies (a 35.6% mean agency response rate). The mean PSQI score exceeded the benchmark for poor sleep (6.9, 95% confidence interval [CI] 6.6, 7.2). More than half of the respondents were classified as fatigued (55%, 95% CI 50.7, 59.3). Eighteen percent of the respondents reported an injury (17.8%, 95% CI 13.5, 22.1), 41% reported a medical error or AE (41.1%, 95% CI 36.8, 45.4), and 90% reported a safety-compromising behavior (89.6%, 95% CI 87, 92). After controlling for confounding, we identified 1.9 greater odds of injury (95% CI 1.1, 3.3), 2.2 greater odds of medical error or AE (95% CI 1.4, 3.3), and 3.6 greater odds of safety-compromising behavior (95% CI 1.5, 8.3) among fatigued respondents versus nonfatigued respondents. In this sample of EMS workers, poor sleep quality and fatigue are common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes.

  6. 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.

  7. Assessing the need for a medical respite: perceptions of service providers and homeless persons.

    Science.gov (United States)

    Biederman, Donna J; Gamble, Julia; Manson, Marigny; Taylor, Destry

    2014-01-01

    For homeless persons, posthospitalization care is increasingly provided in formal medical respite programs, and their success is now reported in the literature. However, there is a dearth of literature on posthospitalization transitional care for homeless persons in the absence of a respite program. Through this formative study, we sought to understand the process of securing posthospitalization care in the absence of a formal homeless medical respite. Results demonstrated a de facto patchwork respite process that has emerged. We describe both human and monetary costs associated with patchwork respite and demonstrate opportunities for improvement in homeless health care transitions.

  8. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Science.gov (United States)

    2010-07-01

    ... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or... section covers collection or recovery by VA, under 38 U.S.C. 1729, for medical care or services provided...

  9. Letter to Editor: Electronic Medical Record, Step toward Improving the Quality of Healthcare Services and Treatment Provided to Patients

    Directory of Open Access Journals (Sweden)

    Elahe Gozali

    2014-04-01

    Full Text Available Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR, one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing . S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.

  10. 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…

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

    Directory of Open Access Journals (Sweden)

    Chien Tsair-Wei

    2012-05-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion 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.

  12. 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.

  13. Comfort level of emergency medical service providers in responding to weapons of mass destruction events: impact of training and equipment.

    Science.gov (United States)

    Reilly, Michael J; Markenson, David; DiMaggio, Charles

    2007-01-01

    Numerous studies have suggested that emergency medical services (EMS) providers are ill-prepared in the areas of training and equipment for response to events due to weapons of mass destruction (WMD) and other public health emergencies (epidemics, etc.). A nationally representative sample of basic and paramedic EMS providers in the United States was surveyed to assess whether they had received training in WMD and/or public health emergencies as part of their initial provider training and as continuing medical education within the past 24 months. Providers also were surveyed as to whether their primary EMS agency had the necessary specialty equipment to respond to these specific events. More than half of EMS providers had some training in WMD response. Hands-on training was associated with EMS provider comfort in responding to chemical, biological, and/or radiological events and public health emergencies (odds ratio (OR) = 3.2, 95% confidence interval (CI) 3.1, 3.3). Only 18.1% of providers surveyed indicated that their agencies had the necessary equipment to respond to a WMD event. Emergency medical service providers who only received WMD training reported higher comfort levels than those who had equipment, but no training. Lack of training and education as well as the lack of necessary equipment to respond to WMD events is associated with decreased comfort among emergency medical services providers in responding to chemical, biological, and/or radiological incidents. Better training and access to appropriate equipment may increase provider comfort in responding to these types of incidents.

  14. 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.

  15. 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.

  16. The Role of Oral Health Care Professionals in Providing Medical Services.

    Science.gov (United States)

    Glick, Michael; Greenberg, Barbara L

    2017-08-01

    Integration of oral health care professionals (OHCPs) into medical care could advance efforts to control increasingly prevalent conditions such as cardiovascular disease, diabetes mellitus, human immunodeficiency virus infection, and hepatitis C infection, each of which is associated with significant morbidity and health care costs. Prevention and early intervention are effective for reducing the incidence and severity of these diseases, while increasing cost of health care may drive the need for nontraditional models of health education and delivery. Studies have suggested that a dental office is a suitable setting for the purpose of screening and referrals for these conditions and may result in medical expenditure savings. Such innovations would challenge the current dental educational model and the education and training of faculty. Implementing this change would require recognizing opportunities and challenges for the profession and the need for new competencies in dental curricula. Challenges and opportunities are described, including reimbursement models and integration of OHCPs into emerging health care delivery models. Ideas for curricular change are presented, including the need for added emphasis on biological sciences and the introduction of new courses to address systems thinking and forces driving preventive behavior. To embrace the evolving health care arena and be a part of the future interprofessional health care delivery dynamic, dental curricula should also include substantive interprofessional education opportunities. Such opportunities would provide the basic skills and training to recognize and appreciate patients' oral health issues in the broader context of their overall health and well-being. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  17. Regional medical professionals' confidence in providing palliative care, associated difficulties and availability of specialized palliative care services in Japan.

    Science.gov (United States)

    Hirooka, Kayo; Miyashita, Mitsunori; Morita, Tatsuya; Ichikawa, Takeyuki; Yoshida, Saran; Akizuki, Nobuya; Akiyama, Miki; Shirahige, Yutaka; Eguchi, Kenji

    2014-03-01

    Although confidence in providing palliative care services is an essential component of providing such care, factors relating to this have not been investigated in Japan. This study aimed to explore confidence in the ability to provide palliative care and associated difficulties and to explore correlations between these variables. Design A cross-sectional mail survey of medical doctors and registered nurses in Japan was performed as part of a regional intervention trial: the Outreach Palliative Care Trial of Integrated Regional Model study. Subjects Questionnaires were sent to 7905 medical professionals, and 409 hospital doctors, 235 general practitioners, 2160 hospital nurses and 115 home visiting nurses completed them. Confidence in providing palliative care was low and difficulties frequent for all types of medical professionals assessed. In particular, only 8-24% of them, depending on category, agreed to 'having adequate knowledge and skills regarding cancer pain management'. In particular, 55-80% of medical professionals acknowledged difficulty with 'alleviation of cancer pain'. Multiple regression analysis revealed that confidence was positively correlated with the amount of relevant experience and, for medical doctors, with 'prescriptions of opioids (per year)'. Moreover, difficulties were negatively correlated with the amount of relevant clinical experience. Effective strategies for developing regional palliative care programs include basic education of medical professionals on management of cancer-related pain (especially regarding opioids) and other symptoms.

  18. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

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

    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...

  19. 76 FR 40749 - Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department...

    Science.gov (United States)

    2011-07-11

    ... BUDGET DEPARTMENT OF VETERANS AFFAIRS Cost-Based and Inter-Agency Billing Rates for Medical Care or... updates the Cost-Based and Inter-Agency billing rates for medical care or services provided by the... care or services provided by VA is set forth in 38 CFR 17.102(h). These rates apply to medical care or...

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

    Science.gov (United States)

    Isetts, Brian

    2017-10-16

    (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.

  1. Providing psychiatric services in general medical settings in South Africa: Mental health-friendly services in mental health-friendly hoaspitals

    Directory of Open Access Journals (Sweden)

    Margaretha S van Heerden

    2008-03-01

    Full Text Available Neuropsychiatric disorders rank high on the list of the mostdisabling medical disorders in both the developed anddeveloping worlds.1Significant comorbidity also exists betweenneuropsychiatric disorders and general medical disorders;2this iskey in the South African context where HIV/AIDS and substanceuse disorders are highly prevalent.3,4It has therefore becomeessential to provide mental health services in a range of settings,including those that focus on the delivery of general medicalservices. Furthermore, the Mental Health Care Act 17 of 2002underlines the importance of providing integrated, accessiblemental health care in the local community.

  2. 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...

  3. 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...

  4. Preparing to provide MTM services.

    Science.gov (United States)

    Glenn, Zandra M; Mahdavian, Soheyla L; Woodard, Todd J

    2015-02-01

    Medication Therapy Management (MTM) has been a way for pharmacist to enhance their position as an integral member of the health care team as the need for improved clinical and economic outcomes in relation to the US health care system became apparent. MTM Certificate training programs are provided by numerous organizations. Collaboration Practice Agreements (CPA) are gaining significance as the role of the pharmacist is expanding in the care of patients as part of a multidisciplinary health care team. One major hurdle that many pharmacists are faced with is receiving reimbursement for the services provided. The Medicare Modernization Act of 2003 recognized that pharmacists play an important role in the management of patient care and that pharmacists bring an expertise and knowledge that will help to identify and resolve patient medication therapy problems. © The Author(s) 2014.

  5. Querying Data Providing Web Services

    OpenAIRE

    Sabesan, Manivasakan

    2010-01-01

    Web services are often used for search computing where data is retrieved from servers providing information of different kinds. Such data providing web services return a set of objects for a given set of parameters without any side effects. There is need to enable general and scalable search capabilities of data from data providing web services, which is the topic of this Thesis. The Web Service MEDiator (WSMED) system automatically provides relational views of any data providing web service ...

  6. Disparity in naloxone administration by emergency medical service providers and the burden of drug overdose in US rural communities.

    Science.gov (United States)

    Faul, Mark; Dailey, Michael W; Sugerman, David E; Sasser, Scott M; Levy, Benjamin; Paulozzi, Len J

    2015-07-01

    We determined the factors that affect naloxone (Narcan) administration in drug overdoses, including the certification level of emergency medical technicians (EMTs). In 2012, 42 states contributed all or a portion of their ambulatory data to the National Emergency Medical Services Information System. We used a logistic regression model to measure the association between naloxone administration and emergency medical services certification level, age, gender, geographic location, and patient primary symptom. The odds of naloxone administration were much higher among EMT-intermediates than among EMT-basics (adjusted odds ratio [AOR] = 5.4; 95% confidence interval [CI] = 4.5, 6.5). Naloxone use was higher in suburban areas than in urban areas (AOR = 1.41; 95% CI = 1.3, 1.5), followed by rural areas (AOR = 1.23; 95% CI = 1.1, 1.3). Although the odds of naloxone administration were 23% higher in rural areas than in urban areas, the opioid drug overdose rate is 45% higher in rural communities. Naloxone is less often administered by EMT-basics, who are more common in rural areas. In most states, the scope-of-practice model prohibits naloxone administration by basic EMTs. Reducing this barrier could help prevent drug overdose death.

  7. Medical Services: Patient Administration

    Science.gov (United States)

    2001-03-12

    be provided at the MTF serving the station if obstetrics and gynecology (OB/GYN) services are available and the member resides and works within 50...includes doctors of medicine, doctors of osteopathy , doctors of dentistry, podiatrists, optometrists, physician assistants, nurse practitioners, and nurse...of a licensed doctor of medicine, osteopathy , or dentistry as part of the medical care required. (3) Payment is not authorized for the following

  8. Association of provider opioid prescribing practices and the Centers for Medicare and Medicaid Services hierarchical condition category score: A retrospective examination of correlation between the volume of provider-prescribed opioid medications and provider panel complexity

    Directory of Open Access Journals (Sweden)

    Frederick North

    2017-03-01

    Full Text Available Objective: Opioids are being prescribed at increasing rates in primary care practices, and among individual providers there is significant variability in opioid prescribing. Primary care practices also vary significantly in complexity of their patients, ranging from healthy patients to those with multiple comorbidities. Our objective was to examine individual primary care providers for an association between their opioid prescribing and the complexity/risk of their panel of patients (a panel of patients is a group of patients whose medical care is the responsibility of a specific healthcare provider or care team. Methods: We retrospectively examined 12 months of opioid prescription data from a primary care practice. We obtained counts of opioids prescribed by providers in the Mayo Clinic, Rochester, Minnesota primary care practice. For patients paneled (assigned to family medicine and internal medicine, we used the Centers for Medicare and Medicaid Services hierarchical condition category patient risk score as a measure of patient complexity. After adjusting the opioid counts for panel patient count (to get opioid counts per patient, we used linear regression analysis to determine the correlation between the hierarchical condition category risk and the amount of opioid prescribed by individual providers. Results: Among our combined 103 primary care providers, opioid unit counts prescribed per patient were highly correlated with the providers’ hierarchical condition category panel risk score (r2 = 0.54. After excluding three outliers, r2 was 0.74. With and without the outliers, the correlation was very significant (p  0.45 showed significant correlation with hierarchical condition category (r2 = 0.26; p = 0.001. Conclusion: When examining differences in primary care providers’ opioid prescribing practices, the Centers for Medicare and Medicaid Services endorsed risk score (the hierarchical condition category score can help

  9. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people ... facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  10. The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa.

    Directory of Open Access Journals (Sweden)

    Naomi Lince-Deroche

    Full Text Available Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA services to inform planning for first-trimester service provision in South Africa and similar settings.We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars.A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5% were eligible to choose their abortion procedure; 94.1% (n = 834 chose medication abortion. The total average cost per medication abortion was $63.91 (52.32-75.51. The total average cost per MVA was higher at $69.60 (52.62-86.57; though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4% medication abortion women being hospitalized and two (0.3% having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods.This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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...

  16. Provision of medical abortion by midlevel healthcare providers in Kyrgyzstan: testing an intervention to expand safe abortion services to underserved rural and periurban areas.

    Science.gov (United States)

    Johnson, Brooke Ronald; Maksutova, Elmira; Boobekova, Aigul; Davletova, Ainura; Kazakbaeva, Chinara; Kondrateva, Yelena; Landoulsi, Sihem; Lazdane, Gunta; Monolbaev, Kubanychbek; Seuc Jo, Armando H

    2017-11-10

    To demonstrate the feasibility and safety of training midlevel healthcare providers (midwives and family nurses) to provide medical abortion and postabortion contraception in underserved areas in Kyrgyzstan. This was an implementation study at four referral facilities and 28 Felsher Obstetric Points in two districts to train their midwives and family nurses to deliver safe and effective abortion care with co-packaged mifepristone-misoprostol and provide contraceptives postabortion. The outcome of abortion - complete abortion, incomplete abortion or o-going pregnancy - was the primary end point measured. An international consultant trained 18 midwives and 14 family nurses (with midwifery diplomas) to provide medical abortion care. Supervising gynecologists based in the referral centers and study investigators based in Bishkek provided monthly monitoring of services and collection of patient management forms. A voluntary self-administered questionnaire at the follow-up visit documented women's acceptability of medical abortion services. All study data were cross-checked and entered into an online data management system for descriptive analysis. Between August 2014 and September 2015, midwives provided medical abortion to 554 women with a complete abortion rate of 97.8%, of whom 62% chose to use misoprostol at home. No women were lost to follow-up. Nearly all women (99.5%) chose a contraceptive method postabortion; 61% of women receiving services completed the acceptability form, of whom more than 99% indicated a high level of satisfaction with the service and would recommend it to a friend. This study demonstrates that trained Kyrgyz midwives and nurses can provide medical abortion safely and effectively. This locally generated evidence can be used by the Kyrgyz Ministry of Health to reduce unintended pregnancy and expand safe abortion care to women in underserved periurban and rural settings. Success in scaling up midwife/nurse provision of medical abortion in

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

    National Research Council Canada - National Science Library

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

    2012-01-01

    ... (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...

  18. 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.

  19. 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...

  20. REMINDER FROM MEDICAL SERVICE

    CERN Document Server

    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

  1. 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

  2. REMINDER FROM MEDICAL SERVICE

    CERN Document Server

    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

  3. 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

  4. 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

  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 Nurseson telephone: 73802.by electronic mail to:Infirmary.Service@cern.chMarion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.chMedicalService

  6. 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.

  7. 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.

  8. Utilization of the medical librarian in a state Medicaid program to provide information services geared to health policy and health disparities.

    Science.gov (United States)

    Droese, Peter; Peterson, Nancy

    2006-04-01

    The role of two solo medical librarians in supporting Medicaid programs by functioning as information specialists at regional and state levels is examined. A solo librarian for the Massachusetts Medicaid (MassHealth) program and a solo librarian for the New England States Consortium Systems Organization (NESCSO) functioned as information specialists in context to support Medicaid policy development and clinical, administrative, and program staff for state Medicaid programs. The librarian for MassHealth initially focused on acquiring library materials and providing research support on culturally competent health care and outreach, as part of the United States Department of Health and Human Services Culturally and Linguistically Appropriate Services in Health Care Standards. The NESCSO librarian focused on state Medicaid system issues surrounding the implementation of the Health Insurance Portability and Accountability Act. The research focus expanded for both the librarians, shaping their roles to more directly support clinical and administrative policy development. Of note, the availability and dissemination of information to policy leaders facilitated efforts to reduce health disparities. In Massachusetts, this led to a state legislative special commission to eliminate health disparities, which released a report in November 2005. On a regional level, the NESCSO librarian provided opportunities for states in New England to share ideas and Medicaid program information. The Centers for Medicaid and Medicare are working with NESCSO to explore the potential for using the NESCSO model for collaboration for other regions of the United States. With the increased attention on evidence-based health care and reduction of health disparities, medical librarians are called on to support a variety of health care information needs. Nationally, state Medicaid programs are being called on to provide coverage and make complex medical decisions regarding the delivery of benefits

  9. 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

    OpenAIRE

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

    2015-01-01

    Introduction 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...

  10. Removal of metal penile foreign body with a widely available emergency-medical-services-provided air-driven grinder.

    Science.gov (United States)

    Santucci, Richard A; Deng, Donna; Carney, Jeff

    2004-06-01

    Penile incarceration with heavy metal objects can be a difficult problem, especially if the object cannot be removed by the standard equipment available in the hospital (eg, ring cutters, bolt cutters, motorized rotary tool). We report removal of heavy iron (barbell) and steel (sledgehammer head) items incarcerating the penis with a heavy-duty air grinder provided by the fire department. This is the first such report of which we are aware. Features of safe removal of these items are reviewed, including cooling the metal item with ice to prevent tissue heating, protecting the patient from sparks, and protecting the penis from the cutting blade.

  11. Consumer Perception of Inpatient Medical Services.

    Science.gov (United States)

    Izugami, Satoko; Takase, Kozo

    2016-01-01

    Although it is currently popular to reflect consumers' perspectives to medical service management, insufficient attempts have been made to understand detailed perception of the consumer side of medical services to promote medical services' evaluation from the consumer viewpoint. The aim of this study was to descriptively reveal how consumers perceive medical services that they receive, focusing on inpatient medical services. We conducted semi-structured interviews with 10 adults who experienced hospitalization of five or more days. Constant comparative analysis was performed on the obtained descriptive data. We identified 1) medical procedures, 2) explanations from medical professionals, 3) behavior of medical service providers, 4) somatic sensations, and 5) self-perceived physical conditions as target factors that medical service consumers perceived during hospitalization. The response to the perceived target factors, "compared with the expectation that the consumer had before the hospitalization," suggests that it is an important medical service consumer reaction to check if the service met their expectations for perceived factors. The response to the medical services perception targets suggested that medical service consumers are involved in medical services and interested in various perception targets. The expectations that medical service consumers have prior to hospitalization can largely influence inpatient medical services evaluation.

  12. Consumer Perception of Inpatient Medical Services

    Science.gov (United States)

    Takase, Kozo

    2016-01-01

    Although it is currently popular to reflect consumers’ perspectives to medical service management, insufficient attempts have been made to understand detailed perception of the consumer side of medical services to promote medical services’ evaluation from the consumer viewpoint. The aim of this study was to descriptively reveal how consumers perceive medical services that they receive, focusing on inpatient medical services. We conducted semi-structured interviews with 10 adults who experienced hospitalization of five or more days. Constant comparative analysis was performed on the obtained descriptive data. We identified 1) medical procedures, 2) explanations from medical professionals, 3) behavior of medical service providers, 4) somatic sensations, and 5) self-perceived physical conditions as target factors that medical service consumers perceived during hospitalization. The response to the perceived target factors, “compared with the expectation that the consumer had before the hospitalization,” suggests that it is an important medical service consumer reaction to check if the service met their expectations for perceived factors. The response to the medical services perception targets suggested that medical service consumers are involved in medical services and interested in various perception targets. The expectations that medical service consumers have prior to hospitalization can largely influence inpatient medical services evaluation. PMID:27832165

  13. Emergency medical services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program.

    Science.gov (United States)

    Jones, Jerrilyn; Kue, Ricky; Mitchell, Patricia; Eblan, Gary; Dyer, K Sophia

    2014-08-01

    Emergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care. Describe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program. An unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis. Two hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a

  14. 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

  15. 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: Infirmary.Service@cern.ch Marion.Diedrich@cern.ch Janet.Doody@cern.ch Mireille.Vosdey@cern.ch

  16. 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

  17. 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  

  18. 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

  19. Wilderness Emergency Medical Services Systems.

    Science.gov (United States)

    Millin, Michael G; Hawkins, Seth C

    2017-05-01

    Wilderness emergency medical services (WEMS) are designed to provide high quality health care in wilderness environments. A WEMS program should have oversight by a qualified physician responsible for protocol development, education, and quality improvement. The director is also ideally fully trained as a member of that wilderness rescue program, supporting the team with real-time patient care. WEMS providers function with scopes of practice approved by the local medical director and regulatory authority. With a focus on providing quality patient care, it is time for the evolution of WEMS as an integrated element of a local emergency response system. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Problems of providing services to people affected by HIV/AIDS: service providers and recipients perspectives.

    Science.gov (United States)

    Moradi, G; Mohraz, M; Gouya, M M; Dejman, M; Alinaghi, S S; Rahmani, K; Malekafzali-Ardakani, H

    2015-02-25

    This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region.

  1. Ecosystem services provided by birds.

    Science.gov (United States)

    Whelan, Christopher J; Wenny, Daniel G; Marquis, Robert J

    2008-01-01

    Ecosystem services are natural processes that benefit humans. Birds contribute the four types of services recognized by the UN Millennium Ecosystem Assessment-provisioning, regulating, cultural, and supporting services. In this review, we concentrate primarily on supporting services, and to a lesser extent, provisioning and regulating services. As members of ecosystems, birds play many roles, including as predators, pollinators, scavengers, seed dispersers, seed predators, and ecosystem engineers. These ecosystem services fall into two subcategories: those that arise via behavior (like consumption of agricultural pests) and those that arise via bird products (like nests and guano). Characteristics of most birds make them quite special from the perspective of ecosystem services. Because most birds fly, they can respond to irruptive or pulsed resources in ways generally not possible for other vertebrates. Migratory species link ecosystem processes and fluxes that are separated by great distances and times. Although the economic value to humans contributed by most, if not all, of the supporting services has yet to be quantified, we believe they are important to humans. Our goals for this review are 1) to lay the groundwork on these services to facilitate future efforts to estimate their economic value, 2) to highlight gaps in our knowledge, and 3) to point to future directions for additional research.

  2. MEDICAL SERVICE - URGENT CALLS

    CERN Document Server

    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 ...

  3. 75 FR 6839 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-02-12

    ... Conservation Service 7 CFR Part 652 RIN 0578-AA48 Technical Service Provider Assistance AGENCY: Natural... Final rule amends the Natural Resources Conservation Service (NRCS) regulations for technical service provider (TSP) provisions under the Food Security Act of 1985. The Food, Conservation, and Energy Act of...

  4. 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.

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

    African Journals Online (AJOL)

    Erah

    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 ...

  6. Analysis of paediatric dental services provided at a regional hospital in Sweden. Dental treatment need in medically compromised children referred for dental consultation.

    Science.gov (United States)

    Arnrup, K; Lundin, S A; Dahllöf, G

    1993-01-01

    All inpatients at a regional hospital in Sweden referred for a paediatric dental consultation (n = 269) were studied retrospectively during a two-year period. The children were studied concerning their medical and oral condition and subsequent dental treatment. The most frequent medical condition among the referred children was insulin dependent diabetes mellitus (20%), asthma (9%) and epilepsy (7%). Children with asthma exhibited a significantly increased caries prevalence (p Gingivitis, disturbances in occlusal development and dental caries were the most commonly found diagnoses Acute dental or oral problems were diagnosed in 9% of the children. The mean time allocated for each patient was 60 minutes. Thirty percent of the children were subsequently treated at the paediatric dentistry specialist clinic. In conclusion the study emphasises the need of paediatric dental consultation services at regional hospitals.

  7. Medical Student Mental Health Services: Psychiatrists Treating Medical Students

    OpenAIRE

    Gentile, Julie P.; Roman, Brenda

    2009-01-01

    Medical school is a stressful and challenging time in the academic career of physicians. Because of the psychological pressure inherent to this process, all medical schools should have easily accessible medical student mental health services. Some schools of medicine provide these services through departments of psychiatry or other associated training programs. Since this stressful lifestyle often continues through residency training and life as a physician, this is a critical period in which...

  8. Medication abortion knowledge among adolescent medicine providers

    Science.gov (United States)

    Coles, Mandy S; Makino, Kevin K; Phelps, Rachael

    2012-01-01

    Purpose Adolescents are at high risk for unintended pregnancy and abortion. The purpose of this study is to understand if providers caring for adolescents have the knowledge to counsel accurately on medication abortion, a suitable option for many teens seeking to terminate a pregnancy. Methods Using an online questionnaire, we surveyed US providers in the Society for Adolescent Health and Medicine on medication abortion. We conducted chi-squared analyses to evaluate medication abortion knowledge by adolescent medicine fellowship training, and to compare responses to specific knowledge questions by medication abortion counseling. Further, we examined the relationship between providers’ self-assessed and actual knowledge using ANOVA. Results We surveyed 797 providers, with a 54% response rate. Almost a quarter of respondents incorrectly believed medication abortion was not very safe, 40% misidentified that it was pregnant teens receive accurate counseling on all options, adolescent medicine providers need better education on medication abortion. PMID:22443843

  9. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ..., medical devices, and medical services. 594.515 Section 594.515 Money and Finance: Treasury Regulations....515 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006..., medical devices, and medical services to the Palestinian Authority Ministry of Health, provided that such...

  10. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ..., medical devices, and medical services. 595.513 Section 595.513 Money and Finance: Treasury Regulations...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006..., medical devices, and medical services to the Palestinian Authority Ministry of Health, provided that such...

  11. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ..., medical devices, and medical services. 597.511 Section 597.511 Money and Finance: Treasury Regulations... Licensing Policy § 597.511 In-kind donations of medicine, medical devices, and medical services. (a... medicine, medical devices, and medical services to the Palestinian Authority Ministry of Health, provided...

  12. 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...

  13. Data Service Provider Cost Estimation Tool

    Science.gov (United States)

    Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel

    2011-01-01

    The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

  14. 75 FR 48273 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-08-10

    ... provisions by expanding the definition Technical Service Provider Assistance, which contained an error in the omission of ``Indian Tribe'' in the definition of Technical Service Provider. DATES: Effective Date: This amendment is effective on August 10, 2010. FOR FURTHER INFORMATION CONTACT: Angel Figueroa, Team Leader...

  15. 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...

  16. Dynamics of ecosystem services provided by subtropical ...

    Science.gov (United States)

    The trends in the provision of ecosystem services during restoration and succession of subtropical forests and plantations were quantified, in terms of both receiver and donor values, based on a case study of a 3-step secondary succession series that included a 400-year-old subtropical forest and a 23-year history of growth on 3 subtropical forest plantations in Southeastern China. The ‘People's Republic of China Forestry Standard: Forest Ecosystem Service Valuation Norms’ was revised and applied to quantify the receiver values of ecosystem services, which were then compared with the emergy-based, donor values of the services. The results revealed that the efficiencies of subtropical forests and plantations in providing ecosystem services were 2 orders of magnitude higher than similar services provided by the current China economic system, and these efficiencieskept increasing over the course of succession. As a result, we conclude that afforestation is an efficient way to accelerate both the ability and efficiency of subtropical forests to provide ecosystem services. This paper is significant because it examines the dynamics of the provision of ecosystem services by forests over a succession series that spans 400 years. The paper also examines the rate of increase of services during forest restoration over a period of 23 years. The emergy used in ecosystem services provision is compared to the provision of similar services by economic means in the Chinese e

  17. Reminder from the Medical Service

    CERN Document Server

    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

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

    National Research Council Canada - National Science Library

    V. S. Aćimović-Raspopović; V. Radonjić

    2011-01-01

    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...

  19. Client Provider Collaboration for Service Bundling

    Directory of Open Access Journals (Sweden)

    LETIA, I. A.

    2008-04-01

    Full Text Available The key requirement for a service industry organization to reach competitive advantages through product diversification is the existence of a well defined method for building service bundles. Based on the idea that the quality of a service or its value is given by the difference between expectations and perceptions, we draw the main components of a frame that aims to support the client and the provider agent in an active collaboration meant to co-create service bundles. Following e3-value model, we structure the supporting knowledge around the relation between needs and satisfying services. We deal with different perspectives about quality through an ontological extension of Value Based Argumentation. The dialog between the client and the provider takes the form of a persuasion whose dynamic object is the current best configuration. Our approach for building service packages is a demand driven approach, allowing progressive disclosure of private knowledge.

  20. Oregon's mobility needs : social service provider survey

    Science.gov (United States)

    1999-06-01

    In 1998, the Oregon Department of Transportation undertook the Social Services Provider Survey as part of an investigation of the transportation needs of mobility impaired individuals in Oregon. This survey was designed to gain information about the ...

  1. 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...

  2. 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...

  3. Supercomputing Centers and Electricity Service Providers

    DEFF Research Database (Denmark)

    Patki, Tapasya; Bates, Natalie; Ghatikar, Girish

    2016-01-01

    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 pro......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...

  4. 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

  5. Providing Secure Web Services for Mobile Applications

    OpenAIRE

    Kivisaari, Tero

    2015-01-01

    Changing consumer behavior drives the demand for convenient and easy-to-use mobile applications across industries. This also impacts the financial sector. Banks are eager to offer their services as mobile applications to match the modern consumer needs. The mobile applications are not independently able to provide the required functionality; they interact with the existing core business functions by consuming secure Web Services over the Internet. The thesis analyses th...

  6. 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

  7. 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.

  8. Scalable service architecture for providing strong service guarantees

    Science.gov (United States)

    Christin, Nicolas; Liebeherr, Joerg

    2002-07-01

    For the past decade, a lot of Internet research has been devoted to providing different levels of service to applications. Initial proposals for service differentiation provided strong service guarantees, with strict bounds on delays, loss rates, and throughput, but required high overhead in terms of computational complexity and memory, both of which raise scalability concerns. Recently, the interest has shifted to service architectures with low overhead. However, these newer service architectures only provide weak service guarantees, which do not always address the needs of applications. In this paper, we describe a service architecture that supports strong service guarantees, can be implemented with low computational complexity, and only requires to maintain little state information. A key mechanism of the proposed service architecture is that it addresses scheduling and buffer management in a single algorithm. The presented architecture offers no solution for controlling the amount of traffic that enters the network. Instead, we plan on exploiting feedback mechanisms of TCP congestion control algorithms for the purpose of regulating the traffic entering the network.

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

    African Journals Online (AJOL)

    Multiple regression analysis of our data showed that common business practices and introvert and extrovert personality traits, out of the nine causal variables predicted media self employment providing services among male graduates. Among the females graduates, only common business practices and introvert personality ...

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

    African Journals Online (AJOL)

    information centre to the community of users. But many have failed to serve this purpose after spending lots of money due to some reason and the other. This survey study is aimed at assessing Effectiveness of Reference Services in Providing Students' Information Needs in. Some Selected Tertiary Institutions in Borno State ...

  11. 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.

  12. Management Standards Integration in Service Providing Organizations

    OpenAIRE

    Anton Persic; Mirko Markic

    2012-01-01

    The purpose of the paper is to define key leadership models, to recognize advantages and benefits, and define influence factors of business success on leadership systems integration in service providing organizations in Slovenia. We use quantitative research with frequent analysis complex questions to present and analyse some factors of leadership standards and build a new regression leadership model of organization. We have sent the questionnaire to 89 organizations, all with certificate sys...

  13. 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.

  14. Physician medical oversight in emergency medical services: where are we?

    Science.gov (United States)

    Studnek, Jonathan R; Fernandez, Antonio R; Margolis, Gregg S; O'Connor, Robert E

    2009-01-01

    The objective of this study was to quantify the amount of direct contact with medical direction that nationally registered emergency medical services (EMS) professionals receive. The secondary objective was to determine whether differences in medical director contact were associated with work-related characteristics. As part of biennial reregistration paperwork, nationally registered EMS professionals reregistering in 2004 were asked to complete a survey regarding medical direction. There were three survey questions asking participants to indicate, on a five-point scale, how often they interacted with their medical director in specific situations (whether the medical director participated in continuing education, met personally to discuss an EMS issue, and was seen at the scene of an EMS call). Individuals were categorized as having limited contact if they had not observed their medical director in any of the above situations for more than six months. All others where categorized as having recent contact. Demographic characteristics were collected and statistical analysis was performed using chi-square. In 2004, 45,173 individuals reregistered, with 28,647 (63%) returning surveys. A complete case analysis was performed, leaving 22,026 (49%) individuals. There were 13,756 (62.5%) individuals who reported having recent medical director contact. A stepwise increase in the percentage of those reporting recent contact was present when comparing the providers' certification levels (emergency medical technician EMT-Basic 47.6%, EMT-Intermediate 62.3%, and EMT-Paramedic 78.5%, p medical director. Nearly one-third of participants in this study reported having limited medical director contact. Certification level, service type, and community size were significantly associated with the amount of contact with medical direction.

  15. 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.

  16. 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

  17. Rural Emergency Medical Services (EMS) and Trauma

    Science.gov (United States)

    ... Rural Health Topics & States Topics View more Rural Emergency Medical Services (EMS) and Trauma Emergency medical services ( ... related deaths and nonfatal injuries treated in rural emergency departments? According to a Centers for Disease Control ...

  18. 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...

  19. 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.

  20. Designated Medical Directors for Emergency Medical Services: Recruitment and Roles

    Science.gov (United States)

    Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel

    2009-01-01

    Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

  1. 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.

  2. 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.

  3. Challenges in providing services in methadone maintenance therapy clinics in China: service providers' perceptions.

    Science.gov (United States)

    Lin, Chunqing; Wu, Zunyou; Rou, Keming; Pang, Lin; Cao, Xiaobin; Shoptaw, Steven; Detels, Roger

    2010-05-01

    The Methadone Maintenance Therapy (MMT) program has been initiated in China since 2004. As of the end of November, 2008, 558 MMT clinics had been established countrywide. The objective of this study was to elucidate the difficulties and challenges as perceived by service providers working in MMT clinics. One service provider from each of the 28 MMT study clinics in Zhejiang and Jiangxi Provinces of China participated in a face-to-face in-depth interview for about 1-2h to describe their perceptions of working in MMT clinics. Qualitative data were analysed using ATLAS.ti. The grounded theory was used to guide the data analysis. Participants identified major problems in providing services in MMT clinics including lack of resources, professional training, and institutional support. Difficulties in pursuit of career, concern for personal safety, low income, heavy working load, and poor opinion of MMT by Chinese society often contributed to greater stress and burnout among the service providers. The MMT programs in China desperately need additional resource allocation and institutional support for the current and perhaps future expansion of the programs. The service providers are in urgent need of professional training to improve the quality of care they can offer MMT clients. Copyright 2009 Elsevier B.V. All rights reserved.

  4. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing and related services, medical social... services, medical social services; use of hospital or CAH facilities. (a) Except as provided in paragraph... facilities, and medical social services as inpatient hospital or inpatient CAH services only if those...

  5. 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

  6. 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.

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

    African Journals Online (AJOL)

    In located services, such as restaurants, about half of all switching is based on access to the service; in non-located services, such as credit cards, access problems are minor and service failure is often the reason for switching. The orders of events, or sequences, involved in switching are also examined; different sequences ...

  8. Collaborative social and medical service application.

    Science.gov (United States)

    Petermann, C A; Buffone, G J; Bobroff, R B; Moore, D M; Dargahi, R; Moreau, D R; Gilson, H S; Li, Y; Fowler, J; Beck, J R

    1995-01-01

    Baylor College of Medicine has five Teen Health Clinics (THC) dispersed throughout Harris county. The population served by the clinics includes inner-city adolescent boys and girls 19 years of age and under. Patients receive services such as family planning, sexually transmitted disease screening and treatment, perinatal care, counseling, and support services. Adolescents may receive services at any one of the clinics at no cost to the adolescent or their dependents. Given the geographical distribution of the clinics and the reliance on paper-based records, client services cannot be provided efficiently or expeditiously. According to the statistics developed by Clinic staff, ineffective coordination of service needs and client schedules undermine the follow-up needed for effective care. For example, a counselor will often need to balance a school schedule, clinic visits, well baby follow-up, and the Best Friends Program for a new mother. In addition, the lack of ready access to patient information impairs the ability of clinical and social service staff to provide continuity of care. In fact, some cases of client dropout are attributable to these difficulties. We have developed the Collaborative Social and Medical Service Application (CSMSA) to facilitate the provision of social and medical services to this population. The CSMSA is a domain-specific application based on a robust infrastructure known as the Ambulatory Services Architecture (ASA). This system is designed to support integrated social and ambulatory care. The ASA is a Baylor developed application framework and architecture for the computerization of the patient medical record in the ambulatory care setting. The working environment for the CSMSA user is an integrated desktop which provides an operating environment for both third-party applications and the CSMSA, as well as a fundamental set of services. The integrated desktop services include a mechanism for object organization or grouping, a facility

  9. 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…

  10. 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.

  11. 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 ...

  12. Chat reference service in medical libraries: part 1--An introduction.

    Science.gov (United States)

    Dee, Cheryl R

    2003-01-01

    Chat reference services offer the opportunity to provide immediate access to quality information to meet the medical information needs of students, faculty, staff, physicians, nurses, and allied health care professionals. Part 1 of this two-part article on chat reference service in medical libraries is an introduction to the management of chat reference services and to features available for chat reference. The management of chat reference services raises issues of planning, staffing, selecting, and marketing. Planning issues focus on the identification of the users, the users' medical information needs, and the users' information-seeking behavior. Staffing issues relate to the selection of chat hours, the location of the chat service, and participation in collaborative agreements. Selecting chat software weighs the sophistication of the chat features against the related cost. Marketing uses techniques similar to traditional reference services and often begins slowly as chat expertise develops. Part 2 of the article discusses trends in chat reference services in medical libraries.

  13. Pediatric emergency medical services and their drawbacks

    Directory of Open Access Journals (Sweden)

    Abdullah Foraih Al-Anazi

    2012-01-01

    Full Text Available Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.

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

    OpenAIRE

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

    2013-01-01

    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...

  15. 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.

  16. 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

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

    African Journals Online (AJOL)

    Eighty one percent of medical students expressed confidence in the ability of clinical pharmacists to minimize medication errors. Although slightly more than half of the respondents (53%) reported that they did not have clinical pharmacy services in their institutions, there was substantial willingness among physicians and ...

  18. Medical Services: Medical, Dental, and Veterinary Care

    Science.gov (United States)

    2002-01-28

    Temporomandibular disorder patients in maintenance therapy. c. Class 3. Patients who have oral conditions that if not treated are expected to result in dental...oral infections, or provide timely follow-up care (for example, drain or suture removal) until resolved. (8) Temporomandibular disorders requiring...Standards. Cervical cytological smear (Papanicolaou smear) screening results should be available to the patient within 14 days of specimen collection

  19. 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... under the supervision of the Bureau in regard to the use and disbursement of funds in the child's or...

  20. 75 FR 81335 - Reasonable Charges for Medical Care or Services; 2011 Calendar Year Update

    Science.gov (United States)

    2010-12-27

    ... AFFAIRS Reasonable Charges for Medical Care or Services; 2011 Calendar Year Update AGENCY: Department of... medical care or services provided or furnished by VA to a veteran for: (1) A non service-connected... regulations concerning ``reasonable charges'' for medical care or services provided or furnished by VA to a...

  1. [Users satisfaction with dental care services provided at IMSS].

    Science.gov (United States)

    Landa-Mora, Flora Evelia; Francisco-Méndez, Gustavo; Muñoz-Rodríguez, Mario

    2007-01-01

    To determine users' satisfaction with dental care services provided at Instituto Mexicano del Seguro Social in Veracruz. An epidemiological survey was conducted in 14 family medicine clinics located in the northern part of the state of Veracruz. The clinics were selected by stratified-random sampling. All users older than 20 years seeking medical or dental care services were interviewed; previously, their informed consent was obtained. We used the 6-items United Kingdom dental care satisfaction questionnaire (Spanish version) where question number four evaluates user satisfaction. From October to December 2005, 3601 users were interviewed. We excluded 279 questionnaires because the age of the interviewees was <20 years. The final analysis included 3322 interviews (92%); 73% were female with an average age of 45 +/- 16 years old. 82% were satisfied with dental care services and 91% never felt like making a complaint. Waiting time of less than 30 minutes and last visit to the dentist in the last year were the only variables related to satisfaction (p = 0.0001). There is a high level of satisfaction regarding dental care services among Mexican Institute of Social Security users. However, it would be possible to increase the level of satisfaction if the waiting time is reduced and the number of dental care users attending twice a year increases.

  2. Medical Service: 40 years of outpatient care

    CERN Document Server

    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...

  3. 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.

  4. Medical and Health Services Managers

    Science.gov (United States)

    ... follow current regulations and adapt to new laws. Communication skills. These managers must effectively communicate policies and procedures ... must hire, train, motivate, and lead staff. Technical skills. Medical and ... in healthcare technology and data analytics. For example, they may need ...

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

    African Journals Online (AJOL)

    2014-02-12

    Feb 12, 2014 ... Eighteen years after apartheid, South Africa is still a country striving to build a nation and to be healed. Marches and protests against poor public service ... (Rm 5:13). A fundamental principle of the Christian faith is that man is saved through the grace of and by faith in the Triune God, not by deeds.

  6. 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

  7. An Analysis of the Questions of Online Medication Consultation Service

    Directory of Open Access Journals (Sweden)

    Kai-Ying Chu

    2017-11-01

    Full Text Available Due to the development of the Internet, online medical consultation has become another source for consumers to search for medical information. Medication consultation is one of the medical consultation, and drug treatment acts an important role in the course of treatment for the patients. The health will be improved by following the medical compliance. Based on different demographic differences, the demand for the medical advice is also different. Thus, the research is based on the gender and age, and sets to analyze the expression, requirement and require performance characteristics of the online medication consultation. This study content analyzed 1,272 medication consultation questions posted on Taiwan e-Doctor platform, an official online medical consultation service supported by Ministry of Health and Welfare in Taiwan. It is aimed to provide insights and understanding into people’s information need for medication.

  8. Medical subinternship: student experience on a resident uncovered hospitalist service.

    Science.gov (United States)

    O'Leary, Kevin J; Chadha, Vinky; Fleming, Victoria M; Martin, Gary J; Baker, David W

    2008-01-01

    Studies demonstrating the value of hospitalists to medical student education have been performed in traditional resident covered ward service settings (RCWS). To compare medical subinterns' experiences on an RCWS to that on a resident uncovered hospitalist service (RUHS). We assessed students' overall experience and knowledge learned on the two services using a 5-point Likert scale. We also assessed learning environment characteristics, workload, and time spent at the hospital on each service. The mean rating for knowledge learned was higher on the RCWS. Subinterns rated the two services equivalent on measures of educational value of patient problems, faculty assessment, supervision, and number and value of teaching sessions. The RCWS received higher ratings on variety of patient problems and frequency of intellectual discussion. The RCWS provided a superior learning experience for subinterns. Academic medical centers should take these findings into consideration before placing medical students on an RUHS.

  9. 42 CFR 410.10 - Medical and other health services: Included services.

    Science.gov (United States)

    2010-10-01

    .... (p) Hepatitis B vaccine. (q) Blood clotting factors for hemophilia patients competent to use these factors without medical or other supervision. (r) Screening mammography services. (s) Federally qualified... § 410.71. (w) Clinical social worker services, as provided in § 410.73. (x) Services of physicians and...

  10. Providing Medical Care in Yekaterynoslav during World War I

    Directory of Open Access Journals (Sweden)

    V.V. Haponov

    2015-06-01

    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.

  11. External Service Providers to the National Security Technology Incubator

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-02-28

    This report documents the identification and assessment of external service providers to the National Security Technology Incubator (NSTI) program for southern New Mexico. The NSTI is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant to Arrowhead Center, New Mexico State University. This report contains 1) a summary of the services to be provided by NSTI; 2) organizational descriptions of external service providers; and 3) a comparison of NSTI services and services offered by external providers.

  12. 20 CFR 670.720 - Who provides placement services?

    Science.gov (United States)

    2010-04-01

    ... CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Placement and Continued Services § 670.720 Who... graduates and former students in jobs. Job Corps placement agencies provide placement services under a...

  13. [Organization of medical genetic service in Russia].

    Science.gov (United States)

    Ginter, E K; Kozlova, S I

    2011-01-01

    Short history of the development of medical genetic service in Russia from the 1960s till now is described. Analysis of many orders of the Ministry of Health of USSR and Russia was performed which shows how separate components of the service were designed and integrated into the efficacious genetic counseling system. All of them were supported by educational programs. The important contribution made by professor Nikolai Bochkov to the creation of genetic service in Russia especially at the early stages is underlined.

  14. Integrated Cloud-Based Services for Medical Workflow Systems

    Directory of Open Access Journals (Sweden)

    Gharbi Nada

    2016-12-01

    Full Text Available Recent years have witnessed significant progress of workflow systems in different business areas. However, in the medical domain, the workflow systems are comparatively scarcely researched. In the medical domain, the workflows are as important as in other areas. In fact, the flow of information in the healthcare industry is even more critical than it is in other industries. Workflow can provide a new way of looking at how processes and procedures are completed in particular medical systems, and it can help improve the decision-making in these systems. Despite potential capabilities of workflow systems, medical systems still often perceive critical challenges in maintaining patient medical information that results in the difficulties in accessing patient data by different systems. In this paper, a new cloud-based service-oriented architecture is proposed. This architecture will support a medical workflow system integrated with cloud services aligned with medical standards to improve the healthcare system.

  15. k-MED - from a local project to a service provider for eLearning

    Directory of Open Access Journals (Sweden)

    Wagner, Richard

    2006-11-01

    Full Text Available k-MED evolved from a single medical subject project in 1999 to a provider of comprehensive technology, infrastructure and content for authors and learners. It currently offers about 170 courses covering 16 medical subjects. The k-MED community consists of medical authors and experts for technology, graphical and instructional design. It has its proprietary authoring tools and an internet based learning management system, both being continually improved corresponding to service experiences. k-MED aims at ongoing development as a service provider for educational institutions for undergraduate or continuing medical education. For further information see http://www.k-med.org.

  16. Awareness of LGBT aging issues among aging services network providers.

    Science.gov (United States)

    Hughes, Anne K; Harold, Rena D; Boyer, Janet M

    2011-10-01

    Very little research exists examining the interactions between community-based aging service providers and lesbian, gay, bisexual, and transgender (LGBT) older adults. It is unclear whether mainstream aging services acknowledge the needs of this community. We asked direct care providers and administrators in the Michigan aging services network to describe their work with LGBT older adults. We found there are very few services specific to the needs of older LGBT adults and very little outreach to this community. At the agency level, resistance to providing services was found.

  17. Information from the MEDICAL SERVICE

    CERN Multimedia

    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.

  18. Welcoming max: Increasing pediatric provider knowledge of service dogs.

    Science.gov (United States)

    Stace, Laura Britton

    2016-08-01

    Service dogs have been used in the adult population for decades. Recently, there has been a diversification in types of service dogs, specifically for the pediatric population. Although guide dogs and mobility dogs are accepted in society, autism assistance dogs, seizure alert and response dogs and diabetic alert dogs are relatively new. As pediatric service dogs attract more attention, pediatric providers need to be prepared to answer parental inquires regarding service dog use. The pediatric provider is well equipped to identify children who could benefit from a service dog intervention and should be able to make a referral to a reputable service dog provider. This article presents guidance on appropriate patient selection, making a service dog referral, and risks and benefits involved. Pediatric providers are ideally positioned to be leaders in implementing this evolving new assistive technology that can help to alleviate pediatric disabilities for both the patient and family. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Clinical service desires of medical cannabis patients

    Directory of Open Access Journals (Sweden)

    Janichek Jennifer L

    2012-03-01

    Full Text Available Abstract Background Medical cannabis dispensaries following the social or hybrid model offer supplementary holistic services in addition to dispensing medical cannabis. Historically, alternative physical health services have been the norm for these dispensaries, including services such as yoga, acupuncture, or chiropractor visits. A clinical service dearth remains for medical cannabis patients seeking substance use, misuse, dependence, and mental health services. This study examined patient desires for various clinical services and level of willingness to participate in specific clinical services. Methods Anonymous survey data (N = 303 were collected at Harborside Health Center (HHC, a medical cannabis dispensary in Oakland, CA. The sample was 70% male, 48% Caucasian and 21% African American. The mean male age was 38 years old and female mean age was 30. Sixty two percent of the male participants and 44% of the female participants are single. Sixteen percent of the population reported having a domestic partner. Forty six percent of the participants are employed full time, 41% have completed at least some college, and 49% make less than $40,000 a year. Results A significant portion of the sample, 62%, indicated a desire to participate in free clinical services at HHC, 34% would like more information about substances and use, and 41% want to learn more about reducing harms from substance use. About one quarter of the participants marked "would" or "likely would" participate in individual services such as consultation. Approximately 20% indicated "would" or "likely would" participate in psycho-educational forums, harm reduction information sharing sessions, online support groups, and coping, life, and social skills group. There was little interest in traditional NA/AA 12-step groups or adapted 12-step groups. Conclusions Desired clinical services can be qualified as a combination of harm reduction, educational, skills-based, peer support and

  20. REGULATION MISUNDERSTANDING: CONVERGENCE COMPLEXITY PROVIDING FAILURES IN TELECOMMUNICATION SERVICES COSTS

    National Research Council Canada - National Science Library

    Emílio José Montero Arruda Filho

    2017-01-01

    .... This study begins by giving the background to voice communication in the telecommunications sector and the misunderstanding of the competitive boundaries between technologies, service providers...

  1. Privately Provided Accommodation Service Quality and Customer Satisfaction

    National Research Council Canada - National Science Library

    Joshua Mugambwa; George William Mugerwa; Wilson Williams Mutumba; Claire Muganzi; Bridget Namubiru; Yusuf Waswa; Isaac Newton Kayongo

    2016-01-01

    .... 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...

  2. 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…

  3. 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.

  4. Caring for Patients with Service Dogs: Information for Healthcare Providers

    Science.gov (United States)

    Krawczyk, Michelle

    2016-11-29

    People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.

  5. Note from the CERN Medical Service

    CERN Document Server

    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.

  6. Clinical laboratories: production industry or medical services?

    Science.gov (United States)

    Plebani, Mario

    2015-06-01

    The current failure to evidence any link between laboratory tests, clinical decision-making and patient outcomes, and the scarcity of financial resources affecting healthcare systems worldwide, have put further pressure on the organization and delivery of laboratory services. Consolidation, merger, and laboratory downsizing have been driven by the need to deliver economies of scale and cut costs per test while boosting productivity. Distorted economics, based on payment models rewarding volume and efficiency rather than quality and clinical effectiveness, have underpinned the entrance of clinical laboratories into the production industry thus forcing them to relinquish their original mission of providing medical services. The sea change in laboratory medicine in recent years, with the introduction of ever newer and ever more complex tests, including 'omics', which impact on clinical decision-making, should encourage clinical laboratories to return to their original mission as long as payments models are changed. Rather than being considered solely in terms of costs, diagnostic testing must be seen in the context of an entire hospital stay or an overall payment for a care pathway: the testing process should be conceived as a part of the patient's entire journey.

  7. 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.

  8. Why don?t humanitarian organizations provide safe abortion services?

    OpenAIRE

    McGinn, Therese; Casey, Sara E

    2016-01-01

    Background Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors? observations suggest that four reasons are typically given for this gap: ?There?s no need?; ?Abortion is too complicated to provide in crises?; ?Donors don?t fund abortion services?; and ?Abortion is illegal?. Discussion However, each of these reasons is based on false premises. Unsafe abortion is a...

  9. An Open Service Provider Concept for Enterprise Complex Automation

    Science.gov (United States)

    Ivaschenko, A. V.; Sitnikov, P. V.; Tanonykhina, M. O.

    2017-01-01

    The paper introduces a solution for IT services representation and management in the integrated information space of distributed enterprises. It is proposed to develop an Open Service Provider as a software platform for interaction between IT services providers and their users. Implementation of the proposed concept and approach is illustrated by an after-sales customer support system for a large manufacturing corporation delivered by SEC “Open Code”.

  10. Content-based management service for medical videos.

    Science.gov (United States)

    Mendi, Engin; Bayrak, Coskun; Cecen, Songul; Ermisoglu, Emre

    2013-01-01

    Development of health information technology has had a dramatic impact to improve the efficiency and quality of medical care. Developing interoperable health information systems for healthcare providers has the potential to improve the quality and equitability of patient-centered healthcare. In this article, we describe an automated content-based medical video analysis and management service that provides convenience and ease in accessing the relevant medical video content without sequential scanning. The system facilitates effective temporal video segmentation and content-based visual information retrieval that enable a more reliable understanding of medical video content. The system is implemented as a Web- and mobile-based service and has the potential to offer a knowledge-sharing platform for the purpose of efficient medical video content access.

  11. 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

  12. Patient satisfaction with health care services provided at HIV clinics ...

    African Journals Online (AJOL)

    Background: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided.

  13. Pharmaceutical services at a medical site after Hurricane Andrew.

    Science.gov (United States)

    Nestor, A; Aviles, A I; Kummerle, D R; Barclay, L P; Rey, J A

    1993-09-01

    The experiences of a group of volunteer clinical pharmacists who provided pharmacy services as part of a disaster relief effort following a hurricane are reported. Hurricane Andrew left many people in southern Florida without shelter and other basic necessities, including health care services. A group of seven pharmacists volunteered to provide services at a temporary medical site set up in a community center. The pharmacy stock consisted of donated drugs. The pharmacists dispensed medications directly to patients and worked closely with other volunteer medical personnel to make sure proper medications were used. Because the pharmacy stock was limited, physicians relied upon the pharmacists for information about therapeutic interchanges, dosage conversions, and new medications. Prescriptions were often ordered and dispensed with only oral instructions. The pharmacists also provided patient counseling, although problems caused by inexperience with certain types of patients, a language barrier, and substandard living conditions after the hurricane made counseling more difficult. The contributions of seven pharmacists who provided services at an emergency medical site after Hurricane Andrew were well received by other health care personnel and by the community.

  14. Medical travel facilitators: connecting patients and providers in a globalized world.

    Science.gov (United States)

    Dalstrom, Matthew

    2013-04-01

    International medical travel is a rapidly developing phenomenon that promises patients cheap and affordable medical care abroad. However, the logistics of making travel arrangements, selecting a medical provider, and evaluating quality can be a daunting task for even the most experienced traveler. At the nexus, connecting patients and providers are medical travel facilitators (MTFs), who are individuals and companies that market foreign medical care to patients. While the services that MTFs offer vary, they primarily focus on making foreign medical care more accessible to patients through commodifying the medical experience and providing logistical support. Although they are an important part of international medical travel they are often overlooked, especially along the US/Mexico border. This paper contributes to the discussion on medical travel by focusing on MTFs and the methods they employ through (1) discussing the characteristics and logistical challenges of medical travel; (2) identifying the different types of medical travel facilitators; and (3) addressing how MTFs remake patients into consumers. Findings suggest that while MTFs operate on a variety of different scales, and market their services differently, they all emphasize the consumer experience through advertising quality assurances and logistical support.

  15. Providers must plan for accrual of medical malpractice claims.

    Science.gov (United States)

    Zatorski, R

    1988-11-01

    Because of the change in accounting regulations that requires accrual for certain medical malpractice claims, healthcare providers could soon be experiencing significant effects on their financial results. AICPA Statement Position 87-1, "Accounting for Asserted and Unasserted Medical Malpractice Claims of Health Care Providers and Related Issues," states that if healthcare providers have not transferred all risk for medical malpractice claims arising out of occurrences prior to the financial statement date to a third party, some accrual will be required. Providers need to prepare themselves for the financial problems that could arise from these reporting guidelines. Estimating the potential accrual amounts with advanced planning and extensive data gathering and analysis could lower a healthcare provider's financial risk.

  16. Beyond the Clinic: Providing Services, Supports, and Connections to Help Children and Their Families Thrive

    Science.gov (United States)

    Nolan, Kevin J., Jr.

    2013-01-01

    As one of the premier pediatric hospitals in the United States, Boston Children's Hospital serves a wide range of children and provides top quality medical care, including a program for deaf and hard of hearing children that extends services beyond the medical scope. Within this program is a unique and particularly critical position--that of…

  17. Provider communication effects medication adherence in hypertensive African Americans

    Science.gov (United States)

    Schoenthaler, Antoinette; Chaplin, William F.; Allegrante, John P.; Fernandez, Senaida; Diaz-Gloster, Marleny; Tobin, Jonathan N.; Ogedegbe, Gbenga

    2009-01-01

    Objective To evaluate the effect of patients’ perceptions of providers’ communication on medication adherence in hypertensive African Americans. Methods Cross-sectional study of 439 patients with poorly-controlled hypertension followed in community-based healthcare practices in the New York metropolitan area. Patients’ rating of their providers’ communication was assessed with a perceived communication style questionnaire,while medication adherence was assessed with the Morisky self-report measure. Results Majority of participants were female, low-income, and had high school level educations, with mean age of 58 years. Fifty-five percent reported being nonadherent with their medications; and 51% rated their provider’s communication to be non-collaborative. In multivariate analysis adjusted for patient demographics and covariates (depressive symptoms, provider degree), communication rated as collaborative was associated with better medication adherence (β = -.11, p = .03). Other significant correlates of medication adherence independent of perceived communication were age (β = .13, p = .02) and depressive symptoms (β = -.18, p = .001). Conclusion Provider communication rated as more collaborative was associated with better adherence to antihypertensive medications in a sample of low-income hypertensive African-American patients. Practice Implications The quality of patient-provider communication is a potentially modifiable element of the medical relationship that may affect health outcomes in this high-risk patient population. PMID:19013740

  18. Postdischarge community pharmacist-provided home services for patients after hospitalization for heart failure.

    Science.gov (United States)

    Kalista, Tom; Lemay, Virginia; Cohen, Lisa

    2015-01-01

    To establish a community pharmacist-provided home health service to improve medication adherence and reduce 30-day heart failure-related hospital readmissions. Visiting Nurse Services of Newport and Bristol Counties located in Portsmouth, RI, from December 2013 to April 2014. Each patient received one in-home visit provided by a Postgraduate Year 1 community pharmacy resident within 1 week of admission to visiting nurse services followed by two follow-up telephone calls, 1 week and 4 weeks after the visit. The in-home visit consisted of a baseline assessment of medication adherence using the Morisky 8-Item Medication Adherence Questionnaire as well as pharmacist-provided education regarding chronic heart failure management. The follow-up telephone calls were used to reassess patient adherence and to monitor for hospital readmission within 30 days of the initial in-home visit. Community pharmacist-provided in-home medication reconciliation and medication teaching has not been described in the literature previously. In addition, pharmacists are often not included on home health care teams placing patients undergoing transitions in care at risk for potential medication-related errors. Improvement in medication adherence and reduction in 30-day heart failure-related hospital readmission rates. Ten patients were enrolled from December 2013 through April 2014. Following intervention, all patients saw improvements in adherence questionnaire scores during follow-up. Hospital readmission rates for patients seen by the pharmacist were lower compared with agencywide figures over a similar time period. A community pharmacist-provided in-home medication teaching service for patients following recent hospital discharge helps facilitate successful transitions of care from an inpatient to outpatient setting, improves medication adherence and has produced lower observed 30-day heart failure-related hospital readmission rates. Expansion of this or a similar service within the

  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. Conceptual Models of the Individual Public Service Provider

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Bhatti, Yosef; Petersen, Ole Helby

    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...... 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...... 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....

  1. Social Work Services Utilization by Children with Medical Complexity.

    Science.gov (United States)

    Coquillette, Madeline; Cox, Joanne E; Cheek, Sara; Webster, Romi A

    2015-12-01

    Children with medical complexity (CMC) are a growing population in pediatric primary care practices, and families caring for these children face increased medical, developmental, education and social needs. The objective of this study was to quantify hospital-wide social work services utilization by CMC compared to non-medically-complex children (non-CMC) to inform the development of family-centered care models that support these vulnerable patients and families. Social work department records from a tertiary children's hospital were used to compare CMC aged 0-17 (n = 564) with age- and sex-matched non-CMC (n = 1128) over a 16-month retrospective period. The main outcomes measures were the proportion of patients who used social work services and mean number of hours of services provided per patient, both by social work providers in the primary care setting and throughout the hospital. A greater percentage of CMC used social work services than non-CMC (60.3 vs. 18.9%), and CMC used more hours per child (5.50 h/child vs. 0.69). In multivariate analysis, medical complexity was associated with 6.23-fold greater odds of using social work services (95% CI 4.94-7.85) and with 8.07 times more hours of services per child (95% CI 6.30-10.34), independent of primary health insurance, age, or sex. This study confirms that CMC use significantly more social work services in the medical setting. This must be considered when designing proactive medical home models to provide high quality family-centered care for this population, and further research is needed to elucidate the factors that drive this utilization.

  2. Providing Educationally Relevant Occupational and Physical Therapy Services

    Science.gov (United States)

    Laverdure, Patricia A.; Rose, Deborah S.

    2012-01-01

    As defined in the Individuals with Disabilities Education Improvement Act, occupational and physical therapists provide services to support students to access, participate, and progress in their educational program within the least restrictive educational environment. Educationally relevant occupational and physical therapy services in school…

  3. Providing Mental Health Services to Arab Americans: Recommendations and Considerations.

    Science.gov (United States)

    Erickson, Chris D.; Al-Timimi, Nada R.

    2001-01-01

    This paper presents background information on the cultural sociopathology of the Arab American experience. It discusses how, in order to effectively deliver services, mental health workers need to be aware of their own biases. It explores ways to provide culturally relevant mental health services to Arab Americans. (JDM)

  4. 20 CFR 631.52 - Selection of service providers.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Selection of service providers. 631.52 Section 631.52 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE III OF THE JOB TRAINING PARTNERSHIP ACT Substate Programs § 631.52 Selection of service...

  5. Local perception of ecosystem services provided by bats and bees ...

    African Journals Online (AJOL)

    Indigenous perception on ecosystem services provided by honey bees and fruit bats were assessed in Bénin to find out whether the communities value these services and to appreciate if there is any chance to conserve them locally. Farmers were interviewed with questionnaire in three regions of Bénin to report their ...

  6. Redefining the bureaucratic encounter between service providers and service users: evidence from the Norwegian HUSK projects.

    Science.gov (United States)

    Carnochan, Sarah; Austin, Michael J

    2015-01-01

    The HUSK projects, involving collaboration between service users, providers, educators, and researchers, coincided with the reorganization of national government services (NAV). The NAV reorganization brought together employment services, social insurance, and municipal social service benefits, and called for a service model where users would be empowered to influence the provision of services. In this analysis of the HUSK cases the authors focus on the relationship between the service user and the service provider, identifying themes in two broad domains: concepts of the individual that included the service user and the service provider and concepts of the relationship that included power, role, activity, interaction, and communication. Within each theme, the analysis highlights the transition from a traditional or historical state to a new or desired state and draws upon some of the classic literature that frames the encounters between service users and providers.

  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. Challenging RSD clients’ preferences for foreign service providers

    Directory of Open Access Journals (Sweden)

    Christian Pangilinan

    2012-12-01

    Full Text Available Organisations that provide legal services to refugees and asylumseekers face the challenge of responding ethically to clients’ requeststo be assisted by foreigners as opposed to by nationals in countryoffices.

  9. Dutch logistics service providers and sustainable physical distribution

    NARCIS (Netherlands)

    Onno Omta; Hans-Heinrich Glöckner; Reinder Pieters; Stef Weijers

    2013-01-01

    As environmental concerns becoming increasingly important to logistics service providers, the question arises as to how they can achieve sustainable physical distribution practices while surviving the severe competition in freight transport. This issue is further complicated by the pressures from

  10. Demonstrate provider accessibility with desktop and online services.

    Science.gov (United States)

    2001-10-01

    It's available on personal computers with a CD or through Internet access. Assess instantly the accessibility of your provider network or the most promising areas to establish a health service with new GIS tools.

  11. Providing Multi-Page Data Extraction Services with XWRAPComposer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ling; Zhang, Jianjun; Han, Wei; Pu, Calton; Caverlee, James; Park, Sungkeun; Critchlow, Terence J.; Buttler, David; Coleman, Matthew A.

    2008-04-30

    Dynamic Web data sources – sometimes known collectively as the Deep Web – increase the utility of the Web by providing intuitive access to data repositories anywhere that Web access is available. Deep Web services provide access to real-time information, like entertainment event listings, or present a Web interface to large databases or other data repositories. Recent studies suggest that the size and growth rate of the dynamic Web greatly exceed that of the static Web, yet dynamic content is often ignored by existing search engine indexers owing to the technical challenges that arise when attempting to search the Deep Web. To address these challenges, we present DYNABOT, a service-centric crawler for discovering and clustering Deep Web sources offering dynamic content. DYNABOT has three unique characteristics. First, DYNABOT utilizes a service class model of the Web implemented through the construction of service class descriptions (SCDs). Second, DYNABOT employs a modular, self-tuning system architecture for focused crawling of the Deep Web using service class descriptions. Third, DYNABOT incorporates methods and algorithms for efficient probing of the Deep Web and for discovering and clustering Deep Web sources and services through SCD-based service matching analysis. Our experimental results demonstrate the effectiveness of the service class discovery, probing, and matching algorithms and suggest techniques for efficiently managing service discovery in the face of the immense scale of the Deep Web.

  12. Smartphone medication adherence apps: potential benefits to patients and providers.

    Science.gov (United States)

    Dayer, Lindsey; Heldenbrand, Seth; Anderson, Paul; Gubbins, Paul O; Martin, Bradley C

    2013-01-01

    To provide an overview of medication adherence, discuss the potential for smartphone medication adherence applications (adherence apps) to improve medication nonadherence, evaluate features of adherence apps across operating systems (OSs), and identify future opportunities and barriers facing adherence apps. Medication nonadherence is a common, complex, and costly problem that contributes to poor treatment outcomes and consumes health care resources. Nonadherence is difficult to measure precisely, and interventions to mitigate it have been largely unsuccessful. Using smartphone adherence apps represents a novel approach to improving adherence. This readily available technology offers many features that can be designed to help patients and health care providers improve medication-taking behavior. Currently available apps were identified from the three main smartphone OSs (Apple, Android, and Blackberry). In addition, desirable features for adherence apps were identified and ranked by perceived importance to user desirability using a three-point rating system: 1, modest; 2, moderate; or 3, high. The 10 highest-rated apps were installed and subjected to user testing to assess app attributes using a standard medication regimen. RESULTS 160 adherence apps were identified and ranked. These apps were most prevalent for the Android OS. Adherence apps with advanced functionality were more prevalent on the Apple iPhone OS. Among all apps, MyMedSchedule, MyMeds, and RxmindMe rated the highest because of their basic medication reminder features coupled with their enhanced levels of functionality. Despite being untested, medication apps represent a possible strategy that pharmacists can recommend to nonadherent patients and incorporate into their practice.

  13. 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.

  14. 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...

  15. Medical-grade collagen peptide in injectables provides antioxidant protection.

    Science.gov (United States)

    Kobayashi, Kyo; Maehata, Yojiro; Okada, Yasue; Kusubata, Masashi; Hattori, Shunji; Tanaka, Keisuke; Miyamoto, Chihiro; Yoshino, Fumihiko; Yoshida, Ayaka; Tokutomi, Fumiaki; Wada-Takahashi, Satoko; Komatsu, Tomoko; Otsuka, Takero; Takahashi, Shun-Suke; Lee, Masaichi-Chang-Il

    2015-03-01

    Medical-grade collagen peptide is used as an additive agent in pharmaceutical formulations; however, it is unknown as to whether the compound exerts antioxidant effects in vitro. In this study, we evaluated the antioxidant effects of medical-grade collagen peptide on reactive oxygen species such as hydroxyl radical, superoxide anion radical and singlet oxygen using electron spin resonance and spin trapping. We confirmed that medical-grade collagen peptide directly inhibited hydroxyl radical generated by the Fenton reaction or by ultraviolet irradiation of hydrogen peroxide, and singlet oxygen. In addition, an antioxidant effect of medical-grade collagen peptide on singlet oxygen was observed in peptide fractions 12-22. The total amount of antioxidant amino acids (Gly, Hyp, Glu, Ala, Cys, Met and His) constituted more than half of the total amino acids in these fractions. These results suggest that the observed antioxidant properties of medical-grade collagen peptide are due to the compound containing antioxidant amino acids. Medical-grade collagen peptide, which is used in pharmaceuticals, and especially in injectables, could provide useful antioxidant properties to protect the active ingredient from oxidation.

  16. 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.

  17. Benchmarking online dispatch algorithms for Emergency Medical Services

    NARCIS (Netherlands)

    C.J. Jagtenberg (Caroline); P. L.-J. van den Berg (Pieter); R.D. van der Mei (Rob)

    2017-01-01

    textabstractProviders 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

  18. 77 FR 70893 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ..., Mental health programs, Nursing homes, Reporting and recordkeeping requirements, Veterans. Dated... authority to provide needed non- VA care using community resources, such as private physicians or community... such medical services for a veteran who has been furnished hospital care, nursing home care...

  19. Long-Term Mortality of Emergency Medical Services Patients

    DEFF Research Database (Denmark)

    Bøtker, Morten T; Terkelsen, Christian J; Sørensen, Jan Nørtved

    2017-01-01

    STUDY OBJECTIVE: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark. METHODS: We analyzed linked EMS, hospital...

  20. Information Infrastructure for Emergency Medical Services

    OpenAIRE

    Orthner, Helmuth; Mishra, Ninad; Terndrup, Thomas; Acker, Joseph; Grimes, Gary; Gemmill, Jill; Battles, Marcie

    2005-01-01

    The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We hav...

  1. A Proposal of Secure Session Provider Service over NGN

    Science.gov (United States)

    Kaji, Tadashi; Fujishiro, Takahiro; Susaki, Seiichi; Kawai, Eri; Hoshino, Kazuyoshi; Higashino, Teruo

    In these days, telecom operators in the world have been constructing Next Generation Network (NGN). NGN can provide QoS and security guaranteed communication to its users. However, the protection of communication is limited inside NGN. Therefore, when the interconnection between NGN and the Internet will be widely used in near future, it will become an important problem to solve how it protects the communications crossing over NGN and the Internet. This paper proposes a secure communication provider service that protects the confidentiality and integrity of communications crossing over NGN and the Internet by setting up and controlling the IPsec session in cooperation with NGN's call session control function (CSCF). In this service, the secure session control provider (sSCP) server and CSCF authenticate its user as Trusted Third Party on behalf of service providers. In addition, this service provides the ability of fast session establishment because sSCP distributes a security association for IPsec session between the user and service provider via the SIP session protected by NGN.

  2. 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.

  3. EV and HP Providing Ancillary Services in the Nordic Region

    DEFF Research Database (Denmark)

    Liu, Zhaoxi; Wu, Qiuwei

    This report covers the analysis of the electric vehicle (EV) and heat pump (HP) providing ancillary services to the power system of the Nordic region including Denmark, Finland, Norway and Sweden. The analysis is to investigate the feasibility of EVs and HPs to serve as demand as frequency reserve...... (DFR) providers in the distribution power system in the four mentioned Nordic countries....

  4. Definitions of Multicultural Competence: Frontline Human Service Providers' Perspective

    Science.gov (United States)

    Caldwell, Leon D.; Tarver, Dolores D.; Iwamoto, Derek K.; Herzberg, Sarah E.; Cerda-Lizarraga, Patricia; Mack, Tabethah

    2008-01-01

    In this qualitative study, the authors explored definitions of multicultural competence given by 99 frontline human service providers. The providers had no formal training in counseling but served in a helping role. Seven thematic definitions emerged: color blindness, client focused, acknowledgment of cultural differences, textbook consistent,…

  5. Expression of patients' and providers' identities during the medical interview.

    Science.gov (United States)

    Scholl, Juliann C; Wilson, Jacquee B; Hughes, Patrick C

    2011-08-01

    We apply the Communication Theory of Identity to investigate how patients display their ethnic identities during intercultural patient-provider interactions. Ethnic identity displays play a large part in reflecting patients' and providers' assumptions about the other, as well as their communicative needs. We collected paper-and-pencil responses from a convenience sample of providers and their patients, and conducted a constant comparative analysis of their open-ended reports of a recent intercultural medical interview. The results revealed how both parties viewed their roles in intercultural medical encounters and how they looked for accommodative behaviors from the other party. We draw implications for new applications and future developments of the Communication Theory of Identity and Communication Accommodation Theory.

  6. 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. .

  7. 76 FR 77327 - Reasonable Charges for Medical Care or Services; V3.9, 2012 Calendar Year Update

    Science.gov (United States)

    2011-12-12

    ... AFFAIRS Reasonable Charges for Medical Care or Services; V3.9, 2012 Calendar Year Update AGENCY... for medical care or services provided or furnished by VA to a veteran for: (1) A non service-connected... ``Reasonable Charges'' for medical care or services provided or furnished by VA to a veteran for: (1) A non...

  8. 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.

  9. 22 CFR 96.14 - Providing adoption services using other providers.

    Science.gov (United States)

    2010-04-01

    ... termination of parental rights and to adoption, if the primary provider verifies consent pursuant to § 96.46(c... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA...

  10. Innovative models for providing clinical pharmacy services to remote locations using clinical video telehealth.

    Science.gov (United States)

    Perdew, Cassie; Erickson, Katie; Litke, Jessica

    2017-07-15

    The use of videoconferencing and other telehealth technologies to expand access to clinical pharmacy services at multiple Veterans Affairs (VA) clinics in rural areas of Alaska and the northwestern United States is described. Beginning in 2014, clinical pharmacy specialists at a regional VA Telehealth Hub based at Boise VA Medical Center in Idaho have provided telehealth services for 16 clinics. In one telehealth model, a pharmacist and other remotely located primary care team members (a medical provider, a medical support assistant, a social worker, and a psychologist) conduct telehealth visits with veterans located at VA clinics, with support provided by clinic-based nursing staff; this model has been used to improve medication management services for veterans in sparsely populated areas. In the second VA telehealth model, a remotely located pharmacist uses telehealth technology to participate in clinical encounters along with primary care team members located at the patient site; this model allows on-demand remote coverage in the event of planned or unplanned absences of clinic-based pharmacists. Since the Telehealth Hub was established, pharmacists have engaged in video encounters and provided other telehealth-based clinical services to more than 1,200 veterans with diabetes, hyperlipidemia, hypertension, and other chronic conditions. Within the VA healthcare system, telehealth technology has been demonstrated to be a cost-effective and well-received means of providing clinical pharmacy services in rural areas. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  11. Understanding Climate Service Science: Balancing Users' Needs with Providers' Capabilities

    Science.gov (United States)

    Street, Roger B.; Bley, Dagmar; Manez, Maria

    2013-04-01

    Understanding Climate Service Science: Balancing Users' Needs with Providers' Capabilities The overall strategic objective of the Joint Programming Initiative (JPI)-Climate is to contribute to highly coordinated knowledge development by not only improving the scientific expertise on climate change risks and adaptation options, but also by connecting that knowledge with decision making. Understanding the nature and scope of those providing climate services and the services being provided and understanding userś needs and requirements is critical to realisation of this strategic objective. The main aim of the JPI-Climate Working Group 2 "Researching and advancing Climate Service Development" is to coordinate knowledge development and transfer to improve the climate (change) services to society and within Europe. In order to avoid duplication of efforts and picking on differences in the quality and nature of information being provided from country to country there is a need for a certain degree of consistency of approaches and quality assurance. The JPI-Climate will bring interaction between the emerging national and European climate services initiatives. Climate services produce strongly science-based client-oriented information. They should be built on a good understanding of the stakeholder needs, and provide easy access to up-to-date information and expertise regarding specific policy or research questions. It is evident from experience that such services need (and are perceived) to be salient, credible and legitimate from the perspective of the intended users and providers of those services, and within the supportive research community. Achieving this aim and developing and delivering the required services necessitates the engagement of the spectrum of users and providers, as well as researchers from the physical, natural, engineering, economics and social sciences - the science underpinning climate services. The JPI-Climate, Module 2 Fast Track Activities (FTAs

  12. Effectiveness and acceptability of medical abortion provided through telemedicine.

    Science.gov (United States)

    Grossman, Daniel; Grindlay, Kate; Buchacker, Todd; Lane, Kathleen; Blanchard, Kelly

    2011-08-01

    To estimate the effectiveness and acceptability of telemedicine provision of early medical abortion compared with provision with a face-to-face physician visit at a Planned Parenthood affiliate in Iowa. Between November 2008 and October 2009, we conducted a prospective cohort study of women obtaining medical abortion by telemedicine or face-to-face physician visits. We collected clinical data, and women completed a self-administered questionnaire at follow-up. We also compared the prevalence of reportable adverse events between the two service delivery models among all patients seen between July 2008 and October 2009. Of 578 enrolled participants, follow-up data were obtained for 223 telemedicine patients and 226 face-to-face patients. The proportion with a successful abortion was 99% for telemedicine patients (95% confidence interval [CI] 96-100%) and 97% for face-to-face patients (95% CI 94-99%). Ninety-one percent of all participants were very satisfied with their abortion, although in multivariable analysis, telemedicine patients had a higher odds of saying they would recommend the service to a friend compared with face-to-face patients (odds ratio, 1.72; 95% CI 1.26-2.34). Twenty-five percent of telemedicine patients said they would have preferred being in the same room with the doctor. Younger age, less education, and nulliparity were significantly associated with preferring face-to-face communication. There was no significant difference in the prevalence of adverse events reported during the study period among telemedicine patients (n = 1,172) (1.3%; 95% CI 0.8-2.1%) compared with face-to-face patients (n = 2,384) (1.3%; 95% CI 0.9-1.8%) (82% power to detect difference of 1.3%). Provision of medical abortion through telemedicine is effective and acceptability is high among women who choose this model. II.

  13. 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.

  14. Service Provision for Autism in Mainland China: A Service Providers' Perspective

    Science.gov (United States)

    Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Matthews, Fiona E.; Murray, Stuart; Baron-Cohen, Simon; Brayne, Carol

    2013-01-01

    Qualitative semi-structured interviews were conducted with service providers regarding the current healthcare provision and education services for children with Autism Spectrum Conditions (ASC) and their families in mainland China. 10 service providers described the current policy and identified unmet needs within current practice. Providers…

  15. Nutrition: Intervention Guidance for Service Providers and Families. Connecticut Birth to Three System, Service Guideline 6.

    Science.gov (United States)

    Connecticut Birth to Three System, Hartford.

    This guide was developed to assist families and service providers in Connecticut with nutrition services for infants and toddlers with disabilities. Individual sections provide information about the following topics: laws and regulations related to nutrition services; eligibility for the Connecticut Birth to Three System and nutrition; nutrition…

  16. Contraceptive service provider imposed restrictions to contraceptive access in Urban Nigeria.

    Science.gov (United States)

    Schwandt, Hilary M; Speizer, Ilene S; Corroon, Meghan

    2017-04-17

    Health service providers can restrict access to contraceptives through their own imposed biases about method appropriateness. In this study, provider biases toward contraceptive service provision among urban Nigerian providers was assessed. Health providers working in health facilities, as well as pharmacists and patent medical vendors (PMV), in Abuja, Benin City, Ibadan, Ilorin, Kaduna, and Zaria, were surveyed in 2011 concerning their self-reported biases in service provision based on age, parity, and marital status. Minimum age bias was the most common bias while minimum parity was the least common bias reported by providers. Condoms were consistently provided with the least amount of bias, followed by provision of emergency contraception (EC), pills, injectables, and IUDs. Experience of in-service training for health facility providers was associated with decreased prevalence of marital status bias for the pill, injectable, and IUD; however, training experience did not, or had the opposite effect on, pharmacists and PMV operator's reports of service provision bias. Provider imposed eligibility barriers in urban study sites in Nigeria were pervasive - the most prevalent restriction across method and provider type was minimum age. Given the large and growing adolescent population - interventions aimed at increasing supportive provision of contraceptives to youth in this context are urgently needed. The results show that the effect of in-service training on provider biases was limited. Future efforts to address provider biases in contraceptive service provision, among all provider types, must find creative ways to address this critical barrier to increased contraceptive use.

  17. 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...... required to provide advanced services within customers’ R&D functions, while simultaneously attempting to scale these for a production context. The emergent complexities of operating in multiple arenas in order to explore and exploit technologies-along the three trajectories of serviceability, scalability...... 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...

  18. DEVELOPMENT PERSPECTIVES OF LOGISTICS SERVICES PROVIDERS IN POLAND

    Directory of Open Access Journals (Sweden)

    Ewa PŁACZEK

    2015-04-01

    Full Text Available The market of logistics services (TSL in Poland is new, yet already mature. There are a lot of diverse entities operating there that provide various types of logistics services. So far the major goal of business conducted by them has been to generate profit that ensured further development. However, currently a change in the attitude towards business that is aimed for example at management of the company value is observed. And thus the following question should be asked: „What activities are undertaken by logistics services providers for the purpose of achievement of success such as for example improvement of the company attractiveness or growth in the company value?”. To answer the question put in this way, the analysis of activities undertaken by providers of logistics services in Poland is performed. The article presents activities of logistics services providers that are the response to demands of the market – the customer, for the purpose of satisfaction of their individualised needs. We can consider them determinants of further operations that describe possible trends of development.

  19. 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.  

  20. A MANAGEMENT INFORMATION SYSTEM FOR MEDICAL SERVICES AT COMMAND HEADQUARTERS.

    Science.gov (United States)

    Gulati, H L; Sandhu, H S

    1995-01-01

    Management information system (MIS) is increasingly being used for information storage, handling, processing and retrieval of data for improving the services provided by any organisation. It allows quick decision making for overall functional improvement. Headquarters Central Command (Medical) Lucknow has developed software for data capturing in respect of six important functional areas. These include employability and availability of specialist officers, assessment of hospital services through functional update and monitoring team (FUMTs), patient satisfaction survey, user commanders opinion, state of critical items of hospital clothing and modernisation of hospitals. This automation has resulted in quick and scientific decision making for improving the medicare services to the clientele.

  1. 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

  2. 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

  3. 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

  4. 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!

  5. 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.

  6. Meeting Basic Needs: Social Supports and Services Provided by Hospice.

    Science.gov (United States)

    Boucher, Nathan A; Kuchibhatla, Maragatha; Johnson, Kimberly S

    2017-06-01

    Describe social goods and services for which hospices assist patients and families and the resources hospices use to do so. Basic social supports and services not routinely covered by insurers may be needed by terminally ill patients and their families. Little is known about hospices' provision of such social supports and services. A 2014-2015 cross-sectional survey of hospices nationwide. Participating hospices had been in operation for at least 3 years and were located in any of the 50 states or District of Columbia. Hospices were surveyed about availability and sources of internal funds and referral to obtain basic social supports for patients. Descriptive statistics, bivariate analysis, and categorization were used to describe hospice practices. Measures included frequency and nature of goods and services provision in the prior year; and extent to which hospices used internal funds or community referral for goods and services. Over 80% (n = 203) reported internal funds covered services not reimbursed by insurers; 78% used funds in last year. Hospices used internal funds for food (81.7%), shelter (57.8%), utility bills (73.5%), and funeral costs (50%). Hospices referred patients/families to community organizations to obtain a similar range of services, including transportation, clothing, linens/towels, furniture/appliances, home repairs, and caregiver support. Hospices are using internal resources and accessing community resources to provide patients with basic social needs not routinely covered by insurance.

  7. PTSD among Bosnian refugees: a survey of providers' knowledge, attitudes and service patterns.

    Science.gov (United States)

    Weine, S M; Kuc, G; Dzudza, E; Razzano, L; Pavkovic, I

    2001-06-01

    The objective of this study was to investigate providers' knowledge, attitudes and service provision patterns for Bosnian refugees with PTSD and to consider the overall implications for trauma-related mental health services. A survey instrument was developed and administered to 30 randomly selected service providers working with Bosnian refugees in Chicago. This sample includes primary medical care providers (n = 7), community social service providers (n = 12), and mental health service providers (n = 11). Results showed that knowledge about PTSD is highest in mental health service providers, as is amount of previous training and education about PTSD. Less than half of all providers systematically assess for PTSD, and standardized instruments for PTSD are rarely used. The top three overall recommendations for services were ranked as: 1. Psychotherapy; 2. No intervention; 3. Psychiatric evaluation. In general, less than half of providers hold attitudes toward refugees as suffering from illnesses or mental disorders, or that "something" is wrong with them. Likewise, only half of the providers reported providing education to refugees and their families about the possible mental health consequences of trauma. In conclusion, assessment, intervention and educational activities of providers are not consistent with literature documenting that PTSD is highly prevalent in refugee populations. New training programs, model development, and research initiatives are needed to address the needs of refugees.

  8. A Distributed Service and Business Model for Providing Cloud Computing Service

    OpenAIRE

    Shreya Bhadra; Tirthankar Gayen

    2013-01-01

    Cloud Computing model has enabled IT organizations to serve the users globally. It gives the services like Platform as a Service, Software as a Service and Infrastructure as a Service without users being much aware of the details in which the services are provided. As in File Access System Service the users are not aware of the locations of the files in Clouds. File access seems to them as a single coherent file system. Considering this aspect, this paper is concerned with an effective servic...

  9. 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.

  10. 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.

  11. [Medical service systems for tuberculosis in low-incidence countries].

    Science.gov (United States)

    Kato, Seiya; Ito, Kunihiko; Takatorige, Toshio; Ohkado, Akihiro; Tanaka, Keiji; Ishikawa, Nobukatsu

    2012-09-01

    Currently, Japan has a near low incidence of tuberculosis (TB); the incidence is below 20/100,000. Considering this incidence, the medical service provision system needs to be restructured and related policies need to be revised. The Revised National Guidelines for TB Control, issued in May 2011 by the Ministry of Health, Labour, and Welfare, provided the policy towards achieving a low incidence of TB. This study aims to provide suggestions for restructuring the medical service system in Japan by analyzing the systems in selected countries with low incidence. Between 2004 and 2010, we conducted tours to study TB control and medical services in the UK, the USA, Germany, The Netherlands, and Norway. In these tours, we visited the medical facilities, agencies implementing preventive activities, health departments of central and local governments, reference laboratories, technical agencies, non-governmental organizations, and other organizations involved in TB control in these countries. In addition, we collected information from published papers and related documents through the internet. This paper reports the policies and strategies adopted in these low-incidence countries, especially pertaining to medical service systems, directly observed treatment, short-course (DOTS) services, hospital beds and facilities, objectives and duration of hospitalization, and mechanisms for maintaining quality medical services. In all the visited countries, except Germany, TB patients were diagnosed and treated, as well as provided support such as DOTS, by a single organization or agency. In the US and Norway, DOTs was provided to all TB patients at chest centers and/or health centers. On the other hand, in the UK, guidelines from the National Institute for Health and Clinical Excellence (NICE) stated that DOT is not necessary for managing most active TB cases. In these countries there were 3 modes of treating infectious patients: home isolation, hospitalization for the first 2 weeks

  12. 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.

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

    Science.gov (United States)

    Brennen, P W

    1992-01-01

    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

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

    African Journals Online (AJOL)

    Seventy one percent of the health service providers indicated that their patients suffered from body weakness, 86 % indicated that they had patients who suffered from recent loss of body weight, and another 86 % pointed out that their patients had influenza/common cold. Other health complaints reported included unusual ...

  15. Information Services Provided By Special Collections Units In ...

    African Journals Online (AJOL)

    This study assessed the information services provided in special collections unit in federal and state University libraries in Nigeria. One research question was formulated to guide the study. Descriptive survey design was adopted in carrying out the study. A purposive sampling procedure was used to obtain a sample of 178 ...

  16. Location of development NGOs providing HIV and AIDS services to ...

    African Journals Online (AJOL)

    Development Non-Governmental Organisations (NGOs) have been crucial players in HIV and AIDS from the onset of the epidemic in South Africa. We examined development NGOs that provide HIV and AIDS services to young people within the Cape Metropole District of the Western Cape Province, with a view to analyse ...

  17. Concurrent remote management of CPE by multiple service providers

    NARCIS (Netherlands)

    Balemans, H.; Smedt, A. de; Hartog, F.T.H. de; Önnegren, J.

    2006-01-01

    Configuration and management of devices in the home is becoming ever more complex for the user. The trend is, therefore, that it will be performed remotely by network and service providers using dedicated configuration servers. The current remote management architectures do not support an

  18. Assessment of Services Provided By Village Alive Women ...

    African Journals Online (AJOL)

    Assessment of Services Provided By Village Alive Women Association to Rural Women in Ifelodun Local Government Area of Kwara State, Nigeria. ... hardworking Rural women of Nigeria by different NGOs and Voluntary organizations so that they can increase their productivity those government organs or agencies (ADP, ...

  19. 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

  20. 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…

  1. Veterinary Extension Services Provided To Livestock Farmers In ...

    African Journals Online (AJOL)

    This paper examines the differences in the veterinary services provided by university and ministry based officers to livestock farmers in Oyo State. Simple random sampling technique was used to select veterinary clinics and livestock farmers who visited the clinics. One hundred and twenty five farmers were selected and ...

  2. Allocation of advertising space by a web service provider using ...

    Indian Academy of Sciences (India)

    Internet has emerged as a powerful medium for trade and commerce. Online advertising over the internet has increased more than hundredfold since 2001. In the present work, we address problems faced by online advertisement service providers. In this paper, we propose a multi-slot and multi-site combinatorial auction ...

  3. Methods employed by public libraries in providing services to ...

    African Journals Online (AJOL)

    The study is on methods employed by public libraries in providing services to PLWHA in Benue State, Nigeria. The study area is Benue State , while the study design is descriptive survey. The population comprise d of 14 public librarians. A set of quest ionnaire was structured with 25 items for public librarians. Data was ...

  4. 20 CFR 627.422 - Selection of service providers.

    Science.gov (United States)

    2010-04-01

    ..., business ethics, and fiscal accountability; (6) The necessary organization, experience, accounting and...) Appropriate education agencies in the service delivery area/substate area shall be provided the opportunity to... additional points to proposals received from such organizations as minority business enterprises and women...

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

    African Journals Online (AJOL)

    of Ni-Cu in the area. This investigation furthermore afforded researchers an opportunity to explore the health services that are provided in the area. The study area ..... Environmental air pollution or ingestion of contaminated phane worms, could ultimately result in allergies, asthma, bleeding tendencies and hypertension.

  6. 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

    Directory of Open Access Journals (Sweden)

    Veronica Sikka

    2017-01-01

    Full Text Available 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.

  7. 42 CFR 409.24 - Medical social services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

  8. 75 FR 62348 - Reimbursement Offsets for Medical Care or Services

    Science.gov (United States)

    2010-10-08

    ... Offsets for Medical Care or Services AGENCY: Department of Veterans Affairs. ACTION: Proposed rule... reimbursement of medical care and services delivered to veterans for nonservice-connected conditions. The... 2900-AN55, Reimbursement Offsets for Medical Care or Services.'' Copies of comments received will be...

  9. 76 FR 37201 - Reimbursement Offsets for Medical Care or Services

    Science.gov (United States)

    2011-06-24

    ... Offsets for Medical Care or Services AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY... reimbursement of medical care and services delivered to veterans for nonservice-connected conditions. This rule... States reasonable charges for the cost of medical care or services furnished to a veteran for a...

  10. Information infrastructure for emergency medical services.

    Science.gov (United States)

    Orthner, Helmuth; Mishra, Ninad; Terndrup, Thomas; Acker, Joseph; Grimes, Gary; Gemmill, Jill; Battles, Marcie

    2005-01-01

    The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We propose a conceptual model to enable improved clinical decision making in the pre-hospital environment using these change agents.

  11. Summative service and stakeholder evaluation of an NHS-funded community Pharmacy Emergency Repeat Medication Supply Service (PERMSS)

    OpenAIRE

    Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

    2016-01-01

    Objectives: Service and stakeholder evaluation of an NHS-funded service providing out-ofhours (OOH) emergency repeat medications to patients self-presenting at community pharmacies. Setting: Community pharmacies across the North East of England accredited to provide this service. Participants: Patients self-presenting to community pharmacies during OOH periods with emergency repeat medication supply requests. Intervention: Community pharmacists assessed each request for clinical appr...

  12. Can Collaboration Provide Integrated Services for Prisoners in Norway?

    Directory of Open Access Journals (Sweden)

    Gunnar Vold Hansen

    2015-12-01

    Full Text Available In this article, my contention is that Norway's criminal justice policy is increasingly based on principles taken from positive criminology. This means that the correctional service places strong emphasis on establishing collaboration with the local authorities (the municipalities in order to offer convicted persons integrated services, both during and after serving their sentences. I also point out that positive criminology's principle of viewing convicted persons as unique individuals with individual problems and resources – problems to which there are rarely clear-cut solutions – means that these problems are perceived as 'wicked problems'. A recommended approach to 'wicked problems' is to establish collaboration between the different service providers involved. The article describes the experiences gained from a pilot project that entailed offering a training programme to convicted persons with substance abuse problems. One of the goals of the project was to link the programme to an offer of integrated services after the sentence had been served. The experiences described in semi-structured interviews with 16 convicted persons, seven correctional service employees and three local authority employees was that it was difficult to put in place such an integrated service package. On this basis, I discuss the reasons why it was so difficult to achieve the desired collaboration, and I outline some proposals for how these challenges can be resolved in future.

  13. Ecosystem services provided by groundwater dependent wetlands in karst areas

    Science.gov (United States)

    Massimo Delle Grazie, Fabio; Gill, Laurence

    2017-04-01

    Ecosystem services provided by groundwater dependent wetlands in karst areas Turloughs are topographic depressions in karst, which are intermittently flooded on an annual cycle via groundwater sources and have substrate and/or ecological communities characteristic of wetlands. Turloughs are designated a Priority Habitat in Annex 1 of the EU Habitats Directive (92/43/EEC) as well as GWDTEs under the Water Framework Directive (WFD). Hydrology is the primary driver of these unique ecosystems and so a rigorous understanding of the flooding regime is required in order to assess their conservation and future sustainability. This research aims to identify and quantify the ecosystem services associated with turloughs, particularly in relation to the need for habitat conservation in the face of external pressures associated with agriculture, road drainage schemes, water supply and wastewater disposal. The research focuses primarily on quantifying the ecosystem functions responsible for producing terrestrial hydrologic and climatic services, as well as intrinsic biodiversity services, and uses this context to lay out a blueprint for a more detailed ecosystem service assessment. These services have been quantified in appropriate units (biophysical or otherwise), based on actual or potential sustainable use levels. Available data and field studies have been used to assess the hydrological conditions necessary to sustain the biodiversity of vegetation as well as to better understand the connections between hydrology and biogeochemical cycles. The benefits of the turlough services have then been analyzed and quantified in appropriate units (ecological, socio-cultural and economic indicators) as well as monetary values. This has been done using the inVEST tool. InVEST includes models for quantifying, mapping, and valuing the benefits provided by terrestrial, freshwater, and marine systems. In particular the Habitat Risk Assessment and the Nutrient Delivery Ratio modules have been

  14. 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...

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

    DEFF Research Database (Denmark)

    Govindan, Kannan; Chaudhuri, Atanu

    2016-01-01

    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...... 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...... management, flexibility of its operations and also geographical coverage of their services....

  16. 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.

  17. 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.

  18. Managing acute medical admissions: a survey of acute medical services and medical assessment and planning units in New Zealand.

    Science.gov (United States)

    Providence, C; Gommans, J; Burns, A

    2012-01-01

    To determine the current provision of acute medical services, including the development of medical assessment and planning units (MAPUs), by district health boards (DHBs) throughout New Zealand (NZ). A questionnaire-based survey about organisation of acute medical services and establishment of MAPUs was sent to all 21 DHBs in NZ. All 21 DHBs responded. Seven DHBs serving 42% of the population have established MAPUs since 2003 and a further six have plans to do so over the next 3 years, potentially expanding service to 73% of the NZ population. All seven current MAPUs are in close proximity to and accept patients directly from emergency departments. Each MAPU has a documented target length of stay, four units have referral protocols, five provide guidelines for management of common medical emergencies and five routinely audit unit performance. Five MAPUs have cardiac monitored beds and isolation rooms. Rapid access is available to computed tomography scanning (six units), ultrasound (five) and echocardiography (four). Two units have no nominated physician leadership and two lack dedicated therapy resources. General physicians are involved in provision of acute medical services in 20 of 21 DHBs. Medical assessment and planning units have become an important component of acute medical service provision in NZ. The established units largely comply with Australasian recommendations, although important deficiencies exist. Training of physicians must combine the needs of acute medical patients and clinical roles of physicians within MAPUs with local DHB requirements for services to be most effective. © 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.

  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 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.

  20. Note from the CERN Medical Service FLU VACCINATION

    CERN Document Server

    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.

  1. 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.

  2. 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…

  3. The relationship between innovation in services and standardization : Emperical evidence of service providers' involvement in standardization

    NARCIS (Netherlands)

    P. Wakke (Paul); K. Blind (Knut); H.J. de Vries (Henk)

    2012-01-01

    textabstractExtant research suggests a positive and bidirectional relation between innovation and standardization. Focusing on the service industries, this paper relates the theory of innovation in services to the participation of service providers in standardization committees. For this purpose, we

  4. Providing Health Care Service-learning Experiences for IPPE Credit

    Directory of Open Access Journals (Sweden)

    Kassandra M. Bartelme, Pharm.D.

    2011-01-01

    Full Text Available Service-learning (SL provides an opportunity for students to learn personal and professional skills while providing a useful service to the community. Many pharmacy education programs use SL within their curriculum because of the benefits to the community, the faculty, the learning institution and the student(s. While SL has been used in schools/colleges of pharmacy for many years, SL that also fulfills IPPE requirements is newer. This paper seeks to promote the use of combined SL/IPPE experiences. It provides an example where students volunteered at federally qualified health centers and also reviews the ACPE Standards related to SL. Schools/colleges of pharmacy are encouraged to design mechanisms for students to participate in combined SL/IPPE experiences as part of their IPPE requirements.

  5. A Nationwide Evaluation of Services Provided to Domestic Violence Survivors at Shelters in Bosnia-Herzegovina.

    Science.gov (United States)

    Muftić, Lisa R; Deljkić, Irma; Fansher, Ashley K

    2016-04-27

    The shelter movement in Bosnia-Herzegovina was born out of a tradition of assisting survivors of gender-based violence in the early 1990s during the Bosnian conflict. To date, nine shelters are in existence providing emergency shelter and services to survivors. Little is known about these shelters, or the clients these shelters serve. The purpose of this study is to examine what services are provided to domestic violence survivors by shelters in Bosnia-Herzegovina and who these survivors are. A total of 43 service providers from all existing shelters within the country were surveyed about shelter characteristics, client demographics, and services provided. Findings revealed that the typical Bosnian shelter had been in operation for 11 years and had assisted 64 survivors in the previous year; the majority of whom were married females with minor children who had sought shelter services before. Core services were provided by the majority of shelters, including crisis services, legal and medical advocacy, counseling, and community education. While services were provided to a diverse group of survivors (e.g., children, elderly women, victims of human trafficking), shelters were less likely to be available for male and lesbian, gay, bisexual, and transgender survivors. Implications from these findings, as well as limitations and suggestions for further research, are discussed. © The Author(s) 2016.

  6. 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.

  7. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Physicians' services and medical and surgical... Definitions § 440.50 Physicians' services and medical and surgical services of a dentist. (a) “Physicians... licensed under State law to practice medicine or osteopathy. (b) “Medical and surgical services of a...

  8. 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.

  9. 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...

  10. Optimizing medical data quality based on multiagent web service framework.

    Science.gov (United States)

    Wu, Ching-Seh; Khoury, Ibrahim; Shah, Hemant

    2012-07-01

    One of the most important issues in e-healthcare information systems is to optimize the medical data quality extracted from distributed and heterogeneous environments, which can extremely improve diagnostic and treatment decision making. This paper proposes a multiagent web service framework based on service-oriented architecture for the optimization of medical data quality in the e-healthcare information system. Based on the design of the multiagent web service framework, an evolutionary algorithm (EA) for the dynamic optimization of the medical data quality is proposed. The framework consists of two main components; first, an EA will be used to dynamically optimize the composition of medical processes into optimal task sequence according to specific quality attributes. Second, a multiagent framework will be proposed to discover, monitor, and report any inconstancy between the optimized task sequence and the actual medical records. To demonstrate the proposed framework, experimental results for a breast cancer case study are provided. Furthermore, to show the unique performance of our algorithm, a comparison with other works in the literature review will be presented.

  11. 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

    2017-01-26

    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.

  12. 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.

  13. 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.

  14. 360º Degree Requirement Elicitation Framework for Cloud Service Providers

    Directory of Open Access Journals (Sweden)

    Versha Saxena

    2015-03-01

    Full Text Available Thisstudy addresses the factors responsible for cloud computing adoption in implementing cloud computing for any organization. Service Level Agreements play a major role for cloud consumer as well as for cloud provider. SLA depends on the requirements gathered by the cloud providers and they vary with the type of organizations for which process is being performed such as education, retail, IT industry etc. SLAs for cloud computing involves technical as well as business requirements which makes the gathering of requirements from stakeholders point of view the heterogeneous process. This research work proposes a 360 degree requirement gathering framework, which reduces the complexitiesduring the process of requirement gathering by cloud service providersas well as SLAs more reliant.

  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 with at the beginning of the pollination season. This shortfall needs to be regained while still servicing the vegetable industry during February and March and the canola industry during August. E.cladocalyx provides a much necessary improvement in colony health.... conferruminata (previously incorrectly known as E. lehmannii in South Africa) August Canola Fynbos (if canola is not available) September Deciduous fruit E. camaldulensis (for those colonies not on deciduous fruit) October Deciduous fruit E. camaldulensis...

  16. 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.

  17. Improving continence services for older people from the service-providers' perspective: a qualitative interview study.

    Science.gov (United States)

    Orrell, Alison; McKee, Kevin; Dahlberg, Lena; Gilhooly, Mary; Parker, Stuart

    2013-07-30

    To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. 3 acute and 13 primary care National Health Service Trusts in England. 16 continence service leads in England actively treating and managing older people with UI. In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. Custom HL7 V3 message provider using web services security features.

    Science.gov (United States)

    Voos, Javier; Riva, Guillermo; Zerbini, Carlos; Centeno, Carlos; Gonzalez, Eduardo

    2010-01-01

    Due the availability of new data transmission technologies and new standards for medical studies development, e-health systems have had a sustained adoption in recent years. In this scenario, the health systems are incorporating and increasing the health services offering in response to their needs. This paper presents a system able to transmit medical studies using different communication channels providing an effective use of the medical equipment, the data transmission networks and the human resources availability. This system is based on service oriented architecture (SOA) to propose different alternatives in terms of which data needs to be transmitted for the acquired medical study, in order to attend different medical diagnosis providing an efficient use of the available communication channels. About the security implemented for the data transmission, there are different configurations available for encryption and signing at message level, to ensure that messages cannot be changed without detection during the transmission. For message definition, the HL7 V3 standard is implemented and the medical studies are stored in a centralized database located in a web server accessible via Internet to enable second medical opinion from other specialists.

  4. Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers

    Directory of Open Access Journals (Sweden)

    Riggs Elisha

    2012-05-01

    Full Text Available Abstract Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years. Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making

  5. 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.

  6. 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.

  7. 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

  8. 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...

  9. Proposition of a multicriteria model to select logistics services providers

    Directory of Open Access Journals (Sweden)

    Miriam Catarina Soares Aharonovitz

    2014-06-01

    Full Text Available This study aims to propose a multicriteria model to select logistics service providers by the development of a decision tree. The methodology consists of a survey, which resulted in a sample of 181 responses. The sample was analyzed using statistic methods, descriptive statistics among them, multivariate analysis, variance analysis, and parametric tests to compare means. Based on these results, it was possible to obtain the decision tree and information to support the multicriteria analysis. The AHP (Analytic Hierarchy Process was applied to determine the data influence and thus ensure better consistency in the analysis. The decision tree categorizes the criteria according to the decision levels (strategic, tactical and operational. Furthermore, it allows to generically evaluate the importance of each criterion in the supplier selection process from the point of view of logistics services contractors.

  10. 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

  11. The field hospital at Zagreb: tri-service medical care in a peacekeeping operation.

    Science.gov (United States)

    Reed, R J; Martino, J; Eyestone, S M; Pugh, W M

    1998-06-01

    The objective of this investigation was to provide military medical planners with insights into the specific materiel, skills, and information requirements demanded by humanitarian missions through review of approximately 16,000 records from a tri-service medical patient database used at the field hospital in Zagreb, Croatia, during Operation Provide Promise. This review describes (1) the origin, rationale, structure, and implementation of the database; (2) the patients who used medical services provided by the hospital; (3) the diagnoses encountered in outpatient visits, admissions, and surgical operations; and (4) the distribution of medical services used by various subgroups of interest.

  12. 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.

  13. 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.

  14. [Use of functional packages of medical stuff by military level of medical service of the Armed Forces].

    Science.gov (United States)

    Miroshnichenko, Iu V; Kononov, V N; Miliaev, A V; Stupnikov, A V; Slobodeniuk, A V

    2013-11-01

    Authors submitted results of recent developments made by The Kirov Military-Medical Academy and OOO "Special medical equipment" in accordance with State defence order in the area of modernization of the system of organizational equipment of military level of medical service of the Armed Forces of the Russian Federation. Along with other samples of organizational equipment, new functional equipment of medical stuff was developed and approved as supply. New equipment of medical stuff meets modern requirements and is highly valuated by medical services of foreign countries. Authors came to conclusion that functional equipment which is approved as supply and included into the Supply rate provides operational flexibility of set-up/tear-down stages of medical evacuation under the conditions of battlefield, allows to deliver medical aid on the basis of innovative medical technologies.

  15. 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.

  16. Addressing Needs of Military Families during Deployment: Military Service Providers' Perceptions of Integrating Support Services

    Science.gov (United States)

    Hayden, Seth Christian Walter

    2011-01-01

    Service providers are increasingly recognizing the need to develop effective methods for delivering supporting services to military families during deployment. Research suggests that military families experience increased levels of stress during the cycle of deployment. Bronfenbrenner (1979) conceptualized the family operating within the context…

  17. 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.

  18. 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.

  19. Implementing the National Service Framework for Long-Term (Neurological) Conditions: service user and service provider experiences.

    Science.gov (United States)

    Sixsmith, Judith; Callender, Matthew; Hobbs, Georgina; Corr, Susan; Huber, Jörg W

    2014-01-01

    This research explored the experiences of service users and providers during the implementation of the National Service Framework (NSF) for Long-Term (Neurological) Conditions (LTNCs). A participatory qualitative research design was employed. Data were collected using 50 semi-structured interviews with service users, 25 of whom were re-interviewed on three occasions. Forty-five semi-structured interviews were also conducted with service providers who worked with individuals with LTNCs. Interviews focused on health, well-being and quality of life in relation to service provision, access and delivery. Data were thematically analysed individually and collaboratively during two data analysis workshops. Three major themes were identified that related to the implementation of the NSF: "Diagnosis and treatment", "Better connected services" and "On-going rehabilitation". Service users reported that effective care was provided when in hospital settings but such treatments often terminated on return to their communities despite on-going need. In hospital and community settings, service providers indicated that they lacked the support and resources to provide continuous care, with patients reaching a crisis point before referral to specialist care. This research highlighted a range of issues concerning the recent UK-drive towards patient-centred approaches within healthcare, as service users were disempowered within the LTNC care pathway. Moreover, service providers indicated that resource constraints limited their ability to provide long-term, intensive and integrated service provision. Our research suggests that many service users with long-term neurological conditions experienced disconnections between services within their National Service Framework care pathway. For health and social care practitioners, a lack of continuity within a care pathway was suggested to be most pertinent following immediate care and moving to rehabilitative care. Our findings also indicate that

  20. 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.

  1. 78 FR 76061 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2013-12-16

    ....009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care... Domiciliary Care; 64.015, Veterans State Nursing Home Care; 64.018, Sharing Specialized Medical Resources; 64... furnished hospital care, nursing home care, domiciliary care, or medical services, and requires medical...

  2. Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, J.; Pesaran, A.

    2013-05-01

    Battery electric vehicles (BEVs) could significantly reduce the nation's gasoline consumption and greenhouse gas emissions rates. However, both the upfront cost and the limited range of the vehicle are perceived to be deterrents to the widespread adoption of BEVs. A service provider approach to marketing BEVs, coupled with a battery swapping infrastructure deployment could address both issues and accelerate BEV adoption. This presentation examines customer selection, service usage statistics, service plan fees and driver economics. Our results show it is unlikely that a battery swapping service plan will be more cost-effective than ownership of a conventional vehicle. A battery swapping service plan may be a more cost-effective solution than a directly owned BEV for some single-vehicle, high-mileage consumers. However, other factors not considered in this analysis could decrease the viability of such a service.

  3. Reflections on a Medical Service Trip: Did we do the right thing?

    Directory of Open Access Journals (Sweden)

    Rene Franco

    2013-09-01

    Full Text Available Medical service trips have a long and distinguished history. In the United States,interest in medical outreach trips has grown substantially, as medical schools andnon-governmental organizations support numerous overseas endeavors at an estimatedcost of 250 million dollars a year. Although providing care to those in need is arewarding experience, the question that needs to be answered is whether these tripsdo more harm than good. We describe our experience during a medical service trip toEnsenada, Mexico. We treated over 500 people for numerous problems, but due to thelack of services were not able to monitor or ensure follow-up. Did we do more harmby providing medications that can have serious side effects? Recommendations havebeen developed to help short-term international medical service trips provide the bestoverall experience for the participants and the best care for the patients.

  4. Data services providing by the Ukrainian NODC (MHI NASU)

    Science.gov (United States)

    Eremeev, V.; Godin, E.; Khaliulin, A.; Ingerov, A.; Zhuk, E.

    2009-04-01

    At modern stage of the World Ocean study information support of investigation based on ad-vanced computer technologies becomes of particular importance. These abstracts are devoted to presentation of several data services developed in the Ukrainian NODC on the base of the Ma-rine Environmental and Information Technologies Department of MHI NASU. The Data Quality Control Service Using experience of international collaboration in the field of data collection and quality check we have developed the quality control (QC) software providing both preliminary(automatic) and expert(manual) data quality check procedures. The current version of the QC software works for the Mediterranean and Black seas and includes the climatic arrays for hydrological and few hydrochemical parameters based on such products as MEDAR/MEDATLAS II, Physical Oceanography of the Black Sea and Climatic Atlas of Oxygen and Hydrogen Sulfide in the Black sea. The data quality check procedure includes metadata control and hydrological and hydrochemical data control. Metadata control provides checking of duplicate cruises and pro-files, date and chronology, ship velocity, station location, sea depth and observation depth. Data QC procedure includes climatic (or range for parameters with small number of observations) data QC, density inversion check for hydrological data and searching for spikes. Using of cli-matic fields and profiles prepared by regional oceanography experts leads to more reliable results of data quality check procedure. The Data Access Services The Ukrainian NODC provides two products for data access - on-line software and data access module for the MHI NASU local net. This software allows select-ing data on rectangle area, on date, on months, on cruises. The result of query is metadata which are presented in the table and the visual presentation of stations on the map. It is possible to see both metadata and data. For this purpose it is necessary to select station in the table of

  5. 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.

  6. Monitoring consumer satisfaction with the clinical services provided to 'exceptional' children.

    Science.gov (United States)

    Sommers, P A; Nycz, G R

    1978-09-01

    Given recent federal and state legislation mandating all necessary services for children with handicapping conditions, it is incumbent upon the providers of health care services to demonstrate accountability for their services to children with special needs. A procedure to assess the satisfaction of parents and community-based case coordinators with clinical services provided to such children has been demonstrated. By focusing on specific service elements, it is possible to align optimum versus actual consumer satisfaction. Through an analysis of observed variance, the modification of documented weaknesses can decrease the difference between optimum and actual consumer satisfaction levels. This procedure will be continued on a bi-annual, longitudinal follow-up basis to monitor progress. The concept of consumer input into the provision of clinical services is relevant to other developments in the field of health care which place importance on administration accountability. Those health care providers who recognize the value of consumer input and allow for its incorporation into their service programs will be better able to adapt their systems to the emerging trend towards medical accountability. Self-ordered accountability is more meaningful, is easier to understand than government imposed regulations, and can be smoothly blended into an organization's goals and objectives.

  7. 77 FR 75499 - Reasonable Charges for Medical Care or Services; V3.12, 2013 Calendar Year Update and National...

    Science.gov (United States)

    2012-12-20

    ... AFFAIRS Reasonable Charges for Medical Care or Services; V3.12, 2013 Calendar Year Update and National... for calculating the ``Reasonable Charges'' collected or recovered by VA for medical care or services... ``Reasonable Charges'' for medical care or services provided or furnished by VA to a veteran for: (1) A...

  8. 78 FR 42455 - Medications Prescribed by Non-VA Providers

    Science.gov (United States)

    2013-07-16

    ... programs or the rights and obligations of recipients thereof; or (4) Raise novel legal or policy issues....009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care... Domiciliary Care; 64.015, Veterans State Nursing Home Care; 64.018, Sharing Specialized Medical Resources; 64...

  9. 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

  10. 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 (state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

  11. 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.

  12. 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.

  13. 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.

  14. Continuous Care Provided Through Comprehensive Medication Management in an Acute Care Practice Model.

    Science.gov (United States)

    Marr, T David; Pinelli, Nicole R; Jarmul, Jamie A; Waldron, Kayla M; Eckel, Stephen F; Cicci, Jonathan D; Bates, Jill S; Amerine, Lindsey B

    2017-10-01

    Pharmacy practice models that foster pharmacists' accountability for medication-related outcomes are imperative for the profession. Comprehensive medication management (CMM) is an opportunity to advance patient care. The objective of this study was to evaluate the impact of a CMM practice model in the acute care setting on organizational, patient, and financial outcomes. Three adult service lines focused on at-risk patients identified using internal risk stratification methodology were implemented. Core CMM elements included medication reconciliation, differentiated clinical pharmacy services, inpatient MTM consultations, discharge services, and documentation. Mixed methods compared the effect of the CMM model before and after implementation. Historical patients served as comparative controls in an observational design. Pharmacists completed a 60-minute interview regarding their experiences. Qualitative data were analyzed using thematic coding to characterize perception of the model. Three pharmacists implemented the model on cardiology, hematology/oncology, and surgery transplant services and provided services to 75 patients during the study. A total of 145 medication-related problems were identified and resolved. CMM was associated with a nonsignificant reduction of 8.8% in 30-day hospital readmission rates ( P = 0.64) and a 24.9% reduction in 30-day hospital utilization ( P = 0.41) as well as a significant reduction of 86.5% in emergency department visits ( P = 0.02). Patients receiving discharge prescriptions from our outpatient pharmacies increased by 21.4%, resulting in an 11.3% increase in discharge prescription capture and additional revenue of $5780. Themes identified from qualitative interviews included CMM structure, challenges, value, and resources. This study demonstrated successful implementation of a CMM model that positively affected organizational, patient, and financial outcomes.

  15. 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.

  16. 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

  17. Research Update. Providing Leisure Services for Gays and Lesbians.

    Science.gov (United States)

    Grossman, Arnold H.

    1993-01-01

    There is a paucity of research on leisure services for gays and lesbians. The article highlights research on homosexuals, from various disciplines; it focuses on gay and lesbian youth and notes practical implications for leisure service delivery. (SM)

  18. 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...

  19. 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.

  20. 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.

  1. The search for an effective medical care service for Nigeria ...

    African Journals Online (AJOL)

    Although not always well appreciated by the general public, medical service in Nigeria consists of two main braches or divisions - a Public Health Division which deals with social and preventive medicine and a medical Division which deals with curative medicine. The level and efficiency of the Public Health Service reflects ...

  2. 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 (LoAIN). 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 (LoAON) 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 (LoAFor).

  3. 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.

  4. Emotional intelligence competencies provide a developmental curriculum for medical training.

    Science.gov (United States)

    Stoller, James K; Taylor, Christine A; Farver, Carol F

    2013-01-01

    Since healthcare faces challenges of access, quality, and cost, effective leadership for healthcare is needed. This need is especially acute among physicians, whose demanding training focuses on scientific and clinical skills, eclipsing attention to leadership development. Among the competencies needed by leaders, emotional intelligence (EI) - defined as the ability to understand and manage oneself and to understand others and manage relationships - has been shown to differentiate between great and average leaders. In this context, teaching EI as part of the medical training curriculum is recommended. Furthermore, because physicians' developmental needs evolve over the course of prolonged training, specific components of EI (e.g., teambuilding, empathy, and negotiation) should be taught at various phases of medical training. Consistent with the concept of a spiral curriculum, such EI competencies should be revisited iteratively throughout training, with differing emphasis and increasing sophistication to meet evolving needs. For example, teamwork training is needed early in undergraduate medical curricula to prompt collaborative learning. Teamwork training is also needed during residency, when physicians participate with differing roles on patient care teams. Training in EI should also extend beyond graduate medical training to confer the skills needed by clinicians and by faculty in academic medical centers.

  5. A comparison of patients' and pharmacists' satisfaction with medication counseling provided by community pharmacies: a cross-sectional survey.

    Science.gov (United States)

    Yang, Seungwon; Kim, Dasohm; Choi, Hye Joung; Chang, Min Jung

    2016-04-14

    Medication counseling is a critical component of pharmaceutical care to promote the safe and effective use of medications and to maximize therapeutic outcomes. The assessment of patients' and pharmacists' satisfaction with medication counseling services could be one of the vital parameters for predicting the quality of pharmacy services. No study has measured and compared both patients' and pharmacists' satisfaction with medication counseling. The objectives of this study were to describe and compare patients' and pharmacists' levels of satisfaction with medication counseling services offered by community pharmacists in South Korea. This was a descriptive, cross-sectional survey. The online survey was distributed to patients and community pharmacists using a structured questionnaire. The questionnaires consisted of 4 main areas: (1) responders' characteristics (2) current state of medication counseling methods provided by community pharmacies (3) overall satisfaction with medication counseling (4) demand for the development of medication counseling standards. A comparison between patients and pharmacists was made using either a chi-square test or a Fisher's exact test. Between June 13, 2014 and July 15, 2014, a total of 252 patients and 620 pharmacists completed the survey. It was found that 47.3% of pharmacists and 34.0% of patients were satisfied with the current medication counseling service. Pharmacists showed a higher degree of satisfaction with the medication counseling service compared to patients (p <0.05). A major reason for patients not being satisfied with the medication counseling from community pharmacists was the insufficient time spent on counseling (51.2%). The pharmacists' perception of a major barrier to providing appropriate medication counseling for patients was the lack of time (24.3%). Moreover, a substantial number of patients (88%) and pharmacists (73%) supported the development of medication counseling standards to improve community

  6. 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.

  7. 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...

  8. Application of a Health Service Growth Model to Determine the Management Requirements of Health Service Providers.

    Science.gov (United States)

    1980-09-01

    BACKGROUND AND INTRODUCTION ...... ............. 9 II. APPROACH ......... ...................... 13 Methodology ........ ................... .13 Data...1 N ~12 II. APPROACH Methodology In contemplating which methods were to be used in this study to determine whether a physician or an administrator...system, while sig- nificant, does not have as large a scope. 51 Kaiser is rated highest in provider compensation because the Permanente Medical Group ( PMG

  9. Providing quality reference services at a special library

    OpenAIRE

    Semertzaki, Eva (Semertzaki-Koutra, 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.

  10. A Service Learning Program in Providing Nutrition Education to Children

    OpenAIRE

    Falter, Rebecca A.; Pignotti-Dumas, Karla; Popish, Sarah J.; Petrelli, Heather M.W.; Best, Mark A.; Wilkinson, Julie J.

    2011-01-01

    Objective. To implement a service learning program in nutrition and assess its impact on pharmacy students' communication skills and professionalism and elementary school children's knowledge of nutrition concepts.

  11. A service learning program in providing nutrition education to children

    National Research Council Canada - National Science Library

    Falter, Rebecca A; Pignotti-Dumas, Karla; Popish, Sarah J; Petrelli, Heather M W; Best, Mark A; Wilkinson, Julie J

    2011-01-01

    To implement a service learning program in nutrition and assess its impact on pharmacy students' communication skills and professionalism and elementary school children's knowledge of nutrition concepts...

  12. Why are organisations that provide healthcare services fuzzy?

    Science.gov (United States)

    Hempe, Eva-Maria

    2013-01-01

    Healthcare organisations are an enigma to many people inand outside the service. Organisational fuzziness is a common state, characterised by a lack of clarity, lack of awareness, lack of organisational knowledge, and the reliance on practice and custom instead of transparency. The objective of this study was to obtain a better understanding of what causes this fuzziness and provide an actionable description of fuzzy organisations. Such a description is essential to managing and preventing organisational fuzziness. We used a longitudinal case study in an integrated healthand social care organisation to obtain a thorough understanding of how the organisation functions. These indepth insights allowed the identification of three generators of fuzziness. We found that the three main generators of organisational fuzziness are change, informal organisation and complexity. Organisational fuzziness is thus partly due to the inherent complexities of human systems. However, also continuous change and the inability of the system to adapt its formal structures resulted in structures deteriorating or no longer being appropriate. Existing approaches to explain unclear or absent structures in healthcare organisations by describing these organisations as complex adaptive systems (CAS) are too simplistic. While aspects relating to people and their interactions are indeed complex, fuzziness of structural aspects are often the result of continuous change and insufficient organisational capacity to adapt to it.

  13. Why some physicians envy dentists: the applications service provider.

    Science.gov (United States)

    LeBeau, S A

    2001-03-01

    To summarize, here's what I get from my ASP. My staff and I can access our schedules, patient information, etc, any time and from anywhere--not just from the office PC. All I need is a standard Internet browser and a connection to the Internet. Only authorized personnel have access to my data. My online practice management system is password protected and operates with Verisign SSL--the highest level of Internet security. All information is stored in my secure database, which my ASP backs up and replicates continuously. Dental. PackOnline even operates dual servers. In case one server has a problem, they just switch to the other server, so I never have to worry about "down-time." I can give patients access to their own information online-treatment plans, patient education material, balances, etc, in a highly private and confidential manner. I can share patient information, x-rays, and other materials online with colleagues, specialists, and labs, again in a highly confidential manner. I send out billing, recalls, claims, and more automatically because my ASP has real-time connections to service providers. No more time spent printing, folding, stamping cards, billing, or processing claims. This is a tremendous cost and time saver!

  14. Supplanting ecosystem services provided by scavengers raises greenhouse gas emissions

    Science.gov (United States)

    Morales-Reyes, Zebensui; Pérez-García, Juan M.; Moleón, Marcos; Botella, Francisco; Carrete, Martina; Lazcano, Carolina; Moreno-Opo, Rubén; Margalida, Antoni; Donázar, José A.; Sánchez-Zapata, José A.

    2015-01-01

    Global warming due to human-induced increments in atmospheric concentrations of greenhouse gases (GHG) is one of the most debated topics among environmentalists and politicians worldwide. In this paper we assess a novel source of GHG emissions emerged following a controversial policy decision. After the outbreak of bovine spongiform encephalopathy in Europe, the sanitary regulation required that livestock carcasses were collected from farms and transformed or destroyed in authorised plants, contradicting not only the obligations of member states to conserve scavenger species but also generating unprecedented GHG emission. However, how much of this emission could be prevented in the return to traditional and natural scenario in which scavengers freely remove livestock carcasses is largely unknown. Here we show that, in Spain (home of 95% of European vultures), supplanting the natural removal of dead extensive livestock by scavengers with carcass collection and transport to intermediate and processing plants meant the emission of 77,344 metric tons of CO2 eq. to the atmosphere per year, in addition to annual payments of ca. $50 million to insurance companies. Thus, replacing the ecosystem services provided by scavengers has not only conservation costs, but also important and unnecessary environmental and economic costs.

  15. Key Aspects of Providing Healthcare Services in Disaster Response Stage.

    Science.gov (United States)

    Pourhosseini, Samira Sadat; Ardalan, Ali; Mehrolhassani, Mohammad Hossien

    2015-01-01

    Health care management in disasters is one of the main parts of disaster management. Health in disasters is affected by performance of various sectors, and has an interactive impact on various aspects of disaster management. The aim of this study was to identify the most important themes affecting the healthcare management in disaster. In this qualitative study with a content analysis approach, in-depth interviews in two steps with 30 disaster experts and managers were conducted to collect the data. Eleven themes affecting healthcare management in disasters were identified. These themes were related to human resources management, resources management, victims' management transfer, environmental hygiene monitoring, nutrition management, mental health control, inter-agency coordination, training, technology management, information and communication management, and budget management. Providing effective health care service in disasters requires a comprehensive look at the various aspects of disaster management. Effective factors on the success of healthcare in disaster are not limited to the scope of healthcare. There should be a close relationship and interaction between different sectors of disaster management.

  16. The effects of cultural diversity on providing health services.

    Science.gov (United States)

    Kreitler, S

    2005-01-01

    The purpose of the study was to highlight major aspects and problems of cultural diversity in the context of providing health services, and to suggest means for overcoming problems in this context. The major issues discussed were communication as a culture-dependent process, paradigms of relationships between the health professional and the patient, and the potential of various communication features to serve as barriers or bridges between the patient and the health professional. In order to overcome inhibitory effects of cultural diversity on communication, two theoretical approaches were presented. One approach was grounded in the theory of meaning that deals with processing information, the other in cognitive orientation theory that deals with predicting, understanding and changing behaviours. Results demonstrated how to overcome stereotypes and other communication barriers by means of awareness of meanings and expansion of meanings of the relevant stimuli (e.g., patient), and by means of promoting the production of a motivational disposition grounded in beliefs about oneself, about reality, about norms and about one's goals. In summary it is possible to overcome communication barriers and other difficulties potentially dependent on cultural diversity and produce an environment in which cultural diversity is an advantage rather than a source of problems.

  17. Development of a medication review service for patients with enteral tubes in a community teaching hospital.

    Science.gov (United States)

    Li, Tracey; Eisenhart, Alison; Costello, Jennifer

    2017-06-01

    The results of a study to develop a hospital-wide medication review service for patients with enteral tubes to improve patient safety are presented. Inappropriate enteral administration of medications can result in occluded tubes, altered clinical response, and an increase in adverse effects. At Saint Barnabas Medical Center, a 600-bed community teaching hospital located in Livingston, New Jersey, a medication review service for patients with an enteral tube was developed. A phased approach was used. In phase 1, a retrospective chart review revealed that 43% of our patients with enteral tubes received at least one medication that should not be crushed. In phase 2, we identified formulary medications that should not be crushed based on guidance from the Institute for Safe Medication Practices. We added a "do not crush" warning to the identified medications in our electronic medication administration record and automated medication dispensing system. In phase 3, we created an automatic substitution list of medications. Phase 4 involved the development of the program in our health information technology platform. An electronic task list alerted pharmacists about patients with enteral tubes who required medication review and potential medication substitutions, as well as patients with newly removed enteral tubes who can be placed back on their original medications. In phase 5, we provided education to prescribers, nurses, and pharmacists. A hospital-wide medication review service for patients with enteral tubes at our community teaching medical center was developed. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. Smartphone app use among medical providers in ACGME training programs.

    Science.gov (United States)

    Franko, Orrin I; Tirrell, Timothy F

    2012-10-01

    The past decade has witnessed the advent of the smartphone, a device armed with computing power, mobility and downloadable "apps," that has become commonplace within the medical field as both a personal and professional tool. The popularity of medically-related apps suggests that physicians use mobile technology to assist with clinical decision making, yet usage patterns have never been quantified. A digital survey examining smartphone and associated app usage was administered via email to all ACGME training programs. Data regarding respondent specialty, level of training, use of smartphones, use of smartphone apps, desired apps, and commonly used apps were collected and analyzed. Greater than 85% of respondents used a smartphone, of which the iPhone was the most popular (56%). Over half of the respondents reported using apps in their clinical practice; the most commonly used app types were drug guides (79%), medical calculators (18%), coding and billing apps (4%) and pregnancy wheels (4%). The most frequently requested app types were textbook/reference materials (average response: 55%), classification/treatment algorithms (46%) and general medical knowledge (43%). The clinical use of smartphones and apps will likely continue to increase, and we have demonstrated an absence of high-quality and popular apps despite a strong desire among physicians and trainees. This information should be used to guide the development of future healthcare delivery systems; expanded app functionality is almost certain but reliability and ease of use will likely remain major factors in determining the successful integration of apps into clinical practice.

  19. Evaluation of Dutch Helicopter Emergency Medical Services in transporting children.

    Science.gov (United States)

    Peters, Joost; Beekers, Christian; Eijk, Ruud; Edwards, Michael; Hoogerwerf, Nico

    2014-01-01

    In the Netherlands, helicopter emergency medical services (HEMS) function as an adjunct to paramedic ambulance service delivering hospital-level medical care to a prehospital location. The main goal of Dutch HEMS is to provide on-scene medical expertise and not primarily to serve as transport. The transportation of patients to specialized hospitals is sometimes mandatory, especially in cases of critically ill or wounded children. In the literature, no support can be found to support the safety of transportation by helicopter. We retrospectively evaluated the safety of this type of transportation and if any problems were encountered transporting children by helicopter. We reviewed our local HEMS database for all children (, 16 years) transported by helicopter to a level 1 trauma center between January 2007 and December 2012. A total number of 430 patients were transported by helicopter to a hospital (0-87 years, mean 5 31.6 years). Of these patients, 83 (19%) were younger than 16 years (0-15.7 years, mean 5 6.6 years). Causes for HEMS transport in children varied, but the main groups were road traffic accidents (40%), cardiopulmonary arrests (15%), falls from height (12%), and horse riding accidents (7%). In the children group, 1 accidental extubation of the orotracheal tube was noted while lifting the patient (10 years old) into the helicopter. This was immediately noticed, and the patient was reintubated without complications. No further adverse events were encountered during transportation time. The accidental extubation is not a specific complication of helicopter transportation but is inextricably linked with moving severely injured and intubated patients/children. We conclude that transporting children by helicopter is a safe method of transportation for critically ill children to adequately equipped medical centers. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  20. 20 CFR 30.700 - What kinds of medical records must providers keep?

    Science.gov (United States)

    2010-04-01

    ... illness or covered illness, the results of any diagnostic studies performed, and the nature of the... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What kinds of medical records must providers... for Medical Providers Medical Records and Bills § 30.700 What kinds of medical records must providers...

  1. Defining, valuing and providing ecosystem goods and services

    Science.gov (United States)

    Thomas C. Brown; John C. Bergstrom; John B. Loomis

    2007-01-01

    Ecosystem services are the specific results of ecosystem processes that either directly sustain or enhance human life (as does natural protection from the sun's harmful ultraviolet rays) or maintain the qualify of ecosystem goods (as water purification maintains the quality of streamflow). "Ecosystem service" has come to represent several related topics...

  2. Medical genetics services in the city of Sao Paulo, Brazil.

    Science.gov (United States)

    Brunoni, Decio

    2004-01-01

    The city of Sao Paulo is located in the center of a metropolitan area with nearly 18 million inhabitants and 300,000 births/year. The currently existing medical genetics services are unable to meet the demand, due to their insufficient physical and personnel infrastructure. Institutions and experts in medical genetics could give short training and refresher courses to health professionals to enable them to work in the public health network. The city has a reasonably well developed health care network, represented by the Single Health System (Sistema Unico de Saude - SUS) and by the Family Health Program (Programa de Saude da Familia - PSF). The financial resources for such actions originate in the budget of the managing agencies of such systems. The limitations of genetic services provided to the population of the city could be overcome in a short period of time by developing programs within the public health care network. The city has institutions, professionals and financial resources to make this project feasible. To that end, the competent authorities of the Sao Paulo State and City Secretariats of Health should take managerial responsibility for the genetic services in the city. Copyright (c) 2004 S. Karger AG, Basel.

  3. 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.

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

    Science.gov (United States)

    2010-01-01

    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. PMID:20470377

  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. [Medical services at Paris-Charles-de-Gaulle airport].

    Science.gov (United States)

    Bargain, Philippe

    2015-01-01

    Charles-de-Gaulle airport in Roissy, a 3 400 hectare citadel, contains a multitude of airlines, service companies, businesses, retailers and public services, including firefighters, police officers, customs officers, ministers and medical teams. This article presents its missions, notably with regard to health services. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. 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

  8. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    Science.gov (United States)

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research.

  9. Incorporating a pharmacist into an interprofessional team providing transgender care under a medical home model.

    Science.gov (United States)

    Newsome, Cheyenne; Colip, Leslie; Sharon, Nathaniel; Conklin, Jessica

    2017-02-01

    A pharmacist's role in providing care to transgender and gender-nonconforming (TGNC) patients within a medical home model of care is described. A comprehensive transgender services clinic was established in February 2015 in New Mexico. Clinic services are provided under an "informed consent" model of care, as opposed to the traditional "gatekeeper" approach. The clinic's interprofessional team consists of a clinical pharmacist, a psychiatrist, a nurse practitioner, an endocrinologist, a diabetes educator, a massage therapist, a nurse, a nutritionist, and medical assistants. The clinical pharmacist has served in the following roles: (1) assessing health literacy and tailoring the consent process to the patient's literacy level, (2) initiating in-depth discussion of the medical risks and benefits of cross-sex hormone therapy (HT), as well as HT alternatives, (3) discussing typical timelines for physical outcomes of HT, (4) discussing a patient's expectations and goals for csHT, (5) discussing the different HT formulations and helping to determine which formulation is best suited to meeting patient's goals, (6) helping the team obtain prior authorizations for csHT, and (7) managing risk reduction strategies such as smoking cessation and weight loss. Involvement of a pharmacist in the clinic has improved care access and quality for TGNC patients in the southwestern United States. A pharmacist in an interprofessional team staffing a clinic for TGNC people has assumed multiple responsibilities and helped improve patient care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Acquisition: Direct Care Medical Services Contracts

    Science.gov (United States)

    2004-06-24

    implementation of a management structure for the procurement of services . National Defense Authorization Act for FY 2001. The National Defense...and implement a management structure for the procurement of services for DoD. The management structure was to include a designated official for each...Military Department, Defense agency, and DoD Component. The designated official would be responsible for managing the procurement of services and

  11. Medical marijuana: largest provider closed, some alternatives available.

    Science.gov (United States)

    James, J S

    1998-06-05

    The Cannabis Healing Center, the largest of the medical marijuana buyers' clubs in San Francisco, was shut down on May 25 due to a court order obtained by State Attorney General Dan Lungren. The closure creates an emergency situation for thousands of persons who obtained the drug through the center. City officials are exploring ways to develop guidelines for the medical usage of marijuana that would be consistent with California Proposition 215. Proposition 215 does not nullify Federal laws against marijuana, however, Federal authorities usually allow State or local jurisdictions to handle marijuana enforcement. The three other buyers' clubs in the city are unable to meet the needs of everyone due to insufficient staffing. The closure also shut down the campaign office of Dennis Peron, who was the founder of the previous Cannabis Buyers' Club, and who was running for governor. Contact information and documentation requirements are included for the buyers' clubs.

  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. 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.

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

    Science.gov (United States)

    ... Prescribe medication Psychologist A psychologist is trained in psychology — a science that deals with thoughts, emotions and ... of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo ...

  15. 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

  16. 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.

  17. 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.

  18. 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.

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

    DEFF Research Database (Denmark)

    Rahnama, Samira; Green, Torben; Lyhne, Casper

    2017-01-01

    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......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...

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

    National Research Council Canada - National Science Library

    Luiz Ricardo Aguena Jacintho Gil de Castro; Fernando de Almeida Santos

    2012-01-01

    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...

  1. 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. USERS’ SATISFACTION WITH THE QUALITY OF MEDICAL SERVICES

    Directory of Open Access Journals (Sweden)

    I. B. Boltenkova

    2014-01-01

    Full Text Available The level of patient satisfaction with the result of the medical services received is one of the important aspects of assessment of the quality of medical care. The rendered medical care that meets the expectations and requirements of patients determines the level of their satisfaction. Insufficiently high patient satisfaction with the quality of medical services is today a problem not only for the Institute, but also for whole Russia’s public health care. The elements of market mechanisms as a quality management system are being introduced to solve intricate problems to achieve the effective work of the public health care system under limited resources. Annual assessment of the level of satisfaction of the Institute’s patients, users of medical services, and calculation of the satisfaction index make it possible to estimate changes in the activity of the Novosibirsk Research Institute of Tuberculosis and its strengths and weaknesses and to elaborate a strategy for continuous medical care quality improvement.

  4. 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.

  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. 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.

  7. Provision of clinical forensic medical services in Australia: a qualitative survey 2011/12.

    Science.gov (United States)

    Stark, Margaret M; Payne-James, J Jason

    2014-01-01

    The provision of clinical forensic medicine services is dependent on jurisdiction and relevant legal instruments. A needs analysis was performed to understand the current service provision within NSW and compare and contrast the service with other jurisdictions in Australia. The aim of this study was therefore to identify the roles, functions and clinical forensic medical services currently provided in the different Australian jurisdictions. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  8. 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...

  9. 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.

  10. [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.

  11. 77 FR 6122 - Providing Refurbishment Services to Federal Agencies

    Science.gov (United States)

    2012-02-07

    ... refurbished equipment) fit into viable business models for computer refurbishment companies? 4. How do the... process for disposing and recycling of failed equipment. Have all facilities in your recycling and... refurbishment services, including those developed specifically for recycling facilities (e.g., R2 and e-Stewards...

  12. 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...

  13. 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.

  14. 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…

  15. Perancangan Sistem Informasi Penjualan pada Perusahaan Jasa Service Provider

    Directory of Open Access Journals (Sweden)

    Lianawati Christian

    2012-06-01

    Full Text Available Along with the development of technology, every line of business as well as services needs information systems to support the company operations. This research is objected to analyze, identify information needs, repair and design accounting information system of service sales required by the management to support decision making and address the issues in the running system on a service company. Several methods were carried out on this research, such as data collection and information; analyses on the running system; analysesof research findings;, identification of information needs, and identification of system requirements, as well as object-oriented design methods, namely the problem domain analysis, application domain analysis, architecturedesign and component diagram. The results obtained in the form of improvements in the running system which was an application that informs the design of document numbering, filing, and reports. The accountinginformation system of service sales at the studied company produced needed reports timely, completely and accurately that can be utilized by the management in decision-making.

  16. Effectiveness of reference services in providing students' information ...

    African Journals Online (AJOL)

    The main purpose of establishing library in any academic environment is to serve as the information centre to the community of users. But many have failed to serve this purpose after spending lots of money due to some reason and the other. This survey study is aimed at assessing Effectiveness of Reference Services in ...

  17. 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....

  18. 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....

  19. Reporting Helicopter Emergency Medical Services in Major Incidents

    DEFF Research Database (Denmark)

    Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

    2016-01-01

    OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...

  20. How to provide tailored career coaching for medical students.

    Science.gov (United States)

    Hur, Yera; Cho, A Ra; Kim, Sun

    2015-03-01

    This study was performed to develop a counseling strategy, based on the profiles of medical students' Strong Interest Inventory (STRONG) and Myer-Briggs Type Indicator (MBTI) results, focusing on the three following questions: Into what distinct levels are students categorized by STRONG and MBTI? and What is the dispersion of the integrated profiles? Freshmen students from Konyang University College of Medicine who matriculated between March 2011 and 2013 were administered the MBTI personality type test and the STRONG interest inventory assessment. The integrated profiles were categorized per Kim et al. (2006), and frequency analysis was performed with the collected data, using SPSS version 21.0. Regarding MBTI types, 16.9% of students were categorized as ESTJ, and 12.9% was ISTJ. Further, 62.4% of students were Investigative (I) according to STRONG. The integrated profiles were divided into four types, according to their unclear/clear preference in the STRONG and MBTI results. Most students had 'clear preference and clear interest' (n=144, 80.9%), six students (3.4%) had 'clear interest but unclear preference,' and 28 students (15.7%) showed 'unclear interest but clear preference.' Using the combined results of the STRONG interest inventory assessment and MBTI tools, we can purvey more tailored information to students.

  1. Should female health providers be involved in medical male ...

    African Journals Online (AJOL)

    This study explored the acceptability, by male clients, of female clinicians taking part in the circumcision procedure. ... public space where female health providers can participate, even for men coming from traditionally non-circumcising .... circumcision should be an individual's personal informed choice and not a parental ...

  2. Adolescents' informedness about the services provided by Children's helpline

    Directory of Open Access Journals (Sweden)

    V.V. Kovrov

    2014-08-01

    Full Text Available We present the results of studies of informedness about the Children's helpline and access to remote emergency psychological assistance in the case of a difficult life situation in family, school, peer group (violence, conflicts, antivital experiences etc. in students of VII-IX grades of twenty educational organizations of general (complete education in Moscow. We discuss the reasons for reducing the likelihood of using services of the Children's Helpline, psychological barriers – conscious and unconscious – complicating the use of this service. The study showed that the need for psychological assistance, implemented by means of remote consultation, has not been formed in the majority of students in Moscow. We revealed a general rule that awareness of the Children's Helpline, the perception of its effectiveness and the motivation “to call in future” and “to recommend others to call”, are closely interrelated among respondents with experience of such calls.

  3. Sociologist as a Service Provider. Using Psychology to Support Selling

    Directory of Open Access Journals (Sweden)

    N Е Aimautova

    2011-03-01

    Full Text Available The article helms the reader to the results of the sociological services market observation. A basic selling scheme is outlined with the components of interactions space as well as the set of "must-have" psychological skills and competencies essential for the seller highlighted as factors of high priority. The principal stages of the selling process are identified. The notion of "offeror" who meets the desires of the client purchasing sociological services is introduced. The prominent role of psychological selling techniques is emphasized in the guidelines to be abided by the sociologist in order to prevent potential misunderstandings and conflicts as well as to establish new contacts and keep old ties with the client after making a deal.

  4. Considerations for Providing Counseling Services in Second Life

    Directory of Open Access Journals (Sweden)

    Debra P. Russ

    2012-11-01

    Full Text Available Second Life is a multiuser environment that can be found on the Internet. There are hundreds of counselors using Second Life as a service delivery mode. Currently, Second Life remains an unregulated avenue for practice. Counselors considering opening a practice need to investigate the benefits and disadvantages for using this medium. The author will discuss the opportunities, issues, and steps for establishing a counseling practice in Second Life.

  5. 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...

  6. Indications, medical conditions and services related to gastrostomy ...

    African Journals Online (AJOL)

    Objectives. To describe South African infants and children requiring gastrostomies in a tertiary hospital, including the indications, medical conditions and health services, during a 5-year period (2005 - 2009). Design. The research design was a retrospective descriptive survey of medical records. Setting. A tertiary paediatric ...

  7. 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

  8. Proud, not yet satisfied: the experiences of abortion service providers in the Kathmandu Valley, Nepal.

    Science.gov (United States)

    Möller, Amanda; Öfverstedt, Sofie; Siwe, Karin

    2012-12-01

    In Nepal, the change of the abortion law in 2002 extended the staff duties at family planning clinics to include performing induced abortions. This study investigated the experiences, opinions and attitudes of the staff about their work at safe abortion service centres in the Kathmandu Valley and identified areas in which the health care staff stated the need for improvement. Fifteen qualitative semi-structured interviews were conducted with doctors and nurses working with induced abortion at one hospital and five clinics in the Kathmandu Valley. The interviews were transcribed verbatim and analysed using the constant comparative method. The core category 'Proud, not yet satisfied' comprised a strong perception of providing an important service that is beneficial for women's health and a feeling of pride in providing quality service. Four related categories were identified: 'Beneficial legal framework', 'A will to reach out to all women', 'Frustration about misuse' and 'Dilemma of sex-selective abortion'. The respondents emphasised that improvements are necessary to (1) ensure that all women have access to safe abortion services; (2) prevent abortions from being used instead of contraceptives; (3) stop illegal medical abortions; and (4) deal with the dilemma of sex-selective abortions. Respondents were proud of and had positive experiences from their work. They stated they have the opportunity to secure women's rights and health; however, changes are needed to bring the quality of abortion care to a satisfactory level. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. British Coal Medical Service annual report 1989-90

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The report contains detailed results of surveys on the prevalence of pneumoconiosis in coal miners of various age groups from 1962 to 1989. Only 0.6% of 14,300 men X-rayed in 1989 showed any sign of the disease and the overall figure for the 112 collieries surveyed after the completed seventh round of surveys was 0.7%. Emphasis has continued on dust control measures on coal faces and in drivages - dust concentration of 3.1 mg/m {sup 3} in 1989-90 was in keeping with the trend since 1970. A 'cohort' of young miners is being monitored to develop an early warning system to identify changes in the incidence of pneumoconiosis. The role of Medical Service in treating injuries, skin diseases, back pain etc. and problems caused by noise and chemicals is explained. Continued attention has been paid to implication of the COSHH regulations and audiometry has been introduced to all British Coal's employees. Services are now provided to workers of Coal Products Ltd. Reports of first aid and nursing services are included. Use of pethidine for relieving pain is now being advocated. 6 figs., 20 tabs.

  10. Helicopter emergency medical service in Italy: reality and perspectives.

    Science.gov (United States)

    Marinangeli, Franco; Tomei, Marco; Ursini, Maria Laura; Ricotti, Valeria; Varrassi, Giustino

    2007-01-01

    The organization of a homogeneous medical emergency system was developed in Italy in 1999. Currently, 104 stations manage medical emergencies with ambulances and 47 helicopter-capable bases for more difficult missions. The current study describes the organization of the helicopter emergency system in Italy. Data were collected from questionnaires filled in by each base commander. Six hundred twenty-seven physicians are enrolled in helicopter-capable base emergency teams. Of those physicians, 89.5% are specialists in anesthesiology. Professional nurses are enrolled in 46 bases. Twenty-six bases specialize in search-and-rescue (SAR) missions (which take place in geographically unfriendly terrain), where a mountain rescue technician (CNSAS) is part of the team. Twenty-one bases are for missions in geographically friendly terrain (HEMS bases). Eight bases provide 24-hour service. Specialized training is given to physicians and nurses: it is considered of first level (high standard) in 21 bases, of second level (intermediary) in 17 bases, and of third level (low) in nine bases. In the mountain bases (Alps and Apennines), the more widely used helicopters are the AB412 and the BK117C1. During 2004, there were 20,660 primary interventions and 7,790 secondary interventions. From 1999 to 2004 there was a 33% increase of activity for primary and 35% for secondary interventions. The data show the activity of the helicopter-ambulance service, the role of anesthetists within the helicopter-based Advanced Cardiac Life Support (ACLS) team, and the diverse organization of training for medical staff in different regions of Italy.

  11. Customers' satisfaction about prehospital emergency medical services in Lorestan, Iran.

    Science.gov (United States)

    Heydari, Heshmatolah; Kamran, Aziz; Zali, Morad Esmaiel; Novinmehr, Nasser; Safari, Mehdi

    2017-03-01

    Patient's satisfaction with health care in ambulance services is an important quality indicator and a helpful tool for managers of prehospital emergency services. This study aimed to measure patient satisfaction with health provided by prehospital emergency medical services (EMS) in Lorestan, Iran. This cross-sectional study was conducted on patients (n=450) transferred by EMS to hospitals of Lorestan University of Medical Sciences in a two-year period (2013-2014). Data collection was performed by patient questionnaire, which is a standard LKFR tool. Validity and reliability of the instrument was confirmed by scientific method. Collected data were analyzed by SPSS Version 19. Descriptive and inferential statistics such as Chi-square, paired-samples t-test, independent-samples t-test, ANOVA, Pearson's product-moment correlation coefficient, and Fisher's exact test were used. One hundred ninety-two (42.8%) and 257 (57.2%) patients were female and male, respectively (mean: 41 years, r: 37-83). Patient satisfaction of the dispatcher was good, and satisfaction level in regards to the technicians' performance, physical situation, and facilities inside the ambulance was moderate. The Wilcoxon test did not show any significant difference between pain severity before and after arriving EMS in the cardiac and respiratory patients (p=0.691), but severity of pain in orthopedic patients after arriving EMS was decreased (p=0.001). Cardiac and respiratory patients had low satisfaction of EMS, and the Chi-square test was significant (p=0.001). Orthopedic patients had the most satisfaction of EMS. Generally, patients' satisfaction of EMS was low. Satisfaction with pain relief in orthopedic patients was better than pain relief in cardiac and respiratory patients. It is recommended to take necessary actions to improve the level of patient satisfaction of EMS.

  12. Customers’ satisfaction about prehospital emergency medical services in Lorestan, Iran

    Science.gov (United States)

    Heydari, Heshmatolah; Kamran, Aziz; Zali, Morad Esmaiel; Novinmehr, Nasser; Safari, Mehdi

    2017-01-01

    Introduction Patient’s satisfaction with health care in ambulance services is an important quality indicator and a helpful tool for managers of prehospital emergency services. This study aimed to measure patient satisfaction with health provided by prehospital emergency medical services (EMS) in Lorestan, Iran. Methods This cross-sectional study was conducted on patients (n=450) transferred by EMS to hospitals of Lorestan University of Medical Sciences in a two-year period (2013–2014). Data collection was performed by patient questionnaire, which is a standard LKFR tool. Validity and reliability of the instrument was confirmed by scientific method. Collected data were analyzed by SPSS Version 19. Descriptive and inferential statistics such as Chi-square, paired-samples t-test, independent-samples t-test, ANOVA, Pearson’s product-moment correlation coefficient, and Fisher’s exact test were used. Results One hundred ninety-two (42.8%) and 257 (57.2%) patients were female and male, respectively (mean: 41 years, r: 37–83). Patient satisfaction of the dispatcher was good, and satisfaction level in regards to the technicians’ performance, physical situation, and facilities inside the ambulance was moderate. The Wilcoxon test did not show any significant difference between pain severity before and after arriving EMS in the cardiac and respiratory patients (p=0.691), but severity of pain in orthopedic patients after arriving EMS was decreased (p=0.001). Cardiac and respiratory patients had low satisfaction of EMS, and the Chi-square test was significant (p=0.001). Orthopedic patients had the most satisfaction of EMS. Conclusion Generally, patients’ satisfaction of EMS was low. Satisfaction with pain relief in orthopedic patients was better than pain relief in cardiac and respiratory patients. It is recommended to take necessary actions to improve the level of patient satisfaction of EMS. PMID:28461872

  13. 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 ...

  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 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Centers for Medicare and Medicaid Services Support for Medication Therapy Management (Enhanced Medication Therapy Management): Testing Strategies for Improving Medication Use Among Beneficiaries Enrolled in Medicare Part D.

    Science.gov (United States)

    Brandt, Nicole J; Cooke, Catherine E

    2017-05-01

    In 2006, Medicare beneficiaries began receiving prescription coverage benefits through Part D of the Medicare benefit. Medicare Part D plans must provide medication therapy (MTM) services. MTM services aim to improve medication use and are targeted toward eligible beneficiaries, determined by morbidity, prescription use, and anticipated cost of prescription use. Now, 10 years after the start of Medicare Part D, several changes have been made to the program's design. This article focuses on changes related to MTM and the impact that these changes have and will continue to have on Medicare beneficiaries and medication use. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Exploring Social Service Providers' Perspectives on Barriers to Social Services for Early Adjustment of Immigrant Adolescents in South Korea.

    Science.gov (United States)

    Yi, Jaehee; Kim, Min Ah; Kim, Kihyun; Hong, Jun Sung

    2016-10-01

    Recently arrived immigrant adolescents experience difficulties in adjusting to school in South Korea. However, the existing social services do not meet their psychosocial needs. This study investigates the perspectives of social service providers about challenges in providing services for immigrant adolescents early in their adjustments. We conducted qualitative, in-depth interviews with 27 South Korean social service providers. We identified barriers to social services, categorized into three themes: (1) Initial Contact Phase; (2) Service Delivery Phase; and (3) Structural Challenges. We suggest interventions concerning work-related stress for the social service providers, family-level involvement, diversity training, and integrated and collaborative immigration services. An examination of social service providers' challenges in working with immigrant adolescents is a necessary first step toward the development of programs and policies.

  4. Community Mobilization and Awareness Creation for Orofacial Cleft Services: A Survey of Nigerian Cleft Service Providers.

    Science.gov (United States)

    Adebola, Raphael A; Bamgbose, Babatunde O; Adeoye, Joshua B

    2014-01-01

    Background. The opportunity to provide free surgical care for orofacial clefts has opened a new vista and is enhanced by well-informed communities who are aware of the free surgical services available to them. It is the responsibility of cleft care providers to adequately inform these communities via a combination of community mobilization and awareness creation. Methods. This was a nationwide, cross-sectional descriptive study of all orofacial cleft service providers in Nigeria using a structured, self-administered questionnaire. Results. A total of 4648 clefts have been repaired, 50.8% by the ten government-owned and 49.2% by the five nongovernment-owned organizations included in the study. The nongovernment-owned institutions seemed to be more aggressive about community mobilization and awareness creation than government-owned ones, and this was reflected in their patient turnout. Most of the organizations studied would prefer a separate, independent body to handle their awareness campaign. Conclusion. Community mobilization requires skill and dedication and may require formal training or dedicated budgets by government-owned and nongovernment-owned institutions alike. Organizations involved in cleft care provision must take community mobilization and awareness seriously if the largely unmet needs of orofacial cleft patients in Nigeria are to be tackled.

  5. THE DEVELOPMENT OF INTERLIBRARY LOAN SERVICE IN JAPANESE MEDICAL LIBRARIES.

    Science.gov (United States)

    FUKUDOME, T

    1964-01-01

    An interlibrary loan system in Japan was established by the Japanese Medical Library Association in 1927. Since then the members of the Association have increased from five to forty-eight-all forty-six medical school libraries and two dental school libraries. The Association's service has been enlarged, particularly since World War II. The number of interlibrary loans among member libraries has increased greatly, especially since 1954, thanks to the development of union lists and photoduplication service. Today, more than 80 percent of the requests are filled with photocopied materials. On the other hand, the growth of medical literature has made interlibrary cooperation very necessary, especially internationally. An agreement was made in 1948 concerning photoduplication service between the Japanese Medical Library Association and the National Library of Medicine.

  6. [Medical entomology for the Armed services: preliminary results from the medical entomology unit].

    Science.gov (United States)

    Pages, F; Girod, R

    2004-01-01

    Vector-borne diseases constitutes a threat to the operational capability of armed forces personnel operating outside or stationed overseas. To take this risk into account, the French armed forces medical corps created a medical entomology unit in 2003. The primary function of this unit is to monitor the entomological status of French military bases in sub-Saharan Africa (identification of vectors, study of vector behavior, and measurement of resistance to insecticides) as a means of maintaining an effective vector-control strategy. The French medical entomology unit takes part in the Impact Vector project aimed at evaluating the vector-borne disease risks for troops in combat situations, contributes its expertise to the investigation of epidemic disease, and participates in the development of a global strategy for vector-control for the armed services. To improve understanding and control of vector-borne disease risks, the unit provides basic training in medical entomology to army physicians, veterinarians, and pharmacists as well as to others involved in control programs. The purpose of this article is to present the results of the unit's first activities: investigation of a malaria epidemic that occurred in Ivory Coast in 2003, measurement of malaria exposure over a 4-month period in a combat group on duty in rural Africa, and initial evaluation of control techniques (spraying around living quarters and use of insecticide-impregnated battle dress).

  7. [Medical doctor in mountain rescue service - a profession's perspective].

    Science.gov (United States)

    Putzke, Matthias

    2008-01-01

    Helicopter emergency services (HEMS) carrying doctors trained in emergency medicine represent a well established system for primary care with increasing professionalism since their implementation in the seventies until now. However, considerable differences persist in Europe concerning the structure as well as integration of the system in the entire organisation of area-wide demands. Based on the particular geographic conditions in the alps which are highly associated with challenges for man and material a dense network of helicopter airbases has been established. Hence, this system accounts for the social, economical and touristic requirements of this region in terms of providing sufficient emergency medical treatment. In addition to statutory and professional provisions qualification requirements for emergency doctors comprehend extensive alpine training. Primarily this provides personal safety as well as security for the entire team and the patient which particularly applies for technical rope rescue. Advanced all-season training is compulsory due to seasonal differences in casualties. Well harmonized training with cross-border validity is not available to-date. Hence, the development of obligatory standard operating procedures should be the major goal of medical associations and societies.

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

    National Research Council Canada - National Science Library

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

    2013-01-01

    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...

  9. Ready, willing, and able to provide MTM services?: A survey of community pharmacists in the USA.

    Science.gov (United States)

    Law, Anandi V; Okamoto, Mark P; Brock, Kelly

    2009-12-01

    Changes in US Medicare legislation could benefit pharmacy's attempt to make medication therapy management (MTM) practice more commonplace; however, little is known about pharmacists' capabilities and preferences to do so. The purpose of this study was to explore US pharmacists' perceived preparedness, willingness, and challenges toward providing MTM services. A brief purpose of the survey and its website link were included in the electronic weekly newsletter of the National Community Pharmacists Association (NCPA) in January 2007. The web-based survey consisted of 8 demographic questions, 8 questions examining preparedness and willingness of the respondents regarding MTM, 2 questions regarding reimbursement to pharmacists, and 2 checklists for challenges in establishing MTM services. Most of the 143 respondents indicated that they were aware of MTM, and 92 (65%) reported that they were currently practicing MTM. A majority of the sample agreed that pharmacists should provide MTM and have the ability to do so. Major challenges reported by the sample include the different specification of MTM by each health plan, time, staffing, and reimbursement issues. Respondents selected valid measures of program effectiveness but revealed that they needed help with documentation and billing. Expected reimbursement range was $1-10/minute. Community independent pharmacists reported being ready, willing, and able to provide MTM services, but need assistance in the process, that is, standardized MTM protocols, documentation and billing.

  10. 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...

  11. 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.

  12. 20 CFR 10.800 - What kind of medical records must providers keep?

    Science.gov (United States)

    2010-04-01

    ... studies performed, the nature of the treatment rendered and the degree of any impairment and/or disability... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What kind of medical records must providers...' COMPENSATION ACT, AS AMENDED Information for Medical Providers Medical Records and Bills § 10.800 What kind of...

  13. 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.

  14. 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

  15. 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...

  16. 41 CFR 302-12.102 - What contracted relocation services may we provide at Government expense?

    Science.gov (United States)

    2010-07-01

    ... relocation services may we provide at Government expense? 302-12.102 Section 302-12.102 Public Contracts and... 12-USE OF A RELOCATION SERVICES COMPANY Agency's Use of a Relocation Services Company § 302-12.102 What contracted relocation services may we provide at Government expense? You may pay for contracted...

  17. 34 CFR 646.4 - What activities and services may a project provide?

    Science.gov (United States)

    2010-07-01

    ...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION STUDENT SUPPORT SERVICES PROGRAM General § 646.4 What activities and services may a project provide? A Student Support Services project may provide services such as: (a) Instruction in reading, writing, study skills, mathematics, and other subjects...

  18. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on supported services for rural health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported...

  19. 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

  20. Assessment of Information Sources and Services Provided for the ...

    African Journals Online (AJOL)

    From the parent population of micro and small business enterprises, seven municipal areas of the geopolitical zone were randomly sampled. Research instrument used for collecting data was the questionnaire which was constructed along the theoretical frame of the study. Hypotheses were formulated to provide basis for ...

  1. 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...

  2. The Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine: status of the Federal Medical School after 25 years.

    Science.gov (United States)

    Gardner, J W; Harmon, S; Stavish, P J

    1998-05-01

    In its first 25 years, the Uniformed Services University of the Health Sciences (USUHS) has become a quality institution of medical education that provides a steady flow of career physicians for the military. It compares favorably with U.S. medical school averages in all aspects of undergraduate medical education: faculty, teaching facilities, matriculants, curriculum, student performance, and cost. USUHS provides excellent medical education and adds unique preparation for uniformed public service. It also provides military-specific graduate education, graduate medical education, continuing health education, medical research, clinical services, consultation, public service, and ties with international military, medical, and research institutions.

  3. Some Ramifications of Compensation Limitations in Personal Services Contracts for Direct Health Care Providers

    Science.gov (United States)

    1990-12-01

    contracting agency may require. C. CONTRACT TYPES 1. Service Contracts General policy and procedures for the procurement of services by contract are...Acquisition Regulation and the Department of 16 Defense nNR Supplement recognize and address the unique needs o0z medical department!. in procurement of services . The...major rationale for price ceilings in these contracts is to prevent the government from appearing improper in procurement of services from a limited

  4. Multidisciplinary views toward pharmacist-delivered medication therapy management services in dialysis facilities.

    Science.gov (United States)

    Parker, Wendy M; Jang, Soo Min; Muzzy, Julia D; Cardone, Katie E

    2015-01-01

    To determine views of staff of dialysis centers toward pharmacist-delivered medication therapy management (MTM) services. Focus group study. Three private, nonprofit, outpatient dialysis facilities. Multidisciplinary dialysis staff. Two focus group sessions were conducted using a semistructured interview guide. Views of staff toward MTM services at a dialysis center. A total of 13 staff members of dialysis centers participated in the study. Participants included nurses, patient care technicians, a social worker, dietitian, and administrative personnel. Key themes included: the need for access to MTM services in dialysis facilities exists; services should include medication reconciliation and patient education; services should be proactive, consistent, individualized, and covered by insurance; and that pharmacists are uniquely suited to provide MTM services. Dialysis staff support the integration of MTM services in facilities. Further research is needed to identify barriers and opportunities in the implementation process, including patient perspectives.

  5. 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.

  6. Internet access and investment incentives for broadband service providers

    OpenAIRE

    Baranes, Edmond; Poudou, Jean-Christophe

    2011-01-01

    This paper studies a model of the Internet broadband market as a platform in order to show how di¤erent pricing schemes from the so-called "net neutrality " can increase economic e¢ ciency by allowing more investment of access providers and enhancing consumers surplus and social welfare. We show that departing from the "net neutrality", where at rates are used, introducing termination fees can increase incentives to invest for the ISP and enhance social surplus. Keywords : Network neutrality,...

  7. Smart environment as a service: three factor cloud based user authentication for telecare medical information system.

    Science.gov (United States)

    Siddiqui, Zeeshan; Abdullah, Abdul Hanan; Khan, Muhammad Khurram; Alghamdi, Abdullah S

    2014-01-01

    The Telecare Medical Information System (TMIS) provides a set of different medical services to the patient and medical practitioner. The patients and medical practitioners can easily connect to the services remotely from their own premises. There are several studies carried out to enhance and authenticate smartcard-based remote user authentication protocols for TMIS system. In this article, we propose a set of enhanced and authentic Three Factor (3FA) remote user authentication protocols utilizing a smartphone capability over a dynamic Cloud Computing (CC) environment. A user can access the TMIS services presented in the form of CC services using his smart device e.g. smartphone. Our framework transforms a smartphone to act as a unique and only identity required to access the TMIS system remotely. Methods, Protocols and Authentication techniques are proposed followed by security analysis and a performance analysis with the two recent authentication protocols proposed for the healthcare TMIS system.

  8. Provision of clinical pharmacy services in two safety net provider settings.

    Directory of Open Access Journals (Sweden)

    Connor SE

    2009-06-01

    free clinic and the community health center. Conclusion: A clinical pharmacy services model provides a role for the pharmacist in an interdisciplinary team (beyond the traditional dispensing role to identify medication related problems in the drug therapy of patients who utilize safety-net provider health care services.

  9. Performance Measurement for a Logistics Services Provider to the Polymer Industry

    OpenAIRE

    Tok, King Lai

    2007-01-01

    This management project discusses the form of performance measurement system suitable for a logistics services provider who focuses on providing its services to large multinational petrochemical companies in the polymer industry

  10. 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

  11. Delivering safer conception services to HIV serodiscordant couples in Kenya: perspectives from healthcare providers and HIV serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Kenneth Ngure

    2017-02-01

    Conclusions: Antiretroviral-based HIV prevention is acceptable and accessible to meet the growing demand for safer conception services in Kenya, since medically assisted interventions are currently cost prohibitive. Cross-disciplinary training for health providers would expand confidence in all prevention options and foster the tailoring of counselling to couples’ preferences.

  12. 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.

  13. 75 FR 22338 - Reexamination of Roaming Obligations of Commercial Mobile Radio Service Providers

    Science.gov (United States)

    2010-04-28

    ... have on the terms of retail service provided to consumers, how such impacts differ from those resulting... COMMISSION 47 CFR Part 20 Reexamination of Roaming Obligations of Commercial Mobile Radio Service Providers... to data services that are provided without interconnection to the public switched network--including...

  14. Attitudes of Social Service Providers towards the Sexuality of Individuals with Intellectual Disability

    Science.gov (United States)

    Bazzo, Giuseppe; Nota, Laura; Soresi, Salvatore; Ferrari, Lea; Minnes, Patricia

    2007-01-01

    Background: The sexual lives of people with intellectual disability is made complex by the involvement and influence of social service providers, whose beliefs and values have a great impact on the support they provide. We hypothesized that social service providers' role, educational level and service in which they worked could affect attitudes…

  15. Hoe tevreden zijn e-commerce bedrijven met hun dienstverleners? : service providers onder de loep

    NARCIS (Netherlands)

    Weltevreden, Jesse; Abraham, Jorij

    2013-01-01

    In Nederland gevestigde e-commerce bedrijven zijn meer tevreden over hun logistics service provider en affiliatenetwerk, dan over hun payment service provider. Daarnaast zijn ze aanzienlijk meer loyaal aan hun logistics service provider dan aan beide andere e-commerce dienstverleners. Dit blijkt uit

  16. Preliminary Construction of a Service Provider-Informed Domestic Violence Research Agenda

    Science.gov (United States)

    Murray, Christine E.; Welch, Metoka L.

    2010-01-01

    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…

  17. Medication therapy management services in North Carolina community pharmacies: current practice patterns and projected demand.

    Science.gov (United States)

    Hansen, Richard A; Roth, Mary T; Brouwer, Emily S; Herndon, Susan; Christensen, Dale B

    2006-01-01

    To evaluate the types of cognitive services offered and the number of patients being served in community pharmacies, determine the number of pharmacies that plan to offer medication therapy management (MTM) services under the Medicare Part D prescription drug benefit, and assess whether current and expected practices will meet the potential needs of enrollees. Cross-sectional study. North Carolina in January 2005. 1,593 community pharmacy managers. Survey using a Web-based tool. Provision of cognitive services and number of patients for whom services are provided. A total of 262 (16%) pharmacy managers provided usable responses. Approximately 42% of respondents (n = 110) indicated that they provide some type of cognitive service. Comprehensive MTM services, or services consistent with the professionwide consensus definition, were provided by 31% of respondents (n = 81). Independent pharmacies were more likely to offer some type of service compared with chain pharmacies (58% versus 31%, respectively; P Pharmacy managers with a doctor of pharmacy degree were less likely than pharmacy managers with a bachelor's degree to offer services in their pharmacies (P = .02), and pharmacies with pharmacists on staff who had received certificate training were more likely to offer cognitive services (P = .03). Of all respondents, 28% (n = 73) indicated that they planned to offer MTM services under the Medicare Part D prescription drug benefit. Comparing these results with those of a 1999 survey of North Carolina pharmacists that used some of the same items, the percentage of community pharmacies that provide cognitive services has increased in the intervening years but remains low. Among the services being offered in 2005, most were focused on patient education and training, coordinating and integrating care, and medication regimen reviews. Implementation of MTM services under the Medicare Part D prescription drug benefit should hasten the development and offering of these

  18. 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.

  19. 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

  20. [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

  1. Influenza Vaccination among Pregnant Women: Patient Beliefs and Medical Provider Practices

    National Research Council Canada - National Science Library

    Stark, Lauren M; Power, Michael L; Turrentine, Mark; Samelson, Renee; Siddiqui, Maryam M; Paglia, Michael J; Strassberg, Emmie R; Kelly, Elizabeth; Murtough, Katie L; Schulkin, Jay

    2016-01-01

    ...% of patients reported receiving a recommendation. Age, education, a medical provider's recommendation, and educational materials were found to positively influence patient beliefs about the influenza...

  2. 21 CFR 203.11 - Applications for reimportation to provide emergency medical care.

    Science.gov (United States)

    2010-04-01

    ... emergency medical care. 203.11 Section 203.11 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Applications for reimportation to provide emergency medical care. (a) Applications for reimportation for emergency medical care shall be submitted to the director of the FDA District Office in the district where...

  3. Assessing the ecosystem services provided by urban green spaces along urban center-edge gradients.

    Science.gov (United States)

    Chang, Jie; Qu, Zelong; Xu, Ronghua; Pan, Kaixuan; Xu, Bin; Min, Yong; Ren, Yuan; Yang, Guofu; Ge, Ying

    2017-09-11

    Urban green spaces provide various ecosystem services, especially cultural services. Previous assessment methods depend either on hypothetic payments for ecosystems or real payments not directly related to ecosystems. In this paper, we established a method for assessing the cultural ecosystem services in any location in urban area using only two variables, green space (ecosystem) and land rent (real payment). We integrated the cultural and the regulating services into the total ecosystem services because urban green spaces provide almost no provisioning services. Results showed that the same area of green spaces near the center provided much higher cultural services than that near the urban edge; the regulating services accounted for 5% to 40% of the total ecosystem services from the center to the edge of urban area; along the center-edge gradient, there was a threshold out which the ecosystem services were lower than the maintenance cost of green spaces.

  4. 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.

  5. SERVICE EVALUATION OF A CYSTIC FIBROSIS HOME INTRAVENOUS ANTIBIOTIC SERVICE PROVIDED BY A NHS FOUNDATION TRUST.

    Science.gov (United States)

    Elsey, Lynn

    2016-09-01

    To evaluate carers' satisfaction with the current service for home reconstitution and administration of intravenous (IV) antibiotics to cystic fibrosis (CF) patients and identify ways of improving this service to reduce treatment burden. A formative evaluation was conducted of all 17 carers who reconstituted and administered the IV antibiotics at home. This was carried out using a cross-sectional survey. A questionnaire of open and closed questions was sent first class with a pre-paid return envelope to the carers. This was followed by a reminder letter after the set return date. Thirteen carers responded giving a response rate of 76.5%. The carers had a mean of 2 children in the household with all having 1 child under the care of the paediatric CF team. They had been receiving IV antibiotics for a mean of 8 years and 7 months and had been administering them at home for a mean of 6 years and 1 month. The majority had administered the antibiotics in the last 3 months.Over half received their drugs from the hospital pharmacy, but one carer highlighted that they did not always receive a full supply of the treatment.Removing the reconstitution step by providing pre-prepared syringes could reduce treatment time by around 18 minutes. Overall this could mean a daily reduction in treatment time of almost two hours for a patient who is on two antibiotics three times a day. The majority of respondents stated that they would prefer pre-filled syringes.The carers felt that they received enough training and felt confident in reconstituting and administering the antibiotics. The majority felt that they should receive regular updates to their training and it was highlighted that they are reassessed at the start of each course. Most of the carers felt that they had an opportunity to discuss the IV antibiotics in the out-patient clinic with the doctors and the nurses but none of them would contact the pharmacist. They felt that they were appropriately contacted in advance to

  6. 42 CFR 433.56 - Classes of health care services and providers defined.

    Science.gov (United States)

    2010-10-01

    ... practitioners, and private duty nurses; (17) Laboratory and x-ray services, defined as services provided in a licensed, free-standing laboratory or x-ray facility. This definition does not include laboratory or x-ray... defined to include facility services only and do not include surgical procedures; (10) Dental services...

  7. 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.

  8. 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

  9. 20 CFR 670.525 - What residential support services must Job Corps center operators provide?

    Science.gov (United States)

    2010-04-01

    ... ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program... week, 24 hours a day; (b) An ongoing, structured counseling program for students; (c) Food service, which includes provision of nutritious meals for students; (d) Medical services, through provision or...

  10. How does patient-provider communication influence adherence to asthma medications?

    Science.gov (United States)

    Young, Henry N; Len-Rios, Maria E; Brown, Roger; Moreno, Megan M; Cox, Elizabeth

    2017-04-01

    To assess hypothesized pathways through which patient-provider communication impacts asthma medication adherence. A national sample of 452 adults with asthma reported assessments of patient-provider communication, proximal outcomes (understanding of asthma self-management, patient-provider agreement, trust in the clinician, involvement in care, motivation), and adherence to asthma medications. Structural equation modeling was used to examine hypothesized pathways. Significantly positive direct pathways were found between patient-provider communication and all proximal outcomes. Only positive indirect pathways, operating through trust and motivation, were found between patient-provider communication and medication adherence. Patient-provider communication influences many desirable proximal outcomes, but only influences adherence through trust and motivation. To promote better adherence to asthma medication regimens and, ultimately positive asthma outcomes, healthcare providers can focus on implementing communication strategies that strengthen patients' trust and increase patient motivation to use asthma medications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Medication discrepancies at discharge from an internal medicine service.

    Science.gov (United States)

    Herrero-Herrero, José-Ignacio; García-Aparicio, Judit

    2011-02-01

    Medication errors most commonly occur at the time of medication prescribing and particularly at the moment of the transitions of care. The objectives of this study were to identify and characterize the discrepancies between the physicians' discharge medication orders and the medication lists at admission obtained by an internal medicine specialist physician in a general internal medicine service. This descriptive, retrospective, study was carried out at a tertiary care university teaching hospital in Spain. It was based on the review of non selected, consecutive, hospital discharge reports. Discrepancies were identified, categorized and characterized through the analysis of the information (medication lists, laboratory tests results, diagnosis, and clinical evolution) contained in them. We analyzed 954 discharge reports. In the medication reconciliation process, we find discrepancies in 832 (87.2%) of them. Justified discrepancies were found in 828 (86.8%) reports and unjustified discrepancies in 52 (5.4%). Omission of a medication was the most frequent medication error detected in 86.4% of cases, followed by incomplete prescription (9.6%). The number of diagnosis, the length of hospital stay and the number of permanent medications at admission were the characteristics of cases associated with medication discrepancies in multivariate linear regression (Pmedication errors detected in our study. Appropriate routines to ensure an accurate medication history collection and a methodical elaboration of the medication list at discharge, when performed by trained internists, are important for an adequate medication reconciliation process. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. [Survey on the barriers in providing the mental health services to the suicide attempters in ED].

    Science.gov (United States)

    Zhao, Xiaohui; Li, Tao; Hong, Xia; Jiang, Yinan; Xiong, Nana; Cao, Jinya; Wei, Jing

    2015-06-16

    The purpose of this study was to explore the barriers existing in medical settings behind the phenomenon that few suicide attempters were provided by mental health services when they got treatment in the general hospital ED. An anonymous and voluntary survey was administered among two groups: ED physicians and psychiatrists. Two tertiary general hospitals and one psychiatric hospital were chosen through convenience sampling. Suicide Behavior Attitude Questionnaire and a self-made questionnaire to evaluate barriers were used. The response rate was 68.7% for ED physicians, and 87.0% for psychiatrists. ED physicians generally scored unfavorably than psychiatrists on many items in SBAQ (P suicide attempters should have access to mental health services, the median of the scores = 10 for both group (P = 0.059), meaning highly agree. Some consistent barriers could be summarized from the self-made questionnaire. The majority of ED physicians in general hospitals still hold some misunderstanding about the suicide attempters, but they fully agree that the suicide attempters should have access to mental health services. The barriers for psychiatrists are clear.The barriers for ED physicians are complicated but workable.

  13. [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.

  14. 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…

  15. 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.

  16. Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS)

    Science.gov (United States)

    Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

    2016-01-01

    Objectives To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Design Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. Setting North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Participants Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. Interventions NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Main outcome measures Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. Results NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014–7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. Conclusions NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community

  17. Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia.

    Science.gov (United States)

    Kruger, Estie; Perera, Irosha; Tennant, Marc

    2010-01-01

    Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

  18. 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.

  19. 42 CFR 417.554 - Apportionment: Provider services furnished directly by the HMO or CMP.

    Science.gov (United States)

    2010-10-01

    ... by the HMO or CMP. 417.554 Section 417.554 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Apportionment: Provider services furnished directly by the HMO or CMP. The Medicare share of the cost of covered services furnished to Medicare enrollees by providers that are owned or operated by the HMO or CMP or are...

  20. 26 CFR 301.6223(e)-1 - Effect of Internal Revenue Service's failure to provide notice.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Effect of Internal Revenue Service's failure to... General § 301.6223(e)-1 Effect of Internal Revenue Service's failure to provide notice. (a) Notice group...), the Internal Revenue Service's failure to provide notice to a pass-thru partner entitled to notice...

  1. 25 CFR 171.210 - Where will BIA provide my irrigation service?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Where will BIA provide my irrigation service? 171.210 Section 171.210 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER IRRIGATION OPERATION AND MAINTENANCE Irrigation Service § 171.210 Where will BIA provide my irrigation service? (a) We...

  2. Cooperation between Logistic Service Providers and Shippers on making transportation sustainable

    NARCIS (Netherlands)

    Stef Weijers; Reinder Pieters; Onno Omta; Hans-Heinrich Glöckner

    2011-01-01

    This paper describes Dutch Logistic Service Providers attitudes towards sustainability and how they translate this into business practise. This is done by looking at what Logistic Service Providers say what they are doing or intend to do to improve sustainability for their transport services.

  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. Essential medical laboratory services: their role in delivering ...

    African Journals Online (AJOL)

    This paper examines the establishment of Essential Medical Laboratory Services (EMLS) and their crucial role for delivering equitable health care to the poor population of Malawi as part of the Essential Health Package. We examine each of the major areas identified for intervention (maternal health, malaria, tuberculosis ...

  5. 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…

  6. The effect of emergency medical services response on outcome of ...

    African Journals Online (AJOL)

    Background: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any ...

  7. Assessment of emergency medical services in the Ashanti region of ...

    African Journals Online (AJOL)

    Background: We aimed to assess the structure, function and performance of Ashanti Region's emergency medical services system in the context of the regional need for prehospital emergency care. Design: A mixed-methods approach was employed, using retrospective collection of quantitative data and prospectively ...

  8. Fees for medical services: money and medicine | Schulenburg ...

    African Journals Online (AJOL)

    Fees for medical services: money and medicine. Carl Schulenburg. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  9. Fees for medical services: money and medicine | Schulenburg ...

    African Journals Online (AJOL)

    Fees for medical services: money and medicine. Carl Schulenburg. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

  10. A SIMULATION MODEL FOR EMERGENCY MEDICAL SERVICES CALL CENTERS

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai); L. Yilmaz; W.K.V. Chan; I. Moon; T.M.K. Roeder; C. Macal; M.D. Rosetti

    2015-01-01

    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  11. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    van Buuren, M.; Kommer, G.J.; van der Mei, R.D.; Bhulai, S.

    2015-01-01

    In pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response time to the

  12. Achievements in emergency medical care service, North-West ...

    African Journals Online (AJOL)

    Objective. To analyse the performance of the Emergency Medical Rescue Service (EMRS) in North-West province. Design. A prospective study of the activity of the EMRS. Setting. North-West province, 2002 - 2004. Results. During this period the EMRS response time tended to decrease (reduction of 8 minutes for rural and ...

  13. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai)

    2015-01-01

    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  14. Medical services in German South West Africa | Bouch | Scientia ...

    African Journals Online (AJOL)

    Scientia Militaria: South African Journal of Military Studies. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (1974) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Medical services in German South West Africa.

  15. 76 FR 29131 - Emergency Medical Services Week, 2011

    Science.gov (United States)

    2011-05-19

    ... the EMS system function, including emergency dispatchers, physicians, nurses, and researchers, as well... May 19, 2011 Part V The President Proclamation 8674--Emergency Medical Services Week, 2011... May 17, 2011--Continuation of the National Emergency With Respect to the Stabilization of Iraq #0; #0...

  16. EXPERT ESTIMATION OF QUALITY OF MEDICAL SERVICES IN REPUBLIC BASHKORTOSTAN

    Directory of Open Access Journals (Sweden)

    S.A. Kirillova

    2009-06-01

    Full Text Available Strategic national projects in such spheres as public health services, formation and others certain according to the state initiatives as social priorities of development of the country are aimed at creation of new mechanisms for improvement of quality of a life of citizens of Russia. The condition of these spheres defines social and demographic well-being of a society, forms conditions for development of the human capital. Thus the estimation of quality of social services should be carried out within the limits of substantial definition of service as sets of the characteristics defining established or prospective needs of the consumer. In given clause the author's technique of an expert estimation of quality of the medical services, approved on an example of sphere of public health services in Republic Bashkortostan reveals.

  17. 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.

  18. Old age and chronic disease: is the emergency medical system the appropriate provider for the elderly?

    Science.gov (United States)

    Mochmann, Hans-Christian; Arntz, Hans-Richard; Dincklage, Falk V; Rauch, Ursula; Schultheiss, Heinz P; Bobbert, Peter

    2014-04-01

    The use of emergency medical services increases with the age of patients. Some care providers hold on to the prejudice that these alarms are unnecessary or of a lower importance. We assessed the relation of age and age-dependent emergency characteristics, taking into consideration the ratings of emergency physicians on whether or not emergency cases were considered truly in need of emergency physician attendance. Emergency physicians dispatched by the Berlin Fire Department evaluated for each case the necessity of emergency physician attendance. Case characteristics such as the day of the week and location of the emergency as well as patient characteristics such as age, sex, prior status, and care dependency were recorded. In addition, whether or not the physician accompanied the patient to the hospital was recorded as a parameter for emergency severity. Analysis was performed using multiple logistic regression modeling. During the 6-month prospective study period, 2702 cases were evaluated. Emergency medical services are used more frequently by older individuals, especially octogenarians. Emergency cases in older individuals were significantly more often rated as in need of emergency physician attendance; however, the rate of patients accompanied by the emergency physician to the hospital did not differ between the age groups. The age of patients, the primary diagnosis, the day and location of the emergency, and the presence of pre-existing dementia showed a significant impact on the necessity of physician-attended emergency missions. Despite common prejudices, emergency cases in elder patients are rated more often as in need of emergency physician attendance compared with those involving younger patients.

  19. Customer service providers' attitudes relating to customer service and customer satisfaction in the customer-server exchange.

    Science.gov (United States)

    Susskind, Alex M; Kacmar, K Michele; Borchgrevink, Carl P

    2003-02-01

    The authors proposed and tested a model describing the relationship between customer service providers' perceptions and attitudes toward their service-related duties and their customers' perceptions of satisfaction with their service experiences. Results indicated that the perception of having standards for service delivery in an organization is strongly related to line-level employees' perceptions of support from coworkers and supervisors. Perceived support from coworkers was significantly related to service providers' customer orientation, whereas perceived support from supervisors showed a weaker relationship to a customer orientation. Ultimately, service providers' customer orientation was strongly related to customers' satisfaction with service. Finally, a set of post hoc analyses indicated that coworker and supervisory support explained a greater proportion of incremental variance in the model than did perceived organizational support alone.

  20. 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.

  1. Note from the CERN Medical Service - FLU VACCINATIONs

    CERN Document Server

    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.

  2. 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.

  3. Note from the CERN Medical Service - FLU VACCINATIONs

    CERN Document Server

    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.

  4. Flexible medical image management using service-oriented architecture.

    Science.gov (United States)

    Shaham, Oded; Melament, Alex; Barak-Corren, Yuval; Kostirev, Igor; Shmueli, Noam; Peres, Yardena

    2012-01-01

    Management of medical images increasingly involves the need for integration with a variety of information systems. To address this need, we developed Content Management Offering (CMO), a platform for medical image management supporting interoperability through compliance with standards. CMO is based on the principles of service-oriented architecture, implemented with emphasis on three areas: clarity of business process definition, consolidation of service configuration management, and system scalability. Owing to the flexibility of this platform, a small team is able to accommodate requirements of customers varying in scale and in business needs. We describe two deployments of CMO, highlighting the platform's value to customers. CMO represents a flexible approach to medical image management, which can be applied to a variety of information technology challenges in healthcare and life sciences organizations.

  5. [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.

  6. Logistics in providing private accommodation services in Primorsko-goranska county

    OpenAIRE

    Mrnjavac, Edna; Pavia, Nadia; Cerović, Marta

    2014-01-01

    Purpose – The purpose of this study is to find a concept for optimizing cost and revenue from providing private accommodation services. The aim is to display how linking all participants who provide private accommodation services into a logistics network will result in better and higher quality service for the guest and in reduced cost for the private accommodation provider. Design – This study researches private accommodation providers in the Primorsko - Goranska County. Primorsko - Goran...

  7. 75 FR 32845 - Consultative Examination-Annual Onsite Review of Medical Providers

    Science.gov (United States)

    2010-06-10

    ... 416 RIN 0960-AH17 Consultative Examination--Annual Onsite Review of Medical Providers AGENCY: Social... triggers annual on-site reviews of medical providers who conduct consultative examinations (CEs) for our... in 1991. We expect the revised threshold amount will reestablish the level of oversight activity we...

  8. 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

  9. 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.

  10. Physicians' Preferences for Communication of Pharmacist-Provided Medication Therapy Management in Community Pharmacy.

    Science.gov (United States)

    Guthrie, Kendall D; Stoner, Steven C; Hartwig, D Matthew; May, Justin R; Nicolaus, Sara E; Schramm, Andrew M; DiDonato, Kristen L

    2017-02-01

    (1) To identify physicians' preferences in regard to pharmacist-provided medication therapy management (MTM) communication in the community pharmacy setting; (2) to identify physicians' perceived barriers to communicating with a pharmacist regarding MTM; and (3) to determine whether Missouri physicians feel MTM is beneficial for their patients. A cross-sectional prospective survey study of 2021 family and general practice physicians registered with MO HealthNet, Missouri's Medicaid program. The majority (52.8%) of physicians preferred MTM data to be communicated via fax. Most physicians who provided care to patients in long-term care (LTC) facilities (81.0%) preferred to be contacted at their practice location as opposed to the LTC facility. The greatest barriers to communication were lack of time and inefficient communication practices. Improved/enhanced communication was the most common suggestion for improvement in the MTM process. Approximately 67% of respondents reported MTM as beneficial or somewhat beneficial for their patients. Survey respondents saw value in the MTM services offered by pharmacists. However, pharmacists should use the identified preferences and barriers to improve their currently utilized communication practices in hopes of increasing acceptance of recommendations. Ultimately, this may assist MTM providers in working collaboratively with patients' physicians.

  11. 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

  12. The potential of electronic medical records for health service management.

    NARCIS (Netherlands)

    Zee, J. van der; Fleming, D.M.

    2006-01-01

    The medical record held in primary care provides the most comprehensive summary of all medical events. Diagnostic, laboratory, and prescribing data are all linked in individual patient records. Networks of GPs in some European countries are routinely recording data electronically in a way which

  13. Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers.

    Science.gov (United States)

    van der Vaart, Rosalie; Drossaert, Constance H C; Taal, Erik; van de Laar, Mart A F J

    2013-09-01

    Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient-provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient-provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered.

  14. Implementing an emergency medical services system in Kathmandu, Nepal: a model for "white coat diplomacy".

    Science.gov (United States)

    Walker, Rebecca; Auerbach, Paul S; Kelley, Benjamin V; Gongal, Rajesh; Amsalem, David; Mahadevan, Swaminatha

    2014-09-01

    Wilderness medicine providers often visit foreign lands, where they come in contact with medical situations that are representative of the prevailing healthcare issues in the host countries. The standards of care for matters of acute and chronic care, public health, and crisis intervention are often below those we consider to be modern and essential. Emergency medical services (EMS) is an essential public medical service that is often found to be underdeveloped. We describe our efforts to support development of an EMS system in the Kathmandu Valley of Nepal, including training the first-ever class of emergency medical technicians in that country. The purpose of this description is to assist others who might attempt similar efforts in other countries and to support the notion that an effective approach to improving foreign relations is assistance such as this, which may be considered a form of "white coat diplomacy." Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  15. Medical services at ultra-endurance foot races in remote environments: medical issues and consensus guidelines.

    Science.gov (United States)

    Hoffman, Martin D; Pasternak, Andy; Rogers, Ian R; Khodaee, Morteza; Hill, John C; Townes, David A; Scheer, Bernd Volker; Krabak, Brian J; Basset, Patrick; Lipman, Grant S

    2014-08-01

    An increasing participation in ultra-endurance foot races is cause for greater need to ensure the presence of appropriate medical care at these events. Unique medical challenges result from the extreme physical demands these events place on participants, the often remote settings spanning broad geographical areas, and the potential for extremes in weather conditions and various environmental hazards. Medical issues in these events can adversely affect race performance, and there is the potential for the presentation of life-threatening issues such as exercise-associated hyponatremia, severe altitude illnesses, and major trauma from falls or animal attacks. Organization of a medical support system for ultra-endurance foot races starts with a determination of the level of medical support that is appropriate and feasible for the event. Once that is defined, various legal considerations and organizational issues must be addressed, and medical guidelines and protocols should be developed. While there is no specific or universal standard of medical care for ultra-endurance foot races since a variety of factors determine the level and type of medical services that are appropriate and feasible, the minimum level of services that each event should have in place is a plan for emergency transport of injured or ill participants, pacers, spectators and event personnel to local medical facilities.

  16. [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.

  17. 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.

  18. SMS for Sexual Health: A Comparison of Service Types and Recommendations for Sexual Health Text Message Service Providers

    Science.gov (United States)

    Willoughby, Jessica Fitts; Muldrow, Adrienne

    2017-01-01

    Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…

  19. Medication Management in Primary and Secondary Schools: Evaluation of Mental Health Related In-Service Education in Local Schools

    Science.gov (United States)

    Reutzel, Thomas J.; Desai, Archana; Workman, Gloria; Atkin, John A.; Grady, Sarah; Todd, Timothy; Nguyen, Nhu; Watkins, Melissa; Tran, Kim; Liu, Nian; Rafinski, Michelle; Dang, Thanh

    2008-01-01

    An increasing number of students are taking medications while they are in school or are under the influence of medication during school hours. In a novel effort, clinical pharmacists and mental health therapists worked together to provide "mini-in-service" educational programs on psychological disorders and medications used to treat…

  20. Improving mental health service users' physical health through medication monitoring: a literature review.

    Science.gov (United States)

    Nash, Michael

    2011-04-01

    To explore the importance of improving physical health in mental health service users through medication monitoring. Mental health service users' physical health is frequently poor, although many have contact with health-care services. Adverse drug reactions are a unique risk factor for poor physical health. However, medication monitoring remains inconsistent. A literature review was conducted using search terms: medication monitoring, adverse drug reactions, physical health/illness, mental health/psychiatric nursing. Databases searched included PsychINFO, Pubmed, CINHAL and the British Nursing Index. Structured medication monitoring is required to enhance physical health and reduce the risk of adverse events. Nurse managers should promote a culture of evidence-based practice in medication monitoring. Practitioner learning needs and competencies should be assessed to provide relevant education and skills training. Nurse managers require strategic leadership to transform practice and enhance mental health service users' physical health through medication monitoring. Good practice guidelines should be implemented to improve quality of care and reduce the risk of adverse events. ADDITION TO CURRENT KNOWLEDGE: This paper illustrates the importance of medication monitoring in improving physical health. © 2011 The Author. Journal compilation © 2011 Blackwell Publishing Ltd.