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Sample records for qualified medical care-seeking

  1. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study.

    Science.gov (United States)

    Steenbeek, Romy

    2012-08-31

    The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Data were collected in a longitudinal two-wave study (n = 2305 workers). The outcome measures were visits (yes/no and frequency) to a general practitioner (GP), a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance) was the only work characteristic associated with more care-seeking (GP). For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency), high levels of decision latitude (GP frequency) and high levels of social support by the supervisor (medical specialist). Other work characteristics led to more care-seeking: high levels of engagement (GP), full time work (GP frequency) and experiencing a work handicap (physical therapist). We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to medical care-seeking but only for men and only for the

  2. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study

    NARCIS (Netherlands)

    Steenbeek, R.

    2012-01-01

    The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will

  3. A cross-sectional analysis of barriers to health-care seeking among medical students across training period

    Directory of Open Access Journals (Sweden)

    Vikas Menon

    2017-01-01

    Full Text Available Background and Aims: Very little information is available on how needs and perceptions to service utilization may change with duration of medical training. Our objective was to compare the self-reported barriers to health-care seeking for mental and physical health services separately between 1st year and final year medical students. Methods: In this cross-sectional study, we invited all medical students of the concerned cohorts to complete a prevalidated checklist and 28-item self-reported questionnaire about perceived barriers to health-care seeking. The questionnaire had separate items pertaining to usage of mental and physical health-care services. Results: The response rate of the 1st year and final year cohorts were 83.8% and 86.6%, respectively. Lack of time, unawareness about where to seek help, cost issues, and fear of future academic jeopardy were more common concerns among 1st year students to the usage of mental health services (odds ratio [OR] 0.27, 0.45,0.09, and 0.49, respectively whereas issues of stigma were more commonly reported by final year students for using mental health services (OR = 2.87. In contrast, the barriers in using physical health services were broadly comparable between the two cohorts. Conclusion: Differences exist between medical students in various years of training particularly with regard to self-reported barriers and perceptions particularly about using mental health-care services. This may have key implications for designing and delivery of service provisions in this group.

  4. Self-reported medical care seeking behaviour of doctors in Nigeria

    African Journals Online (AJOL)

    A.E. Fawibe

    2016-05-14

    May 14, 2016 ... b Department of Family Medicine, University of Ilorin Teaching ... Purpose: This work was therefore designed to study the medical care ... for their health problems and find it difficult to adopt the role ..... Conflict of interest. None ...

  5. The lack of paid sick leave as a barrier to cancer screening and medical care-seeking: results from the National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Peipins Lucy A

    2012-07-01

    Full Text Available Abstract Background Preventive health care services, such as cancer screening can be particularly vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. We first describe the prevalence of paid sick leave by broad occupational categories and then examine the association between access to paid sick leave and cancer testing and medical care-seeking in the U.S. workforce. Methods Data from the 2008 National Health Interview survey were analyzed by using paid sick leave status and other health-related factors to describe the proportion of U.S. workers undergoing mammography, Pap testing, endoscopy, fecal occult blood test (FOBT, and medical-care seeking. Results More than 48 million individuals (38% in an estimated U.S. working population of 127 million did not have paid sick leave in 2008. The percentage of workers who underwent mammography, Pap test, endoscopy at recommended intervals, had seen a doctor during the previous 12 months or had at least one visit to a health care provider during the previous 12 months was significantly higher among those with paid sick leave compared with those without sick leave after controlling for sociodemographic and health-care-related factors. Conclusions Lack of paid sick leave appears to be a potential barrier to obtaining preventive medical care and is a societal benefit that is potentially amenable to change.

  6. Care seeking for orofacial pain

    NARCIS (Netherlands)

    Rollman, A.; Visscher, C.M.; Gorter, R.C.; Naeije, M.

    2012-01-01

    AIMS: To determine the contribution of a wide range of factors to care-seeking behavior in orofacial pain patients, expressed as (A) decision to seek care and (B) number of health care practitioners visited. METHODS: Subjects with orofacial pain complaints were recruited in seven TMD clinics and

  7. Care-seeking behaviour of adolescents with knee pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Skuldbøl, Sune Kjems; Rasch, Mads Nyhuus

    2013-01-01

    Knee pain is common during adolescence. Adolescents and their parents may think that knee pain is benign and self-limiting and therefore avoid seeking medical care. However, long-term prognosis of knee pain is not favourable and treatment seems to offer greater reductions in pain compared...... to a "wait-and-see" approach. The purpose of this study was to describe the determinants of care-seeking behaviour among adolescents with current knee pain and investigate what types of treatment are initiated....

  8. Doctors qualifying from United Kingdom medical schools during the calendar years 1977 and 1983.

    Science.gov (United States)

    Parkhouse, J; Parkhouse, H F

    1989-01-01

    At the conclusion of undergraduate medical education in the United Kingdom most students pass a university qualifying examination and obtain a degree in medicine and surgery. Some students pass an external non-university qualifying examination in medicine as an alternative to obtaining a degree, and some do both. The degree may be obtained in the same year as the non-university qualifying examination, or in a different year. Some students from a medical school intake qualify in a later year than expected, for various reasons. Data from university, Health Department and other sources may relate to the academic year, the calendar year, or a fixed date such as 30 September. It is not a simple exercise, therefore, to define the exact number of people who qualify to practise medicine, for the first time, in any given 'year'. In counting qualifiers from individual medical schools, the problems are further compounded by the movement of students between the preclinical and clinical stages of the course, particularly from Oxford and Cambridge to London teaching hospitals. This paper analyses the situation for the calendar years 1977 and 1983, showing a decline in the number of students obtaining double (i.e. both university and non-university) qualifications. The number of UK graduates not registering with the General Medical Council to practise, at least for a time, in the UK was small, and the population base compiled for Medical Career Research Group studies was reasonably accurate in each of the 2 years examined.

  9. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (Russian Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    This publication addresses the shortfall of well trained and clinically qualified medical physicists working in radiation medicine. The roles, responsibilities and clinical training requirements of medical physicists have not always been well defined or well understood by health care professionals, health authorities and regulatory agencies. To fill this gap, this publication provides recommendations for the academic education and clinical training of clinically qualified medical physicists, including recommendations for their accreditation certification and registration, along with continuous professional development. The goal is to establish criteria that support the harmonization of education and clinical training worldwide

  10. THE UNQUALIFIED MEDICAL PRACTITIONERS - Methods of Practice and Nexus with the Qualified Doctors

    OpenAIRE

    K.V. Narayana

    2006-01-01

    The private sector accounts for about 75 percent of outpatient as well as inpatient medical care in Andhra Pradesh. The presence of a large number of unqualified medical practitioners in the rural areas and urban slums indicate that they provide most of the outpatient services in the private sector. Given the huge quantum of services provided by the RMPs, the present study aims at identifying their number, characteristics and the nexus with the qualified doctors through a case study of one di...

  11. Delays and care seeking behavior among tuberculosis patients in ...

    African Journals Online (AJOL)

    Delays and care seeking behavior among tuberculosis patients in Tigray of Northern Ethiopia. Mengiste M Mesfin, Tesfay W Tasew, Israel G Tareke, Yohannes T Kifle, Witten H Karen, Madeley J Richard ...

  12. Understanding the role of the qualified professional: a comparison of medical and dental students' attitudes.

    Science.gov (United States)

    Widdifield, H; Ryan, C A; O'Sullivan, E

    2006-10-01

    The Royal College of Physicians & Surgeons of Canada developed a competency framework to assist future specialists in responding to challenges as health care providers. The CANMEDs project described 7 essential roles of Specialist Physicians include Health Advocate, Manager, Scholar, Medical Expert, Professional, Communicator and Collaborator (HMSEPC(2)). The object of the current study was to investigate whether medical students and dental students in Ireland recognised these responsibilities as essential to a qualified doctor/dentist. Ninety-eight medical and forty-six dental students (year 1 and year 4) were asked to mind map the responsibilities of qualified doctors/dentists. The comments on the mind map were applied to one of the 7 CANMED roles. There were 484 comments from 128 students. Students had the greatest number of responses referring to the Medical and Dental Expert (257, 30.4%) and Professional (227, 26.9%) roles. This was followed by Communicator (130, 15.4%), Scholar (107, 12.7%) and Health Advocate (82, 9.7%) roles. There were relatively few responses relating to Manager (12, 1.4%) and Collaborator (i.e. teamwork) roles (30, 3.6%). There were no differences in responses between Dental Students and Medical Students and between 1 st year and 4th year students. Similarly there were no differences between the responses of Irish students (n =95; 68%) and International students (n =45; 32%) Students are aware of their responsibilities as Medical or Dental experts (diagnostic and therapeutic skills) for ethical and effective patient care (professional role). They are somewhat aware of the Communicator (therapeutic relationships and effective listening), Scholar (personal continuing education strategies) and Health Advocate (contribute to improved community health) roles. In general they have little concept of the importance of Management skills (utilising resources effectively), and of Collaboration (teamwork and consulting effectively with other

  13. Maternal knowledge and care.seeking behaviors for newborn ...

    African Journals Online (AJOL)

    Background: Delay in the presentation of infants with jaundice at the hospital is a reason for the persistence of the severe forms of jaundice. Objective: The aim was to determine the influence of maternal knowledge on newborn jaundice on their care-seeking practices. Methods: In a cross-sectional survey, mothers whose ...

  14. Newborn care seeking practices in Central and Southern Ethiopia ...

    African Journals Online (AJOL)

    admin

    Objective: To investigate local perspectives and practices related to newborn care-seeking and the factors affecting them. .... In Arbe Gonna, they rub the newborn with a herb called hamessa, or take the baby to a health facility like many mothers in the other communities. Sore skin is .... Levels & Trends in Child Mortality.

  15. Care Seeking Determinants among Adolescents in Lagos, Nigeria ...

    African Journals Online (AJOL)

    Adolescents often lack basic reproductive health information, knowledge, and access to affordable confidential health services for reproductive health. This cross-sectional descriptive study aimed to examine the care seeking determinants of adolescents accessing the adolescent friendly services at the Action Health ...

  16. Care seeking for maternal health: challenges remain for poor women

    African Journals Online (AJOL)

    Bernt Lindtjorn

    Timely care seeking is reliant on the knowledge, understanding and financial ... on the relative heterogeneity and security situation of that region. ... adolescent girls and boys, newly delivered mothers, older ... such as the mother in-law or older sister in-laws. The main overriding factors that contribute to the decisions and ...

  17. Health care-seeking behaviour for child illnesses among rural ...

    African Journals Online (AJOL)

    The aim of this study was to examine the health care-seeking behaviour of mothers when their children under five years suffer from common childhood illnesses such as diarrhoea, fever, cough and worms. The study was conducted in a rural community in the Limpopo Province of South Africa. The sample consisted of 100 ...

  18. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (Spanish Edition)

    International Nuclear Information System (INIS)

    2014-01-01

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  19. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists

    International Nuclear Information System (INIS)

    2013-01-01

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  20. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  1. Health Problems and Health Care Seeking Behaviour of Rohingya Refugees

    OpenAIRE

    Masud, Abdullah Al; Ahmed, Md. Shahoriar; Sultana, Mst. Rebeka; Alam, S. M. Iftekhar; Kabir, Russell; Arafat, S. M. Yasir; Papadopoulos, Konstantinos

    2017-01-01

    Abstract Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence. Aim: The present study aims to find out the health problems and health care seeking behavior of rohingya refugee peoples, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient's physical, emotional, perceptions, attitudes and environmen...

  2. Career destinations, views and future plans of the UK medical qualifiers of 1988.

    Science.gov (United States)

    Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

    2010-01-01

    To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5-25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1-10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change.

  3. Integration of pharmacists into patient-centered medical homes in federally qualified health centers in Texas.

    Science.gov (United States)

    Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L

    To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider

  4. Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Roberton, Timothy; Akhu-Zaheya, Laila; Oweis, Arwa; Burnham, Gilbert

    2015-10-31

    There are currently more people displaced by conflict than at any time since World War II. The profile of displaced populations has evolved with displacement increasingly occurring in urban and middle-income settings. Consequently, an epidemiological shift away from communicable diseases that have historically characterized refugee populations has occurred. The high prevalence of non-communicable diseases (NCDs) poses a challenge to in terms of provision of appropriate secondary and tertiary services, continuity of care, access to medications, and costs. In light of the increasing burden of NCDs faced by refugees, we undertook this study to characterize the prevalence of NCDs and better understand issues related to care-seeking for NCDs among Syrian refugees in non-camp settings in Jordan. A cross-sectional survey of 1550 refugees was conducted using a multi-stage cluster design with probability proportional to size sampling to obtain a nationally representative sample of Syrian refugees outside of camps. To obtain information on chronic conditions, respondents were asked a series of questions about hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and arthritis. Differences by care-seeking for these conditions were examined using chi-square and t-test methods and characteristics of interest were included in the adjusted logistic regression model. Among adults, hypertension prevalence was the highest (9.7%, CI: 8.8-10.6), followed by arthritis (6.8%, CI: 5.9-7.6), diabetes (5.3%, CI: 4.6-6.0), chronic respiratory diseases (3.1%, CI: 2.4-3.8), and cardiovascular disease (3.7%, CI: 3.2, 4.3). Of the 1363 NCD cases, 84.7% (CI: 81.6-87.3) received care in Jordan; of the five NCDs assessed, arthritis cases had the lowest rates of care seeking at 65%, (CI:0-88, p = 0.005). Individuals from households in which the head completed post-secondary and primary education, respectively, had 89% (CI: 22-98) and 88% (CI: 13-98) lower odds of seeking care

  5. Help and Care Seeking for Sexually Transmitted Infections Among Youth in Low- and Middle-Income Countries

    OpenAIRE

    Newton-Levinson, Anna; Leichliter, Jami S.; Chandra-Mouli, Venkatraman

    2017-01-01

    Background The ability to seek help or medical care for sexually transmitted infections (STIs) is vital for sexually active youth; yet, their needs are often unmet. Methods We conducted a qualitative systematic review of studies to assess youth and provider views about the behaviors of young people in help seeking and care seeking for STI services in low- and middle-income countries. We searched peer-reviewed literature for studies published between 2001 and 2014 with a study population of yo...

  6. 3 CFR - Medicare Demonstration To Test Medical Homes in Federally Qualified Health Centers

    Science.gov (United States)

    2010-01-01

    ... buy equipment, modernize clinic facilities, expand into new facilities, and adopt or expand the use of... interdisciplinary teams to treat the “whole patient” and focus on chronic disease management to reduce the use of costlier providers of care, such as emergency rooms and hospitals. Federally qualified health centers...

  7. Widespread pain - do pain intensity and care-seeking influence sickness absence? - A population-based cohort study

    DEFF Research Database (Denmark)

    Mose, Søren; Christiansen, David Høyrup; Jensen, Jens Christian

    2016-01-01

    BACKGROUND: Both musculoskeletal pain-intensity in relation to a specific location (e.g. lower back or shoulder) and pain in multiple body regions have been shown to be associated with impaired function and sickness absence, but the impact of pain intensity on the association between widespread...... between number of musculoskeletal pain sites and sickness absence, and to analyze the impact on absenteeism from care-seeking in general practice due to musculoskeletal disorders.METHODS: 3745 Danish adults registered with eight General Practitioners (GPs) in one primary medical center reported location...... pain and sickness absence has not been studied. Additionally it is unknown whether care-seeking in general practice due to musculoskeletal disorders has a positive or negative impact on future absenteeism. The purpose of this study was to examine the influence of pain intensity on the association...

  8. Differences in health care seeking behaviour between rural and urban communities in South Africa

    Science.gov (United States)

    2012-01-01

    Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443

  9. Performing 'pragmatic holism': Professionalisation and the holistic discourse of non-medically qualified acupuncturists and homeopaths in the United Kingdom.

    Science.gov (United States)

    Givati, Assaf

    2015-01-01

    Complementary and alternative medicine practitioners have often utilised 'holism' as a key identification mark of their practice, distancing themselves from 'the reductionist biomedicine'. However, the past couple of decades have witnessed increased engagement of several complementary and alternative medicines in professionalisation, which includes a degree of biomedical alignment while 'reducing' holistic claims in order to provide practice with a 'credible outlook' and move closer to the mainstream, a development which challenges the role of holism in complementary and alternative medicine practices. This article explores the strategies by which two groups of complementary and alternative medicine practitioners, namely, non-medically qualified acupuncturists and homeopaths in the United Kingdom, pragmatically accommodate holistic notions as a professional resource, a process of negotiation between maintaining their holistic premise, on the one hand, and the drive to professionalise and enhance their societal status, on the other. Based on in-depth interviews with non-medically qualified acupuncture and homeopathy practitioners and school principals, textual analysis of practitioners' web sites and observation of practice, the findings demonstrate the dynamic approach to 'holism' in complementary and alternative medicine practice. This discourse, through which practitioners use a range of strategies in order to 'narrow' or 'expand' their holistic expression, can be described as 'pragmatic holism', by which they try to make gains from the formalisation/standardisation processes, without losing the therapies' holistic outlook and appeal. © The Author(s) 2014.

  10. Primary care program improves reimbursement. The Federally Qualified Health Center program helps hospitals improve services to the medically indigent.

    Science.gov (United States)

    Fahey, T M; Gallitano, D G

    1993-03-01

    Under a program created by Congress in 1989, certain primary care treatment centers serving the medically and economically indigent can become Federally Qualified Health Centers (FQHCs). Recently enacted rules and regulations allow participants in the FQHC program to receive 100 percent reasonable cost reimbursement for Medicaid services and 80 percent for Medicare services. An all-inclusive annual cost report is the basis for determining reimbursement rates. The report factors in such expenses as physician and other healthcare and professional salaries and benefits, medical supplies, certain equipment depreciation, and overhead for facility and administrative costs. Both Medicaid and Medicare reimbursement is based on an encounter rate, and states employ various methodologies to determine the reimbursement level. In Illinois, for example, typical reimbursement for a qualified encounter ranges from $70 to $88. To obtain FQHC status, an organization must demonstrate community need, deliver the appropriate range of healthcare services, satisfy management and finance requirements, and function under a community-based governing board. In addition, an FQHC must provide primary healthcare by physicians and (where appropriate) midlevel practitioners; it must also offer its community diagnostic laboratory and x-ray services, preventive healthcare and dental care, case management, pharmacy services, and arrangements for emergency services. Because FQHCs must be freestanding facilities, establishing them can trigger a number of ancillary legal issues, such as those involved in forming a new corporation, complying with not-for-profit corporation regulations, applying for tax-exempt status, and applying for various property and sales tax exemptions. Hospitals that establish FQHCs must also be prepared to relinquish direct control over the delivery of primary care services.

  11. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

    Science.gov (United States)

    Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

    2013-01-01

    Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

  12. Psychology Consequences of Abortion Among The Post Abortion Care Seeking Women in Tehran

    Directory of Open Access Journals (Sweden)

    Abolghasem Pourreza

    2011-01-01

    Full Text Available "nObjective: abortion either medical or criminal has distinctive physical, social, and psychological side effects. Detecting types and frequent psychological side effects of abortion among post abortion care seeking women in Tehran was the main objective of the present study. "n Method: 278 women of reproductive age (15-49 interviewed as study population. Response rate was 93/8. Data collected through a questionnaire with 2 parts meeting broad socio-economic characteristics of the respondents and health- related abortion consequences. Tehran hospitals were the site of study. "nResults: The results revealed that at least one-third of the respondents have experienced psychological side effects. Depression, worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents. Decreased self-esteem, nightmare, guilt, and regret with 43.7%, 39.5%, 37.5%, and 33.3% prevalence rates have been placed in the lower status, respectively. "nConclusion: Psychological consequences of abortion have considerably been neglected. Several barriers made findings limited. Different types of psychological side effects, however, experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders, and women's health impact on family and population health.

  13. Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

    Science.gov (United States)

    Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

    2017-09-01

    Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Health care-seeking behavior in benign prostatic hyperplasia patients

    Directory of Open Access Journals (Sweden)

    Yu-Hua Fan

    2017-09-01

    Conclusion: Bothersome urinary symptoms drive most BPH patients to consult a physician. When considering medical treatments for BPH, about half of the patients wish to reduce the risk of long-term complication, such as acute urinary retention and BPH-related surgery.

  15. Health care-seeking behavior among patients with chronic kidney disease: A cross-sectional study of patients presenting at a single teaching hospital in Lagos

    Directory of Open Access Journals (Sweden)

    Babawale Taslim Bello

    2015-01-01

    Full Text Available Introduction: Health care-seeking behavior of individuals determines how early they present for appropriate care. In patients with chronic kidney disease (CKD, late presentation to the nephrologist is associated with poor outcomes. This study aims to describe the health care-seeking behavior of patients with CKD attending the nephrology outpatient clinic of a teaching hospital located in Lagos, Nigeria. Materials and Methods: This was a cross-sectional survey conducted on 104 consecutive adult patients with CKD, presenting for the first time at the nephrology outpatient clinic of a teaching hospital located in Lagos, South West Nigeria. Information was retrieved from the study participants using a structured interviewer-administered questionnaire, entered into an Excel spreadsheet, and analyzed using Epi Info® statistical software version 7.0. Results: Overall, 74 (71.2% patients sought help, first from a trained health care provider, and their health care-seeking behavior was adjudged to be appropriate. Compared to patients with appropriate health care-seeking behavior, those with inappropriate health care-seeking behavior had a lower mean age (40.4 ± 13.7 years vs 47.3 ± 15.6 years;P = 0.03, were less likely to see their illness as a medical problem (46.7% vs 67.6%;P = 0.04, more likely to have a monthly income less than N25,000 ($150 (80.0% vs 59.5%;P = 0.04, and have received below tertiary level education (20.0% vs 48.6%; P < 0.01. They were also more likely to have consulted more than one health care provider before being referred to our clinic. The factors predicting inappropriate health care-seeking behavior were education below the tertiary level and age less than 45 years. Conclusion: Though health care-seeking behavior was appropriate in majority of our patients with CKD, there remains a need for improved public health awareness.

  16. Symptom interpretation and health care seeking in ovarian cancer

    DEFF Research Database (Denmark)

    Seibaek, Lene; Petersen, Lone K; Blaakær, Jan

    2011-01-01

    exclusively a medical problem, as the delay proved to be influenced by organisational, cultural, and social factors, too. Initiatives facilitating the diagnostic process and research concerning the selection of individuals for further investigation are indicated. The way in which the women interpreted...... their symptoms was influenced by their personal experiences, their cultural, and their social background. This became crucial to the diagnostic process. These issues need to be explored through further research on women's experiences during the diagnostic process....

  17. Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo.

    Science.gov (United States)

    Bartels, Susan A; Scott, Jennifer A; Leaning, Jennifer; Kelly, Jocelyn T; Joyce, Nina R; Mukwege, Denis; Vanrooyen, Michael J

    2012-12-01

    One of the most striking features of the ongoing conflict in the Democratic Republic of Congo (DRC) is the use of sexual violence. In spite of the brutality of these crimes, the experiences of women affected by sexual violence in Eastern DRC remain poorly characterized. This analysis aimed to (1) provide detailed demographics of sexual violence survivors presenting to Panzi Hospital; (2) examine how demographic factors might impact patterns of sexual violence; and (3) describe care-seeking behavior among sexual violence survivors. The demographics and care-seeking behavior of sexual violence survivors in South Kivu Province were described from a retrospective registry-based study of sexual violence survivors presenting to Panzi Hospital (2004-2008). A total of 4311 records were reviewed. The mean age of survivors was 35 years. Most women (53%) were married, self-identified with the Bashi tribe (65%), and reported agriculture as their livelihood (74%). The mean time delay between sexual assault and seeking care was 10.4 months. Five reasons were identified to help explain the lengthy delays to seeking care: waiting for physical symptoms to develop or worsen before seeking medical attention, lack of means to access medical care, concerns that family would find out about the sexual assault, stigma surrounding sexual violence, and being abducted into sexual slavery for prolonged periods of time. Many sexual assault survivors have very delayed presentations to medical attention. Promoting timely access of medical care may best be facilitated by reducing stigma and by educating women about the benefits of early medical care, even in the absence of injuries or symptoms.

  18. Care-seeking patterns for fatal non-communicable diseases among women of reproductive age in rural northwest Bangladesh.

    Science.gov (United States)

    Sikder, Shegufta S; Labrique, Alain B; Ullah, Barkat; Mehra, Sucheta; Rashid, Mahbubur; Ali, Hasmot; Jahan, Nusrat; Shamim, Abu A; West, Keith P; Christian, Parul

    2012-08-15

    Though non-communicable diseases contribute to an increasing share of the disease burden in South Asia, health systems in most rural communities are ill-equipped to deal with chronic illness. This analysis seeks to describe care-seeking behavior among women of reproductive age who died from fatal non-communicable diseases as recorded in northwest rural Bangladesh between 2001 and 2007. This analysis utilized data from a large population-based cohort trial in northwest rural Bangladesh. To conduct verbal autopsies of women who died while under study surveillance, physicians interviewed family members to elicit the biomedical symptoms that the women experienced as well as a narrative of the events leading to deaths. We performed qualitative textual analysis of verbal autopsy narratives for 250 women of reproductive age who died from non-communicable diseases between 2001 and 2007. The majority of women (94%) sought at least one provider for their illnesses. Approximately 71% of women first visited non-certified providers such as village doctors and traditional healers, while 23% first sought care from medically certified providers. After the first point of care, women appeared to switch to medically certified practitioners when treatment from non-certified providers failed to resolve their illness. This study suggests that treatment seeking patterns for non-communicable diseases are affected by many of the sociocultural factors that influence care seeking for pregnancy-related illnesses. Families in northwest rural Bangladesh typically delayed seeking treatment from medically certified providers for NCDs due to the cost of services, distance to facilities, established relationships with non-certified providers, and lack of recognition of the severity of illnesses. Most women did not realize initially that they were suffering from a chronic illness. Since women typically reached medically certified providers in advanced stages of disease, they were usually told that

  19. Care-seeking patterns for fatal non-communicable diseases among women of reproductive age in rural northwest Bangladesh

    Directory of Open Access Journals (Sweden)

    Sikder Shegufta S

    2012-08-01

    Full Text Available Abstract Background Though non-communicable diseases contribute to an increasing share of the disease burden in South Asia, health systems in most rural communities are ill-equipped to deal with chronic illness. This analysis seeks to describe care-seeking behavior among women of reproductive age who died from fatal non-communicable diseases as recorded in northwest rural Bangladesh between 2001 and 2007. Methods This analysis utilized data from a large population-based cohort trial in northwest rural Bangladesh. To conduct verbal autopsies of women who died while under study surveillance, physicians interviewed family members to elicit the biomedical symptoms that the women experienced as well as a narrative of the events leading to deaths. We performed qualitative textual analysis of verbal autopsy narratives for 250 women of reproductive age who died from non-communicable diseases between 2001 and 2007. Results The majority of women (94% sought at least one provider for their illnesses. Approximately 71% of women first visited non-certified providers such as village doctors and traditional healers, while 23% first sought care from medically certified providers. After the first point of care, women appeared to switch to medically certified practitioners when treatment from non-certified providers failed to resolve their illness. Conclusions This study suggests that treatment seeking patterns for non-communicable diseases are affected by many of the sociocultural factors that influence care seeking for pregnancy-related illnesses. Families in northwest rural Bangladesh typically delayed seeking treatment from medically certified providers for NCDs due to the cost of services, distance to facilities, established relationships with non-certified providers, and lack of recognition of the severity of illnesses. Most women did not realize initially that they were suffering from a chronic illness. Since women typically reached medically certified

  20. Health insurance and care-seeking behaviours of female migrants in Accra, Ghana.

    Science.gov (United States)

    Lattof, Samantha R

    2018-05-01

    People working in Ghana's informal sector have low rates of enrolment in the publicly funded National Health Insurance Scheme. Informal sector workers, including migrant girls and women from northern Ghana working as head porters (kayayei), report challenges obtaining insurance and seeking formal health care. This article analyses how health insurance status affects kayayei migrants' care-seeking behaviours. This mixed-methods study involved surveying 625 migrants using respondent-driven sampling and conducting in-depth interviews with a sub-sample of 48 migrants. Analyses explore health status and health seeking behaviours for recent illness/injury. Binary logistic regression modelled the effects of selected independent variables on whether or not a recently ill/injured participant (n = 239) sought health care. Although recently ill/injured participants (38.4%) desired health care, less than half (43.5%) sought care. Financial barriers overwhelmingly limit kayayei migrants from seeking health care, preventing them from registering with the National Health Insurance Scheme, renewing their expired health insurance policies, or taking time away from work. Both insured and uninsured migrants did not seek formal health services due to the unpredictable nature of out-of-pocket expenses. Catastrophic and impoverishing medical expenses also drove participants' migration in search of work to repay loans and hospital bills. Health insurance can help minimize these expenditures, but only 17.4% of currently insured participants (58.2%) reported holding a valid health insurance card in Accra. The others lost their cards or forgot them when migrating. Access to formal health care in Accra remains largely inaccessible to kayayei migrants who suffer from greater illness/injury than the general female population in Accra and who are hindered in their ability to receive insurance exemptions. With internal migration on the rise in many settings, health systems must recognize the

  1. A cross-sectional survey of parental care-seeking behavior for ...

    African Journals Online (AJOL)

    Background: Infections are a common cause of childhood morbidity and mortality in developing countries. Proper management of these conditions in appropriate health facilities provides the best opportunity for survival and reducing disability. Aims: To evaluate the care-seeking behavior by parents of under-five children ...

  2. Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

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    Oshima Sumiko

    2013-01-01

    Full Text Available Abstract Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively. Results Survivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking. Conclusions Post-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care.

  3. Awareness of treatment history in family and friends, and mental health care seeking propensity.

    Science.gov (United States)

    Thériault, François L; Colman, Ian

    2017-04-01

    Many adults suffering from mental disorders never receive the care they need. The role of family and friends in overcoming mental health treatment barriers is poorly understood. We investigated the association between awareness of lifetime mental health treatment history in one's family or friends, and likelihood of having recently received mental health care for oneself. Using Canadian Community Health Survey 2012-Mental Health data, we defined care seekers as individuals who talked about mental health issues to at least one health professional in the past 12 months. Seekers were matched to non-seekers based on estimated care seeking propensity, and 1933 matched pairs were created. Reported awareness of lifetime treatment history in family and friends was compared between seekers and non-seekers. There were no differences in the distribution of any confounder of interest between seekers and non-seekers. 73% of seekers were aware of treatment history in family or friends, compared to only 56% of non-seekers (RR 1.3; 95% CI 1.2, 1.3). Awareness of treatment history in family members had nearly identical associations with care seeking as awareness of treatment history in friends. We have found a social clustering of mental health care seeking behavior; individuals who were aware of lifetime treatment history in family or friends were more likely to have recently sought care for themselves. These novel results are consistent with a social learning model of care seeking behavior, and could inform efforts to bridge the current mental health treatment gap.

  4. Effect of community mobilization on appropriate care seeking for pneumonia in Haripur, Pakistan

    Directory of Open Access Journals (Sweden)

    Salim Sadruddin

    2015-07-01

    Full Text Available Background: Appropriate and timely care seeking reduces mortality for childhood illnesses including pneumonia. Despite over 90 000 Lady Health Workers (LHWs deployed in Pakistan, whose tasks included management of pneumonia, only 16% of care takers sought care from them for respiratory infections. As part of a community case management trial for childhood pneumonia, community mobilization interventions were implemented to improve care seeking from LHWs in Haripur district, Pakistan. The objective of the study was to increase the number of children receiving treatment for pneumonia and severe pneumonia by Lady Health Workers (LHWs through community mobilization approaches for prompt recognition and care seeking in 2 to 59 month–old children. Methods: To assess pneumonia care seeking practices, pre and post– intervention household surveys were conducted in 28 target Union Councils. Formative research to improve existing LHW training materials, job aids and other materials was carried out. Advocacy events were organized, LHWs and male health promoters were trained in community mobilization, non–functional women and male health committees were revitalized and LHWs and male health promoters conducted community awareness sessions. Results: The community mobilization interventions were implemented from April 2008 – December 2009. Project and LHW program staff organized 113 sensitization meetings for opinion leaders, which were attended by 2262 males and 3288 females. The 511 trained LHWs organized 6132 community awareness sessions attended by 50 056 women and 511 male promoters conducted 523 sessions attended by 7845 males. In one year period, the number of LHWs treating pneumonia increased from 11 in April 2008 to 505 in March 2009. The care seeking from LHWs for suspected pneumonia increased from 0.7% in pre–intervention survey to 49.2% in post–intervention survey. Conclusion: The increase in care seeking from LHWs benefited the community

  5. Help and Care Seeking for Sexually Transmitted Infections Among Youth in Low- and Middle-Income Countries.

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S; Chandra-Mouli, Venkatraman

    2017-06-01

    The ability to seek help or medical care for sexually transmitted infections (STIs) is vital for sexually active youth; yet, their needs are often unmet. We conducted a qualitative systematic review of studies to assess youth and provider views about the behaviors of young people in help seeking and care seeking for STI services in low- and middle-income countries. We searched peer-reviewed literature for studies published between 2001 and 2014 with a study population of youth (age, 10-24 years) and/or health service providers. Eighteen studies were identified for inclusion from 18 countries. Thematic analyses identified key themes across the studies. The majority of studies included discussion of youth not seeking treatment, resorting to self-treatment, or waiting to access care, suggesting that many youth still do not seek timely care for STIs. Youth desired more information on sexual health and cited barriers related to fear or taboos in obtaining help or information, especially from providers or parents. Many did not recognize symptoms or waited until symptoms worsened. However, many youth were able to identify a number of sources for STI related care including public and private clinics, pharmacies, alternative healers, and nongovernmental organizations. Youth's help seeking and care seeking preferences were frequently influenced by desires for confidentiality, friendliness, and cost. Youth in low- and middle-income countries experience significant barriers in help seeking for STIs and often do not seek or postpone medical care. Improving uptake may require efforts to address clinic systems, provider attitudes, confidentiality, and cultural norms related to youth sexuality.

  6. Social differentiation and embodied dispositions: a qualitative study of maternal care-seeking behaviour for near-miss morbidity in Bolivia

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    Liljestrand Jerker

    2009-07-01

    Full Text Available Abstract Background Use of maternal health care in low-income countries has been associated with several socioeconomic and demographic factors, although contextual analyses of the latter have been few. A previous study showed that 75% of women with severe obstetric morbidity (near-miss identified at hospitals in La Paz, Bolivia were in critical conditions upon arrival, underscoring the significance of pre-hospital barriers also in this setting with free and accessible maternal health care. The present study explores how health care-seeking behaviour for near-miss morbidity is conditioned in La Paz, Bolivia. Methods Thematic interviews with 30 women with a near-miss event upon arrival at hospital. Near-miss was defined based on clinical and management criteria. Modified analytic induction was applied in the analysis that was further influenced by theoretical views that care-seeking behaviour is formed by predisposing characteristics, enabling factors, and perceived need, as well as by socially shaped habitual behaviours. Results The self-perception of being fundamentally separated from "others", meaning those who utilise health care, was typical for women who customarily delivered at home and who delayed seeking medical assistance for obstetric emergencies. Other explanations given by these women were distrust of authority, mistreatment by staff, such as not being kept informed about their condition or the course of their treatment, all of which reinforced their dissociation from the health-care system. Conclusion The findings illustrate health care-seeking behaviour as a practise that is substantially conditioned by social differentiation. Social marginalization and the role health institutions play in shaping care-seeking behaviour have been de-emphasised by focusing solely on endogenous cultural factors in Bolivia.

  7. The Association Between Internet Use and Ambulatory Care-Seeking Behaviors in Taiwan: A Cross-Sectional Study.

    Science.gov (United States)

    Hsieh, Ronan Wenhan; Chen, Likwang; Chen, Tsung-Fu; Liang, Jyh-Chong; Lin, Tzu-Bin; Chen, Yen-Yuan; Tsai, Chin-Chung

    2016-12-07

    Compared with the traditional ways of gaining health-related information from newspapers, magazines, radio, and television, the Internet is inexpensive, accessible, and conveys diverse opinions. Several studies on how increasing Internet use affected outpatient clinic visits were inconclusive. The objective of this study was to examine the role of Internet use on ambulatory care-seeking behaviors as indicated by the number of outpatient clinic visits after adjusting for confounding variables. We conducted this study using a sample randomly selected from the general population in Taiwan. To handle the missing data, we built a multivariate logistic regression model for propensity score matching using age and sex as the independent variables. The questionnaires with no missing data were then included in a multivariate linear regression model for examining the association between Internet use and outpatient clinic visits. We included a sample of 293 participants who answered the questionnaire with no missing data in the multivariate linear regression model. We found that Internet use was significantly associated with more outpatient clinic visits (P=.04). The participants with chronic diseases tended to make more outpatient clinic visits (PInternet may be associated with patients' increasing need for interpreting and discussing the information with health care professionals, thus resulting in an increasing number of outpatient clinic visits. In addition, the media literacy of Web-based health-related information seekers may also affect their ambulatory care-seeking behaviors, such as outpatient clinic visits. ©Ronan Wenhan Hsieh, Likwang Chen, Tsung-Fu Chen, Jyh-Chong Liang, Tzu-Bin Lin, Yen-Yuan Chen, Chin-Chung Tsai. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.12.2016.

  8. Health Care Seeking Behavior of Persons with Acute Chagas Disease in Rural Argentina: A Qualitative View

    Directory of Open Access Journals (Sweden)

    Ignacio Llovet

    2016-01-01

    Full Text Available Chagas disease (CD is a tropical parasitic disease largely underdiagnosed and mostly asymptomatic affecting marginalized rural populations. Argentina regularly reports acute cases of CD, mostly young individuals under 14 years old. There is a void of knowledge of health care seeking behavior in subjects experiencing a CD acute condition. Early treatment of the acute case is crucial to limit subsequent development of disease. The article explores how the health outcome of persons with acute CD may be conditioned by their health care seeking behavior. The study, with a qualitative approach, was carried out in rural areas of Santiago del Estero Province, a high risk endemic region for vector transmission of CD. Narratives of 25 in-depth interviews carried out in 2005 and 2006 are analyzed identifying patterns of health care seeking behavior followed by acute cases. Through the retrospective recall of paths for diagnoses, weaknesses of disease information, knowledge at the household level, and underperformance at the provincial health care system level are detected. The misdiagnoses were a major factor in delaying a health care response. The study results expose lost opportunities for the health care system to effectively record CD acute cases.

  9. Care-seeking patterns among families that experienced under-five child mortality in rural Rwanda.

    Science.gov (United States)

    Kagabo, Daniel M; Kirk, Catherine M; Bakundukize, Benjamin; Hedt-Gauthier, Bethany L; Gupta, Neil; Hirschhorn, Lisa R; Ingabire, Willy C; Rouleau, Dominique; Nkikabahizi, Fulgence; Mugeni, Catherine; Sayinzoga, Felix; Amoroso, Cheryl L

    2018-01-01

    Over half of under-five deaths occur in sub-Saharan Africa and appropriate, timely, quality care is critical for saving children's lives. This study describes the context surrounding children's deaths from the time the illness was first noticed, through the care-seeking patterns leading up to the child's death, and identifies factors associated with care-seeking for these children in rural Rwanda. Secondary analysis of a verbal and social autopsy study of caregivers who reported the death of a child between March 2013 to February 2014 that occurred after discharge from the child's birth facility in southern Kayonza and Kirehe districts in Rwanda. Bivariate analyses using Fisher's exact tests were conducted to identify child, caregiver, and household factors associated with care-seeking from the formal health system (i.e., community health worker or health facility). Factors significant at α = 0.10 significance level were considered for backwards stepwise multivariate logistic regression, stopping when remaining factors were significantly associated with care-seeking at α = 0.05 significance level. Among the 516 eligible deaths among children under-five, 22.7% (n = 117) did not seek care from the health system. For those who did, the most common first point of contact was community health workers (45.8%). In multivariate logistic regression, higher maternal education (OR = 3.36, 95% CI: 1.89, 5.98), having diarrhea (OR = 4.21, 95%CI: 1.95, 9.07) or fever (OR = 2.03, 95%CI: 1.11, 3.72), full household insurance coverage (3.48, 95%CI: 1.79, 6.76), and longer duration of illness (OR = 22.19, 95%CI: 8.88, 55.48) were significantly associated with formal care-seeking. Interventions such as community health workers and insurance promote access to care, however a gap remains as many children had no contact with the health system prior to death and those who sought formal care still died. Further efforts are needed to respond to urgent cases in communities and further

  10. 26 CFR 1.401-14 - Inclusion of medical benefits for retired employees in qualified pension or annuity plans.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Inclusion of medical benefits for retired...-Sharing, Stock Bonus Plans, Etc. § 1.401-14 Inclusion of medical benefits for retired employees in... employer providing such medical benefits by reason of permanent disability. For purposes of the preceding...

  11. What do health coaches do? Direct observation of health coach activities during medical and patient-health coach visits at 3 federally qualified health centers.

    Science.gov (United States)

    Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H

    2018-05-01

    To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Predictive value of grade point average (GPA), Medical College Admission Test (MCAT), internal examinations (Block) and National Board of Medical Examiners (NBME) scores on Medical Council of Canada qualifying examination part I (MCCQE-1) scores.

    Science.gov (United States)

    Roy, Banibrata; Ripstein, Ira; Perry, Kyle; Cohen, Barry

    2016-01-01

    To determine whether the pre-medical Grade Point Average (GPA), Medical College Admission Test (MCAT), Internal examinations (Block) and National Board of Medical Examiners (NBME) scores are correlated with and predict the Medical Council of Canada Qualifying Examination Part I (MCCQE-1) scores. Data from 392 admitted students in the graduating classes of 2010-2013 at University of Manitoba (UofM), College of Medicine was considered. Pearson's correlation to assess the strength of the relationship, multiple linear regression to estimate MCCQE-1 score and stepwise linear regression to investigate the amount of variance were employed. Complete data from 367 (94%) students were studied. The MCCQE-1 had a moderate-to-large positive correlation with NBME scores and Block scores but a low correlation with GPA and MCAT scores. The multiple linear regression model gives a good estimate of the MCCQE-1 (R2 =0.604). Stepwise regression analysis demonstrated that 59.2% of the variation in the MCCQE-1 was accounted for by the NBME, but only 1.9% by the Block exams, and negligible variation came from the GPA and the MCAT. Amongst all the examinations used at UofM, the NBME is most closely correlated with MCCQE-1.

  13. CARE SEEKING BEHAVIOUR OF MOTHERS DURING ILLNESS OF NEWBORN IN URBAN SLUMS OF LUCKNOW CITY

    Directory of Open Access Journals (Sweden)

    P Gupta

    2012-09-01

    Full Text Available Objectives: To study the knowledge of mothers about recognition of danger signs and care seeking behaviour during illness of newborn child in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (76.9% of the mothers said that if the baby was very cold to touch or running temperature is a danger sign during newborn period followed by absence of sucking (68.9% in previously sucking newborn as danger sign. Majority (71.9% of the mothers consulted local doctor for any problem during neonatal period. Only 12 percent of the mothers approached Govt. doctor for the treatment . It was observed that Hing was given by 86.2 percent mothers in case of stomachache. 82.8 percent mothers had given salt and sugar solutions in the case of diarrhoea . Conclusion: In majority of cases correct knowledge and care seeking behaviour during illness of newborn were lacking among mothers and this should be promoted through improved coverage with existing health services.

  14. CARE SEEKING BEHAVIOUR OF MOTHERS DURING ILLNESS OF NEWBORN IN URBAN SLUMS OF LUCKNOW CITY.

    Directory of Open Access Journals (Sweden)

    P Gupta

    2012-10-01

    Full Text Available Objectives: To study the knowledge of mothers about recognition of danger signs and care seeking behaviour during illness of newborn child in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (76.9% of the mothers said that if the baby was very cold to touch or running temperature is a danger sign during newborn period followed by absence of sucking (68.9% in previously sucking newborn as danger sign. Majority (71.9% of the mothers consulted local doctor for any problem during neonatal period. Only 12 percent of the mothers approached Govt. doctor for the treatment . It was observed that Hing was given by 86.2 percent mothers in case of stomachache. 82.8 percent mothers had given salt and sugar solutions in the case of diarrhoea\t. Conclusion: In majority of cases correct knowledge and care seeking behaviour during illness of newborn were lacking among mothers and this should be promoted through improved coverage with existing health services.

  15. Physician office vs retail clinic: patient preferences in care seeking for minor illnesses.

    Science.gov (United States)

    Ahmed, Arif; Fincham, Jack E

    2010-01-01

    Retail clinics are a relatively new phenomenon in the United States, offering cheaper and convenient alternatives to physician offices for minor illness and wellness care. The objective of this study was to investigate the effects of cost of care and appointment wait time on care-seeking decisions at retail clinics or physician offices. As part of a statewide random-digit-dial survey of households, adult residents of Georgia were interviewed to conduct a discrete choice experiment with 2 levels each of 4 attributes: price ($59; $75), appointment wait time (same day; 1 day or longer), care setting-clinician combination (nurse practitioner in retail clinic; physician in private office), and acute illness (urinary tract infection [UTI]; influenza). The respondents indicated whether they would seek care under each of the 16 resulting choice scenarios. A cooperation rate of 33.1% yielded 493 completed telephone interviews. The respondents preferred to seek care for both conditions; were less likely to seek care for UTI (beta = -0.149; P = .008); preferred to seek care from a physician (beta = 1.067; P clinic and $82.12 to wait 1 day or more. Time and cost savings offered by retail clinics are attractive to patients, and they are likely to seek care there given sufficient cost savings. Appointment wait time is the most important factor in care-seeking decisions and should be considered carefully in setting appointment policies in primary care practices.

  16. Patterns and determinants of care seeking for obstetric complications in rural northwest Bangladesh: analysis from a prospective cohort study.

    Science.gov (United States)

    Sikder, Shegufta S; Labrique, Alain B; Craig, Ian M; Wakil, Mohammad Abdul; Shamim, Abu Ahmed; Ali, Hasmot; Mehra, Sucheta; Wu, Lee; Shaikh, Saijuddin; West, Keith P; Christian, Parul

    2015-04-18

    In communities with low rates of institutional delivery, little data exist on care-seeking behavior for potentially life-threatening obstetric complications. In this analysis, we sought to describe care-seeking patterns for self-reported complications and near misses in rural Bangladesh and to identify factors associated with care seeking for these conditions. Utilizing data from a community-randomized controlled trial enrolling 42,214 pregnant women between 2007 and 2011, we used multivariable multinomial logistic regression to explore the association of demographic and socioeconomic factors, perceived need, and service availability with care seeking for obstetric complications or near misses. We also used multivariable multinomial logistic regression to analyze the factors associated with care seeking by type of obstetric complication (eclampsia, sepsis, hemorrhage, and obstructed labor). Out of 9,576 women with data on care seeking for obstetric complications, 77% sought any care, with 29% (n = 2,150) visiting at least one formal provider and 70% (n = 5,149) visiting informal providers only. The proportion of women seeking at least one formal provider was highest among women reporting eclampsia (57%), followed by hemorrhage (28%), obstructed labor (22%), and sepsis (17%) (p s literacy (RRR of 1.21; 95% CI of [1.05-1.42]), and women's employment (RRR of 1.10; 95% CI of [1.01-1.18]) were significantly associated with care seeking from formal providers. Service factors including living less than 10 kilometers from a health facility (RRR of 1.16; 95% CI of [1.05-1.28]) and facility availability of comprehensive obstetric services (RRR of 1.25; 95% CI of 1.04-1.36) were also significantly associated with seeking care from formal providers. While the majority of women reporting obstetric complications sought care, less than a third visited health facilities. Improvements in socioeconomic factors such as maternal literacy, coupled with improved geographic access and

  17. Factors Affecting Initial Intimate Partner Violence-Specific Health Care Seeking in the Tokyo Metropolitan Area, Japan.

    Science.gov (United States)

    Kamimura, Akiko; Bybee, Deborah; Yoshihama, Mieko

    2014-09-01

    This study examined the factors affecting a women's initial intimate partner violence (IPV)-specific health care seeking event which refers to the first health care seeking as a result of IPV in a lifetime. Data were collected using the Life History Calendar method in the Tokyo metropolitan area from 101 women who had experienced IPV. Discrete-time survival analysis was used to assess the time to initial IPV-specific health care seeking. IPV-related injury was the most significant factor associated with increased likelihood of seeking IPV-specific health care seeking for the first time. In the presence of a strong effect of formal help seeking, physical and sexual IPV were no longer significantly related to initial IPV-specific health care seeking. The results suggest some victims of IPV may not seek health care unless they get injured. The timing of receiving health care would be important to ensure the health and safety of victims. © The Author(s) 2014.

  18. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia

    NARCIS (Netherlands)

    Mehmood, Syed Imran; Norcini, John J.; Borleffs, Jan C. C.

    2013-01-01

    Background: Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to

  19. Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi.

    Science.gov (United States)

    Flax, Valerie L; Thakwalakwa, Chrissie; Ashorn, Ulla

    2016-12-01

    Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children. © The Author(s) 2015.

  20. Exploring the feelings of Iranian women of reproductive age about health care seeking behavior: a qualitative study

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    Mohammad Ali Morowatisharifabad

    2018-01-01

    Full Text Available Background: Despite the important role of feelings in health care seeking behavior (HCSB, this subject has not yet been adequately investigated. HCSB-related feelings begin with the onset of disease symptoms and persist in different forms after treatment. The aim of current study was to explore the feelings that women of reproductive age experience when they seek health care.Methods: In this deductive, qualitative content analysis, participants were selected by purposeful sampling. Semi-structured, in-depth interviews with 17 women of reproductive age and 5 healthcare staffs in Qom, Iran were carried out until data saturation was achieved. Qualitative data were concurrently analyzed by deductive content analysis, using the Health Promotion Model (HPM. The MAXQDA10 software was used to manage qualitative data analysis.Results: Three main categories were drawn from data to explain the HCSB-related feelings of participants consisting of (1 feeling of inner satisfaction with the treatment with 2 subcategories including "peace of mind" and "feeling alive", (2 multiple roles of fear with 5 subcategories including "fear about the consequences of delay", "fear of having hidden diseases", "fear of unknown experiences", "fear of hearing bad news" and "fear of medical errors" and (3uncomfortable feelings with 3 subcategories including "feeling uneasy when attending health facility", "feeling embarrassed" and "feeling worthless due to dealing the doctor".Conclusion: This study revealed that the inner feelings of women varied widely, ranging from positive or motivating feelings to negative or inhibitory ones, given their experiences with the formal health care system and the current situation of medical and health services. Highlighting patients’ perceived inner satisfaction and reducing fear and uncomfortable feelings by adopting culture-based practical strategies can enhance women’s HCSB.

  1. Chronic morbidity and health care seeking behaviour amongst elderly population in rural areas of Uttarakhand

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    Surekha Kishore

    2015-06-01

    Full Text Available Background: Ageing is a natural process, always associated with physiological and biological decline. Global population is ageing; the proportion of older persons has been rising steadily, from 7% in 1950 to 11% in 2007, with an expected rise to reach 22 % in 2050. With improving knowledge and awareness the health care seeking behavior has shown an increasingly positive trend. With increasing age, morbidity,   especially those arising from chronic diseases also increases. On the contrary, health care delivered at household level has definitely   gone down due to financial constraints and increasing cost of living, thus posing a problem for the elderly.  Aims & Objective: To find out the prevalence of chronic morbidity and health care seeking behaviour amongst the elderly in rural areas of Uttarakhand. Material and Methods: A cross-sectional study was carried out in rural areas of Uttarakhand to assess the chronic morbidity amongst elderly population. All the persons above the age group of 60 years of the eight villages were interviewed using a pre-defined, pre-tested, semi-structured and indigenously developed questionnaire. Results: The study group suffered from various chronic morbidities like hypertension, diabetes, cardiovascular diseases. Men were greater in number (158, 62.2%. Participants belonging mostly to nuclear families (156, 61.9%. Below the poverty line were (98, 38.9%. Half of the study population had one or the other chronic morbid condition. Majority of the elderly men contacted the health care facility whereas majority of the elderly women chose to use remedies. Conclusion: There is definitely a need of   provision of health care services for poor geriatric population. In addition to this government should take up some program for social security of this population along with creating an awareness about the same.

  2. Care seeking behaviour and various delays in tuberculosis patients registered under RNTCP in Pune city

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    Jayashree Sachin Gothankar

    2016-03-01

    Full Text Available Introduction: Case finding in tuberculosis is known to be influenced by factors such as patient motivation, care seeking, the degree of diagnostic suspicion by health care provider which could result in a delayed diagnosis.Objective: To determine care seeking behaviour and delay in diagnosis and treatment of new sputum positive tuberculosis patients registered under RNTCP.Material and Methods: Descriptive cross sectional study. 283 new sputum positive tuberculosis patients (≥15 years of age registered during a period of six months at two randomly selected tuberculosis unit of Pune city. Questionnaire by WHO was modified and used. Interviews were conducted in DOT centres. Statistical analysis: Frequency, mean and standard deviation, chi square test.Results: Mean age of patients was 35 (±15 years18% of patients were unemployed and 77% resided in urban slums. The commonest co morbidity in 7.4% and 3.5 % patients was HIV/ AIDS followed by diabetics respectively. Majority of the patients, for the first and second time visited a general practitioner. Median patient, health care system and total delay were 18, 22 and 47 days with mean of 24±21, 32±30 and 56±33 days respectively. Health care system delay was less (p<0.05 in patients who first visited the public health care facility than patients who first visited a private health care provider.Conclusions: General practitioners are preferred first choice of health care provider for tuberculosis patients. Mean health care system delay is more than patient delay.

  3. Postpartum haemorrhage and eclampsia: differences in knowledge and care-seeking behaviour in two districts of Bangladesh.

    Science.gov (United States)

    Kalim, Nahid; Anwar, Iqbal; Khan, Jasmin; Blum, Lauren S; Moran, Allisyn C; Botlero, Roslin; Koblinsky, Marge

    2009-04-01

    In high- and low-performing districts of Bangladesh, the study explored the demand-side of maternal healthcare by looking at differences in perceived knowledge and care-seeking behaviours of women in relation to postpartum haemorrhage or eclampsia. Haemorrhage and eclampsia are two major causes of maternal mortality in Bangladesh. The study was conducted during July 2006-December 2007. Both postpartum bleeding and eclampsia were recognized by women of different age-groups as severe and life-threatening obstetric complications. However, a gap existed between perception and actual care-seeking behaviours which could contribute to the high rate of maternal deaths associated with these conditions. There were differences in care-seeking practices among women in the two different areas of Bangladesh, which may reflect sociocultural differences, disparities in economic and educational opportunities, and a discrimination in the availability of care.

  4. Care-Seeking for Diarrhoea in Southern Malawi: Attitudes, Practices and Implications for Diarrhoea Control

    Directory of Open Access Journals (Sweden)

    Salule Masangwi

    2016-11-01

    Full Text Available This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4%, statistically higher than the national average of 17%. Using hierarchically built data from a survey of 1403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour. The results show that 68% of mothers used oral rehydration solutions (ORS the last time a child in their family had diarrhoea. However, when asked on the action they take when a member of their household has diarrhoea two thirds of the mothers said they visit a health facility. Most respondents (73% mentioned distance and transport costs as the main obstacles to accessing their nearest health facility and the same proportion of respondents mentioned prolonged waiting time and absence of health workers as the main obstacles encountered at the health facilities. The main predictor variables when a member of the family had diarrhoea were maternal age, distance to the nearest health facility, school level, and relative wealth, household diarrhoea endemicity, and household size while the main predictor variables when a child had diarrhoea were existence of a village health committee (VHC, distance to the nearest health facility, and maternal age. Most households use ORS for the treatment of diarrhoea and village health committees and health surveillance assistants (HSAs are important factors in this choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and prescribed handling are important. There is need for a comprehensive concept addressing several dimensions of management and

  5. Birth rights and rituals in rural south India: care seeking in the intrapartum period.

    Science.gov (United States)

    Matthews, Zoë; Ramakrishna, Jayashree; Mahendra, Shanti; Kilaru, Asha; Ganapathy, Saraswathy

    2005-07-01

    Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women's experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births

  6. Health care seeking practices of caregivers of children under 5 with diarrhea in two informal settlements in Nairobi, Kenya.

    Science.gov (United States)

    Mukiira, Carol; Ibisomi, Latifat

    2015-06-01

    In Kenya, as in other developing countries, diarrhea is among the leading causes of child mortality. Despite being easy to prevent and treat, care seeking for major child illnesses including diarrhea remains poor in the country. Mortality due to diarrhea is even worse in informal settlements that are characterized by poor sanitary conditions and largely unregulated health care system among other issues. The study aims to examine the health care seeking practices of caregivers of children under 5 with diarrhea in two informal settlements in Nairobi, Kenya. The article used data from a maternal and child health (MCH) prospective study conducted between 2006 and 2010. Results show that more than half (55%) of the caregivers sought inappropriate health care in the treatment of diarrhea of their child. Of the 55%, about 35% sought no care at all. Use of oral rehydration solution and zinc supplements, which are widely recommended for management of diarrhea, was very low. The critical predictors of health care seeking identified in the study are duration of illness, informal settlement of residence, and the child's age. The study showed that appropriate health care seeking practices for childhood diarrhea remain a great challenge among the urban poor in Kenya. © The Author(s) 2013.

  7. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    DEFF Research Database (Denmark)

    Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul

    2013-01-01

    's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. METHODS: This is a prospective study...

  8. Patterns and Determinants of Care-Seeking for Antepartum and Intrapartum Complications in Rural Bangladesh: Results from a Cohort Study.

    Science.gov (United States)

    Khanam, Rasheda; Creanga, Andreea A; Koffi, Alain K; Mitra, Dipak K; Mahmud, Arif; Begum, Nazma; Moin, Syed Mamun Ibne; Ram, Malathi; Quaiyum, Md Abdul; Ahmed, Saifuddin; Saha, Samir K; Baqui, Abdullah H

    2016-01-01

    The burden of maternal complications during antepartum and intrapartum periods is high and care seeking from a trained provider is low, particularly in low middle income countries of sub-Saharan Africa and South Asia. Identification of barriers to access to trained care and development of strategies to address them will contribute to improvements in maternal health. Using data from a community-based cohort of pregnant women, this study identified the prevalence of antepartum and intrapartum complications and determinants of care-seeking for these complications in rural Bangladesh. The study was conducted in 24,274 pregnant women between June 2011 and December 2013 in rural Sylhet district of Bangladesh. Women were interviewed during pregnancy to collect data on demographic and socioeconomic characteristics; prior miscarriages, stillbirths, live births, and neonatal deaths; as well as data on their ability to make decision to go to health center alone. They were interviewed within the first 7 days of child birth to collect data on self-reported antepartum and intrapartum complications and care seeking for those complications. Bivariate analysis was conducted to explore association between predisposing (socio-demographic), enabling (economic), perceived need, and service related factors with care-seeking for self-reported antepartum and intrapartum complications. Multivariable multinomial logistic regression was performed to examine the association of selected factors with care-seeking for self-reported antepartum and intrapartum complications adjusting for co-variates. Self-reported antepartum and intrapartum complications among women were 14.8% and 20.9% respectively. Among women with any antepartum complication, 58.9% sought care and of these 46.5% received care from a trained provider. Of the women with intrapartum complications, 61.4% sought care and of them 46.5% did so from a trained provider. Care-seeking for both antepartum and intrapartum complications from

  9. Transaction costs of access to health care: Implications of the care-seeking pathways of tuberculosis patients for health system governance in Nigeria.

    Science.gov (United States)

    Abimbola, Seye; Ukwaja, Kingsley N; Onyedum, Cajetan C; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra L C

    2015-10-01

    Health care costs incurred prior to the appropriate patient-provider transaction (i.e., transaction costs of access to health care) are potential barriers to accessing health care in low- and middle-income countries. This paper explores these transaction costs and their implications for health system governance through a cross-sectional survey of adult patients who received their first diagnosis of pulmonary tuberculosis (TB) at the three designated secondary health centres for TB care in Ebonyi State, Nigeria. The patients provided information on their care-seeking pathways and the associated costs prior to reaching the appropriate provider. Of the 452 patients, 84% first consulted an inappropriate provider. Only 33% of inappropriate consultations were with qualified providers (QP); the rest were with informal providers such as pharmacy providers (PPs; 57%) and traditional providers (TP; 10%). Notably, 62% of total transaction costs were incurred during the first visit to an inappropriate provider and the mean transaction costs incurred was highest with QPs (US$30.20) compared with PPs (US$14.40) and TPs (US$15.70). These suggest that interventions for reducing transaction costs should include effective decentralisation to integrate TB care with services at the primary health care level, community engagement to address information asymmetry, enforcing regulations to keep informal providers within legal limits and facilitating referral linkages among formal and informal providers to increase early contact with appropriate providers.

  10. Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh.

    Science.gov (United States)

    Alfonso, Natalia Y; Alonge, Olakunle; Hoque, Dewan Md Emdadul; Baset, Kamran Ul; Hyder, Adnan A; Bishai, David

    2017-04-29

    This study provides a comprehensive review of the care-seeking patterns and direct economic burden of injuries from the victims' perspective in rural Bangladesh using a 2013 household survey covering 1.17 million people. Descriptive statistics and bivariate analyses were used to derive rates and test the association between variables. An analytic model was used to estimate total injury out-of-pocket (OOP) payments and a multivariate probit regression model assessed the relationship between financial distress and injury type. Results show non-fatal injuries occur to 1 in 5 people in our sample per year. With average household size of 4.5 in Bangladesh--every household has an injury every year. Most non-fatally injured patients sought healthcare from drug sellers. Less than half of fatal injuries sought healthcare and half of those with care were hospitalized. Average OOP payments varied significantly (range: $8-$830) by injury type and outcome (fatal vs. non-fatal). Total injury OOP expenditure was $$355,795 and $5000 for non-fatal and fatal injuries, respectively, per 100,000 people. The majority of household heads with injuries reported financial distress. This study can inform injury prevention advocates on disparities in healthcare usage, OOP costs and financial distress. Reallocation of resources to the most at risk populations can accelerate reduction of preventable injuries and prevent injury related catastrophic payments and impoverishment.

  11. Gender differences in care-seeking behavior and healthcare consumption immediately after whiplash trauma.

    Directory of Open Access Journals (Sweden)

    Artur Tenenbaum

    Full Text Available The aim was to study gender differences in care-seeking behavior and treatment provided immediately after whiplash trauma.Participants were residents from a defined geographical area, Skaraborg County in the southwestern part of Sweden. A cohort of 3,368 persons exposed to whiplash trauma and attending a healthcare facility immediately after the trauma between 1999 and 2008 were identified in a database. Information about gender, age, time elapsed prior to seeking care, type of healthcare contact, initial treatment provided and eventual hospitalization time was retrieved.Women sought care later than men (p = 0.00074. Women consulted primary healthcare first more often than men, who more often first sought hospital care (p = 0.0060. There were no gender differences regarding the type of treatment after trauma. Women had longer hospital admission than men (p = 0.022, indicating their injuries were at least similar to or worse than men's.Women sought healthcare later than men after whiplash trauma. Although not directly investigated in this study, it raises the question if this may reduce their probability of getting financial compensation compared to men.

  12. Gender differences in care-seeking behavior and healthcare consumption immediately after whiplash trauma

    Science.gov (United States)

    Tenenbaum, Artur; Nordeman, Lena; Sunnerhagen, Katharina S.; Gunnarsson, Ronny

    2017-01-01

    Objective The aim was to study gender differences in care-seeking behavior and treatment provided immediately after whiplash trauma. Methods Participants were residents from a defined geographical area, Skaraborg County in the southwestern part of Sweden. A cohort of 3,368 persons exposed to whiplash trauma and attending a healthcare facility immediately after the trauma between 1999 and 2008 were identified in a database. Information about gender, age, time elapsed prior to seeking care, type of healthcare contact, initial treatment provided and eventual hospitalization time was retrieved. Results Women sought care later than men (p = 0.00074). Women consulted primary healthcare first more often than men, who more often first sought hospital care (p = 0.0060). There were no gender differences regarding the type of treatment after trauma. Women had longer hospital admission than men (p = 0.022), indicating their injuries were at least similar to or worse than men’s. Conclusion Women sought healthcare later than men after whiplash trauma. Although not directly investigated in this study, it raises the question if this may reduce their probability of getting financial compensation compared to men. PMID:28441465

  13. Health Care Seeking Behavior among Caregivers of Sick Children Who Had Cerebral Malaria in Northwestern Nigeria

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    Edwin E. Eseigbe

    2012-01-01

    Full Text Available Cerebral malaria is a significant cause of childhood morbidity in our region. The challenges of effective management include time and quality of treatment. The study appraised the health care seeking behavior of caregivers of sick children who developed cerebral malaria, in Zaria, northwestern Nigeria. Caregivers indentified were parents 29 (87.9% and grandparents 4 (12.1%. Most of them were in the upper social classes. Health care options utilized before presentation at our facility were formal health facility 24 (72.7%, patent medicine seller 12 (36.4%, home treatment 10 (30.3%, and herbal concoction 6 (18.2% with majority 24 (72.7% using more than one option. Antimalarial therapy was instituted in 25 (75.6% of the cases. Mortality was significantly associated with the use of herbal concoction, treatment at a formal health facility and patent medicine seller, multiple convulsions, age less than 5 years, and noninstitution of antimalarial therapy before presentation. The study showed use of inappropriate health care options by caregivers and highlighted the need to pursue an awareness drive among caregivers on the use of health care options.

  14. Danger Signs of Childhood Pneumonia: Caregiver Awareness and Care Seeking Behavior in a Developing Country

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    Ikenna K. Ndu

    2015-01-01

    Full Text Available Background. Efforts to reduce child mortality especially in Africa must as a necessity aim to decrease mortality due to pneumonia. To achieve this, preventive strategies such as expanding vaccination coverage are key. However once a child develops pneumonia prompt treatment which is essential to survival is dependent on mothers and caregiver recognition of the symptoms and danger signs of pneumonia. Methods. This community based cross-sectional study enrolled four hundred and sixty-six caregivers in Enugu state. It aimed to determine knowledge of caregivers about danger signs of pneumonia and the sociodemographic factors that influence knowledge and care seeking behaviour of caregivers. Results. There is poor knowledge of the aetiology and danger signs of pneumonia among caregivers. Higher maternal educational attainment and residence in semiurban area were significantly associated with knowledge of aetiology, danger signs, and vaccination of their children against pneumonia. Fast breathing and difficulty in breathing were the commonest known and experienced WHO recognized danger signs while fever was the commonest perceived danger sign among caregivers. Conclusion. Knowledge of danger signs and health seeking behaviour among caregivers is inadequate. There is need for intensified public and hospital based interventions targeted at mothers to improve their knowledge about pneumonia.

  15. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    Science.gov (United States)

    Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul; Andersen, Johan Hviid

    2013-10-01

    Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender. High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.

  16. A community based approach to improve health care seeking for newborn danger signs in rural Wardha, India.

    Science.gov (United States)

    Dongre, Amol R; Deshmukh, Pradeep R; Garg, Bishan S

    2009-01-01

    To find out the effect of community mobilization and health education effort on health care seeking behavior of families with sick newborns, and to explore the rationale behind the changed health care seeking behaviors of mothers in a rural Indian community. In the present community based participatory intervention, a triangulated research design of quantitative (survey) and qualitative (Focus group discussions, FGDs) method was undertaken for needs assessment in year 2004. In community mobilization, women's self help groups; Kishori Panchayat (KP, forum of adolescent girls), Kisan Vikas Manch (Farmers' club) and Village Coordination Committees (VCC) were formed in the study area. The trained social worker facilitated VCCs to develop village health plans to act upon their priority maternal and child health issues. The pregnant women and group members were given health education. The Lot Quality Assurance Sampling (LQAS) technique was used to monitor awareness regarding newborn danger signs among pregnant women. In year 2007, a triangulation of quantitative survey and a qualitative study (free list and pile sort exercise) was undertaken to find out changes in health care seeking behaviors of mothers. There was significant improvement in mothers' knowledge regarding newborn danger signs. About half of the mothers got information from CLICS doot (female community health worker). The monitoring over three years period showed encouraging trend in level of awareness among pregnant women. After three years, the proportion of mothers giving no treatment/home remedy for newborn danger signs declined significantly. However, there was significant improvement in mothers' health care seeking from private health care providers for sick newborns. The present approach improved mothers' knowledge regarding newborn danger signs and improved their health care seeking behavior for newborn danger signs at community level. Due to lack of faith in government health services, women

  17. Health care-seeking behaviours and health expenditures in adults aged 45 years and older in China, 2011-2013.

    Science.gov (United States)

    Li, Jiasen; Feng, Xing Lin

    2017-05-01

    To provide an assessment of China's progress to universal health coverage (UHC) from the perspective of people-centred care. We obtained data on 28 103 participants from the China Health and Retirement Longitudinal Study (CHALRS) during 2011-2013. We used logistic regressions and generalised linear models to analyse care-seeking behaviours and medical expenditures. We found that 95.5% of the subjects were covered by social health insurance in 2013, and nearly 60% subjects in need of medical care were self-medicated. Health insurance was a strong predictor for the access to outpatient care. Use of pure and mixed self-medication increased by 15% and 32% respectively, while use of pure outpatient care fell by 10% between 2011 and 2013, after adjusting for predisposing, service needs and enabling factors. Such trends were particularly evident for the Urban Resident Basic Medical Insurance and the New Cooperative Medical Scheme, which covered more than 80%. The monthly out-of-pocket medical expenditures and the probability of encountering catastrophic health expenditures for outpatient care were four times larger than that for self-medication. Between 2011 and 2013, outpatient care medical costs rose by nearly 50%, whereas there was no such obvious trend for self-medication. People with insurance schemes offering lower cost sharing incurred consistently higher out-of-pocket outpatient payments. The monitoring of global progress to UHC should incorporate self-medication. In China, it seems that the current reform and the huge government investment have not resulted in access to affordable quality care. To achieve UHC, not only universal insurance, but system-level efforts are needed. © 2017 John Wiley & Sons Ltd.

  18. A cross-sectional survey of parental care-seeking behavior for febrile illness among under-five children in Nigeria

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    Mohammed Baba Abdulkadir

    2017-03-01

    Conclusion: There is poor care-seeking for fever in under-five children by parents in Nigeria. Improved literacy, women empowerment and health education are strategies that may improve care-seeking behavior. Highlighted regional differences are additional considerations for such interventions.

  19. Factors affecting eye care-seeking behavior of parents for their children.

    Science.gov (United States)

    Balasubramaniam, Sudharsanam M; Kumar, Divya Senthil; Kumaran, Sheela Evangeline; Ramani, Krishna Kumar

    2013-10-01

    Most of the causes of childhood blindness are either treatable or preventable. Eye care-seeking behavior (ESB) of parents for their children plays a pivotal role in reducing this problem. This study was done because there was a sparsity of literature in this context and with a view to help eye care professionals plan better programs and to identify factors facilitating and/or hindering ESB of parents for their school-going children in an urban area. This study adopted a qualitative snapshot narrative study design. In-depth interviews and focus group discussions were conducted in areas of Chennai with parents and eye care professionals selected through stratified purposive sampling. Parents were based on those who sought care and did not seek care after a school eye screening program and on their socioeconomic status. Data were transcribed to English, familiarized, and inductive coded, and themes were formed. Redundancy was considered as end point of data collection. Two focus group discussions and 11 in-depth interviews were conducted. Squint, redness or watering of eyes, eye irritation, headache, family history of ocular diseases, severity, and repetitiveness of symptoms facilitate parents seeking eye care for their wards/children. Economic status was an important barrier reported to affect the ESB. Logistic factors like taking appointment with doctor, taking leave from work, transport, and traveling distance were noted. This study shows the facilitating factors and barriers for ESB of the Chennai urban parents for their wards. The results suggest that efforts needed to be put to overcome the barriers through planned awareness programs.

  20. Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.

    Science.gov (United States)

    Kinsell, Heidi S; Hall, Allyson G; Harman, Jeffrey S; Tewary, Sweta; Brickman, Andrew

    2017-10-01

    Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida. We used de-identified, longitudinal electronic health record (EHR) data from 2010-2012 and multivariate logistic regression to analyze the effects of initial transformation on the odds of having well-controlled HbA1c, body mass index (BMI), and blood pressure (BP) among vulnerable patients with diabetes. Models controlled for clustering by year, patient, and organizational characteristics. Overall, transformation to a PCMH was associated with 19% greater odds of having well-controlled HbA1c values with no statistically significant impact on BMI or BP. Subanalyses showed transformation had less of an effect on BP for African American patients and HbA1c control for Medicare enrollees but a greater effect on weight control for patients older than 35 years. Transformation to a PCMH in FQHCs appears to improve the health of vulnerable patients with diabetes, with less improvement for subsets of patients. Future research should seek to understand the heterogeneous effects of patient-centered transformation on various subgroups.

  1. Calibrating the Medical Council of Canada's Qualifying Examination Part I using an integrated item response theory framework: a comparison of models and designs.

    Science.gov (United States)

    De Champlain, Andre F; Boulais, Andre-Philippe; Dallas, Andrew

    2016-01-01

    The aim of this research was to compare different methods of calibrating multiple choice question (MCQ) and clinical decision making (CDM) components for the Medical Council of Canada's Qualifying Examination Part I (MCCQEI) based on item response theory. Our data consisted of test results from 8,213 first time applicants to MCCQEI in spring and fall 2010 and 2011 test administrations. The data set contained several thousand multiple choice items and several hundred CDM cases. Four dichotomous calibrations were run using BILOG-MG 3.0. All 3 mixed item format (dichotomous MCQ responses and polytomous CDM case scores) calibrations were conducted using PARSCALE 4. The 2-PL model had identical numbers of items with chi-square values at or below a Type I error rate of 0.01 (83/3,499 or 0.02). In all 3 polytomous models, whether the MCQs were either anchored or concurrently run with the CDM cases, results suggest very poor fit. All IRT abilities estimated from dichotomous calibration designs correlated very highly with each other. IRT-based pass-fail rates were extremely similar, not only across calibration designs and methods, but also with regard to the actual reported decision to candidates. The largest difference noted in pass rates was 4.78%, which occurred between the mixed format concurrent 2-PL graded response model (pass rate= 80.43%) and the dichotomous anchored 1-PL calibrations (pass rate= 85.21%). Simpler calibration designs with dichotomized items should be implemented. The dichotomous calibrations provided better fit of the item response matrix than more complex, polytomous calibrations.

  2. Calibrating the Medical Council of Canada’s Qualifying Examination Part I using an integrated item response theory framework: a comparison of models and designs

    Directory of Open Access Journals (Sweden)

    Andre F. De Champlain

    2016-01-01

    Full Text Available Purpose: The aim of this research was to compare different methods of calibrating multiple choice question (MCQ and clinical decision making (CDM components for the Medical Council of Canada’s Qualifying Examination Part I (MCCQEI based on item response theory. Methods: Our data consisted of test results from 8,213 first time applicants to MCCQEI in spring and fall 2010 and 2011 test administrations. The data set contained several thousand multiple choice items and several hundred CDM cases. Four dichotomous calibrations were run using BILOG-MG 3.0. All 3 mixed item format (dichotomous MCQ responses and polytomous CDM case scores calibrations were conducted using PARSCALE 4. Results: The 2-PL model had identical numbers of items with chi-square values at or below a Type I error rate of 0.01 (83/3,499 or 0.02. In all 3 polytomous models, whether the MCQs were either anchored or concurrently run with the CDM cases, results suggest very poor fit. All IRT abilities estimated from dichotomous calibration designs correlated very highly with each other. IRT-based pass-fail rates were extremely similar, not only across calibration designs and methods, but also with regard to the actual reported decision to candidates. The largest difference noted in pass rates was 4.78%, which occurred between the mixed format concurrent 2-PL graded response model (pass rate= 80.43% and the dichotomous anchored 1-PL calibrations (pass rate= 85.21%. Conclusion: Simpler calibration designs with dichotomized items should be implemented. The dichotomous calibrations provided better fit of the item response matrix than more complex, polytomous calibrations.

  3. Associations between health care seeking and socioeconomic and demographic determinants among people reporting alarm symptoms of cancer

    DEFF Research Database (Denmark)

    Svendsen, Rikke P; Jarbol, Dorte E; Larsen, Pia V

    2013-01-01

    Late diagnosis of cancer may partly be explained by the fact that some patients do not seek health care promptly when experiencing an alarm symptom. Socioeconomic and demographic differences exist concerning knowledge and awareness of cancer alarm symptoms in the general population...... and socioeconomic differences are found in cancer incidence and survival. We therefore hypothesise that socioeconomic and demographic differences in health care-seeking behaviour are present among people with alarm symptoms....

  4. Experiences of Traumatic Events and Associations with PTSD and Depression Development in Urban Health Care-seeking Women

    OpenAIRE

    Gill, Jessica M.; Page, Gayle G.; Sharps, Phyllis; Campbell, Jacquelyn C.

    2008-01-01

    Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after a traumatic event and has been linked to psychiatric and physical health declines. Rates of PTSD are far higher in individuals with low incomes and who reside in urban areas compared to the general population. In this study, 250 urban health care-seeking women were interviewed for a diagnosis of PTSD, major depressive disorder, and also the experience of traumatic events. Multivariate logistic regressions were used ...

  5. A qualitative exploration of care-seeking pathways for sick children in the rural Oromia region of Ethiopia.

    Science.gov (United States)

    Shaw, Bryan; Amouzou, Agbessi; Miller, Nathan P; Bryce, Jennifer; Surkan, Pamela J

    2017-03-09

    Ethiopia has experienced rapid improvements in its healthcare infrastructure, such as through the recent scale up of integrated community case management (iCCM) delivered by community-based health extension workers (HEWs) targeting children under the age of five. Despite notable improvements in child outcomes, the use of HEWs delivering iCCM remains very low. The aim of our study was to explain this phenomenon by examining care-seeking practices and treatment for sick children in two rural districts in the Oromia Region of Ethiopia. Using qualitative methods, we explored perceptions of child illness, influences on decision-making processes occurring over the course of a child's illness and caregiver perceptions of available community-based sources of child illness care. Sixteen focus group discussions (FGDs) and 40 in-depth interviews (IDIs) were held with mothers of children under age five. For additional perspective, 16 IDIs were conducted fathers and 22 IDIs with health extension workers and community health volunteers. Caregivers often described the act of care-seeking for a sick child as a time of considerable uncertainty. In particular, mothers of sick children described the cultural, social and community-based resources available to minimize this uncertainty as well as constraints and strategies for accessing these resources in order to receive treatment for a sick child. The level of trust and familiarity were the most common dynamics noted as influencing care-seeking strategies; trust in biomedical and government providers was often low. Overall, our research highlights the multiple and dynamic influences on care-seeking for sick children in rural Ethiopia. An understanding of these influences is critical for the success of existing and future health interventions and continued improvement of child health in Ethiopia.

  6. Autonomy dimensions and care seeking for delivery in Zambia; the prevailing importance of cluster-level measurement

    Science.gov (United States)

    Gabrysch, Sabine; McMahon, Shannon A.; Siling, Katja; Kenward, Michael G.; Campbell, Oona M. R.

    2016-01-01

    It is widely held that decisions whether or when to attend health facilities for childbirth are not only influenced by risk awareness and household wealth, but also by factors such as autonomy or a woman’s ability to act upon her own preferences. How autonomy should be constructed and measured – namely, as an individual or cluster-level variable – has been less examined. We drew on household survey data from Zambia to study the effect of several autonomy dimensions (financial, relationship, freedom of movement, health care seeking and violence) on place of delivery for 3200 births across 203 rural clusters (villages). In multilevel logistic regression, two autonomy dimensions (relationship and health care seeking) were strongly associated with facility delivery when measured at the cluster level (OR 1.27 and 1.57, respectively), though not at the individual level. This suggests that power relations and gender norms at the community level may override an individual woman’s autonomy, and cluster-level measurement may prove critical to understanding the interplay between autonomy and care seeking in this and similar contexts. PMID:26931301

  7. Autonomy dimensions and care seeking for delivery in Zambia; the prevailing importance of cluster-level measurement.

    Science.gov (United States)

    Gabrysch, Sabine; McMahon, Shannon A; Siling, Katja; Kenward, Michael G; Campbell, Oona M R

    2016-03-02

    It is widely held that decisions whether or when to attend health facilities for childbirth are not only influenced by risk awareness and household wealth, but also by factors such as autonomy or a woman's ability to act upon her own preferences. How autonomy should be constructed and measured - namely, as an individual or cluster-level variable - has been less examined. We drew on household survey data from Zambia to study the effect of several autonomy dimensions (financial, relationship, freedom of movement, health care seeking and violence) on place of delivery for 3200 births across 203 rural clusters (villages). In multilevel logistic regression, two autonomy dimensions (relationship and health care seeking) were strongly associated with facility delivery when measured at the cluster level (OR 1.27 and 1.57, respectively), though not at the individual level. This suggests that power relations and gender norms at the community level may override an individual woman's autonomy, and cluster-level measurement may prove critical to understanding the interplay between autonomy and care seeking in this and similar contexts.

  8. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

    Directory of Open Access Journals (Sweden)

    Nerges Mistry

    Full Text Available Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai.A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values.The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days and retreatment patients (25 days. Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation.Achieving positive behavioural changes in providers (especially non-allopaths and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics

  9. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

    Science.gov (United States)

    Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

    2016-01-01

    Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be

  10. Animal health care seeking behavior of pets or livestock owners and knowledge and awareness on zoonoses in a university community.

    Science.gov (United States)

    Awosanya, Emmanuel J; Akande, H O

    2015-07-01

    We investigated the attitude of pets or livestock owning households in a university community to animal health care services and assessed the knowledge and awareness level of the residents on zoonoses. Structured questionnaire was used to obtain information on demography, pet or livestock ownership, animal health care seeking behavior, awareness and knowledge of zoonoses from 246 households. We did descriptive statistics and bivariate analysis to determine the level of association in discrete variables between owners and non-owners of pets or livestock at a significant level of panimal health care seeking behavior of the 80 pets or livestock owners in terms of treatment and vaccination was 70%. Of the 56 (70%) who provided health care services for their animals, about 48 (85.7%) engaged the services of a veterinarian. Dog owning households (42) had the highest frequency of treating their pets against endoparasites (97.6%); ectoparasites (81%) and vaccination against diseases (73.8%). Of the 246 respondents, only 47 (19.1%) have heard of the term zoonoses. Of the considered zoonoses; their awareness of rabies (79.3%) was the highest, followed by Lassa fever (66.3%), the least was pasteurellosis with 18.7%. Having pets or livestock was significantly associated (p=0.04) with rabies awareness. However, there is no significant difference in the level of awareness of zoonoses; knowledge of zoonoses, knowledge of prevention of zoonoses and knowledge of risk of zoonoses between owners and non-owners of pets or livestock. The animal health care seeking behavior of households with pets or livestock is good and should be encouraged. Public education should be created for other zoonoses aside from rabies, Lassa fever, and avian influenza.

  11. A cross-sectional survey of parental care-seeking behavior for ...

    African Journals Online (AJOL)

    Mohammed Baba Abdulkadir

    2016-03-11

    Mar 11, 2016 ... Material and methods: The study is a secondary analysis of 2013 Demographic ... data for Nigeria, which was a cross-sectional survey conducted nationwide to .... excludes no medical care, pharmacies, shops and traditional.

  12. Determinants of hardship financing in coping with out of pocket payment for care seeking of under five children in selected rural areas of Bangladesh

    Science.gov (United States)

    Ali, Nazia Binte; Siddique, Md. Abu Bakkar; Ahmed, Sameen; Rahman, Mubashshira; Islam, Sajia; Rahman, Md. Mezanur; Amena, Bushra; Hoque, D. M. Emdadul; Huda, Tanvir M.; Arifeen, Shams El

    2018-01-01

    Background Around 63% of total health care expenditure in Bangladesh is mitigated through out of pocket payment (OOP). Heavy reliance on OOP at the time of care seeking poses great threat for financial impoverishment of the households. Households employ different strategies to cope with the associated financial hardship. Objective The aim of this paper is to understand the determinants of hardship financing in coping with OOP adopted for health care seeking of under five childhood illnesses in rural setting of Bangladesh. Methods A community based cross sectional survey was conducted during August to October, 2014 in 15 low performing sub-districts of northern and north-east regions of Bangladesh. Of the 7039 mothers of under five children surveyed, 1895 children who suffered from illness and sought care for their illness episodes were reported in this study. Descriptive statistics and ordinal regression analysis were conducted. Results A total number of 7,039 under five children reported to have suffered illness by their mothers. Among these children 37% suffered from priority illness. Care was sought for 88% children suffering from illnesses. Among them 26% went to a public or private sector medically trained provider. 5% of households incurred illness cost more than 10% of the household’s monthly expenditure. The need for assistance was higher among those compared to others (31% vs 13%). Different financing mechanisms adopted to meet OOP are loan with interest (6%), loan without interest (9%) and financial help from relatives (6%) Need for financial assistance varied from 19% among households in the lowest quintile to 9% in the highest wealth. Ordinal regression analysis revealed that burden of hardship financing increases by 2.17 times when care is sought from a private trained provider compared to care seeking from untrained provider (CI: 1.49, 3.17). Similarly, for families that incur a health care expenditure that is more than 10% of their total monthly

  13. Determinants of hardship financing in coping with out of pocket payment for care seeking of under five children in selected rural areas of Bangladesh.

    Science.gov (United States)

    Tahsina, Tazeen; Ali, Nazia Binte; Siddique, Md Abu Bakkar; Ahmed, Sameen; Rahman, Mubashshira; Islam, Sajia; Rahman, Md Mezanur; Amena, Bushra; Hoque, D M Emdadul; Huda, Tanvir M; Arifeen, Shams El

    2018-01-01

    Around 63% of total health care expenditure in Bangladesh is mitigated through out of pocket payment (OOP). Heavy reliance on OOP at the time of care seeking poses great threat for financial impoverishment of the households. Households employ different strategies to cope with the associated financial hardship. The aim of this paper is to understand the determinants of hardship financing in coping with OOP adopted for health care seeking of under five childhood illnesses in rural setting of Bangladesh. A community based cross sectional survey was conducted during August to October, 2014 in 15 low performing sub-districts of northern and north-east regions of Bangladesh. Of the 7039 mothers of under five children surveyed, 1895 children who suffered from illness and sought care for their illness episodes were reported in this study. Descriptive statistics and ordinal regression analysis were conducted. A total number of 7,039 under five children reported to have suffered illness by their mothers. Among these children 37% suffered from priority illness. Care was sought for 88% children suffering from illnesses. Among them 26% went to a public or private sector medically trained provider. 5% of households incurred illness cost more than 10% of the household's monthly expenditure. The need for assistance was higher among those compared to others (31% vs 13%). Different financing mechanisms adopted to meet OOP are loan with interest (6%), loan without interest (9%) and financial help from relatives (6%) Need for financial assistance varied from 19% among households in the lowest quintile to 9% in the highest wealth. Ordinal regression analysis revealed that burden of hardship financing increases by 2.17 times when care is sought from a private trained provider compared to care seeking from untrained provider (CI: 1.49, 3.17). Similarly, for families that incur a health care expenditure that is more than 10% of their total monthly expenditure (CI:1.46, 3.88), the

  14. Exploring determinants of care-seeking behaviour of oral cancer patients in India: A qualitative content analysis.

    Science.gov (United States)

    Rath, Hemamalini; Shah, Swikant; Sharma, Gaurav; Mishra, Ekagrata

    2018-04-01

    A major public health concern in India is the high morbidity and mortality rates of oral cancer because of late diagnosis. Among the several determinants of this late diagnosis, the most important is the healthcare-seeking behaviour of the oral cancer patients. The aim of this study was to explore the care-seeking behaviour and its determinants among oral cancer patients. A face-to-face in-depth interview was conducted among 70 oral cancer patients using a semi-structured questionnaire, and qualitative content analysis of the results was performed. All the patients had squamous-cell carcinoma and none had attended any screening programme. The most common site affected was the buccal mucosa with a non-healing wound. Most of the patients contacted a doctor available nearby; only 7% of patients consulted a dentist. Only one patient approached a traditional healer. The median patient delay was 30 (4-365) days and the professional delay was 40 (4-650) days. Enablers included determinants such as increasing symptoms (80%), influence of the society (74%), fear (10%), and social media (3%). The main barriers were lack of awareness (97%), hope that the lesion will heal spontaneously (90%), lack of perception of seriousness (64%), financial constraints (55%), provider switching (47%), and missed diagnosis (44%). The care-seeking path among oral cancer patients is complex, customised, and influenced by multiple patient-related and system-related factors. Copyright © 2018. Published by Elsevier Ltd.

  15. Gender differences in health care-seeking behavior for sexually transmitted diseases: a population-based study in Nairobi, Kenya.

    Science.gov (United States)

    Voeten, Hélène A C M; O'hara, Hilda B; Kusimba, Judith; Otido, Julius M; Ndinya-Achola, Jeckoniah O; Bwayo, Job J; Varkevisser, Corlien M; Habbema, J Dik F

    2004-05-01

    Health care-seeking behavior for sexually transmitted diseases (STDs) is important in STD/HIV control. The goal of this study was to describe the proportion seeking care, patient delay, and choice of provider among men and women with STD-related complaints in Nairobi, Kenya. A population-based questionnaire was administered in 7 randomly selected clusters (small geographic areas covering approximately 150 households each). Of the 291 respondents reporting complaints, 20% of men versus 35% of women did not seek care, mainly because symptoms were not considered severe, symptoms had disappeared, or as a result of lack of money. Of those who sought care, women waited longer than men (41 vs. 16 days). Most men and women went to the private sector (72% and 57%, respectively), whereas the informal sector was rarely visited (13% and 16%, respectively). Relatively more women visited the government sector (28% vs. 15%). Because women were mostly monogamous, they did not relate their complaints to sexual intercourse, which hampered prompt care-seeking. Women should be convinced to seek care promptly, eg, through health education in communities.

  16. Divorce, divorce rates, and professional care seeking for mental health problems in Europe: a cross-sectional population-based study.

    Science.gov (United States)

    Bracke, Piet F; Colman, Elien; Symoens, Sara A A; Van Praag, Lore

    2010-04-29

    Little is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced or separated compared to the married or cohabiting. The aim of this study is to determine whether, in a sample of the European general population, the divorced or separated seek more professional mental health care than the married or cohabiting, regardless of self-reported mental health problems. Furthermore, we examine whether two country-level features--the supply of mental health professionals and the country-level divorce rates--contribute to marital status differences in professional care-seeking behavior. We use data from the Eurobarometer 248 on mental well-being that was collected via telephone interviews. The unweighted sample includes 27,146 respondents (11,728 men and 15,418 women). Poisson hierarchical regression models were estimated to examine whether the divorced or separated have higher professional health care use for emotional or psychological problems, after controlling for mental and somatic health, sociodemographic characteristics, support from family and friends, and degree of urbanization. We also considered country-level divorce rates and indicators of the supply of mental health professionals, and applied design and population weights. We find that professional care seeking is strongly need based. Moreover, the divorced or separated consult health professionals for mental health problems more often than people who are married or who cohabit do. In addition, we find that the gap between the divorced or separated and the married or cohabiting is highest in countries with low divorce rates. The higher rates of professional care seeking for mental health problems among the divorced or separated only partially correlates with their more severe mental health problems. In countries where marital dissolution is more common, the marital status gap in professional care seeking is

  17. Divorce, divorce rates, and professional care seeking for mental health problems in Europe: a cross-sectional population-based study

    Directory of Open Access Journals (Sweden)

    Symoens Sara AA

    2010-04-01

    Full Text Available Abstract Background Little is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced or separated compared to the married or cohabiting. The aim of this study is to determine whether, in a sample of the European general population, the divorced or separated seek more professional mental health care than the married or cohabiting, regardless of self-reported mental health problems. Furthermore, we examine whether two country-level features--the supply of mental health professionals and the country-level divorce rates--contribute to marital status differences in professional care-seeking behavior. Methods We use data from the Eurobarometer 248 on mental well-being that was collected via telephone interviews. The unweighted sample includes 27,146 respondents (11,728 men and 15,418 women. Poisson hierarchical regression models were estimated to examine whether the divorced or separated have higher professional health care use for emotional or psychological problems, after controlling for mental and somatic health, sociodemographic characteristics, support from family and friends, and degree of urbanization. We also considered country-level divorce rates and indicators of the supply of mental health professionals, and applied design and population weights. Results We find that professional care seeking is strongly need based. Moreover, the divorced or separated consult health professionals for mental health problems more often than people who are married or who cohabit do. In addition, we find that the gap between the divorced or separated and the married or cohabiting is highest in countries with low divorce rates. Conclusions The higher rates of professional care seeking for mental health problems among the divorced or separated only partially correlates with their more severe mental health problems. In countries where marital dissolution is more

  18. Level of modern health care seeking behaviors among mothers having under five children in Dangila town, north West Ethiopia, 2016: a cross sectional study.

    Science.gov (United States)

    Dagnew, Amare Belachew; Tewabe, Tilahun; Murugan, Rajalakshmi

    2018-05-29

    Health seeking behavior is an action taken by an individual who perceive to have a health problem. In most developing countries including Ethiopia the health of the children is strongly dependant on maternal health care behavior. Most childhood morbidities and mortalities are associated with low level of mothers health care seeking behavior. Therefore, the objective of this study was to assess level of modern health care seeking behavior among mothers having under five children in Dangila town, North West Ethiopia. Community based quantitative cross-sectional study was conducted from April 15 to May 15, 2016. Systematic random sampling technique was used to select study participants. A total of273 mothers with children less than five years were included in this study. The data was collected from all five Kebeles using interviewer administered questionnaire. Descriptive and inferential statistics were used to present the data. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with level of modern health care seeking behavior. Prevalence of modern health care seeking behavior was 82.1%. Age of mothers (AOR = 2.4(1.1, 5.3), age of the child (AOR = 6.7(2.8, 22.2), severity of illness (AOR = 5.2(1.2, 22.6) and family number (AOR = 6.4(2.1, 20.2) were predictors of modern health care seeking behavior among mothers. Majority of the mothers preferred to take their children to modern health care when they got illness. Age of children, age of mother, number of family and severity of illness were the determinant factors for modern health care seeking behavior. Therefore, health care services should be strengthened at community level through community integrated management of childhood illness, information, education communication / behavioral change communication strategies to improve mothers health care seeking behaviors.

  19. Qualified Census Tracts

    Data.gov (United States)

    Department of Housing and Urban Development — A Qualified Census Tract (QCT) is any census tract (or equivalent geographic area defined by the Census Bureau) in which at least 50% of households have an income...

  20. Emotions delay care-seeking in patients with an acute myocardial infarction.

    Science.gov (United States)

    Nymark, Carolin; Mattiasson, Anne-Cathrine; Henriksson, Peter; Kiessling, Anna

    2014-02-01

    In acute myocardial infarction the risk of death and loss of myocardial tissue is at its highest during the first few hours. However, the process from symptom onset to the decision to seek medical care can take time. To comprehend patients' pre-hospital delay, attention must be focused on the circumstances preceding the decision to seek medical care. To add a deeper understanding of patients' thoughts, feelings and actions that preceded the decision to seek medical care when afflicted by an acute myocardial infarction. Fourteen men and women with a first or second acute myocardial infarction were interviewed individually in semi-structured interviews. Data were analysed by qualitative content analysis. Four themes were conceptualized: 'being incapacitated by fear, anguish and powerlessness', 'being ashamed of oneself', 'fear of losing a healthy identity' and 'striving to avoid fear by not interacting with others'. Patients were torn between feelings such as anguish, fear, shame and powerlessness. They made an effort to uphold their self-image as being a healthy person thus affected by an unrecognized discomfort. This combined with a struggle to protect others from involvement, strengthened the barriers to seeking care. The present study indicates that emotional reactions are important and influence patients' pre-hospital behaviour. Being ashamed of oneself stood out as a novel finding. Emotions might be an important explanation of undesired and persisting patient delays. However, our findings have to and should be evaluated quantitatively. Such a study is in progress.

  1. Urban–Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs

    Directory of Open Access Journals (Sweden)

    Ugochukwu U. Onyeonoro

    2016-01-01

    Full Text Available Background Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. Methods This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Data were collected using the modified World Health Organization's STEPS questionnaire, including data on care seeking following the onset of illness. Descriptive statistics and logistic regressions were used to analyze care-seeking behavior and to identify differences among those seeking care in urban and rural areas. Results In both urban and rural areas, patent medicine vendors (73.0% were the most common sources of primary care following the onset of illness, while only 20.0% of the participants used formal care. Significant predictors of difference in care-seeking practices between residents in urban and rural communities were educational status, income, occupation, and body mass index. Conclusions Efforts should be made to reduce barriers to formal health-care service utilization in the state by increasing health insurance coverage, strengthening the health-care system, and increasing the role of patent medicine vendors in the formal health-care delivery system.

  2. Urban–Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs

    Science.gov (United States)

    Onyeonoro, Ugochukwu U.; Ogah, Okechukwu S.; Ukegbu, Andrew U.; Chukwuonye, Innocent I.; Madukwe, Okechukwu O.; Moses, Akhimiem O.

    2016-01-01

    BACKGROUND Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. METHODS This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Data were collected using the modified World Health Organization’s STEPS questionnaire, including data on care seeking following the onset of illness. Descriptive statistics and logistic regressions were used to analyze care-seeking behavior and to identify differences among those seeking care in urban and rural areas. RESULTS In both urban and rural areas, patent medicine vendors (73.0%) were the most common sources of primary care following the onset of illness, while only 20.0% of the participants used formal care. Significant predictors of difference in care-seeking practices between residents in urban and rural communities were educational status, income, occupation, and body mass index. CONCLUSIONS Efforts should be made to reduce barriers to formal health-care service utilization in the state by increasing health insurance coverage, strengthening the health-care system, and increasing the role of patent medicine vendors in the formal health-care delivery system. PMID:27721654

  3. Urban-Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs.

    Science.gov (United States)

    Onyeonoro, Ugochukwu U; Ogah, Okechukwu S; Ukegbu, Andrew U; Chukwuonye, Innocent I; Madukwe, Okechukwu O; Moses, Akhimiem O

    2016-01-01

    Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Data were collected using the modified World Health Organization's STEPS questionnaire, including data on care seeking following the onset of illness. Descriptive statistics and logistic regressions were used to analyze care-seeking behavior and to identify differences among those seeking care in urban and rural areas. In both urban and rural areas, patent medicine vendors (73.0%) were the most common sources of primary care following the onset of illness, while only 20.0% of the participants used formal care. Significant predictors of difference in care-seeking practices between residents in urban and rural communities were educational status, income, occupation, and body mass index. Efforts should be made to reduce barriers to formal health-care service utilization in the state by increasing health insurance coverage, strengthening the health-care system, and increasing the role of patent medicine vendors in the formal health-care delivery system.

  4. Influence of culture and discrimination on care-seeking behavior of elderly African Americans: a qualitative study.

    Science.gov (United States)

    Martin, Shadi S; Trask, Jacqueline; Peterson, Tina; Martin, Bryan C; Baldwin, Josh; Knapp, Matthew

    2010-05-01

    In this study, the influence of culture and discrimination on care-seeking behavior of elderly African Americans was explored. This was a qualitative phenomenological study that involved in-depth interviews with 15 African American men and women aged 60 and older in Alabama. The sample size of 15 was adequate for the phenomenological method of this study. While this was a small exploratory study and was not intended for any generalizations, it did provide a unique opportunity to hear the voices, the concerns, and the stories of elderly African Americans, which have often been overlooked in the literature. The following themes emerged from the analysis of data: (1) perception of health as ability to be active, (2) reluctance toward prescription medicine use, (3) lack of trust in doctors, (4) avoidance of bad news, (5) race of doctors, (6) use of home remedies, and (7) importance of God and spirituality on health, illness, and healing.

  5. Multimodality image registration. A special development in medical imaging has been strongly influenced by a small but highly qualified software think-tank

    International Nuclear Information System (INIS)

    Diemling, M.

    2007-01-01

    The importance of image fusion and registration in the field of medical diagnostics will be shown. After some details and background of image registration, as well as the history of nuclear medicine imaging - given by the example of HERMES Medical Solutions of Stockholm, Sweden - the reader finds seven cases illustrating the clinical importance of this method. These cases were collected from various fields of applications of medical imaging, they are carefully documented and illustrated. (orig.)

  6. Effect of residence on mothers' health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross--sectional study.

    Science.gov (United States)

    Gelaw, Yalemzewod Assefa; Biks, Gashaw Andargie; Alene, Kefyalew Addis

    2014-10-08

    Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of

  7. Antenatal Care Seeking Behaviour among Slum Mothers: A Study of Rajshahi City Corporation, Bangladesh.

    Science.gov (United States)

    Rahman, Mahfuzar; Islam, Rafiqul; Rahman, Mosfequr

    2010-04-01

    The study aimed to identify the important effects of some selected variables in antenatal care (ANC) seeking behaviour among slum mothers. The data for the study were collected in 2006 from 700 mothers in the slum areas of Rajshahi City Corporation (RCC), Bangladesh. The results indicate that tetanus toxoid (TT) is relatively widespread in slum areas of RCC. Serious health implications were observed for the mothers and their children who lived in the study areas because more than half of the respondents (56.1%) were not assisted at their last childbirth by any health professional. The respondents were too poor to buy iron tablets/syrup and vitamin tablets/syrup during their last pregnancy. The application of a logistic regression model suggested that demographic and socio-economic factors were associated with ANC seeking behaviour among slum mothers. Respondents' education, place of treatment, husband's occupation, family's income, and exposure to mass media had highly significant effects on mothers seeking medical checkups during their last pregnancy.

  8. ISS qualified thermal carrier equipment

    Science.gov (United States)

    Deuser, Mark S.; Vellinger, John C.; Jennings, Wm. M.

    2000-01-01

    Biotechnology is undergoing a period of rapid and sustained growth, a trend which is expected to continue as the general population ages and as new medical treatments and products are conceived. As pharmaceutical and biomedical companies continue to search for improved methods of production and, for answers to basic research questions, they will seek out new avenues of research. Space processing on the International Space Station (ISS) offers such an opportunity! Space is rapidly becoming an industrial laboratory for biotechnology research and processing. Space bioprocessing offers exciting possibilities for developing new pharmaceuticals and medical treatments, which can be used to benefit mankind on Earth. It also represents a new economic frontier for the private sector. For over eight years, the thermal carrier development team at SHOT has been working with government and commercial sector scientists who are conducting microgravity experiments that require thermal control. SHOT realized several years ago that the hardware currently being used for microgravity thermal control was becoming obsolete. It is likely that the government, academic, and industrial bioscience community members could utilize SHOT's hardware as a replacement to their current microgravity thermal carrier equipment. Moreover, SHOT is aware of several international scientists interested in utilizing our space qualified thermal carrier. SHOT's economic financing concept could be extremely beneficial to the international participant, while providing a source of geographic return for their particular region. Beginning in 2000, flight qualified thermal carriers are expected to be available to both the private and government sectors. .

  9. Demographics and health care seeking behavior of Singaporean women with chronic constipation: implications for therapeutic management.

    Science.gov (United States)

    Gwee, Kok Ann; Setia, Sajita

    2012-01-01

    Chronic constipation is significantly more prevalent in women than men in Singapore. We carried out a survey to study patient demographics, symptom prevalence, healthcare-seeking behavior, and patient satisfaction with available treatment options in women with chronic constipation. Responses were collected predominantly via a web-based survey from a panel representative of Singapore's women population. Eligibility was established using a nine-question screener. A total of 1006 invited females took part in an online screener survey, of which 911 respondents did not meet the eligibility requirements for the chronic constipation survey. Of the total panelists consenting to participate (via both online and face-to-face interviews), 100 women met eligibility requirements and took the 22-question survey. Eligible respondents were skewed to younger patients but well mixed in terms of marital status. The majority of them were not keen on doing exercise and were working women, especially white collar females. The majority complained of straining and hard stools as the most common constipation symptoms (88% and 80% respectively) and rated constipation symptoms as severe or moderate. On average, respondents experienced constipation symptoms for 6 to 7 months in the last year. In more than two-thirds of respondents, constipation symptoms were frequent (at least 1 in 3 times). Most of the patients had attempted to treat constipation themselves and 80% had tried laxatives before visiting the doctor. Satisfaction with fiber supplements and laxatives was average and many of the users were not satisfied with their effect. Ineffectiveness and prolonged time taken for the treatment to take effect were the most common reasons for dissatisfaction. Nearly all respondents (97%) were interested in considering alternative prescriptive medication that is proven more effective. Chronic constipation symptoms in women are often severe and bothersome, and many patients are dissatisfied with

  10. Health-care-seeking patterns in the emerging private sector in Burkina Faso: a population-based study of urban adult residents in Ouagadougou.

    Directory of Open Access Journals (Sweden)

    Idrissa Beogo

    Full Text Available The private medical care sector is expanding in urban cities in Sub-Saharan Africa (SSA. However, people's health-care-seeking behaviors in this new landscape remain poorly understood; furthermore, distinguishing between public and private providers and among various types of private providers is critical in this investigation. This study assessed, by type, the healthcare providers urban residents in Burkina Faso visit, and their choice determinants.We conducted a population-based survey of a representative sample of 1,600 households in Ouagadougou from July to November 2011, consisting of 5,820 adults. We assessed the types of providers people typically sought for severe and non-severe conditions. We applied generalized estimating equations in this study.Among those surveyed, 97.7% and 53.1% indicated that they seek a formal provider for treating severe and non-severe conditions, respectively. Among the formal provider seekers, 20.5% and 17.0% chose for-profit (FP providers for treating severe and non-severe conditions, respectively. Insurance coverage was held by 2.0% of those surveyed. Possessing insurance was the strongest predictor for seeking FP, for both severe (odds ratio [OR]  = 1.15, 95% confidence interval [CI] = 1.04-1.28, and non-severe conditions (OR = 1.22, 95% CI = 1.07-1.39. Other predictors included being a formal jobholder and holding a higher level education. By contrast, we observed no significant difference in predisposing, enabling, or need characteristics between not-for-profit (NFP provider seekers and public provider seekers. Proximity was the primary reason for choosing a provider.The results suggested that FP providers play a crucial role in the urban healthcare market in SSA. Socioeconomic status and insurance status are significant predictors of provider choice. The findings can serve as a crucial reference for policymakers in response to the emergence of FP providers in SSA.

  11. The individual determinants of care-seeking among middle-aged women reporting urinary incontinence: analysis of a 2273-woman cohort.

    Science.gov (United States)

    Fritel, Xavier; Panjo, Henri; Varnoux, Noëlle; Ringa, Virginie

    2014-09-01

    Our main objective was to analyze individual determinants that lead middle-aged women to seek medical care for urinary incontinence (UI). Observational longitudinal study among GAZEL cohort participants: 2,640 women aged 50-62 completed a self-administered questionnaire at baseline. Eight years later (2008) 2,273 (86%) responded to a follow-up questionnaire. Seeking care for UI was defined as any consultation for UI during the 8-year follow-up period. Individual determinants considered in the regression analysis were social and demographic characteristics, social relations, UI type and severity, and other health factors. Among 1,192 women reporting incontinence at baseline, 24.4% had visited a physician at least once for UI during the follow-up period (56.0% of those reporting severe UI). The care-seeking rate increased with age at baseline. Multivariate analysis showed that women who reported severe UI (OR = 4.1; 95% CI 2.6-6.5), mixed UI (2.0; 1.3-3.0), or neurologic disease (1.6; 1.1-2.6), had weak social support (1.4; 1.0-2.0), or talked about their UI with close friends or family (1.5; 1.0-2.1) were more likely to seek care for UI. A model including these factors had a 78% probability of correctly differentiating women with incontinence who chose to seek care from those who did not. Our analysis could not take factors related to the organization of health services into account. Women do not always seek care for UI, even when it is severe. Besides UI severity and type, consultation is associated with aging, weak social support, conversation about it with close friends and family, and neurologic disorders. © 2013 Wiley Periodicals, Inc.

  12. Profitability of Qualified-Labour-Power Production

    Science.gov (United States)

    Baldino, Roberto Ribeiro; Cabral, Tânia Cristina Baptista

    2015-01-01

    In Baldino and Cabral (2013) we introduced the concept of qualified labour-power as the commodity produced by the school system. In the present article we outline a quantitative model to evaluate the profit rate of educational programmes. We compare a medical school programme with a teacher education programme at a public university in Brazil,…

  13. Community perceptions on malaria and care-seeking practices in endemic Indian settings: policy implications for the malaria control programme

    Directory of Open Access Journals (Sweden)

    Das Ashis

    2013-01-01

    Full Text Available Abstract Background The focus of India’s National Malaria Programme witnessed a paradigm shift recently from health facility to community-based approaches. The current thrust is on diagnosing and treating malaria by community health workers and prevention through free provision of long-lasting insecticidal nets. However, appropriate community awareness and practice are inevitable for the effectiveness of such efforts. In this context, the study assessed community perceptions and practice on malaria and similar febrile illnesses. This evidence base is intended to direct the roll-out of the new strategies and improve community acceptance and utilization of services. Methods A qualitative study involving 26 focus group discussions and 40 key informant interviews was conducted in two districts of Odisha State in India. The key points of discussion were centred on community perceptions and practice regarding malaria prevention and treatment. Thematic analysis of data was performed. Results The 272 respondents consisted of 50% females, three-quarter scheduled tribe community and 30% students. A half of them were literates. Malaria was reported to be the most common disease in their settings with multiple modes of transmission by the FGD participants. Adoption of prevention methods was seasonal with perceived mosquito density. The reported use of bed nets was low and the utilization was determined by seasonality, affordability, intoxication and alternate uses of nets. Although respondents were aware of malaria-related symptoms, care-seeking from traditional healers and unqualified providers was prevalent. The respondents expressed lack of trust in the community health workers due to frequent drug stock-outs. The major determinants of health care seeking were socio-cultural beliefs, age, gender, faith in the service provider, proximity, poverty, and perceived effectiveness of available services. Conclusion Apart from the socio-cultural and behavioural

  14. Plasmodium falciparum malaria in pregnancy: prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria

    NARCIS (Netherlands)

    Enato, E. F. O.; Mens, P. F.; Okhamafe, A. O.; Okpere, E. E.; Pogoson, E.; Schallig, H. D. F. H.

    2009-01-01

    SUMMARY: This study evaluated malaria care-seeking behaviour, as well as the prevalence of parasitaemia and anaemia among pregnant women attending antenatal clinics of two tertiary healthcare facilities in Edo State, Nigeria. Malaria was highly prevalent in the study group (20% by microscopy and

  15. Prevalence of chest symptoms amongst brick kiln migrant workers and care seeking behaviour: a study from South India.

    Science.gov (United States)

    Thomas, Beena E; Charles, Niruparani; Watson, Basilea; Chandrasekaran, V; Senthil Kumar, R; Dhanalakshmi, A; Wares, Fraser; Swaminathan, Soumya

    2015-12-01

    Early detection and treatment of tuberculosis (TB) have been key principles of TB control. However, this can be a challenge with 'hard to reach' populations such as migrants. Brick kiln workers are one such group of migrants who are exposed to smoke, heat and dust from brick kilns which are one of the major causes of respiratory illnesses. A cross-sectional community based study was carried out in Thiruvallur, Tamil Nadu, South India, from August 2011 to June 2012. A total of 4002 individuals from 55 brick kiln chambers were interviewed to determine the prevalence of chest symptoms and care seeking behaviour patterns. Three hundred and seventy-seven (9.4%) chest symptomatics were identified. The most significant variables associated with chest symptoms were illiteracy, alcohol abuse and heavy smoking. Of the chest symptomatics identified, 50.4% took action to get relief from their symptoms. The duration of over 6-month stay in the chamber was significantly associated with taking action (OR, 5.5, 95% CI: 2.3, 13.3). The TB control programme needs to further explore how to extend its services to such 'hard to reach' groups. Active case finding to ensure early diagnosis and treatment initiation amongst such groups needs consideration. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Fear of deportation is not associated with medical or dental care use among Mexican-origin farmworkers served by a federally-qualified health center--faith-based partnership: an exploratory study.

    Science.gov (United States)

    López-Cevallos, Daniel F; Lee, Junghee; Donlan, William

    2014-08-01

    Migrant and seasonal farmworkers face many health risks with limited access to health care and promotion services. This study explored whether fear of deportation (as a barrier), and church attendance (as an enabling factor), were associated with medical and dental care use among Mexican-origin farmworkers. Interviews were conducted with 179 farmworkers who attended mobile services provided by a local federally-qualified health center (FQHC) in partnership with area churches, during the 2007 agricultural season. The majority of respondents (87 %) were afraid of being deported, and many (74 %) attended church. Although about half of participants reported poor/fair physical (49 %) and dental (58 %) health, only 37 % of farmworkers used medical care and 20 % used dental care during the previous year. Fear of deportation was not associated with use of medical or dental care; while church attendance was associated with use of dental care. Findings suggest that despite high prevalence of fear of deportation, support by FQHCs and churches may enable farmworkers to access health care services.

  17. Effect of the Uganda Newborn Study on care-seeking and care practices: a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

    Full Text Available Background: Care for women and babies before, during, and after the time of birth is a sensitive measure of the functionality of any health system. Engaging communities in preventing newborn deaths is a promising strategy to achieve further progress in child survival in sub-Saharan Africa. Objective: To assess the effect of a home visit strategy combined with health facility strengthening on uptake of newborn care-seeking, practices and services, and to link the results to national policy and scale-up in Uganda. Design: The Uganda Newborn Study (UNEST was a two-arm cluster-randomised controlled trial in rural eastern Uganda. In intervention villages volunteer community health workers (CHWs were trained to identify pregnant women and make five home visits (two during pregnancy and three in the first week after birth to offer preventive and promotive care and counselling, with extra visits for sick and small newborns to assess and refer. Health facility strengthening was done in all facilities to improve quality of care. Primary outcomes were coverage of key essential newborn care behaviours (breastfeeding, thermal care, and cord care. Analyses were by intention to treat. This study is registered as a clinical trial, number ISRCTN50321130. Results: The intervention significantly improved essential newborn care practices, although many interventions saw major increases in both arms over the study period. Immediate breastfeeding after birth and exclusive breastfeeding were significantly higher in the intervention arm compared to the control arm (72.6% vs. 66.0%; p=0.016 and 81.8% vs. 75.9%, p=0.042, respectively. Skin-to-skin care immediately after birth and cord cutting with a clean instrument were marginally higher in the intervention arm versus the control arm (80.7% vs. 72.2%; p=0.071 and 88.1% vs. 84.4%; p=0.023, respectively. Half (49.6% of the mothers in the intervention arm waited more than 24 hours to bathe the baby, compared to 35.5% in

  18. Malaria care seeking behavior of individuals in Ghana under the NHIS: Are we back to the use of informal care?

    Science.gov (United States)

    Fenny, Ama Pokuaa; Asante, Felix A; Enemark, Ulrika; Hansen, Kristian S

    2015-04-12

    Malaria is Ghana's most endemic disease; occurring across most parts of the country with a significant impact on individuals and the health system as whole. Treatment seeking for malaria care takes various forms. The National Health Insurance Scheme (NHIS) was introduced in 2004 to promote access to health services to mitigate the negative impact of the user fee regime. Ten years on, national coverage is less than 40% of the total population and patients continue to make direct payments for health services. This paper analyses the care-seeking behaviour of households for treatment of malaria in Ghana under the NHI policy. Using a cross-sectional survey of household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah, a multinomial logit model is estimated. The sample consists of 365 adults and children reporting being ill with malaria in the last four weeks prior to the study. Out of the total, 58% were insured and 71% of them sought care from a formal health facility. Among the insured, 15% chose informal care compared to 48% among the uninsured. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. The results show that the insured are 6 times more likely to choose regional/district hospitals: 5 times more likely to choose health centres/clinics and 7 times more likely to choose private hospitals/clinics over informal care when compared with the uninsured. Individual characteristics such as age, education and wealth status were significant determinants of health care provider choice for specific categories of health facilities. Overall, for malaria care the uninsured are more likely to choose informal care compared to the insured for the treatment of malaria.

  19. Plasmodium falciparum malaria in pregnancy: prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria.

    Science.gov (United States)

    Enato, E F O; Mens, P F; Okhamafe, A O; Okpere, E E; Pogoson, E; Schallig, H D F H

    2009-05-01

    This study evaluated malaria care-seeking behaviour, as well as the prevalence of parasitaemia and anaemia among pregnant women attending antenatal clinics of two tertiary healthcare facilities in Edo State, Nigeria. Malaria was highly prevalent in the study group (20% by microscopy and estimated 25% by PCR), but parasitaemia and incidence decreased with increasing number of pregnancies. Although the level of education of the study participants was relatively high, antimalarial control measures during pregnancy were found to be poorly utilised by the women and malaria care-seeking was often delayed. A minority of the interviewed pregnant women said they had received sulphadoxine/pyrimethamine-based intermittent preventive therapy (IPT) during current pregnancy. Moreover, the use of inferior antimalaria treatment (e.g. chloroquine) was frequent. The majority of the pregnant women, mainly primigravidae, were anaemic. Efforts to improve antimalaria healthcare must be intensified, targeting pregnant women, particularly the primigravidae and secundigravidae and the healthcare providers.

  20. Pre-emergency-department care-seeking patterns are associated with the severity of presenting condition for emergency department visit and subsequent adverse events: a timeframe episode analysis.

    Directory of Open Access Journals (Sweden)

    Chien-Lung Chan

    Full Text Available Many patients treated in Emergency Department (ED visits can be treated at primary or urgent care sectors, despite the fact that a number of ED visitors seek other forms of care prior to an ED visit. However, little is known regarding how the pre-ED activity episodes affect ED visits.We investigated whether care-seeking patterns involve the use of health care services of various types prior to ED visits and examined the associations of these patterns with the severity of the presenting condition for the ED visit (EDVS and subsequent events.This retrospective observational study used administrative data on beneficiaries of the universal health care insurance program in Taiwan. The service type, treatment capacity, and relative diagnosis were used to classify pre-ED visits into 8 care types. Frequent pattern analysis was used to identify sequential care-seeking patterns and to classify 667,183 eligible pre-ED episodes into patterns. Generalized linear models were developed using generalized estimating equations to examine the associations of these patterns with EDVS and subsequent events.The results revealed 17 care-seeking patterns. The EDVS and likelihood of subsequent events significantly differed among patterns. The ED severity index of patterns differ from patterns seeking directly ED care (coefficients ranged from -0.05 to 0.13, and the odds-ratios for the likelihood of subsequent ED visits and hospitalization ranged from 1.18 to 1.86 and 1.16 to 2.84, respectively.The pre-ED care-seeking patterns differ in severity of presenting condition and subsequent events that may represent different causes of ED visit. Future health policy maker may adopt different intervention strategies for targeted population to reduce unnecessary ED visit effectively.

  1. Pre-emergency-department care-seeking patterns are associated with the severity of presenting condition for emergency department visit and subsequent adverse events: a timeframe episode analysis.

    Science.gov (United States)

    Chan, Chien-Lung; Lin, Wender; Yang, Nan-Ping; Lai, K Robert; Huang, Hsin-Tsung

    2015-01-01

    Many patients treated in Emergency Department (ED) visits can be treated at primary or urgent care sectors, despite the fact that a number of ED visitors seek other forms of care prior to an ED visit. However, little is known regarding how the pre-ED activity episodes affect ED visits. We investigated whether care-seeking patterns involve the use of health care services of various types prior to ED visits and examined the associations of these patterns with the severity of the presenting condition for the ED visit (EDVS) and subsequent events. This retrospective observational study used administrative data on beneficiaries of the universal health care insurance program in Taiwan. The service type, treatment capacity, and relative diagnosis were used to classify pre-ED visits into 8 care types. Frequent pattern analysis was used to identify sequential care-seeking patterns and to classify 667,183 eligible pre-ED episodes into patterns. Generalized linear models were developed using generalized estimating equations to examine the associations of these patterns with EDVS and subsequent events. The results revealed 17 care-seeking patterns. The EDVS and likelihood of subsequent events significantly differed among patterns. The ED severity index of patterns differ from patterns seeking directly ED care (coefficients ranged from -0.05 to 0.13), and the odds-ratios for the likelihood of subsequent ED visits and hospitalization ranged from 1.18 to 1.86 and 1.16 to 2.84, respectively. The pre-ED care-seeking patterns differ in severity of presenting condition and subsequent events that may represent different causes of ED visit. Future health policy maker may adopt different intervention strategies for targeted population to reduce unnecessary ED visit effectively.

  2. Exploratory study into awareness of heart disease and health care seeking behavior among Emirati women (UAE) - Cross sectional descriptive study.

    Science.gov (United States)

    Khan, Sarah; Ali, Syed Adnan

    2017-09-26

    Cardiovascular disease was the leading cause of death among women in the United Arab Emirates (UAE) in 2010. Heart attacks usually happen in older women thus symptoms of heart disease may be masked by symptoms of chronic diseases, which could explain the delay in seeking health care and higher mortality following an ischaemic episode among women. This study seeks to a) highlight the awareness of heart diseases among Emirati women and b) to understand Emirati women's health care seeking behaviour in UAE. A cross sectional, descriptive study was conducted using a survey instrument adapted from the American Heart Association National survey. A convenience sample of 676 Emirati women between the ages of 18-55 years completed the questionnaire. The study showed low levels of awareness of heart disease and associated risk factors in Emirati women; only 19.4% participants were found to be aware of heart diseases. Awareness levels were highest in Dubai (OR 2.18, p < 0.05) among all the other emirates and in the 18-45 years age group (OR 2.74, p < 0.05). Despite low awareness levels, women paradoxically perceived themselves to be self-efficacious in seeking health care. Interestingly, just 49.1% Emirati women believed that good quality and affordable health care was available in the UAE. Only 28.8% of the participants believed there were sufficient female doctors to respond to health needs of women in UAE. Furthermore, only 36.7% Emirati women chose to be treated in the UAE over treatment in other countries. Emirati women clearly lack the knowledge on severity and vulnerability to heart disease in the region that is essential to improve cardiovascular related health outcomes. This study has identified the need for wider outreach that focuses on gender and age specific awareness on heart disease risks and symptoms. The study has also highlighted potential modifiable barriers in seeking health care that should be overcome to reduce morbidity and mortality due to heart

  3. Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Djibo Ali

    2011-05-01

    Full Text Available Abstract Background Diarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up surveillance of severe diarrheal diseases. Methods A cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted. Results In total, the period prevalence of diarrhea and severe diarrhea between April 24th and May 21st 2009 were 36.8% (95% CI: 33.7 - 40.0 and 3.4% (95% CI: 2.2-4.6, respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1 reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household. Conclusions The proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of

  4. Upper gastrointestinal symptoms, psychosocial co-morbidity and health care seeking in general practice: population based case control study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2009-09-01

    Full Text Available Abstract Background The pathophysiology of upper gastrointestinal (GI symptoms is still poorly understood. Psychological symptoms were found to be more common in patients with functional gastrointestinal complaints, but it is debated whether they are primarily linked to GI symptoms or rather represent motivations for health-care seeking. Purpose of our study was to compare co-morbidity, in particular psychological and social problems, between patients with and without upper GI symptoms. In addition, we investigated whether the prevalence of psychological and social problems is part of a broader pattern of illness related health care use. Methods Population based case control study based on the second Dutch National Survey of general practice (conducted in 2001. Cases (adults visiting their primary care physician (PCP with upper GI symptoms and controls (individuals not having any of these complaints, matched for gender, age, PCP-practice and ethnicity were compared. Main outcome measures were contact frequency, prevalence of somatic as well as psychosocial diagnoses, prescription rate of (psychopharmacological agents, and referral rates. Data were analyzed using odds ratios, the Chi square test as well as multivariable logistic regression analysis. Results Data from 13,389 patients with upper GI symptoms and 13,389 control patients were analyzed. Patients with upper GI symptoms visited their PCP twice as frequently as controls (8.6 vs 4.4 times/year. Patients with upper GI symptoms presented not only more psychological and social problems, but also more other health problems to their PCP (odds ratios (ORs ranging from 1.37 to 3.45. Patients with upper GI symptoms more frequently used drugs of any ATC-class (ORs ranging from 1.39 to 2.90, including psychotropic agents. The observed differences were less pronounced when we adjusted for non-attending control patients. In multivariate regression analysis, contact frequency and not psychological or

  5. Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Sarlahi District, Nepal.

    Science.gov (United States)

    Lama, Tsering P; Khatry, Subarna K; Katz, Joanne; LeClerq, Steven C; Mullany, Luke C

    2017-12-21

    Identification of maternal and newborn illness and the decision-making and subsequent care-seeking patterns are poorly understood in Nepal. We aimed to characterize the process and factors influencing recognition of complications, the decision-making process, and care-seeking behavior among families and communities who experienced a maternal complication, death, neonatal illness, or death in a rural setting of Nepal. Thirty-two event narratives (six maternal/newborn deaths each and 10 maternal/newborn illnesses each) were collected using in-depth interviews and small group interviews. We purposively sampled across specific illness and complication definitions, using data collected prospectively from a cohort of women and newborns followed from pregnancy through the first 28 days postpartum. The event narratives were coded and analyzed for common themes corresponding to three main domains of illness recognition, decision-making, and care-seeking; detailed event timelines were created for each. While signs were typically recognized early, delays in perceiving the severity of illness compromised prompt care-seeking in both maternal and newborn cases. Further, care was often sought initially from informal health providers such as traditional birth attendants, traditional healers, and village doctors. Key decision-makers were usually female family members; husbands played limited roles in decisions related to care-seeking, with broader family involvement in decision-making for newborns. Barriers to seeking care at any type of health facility included transport problems, lack of money, night-time illness events, low perceived severity, and distance to facility. Facility care was often sought only after referral or following treatment failure from an informal provider and private facilities were sought for newborn care. Respondents characterized government facility-based care as low quality and reported staff rudeness and drug type and/or supply stock shortages. Delaying

  6. Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation

    Science.gov (United States)

    Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric

    2014-01-01

    ABSTRACT Background: The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. Methods: The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. Results: While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. Conclusions: The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of i

  7. The Fabrication of Qualified Citizens

    DEFF Research Database (Denmark)

    Andrade-Molina, Melissa

    2017-01-01

    a rhizomatic analytical move, a historization of the present is deployed to map the fabrication of the desired qualified citizen in Chile. The analysis evidences the (re)production of dominant narratives about the “qualified citizen” are and have been entangled with the functioning of school geometry...

  8. Qualifying for Career Planning

    Directory of Open Access Journals (Sweden)

    Aleksandra Kovač

    1996-12-01

    Full Text Available The need for education in various spheres of life, which allows a person to fully develop his/her personality, is more and more presen t also in our society. The discussed educational programme Discovering Vocational Goals and Forming Strategies· to Realize them qualifies people for autonomous career planning by offer­ ing them one of the possible ways of making decisions in relation to profession and job. In the course of the realization of the programme the participants are given the chance to think about the kind of work that would suit their interests, capabilities and individual characteristics as weel as the needs in certain environments (possible employers. They are encouraged to make an actual plan, stating how and when the desired objective will be reached. In 1995 the pro­ gramme was being carried out within nine semi­ nars organized at the Employment Offices in Maribor and Ptuj. During that time the pro­ gramme has also been evaluated by Doba - Education Office, which was funded by the Ministry of Work, Family and Social Matters. The paper includes the content of the programme as well as the assessments of the research project. The presented data show that the participants learned the method of career planning and acqu­ired greater self-confidence and motivation to solve their job problem actively.

  9. Pre-Emergency-Department Care-Seeking Patterns Are Associated with the Severity of Presenting Condition for Emergency Department Visit and Subsequent Adverse Events: A Timeframe Episode Analysis

    OpenAIRE

    Chan, Chien-Lung; Lin, Wender; Yang, Nan-Ping; Lai, K. Robert; Huang, Hsin-Tsung

    2015-01-01

    Background Many patients treated in Emergency Department (ED) visits can be treated at primary or urgent care sectors, despite the fact that a number of ED visitors seek other forms of care prior to an ED visit. However, little is known regarding how the pre-ED activity episodes affect ED visits. Objectives We investigated whether care-seeking patterns involve the use of health care services of various types prior to ED visits and examined the associations of these patterns with the severity ...

  10. Health care seeking among men with genital ulcer disease in South Africa: correlates and relationship to human immunodeficiency virus-1 and herpes simplex virus type 2 detection and shedding.

    Science.gov (United States)

    Leichliter, Jami S; Lewis, David A; Sternberg, Maya; Habel, Melissa A; Paz-Bailey, Gabriela

    2011-09-01

    Episodic acyclovir therapy has been added to genital ulcer disease (GUD) syndromic management guidelines in several sub-Saharan African countries with human immunodeficiency virus (HIV) epidemics. We examined the correlates of health care seeking in men with GUD and its relationship to HIV-1 and herpes simplex virus type 2 outcomes. Men with GUD (n = 615) were recruited from primary health care clinics in Gauteng province, South Africa for a randomized controlled trial of episodic acyclovir therapy. We used baseline survey and sexually transmitted infection/HIV-testing data to examine delay in health care seeking (defined as time from ulcer recognition to baseline study visit). Median delay in health care seeking for GUD was 5 days, and one-quarter of men had previously sought care for the current ulcer. Previous care seekers were older, had more episodes of ulceration in the past year, and were more likely to test seropositive for HIV-1 and HSV-2. Delay in health care seeking was significantly associated with age, education level, and sex during the ulceration episode. Delays in care seeking were related to poorer HIV-1 outcomes; these findings were valid after controlling for advanced HIV. Interventions to help shorten the duration between ulcer recognition and health care seeking for men with GUD are needed.

  11. Qualified Health Plan (QHP) Landscape

    Data.gov (United States)

    U.S. Department of Health & Human Services — QHP Landscape Files present basic information about certified Qualified Health Plans and Stand-alone Dental Plans for individuals-families and small businesses...

  12. Pre-Vaccination Care-Seeking in Females Reporting Severe Adverse Reactions to HPV Vaccine. A Registry Based Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Kåre Mølbak

    Full Text Available Since 2013 the number of suspected adverse reactions to the quadrivalent human papillomavirus (HPV vaccine reported to the Danish Medicines Agency (DMA has increased. Due to the resulting public concerns about vaccine safety, the coverage of HPV vaccinations in the childhood vaccination programme has declined. The aim of the present study was to determine health care-seeking prior to the first HPV vaccination among females who suspected adverse reactions to HPV vaccine.In this registry-based case-control study, we included as cases vaccinated females with reports to the DMA of suspected severe adverse reactions. We selected controls without reports of adverse reactions from the Danish vaccination registry and matched by year of vaccination, age of vaccination, and municipality, and obtained from the Danish National Patient Registry and The National Health Insurance Service Register the history of health care usage two years prior to the first vaccine. We analysed the data by logistic regression while adjusting for the matching variables.The study included 316 cases who received first HPV vaccine between 2006 and 2014. Age range of cases was 11 to 52 years, with a peak at 12 years, corresponding to the recommended age at vaccination, and another peak at 19 to 28 years, corresponding to a catch-up programme targeting young women. Compared with 163,910 controls, cases had increased care-seeking in the two years before receiving the first HPV vaccine. A multivariable model showed higher use of telephone/email consultations (OR 1.9; 95% CI 1.2-3.2, physiotherapy (OR 2.1; 95% CI 1.6-2.8 and psychologist/psychiatrist (OR 1.9; 95% CI 1.3-2.7. Cases were more likely to have a diagnosis in the ICD-10 chapters of diseases of the digestive system (OR 1.6; 95% CI 1.0-2.4, of the musculoskeletal system (OR 1.6; 95% CI 1.1-2.2, symptoms or signs not classified elsewhere (OR 1.8; 95% CI 1.3-2.5 as well as injuries (OR 1.5; 95% CI 1.2-1.9.Before receiving the

  13. Pre-vaccination care-seeking in females reporting severe adverse reactions to HPV vaccine. A registry based case-control study

    DEFF Research Database (Denmark)

    Mølbak, Kåre; Hansen, Niels Dalum; Valentiner-Branth, Palle

    2016-01-01

    to the DMA of suspected severe adverse reactions.We selected controls without reports of adverse reactions from the Danish vaccination registry and matched by year of vaccination, age of vaccination, and municipality, and obtained from the Danish National Patient Registry and The National Health Insurance...... vaccination programme has declined. The aim of the present study was to determine health care-seeking prior to the first HPV vaccination among females who suspected adverse reactions to HPV vaccine. Methods In this registry-based case-control study, we included as cases vaccinated females with reports...... Service Register the history of health care usage two years prior to the first vaccine. We analysed the data by logistic regression while adjusting for the matching variables. Results The study included 316 cases who received first HPV vaccine between 2006 and 2014. Age range of cases was 11 to 52 years...

  14. ‘For a mere cough, men must just chew Conjex, gain strength, and continue working’: the provider construction and tuberculosis care-seeking implications in Blantyre, Malawi

    Directory of Open Access Journals (Sweden)

    Jeremiah Chikovore

    2015-03-01

    Full Text Available Background: Delay by men in seeking healthcare results in their higher mortality while on HIV or tuberculosis (TB treatment and contributes to ongoing community-level disease transmission before going on treatment. Objective: To understand masculinity's role in delay in healthcare seeking for men, with a focus on TB-suggestive symptoms. Design: Data were collected between March 2011 and March 2012 in low-income suburbs in urban Blantyre using focus group discussions with community members (n=8 and health workers (n=2, in-depth interviews with 20 TB patients (female=14 and 20 uninvestigated chronic coughers (female=8, and a 3-day participatory workshop with 27 health stakeholder representatives. The research process drew to a large extent on grounded theory principles in the manner of Strauss and Corbin (1998 and also Charmaz (1995. Results: Role descriptions by both men and women in the study universally assigned men as primary material providers for their immediate family, that is, the ones earning and bringing livelihood and additional material needs. In a context where collectivism was valued, men were also expected to lead the provision of support to wider kin. Successful role enactment was considered key to achieving recognition as an adequate man; at the same time, job scarcity and insecurity, and low earnings gravely impeded men. Pressures to generate continuing income then meant constantly looking for jobs, or working continuously to retain insecure jobs or to raise money through self-employment. All this led men to relegate their health considerations. Conclusions: Early engagement with formal healthcare is critical to dealing with TB and HIV. However, role constructions as portrayed for men in this study, along with the opportunity costs of acknowledging illness seem, in conditions of vulnerability, important barriers to care-seeking. There is a need to address hidden care-seeking costs and to consider more complex interventions

  15. 'For a mere cough, men must just chew Conjex, gain strength, and continue working': the provider construction and tuberculosis care-seeking implications in Blantyre, Malawi.

    Science.gov (United States)

    Chikovore, Jeremiah; Hart, Graham; Kumwenda, Moses; Chipungu, Geoffrey A; Corbett, Liz

    2015-01-01

    Delay by men in seeking healthcare results in their higher mortality while on HIV or tuberculosis (TB) treatment and contributes to ongoing community-level disease transmission before going on treatment. To understand masculinity's role in delay in healthcare seeking for men, with a focus on TB-suggestive symptoms. Data were collected between March 2011 and March 2012 in low-income suburbs in urban Blantyre using focus group discussions with community members (n=8) and health workers (n=2), in-depth interviews with 20 TB patients (female=14) and 20 uninvestigated chronic coughers (female=8), and a 3-day participatory workshop with 27 health stakeholder representatives. The research process drew to a large extent on grounded theory principles in the manner of Strauss and Corbin (1998) and also Charmaz (1995). Role descriptions by both men and women in the study universally assigned men as primary material providers for their immediate family, that is, the ones earning and bringing livelihood and additional material needs. In a context where collectivism was valued, men were also expected to lead the provision of support to wider kin. Successful role enactment was considered key to achieving recognition as an adequate man; at the same time, job scarcity and insecurity, and low earnings gravely impeded men. Pressures to generate continuing income then meant constantly looking for jobs, or working continuously to retain insecure jobs or to raise money through self-employment. All this led men to relegate their health considerations. Early engagement with formal healthcare is critical to dealing with TB and HIV. However, role constructions as portrayed for men in this study, along with the opportunity costs of acknowledging illness seem, in conditions of vulnerability, important barriers to care-seeking. There is a need to address hidden care-seeking costs and to consider more complex interventions, including reducing precarity, in efforts to improve men's engagement

  16. ‘For a mere cough, men must just chew Conjex, gain strength, and continue working’: the provider construction and tuberculosis care-seeking implications in Blantyre, Malawi

    Science.gov (United States)

    Chikovore, Jeremiah; Hart, Graham; Kumwenda, Moses; Chipungu, Geoffrey A.; Corbett, Liz

    2015-01-01

    Background Delay by men in seeking healthcare results in their higher mortality while on HIV or tuberculosis (TB) treatment and contributes to ongoing community-level disease transmission before going on treatment. Objective To understand masculinity's role in delay in healthcare seeking for men, with a focus on TB-suggestive symptoms. Design Data were collected between March 2011 and March 2012 in low-income suburbs in urban Blantyre using focus group discussions with community members (n=8) and health workers (n=2), in-depth interviews with 20 TB patients (female=14) and 20 uninvestigated chronic coughers (female=8), and a 3-day participatory workshop with 27 health stakeholder representatives. The research process drew to a large extent on grounded theory principles in the manner of Strauss and Corbin (1998) and also Charmaz (1995). Results Role descriptions by both men and women in the study universally assigned men as primary material providers for their immediate family, that is, the ones earning and bringing livelihood and additional material needs. In a context where collectivism was valued, men were also expected to lead the provision of support to wider kin. Successful role enactment was considered key to achieving recognition as an adequate man; at the same time, job scarcity and insecurity, and low earnings gravely impeded men. Pressures to generate continuing income then meant constantly looking for jobs, or working continuously to retain insecure jobs or to raise money through self-employment. All this led men to relegate their health considerations. Conclusions Early engagement with formal healthcare is critical to dealing with TB and HIV. However, role constructions as portrayed for men in this study, along with the opportunity costs of acknowledging illness seem, in conditions of vulnerability, important barriers to care-seeking. There is a need to address hidden care-seeking costs and to consider more complex interventions, including reducing

  17. Treating infants with frigg: linking disease aetiologies, medicinal plant use and care-seeking behaviour in southern Morocco.

    Science.gov (United States)

    Teixidor-Toneu, Irene; Martin, Gary J; Puri, Rajindra K; Ouhammou, Ahmed; Hawkins, Julie A

    2017-01-13

    Although most Moroccans rely to some extent on traditional medicine, the practice of frigg to treat paediatric ailments by elderly women traditional healers known as ferraggat, has not yet been documented. We describe the role of these specialist healers, document the medicinal plants they use, and evaluate how and why their practice is changing. Ethnomedicinal and ethnobotanical data were collected using semi-structured interviews and observations of medical encounters. Information was collected from traditional healers, namely ferraggat, patients, herbalists and public health professionals. Patients' and healers' narratives about traditional medicine were analysed and medicinal plant lists were compiled from healers and herbalists. Plants used were collected, vouchered and deposited in herbaria. Ferragat remain a key health resource to treat infant ailments in the rural High Atlas, because mothers believe only they can treat what are perceived to be illnesses with a supernatural cause. Ferragat possess baraka, or the gift of healing, and treat mainly three folk ailments, taqait, taumist and iqdi, which present symptoms similar to those of ear infections, tonsillitis and gastroenteritis. Seventy plant species were used to treat these ailments, but the emphasis on plants may be a recent substitute for treatments that used primarily wool and blood. This change in materia medica is a shift in the objects of cultural meaningfulness in response to the increasing influence of orthodox Islam and state-sponsored modernisation, including public healthcare and schooling. Religious and other sociocultural changes are impacting the ways in which ferraggat practice. Treatments based on no-longer accepted symbolic elements have been readily abandoned and substituted by licit remedies, namely medicinal plants, which play a legitimisation role for the practice of frigg. However, beliefs in supernatural ailment aetiologies, as well as lack or difficult access to biomedical

  18. Partners in qualified equipment supply

    International Nuclear Information System (INIS)

    Rygg, D.E.; O'Hare, G.J.

    1993-01-01

    Industry initiatives have been taken to improve procurement practices and commercial dedication programs, formation of procurement engineering groups, emphasis on product quality, and increased engineering involvement in procurement and maintenance of qualified equipment. This poses new challenges for many licensees in terms of resources, product knowledge, and access to information normally held proprietary by equipment suppliers. Alternative approaches to future licensee/Westinghouse relationships which will allow licensees to adapt to the changing environment are discussed. 2 figs

  19. "I never had the money for blood testing" – Caretakers' experiences of care-seeking for fatal childhood fevers in rural Uganda – a mixed methods study

    Directory of Open Access Journals (Sweden)

    Kaija Judith

    2008-12-01

    Full Text Available Abstract Background The main killer diseases of children all manifest as acute febrile illness, yet are curable with timely and adequate management. To avoid a fatal outcome, three essential steps must be completed: caretakers must recognize illness, decide to seek care and reach an appropriate source of care, and then receive appropriate treatment. In a fatal outcome some or all of these steps have failed and it remains to be elucidated to what extent these fatal outcomes are caused by local disease perceptions, inappropriate care-seeking or inadequate resources in the family or health system. This study explores caretakers' experiences of care-seeking for childhood febrile illness with fatal outcome in rural Uganda to elucidate the most influential barriers to adequate care. Methods A mixed methods approach using structured Verbal/Social autopsy interviews and in-depth interviews was employed with 26 caretakers living in Iganga/Mayuge Demographic Surveillance Site who had lost a child 1–59 months old due to acute febrile illness between March and June 2006. In-depth interviews were analysed using content analysis with deductive category application. Results Final categories of barriers to care were: 1 "Illness interpretation barriers" involving children who received delayed or inappropriate care due to caretakers' labelling of the illness, 2 "Barriers to seeking care" with gender roles and household financial constraints hindering adequate care and 3 "Barriers to receiving adequate treatment" revealing discontents with providers and possible deficiencies in quality of care. Resource constraints were identified as the underlying theme for adequate management, both at individual and at health system levels. Conclusion The management of severely ill children in this rural setting has several shortcomings. However, the majority of children were seen by an allopathic health care provider during the final illness. Improvements of basic health care

  20. Prevalence, care-seeking, and health service utilization for non-communicable diseases among Syrian refugees and host communities in Lebanon.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Hanquart, Baptiste; Woodman, Michael

    2016-01-01

    Given the large burden of non-communicable diseases (NCDs) among both Syrian refugees and the host communities within which they are settled, humanitarian actors and the government of Lebanon face immense challenges in addressing health needs. This study assessed health status, unmet needs, and utilization of health services among Syrian refugees and host communities in Lebanon. A cross-sectional survey of Syrian refugees and host communities in Lebanon was conducted using a two-stage cluster survey design with probability proportional to size sampling. To obtain information on chronic NCDs, respondents were asked a series of questions about hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and arthritis. Differences in household characteristics by care-seeking for these conditions were examined using chi-square, t-test, and adjusted logistic regression methods. Over half (50.4 %) of refugee and host community households (60.2 %) reported a member with one of the five NCDs. Host community prevalence rates were significantly higher than refugees for all conditions except chronic respiratory diseases ( p  = 0.08). Care-seeking for NCDs among refugees and host community households was high across all conditions with 82.9 and 97.8 %, respectively, having sought care in Lebanon for their condition. Refugees utilized primary health care centers (PHCC) (57.7 %) most often while host communities sought care most in private clinics (62.4 %). Overall, 69.7 % of refugees and 82.7 % of host community members reported an out-of-pocket consultation payment ( p  = 0.041) with an average payment of US$15 among refugees and US$42 for the host community ( p Syrian crisis and the burden on the Lebanese health system, implications for both individuals with NCDs and Lebanon's health system are immense. The burden of out of pocket expenses on persons with NCDs are also substantial, especially given the tenuous economic status of many refugees

  1. 7 CFR 4290.110 - Qualified management.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Qualified management. 4290.110 Section 4290.110... Qualifications for the RBIC Program Organizing A Rbic § 4290.110 Qualified management. An Applicant must show, to the satisfaction of the Secretary, that its current or proposed management team is qualified and has...

  2. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries.

    Science.gov (United States)

    Davé, Dattesh R; Nagarjan, Neeraja; Canner, Joseph K; Kushner, Adam L; Stewart, Barclay T

    2018-02-20

    Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. The survey identifies burn etiology, demographics, timing, disability, and barriers to receiving care. Among 13,763 individuals surveyed, 896 burns were identified. Rwanda had the highest proportion of individuals seeking and receiving care (91.6% vs 88.5%) while Sierra Leone reported the fewest (79.3% vs 70.3%). Rwanda reported the largest disability while Nepal reported the highest proportion with no disability (47.5% vs 76.2%). Lack of money, healthcare providers, and rural living reduce the odds of receiving care by 68% and 85% respectively. Despite similar country socioeconomic characteristics there was significant variability in burn demographics, timing, and disability. Nevertheless, being geographically and economically disadvantaged predict lack of access to burn care. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

  3. HIV prevention and care-seeking behaviour among female sex workers in four cities in India, Kenya, Mozambique and South Africa.

    Science.gov (United States)

    Lafort, Yves; Greener, Ross; Roy, Anuradha; Greener, Letitia; Ombidi, Wilkister; Lessitala, Faustino; Haghparast-Bidgoli, Hassan; Beksinska, Mags; Gichangi, Peter; Reza-Paul, Sushena; Smit, Jenni A; Chersich, Matthew; Delva, Wim

    2016-10-01

    To identify gaps in the use of HIV prevention and care services and commodities for female sex workers, we conducted a baseline cross-sectional survey in four cities, in the context of an implementation research project aiming to improve use of sexual and reproductive health services. Using respondent-driven sampling, 400 sex workers were recruited in Durban, 308 in Tete, 400 in Mombasa and 458 in Mysore and interviewed face-to-face. RDS-adjusted proportions were estimated by nonparametric bootstrapping and compared across cities using post hoc pairwise comparison. Condom use with last client ranged from 88.3% to 96.8%, ever female condom use from 1.6% to 37.9%, HIV testing within the past 6 months from 40.5% to 70.9%, receiving HIV treatment and care from 35.5% to 92.7%, care seeking for last STI from 74.4% to 87.6% and having had at least 10 contacts with a peer educator in the past year from 5.7% to 98.1%. Many of the differences between cities remained statistically significant (P sex worker characteristics. Models to improve use of condoms and HIV prevention and care services should be tailored to the specific context of each site. Programmes at each site must focus on improving availability and uptake of those services that are currently least used. © 2016 John Wiley & Sons Ltd.

  4. Care Seeking Behaviour and Barriers to Accessing Services for Sexual Health Problems among Women in Rural Areas of Tamilnadu State in India.

    Science.gov (United States)

    Puthuchira Ravi, Rejoice; Athimulam Kulasekaran, Ravishankar

    2014-01-01

    Background. Sexually transmitted infections (STIs) may be either asymptomatic or symptomatic. Regardless of the presence or absence of symptoms all STIs can lead to major complications if left untreated. Objective. To assess the care seeking behaviour and barriers to accessing services for sexual health problems among young married women in rural areas of Thiruvarur district of Tamil Nadu state in India. Methods. A community based cross-sectional study was conducted in 28 villages selected using multistage sampling technique for selecting 605 women in the age group of 15-24 years during July 2010-April 2011. Results. The prevalence rate of reproductive tract infections (RTIs) and STIs was observed to be 14.5% and 8.8%, respectively, among the study population. Itching/irritation over vulva, thick white discharge, discharge with unpleasant odor, and frequent and uncomfortable urination were most commonly experienced symptoms of sexual health problems. Around three-fourth of the women received treatment for sexual health problems. Perception of symptoms as normal, feeling shy, lack of female health workers, distance to health facility, and lack of availability of treatment were identified as major barriers for not seeking treatment for RTIs/STIs. Conclusion. Family tradition and poor socioeconomic conditions of the family appear to be the main reasons for not utilizing the health facility for sexual health problems. Integrated approach is strongly suggested for creating awareness to control the spread of sexual health problems among young people.

  5. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (Spanish Edition); Funciones y responsabilidades y requisitos de enseñanza y capacitación para los físicos médicos clínicamente cualificados

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-06-15

    The IAEA technical cooperation project Strengthening Medical Physics in Radiation Medicine was approved by the IAEA Board of Governors for the period 2009-2013 with the aim of ensuring the safe and effective diagnosis and treatment of patients. The IAEA, together with the World Health Organization and stakeholders from numerous medical physics professional societies worldwide, including the International Organization for Medical Physics (IOMP), the European Federation of Organisations for Medical Physics, the American Association of Physicists in Medicine (AAPM), the Latin American Medical Physics Association, the Asia-Oceania Federation of Organizations for Medical Physics, the European Society for Radiotherapy and Oncology, the European Commission and the International Radiation Protection Association, as well as regional counterparts from Africa, Asia, Europe and Latin America, met in Vienna in May 2009 to plan and coordinate the new project. A shortage of clinically qualified medical physicists (CQMPs), insufficient education and training (especially properly organized and coordinated clinical training), and lack of professional recognition were identified as the main problems to be addressed under this project. This publication was developed under the project framework in response to these findings. It aims, first, at defining appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Important, non-ionizing radiation imaging specialties, such as magnetic resonance and ultrasound, are also considered for completeness. On the basis of these tasks, this book provides recommended minimum requirements for the academic education and clinical training of CQMPs, including recommendations for their accreditation, certification and registration, along with continuing professional development

  6. Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study.

    Science.gov (United States)

    Chen, Ingrid; Thanh, Huong Ngo Thi; Lover, Andrew; Thao, Phung Thi; Luu, Tang Viet; Thang, Hoang Nghia; Thang, Ngo Duc; Neukom, Josselyn; Bennett, Adam

    2017-10-16

    Vietnam has successfully reduced malaria incidence by more than 90% over the past 10 years, and is now preparing for malaria elimination. However, the remaining malaria burden resides in individuals that are hardest to reach, in highly remote areas, where many malaria cases are treated through the informal private sector and are not reported to public health systems. This qualitative study aimed to contextualize and characterize the role of private providers, care-seeking behaviour of individuals at high risk of malaria, as well as risk factors that should be addressed through malaria elimination programmes in Vietnam. Semi-structured qualitative interviews were conducted with 11 key informants in Hanoi, 30 providers, 9 potential patients, and 11 individuals at risk of malaria in Binh Phuoc and Kon Tum provinces. Audio recorded interviews were transcribed and uploaded to Atlas TI™, themes were identified, from which programmatic implications and recommendations were synthesized. Qualitative interviews revealed that efforts for malaria elimination in Vietnam should concentrate on reaching highest-risk populations in remote areas as well their care providers, in particular private pharmacies, private clinics, and grocery stores. Among these private providers, diagnosis is currently based on symptoms, leaving unconfirmed cases that are not reported to public health surveillance systems. Among at-risk individuals, knowledge of malaria was limited, and individuals reported not taking full courses of treatment, a practice that threatens selection for drug resistance. Access to insecticide-treated hammock nets, a potentially important preventive measure for settings with outdoor biting Anopheles vectors, was also limited. Malaria elimination efforts in Vietnam can be accelerated by targeting improved treatment, diagnosis, and reporting practices to private pharmacies, private clinics, and grocery stores. Programmes should also seek to increase awareness and

  7. "It is good to take her early to the doctor" - mothers' understanding of childhood pneumonia symptoms and health care seeking in Kilimanjaro region, Tanzania.

    Science.gov (United States)

    Muro, Florida; Meta, Judith; Renju, Jenny; Mushi, Adiel; Mbakilwa, Hilda; Olomi, Raimos; Reyburn, Hugh; Hildenwall, Helena

    2017-09-22

    Pneumonia is among the leading causes of avoidable deaths for young children globally. The main burden of mortality falls on children from poor and rural families who are less likely to obtain the treatment they need, highlighting inequities in access to effective care and treatment. Caretakers' illness perceptions and care-seeking practices are of major importance for children with pneumonia to receive adequate care. This study qualitatively explores the caretaker concepts of childhood pneumonia in relation to treatment seeking behaviour and health worker management in Moshi urban district, Tanzania. In May - July 2013 data was gathered through different qualitative data collection techniques including five focus group discussions (FGDs) with mothers of children under-five years of age. The FGDs involved free listing of pneumonia symptoms and video presentations of children with respiratory symptoms done, these were triangulated with ten case narratives with mothers of children admitted with pneumonia and eleven in-depth interviews with hospital health workers. Transcripts were coded and analysed using qualitative content analysis. Mothers demonstrated good awareness of common childhood illnesses including pneumonia, which was often associated with symptoms such as cough, flu, chest tightness, fever, and difficulty in breathing. Mothers had mixed views on causative factors and treatments options but generally preferred modern medicine for persisting and severe symptoms. However, all respondent reported access to health facilities as a barrier to care, associated with transport, personal safety and economic constraints. Local illness concepts and traditional treatment options did not constitute barriers to care for pneumonia symptoms. Poor access to health facilities was the main barrier. Decentralisation of care through community health workers may improve access to care but needs to be combined with strengthened referral systems and accessible hospital care for

  8. Delivering Patient-Centered Care in a Fragile State: Using Patient-Pathway Analysis to Understand Tuberculosis-Related Care Seeking in Pakistan.

    Science.gov (United States)

    Fatima, Razia; Haq, Mahboob Ul; Yaqoob, Aashifa; Mahmood, Nasir; Ahmad, Khawaja Laeeq; Osberg, Mike; Makayova, Julia; Hymoff, Aaron; Hanson, Christy

    2017-11-06

    Pakistan has the sixth largest population in the world and boasts the fifth greatest burden of tuberculosis. The Government of Pakistan has set the ambitious goal of zero deaths due to tuberculosis and universal access to tuberculosis care by 2020. Successfully reaching these goals is dependent on the country's capacity to diagnose and successfully treat an estimated 200000 unnotified or missing patients with tuberculosis. A patient-pathway analysis (PPA) was conducted at the national level, as well as for each of the 4 provinces, to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services. Almost 90% of patients initiated care in the private sector, which accounts for only 15% of facilities with the capacity for tuberculosis diagnosis and treatment. Across the country, nearly 50% of tuberculosis microscopy laboratories were located in public-sector-basic health units and regional health centers. However, very few patients initiated care in these facilities. Overall, tuberculosis case detection was high given the low likelihood of patients reaching facilities with the capacity for tuberculosis service delivery during their first visit. Improving the engagement of the informal sector and lower-level clinicians will improve the efficiency and timeliness of tuberculosis diagnosis for patients in Pakistan. Concurrently, the apparent strength of the referral networks connecting community-level workers and private clinicians to the public sector for tuberculosis diagnosis and treatment suggests that strengthening the capacity of the public sector could be valuable. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  9. Health needs and care seeking behaviours of Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq.

    Science.gov (United States)

    Cetorelli, Valeria; Burnham, Gilbert; Shabila, Nazar

    2017-01-01

    During the summer of 2014, ISIS overran Nineveh governorate in Northern Iraq. Yazidis and other religious minorities were subjected to brutal attacks and forced to seek refuge into the neighbouring Kurdistan Region, where they remain living in local communities or in camps. This survey provides a population-based assessment of the health needs and care seeking behaviours of Yazidis and other groups currently residing in camps. The survey covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1,300 households with a total of 8,360 members were interviewed between November and December 2015. Participants were asked if any household members had needed care for a health condition in the two weeks preceding the survey, and whether care was obtained from the camp primary health care centre, an outside public hospital or a private clinic. If care was received, the out-of-pocket payment was recorded; otherwise, the reason for not seeking care was queried. In 33.9% (CI: 31.0-37.0) of households one or more members had needed care for a health condition in the two weeks preceding the survey. The most likely to have needed care were older persons (18.5%; CI: 13.6-24.6) and infants (18.0%; CI: 11.6-26.8). The reported health conditions revealed a complex picture of communicable and non-communicable diseases as well as mental health problems and physical injuries. Care was primarily sought from private clinics (41.8%; CI: 36.4-47.4) or public hospitals (27.3%; CI: 22.6-32.7) rather than from the camp primary health care clinics (23.6%; CI: 19.5-28.2). The mean out-of-pocket payment for care received was nearly 3 times higher in public hospitals than in the camp primary health care clinics and nearly 11 times higher in private clinics. Cost was the main perceived barrier to obtaining health services. Demand for health services was high among Yazidis and other minorities living in camps. Private services were preferred in

  10. Qualified Empathy - Project Report 2015-16

    DEFF Research Database (Denmark)

    Austring, Bennye Düranc; Sørensen, Merete Cornet

    2016-01-01

    UCSJ-delen af den afsluttende rapport fra Nordplus-projektet "Qualified Empathy", der blev gennemført sammen med Metropolia, Helsinki, og NTNU, Trondheim, i 2015 og 15.......UCSJ-delen af den afsluttende rapport fra Nordplus-projektet "Qualified Empathy", der blev gennemført sammen med Metropolia, Helsinki, og NTNU, Trondheim, i 2015 og 15....

  11. Nominal Group as Qualifier to "Someone"

    Science.gov (United States)

    Sujatna, Eva Tuckyta Sari; Wahyuni, Sri

    2017-01-01

    The paper titled "Nominal Group as Qualifier to 'Someone'" investigated types of qualifiers which are embedded to the head "someone" in a nominal group. This research was conducted in the light of Systemic Functional Linguistics analysis. The data was analyzed, classified then described using descriptive qualitative method.…

  12. Highly qualified in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Renata Čuhlová

    2017-05-01

    Full Text Available The paper aims to analyse the current situation of the highly qualified in the Czech Republic applying the ISCO qualification. Previous studies suggest that educational attainment has an important impact on labour market performance and national competitiveness. Data analyses approved that highly qualified workforce positively influences economic situation of the EU–15 Member States they work in. However, this hypothesis was disapproved for the EU–10+3 Member States joining the EU after 2004. The difference can be explained by the various stage in convergence process since some New Member States are still in transformation period. We positively appraise the significant growth of fraction of the highly qualified in the Czech Republic since 2004, especially in the major group Professionals involving the most qualified workforce. The same trend happened also for the highly qualified foreigners in the Czech Republic, however their attracting still remains a challenge.

  13. Qualified expert training: the ERPC (European Radiation Protection Course)

    International Nuclear Information System (INIS)

    Deboodt, P.; Bourguignon, M.; Juhel, T.; Lirsac, N.; Luciani, A.; Marco, M.; Schmitt-Hanning, A. M.; Van der Steen, J.

    2003-01-01

    Since 2000, a training for the qualified experts is organised by several European partners in France at Saclay near Pais. The objective of this training is to deliver the theoretical knowledge needed to be recognised as a qualified expert in radiation protection according to the European requirements. The training delivered in English, includes four independent modules; basics, occupational exposure in nuclear and industrial applications, medical exposures (patients and workers), radiation protection of the members of the public and the environment (4 or 5 weeks each). A written examination is organised at the end of each module. Lectures, practical works, exercises and visits are given by European lecturers. Students have the possibility to register in one or several module during one or several years. Participants could be students or professionals from all European countries satisfying the pre requite defined by the European board. A certificate validating the successfully passed modules will be delivered by the INSTN (National Institute of Nuclear Sciences and Technologies)

  14. Qualified expert training: the ERPC (European Radiation Protection Course)

    Energy Technology Data Exchange (ETDEWEB)

    Deboodt, P.; Bourguignon, M.; Juhel, T.; Lirsac, N.; Luciani, A.; Marco, M.; Schmitt-Hanning, A. M.; Van der Steen, J.

    2003-07-01

    Since 2000, a training for the qualified experts is organised by several European partners in France at Saclay near Pais. The objective of this training is to deliver the theoretical knowledge needed to be recognised as a qualified expert in radiation protection according to the European requirements. The training delivered in English, includes four independent modules; basics, occupational exposure in nuclear and industrial applications, medical exposures (patients and workers), radiation protection of the members of the public and the environment (4 or 5 weeks each). A written examination is organised at the end of each module. Lectures, practical works, exercises and visits are given by European lecturers. Students have the possibility to register in one or several module during one or several years. Participants could be students or professionals from all European countries satisfying the pre requite defined by the European board. A certificate validating the successfully passed modules will be delivered by the INSTN (National Institute of Nuclear Sciences and Technologies).

  15. PREVALENCE, RISK FACTORS, PROPHYLACTIC BEHAVIOR, THERAPEUTIC BEHAVIOR AND STATE OF KNOWLEDGE REGARDING URINARY TRACT INFECTIONS AMONG CHOSEN POPULATION OF NURSING/MIDWIFERY STUDENTS AND QUALIFIED NURSES/MIDWIFES FROM MEDICAL UNIVERSITY OF ¸ÓDè

    Directory of Open Access Journals (Sweden)

    Aleksandra Grzelewska

    2010-03-01

    Full Text Available evalence, risk factors, therapeutic behavior, knowledge level, prophylactic and treatment methods regarding uncomplicated urinary tract infections (UTI. Materials and methods: Anonymous, closed, previously validated questionnaire, consisting of 12 questions on UTI in women was used in 267 adult nursing/midwifery students and nurses/midwifes from many different clinics/wards of the Medical University of Lodz. Results: 83% of respondents reported UTI at least once in a lifetime, 80% of them periodically, with cystitis being a main diagnosis. 40% of respondents reported periodical presence of UTI signs and symptoms without physician diagnosis confirmation. Main UTI causes were body cooling and cold water baths. 40% of respondents had symptoms suggesting UTI in the past but no diagnosis by physician. The risk of UTI symptoms disregarding or self-treatment prevalence decreased with time of professional practice, and in respondents with UTI symptoms connected with sexual activity, antibiotics treatment or sufficient level of knowledge of UTI. 64% UTI positive respondents had mothers with history of UTI. Conclusions: Cystitis is an important problem in Lodz Medical University students and nurses, however their knowledge level regarding risk factors, prophylactic and management of UTI are insufficient what may lead to underdiagnosis and undertreatment.

  16. Confidence in leadership among the newly qualified.

    Science.gov (United States)

    Bayliss-Pratt, Lisa; Morley, Mary; Bagley, Liz; Alderson, Steven

    2013-10-23

    The Francis report highlighted the importance of strong leadership from health professionals but it is unclear how prepared those who are newly qualified feel to take on a leadership role. We aimed to assess the confidence of newly qualified health professionals working in the West Midlands in the different competencies of the NHS Leadership Framework. Most respondents felt confident in their abilities to demonstrate personal qualities and work with others, but less so at managing or improving services or setting direction.

  17. What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries

    Science.gov (United States)

    Cumming, Oliver; Hunter, Paul R

    2018-01-01

    Patient satisfaction with healthcare has clear implications on service use and health outcomes. Barriers to care seeking are complex and multiple and delays in seeking care are associated with significant morbidity and mortality. We sought to assess the relationship between water, sanitation and hygiene (WASH) provision in healthcare facilities (HCF) and patient satisfaction/care seeking behaviour in low-income and middle-income countries. Pubmed and Medline Ovid were searched using a combination of search terms. 984 papers were retrieved and only 21 had a WASH component warranting inclusion. WASH was not identified as a driver of patient satisfaction but poor WASH provision was associated with significant patient dissatisfaction with infrastructure and quality of care. However, this dissatisfaction was not sufficient to stop patients from seeking care in these poorly served facilities. With specific regard to maternal health services, poor WASH provision was the reason for women choosing home delivery, although providers’ attitudes and interpersonal behaviours were the main drivers of patient dissatisfaction with maternal health services. Patient satisfaction was mainly assessed via questionnaires and studies reported a high risk of courtesy bias, potentially leading to an overestimation of patient satisfaction. Patient satisfaction was also found to be significantly affected by expectation, which was strongly influenced by patients’ socioeconomic status and education. This systematic review also highlighted a paucity of research to describe and evaluate interventions to improve WASH conditions in HCF in low-income setting with a high burden of healthcare-associated infections. Our review suggests that improving WASH conditions will decrease patience dissatisfaction, which may increase care seeking behaviour and improve health outcomes but that more rigorous research is needed. PMID:29765776

  18. Dietary habits of obese patients qualified for bariatric procedures.

    Science.gov (United States)

    Jastrzebska-Mierzyńska, Marta; Ostrowska, Lucyna; Hady, Hady Razak; Dadan, Jacek

    2014-01-01

    Patients with obesity, including morbid obesity, commit numerous dietary mistakes. They prefer high-energy diets, but of poor nutritional value. Patients qualified for bariatric procedures show deficiencies in vitamins and minerals due to insufficient intake of vegetables, fruit and whole grain products. Analysis of dietary habits in morbidly obese patients prepared for bariatric surgery, including assessment of eating style and frequency of consumption of certain products. The study group contained 39 people aged 18 - 65 years, who were surveyed with a questionnaire elaborated in the Department of Clinical Dietetics and Nutrition, Medical University of Bialystok. The following factors were assessed: number of meals, snacking between meals and eating at night, types of snacks eaten, and frequency of consumption of certain foods. Results were analyzed using Statistica 9.0. The majority of surveyed men (41.7%) ate three meals a day, whereas most women (40.7%) had at least 4 meals a day. Nearly 85% of the respondents admitted snacking between meals, mainly eating fruit, sweets and sandwiches. Whole grain cereal, milk and dairy products, fish, fruit, vegetables and pulses appeared in diet of patients qualified for treatment of obesity very rarely. Dietary habits of obese patients qualified for bariatric procedures are not consistent with recommendations. Therefore, these patients should receive nutritional education in order to foster proper eating habits that will help in the postoperative nutrition.

  19. The relationship between complaint-related cognitions in referred patients with irritable bowel syndrom and subsequent health care seeking behaviour in primary care.

    NARCIS (Netherlands)

    Dulmen, A.M. van; Fennis, J.F.M.; Mokkink, H.G.A.; Bleijenberg, G.

    1996-01-01

    BACKGROUND. It is generally accepted that it is important to explore patients' beliefs and fears about the meaning of their symptoms during medical consultations. OBJECTIVE. To discover how referral behaviour of GPs and attention to dysfunctional cognitions of medical specialists affect the

  20. Supply Inventory Management: Evaluation of the Defense Supply Center Columbus Qualified Products List and Qualified Manufacturers List Program

    National Research Council Canada - National Science Library

    2002-01-01

    ... was transitioned from the Military Departments. The Defense Supply Center Columbus currently has management responsibility for over 300 Qualified Products Lists and 4 Qualified Manufacturers Lists...

  1. 26 CFR 1.936-10 - Qualified investments.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Qualified investments. 1.936-10 Section 1.936... (CONTINUED) INCOME TAXES Possessions of the United States § 1.936-10 Qualified investments. (a) In general. [Reserved] (b) Qualified investments in Puerto Rico. [Reserved] (c) Qualified investment in certain...

  2. Solar array qualification through qualified analysis

    Science.gov (United States)

    Zijdemans, J.; Cruijssen, H. J.; Wijker, J. J.

    1991-04-01

    To achieve qualification is in general a very expensive exercise. For solar arrays this is done by a dedicated test program through which final qualification is achieved. Due to severe competition on the solar array market, cheaper means are looked for to achieve a qualified product for the customers. One of the methods is to drastically limit the environmental test program and to qualify the solar-array structure against its environmental loads by analysis. Qualification by analysis is possible. The benefits are that a significant amount of development effort can be saved in case such a powerful tool is available. Extensive testing can be avoided thus saving time and money.

  3. 17 CFR 240.3b-8 - Definitions of “Qualified OTC Market Maker, Qualified Third Market Maker” and “Qualified Block...

    Science.gov (United States)

    2010-04-01

    ... Market Maker, Qualified Third Market Makerâ and âQualified Block Positionerâ. 240.3b-8 Section 240.3b-8... “Qualified Block Positioner”. For the purposes of Regulation U under the Act (12 CFR part 221): (a) The term... inventory turnover in such security. (c) The term Qualified Block Positioner means a dealer who (1) is a...

  4. 46 CFR 390.9 - Qualified withdrawals.

    Science.gov (United States)

    2010-10-01

    ..., construction or reconstruction its fair market value. The party must obtain the prior written permission of the... appraisal to be the fair market value of the vessel, at the time of the acquisition, or the actual cost...: (i) The acquisition, construction or reconstruction of a qualified agreement vessel; (ii) The...

  5. 13 CFR 108.110 - Qualified management.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Qualified management. 108.110... management. An Applicant must show, to the satisfaction of SBA, that its current or proposed management team... or proposed management team has sufficient qualifications, SBA will consider information provided by...

  6. The UK system of recognising qualified experts

    International Nuclear Information System (INIS)

    Bines, W.

    2002-01-01

    EURATOM Basic Safety Standards (BSS) Directives have long included requirements for the involvement of qualified experts, the definition of which has scarcely changed since at least 1976. The Directive requirement, in the definition of qualified expert,, for competent authorities to recognise the capacity to act as a qualified expert has been interpreted by Member States in widely differing ways, ranging from the minimalist or case by case to the highly detailed and prescriptive. In the United Kingdom (UK), the qualified expert for occupational radiation protection is the radiation protection adviser and the competent authority is the Health and Safety Executive (HSE). The Ionising Radiations Regulations 1985, which largely implemented the 1980 BSS Directive, required an employer to appoint one or more radiation protection advisers for the purpose of advising him as to the observance of these Regulations and other health and safety matters in connection with ionising radiation. The Regulations addressed the question of recognition by forbidding an employer to appoint a person as a radiation protection adviser unless: that person was suitably qualified and experienced; the employer had notified the Health and Safety Executive in writing of the intended appointment at least 28 days in advance, giving the name of the person and particulars of his qualifications and experience and the scope of the advice he would be required to give; and the employer had received from HSE an acknowledgement in writing of the notification. This system allowed HSE to follow up and query any apparently unsuitable potential appointments while applying a light overall administrative touch. The Approved Code of Practice supporting the Regulations included advice on the qualifications, experience and qualities that the employer should look for in a suitable radiation protection adviser

  7. Professional paradox: identity formation in qualified doctors pursuing further training.

    Science.gov (United States)

    Chan, Mercedes; Pratt, Dan; Poole, Gary; Sidhu, Ravi

    2018-03-01

    Many newly qualified specialists and subspecialists pursue additional training. Although their motivations are many, the pursuit of further training as an alternative to unemployment is an emerging trend. Paradoxically, doctors continue as trainees with a consultant's credentials, and without the guarantee of eventual employment. This study explores seven doctors' experiences, the effects of further training on their professional identity formation (PIF), and how these effects are reconciled on a personal and professional level. This phenomenological study involved interviews with seven qualified Canadian specialists (three were female) who pursued additional training in response to a lack of available positions in their respective specialties. Template analysis generated theoretical constructs of influences on their PIF, and characteristics of their lived experiences. Four themes shaped PIF: setting and context; language and communication; responsibilities and privileges; and participants' visions of their future selves. Professional identity formation (PIF) continued to develop in further training, but was inconsistently affirmed by participants' communities of practice. Four major themes characterised training experiences: prescription; managing multiple masters; limiting access to others and community ties; and constantly questioning the value of extra training. Qualified doctors traverse professional paradoxes as they seek further education with no guarantee of employment and provide consultant-level care as 'trainees'. An identity dissonance emerges that may continue until a clear identity is prescribed for them. Although disruptive to these doctors' PIF and personal and professional lives, the long-term effects of additional training are unknown. Its utility and influence on securing employment and future job satisfaction are areas for further research. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  8. 33 CFR 154.1026 - Qualified individual and alternate qualified individual.

    Science.gov (United States)

    2010-07-01

    ... alternate must: (1) Be located in the United States; (2) Speak fluent English; (3) Be familiar with the... facility may designate an organization to fulfill the role of the qualified individual and the alternate...

  9. 33 CFR 155.1026 - Qualified individual and alternate qualified individual.

    Science.gov (United States)

    2010-07-01

    ... familiar with the implementation of the vessel response plan; and (4) Be trained in the responsibilities of... vessel may designate an organization to fulfill the role of the qualified individual and alternate...

  10. Attitude to e-learning among newly qualified doctors.

    Science.gov (United States)

    Goh, Jason; Clapham, Michael

    2014-02-01

    e-Learning plays an increasingly important role in medical education. Much research has focused on the evaluation of individual modules among medical students or more senior trainee doctors. We studied the attitude of newly qualified foundation level-1 doctors (FY1s) towards a blended learning programme to gain insight into the perceived role of e-learning in relation to classroom and experiential learning. The blended learning strategy consisted of weekly 3-hour sessions of lectures and flexible e-learning sessions. A questionnaire survey was conducted among 54 per cent (37/69) of FY1 doctors, towards the end of their first year post qualification. The majority of FY1s had to carry out additional e-learning outside of work. When asked where was best to carry out e-learning, 54 per cent preferred to e-learn both at work and at home, whereas 38 per cent preferred to e-learn outside of work exclusively. An equal preference for a classroom-only strategy and a blended programme was reported. Seventy-three per cent of the FY1s thought that e-learning should not be part of their compulsory weekly teaching programme. Fifty-four per cent of FY1s thought that e-learning had been useful for their education and training in their FY1 year. The e-learning package cited as being most useful was the safe prescribing e-programme, pioneered locally. Newly qualified doctors value e-learning as an adjunct to experiential and lecture-based teaching, and most prefer it as part of a blended learning programme at work or at home. Medical educators must place equal emphasis on the delivery and administration of e-learning as well as on the course design. © 2014 John Wiley & Sons Ltd.

  11. Reflections on the newly qualified social worker's journey : From university training to qualified practice

    OpenAIRE

    Walker, Clare

    2014-01-01

    This qualitative research study explores the experience of graduating social workers making the transition from university training into work as qualified social work practitioners. Most studies in this area look at the practice readiness of the newly qualified professional. This study looks at the participants’ experience in the work place. How do participants experience this journey of transition? What skills, particularly reflective practice and supervision, learned in training, are import...

  12. Effect of counselling on health-care-seeking behaviours and rabies vaccination adherence after dog bites in Haiti, 2014-15: a retrospective follow-up survey.

    Science.gov (United States)

    Etheart, Melissa Dominique; Kligerman, Maxwell; Augustin, Pierre Dilius; Blanton, Jesse D; Monroe, Benjamin; Fleurinord, Ludder; Millien, Max; Crowdis, Kelly; Fenelon, Natael; Wallace, Ryan MacLaren

    2017-10-01

    Haiti has an integrated bite case management (IBCM) programme to counsel animal-bite victims on the risk of rabies and appropriate treatment, as well as the Haiti Animal Rabies Surveillance Program (HARSP) to examine the animals. We assessed the usefulness of the IBCM programme to promote best practices for rabies prophylaxis after exposure in a low-income rabies-endemic setting. We did a retrospective follow-up survey of randomly selected bite victims who were counselled by Haiti's IBCM programme between May 15, 2014, and Sept 15, 2015. We classified participants by HARSP decisions of confirmed, probable, suspected, or non-rabies exposures. We compared health-care outcomes in people who sought medical care before IBCM counselling with those in people who sought care after counselling. We used decision trees to estimate the probability of actions taken in the health-care system, and thereby human deaths. During the study period, 1478 dog bites were reported to HARSP for assessment. 37 (3%) were confirmed exposures, 76 (5%) probable exposures, 189 (13%) suspected exposures, and 1176 (80%) non-rabies exposures. 115 of these cases were followed up in the survey. IBCM counselling was associated with a 1·2 times increase in frequency of bite victims seeking medical care and of 2·4 times increase in vaccination uptake. We estimated that there would be four human rabies deaths among the 1478 people assessed by IBCM during the survey period, and 11 in the absence of this programme, which would equate to a 65% decrease in rabies deaths. Among three people dead at the time of the follow-up survey, one was deemed to be due to rabies after a probable rabies exposure. Adherence to medical providers' recommendations might be improved through counselling provided by IBCM programmes. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  13. The practical skills of newly qualified nurses.

    Science.gov (United States)

    Danbjørg, Dorthe Boe; Birkelund, Regner

    2011-02-01

    This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Factors influencing health care access perceptions and care-seeking behaviors of immigrant Latino sexual minority men and transgender individuals: baseline findings from the HOLA intervention study.

    Science.gov (United States)

    Tanner, Amanda E; Reboussin, Beth A; Mann, Lilli; Ma, Alice; Song, Eunyoung; Alonzo, Jorge; Rhodes, Scott D

    2014-11-01

    Little is known about immigrant Latino sexual minorities’ health seeking behaviors. This study examined factors associated with perceptions of access and actual care behaviors among this population in North Carolina. A community-based participatory research partnership recruited 180 Latino sexual minority men and transgender individuals within preexisting social networks to participate in a sexual health intervention. Mixed-effects logistic regression models and GIS mapping examined factors influencing health care access perceptions and use of services (HIV testing and routine check-ups). Results indicate that perceptions of access and actual care behaviors are low and affected by individual and structural factors, including: years living in NC, reported poor general health, perceptions of discrimination, micro-, meso-, and macro-level barriers, and residence in a Medically Underserved Area. To improve Latino sexual minority health, focus must be placed on multiple levels, including: individual characteristics (e.g., demographics), clinic factors (e.g., provider competence and clinic environment), and structural factors (e.g., discrimination).

  15. Development and validation of an instrument to assess patients' appraisal, emotions and action tendencies preceding care-seeking in acute myocardial infarction: The PA-AMI questionnaire.

    Science.gov (United States)

    Nymark, C; Saboonchi, F; Mattiasson, A-C; Henriksson, P; Kiessling, A

    2017-03-01

    Reducing patient delay for patients afflicted by an acute myocardial infarction is a task of great complexity, which might be alleviated if more factors that influence this delay could be identified. Although a number of self-reported instruments associated with patient delay exist, none of these taps the content of the appraisal process related to patients' subjective emotions. The aim of this study was to develop and validate a questionnaire aimed at assessing patients' appraisal, emotions and action tendencies when afflicted by an acute myocardial infarction. An item pool was generated based on themes conceptualized in a recent qualitative study of acute myocardial infarction patients' thoughts, feelings and actions preceding the decision to seek medical care. The 'Think-Aloud Protocol' and test-retest analysis at item level were performed. The modified item pool was administered to 96 patients when treated for acute myocardial infarction. Explorative factor analysis and principal component analysis with the non-linear iterative partial least squares algorithm were performed to examine the underlying factor structure of the items. The findings indicated three core dimensions corresponding to three subscales, namely, 'symptom appraisal'; 'perceived inability to act'; 'autonomy preservation'. The results demonstrated acceptable measures of reliability and validity Conclusions: The PA-AMI questionnaire demonstrated satisfactory psychometric properties. Assessment of the included core dimensions may contribute to greater understanding of the appraisal processes for patients afflicted by an acute myocardial infarction.

  16. 26 CFR 1.132-9 - Qualified transportation fringes.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Qualified transportation fringes. 1.132-9... Qualified transportation fringes. (a) Table of contents. This section contains a list of the questions and answers in § 1.132-9. (1) General rules. Q-1. What is a qualified transportation fringe? Q-2. What is...

  17. 21 CFR 516.141 - Qualified expert panels.

    Science.gov (United States)

    2010-04-01

    ... choose members for the qualified expert panel in accordance with selection criteria listed in paragraph... whether the proposed qualified expert panel meets the selection criteria prior to the panel beginning its... Committee Act, as amended, 5 U.S.C. App. (b) Criteria for the selection of a qualified expert panel. (1) A...

  18. 12 CFR 621.4 - Audit by qualified public accountant.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Audit by qualified public accountant. 621.4... REQUIREMENTS General Rules § 621.4 Audit by qualified public accountant. (a) Each institution shall, at least annually, have its financial statements audited by a qualified public accountant in accordance with...

  19. 11 CFR 9002.11 - Qualified campaign expense.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Qualified campaign expense. 9002.11 Section 9002.11 Federal Elections FEDERAL ELECTION COMMISSION PRESIDENTIAL ELECTION CAMPAIGN FUND: GENERAL ELECTION FINANCING DEFINITIONS § 9002.11 Qualified campaign expense. (a) Qualified campaign expense means...

  20. 11 CFR 9032.9 - Qualified campaign expense.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Qualified campaign expense. 9032.9 Section 9032.9 Federal Elections FEDERAL ELECTION COMMISSION PRESIDENTIAL ELECTION CAMPAIGN FUND: PRESIDENTIAL PRIMARY MATCHING FUND DEFINITIONS § 9032.9 Qualified campaign expense. (a) Qualified campaign expense...

  1. 30 CFR 75.155 - Qualified hoisting engineer; qualifications.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Qualified hoisting engineer; qualifications. 75... Persons § 75.155 Qualified hoisting engineer; qualifications. (a)(1) A person is a qualified hoisting engineer within the provisions of subpart O of this part, for the purpose of operating a steam-driven hoist...

  2. Influence of awareness and availability of medical alternatives on parents seeking paediatric emergency care.

    Science.gov (United States)

    Ellbrant, Julia A; Åkeson, S Jonas; Karlsland Åkeson, Pia M

    2018-06-01

    Direct seeking of care at paediatric emergency departments may result from an inadequate awareness or a short supply of medical alternatives. We therefore evaluated the care-seeking patterns, availability of medical options and initial medical assessments - with overall reference to socioeconomic status - of parents at an urban paediatric emergency department in a Scandinavian country providing free paediatric healthcare. The parents of children assessed by paediatric emergency department physicians at a Swedish university hospital over a 25-day winter period completed a questionnaire on recent medical contacts and their reasons for attendance. Additional information was obtained from ledgers, patient records and population demographics. In total, 657 of 713 eligible patients (92%) were included. Seventy-nine per cent of their parents either failed to or managed to establish medical contact before the emergency department visit, whereas 21% sought care with no attempt at recent medical contact. Visits with a failed telephone or primary care contact (18%) were more common outside office hours ( p=0.014) and were scored as less urgent ( p=0.014). A perceived emergency was the main reason for no attempt at medical contact before the visit. Direct emergency department care-seeking was more common from the city district with the lowest socioeconomic status ( p=0.027). Although most parents in this Swedish study tried to seek medical advice before attending a paediatric emergency department, perceived emergency, a short supply of telephone health line or primary care facilities and lower socioeconomic status contributed to direct care-seeking by almost 40% of parents. Pre-hospital awareness and the availability of medical alternatives with an emphasis on major differences in socioeconomic status should therefore be considered to further optimize care-seeking in paediatric emergency departments.

  3. 26 CFR 1.30-1 - Definition of qualified electric vehicle and recapture of credit for qualified electric vehicle.

    Science.gov (United States)

    2010-04-01

    ... qualified electric vehicle. A qualified electric vehicle is a motor vehicle that meets the requirements of section 30(c). Accordingly, a qualified electric vehicle does not include any motor vehicle that has ever been used (for either personal or business use) as a non-electric vehicle. (b) Recapture of credit for...

  4. Space-Qualified Traveling-Wave Tube

    Science.gov (United States)

    Wilson, Jeffrey D.; Krawczyk, Richard; Simons, Rainee N.; Williams, Wallace D.; Robbins, Neal R.; Dibb, Daniel R.; Menninger, William L.; Zhai, Xiaoling; Benton, Robert T.

    2010-01-01

    The L-3 Communications Electron Technologies, Inc. Model 999HA traveling-wave tube (TWT), was developed for use as a high-power microwave amplifier for high-rate transmission of data and video signals from deep space to Earth (see figure). The 999HA is a successor to the 999H a non-space qualified TWT described in High-Power, High-Efficiency Ka-Band Traveling-Wave Tube (LEW-17900-1), NASA Tech Briefs, Vol. 31, No. 2 (February 2007), page 32. Operating in the 31.8-to-32.3 GHz frequency band, the 999HA has been shown to generate 252 W of continuous- wave output power at 62 percent overall power efficiency a 75-percent increase in output power over the 999H. The mass of the 999HA is 35 percent less than that of the 999H. Moreover, taking account of the elimination of a Faraday cage that is necessary for operation of the 999H but is obviated by a redesign of high-voltage feed-throughs for the 999HA, the overall reduction in mass becomes 57 percent with an 82 percent reduction in volume. Through a series of rigorous tests, the 999HA has been qualified for operation aboard spacecraft with a lifetime exceeding seven years. Offspring of the 999HA will fly on the Kepler and Lunar Reconnaissance Orbiter missions.

  5. [Qualified and emergency specialized surgical care for those with wounds to the extremities].

    Science.gov (United States)

    Iurkevich, V V; Fidarov, E Z; Bauér, V A

    1997-06-01

    Experience of organization of the surgical care in the military hospital to 438 wounded in extremities during armed conflict in Republic of Chechnya is generalized. Maximum reduction of stages of medical evacuation of the wounded in extremities, approaching of the qualified and urgent specialized surgical care directly to the region of battle actions, use of opportunities for it one-moment rendering corresponded to principles of the modern military-medical doctrine. Due to realization of the requirements of the doctrine life of many wounded ++ was saved, terms of treatment, medical and social rehabilitation are reduced. Besides lethality, treatment cost and numbers of transferring to the reserve from the Armed Forces were reduced.

  6. Qualifying cogeneration in Texas and Louisiana

    International Nuclear Information System (INIS)

    Jenkins, S.C.; Cabe, R.; Stauffaeher, J.J.

    1992-01-01

    This paper reports that cogeneration of electricity and useful thermal energy by industrials along the Gulf Coast grew significantly more rapidly than in other parts of the country during and immediately following World War II as a result of the concentration of chemical and plastics processing facilities there. In 1982, Texas passed its version of PURPA, the Public Utility Regulatory Act (PURA) and designated those non-utility generators from which public utilities must purchase electricity as Qualifying Cogenerators. In 1991, there were nearly 7,500 MW of QF power generated for inside-the-fence use or firm capacity sale to utilities, with the two largest utilities in Texas purchasing over half that amount

  7. Qualified market access and inter-disciplinarity

    Directory of Open Access Journals (Sweden)

    Lisa Herzog

    2014-05-01

    Full Text Available This note offers reflections on qualified market access (QMA—the practice of linking trade agreements to values such as human rights, labour standards, or environmental protection. This idea has been suggested by political theorists as a way of fulfilling our duties to the global poor and of making the global economic system more just, and it has influenced a number of concrete policies, such as European Union (EU trade policies. Yet, in order to assess its merits tout court, different perspectives and disciplines need to be brought together, such as international law, economics, political science, and philosophy. It is also worth reflecting on existing practices, such as those of the EU. This note summarises some insights about QMA by drawing such research together and considers the areas in which further research is needed, whilst reflecting also on the merits of interdisciplinary exchanges on such topics.

  8. M2 qualify laser beam propagation

    International Nuclear Information System (INIS)

    Abdelhalim, Bencheikh; Mohamed, Bouafia

    2010-01-01

    One of the most important properties of a laser resonator is the highly collimated or spatially coherent nature of the laser output beam. Laser beam diameter and quality factor M 2 are significant parameters in a wide range of laser applications. This is because the spatial beam quality determines how closely the beam can be focused or how well the beam propagates over long distances without significant dispersion. In the present paper we have used three different methods to qualify the spatial structure of a laser beam propagating in free space, the results are obtained and discussed, and we have found that the Wigner distribution function is a powerful tool which allows a global characterization of any kind of beam

  9. Medicalization of the uncertainty? An empirical study of the relationships between unemployment or job insecurity, professional care seeking, and the consumption of antidepressants / Veerle Buffel, Rozemarijn Dereuddre, Piet Bracke

    Index Scriptorium Estoniae

    Buffel, Veerle

    2015-01-01

    Artiklis analüüsitakse seoseid tööpuuduse/ebakindla töö, meditsiinilise abi otsimise ja antidepressantide kasutamise vahel, pöörates tähelepanu igapäevaelu meditsiinistumisele Euroopa riikides (sh Eesti). Kasutatakse Eurobaromeeter 345 (2010) andmeid

  10. Tricks of the trade: time management tips for newly qualified doctors.

    Science.gov (United States)

    Offiah, Gozie; Doherty, Eva

    2018-03-01

    The transition from medical student to doctor is an important milestone. The discovery that their time is no longer their own and that the demands of their job are greater than the time they have available is extremely challenging. At a recent surgical boot camp training programme, 60 first-year surgical trainees who had just completed their internship were invited to reflect on the lessons learnt regarding effective time management and to recommend tips for their newly qualified colleagues. They were asked to identify clinical duties that were considered urgent and important using the time management matrix and the common time traps encountered by newly qualified doctors. The surgical trainees identified several practical tips that ranged from writing a priority list to working on relationships within the team. These tips are generic and so applicable to all newly qualified medial doctors. We hope that awareness of these tips from the outset as against learning them through experience will greatly assist newly qualified doctors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Pedagogical characteristics of the systems for assessing the technical and tactical skills of qualified volleyball players

    Directory of Open Access Journals (Sweden)

    Мykhailo Oliinyk

    2017-12-01

    Full Text Available Purpose: on the basis of the analysis of the special literature and their own experimental studies, to determine the characteristics of the systems for assessing the technical and tactical skills of qualified volleyball players. Material & Methods: study was conducted on the basis of the material of the national team of Zaporozhye State Medical University on volleyball. Analysis and generalization of the data of scientific and methodical literature are used; registration, analysis and interpretation of indicators of technical and tactical actions of qualified volleyball players in training and competitive processes; pedagogical observations; algorithms for calculating the quantitative and qualitative indicators of technical and tactical skill in volleyball; methods of mathematical statistics. Results: data on the existence of a strong statistical relationship between the systems of assessment of technical and tactical skills of qualified volleyball players, taking into account the specificity of the game role. Conclusion: shows the specifics of the application of various systems for assessing the technical and tactical skills of qualified volleyball players, taking into account the factors of the game role, noted the methodological features of special analysis and interpretation of indicators of technical and tactical actions in the adversarial process.

  12. 29 CFR Appendix G to Part 825 - Certification of Qualifying Exigency for Military Family Leave (Form WH-384)

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Certification of Qualifying Exigency for Military Family Leave (Form WH-384) G Appendix G to Part 825 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Pt. 825, App. G...

  13. 49 CFR 604.7 - Qualified human service organizations.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Qualified human service organizations. 604.7... organizations. (a) A recipient may provide charter service to a qualified human service organization (QHSO) for... disabilities; or (3) With low income. (b) If an organization serving persons described in paragraph (a) of this...

  14. 26 CFR 1.1092(c)-1 - Qualified covered calls.

    Science.gov (United States)

    2010-04-01

    ... lowest qualified benchmark is determined using the adjusted applicable stock price, as defined in § 1... (CONTINUED) INCOME TAXES Wash Sales of Stock Or Securities § 1.1092(c)-1 Qualified covered calls. (a) In.... Under section 1092(d)(3)(B)(i)(I), stock is personal property if the stock is part of a straddle that...

  15. 26 CFR 1.860F-1 - Qualified liquidations.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Qualified liquidations. 1.860F-1 Section 1.860F-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Real Estate Investment Trusts § 1.860F-1 Qualified liquidations. A plan of...

  16. 42 CFR 436.128 - Coverage for certain qualified aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain qualified aliens. 436.128... Mandatory Coverage of the Categorically Needy § 436.128 Coverage for certain qualified aliens. The agency... § 440.255(c) of this chapter to those aliens described in § 436.406(c) of this subpart. [55 FR 36820...

  17. 17 CFR 210.12-09 - Valuation and qualifying accounts.

    Science.gov (United States)

    2010-04-01

    ... period Column C—Additions (1)—Charged to costs and expenses (2)—Charged to other accounts—describe Column... qualifying accounts and reserves by descriptive title. Group (a) those valuation and qualifying accounts... accounts. 210.12-09 Section 210.12-09 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION...

  18. 49 CFR 192.283 - Plastic pipe: Qualifying joining procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Plastic pipe: Qualifying joining procedures. 192... Materials Other Than by Welding § 192.283 Plastic pipe: Qualifying joining procedures. (a) Heat fusion... for making plastic pipe joints by a heat fusion, solvent cement, or adhesive method, the procedure...

  19. 26 CFR 1.7704-3 - Qualifying income.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Qualifying income. 1.7704-3 Section 1.7704-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES General Actuarial Valuations § 1.7704-3 Qualifying income. (a) Certain investment income—(1...

  20. 46 CFR 391.6 - Tax treatment of qualified withdrawals.

    Science.gov (United States)

    2010-10-01

    ... accounting whereby (1) payments shall reduce the basis of the property on the day such payments are actually... 46 Shipping 8 2010-10-01 2010-10-01 false Tax treatment of qualified withdrawals. 391.6 Section...-469 FEDERAL INCOME TAX ASPECTS OF THE CAPITAL CONSTRUCTION FUND § 391.6 Tax treatment of qualified...

  1. 26 CFR 25.2701-4 - Accumulated qualified payments.

    Science.gov (United States)

    2010-04-01

    ... compound interest from the due date of the payment at a rate not less than the appropriate discount rate is... retained interest conferring a distribution right that was previously valued as a qualified payment right (a “qualified payment interest”), the taxable estate or taxable gifts of the individual holding the...

  2. 20 CFR 404.1018b - Medicare qualified government employment.

    Science.gov (United States)

    2010-04-01

    ... AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Work Excluded from Employment § 404.1018b Medicare qualified government employment. (a) General. The work of a... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medicare qualified government employment. 404...

  3. 26 CFR 1.405-1 - Qualified bond purchase plans.

    Science.gov (United States)

    2010-04-01

    ... purchase plan must conform to the definition of a pension plan in paragraph (b)(1)(i) of § 1.401-1, or the.... Accordingly, even though a qualified bond purchase plan is designed as a pension plan, it need not provide... apply in a nondiscriminatory manner. (ii) A qualified bond purchase plan which is designed as a pension...

  4. 26 CFR 52.4682-2 - Qualifying sales.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Qualifying sales. 52.4682-2 Section 52.4682-2... TAXES (CONTINUED) ENVIRONMENTAL TAXES § 52.4682-2 Qualifying sales. (a) In general—(1) Special rules applicable to certain sales. Special rules apply to sales of ODCs in the following cases: (i) Under section...

  5. The qualified possession turn into ownership

    Directory of Open Access Journals (Sweden)

    Popov Danica

    2011-01-01

    Full Text Available Possession is prima facie evidence of ownership. Possession is ninetents of the law, means that possession is good against all other, except the true owner. The possession ripens into ownership if it is qualified and by effluxion of time. In Serbian law there are two kinds of adverse possession ripens into ownership. The first one is named ordinary and second one extraordinary adverse possession. Ordinary possession need to be legal, conscientious and genuine. Extraordinary possession is only conscientious, but in a wide sense. Adverse possession destroys the title of the owner and vests it in possessor. An occupation of land inconsistent with the right of the true owner: the possession of those against whom a right action has accured to the true owner. It is actual possession in the absence of possession by the rightful owner and without lawful title. If the adverse possession continues, the effect at the expiration of the prescribed period is that not only the remedy but the title of former owner is extinguished. The person in adverse possession gains a new possessory title which cannot, normally exceed in extent of duration the interest of the former owner.

  6. 11 CFR 9004.4 - Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses. 9004.4 Section 9004.4 Federal Elections FEDERAL ELECTION COMMISSION PRESIDENTIAL ELECTION CAMPAIGN FUND: GENERAL ELECTION FINANCING ENTITLEMENT OF ELIGIBLE CANDIDATES...

  7. Supporting Qualified Database for Uncertainty Evaluation

    International Nuclear Information System (INIS)

    Petruzzi, A.; Fiori, F.; Kovtonyuk, A.; Lisovyy, O.; D'Auria, F.

    2013-01-01

    Uncertainty evaluation constitutes a key feature of BEPU (Best Estimate Plus Uncertainty) process. The uncertainty can be the result of a Monte Carlo type analysis involving input uncertainty parameters or the outcome of a process involving the use of experimental data and connected code calculations. Those uncertainty methods are discussed in several papers and guidelines (IAEA-SRS-52, OECD/NEA BEMUSE reports). The present paper aims at discussing the role and the depth of the analysis required for merging from one side suitable experimental data and on the other side qualified code calculation results. This aspect is mostly connected with the second approach for uncertainty mentioned above, but it can be used also in the framework of the first approach. Namely, the paper discusses the features and structure of the database that includes the following kinds of documents: 1. The 'RDS-facility' (Reference Data Set for the selected facility): this includes the description of the facility, the geometrical characterization of any component of the facility, the instrumentations, the data acquisition system, the evaluation of pressure losses, the physical properties of the material and the characterization of pumps, valves and heat losses; 2. The 'RDS-test' (Reference Data Set for the selected test of the facility): this includes the description of the main phenomena investigated during the test, the configuration of the facility for the selected test (possible new evaluation of pressure and heat losses if needed) and the specific boundary and initial conditions; 3. The 'QP' (Qualification Report) of the code calculation results: this includes the description of the nodalization developed following a set of homogeneous techniques, the achievement of the steady state conditions and the qualitative and quantitative analysis of the transient with the characterization of the Relevant Thermal-Hydraulics Aspects (RTA); 4. The EH (Engineering Handbook) of the input nodalization

  8. Supporting qualified database for uncertainty evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Petruzzi, A.; Fiori, F.; Kovtonyuk, A.; D' Auria, F. [Nuclear Research Group of San Piero A Grado, Univ. of Pisa, Via Livornese 1291, 56122 Pisa (Italy)

    2012-07-01

    Uncertainty evaluation constitutes a key feature of BEPU (Best Estimate Plus Uncertainty) process. The uncertainty can be the result of a Monte Carlo type analysis involving input uncertainty parameters or the outcome of a process involving the use of experimental data and connected code calculations. Those uncertainty methods are discussed in several papers and guidelines (IAEA-SRS-52, OECD/NEA BEMUSE reports). The present paper aims at discussing the role and the depth of the analysis required for merging from one side suitable experimental data and on the other side qualified code calculation results. This aspect is mostly connected with the second approach for uncertainty mentioned above, but it can be used also in the framework of the first approach. Namely, the paper discusses the features and structure of the database that includes the following kinds of documents: 1. The' RDS-facility' (Reference Data Set for the selected facility): this includes the description of the facility, the geometrical characterization of any component of the facility, the instrumentations, the data acquisition system, the evaluation of pressure losses, the physical properties of the material and the characterization of pumps, valves and heat losses; 2. The 'RDS-test' (Reference Data Set for the selected test of the facility): this includes the description of the main phenomena investigated during the test, the configuration of the facility for the selected test (possible new evaluation of pressure and heat losses if needed) and the specific boundary and initial conditions; 3. The 'QR' (Qualification Report) of the code calculation results: this includes the description of the nodalization developed following a set of homogeneous techniques, the achievement of the steady state conditions and the qualitative and quantitative analysis of the transient with the characterization of the Relevant Thermal-Hydraulics Aspects (RTA); 4. The EH (Engineering

  9. Aging techniques and qualified life for safety system components

    International Nuclear Information System (INIS)

    Weaver, W.W.

    1980-01-01

    Presently, the qualified life objective for Class IE safety system components in nuclear power plants is somewhat of a subjective engineering judgment. When the desired qualified life is ascertained, there are other choices that must be made (which may be influenced by the desired qualified life) such as selecting the aging procedure to use in the qualification process. Adding complexity to the situation is the fact that there are some limitations in aging techniques at the present time. This article presents (1) a discussion of the limitations in aging procedures, (2) the general philosophy of qualification, and (3) a proposed method for specifying a desired qualified life, which uses a probabilistic approach. The probabilistic approach proposed in item 3 can be applied to natural aging programs and eventually to accelerated aging once the present technical difficulties are overcome

  10. Delay in Seeking Medical Help following Transient Ischemic Attack (TIA) or “Mini-Stroke”: A Qualitative Study

    Science.gov (United States)

    Mc Sharry, Jennifer; Baxter, Alison; Wallace, Louise M.; Kenton, Anthony; Turner, Andrew; French, David P.

    2014-01-01

    Background Prompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. However, many patients delay in making contact with medical services. This study aimed to explore TIA patients' accounts of delay between symptom onset and contacting medical services including how decisions to contact services were made and the factors discussed in relation to delay. Methods Twenty interviews were conducted with TIA patients in England. Using a previous systematic review as an initial framework, interview data were organised into categories of symptom recognition, presence of others and type of care sought. A thematic analysis was then conducted to explore descriptions of care-seeking relevant to each category. Results Delay in contacting medical services varied from less than an hour to eight days. Awareness of typical stroke symptoms could lead to urgent action when more severe TIA symptoms were present but could lead to delay when experienced symptoms were less severe. The role of friends and family varied widely from deciding on and enacting care-seeking decisions to simply providing transport to the GP practice. When family or friends played a greater role, and both made and enacted care-seeking decisions, delays were often shorter, even when patients themselves failed to identify symptoms. Healthcare professionals also impacted on patients' care-seeking with greater delays in seeking further care for the same episode described when patients perceived a lack of urgency during initial healthcare interactions. Conclusions This study provides new information on patients' decisions to contact medical services following TIA and identifies overlapping factors that can lead to delay in receiving appropriate treatment. While recognition of symptoms may contribute to delay in contacting medical services, additional factors, including full responsibility being taken by others and initial healthcare interactions, can over

  11. Delay in seeking medical help following Transient Ischemic Attack (TIA) or "mini-stroke": a qualitative study.

    Science.gov (United States)

    Mc Sharry, Jennifer; Baxter, Alison; Wallace, Louise M; Kenton, Anthony; Turner, Andrew; French, David P

    2014-01-01

    Prompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. However, many patients delay in making contact with medical services. This study aimed to explore TIA patients' accounts of delay between symptom onset and contacting medical services including how decisions to contact services were made and the factors discussed in relation to delay. Twenty interviews were conducted with TIA patients in England. Using a previous systematic review as an initial framework, interview data were organised into categories of symptom recognition, presence of others and type of care sought. A thematic analysis was then conducted to explore descriptions of care-seeking relevant to each category. Delay in contacting medical services varied from less than an hour to eight days. Awareness of typical stroke symptoms could lead to urgent action when more severe TIA symptoms were present but could lead to delay when experienced symptoms were less severe. The role of friends and family varied widely from deciding on and enacting care-seeking decisions to simply providing transport to the GP practice. When family or friends played a greater role, and both made and enacted care-seeking decisions, delays were often shorter, even when patients themselves failed to identify symptoms. Healthcare professionals also impacted on patients' care-seeking with greater delays in seeking further care for the same episode described when patients perceived a lack of urgency during initial healthcare interactions. This study provides new information on patients' decisions to contact medical services following TIA and identifies overlapping factors that can lead to delay in receiving appropriate treatment. While recognition of symptoms may contribute to delay in contacting medical services, additional factors, including full responsibility being taken by others and initial healthcare interactions, can over-ride or undermine the importance of patients

  12. The technical qualified expert on radiation protection in Spain

    International Nuclear Information System (INIS)

    Marco Arboli, M.; Rodriguez Suarez, M.

    2002-01-01

    Education and training is considered an important tool for promoting safety culture and improving the level of competence of workers. In the different disciplines involved in Radiation Protection (PR), training programmes are being revised to ensure effective protection of individuals. In the European Union framework, the new normative and its adaptation in the Member States, as well as the past actions in each country, make the community to conclude that harmonization of educational programmes and European recognition of the qualification must be reached. An important point of these actions is the definition of the European Qualified Expert. Article 38 of the EURATOM Basic Safety Standards imposes requirements on training and education of the qualified experts and their exchange within the European Union. Since then, there has been many initiatives to seek to harmonization of the qualified expert requirements. In the Spanish education system, there has been a standard training and competent authority recognition of the high level qualified experts on radiation protection since 1986, whose programme is continuously being updating and improving. Taking into account the European actions to define the qualified expert training requirements, it has been designed an educational course for the Technical Qualified Expert on Radiation Protection. This pilot course has being carried out during May, 2002. The results of this project is shown in this paper. (Author)

  13. An experience of qualified preventive screening: shiraz smart screening software.

    Science.gov (United States)

    Islami Parkoohi, Parisa; Zare, Hashem; Abdollahifard, Gholamreza

    2015-01-01

    Computerized preventive screening software is a cost effective intervention tool to address non-communicable chronic diseases. Shiraz Smart Screening Software (SSSS) was developed as an innovative tool for qualified screening. It allows simultaneous smart screening of several high-burden chronic diseases and supports reminder notification functionality. The extent in which SSSS affects screening quality is also described. Following software development, preventive screening and annual health examinations of 261 school staff (Medical School of Shiraz, Iran) was carried out in a software-assisted manner. To evaluate the quality of the software-assisted screening, we used quasi-experimental study design and determined coverage, irregular attendance and inappropriateness proportions in relation with the manual and software-assisted screening as well as the corresponding number of requested tests. In manual screening method, 27% of employees were covered (with 94% irregular attendance) while by software-assisted screening, the coverage proportion was 79% (attendance status will clear after the specified time). The frequency of inappropriate screening test requests, before the software implementation, was 41.37% for fasting plasma glucose, 41.37% for lipid profile, 0.84% for occult blood, 0.19% for flexible sigmoidoscopy/colonoscopy, 35.29% for Pap smear, 19.20% for mammography and 11.2% for prostate specific antigen. All of the above were corrected by the software application. In total, 366 manual screening and 334 software-assisted screening tests were requested. SSSS is an innovative tool to improve the quality of preventive screening plans in terms of increased screening coverage, reduction in inappropriateness and the total number of requested tests.

  14. Learning beyond graduation: exploring newly qualified specialists' entrance into daily practice from a learning perspective.

    Science.gov (United States)

    Cuyvers, Katrien; Donche, Vincent; Van den Bossche, Piet

    2016-05-01

    The entrance of newly qualified medical specialists into daily practice is considered to be a stressful period in which curriculum support is absent. Although engaging in both personal and professional learning and development activities is recognized fundamental for lifelong professional competence, research on medical professionals' entrance into practice is scarce. This research aims to contribute to the framework of medical professionals' informal learning and outlines the results of an exploratory study on the nature of learning in daily practice beyond postgraduate training. Eleven newly qualified physicians from different specialized backgrounds participated in a phenomenographic study, using a critical incident method and a grounded theory approach. Results demonstrated that learning in the workplace is, to a large extent, informal and associated with a variety of learning experiences. Analysis shows that experiences related to diagnostics and treatments are important sources for learning. Furthermore, incidents related to communication, changing roles, policy and organization offer learning opportunities, and therefore categorized as learning experiences. A broad range of learning activities are identified in dealing with these learning experiences. More specifically, actively engaging in actions and interactions, especially with colleagues of the same specialty, are the most mentioned. Observing others, consulting written sources, and recognizing uncertainties, are also referred to as learning activities. In the study, interaction, solely or combined with other learning activities, are deemed as very important by specialists in the initial entrance into practice. These insights can be used to develop workplace structures to support the entrance into practice following postgraduate training.

  15. Reporting From the Front Lines: Implementing Oregon's Alternative Payment Methodology in Federally Qualified Health Centers.

    Science.gov (United States)

    Cottrell, Erika K; Hall, Jennifer D; Kautz, Glenn; Angier, Heather; Likumahuwa-Ackman, Sonja; Sisulak, Laura; Keller, Sara; Cameron, David C; DeVoe, Jennifer E; Cohen, Deborah J

    Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. We conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations that were part of Oregon's Alternative Payment Methodology demonstration project. Data were analyzed using an immersion-crystallization approach. We identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment. Future research is needed to further understand the implications of these changes.

  16. 26 CFR 1.42-6 - Buildings qualifying for carryover allocations.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Buildings qualifying for carryover allocations. 1... INCOME TAXES Credits Against Tax § 1.42-6 Buildings qualifying for carryover allocations. (a) Carryover... carryover allocation may only be made with respect to a qualified building. A qualified building is any...

  17. 26 CFR 48.4041-19 - Exemption for qualified methanol and ethanol fuel.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Exemption for qualified methanol and ethanol....4041-19 Exemption for qualified methanol and ethanol fuel. (a) In general. Under section 4041(b)(2... or use of qualified methanol or ethanol fuel. (b) Qualified methanol or ethanol fuel defined. For...

  18. 26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Qualified enhanced oil recovery costs. 1.43-4... TAXES Credits Against Tax § 1.43-4 Qualified enhanced oil recovery costs. (a) Qualifying costs—(1) In... “qualified enhanced oil recovery costs” if the amounts are paid or incurred with respect to an asset which is...

  19. Qualified operator training in the simulated control room environment

    International Nuclear Information System (INIS)

    Ionescu, Teodor; Studineanu, Emil; Radulescu, Catalina; Bolocan, Gabriel

    2005-01-01

    Full text: Mainly designed for the training of the Cernavoda NPP Unit 2 operators, the virtual simulated environment allows the training of the already qualified operators for Cernavoda NPP Unit 1, adding to the already trained knowledge, the differences which has occurred in the Unit 2 design. Using state-of-the-art computers and displays and qualified software, the virtual simulated panels could offer a viable alternative to classic hardware-based training. This approach allows quick training of the new procedures required by the new configuration of the re-designed operator panels in the main control room of Cernavoda NPP Unit 2. (authors)

  20. Qualified operator training in the simulated control room environment

    International Nuclear Information System (INIS)

    Ionescu, Teodor; Studineanu, Emil; Radulescu, Catalina; Bolocan, Gabriel

    2005-01-01

    Mainly designed for the training of the Cernavoda NPP Unit 2 operators, the virtual simulated environment allows the training of the already qualified operators for Cernavoda NPP Unit 1, adding to the already trained knowledge, the differences which have occurred in the Unit 2 design. Using state-of-the-art computers and displays and qualified software, the virtual simulated panels could offer a viable alternative to classic hardware-based training. This approach allows quick training of the new procedures required by the new configuration of the re-designed operator panels in the main control room of Cernavoda NPP Unit 2. (authors)

  1. Accident data study of concrete construction companies' similarities and differences between qualified and non-qualified workers in Spain.

    Science.gov (United States)

    López-Arquillos, Antonio; Rubio-Romero, Juan Carlos; Gibb, Alistair

    2015-01-01

    The aim of this paper is to discuss findings from an analysis of accidents in concrete construction companies in Spain and to compare the accident rates of qualified and non-qualified workers. A total of 125,021 accidents between 2003 and 2008 involving both blue-collar and white-collar workers were analysed, comparing the variables of occupation, age, company staff, length of service, location of the accident, together with the severity of the accidents. Results showed that lack of experience in the first month is more significant in non-qualified workers and experienced supervisors and that head injuries are more likely to lead to fatalities. The most remarkable similarity was that fatal accidents to and from the worksite are a problem common to both groups of workers.

  2. 31 CFR Appendix A to Part 500 - Qualifying International Institutions

    Science.gov (United States)

    2010-07-01

    ... Pt. 500, App. A Appendix A to Part 500—Qualifying International Institutions Asian Development Bank (ADB) Food and Agricultural Organization (FAO) International Bank for Reconstruction and Development (IBRD, the “World Bank”) International Civil Aviation Organization (ICAO) International Development...

  3. 77 FR 26175 - Section 42 Qualified Contract Provisions

    Science.gov (United States)

    2012-05-03

    ... indebtedness under general principles of Federal income tax law, and (3) upon the sale of the building, are... building for sale to the general public at the determined qualified contract price upon receipt of a... because of variations under State laws concerning the terms of a bona fide contract and methods for...

  4. 77 FR 9846 - Source of Income From Qualified Fails Charges

    Science.gov (United States)

    2012-02-21

    ... temporary regulations noted that no trading practice existed at that time for fails charges on securities other than Treasuries, but that if a fails charge trading practice pertaining to other securities was... sources within the United States, and the income from the qualified fails charge is treated as effectively...

  5. 9 CFR 77.36 - Interstate movement from qualified herds.

    Science.gov (United States)

    2010-01-01

    ... date of movement. If a group of captive cervids from a qualified herd is being moved interstate... unclassified herd. (4) Captive cervids being moved interstate for the purpose of exhibition only may be moved... being moved directly from a classified herd, the captive cervid must be isolated from all other animals...

  6. Validation of mentorship model for newly qualified professional ...

    African Journals Online (AJOL)

    Newly qualified professional nurses (NQPNs) allocated to community health care services require the use of validated model to practice independently. Validation was done to adapt and assess if the model is understood and could be implemented by NQPNs and mentors employed in community health care services.

  7. 36 CFR 908.13 - Rights of Qualified Persons.

    Science.gov (United States)

    2010-07-01

    ... POLICY AND PROCEDURES TO FACILITATE THE RETENTION OF DISPLACED BUSINESSES AND RESIDENTS IN THE... leasing plan which are, in the Corporation's opinion, major. (c) Each Qualified Person on the List, who is... opportunity to occupy Newly Developed Space shall not be limited to the square on which its previous location...

  8. 42 CFR 416.26 - Qualifying for an agreement.

    Science.gov (United States)

    2010-10-01

    ..., where State law requires licensure, the ASC complies with State licensure requirements; and (3) The ASC.... (c) Acceptance of the ASC as qualified to furnish ambulatory surgical services. If CMS determines... its authorized representative; and (2) File them with CMS. (e) Acceptance by CMS. If CMS accepts the...

  9. 22 CFR 19.6-2 - Qualifying court order.

    Science.gov (United States)

    2010-04-01

    ... principal's Foreign Service retirement benefit or survivor benefit. If a court directs or implies that a... Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN... the Secretary of State. A qualifying court order must— (1) Be consistent with the terms of the Act and...

  10. 34 CFR 300.18 - Highly qualified special education teachers.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Highly qualified special education teachers. 300.18... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE... special education teachers. (a) Requirements for special education teachers teaching core academic...

  11. 24 CFR 266.100 - Qualified housing finance agency (HFA).

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Qualified housing finance agency (HFA). 266.100 Section 266.100 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MORTGAGE...

  12. 26 CFR 1.465-27 - Qualified nonrecourse financing.

    Science.gov (United States)

    2010-04-01

    ... partnership; incidental property. (i) X is a limited liability company that is classified as a partnership for.... (i) UTP1 and UTP2, both limited liability companies classified as partnerships, are the only general... as qualified nonrecourse financing. (4) Partnership liability. For purposes of section 465(b)(6) and...

  13. 26 CFR 54.4980B-3 - Qualified beneficiaries.

    Science.gov (United States)

    2010-04-01

    ... the day before the qualifying event (that is, the divorce or death) will have been by reason of D's... event, and the reason for the individual's lack of actual coverage (such as the individual's having..., the individual is covered under the group health plan by reason of another individual's election of...

  14. 30 CFR 75.153 - Electrical work; qualified person.

    Science.gov (United States)

    2010-07-01

    ... Mine Safety and Health Districts at regular intervals, or as demand requires. (d) A score of at least... Section 75.153 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Qualified and Certified Persons § 75...

  15. 26 CFR 1.41-2 - Qualified research expenses.

    Science.gov (United States)

    2010-04-01

    ... Credits Against Tax § 1.41-2 Qualified research expenses. (a) Trade or business requirement—(1) In general... research and experimental expenses) are not necessarily paid or incurred in carrying on a trade or business for purposes of section 41. A research expense must relate to a particular trade or business being...

  16. Decree of 1 August 1981 on examinations for qualified experts and physicians authorised to undertake physical surveillance for protection against radiation

    International Nuclear Information System (INIS)

    1981-01-01

    English. This Decree of the Minister of labour and Social Affairs of 1 August 1981 concerns the procedure for admission to examinations, for inclusion in the national list, of qualified experts and approved medical practitioners who are competent in radiation protection matters. the Decree replaces a former Decree of 24 June 1978 on the same subjec [fr

  17. 38 CFR 17.241 - Sharing medical information services.

    Science.gov (United States)

    2010-07-01

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

  18. Health effects and medical surveillance

    International Nuclear Information System (INIS)

    1998-01-01

    Source of ionizing radiations have innumerable applications in the work place. Usually, even where the work is performed safely, the employees involved inevitably receive small, regular exposures to radiation that are not manifestly harmful. This Module explains how ionizing radiations can interact with and affect human tissues, the various factors that influence the outcome and the detrimental effects that may result. The medical surveillance that is appropriate for those working with radiation sources, depending on the degree of hazard of the work, is described. The Manual will be of most benefit it if forms part of more comprehensive training or is supplemented by the advice of a medically qualified expert. Where medical surveillance is appropriate for radiation employees, the services of a qualified doctor, occupational physician or other trained medical staff will be required

  19. Competence of newly qualified registered nurses from a nursing college

    Directory of Open Access Journals (Sweden)

    BG Morolong

    2005-09-01

    Full Text Available The South African education and training system, through its policy of outcomesbased education and training, has made competency a national priority. In compliance to this national requirement of producing competent learners, the South African Nursing Council ( 1999 B require that the beginner professional nurse practitioners and midwives have the necessary knowledge, skills, attitudes and values which will enable them to render efficient professional service. The health care system also demands competent nurse practitioners to ensure quality in health care. In the light of competency being a national priority and a statutory demand, the research question that emerges is, how competent are the newly qualified registered nurses from a specific nursing college in clinical nursing education? A quantitative, non-experimental contextual design was used to evaluate the competence of newly qualified registered nurses from a specific nursing college. The study was conducted in two phases. The first phase dealt with the development of an instrument together with its manual through the conceptualisation process. The second phase focused on the evaluation of the competency of newly qualified nurses using the instrument based on the steps of the nursing process. A pilot study was conducted to test the feasibility of the items of the instrument. During the evaluation phase, a sample of twenty-six newly qualified nurses was selected by simple random sampling from a target population of thirty-six newly qualified registered nurses. However, six participants withdrew from the study. Data was collected in two general hospitals where the newly qualified registered nurses were working. Observation and questioning were used as data collection techniques in accordance with the developed instrument. Measures were taken to ensure internal validity and reliability of the results. To protect the rights of the participants, the researcher adhered to DENOSA’S (1998

  20. Simulation used to qualify nuclear waste glass for disposal

    International Nuclear Information System (INIS)

    Reimus, T.W.; Kuhn, W.L.

    1987-07-01

    A hypothetical vitrification system was simulated errors associated with controlling and predicting the composition of the nuclear waste glass produced in the system. The composition of the glass must fall within certain limits to qualify for permanent geologic disposal. The estimated error in predicting the concentrations of various constituents in the glass was 2% to 8%, depending on the strategy for sampling and analyzing the feed and on the assumed magnitudes of the process uncertainties. The estimated error in controlling the glass composition was 2% to 9%, depending on the strategy for sampling and analyzing the waste and on the assumed magnitudes of the uncertainties. This work demonstrates that simulation techniques can be used to assist in qualifying nuclear waste glass for disposal. 3 refs., 2 figs., 4 tabs

  1. Privacy and Confidentiality Practices In Adolescent Family Planning Care At Federally Qualified Health Centers.

    Science.gov (United States)

    Beeson, Tishra; Mead, Katherine H; Wood, Susan; Goldberg, Debora Goetz; Shin, Peter; Rosenbaum, Sara

    2016-03-01

    The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers (FQHCs). A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information. Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents. The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations. Copyright © 2016 by the Guttmacher Institute.

  2. Gender Inequalities in Highly Qualified Professions: A Social Psychological Analysis

    OpenAIRE

    Santos, Maria Helena; Amâncio, Lígia

    2016-01-01

    Research in social and political psychology contributes towards understanding the persistence of job market gender segregation prevailing in recent decades, the consequences for those involved and their reactions when having to cope with gender inequality. Within the framework of the literature on shared ideologies that justify and legitimize discrimination against women, this article focuses on Portugal and analyses the particular case of women in two highly qualified professions traditional...

  3. 21 CFR 640.62 - Medical supervision.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision. A qualified licensed physician shall be on the...

  4. Military Medical Care: Questions and Answers

    Science.gov (United States)

    2013-07-24

    conditions. Qualifying conditions include: • Diagnosis in an infant or toddler of a neuromuscular developmental condition or other condition expected to...TRICARE and Medicare Payments to Providers and the Sustainable Growth Rate ......... 19 Medicare and TRICARE for Life...training, medical research and development , health information technology, facility planning, public health, medical logistics, acquisition, budget, and

  5. Results from Consultancy Meeting on Qualified Technical Centres

    International Nuclear Information System (INIS)

    Novakovic, Mladen

    2017-01-01

    Qualified Technical Centres (QTC) - Current Situation: •Many Member States (MS) need help dealing with DSRS; •Most seek assistance, which can include funding, through the IAEA; •Technical assistance is provided by various governmental organization and private companies (service providers = SP). QTC - Method of Delivery Numerous MS requests are pressing the IAEA’s capacity to assist: •Use qualified internal and external experts/contractors; •Limited pool for DSRS and need to expand; •Dedicated and specialized equipment; •Mobile hot cell; •Mobile tool kit; •Field operations; •Coordinated approach with Nuclear Security and Safety. Qualified Technical Centres for the Management of DSRS: •The challenge is to scale up the support for safe and secure management of DSRS; •Strengthen existing capacity of some MS to support others and make support more sustainable; •Expands the support that can be readily provided and meet the many needs of MS

  6. Essential attributes and qualifiers of primary health care

    Directory of Open Access Journals (Sweden)

    Andréa Silvia Walter de Aguiar

    2012-06-01

    Full Text Available Historically, the primary health care (PHC has been associated with the first level of care from a health system and characterized by the kind of professional that in it operates, where is expected a predominance of specialists in this area. However, the major limitation for this type of characterization is that the profile of professionals engaged in this service may vary from country to country.Several theoretical and conceptual landmarks proposed approaches and indicators to assess and characterize the APS. In 1978, the American Institute of Medicine suggested an approach in which listed its attributes such as accessibility, integrality, coordination, continuity and responsibility. This was an important landmark in an attempt to outline a normative approach to measure it. However, most indicators and specific definition was not suggested. The selected indicators required a high level of performance, were difficult to be achieved, and focused on the capacity of services and not in its concrete realization(1.A 1996 report, from the same institution, defined PHC as the provision of integrated services and accessible by clinicians who are responsible for attending a large majority of personal care needs, developing a continued partnership with patients and working within family and community. This definition does not include the first contact and focuses on individual attention.The Canadian Medical Association, in 1996, considered the APS as a front door of the health system and community interventions included in the definition of the functions of APS. In the same year was published a Charter for General Practice / Family Medicine in Europe (Letter to General Practice / Family Medicine in Europe, which describes 12 characteristics: general, accessible, integrated, continuous, as a team, holistic, personalized, targeted for the family and the community, coordinated, confidential and protectress(2.Donabedian(3 systematized a group of important

  7. Factor Structure of the Air Force Officer Qualifying Test: Analysis and Comparison

    National Research Council Canada - National Science Library

    Carreta, Thomas

    1998-01-01

    The Air Force Officer Qualifying Test (AFOQT) is used to qualify men and women for commissions in the Air Force, classify them for pilot and navigator jobs, and award Reserve Officer Training Corps (ROTC) scholarships...

  8. 47 CFR 59.4 - Definition of “qualifying carrier”.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) INFRASTRUCTURE SHARING § 59.4 Definition of “qualifying carrier”. For purposes of this part, the term “qualifying carrier” means a telecommunications carrier that: (a) Lacks economies of scale or...

  9. Low-Income Housing Tax Credit (LIHTC) Qualified Census Tract (QCT)

    Data.gov (United States)

    Department of Housing and Urban Development — It allows to generate tables for Low-Income Housing Tax Credit (LIHTC) Qualified Census Tracts (QCT) and for Difficult Development Areas (DDA). LIHTC Qualified...

  10. The Netherlands: Quality of work and employment of low-qualified workers

    NARCIS (Netherlands)

    Gouw, P.

    2013-01-01

    Based on the Netherlands Working Condition Survey (NEA, TNO) and the available literature, it seems that low-qualified workers experience more labour market problems than middle- or high-qualified workers. The trend in the 2000-2007 period is that the relative number of low qualified workers has

  11. 29 CFR 779.386 - Restaurants may qualify as exempt 13(a)(2) establishments.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Restaurants may qualify as exempt 13(a)(2) establishments... Service Establishments Restaurants and Establishments Providing Food and Beverage Service § 779.386 Restaurants may qualify as exempt 13(a)(2) establishments. (a) A restaurant may qualify as an exempt retail or...

  12. 6 CFR 25.4 - Designation of qualified anti-terrorism technologies.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Designation of qualified anti-terrorism... REGULATIONS TO SUPPORT ANTI-TERRORISM BY FOSTERING EFFECTIVE TECHNOLOGIES § 25.4 Designation of qualified anti-terrorism technologies. (a) General. The Under Secretary may Designate as a Qualified Anti-Terrorism...

  13. 12 CFR 619.9270 - Qualified Public Accountant or External Auditor.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Qualified Public Accountant or External Auditor... § 619.9270 Qualified Public Accountant or External Auditor. A qualified public accountant or external... constituted State authority, identifying such person as a certified public accountant; (b) Is licensed to...

  14. 49 CFR 192.285 - Plastic pipe: Qualifying persons to make joints.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Plastic pipe: Qualifying persons to make joints... Materials Other Than by Welding § 192.285 Plastic pipe: Qualifying persons to make joints. (a) No person may make a plastic pipe joint unless that person has been qualified under the applicable joining procedure...

  15. 10 CFR 451.4 - What is a qualified renewable energy facility.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false What is a qualified renewable energy facility. 451.4 Section 451.4 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION RENEWABLE ENERGY PRODUCTION INCENTIVES § 451.4 What is a qualified renewable energy facility. In order to qualify for an incentive payment under...

  16. 26 CFR 1.468B-2 - Taxation of qualified settlement funds and related administrative requirements.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 6 2010-04-01 2010-04-01 false Taxation of qualified settlement funds and... Taken § 1.468B-2 Taxation of qualified settlement funds and related administrative requirements. (a) In...) of this section is in lieu of any other taxation of the income of a qualified settlement fund under...

  17. The ecology of medical care in Beijing.

    Directory of Open Access Journals (Sweden)

    Shuang Shao

    Full Text Available BACKGROUND: We presented the pattern of health care consumption, and the utilization of available resources by describing the ecology of medical care in Beijing on a monthly basis and by describing the socio-demographic characteristics associated with receipt care in different settings. METHODS: A cohort of 6,592 adults, 15 years of age and older were sampled to estimate the number of urban-resident adults per 1,000 who visited a medical facility at least once in a month, by the method of three-stage stratified and cluster random sampling. Separate logistic regression analyses assessed the association between those receiving care in different types of setting and their socio-demographic characteristics. RESULTS: On average per 1,000 adults, 295 had at least one symptom, 217 considered seeking medical care, 173 consulted a physician, 129 visited western medical practitioners, 127 visited a hospital-based outpatient clinic, 78 visited traditional Chinese medical practitioners, 43 visited a primary care physician, 35 received care in an emergency department, 15 were hospitalized. Health care seeking behaviors varied with socio-demographic characteristics, such as gender, age, ethnicity, resident census register, marital status, education, income, and health insurance status. In term of primary care, the gate-keeping and referral roles of Community Health Centers have not yet been fully established in Beijing. CONCLUSIONS: This study represents a first attempt to map the medical care ecology of Beijing urban population and provides timely baseline information for health care reform in China.

  18. Wanted, A National Teacher Supply Policy for Education:The Right Way to Meet The "Highly Qualified Teacher" Challenge

    Directory of Open Access Journals (Sweden)

    Linda Darling-Hammond

    2003-09-01

    Full Text Available Teacher quality is now the focus of unprecedented policy analysis. To achieve its goals, the No Child Left Behind Act (NCLB requires a “highly qualified teacher” in all classrooms. The concern with teacher quality has been driven by a growing recognition, fueled by accumulating research evidence, of how critical teachers are to student learning. To acquire and retain high-quality teachers in our Nation’s classrooms will require substantial policy change at many levels. There exists longstanding precedent and strong justification for Washington to create a major education manpower program. Qualified teachers are a critical national resource that requires federal investment and cross-state coordination as well as other state and local action. NCLB provides a standard for equitable access to teacher quality that is both reasonable and feasible. Achieving this goal will require a new vision of the teacher labor market and the framing of a national teacher supply policy. States and local districts have vital roles to play in ensuring a supply of highly qualified teachers; however, they must be supported by appropriate national programs. These programs should be modeled on U.S. medical manpower efforts, which have long supplied doctors to high- need communities and eased shortages in specific health fields. We argue that teacher supply policy should attract well-prepared teachers to districts that sorely need them while relieving shortages in fields like special education, math and the physical sciences. We study the mal-distribution of teachers and examine its causes. We describe examples of both states and local school districts that have fashioned successful strategies for strengthening their teaching forces. Unfortunately, highly successful state and local program to meet the demand for qualified teachers are the exception rather than the rule. They stand out amid widespread use of under-prepared teachers and untrained aides, mainly for

  19. Registration of qualified radiation protection experts in the Netherlands

    International Nuclear Information System (INIS)

    Abrahamse, J.C.; Kops, J.A.M.M.; Vermeulen, A.M.T.I.; Zuur, C.

    2002-01-01

    In Euratom Directive 96/29 (1) the Euratom Basic Safety Standards are given. The member states of the EC have to implement this directive in their national legislation. In the Netherlands this is done in the new radiation protection legislation (Radiation Protection Decree 2002 (2)), which came into force in the first half of 2002. In this new regulation is stated that radiological activities must be done by or under supervision of a qualified radiation protection expert. With respect to the qualified expert is stated that: the qualified expert must be registered in a notified registration system; rules will be formulated with respect to the demanded qualification levels of the experts. These demands can be different for different tasks rules will be formulated for the notification of the register, the way to become registered, the costs and so on. Mid 2001 a project is started to prepare the registration system. Information was gained from and discussions took place with the important parties on the radiological playing field in the Netherlands (employers, organisations of experts and education institutes). Furthermore information is obtained from certification institutes. It was decided to accept as starting point the education levels obtained from the radiation protection education institutes, which are approved at the moment. At a later phase will be evaluated whether this system needs to be changed. In section 2 of this paper the radiation protection system in the Netherlands will be discussed in more detail. Section 2 deals with the target group and in section 3 the outlines of the registration system to be developed are discussed

  20. Qualifying works of the Department of nuclear chemistry (1963 - 2006)

    International Nuclear Information System (INIS)

    Kuruc, J.

    2007-01-01

    In this review qualifying works (theses - bachelor, master, PhD., DrSc., habilitation and inauguration theses) elaborated at the Department of nuclear chemistry, Faculty of Natural Chemistry, Comenius University in Bratislava during forty years (from origin of the Section of Nuclear chemistry in 1963 up to 2006 are presented. During this time, in totally, 3 bachelor theses, 265 master theses, 24 PhD. (CSc.) and 10 PhD. dissertanions, 2 DrSc. dissertanions as well as 8 habilitation and one inauguration these were defended (author)

  1. Qualified equipment for spare parts and modifications in Belgium

    International Nuclear Information System (INIS)

    Berthe, J.

    1993-01-01

    This paper describes the procedure followed for the procurement of components for spare parts and systems modifications, the legal and quality assurance environment and the specific measures taken to cope with various codes and standards. For pressure components, the regulation aspects of the American code used during the construction phase of plants had to be adapted to the Belgian context and to the actual industry situation. Obsolescence of products is treated either by qualification of a new product or by design modifications, or by replacement with an already qualified product. In these cases, the work is handled by the utility's engineering organization. 2 figs

  2. Hiring and keeping qualified personnel in a growing regulatory organisation

    International Nuclear Information System (INIS)

    Marchildon, P.

    1993-01-01

    Although no new nuclear stations are currently committed in Canada, the regulatory authority, the Atomic Energy Control Board (AECB), has started, in 1989, an expansion program which, when completed in 1994 will represent a 60 pc increase in its workforce. The new personnel resources are being used to improve the AECB effectiveness in a number of regulatory activities. This paper reviews some of the key factors which relate to the hiring and integration of the new AECB employees: selection process, timing, fees, scholarship program, subsequent training of qualified personnel, woman quotas. 2 figs

  3. Bank Officers’ Perceptions and Uses of Qualified Audit Reports

    DEFF Research Database (Denmark)

    Sormunen, Nina

    2014-01-01

    Purpose – The purpose of this study is to provide insights into the perceptions and uses of qualified audit reports in financial statements of small- and medium-sized enterprises (SMEs). As there is a long-standing debate on the usefulness of auditor’s going-concern reports, this study aims....... Practical implications – Regulators have taken the action to improve the auditor’s reporting model, and the findings provided by this study are important because they provide a deeper understanding of the perceptions and uses of audit reports from smaller companies. The study also contributes knowledge...

  4. 30 CFR 203.43 - To which production do I apply the RSV earned from qualified deep wells or qualified phase 1...

    Science.gov (United States)

    2010-07-01

    ... in water between 200 and 400 meters deep, you begin drilling an original deep well with a perforated... 200 meters deep; (ii) May 18, 2007, for an RSV earned by a qualified deep well on a lease that is located entirely in water more than 200 meters deep; or (iii) The date that the first qualified well that...

  5. Statistically qualified neuro-analytic failure detection method and system

    Science.gov (United States)

    Vilim, Richard B.; Garcia, Humberto E.; Chen, Frederick W.

    2002-03-02

    An apparatus and method for monitoring a process involve development and application of a statistically qualified neuro-analytic (SQNA) model to accurately and reliably identify process change. The development of the SQNA model is accomplished in two stages: deterministic model adaption and stochastic model modification of the deterministic model adaptation. Deterministic model adaption involves formulating an analytic model of the process representing known process characteristics, augmenting the analytic model with a neural network that captures unknown process characteristics, and training the resulting neuro-analytic model by adjusting the neural network weights according to a unique scaled equation error minimization technique. Stochastic model modification involves qualifying any remaining uncertainty in the trained neuro-analytic model by formulating a likelihood function, given an error propagation equation, for computing the probability that the neuro-analytic model generates measured process output. Preferably, the developed SQNA model is validated using known sequential probability ratio tests and applied to the process as an on-line monitoring system. Illustrative of the method and apparatus, the method is applied to a peristaltic pump system.

  6. Spatial factors as contextual qualifiers of information seeking

    Directory of Open Access Journals (Sweden)

    R. Savolainen

    2006-01-01

    Full Text Available Introduction. This paper investigates the ways in which spatial factors have been approached in information seeking studies. The main attention was focused on studies discussing information seeking on the level of source selection and use. Method. Conceptual analysis of about 100 articles and books thematizing spatial issues of information seeking. Due to research economy, the main attention was paid to studies on everyday life information seeking. Results. Three major viewpoints were identified with regard to the degree of objectivity of spatial factors. The objectifying approach conceives of spatial factors as external and entity-like qualifiers that primarly constrain information seeking. The realistic-pragmatic approach emphasizes the ways in which the availabilty of information sources in different places such as daily work environments orient information seeking. The perspectivist approach focuses on how people subjectively assess the significance of various sources by means of spatial constructs such as information horizons. Conclusion. Spatial factors are centrally important contextual qualifiers of information seeking. There is a need to further explore the potential of the above viewpoints by relating the spatial and temporal factors of information seeking.

  7. Strategy for development modes competent performance in teachers qualified alternative

    Directory of Open Access Journals (Sweden)

    Sailí Rodríguez Fuentes

    2017-12-01

    Full Text Available Introduction: the process of professionalization of the teacher is a subject of contemporary conjuncture, which is debated and investigated by researchers from dissimilar edges. Objective: to contribute to the professionalization process of qualified teachers of Technical and Vocational Education through a pedagogical strategy. Materials and methods: The materialist dialectic is used as a general method, allowing the study of the object as a process, the determination of its components, as well as its contradictions. theoretical methods: the historical and logical to delve into the regularities and qualities of reality in the polytechnic centers. Essential empirical methods were used: the documentary analysis that included the professional model; study plans, to obtain authentic and reliable information for research, interviews with students with the purpose of analyzing the manifestations of the professionalization process of the students and the direction of the process by the teachers, the observation of teaching activities allowed to diagnose the object , the demonstration of the problem, as well as the results of the practice of the strategy to be implemented. Results: a pedagogical strategy is designed and implemented to perfect the competent professional performance modes in the qualified professors. Conclusions: it contributed to the improvement of the professionalization process in favor of the competent professional modes of action.

  8. Dimensions of taste qualifying didactic reflections on home economics education

    DEFF Research Database (Denmark)

    Wistoft, Karen; Qvortrup, Lars

    Aim: Traditionally and worldwide home economics education has been concerned with taste and flavorings based training associated with students cooking in the school kitchen. In contrast new educational research on food knowledge in the Danish public school shows that taste is used as a didactic...... review on children, learning, food and taste followed by analyses in a value reflective pedagogy perspective as well as quantitative and qualitative research in home economic education. This has been combined with systems theory developed by the German sociologist Niklas Luhmann providing concepts...... element and "overtakes" more traditional didactic elements like motivation and active participation. The purpose of this proposal is to present a systematic model for qualifying reflections on taste in home economics and food education. The objective is to identify four dimensions of taste that can...

  9. Information Support of Highly-Qualified Archers’ Training

    Directory of Open Access Journals (Sweden)

    А. П. Власов

    2017-03-01

    Full Text Available The objective is to ground the ways of improving the level of technical preparedness of highly-qualified archers by means of video and multimedia technologies. Materials and methods: The research studied motor actions of 25 athletes of the national team of Ukraine in archery when they were performing training exercises indoors (exercising area and outdoors (archery range. Each athlete’s technique of executing shooting exercises was video recorded in sequence from different angles (from above, from behind, from the front, from the left and the right sides depending on the shooting line with a digital video camera Sony DCR-XR150E. The processing of the video materials was done with the Dartfish Connekt software package. Results: The research grounds the need to use video and multimedia technologies in the process of training of highly-qualified archers. Such methods aim at improving the skills of both coaches and athletes by helping them better understand all aspects of the training exercises execution. Multimedia means offer a delayed-in-time opportunity to watch the video recording of the training after its preliminary computer processing. It enables the coach and the athlete to focus on the analysis of the execution of the entire exercise and its elements. The paper provides examples of the use of video technologies in archers’ training practice. Conclusions: Prospects of the use of the state-of-the-art computer technologies in sports training are infinite. Computer software and hardware systems should be available for most coaches. The task of the latter is to learn to use and implement them for the benefit of themselves and athletes. The task of the scientific groups and experts is to find a most convenient way for the coach to use the innovative technologies. The task of the software developer is to model intellectual programs to help the coach effectively analyze and evaluate his archers or team when preparing them for the most

  10. RERTR program progress in qualifying reduced-enrichment fuels

    International Nuclear Information System (INIS)

    Snelgrove, James L.

    1983-01-01

    In order to provide the technical means for reducing the enrichment of uranium used to fuel research and test reactors, the U.S. Reduced Enrichment Research and Test Reactor (RERTR) Program has been engaged in the development and testing of higher-uranium-density fuels than had been used previously. This fuel development effort included work to increase the density of fuels which were being used at the time the Program began and work on a fuel with the potential for much higher density. The ultimate goal of the fuel development and testing phase of the Program is to 'qualify' the fuel for use. A fuel is considered qualified when a sufficient data base for the fuel exists that it can be approved by regulating bodies for use in reactors. To convert a core to the use of reduced-enrichment fuel it is necessary to show that the core will behave properly during normal and off-normal operating conditions and to show that the fuel will behave properly to a reasonable margin beyond the conditions expected during normal operation. It is this latter area that this paper will address. The main characteristics to be considered in evaluating the performance of a fuel are its swelling, its blister-threshold temperature, and its metallurgical appearance. Data for the qualification of the reduced-enrichment fuels being developed by the RERTR Program are obtained from examination of miniature fuel plates (miniplates) which successfully pass the irradiation screening tests and from examinations of full-sized fuel elements. This paper will summarize the miniplate data reported in other papers presented during this meeting and will give the status of full-sized element irradiations. Finally, the current status of qualification of the various fuel types will be discussed and some projections of the future will be given

  11. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Science.gov (United States)

    2010-04-01

    ... medical technicians. 291.530 Section 291.530 Housing and Urban Development Regulations Relating to Housing... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of... technician by a fire department or emergency medical services responder unit of the federal government, a...

  12. Maternal health-care seeking behavior in North India

    Directory of Open Access Journals (Sweden)

    Anjali Jain

    2017-01-01

    Full Text Available Introduction: Pregnancy and labour, if not kept under constant vigil, can end in serious complications or even death at any moment. The aim of the study was done to know the practices of community regarding maternity care during pregnancy, delivery and postnatal period. Methods: A cross-sectional, community based study was conducted on 120 rural, 120 urban elite and 120 urban slum areas mothers, who delivered within last three months. Results: One-fourth mothers in rural area faced one or the other problem during antenatal period while in urban slum and urban elite only 15% and 9.2% mothers had some problems, this percentage being 19.4 at district level. 14.5% respondents faced some kind of complication during delivery and more problems were faced by rural (17.5% while least common by urban elite (7.5% but the area wise difference was not significant. The most common source of treatment was ANM/ LHV/ Nurse (47.1% in rural, 40% in urban elite and 60% in urban slum. 12.8%, mothers took treatment from doctor (Government- 7.2%; Private- 5.6%. More than 10% did not take any treatment (11.8% in rural, 20% in urban elite. Conclusion: Still the large numbers of mothers are not seeking care of their ailments, during prenatal, natal or postnatal especially rural mothers

  13. Global Health Care-seeking Discourses Facing Local Clinical Realities

    DEFF Research Database (Denmark)

    Andersen, Rikke Sand; Tørring, Marie Louise; Vedsted, Peter

    2014-01-01

    På baggrund af et længerevarende feltarbejde i danske klinikker i almen praksis undersøger denne artikel forholdet mellem forebyggelsesorienterede diskurser om lægesøgning og − hvad der betragtes som − legitime lægesøgningspraksisser på klinik-niveau. Forfatterne argumenterer for, at der i almen ...

  14. High mortality despite good care-seeking behaviour

    DEFF Research Database (Denmark)

    Sodemann, Morten; Jakobsen, M S; Mølbak, Kare

    1997-01-01

    that the interval was shorter for children who died than for those who survived (odds ratio (OR) = 0.7; 95% confidence interval (CI): 0.5-0.99). Of the 125 terminally ill children, 56 were hospitalized. A total of 20 children died on the way to hospital or while waiting in the outpatient clinic. Lack of hospital...

  15. Care seeking for maternal health: challenges remain for poor women

    African Journals Online (AJOL)

    Data were analysed using Nudist software. Important findings: The location of childbirth involves retaining control of the process and outcome, and securing a safe delivery. The pregnant woman is influenced by her attendants; families only seek care for complications if local or herbal, remedies and prayer are defeated.

  16. Ocular injuries and eye care seeking patterns following injuries ...

    African Journals Online (AJOL)

    Background: The work environment of cocoa farmers exposes them to several ocular hazards that predispose them to eye diseases and injuries. However, the extent of ocular injuries and health seeking patterns following these injuries are unknown among cocoa farmers in Ghana. Objectives: To determine the prevalence ...

  17. Mothers' health services utilization and health care seeking ...

    African Journals Online (AJOL)

    Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...

  18. Patterns of Antenatal Care Seeking Behavior in South East Nigeria ...

    African Journals Online (AJOL)

    on inequities on ANC seeking pattern among the pregnant women in Nigeria. Aim: The study ... behavior of women remains poor and poses one of the greatest ..... data – Or tears: An application to educational enrollments in states of. India.

  19. Ocular injuries and eye care seeking patterns following injuries ...

    African Journals Online (AJOL)

    However, the extent of ocular injuries and health seeking patterns following these injuries are unknown among cocoa farmers in ... policy exists in Ghana for the occupational health and safety of ...... Cambridge,. UK:University Press.1963. 29.

  20. health care seeking behavior for common childhood illnesses

    African Journals Online (AJOL)

    tsion

    importance in areas where access to health services is limited (3, 7). ... and utilization of health care facilities remains low. Only 63% ... Lowland. According to information obtained from the ... The proposal was ethically reviewed and approved.

  1. Newly qualified teachers' visions of science learning and teaching

    Science.gov (United States)

    Roberts, Deborah L.

    2011-12-01

    This study investigated newly qualified teachers' visions of science learning and teaching. The study also documented their preparation in an elementary science methods course. The research questions were: What educational and professional experiences influenced the instructor's visions of science learning and teaching? What visions of science learning and teaching were promoted in the participants' science methods course? What visions of science learning and teaching did these newly qualified teachers bring with them as they graduated from their teacher preparation program? How did these visions compare with those advocated by reform documents? Data sources included participants' assignments, weekly reflections, and multi-media portfolio finals. Semi-structured interviews provided the emic voice of participants, after graduation but before they had begun to teach. These data were interpreted via a combination of qualitative methodologies. Vignettes described class activities. Assertions supported by excerpts from participants' writings emerged from repeated review of their assignments. A case study of a typical participant characterized weekly reflections and final multi-media portfolio. Four strands of science proficiency articulated in a national reform document provided a framework for interpreting activities, assignments, and interview responses. Prior experiences that influenced design of the methods course included an inquiry-based undergraduate physics course, participation in a reform-based teacher preparation program, undergraduate and graduate inquiry-based science teaching methods courses, participation in a teacher research group, continued connection to the university as a beginning teacher, teaching in diverse Title 1 schools, service as the county and state elementary science specialist, participation in the Carnegie Academy for the Scholarship of Teaching and Learning, service on a National Research Council committee, and experience teaching a

  2. 26 CFR 1.1092(c)-3 - Qualifying over-the-counter options.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Qualifying over-the-counter options. 1.1092(c)-3...-counter options. (a) In general. Under section 1092(c)(4)(B)(i), an equity option is not a qualified covered call option unless it is traded on a national securities exchange that is registered with the...

  3. Predictors of Self-Directed Learning for Low-Qualified Employees: A Multi-Level Analysis

    Science.gov (United States)

    Raemdonck, Isabel; van der Leeden, Rien; Valcke, Martin; Segers, Mien; Thijssen, Jo

    2012-01-01

    Purpose: This study aims to examine which variables at the level of the individual employee and at the company level are predictors of self-directed learning in low-qualified employees. Methodology: Results were obtained from a sample of 408 low-qualified employees from 35 different companies. The companies were selected from the energy sector,…

  4. 26 CFR 20.2056A-2 - Requirements for qualified domestic trust.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Requirements for qualified domestic trust. 20.2056A-2 Section 20.2056A-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Taxable Estate § 20.2056A-2 Requirements for qualified...

  5. 29 CFR 779.382 - May qualify as exempt 13(a)(2) establishments.

    Science.gov (United States)

    2010-07-01

    ... STANDARDS ACT AS APPLIED TO RETAILERS OF GOODS OR SERVICES Exemptions for Certain Retail or Service Establishments Hotels and Motels § 779.382 May qualify as exempt 13(a)(2) establishments. A hotel or motel establishment may qualify as an exempt retail or service establishment under section 13(a)(2) of the Act...

  6. 77 FR 76941 - Defense Federal Acquisition Regulation Supplement: New Qualifying Country-Poland (DFARS Case 2012...

    Science.gov (United States)

    2012-12-31

    ... discriminatory barriers to procurements of supplies and services produced by industrial enterprises of the other....003 is amended in paragraph (10), the definition of ``qualifying country'' by adding in alphabetical... place; 0 b. In paragraph (a), the definition of ``qualifying country'', by adding, in alphabetical order...

  7. The Learning Intentions of Low-Qualified Employees: A Multilevel Approach

    Science.gov (United States)

    Kyndt, Eva; Dochy, Filip; Onghena, Patrick; Baert, Herman

    2013-01-01

    In the continuously changing society and knowledge-intensive economy, the demand for the recurrent updating of competencies is coming to the fore for all employees, including low-qualified employees. Employees are considered low qualified when they do not have a starter qualification for higher education. Although many educational studies have…

  8. 7 CFR 785.8 - Reports by qualifying States receiving mediation grant funds.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Reports by qualifying States receiving mediation grant... SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS CERTIFIED STATE MEDIATION PROGRAM § 785.8 Reports by qualifying States receiving mediation grant funds. (a) Annual report by certified State...

  9. 26 CFR 1.127-1 - Amounts received under a qualified educational assistance program.

    Science.gov (United States)

    2010-04-01

    ... employee under a qualified educational assistance program described in § 1.127-2, or (2) The value of... Income § 1.127-1 Amounts received under a qualified educational assistance program. (a) Exclusion from.... (c) Amounts received under a nonqualified program. Any amount received under an educational...

  10. 48 CFR 225.872-7 - Industrial security for qualifying countries.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Industrial security for... Agreements and Coordination 225.872-7 Industrial security for qualifying countries. The required procedures... qualifying country sources are in the DoD Industrial Security Regulation DoD 5220.22-R (implemented for the...

  11. Creating Highly Qualified Teachers: Maximizing University Resources to Provide Professional Development in Rural Areas

    Science.gov (United States)

    Mollenkopf, Dawn L.

    2009-01-01

    The "highly qualified teacher" requirement of No Child Left Behind has put pressure on rural school districts to recruit and retain highly qualified regular and special education teachers. If necessary, they may utilize uncertified, rural teachers with provisional certification; however, these teachers may find completing the necessary…

  12. 26 CFR 1.883-4T - Qualified shareholder stock ownership test (temporary).

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Qualified shareholder stock ownership test... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Foreign Corporations § 1.883-4T Qualified shareholder stock... the stock; (D) If the individual directly owns an interest in a corporation, partnership, trust...

  13. 41 CFR 102-80.135 - Who is a qualified fire protection engineer?

    Science.gov (United States)

    2010-07-01

    ... protection engineer? 102-80.135 Section 102-80.135 Public Contracts and Property Management Federal Property... qualified fire protection engineer? A qualified fire protection engineer is defined as an individual with a thorough knowledge and understanding of the principles of physics and chemistry governing fire growth...

  14. 75 FR 1831 - Seeks Qualified Candidates for the Advisory Committee on Reactor Safeguards

    Science.gov (United States)

    2010-01-13

    ... NUCLEAR REGULATORY COMMISSION Seeks Qualified Candidates for the Advisory Committee on Reactor... Regulatory Commission (NRC) seeks qualified candidates for the Advisory Committee on Reactor Safeguards (ACRS... amended. ACRS provides independent expert advice on matters related to the safety of existing and proposed...

  15. 14 CFR 1214.1104 - Evaluation and ranking of highly qualified candidates.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Evaluation and ranking of highly qualified candidates. 1214.1104 Section 1214.1104 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION... ranking of highly qualified candidates. (a) A selection board consisting of discipline experts, and such...

  16. 12 CFR 617.7125 - How should a qualified lender determine the effective interest rate?

    Science.gov (United States)

    2010-01-01

    ... effective interest rate? 617.7125 Section 617.7125 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM BORROWER RIGHTS Disclosure of Effective Interest Rates § 617.7125 How should a qualified lender determine the effective interest rate? (a) A qualified lender must calculate the effective interest rate on...

  17. 7 CFR 636.18 - Technical services provided by qualified personnel not affiliated with USDA.

    Science.gov (United States)

    2010-01-01

    ... HABITAT INCENTIVES PROGRAM § 636.18 Technical services provided by qualified personnel not affiliated with... affiliated with USDA. 636.18 Section 636.18 Agriculture Regulations of the Department of Agriculture... provided by qualified personnel not affiliated with USDA may include, but is not limited to: Conservation...

  18. 7 CFR 1466.11 - Technical services provided by qualified personnel not affiliated with USDA.

    Science.gov (United States)

    2010-01-01

    ... not affiliated with USDA. 1466.11 Section 1466.11 Agriculture Regulations of the Department of... OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM Contracts and Payments § 1466.11 Technical services provided by qualified personnel not affiliated with USDA. (a) NRCS may use the services of qualified TSPs...

  19. 13 CFR 126.204 - May a qualified HUBZone SBC have affiliates?

    Science.gov (United States)

    2010-01-01

    ... affiliates? 126.204 Section 126.204 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION HUBZONE PROGRAM Requirements to be a Qualified HUBZone SBC § 126.204 May a qualified HUBZone SBC have affiliates? A concern may have affiliates provided that the aggregate size of the concern and all of its...

  20. 26 CFR 1.401-7 - Forfeitures under a qualified pension plan.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Forfeitures under a qualified pension plan. 1...) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.401-7 Forfeitures under a qualified pension plan. (a) General rules. In the case of a trust forming a part of a...

  1. 12 CFR 574.8 - Qualified stock issuances by undercapitalized savings associations or holding companies.

    Science.gov (United States)

    2010-01-01

    ... voting stock of the issuing undercapitalized savings association or savings and loan holding company. (8... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Qualified stock issuances by undercapitalized... SUPERVISION, DEPARTMENT OF THE TREASURY ACQUISITION OF CONTROL OF SAVINGS ASSOCIATIONS § 574.8 Qualified stock...

  2. 26 CFR 1.989(a)-1 - Definition of a qualified business unit.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Definition of a qualified business unit. 1.989... definition of the term “qualified business unit” (QBU) within the meaning of section 989. (2) Effective date... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Export Trade Corporations § 1.989(a)-1 Definition of a...

  3. Newly qualified teachers´ possibilities to get foothold in a lifelong career course

    DEFF Research Database (Denmark)

    Krøjgaard, Frede; Frederiksen, Lisbeth Angela Lunde

    Keyword: Induction program, newly qualified teachers, NQT, retention, professional development In Contrary to many other countries in Europe Denmark does not have any kind of national program regarding teacher induction program (TIP) or support in general to newly qualified teachers what so ever...

  4. 26 CFR 1.414(r)-1 - Requirements applicable to qualified separate lines of business.

    Science.gov (United States)

    2010-04-01

    ... lines of business. 1.414(r)-1 Section 1.414(r)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Plans, Etc. § 1.414(r)-1 Requirements applicable to qualified separate lines of business. (a) In general. Section 414(r) prescribes the conditions under which an employer is treated as operating qualified...

  5. 8 CFR 214.14 - Alien victims of certain qualifying criminal activity.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Alien victims of certain qualifying criminal activity. 214.14 Section 214.14 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS NONIMMIGRANT CLASSES § 214.14 Alien victims of certain qualifying criminal activity. (a...

  6. Qualified-agent virtue ethics | van Zyl | South African Journal of ...

    African Journals Online (AJOL)

    Qualified-agent virtue ethics provides an account of right action in terms of the virtuous agent. It has become one of the most popular, but also most frequently criticized versions of virtue ethics. Many of the objections rest on the mistaken assumption that proponents of qualified-agent virtue ethics share the same view when it ...

  7. 26 CFR 1.181-3T - Qualified film or television production (temporary).

    Science.gov (United States)

    2010-04-01

    ... season of programming. (3) Exception for certain sexually explicit productions. A production does not... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Qualified film or television production... (continued) § 1.181-3T Qualified film or television production (temporary). (a) In general. The term...

  8. 26 CFR 1.1293-1 - Current taxation of income from qualified electing funds.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Current taxation of income from qualified electing funds. 1.1293-1 Section 1.1293-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Losses § 1.1293-1 Current taxation of income from qualified electing funds. (a) In general. [Reserved] (1...

  9. 78 FR 56872 - City of Barre, Vermont; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-09-16

    ..., Vermont; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Nelson Street 17 kW...

  10. 78 FR 66355 - Pleasant Grove City, UT; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-11-05

    ... City, UT; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and... Grove City, Utah (Pleasant Grove) filed a notice of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower...

  11. 78 FR 61987 - Corbett Water District; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-10-09

    ... District; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Corbett Hydroelectric...

  12. 78 FR 53752 - City of Sandpoint, Idaho; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-08-30

    ... Sandpoint, Idaho; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and... intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The Little...

  13. 78 FR 61985 - City of Astoria, Oregon; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

    Science.gov (United States)

    2013-10-09

    ..., Oregon; Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting... of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The...

  14. 78 FR 63176 - Notice of Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting...

    Science.gov (United States)

    2013-10-23

    ... Preliminary Determination of a Qualifying Conduit Hydropower Facility and Soliciting Comments and Motions To... of intent to construct a qualifying conduit hydropower facility, pursuant to section 30 of the Federal Power Act, as amended by section 4 of the Hydropower Regulatory Efficiency Act of 2013 (HREA). The...

  15. 78 FR 62350 - FFP Qualified Hydro 14, LLC; Western Minnesota Municipal Power Agency; Notice Announcing...

    Science.gov (United States)

    2013-10-18

    .... 14491-000] FFP Qualified Hydro 14, LLC; Western Minnesota Municipal Power Agency; Notice Announcing... applications were filed by FFP Qualified Hydro 14, LLC for Project No. 13579-002 and Western Minnesota... regular business day. See 18 CFR 385.2001(a)(2) (2013). On October 21, 2013, at 10:00 a.m. (Eastern Time...

  16. Attempting to Predict Success in the Qualifying Round of the International Chemistry Olympiad

    Science.gov (United States)

    Urhahne, Detlef; Ho, Lok Hang; Parchmann, Ilka; Nick, Sabine

    2012-01-01

    The aim of this study was trying to predict success in the qualifying round for the International Chemistry Olympiad (IChO) on the basis of the expectancy-value model of achievement motivation by Eccles et al. The investigation with 52 participants, including 14 females, was conducted during the third of four qualifying rounds of the IChO in…

  17. 12 CFR 617.7130 - What initial disclosures must a qualified lender make to a borrower?

    Science.gov (United States)

    2010-01-01

    ... lender make to a borrower? 617.7130 Section 617.7130 Banks and Banking FARM CREDIT ADMINISTRATION FARM... must a qualified lender make to a borrower? (a) Required disclosures—in general. A qualified lender... certificates that borrowers are required to purchase are at risk and may only be retired at the discretion of...

  18. 26 CFR 1.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Qualified joint and survivor annuities. 1.401(a...)-11 Qualified joint and survivor annuities. (a) General rule—(1) Required provisions. A trust, to...), which is a part of a plan providing for the payment of benefits in any form of a life annuity (as...

  19. 26 CFR 11.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Qualified joint and survivor annuities. 11.401... SECURITY ACT OF 1974 § 11.401(a)-11 Qualified joint and survivor annuities. (a) In general—(1) General rule... annuity (i.e., an annuity requiring survival of the participant or his spouse as a condition for payment...

  20. 76 FR 2029 - Small Business Investment Companies-Energy Saving Qualified Investments

    Science.gov (United States)

    2011-01-12

    ... 3245-AF86 Small Business Investment Companies--Energy Saving Qualified Investments AGENCY: U.S. Small... Administration (SBA) is setting forth the new defined terms, ``Energy Saving Qualified Investment'' and ``Energy Saving Activities'', for the Small Business Investment Company (SBIC) Program. The new definitions are...

  1. Qualifying concrete for a low-level waste repository

    International Nuclear Information System (INIS)

    Philipose, K.E.

    1990-06-01

    A waste repository for the belowground disposal of low-level radioactive waste, labelled IRUS (Intrusion Resistant Underground Structure), is planned at Chalk River Nuclear Laboratories. It relies greatly on the durability of concrete for a minimum of 500 years of service life. A research program based on laboratory testing to design a durable concrete and predict its useful engineered service life is in progress. Durability of concrete depends on its resistance of deterioration from both internal and external causes. Since the rate of degradation depends to a major extent on the rate of ingress of aggressive ions into concrete, laboratory testing is in progress to establish the diffusion rates of ions, especially chlorides, sulphate and carbonate ions. A total of 1000 concrete specimens and 500 paste specimens are being exposed at 22 and 45 degrees C to twenty-five different combinations of corrosive agents, including CO 2 . Procedures to measure the ionic profile and to determine the factors controlling diffusion of ions in the various concretes have been developed. The paper presents the initial results from the research program and the longevity predictions to qualify concretes for the IRUS waste repository, based on twelve months of diffusion testing on laboratory specimens

  2. Life cycle evaluation of spaceflight qualified nickel-hydrogen batteries

    Energy Technology Data Exchange (ETDEWEB)

    Coates, D.K.; Brill, J.N. [Eagle-Picher Industries, Inc., Joplin, MO (United States). Advanced Systems Operation

    1995-12-31

    Life cycle test results are summarized from more than 300 spaceflight qualified nickel-hydrogen (NiH{sub 2}) battery cells currently on life test. Cells ranging in size from 4 ampere-hours (Ah) to 120 Ah are being tested under a variety of conditions to support current NiH{sub 2} battery applications. Results to date include 55,600 accelerated LEO cycles at 30% DOD; 102,840 accelerated LEO cycles at 15% DOD; 44,900 cycles under a real-time LEO profile; 44,100 cycles in real-time LEO; 30 accelerated GEO eclipse seasons and 7 real-time GEO eclipse seasons, both at 75% DOD maximum. Alternative separator materials have completed more than 40,000 charge/discharge cycles in accelerated LEO testing and advanced design electrocatalytic hydrogen electrodes have completed more than 16,000 cycles in real-time LEO testing. Common pressure vessel cell designs have completed 18,000 cycles in real-time LEO testing at 45% DOD.

  3. Gender Inequalities in Highly Qualified Professions: A Social Psychological Analysis

    Directory of Open Access Journals (Sweden)

    Maria Helena Santos

    2016-06-01

    Full Text Available Research in social and political psychology contributes towards understanding the persistence of job market gender segregation prevailing in recent decades, the consequences for those involved and their reactions when having to cope with gender inequality. Within the framework of the literature on shared ideologies that justify and legitimize discrimination against women, this article focuses on Portugal and analyses the particular case of women in two highly qualified professions traditionally carried out by men – politics and medicine. Drawing on the results of quantitative and qualitative studies, our analytical approach demonstrates how while a majority of participants show awareness of the existence of gender inequality in these markedly masculine professions, meritocratic individualism and personal attributions to discrimination are the recurring explanations rather than any gender-based account. These results allow us to highlight the relevance of gender-based analysis as an ideology and furthermore to argue that ignoring this perspective not only diminishes individual responsibility for social change but also perpetuates gender asymmetries.

  4. Transition to independent practice: a national enquiry into the educational support for newly qualified GPs.

    Science.gov (United States)

    Griffin, Ann; Abouharb, Tareq; Etherington, Clare; Bandura, Induja

    2010-09-01

    The nature of the work that NQGPs are undertaking in their transition to independent practice is changing; current training may not fully prepare them for this new peripatetic role, as indicated by rising numbers of reports of poor performance in this group. Educational support at the time of transition from general practitioner (GP) training to independent practice had previously demonstrated benefits, but many formal schemes have finished. This study aimed to map out the current provision of educational support provided by the UK deaneries for NQGPs and to explore NQGPs' perceptions of the present transition from registrar to independent practitioner. Questionnaire surveys of deanery provision and semi-structured telephone interviews of a purposeful sample of newly qualified GPs across the UK. Interviews were thematically analysed. Deanery provision of educational support to NQGPs varies across the UK. Telephone interviews highlighted the transformation as problematic; NQGPs perceived that independent practice was substantially different from being in a training post - locum work, isolation and accessing educational opportunities were concerns. NQGPs frequently expressed a desire for more formalised relationships with mentors, senior colleagues or peer groups, to support their shift. As NQGPs increasingly find themselves working as locums, lacking the opportunity for stable work-based relationships, and with an increase in medical errors being reported in this group of doctors, it is suggested that there is a need to reconsider the educational support required to facilitate the transition in the early years of independent general practice.

  5. Factors affecting age at first dental exam for children seen at Federally Qualified Health Centers

    Science.gov (United States)

    Kuthy, Raymond A.; Pendharkar, Bhagyashree; Momany, Elizabeth T.; Jones, Michael P.; Askelson, Natoshia M.; Chi, Donald L.; Wehby, George L.; Damiano, Peter C.

    2014-01-01

    Objective To estimate age at first dental visit (FDV) and identify variables predicting earlier visits for Medicaid-enrolled children at Federally Qualified Health Centers (FQHC). Methods Statewide Medicaid claims data were used to draw a random sample of children who received their FDV prior to 6 years of age at a FQHC, were Medicaid-enrolled within the first two months of life, and remained continuously enrolled over the study period. Forty children from each of 5 FQHCs had their dental charts abstracted and merged with other Medicaid records and birth certificate data. The logarithmic age at FDV was regressed against several predictor variables. Results Mean and median ages for FDV were 25.6 and 23 months, respectively. When controlling for other variables, there were differences in FDV age by mother’s marital status (p=0.003), number of medical well-child visits (MCV) at a FQHC prior to the FDV (p1MCV at the FQHC. Conclusion Medicaid enrolled children who visited FQHCs for FDV were seen at an earlier age than previously recorded for such health centers (i.e., mean-4 years). Children who also received their MCVs at FQHCs were more likely to have earlier FDVs. PMID:23756303

  6. A long and winding road: federally qualified health centers, community variation and prospects under reform.

    Science.gov (United States)

    Katz, Aaron B; Felland, Laurie E; Hill, Ian; Stark, Lucy B

    2011-11-01

    Community health centers have evolved from fringe providers to mainstays of many local health care systems. Those designated as federally qualified health centers (FQHCs), in particular, have largely established themselves as key providers of comprehensive, efficient, high-quality primary care services to low-income people, especially Medicaid and uninsured patients. The Center for Studying Health System Change's (HSC's) site visits to 12 nationally representative metropolitan communities since 1996 document substantial growth in FQHC capacity, based on growing numbers of Medicaid enrollees and uninsured people, increased federal support, and improved managerial acumen. At the same time, FQHC development has varied considerably across communities because of several important factors, including local health system characteristics and financial and political support at federal, state and local levels. Some communities--Boston; Syracuse, N.Y.; Miami; and Seattle--have relatively extensive FQHC capacity for their Medicaid and uninsured populations, while other communities--Lansing, Mich.; northern New Jersey; Indianapolis; and Greenville, S.C.--fall in the middle. FQHC growth in Phoenix; Little Rock, Ark.; Cleveland; and Orange County, Calif.; has lagged in comparison. Today, FQHCs seem poised to play a key role in federal health care reform, including coverage expansions and the emphasis on primary care and medical homes.

  7. Insufficient dollars and qualified personnel to meet United States mental health needs.

    Science.gov (United States)

    Weil, Thomas P

    2015-04-01

    The American populace currently supports the need for providing additional mental health services for adolescents who frequently express anger and mood instability and maybe are at risk for major psychiatric disorders and behavioral problems; Vietnam, Iraqi, and Afghanistan veterans or military personnel still on duty diagnosed with posttraumatic stress disorder, depression, or other similar combat-related disabilities; the approximately 1 million prisoners currently incarcerated primarily because of substance abuse and needing medically related rehabilitative services; and senior citizens who experience dementia and depression and require improved therapeutics. The problems outlined herein are as follows: far too limited monies are being spent for mental health services (5.6% of total US expenditures for health or roughly one fifth of what is consumed for hospital care); effective therapies are often lacking; and there is a shortage of qualified mental health personnel except in upscale urban and suburban areas. Unfortunately, these problems are so immense that, even with enhanced prioritization of our available resources, they are still not entirely solvable. The American public may continue to impart lip service when attempting to respond to our nation's mental health needs or may decide to spend vastly more money for such care. The latter choice may not be forthcoming in the near future for various cultural-societal-clinical-fiscal reasons.

  8. Career choices for ophthalmology made by newly qualified doctors in the United Kingdom, 1974–2005

    Directory of Open Access Journals (Sweden)

    Goldacre Michael J

    2008-03-01

    Full Text Available Abstract Background The paper aims to report trends in career choices for ophthalmology among UK medical graduates. Methods Postal questionnaire surveys were undertaken of qualifiers from all UK medical schools in nine qualification years since 1974. Data were analysed by univariate cross-tabulation. The significance of comparisons between groups of doctors were calculated by the use of chi-squared tests and adjusted residuals. Results Ophthalmology was the first choice of long term career for 2.3% of men and 1.5% of women one year after qualification; 2.0% of men and 1.4% of women three years after; and 1.8% of men and 1.2% of women at five years. Comparing early choices with eventual destinations, 64% who chose ophthalmology in year one, 84% in year three, and 92% in year five eventually practised in the specialty. The concordance between year one choice and eventual destination was higher for ophthalmology than for most other specialties. 'Enthusiasm for and commitment to the specialty' was the most important single factor in influencing career choice. The prospect of good working hours and conditions was also an important influence: it influenced career choice a great deal for a higher percentage of those who chose ophthalmology (66% in the third year than those who made other surgical choices (23%. Conclusion Those choosing ophthalmology show a high level of commitment to it. Their commitment is strengthened by the prospect of attractive hours and working conditions. Many doctors who become ophthalmologists have already made their choice by the end of their first post-qualification year.

  9. Assessment of Knowledge and Attitudes of Newly-Qualified Doctors Towards AIDS Infection

    Directory of Open Access Journals (Sweden)

    Thomais Kalogirou

    2010-01-01

    Full Text Available Background: Health-care professionals are at a high risk of AIDS infection, among hospitalized HIV infectedpatients. Proper training and knowledge accompanied by necessary preventive measures are by all means, the mostsignificant factors which ensure low accident rates and furthermore lower contamination rates of the health-carepersonnel.Objective: Screening and assessment of knowledge and attitudes of newly-qualified doctors towards AIDSinfection.Methodology: We conducted a cohort study with a screening questionnaire, which included demographic data and16 questions associated with AIDS infection. 51 forms were filled in by specializing and rural doctors. Thestatistical analysis was conducted using the statistical program SPSS 13.Results: 25,5% (n=13 of the participants in this reserch have treated at least one patient for HIV infection, 19%(n=10, of them would willingly specialize in intense care of HIV patients and lastly 90.2%(n=46 believe that weshould preserve the medical confidential for HIV patients. 96.1% (n=49 of the participants doctors knew thatAIDS disease is caused by Human Immunodeficiency Virus (HIV, 88.2%(n=45 is aware that HIV virus damagesthe immune system and finally 92% (n=47 recognize HIV symptomatology.The vast majority of the doctors(98%,n=50 is aware that HIV infection is spread through sexual intercourse, blood contact and by sharing needlesor syringes. Nevertheless, a percentage of 13.7% (n=7 believe that HIV transmission is feasible through kissingand 7.8% (n=15 through insects’ bites. At last 85-98% of the personnel refer that it’s familiar with the generalpreventive measures, which are usually applied to all HIV positive inpatients.Conclusions: Knowledge and attitude of new doctors towards AIDS infection is, in general terms satisfactory.Nevertheless, it’s imperative that we constantly inform and update newly-qualified doctors about AIDS infection,in order to minimize their inhibitions and compensate for the

  10. Federally qualified health center dental clinics: financial information.

    Science.gov (United States)

    Bailit, Howard L; Devitto, Judy; Myne-Joslin, Ronnie; Beazoglou, Tryfon; McGowan, Taegan

    2013-01-01

    Federally Qualified Health Center (FQHC) dental clinics are a major component of the dental safety net system, providing care to 3.75 million patients annually. This study describes the financial and clinical operations of a sample of FQHCs. In cooperation with the National Network for Oral Health Access, FQHC dental clinics that could provide 12 months of electronic dental record information were asked to participate in the study. Based on data from 28 dental clinics (14 FQHCs), 50 percent of patients were under 21 years of age. The primary payers were Medicaid (72.4 percent) and sliding-scale/self-pay patients (17.5 percent). Sites averaged 3.1 operatories, 0.66 dental hygienists, and 1.9 other staff per dentist. Annually, each FTE dentist and hygienist provided 2,801 and 2,073 patient visits, respectively. Eighty percent of services were diagnostic, preventive, and restorative. Patient care accounted for 82 percent of revenues, and personnel (64.2 percent) and central administration (13.4 percent) accounted for most expenses. Based on a small convenience sample of FQHC dental clinics, this study presents descriptive data on their clinical and financial operations. Compared with data from the UDS (Uniform Data System) report, study FQHCs were larger in terms of space, staff, and patients served. However, there was substantial variation among clinics for almost all measures. As the number and size of FQHC dental clinics increase, the Health Resources and Services Administration needs to provide them access to comparative data that they can use to benchmark their operations. © 2013 American Association of Public Health Dentistry.

  11. 'Practising under your own Pin'- a description of the transition experiences of newly qualified midwives.

    Science.gov (United States)

    Avis, Mark; Mallik, Maggie; Fraser, Diane M

    2013-11-01

    Transition experiences of newly qualified midwives were examined in depth during the third phase of a UK evaluation study of midwifery education. The fitness to practise and the retention of newly qualified nursing and midwifery graduates are pressing concerns for health care managers. The advantages of preceptorship are reported in the literature but the content and timing of schemes remain unclear. A semi-structured diary was kept for up to 6 months by 35 newly qualified midwives in 18 work sites covering all countries in the UK. The preceptor and supervisor of midwives for each newly qualified midwife completed short questionnaires about their preceptee's performance, and a further sub-sample of newly qualified midwives and preceptors participated in a semi-structured interview. Data were analysed to elicit aspects of newly qualified midwives transition experiences. Findings confirm that structured preceptorship schemes are not widely available. Newly qualified midwives primarily obtained transition support from members of the midwifery team. Although perceived as competent, there is no demarcation point in becoming confident to practise as a registered practitioner. Implications for managers include the importance of a supportive culture within clinical teams for successful transition and the introduction of structured preceptorship schemes facilitated by appropriate rotation patterns. © 2012 John Wiley & Sons Ltd.

  12. 26 CFR 1.221-1 - Deduction for interest paid on qualified education loans after December 31, 2001.

    Science.gov (United States)

    2010-04-01

    ... Individuals § 1.221-1 Deduction for interest paid on qualified education loans after December 31, 2001. (a) In... interest paid by the taxpayer during the taxable year on a qualified education loan. See paragraph (b)(4... paid on qualified education loans after December 31, 2001, in taxable years ending after December 31...

  13. 26 CFR 1.221-2 - Deduction for interest due and paid on qualified education loans before January 1, 2002.

    Science.gov (United States)

    2010-04-01

    ... Individuals § 1.221-2 Deduction for interest due and paid on qualified education loans before January 1, 2002... interest due and paid by the taxpayer during the taxable year on a qualified education loan. The deduction is allowed only with respect to interest due and paid on a qualified education loan during the first...

  14. 26 CFR 1.6050S-4 - Information reporting for payments of interest on qualified education loans.

    Science.gov (United States)

    2010-04-01

    ... on qualified education loans. 1.6050S-4 Section 1.6050S-4 Internal Revenue INTERNAL REVENUE SERVICE... Information reporting for payments of interest on qualified education loans. (a) Electronic furnishing of... payments of interest on qualified education loans (furnisher) to the individual to whom it is required to...

  15. 26 CFR 1.414(r)-7 - Determination of the employees of an employer's qualified separate lines of business.

    Science.gov (United States)

    2010-04-01

    ... same department, or at the same location, to the same qualified separate line of business would be an... qualified separate lines of business. 1.414(r)-7 Section 1.414(r)-7 Internal Revenue INTERNAL REVENUE...-Sharing, Stock Bonus Plans, Etc. § 1.414(r)-7 Determination of the employees of an employer's qualified...

  16. 9 CFR 85.6 - Interstate movement of pseudorabies vaccinate swine, except swine from qualified negative gene...

    Science.gov (United States)

    2010-01-01

    ... vaccinate swine, except swine from qualified negative gene-altered vaccinated herds, not known to be..., except swine from qualified negative gene-altered vaccinated herds, not known to be infected with or exposed to pseudorabies. Pseudorabies vaccinate swine, except swine from qualified negative gene-altered...

  17. Space Qualified Non-Destructive Evaluation and Structural Health Monitoring Technology, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Encouraged by Phase I accomplishments, the proposed Phase II program will significantly mature and align the development of a Space Qualified Non-Destructive...

  18. Space Qualified Non-Destructive Evaluation and Structural Health Monitoring Technology, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NextGen Aeronautics is proposing an innovative space qualified non-destructive evaluation and health monitoring technology. The technology is built on concepts...

  19. Virginia Tech team qualifies as DARPA Urban Challenge semi-finalist

    OpenAIRE

    Crumbley, Liz

    2007-01-01

    "VictorTango," a team of Virginia Tech engineering and geography students, will travel to Victorville, Calif., for the national qualifying rounds of the Urban Challenge autonomous vehicle competition, sponsored by the Defense Advanced Research Projects Agency (DARPA).

  20. 49 CFR 604.15 - Registration of qualified human service organizations.

    Science.gov (United States)

    2010-10-01

    ... low income, advanced age, or with disabilities), shall register on FTA's charter registration Web site... service organization and whether the qualified human service organization is exempt from taxation under...

  1. 77 FR 23373 - Small Business Investment Companies-Energy Saving Qualified Investments

    Science.gov (United States)

    2012-04-19

    ... appropriate for inclusion in the definition. Furthermore, if a Small Business generates revenues solely from... definition of Energy Saving Qualified Investment by adding a presumption that a Small Business will be...

  2. Regulatory guides for qualifying the calculation methodology of Furnas by CNEN

    International Nuclear Information System (INIS)

    1987-10-01

    Regulatory guides are presented which will be used for qualifying the calculation methodology of FURNAS by CNEN, in the areas of Neutronics, Thermohydraulics, Accident Analysis and Fuel Rod Performance, as applied to Angra 1 NPP. (Author) [pt

  3. 77 FR 13009 - Regulation of Fuels and Fuel Additives: Identification of Additional Qualifying Renewable Fuel...

    Science.gov (United States)

    2012-03-05

    ... Regulation of Fuels and Fuel Additives: Identification of Additional Qualifying Renewable Fuel Pathways Under the Renewable Fuel Standard Program AGENCY: Environmental Protection Agency (EPA). ACTION: Withdrawal... Renewable Fuel Standard program regulations. Because EPA received adverse comment, we are withdrawing the...

  4. Assessment of demand for and supply of qualified manpower for the nuclear industry

    International Nuclear Information System (INIS)

    Morelle, J.

    1993-01-01

    The OECD Nuclear Energy Agency recently published a study which presents the results of a pioneering survey of the demand for and the supply of qualified manpower in various sectors of the nuclear industry (including medicine), and in the related areas of regulation and education in 12 OECD countries. The current manpower situation is presented and the future demand is reviewed. Present and future activities of OECD countries to ensure a balance between supply and demand of qualified manpower are discussed

  5. 49 CFR 40.281 - Who is qualified to act as a SAP?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Who is qualified to act as a SAP? 40.281 Section... § 40.281 Who is qualified to act as a SAP? To be permitted to act as a SAP in the DOT drug and alcohol.... (2) You must be knowledgeable about the SAP function as it relates to employer interests in safety...

  6. Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

    Science.gov (United States)

    Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

    2017-04-01

    A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

  7. Experience in initial training required for the recognition of the qualified RP expert in Spain

    International Nuclear Information System (INIS)

    Rodriguez Suarez, M.; Marco Arboli, M.; Menarguez, J.

    2003-01-01

    An important point of the actions inside the European framework to achieve the harmonisation of the training programmes and recognition was included in the European directive 96/29/Euratom which includes definition and specific tasks of the European Qualified Expert on Radiation Protection (RP). Basic syllabus for training of those experts was developed in the communication 98/C 133/03 concerning BSS applications. Although, in the Spanish education system, the training and recognition requirements of the high level qualified experts on RP was defined since 1977, until 2001, the figure of the Technical Qualified Expert on RP does not appear in the legal framework. In December 2002, a new regulation of the Spanish Regulatory Body, CSN, about qualifications to obtain the recognition of RP Expert in Spain (both high qualified and technical RP experts) was published. Concerning the qualified expert on RP, (RP Officer), responsible of the RP Service, which takes charge of the effective protection and advise radioactive and nuclear facilities in Rp aspects,has to be authorised by the regulatory body. to obtain the RP officer diploma, conceded by the CSN, an initial training of 300 hours and a three-year minimum experience are required (for X-ray installation a 6-month experience is enough). The technical qualified expert on RP is the worker who carried out the tasks in the a RP Service under the supervision of the RP officer. A Technician Qualified Expert on RP does not need an specific accreditation of the Regulatory Body, but an initial RP training and a three-month minimum experience are required and has hold a certificate by the RP officer. Continuous training is also required and as well has to receive a certificate from the RP officer. Since 1977, The Institute for energy Studies has been implementing specific training courses for those professionals who want to obtain the diploma of RP officer (high degree qualified RP expert), conceded by the CSN. Since then

  8. Use of qualitative methods and user-centered design to develop customized health information technology tools within federally qualified health centers to keep children insured.

    Science.gov (United States)

    DeVoe, Jennifer; Angier, Heather; Likumahuwa, Sonja; Hall, Jennifer; Nelson, Christine; Dickerson, Kay; Keller, Sara; Burdick, Tim; Cohen, Deborah

    2014-01-01

    Lack of health insurance negatively impacts children's health. Despite federal initiatives to expand children's coverage and accelerate state outreach efforts, millions of US children remain uninsured or experience frequent gaps in coverage. Most current efforts to enroll and retain eligible children in public insurance programs take place outside of the health care system. This study is a partnership between patients' families, medical informaticists, federally qualified health center (FQHC) staff, and researchers to build and test information technology tools to help FQHCs reach uninsured children and those at risk for losing coverage.

  9. Medical Physics expert and competence in radiation protection

    International Nuclear Information System (INIS)

    Vano, E.; Lamn, I. N.; Guerra, A. del; Van Kleffens, H. J.

    2003-01-01

    The Council Directive 97/43/EURATOM on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, defines the Medical Physical Expert as an expert in radiation physics or radiation technology applied to exposure, within the scope of the Directive, whose training and competence to act is recognized by the competent authorities; and who, as appropriate, acts or gives advice on patient dosimetry, on the development and use of complex techniques and equipment, on optimization, on quality assurance, including quality control, and on other matters relating to radiation protection, concerning exposure within the scope of this Directive. As a consequence, it might be implied that his competence in radiation protection should also cover the staff and the public. In fact, the training programmes of medical physics experts include all the aspects concerning these topics. Some confusion could arise in the medical area when the Qualified Expert defined in the Council Directive 96/29/Euratom laying down basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionizing radiation is considered. The Qualified Expert is defined as a person having the knowledge and training needed to carry out physical, technical or radiochemical tests enabling doses to be assessed, and to give advice in order to ensure effective protection of individuals and the correct operation of protective equipment, whose capacity to act a qualified expert is recognized by the competent authorities. A qualified expert may be assigned the technical responsibility for the tasks of radiation protection of workers and members of the public. In Europe, the Qualified Expert is acting at present in the Medical Area in countries where there are not enough Medical Physics Experts or in countries where this role was established before the publication of the Council Directive 97/43/EURATOM. Now, the coherent

  10. Health effects and medical surveillance

    International Nuclear Information System (INIS)

    2004-01-01

    This Practical Radiation Technical Manual is one of a series which has been designed to provide guidance on radiological protection for employers, Radiation Protection Officers, managers and other technically competent persons who have a responsibility to ensure the safety of employees working with ionizing radiation. The Manual may be used with the appropriate IAEA Practical Radiation Safety Manuals to provide adequate training, instruction or information on health effects and medical surveillance for all employees engaged in work with ionizing radiation. Sources of ionizing radiations have a large number of applications in the workplace. Usually, even where the work is performed safely, the employees involved inevitably receive small, regular exposures to radiation that are not harmful. Some applications involve sources that could deliver more significant radiation doses, particularly when poor methods are practised or an accident occurs. The radiations cannot be seen, felt or sensed by the human body in any way and excessive exposures may cause detriment to the health of a worker in a way that is not immediately apparent. When the symptoms occur, weeks or possibly years later, an untrained worker or inexperienced medical staff probably cannot recognize the effects to be due to the radiation exposure. This Manual explains how ionizing radiations can interact with and affect human tissues, the various factors that influence the outcome and the detrimental effects that may result. The medical surveillance that is appropriate for those working with radiation sources, depending on the degree of hazard of the work, is described. The Manual will be of most benefit if it forms part of more comprehensive training or is supplemented by the advice of a medically qualified expert. Where medical surveillance is appropriate for radiation employees, the services of a qualified doctor, occupational physician or other trained medical staff will be required

  11. What advice is given to newly qualified doctors on Twitter? An analysis of #TipsForNewDocs tweets.

    Science.gov (United States)

    Rashid, Mohammed Ahmed; McKechnie, Doug; Gill, Deborah

    2018-07-01

    Twitter is a social media platform on which users post very brief messages that can be rapidly communicated across wide geographical areas and audiences. Many doctors use Twitter for personal as well as professional communications and networking. The #TipsForNewDocs hashtag is used on Twitter to give advice to newly qualified doctors as they commence their careers. This study explores the nature and focus of such advice. An analysis of Twitter activity containing the #TipsForNewDocs hashtag was performed using Symplur health care analytics software. Tweets sent during a peak 48-hour period in 2016 (immediately preceding the first day of work for newly qualified UK doctors) were studied. The geographical locations and professional backgrounds of participants were categorised and the content of tweets was subjected to thematic analysis. During 1 and 2 August 2016, 661 unique #TipsForNewDocs tweets were posted. A total of 621 (94.0%) were posted by people in the UK; 522 (79.0%) were posted by doctors, and the remainder by allied health care professionals and patients. The majority of included tweets focused on aspects of professional development, improving personal or professional knowledge, particularly tacit knowledge, and developing 'know-how'. These aspects of professional knowledge have previously been described as fundamental to professional education and training. However, a significant subset of tweets focused on accelerating socialisation into the profession, an essential step in joining a professional community. The tweets relating to socialisation were often humorous and colloquial in nature. Despite their brief and often jocular nature, #TipsForNewDocs tweets provided meaningful advice for newcomers to the profession, often focusing on tacit learning and professional socialisation. Hashtag-driven enquiries can be a valuable and time-efficient way of accessing and sharing tacitly held knowledge. Social media content analysis can provide valuable insights

  12. Using neutrosophic graph cut segmentation algorithm for qualified rendering image selection in thyroid elastography video.

    Science.gov (United States)

    Guo, Yanhui; Jiang, Shuang-Quan; Sun, Baiqing; Siuly, Siuly; Şengür, Abdulkadir; Tian, Jia-Wei

    2017-12-01

    Recently, elastography has become very popular in clinical investigation for thyroid cancer detection and diagnosis. In elastogram, the stress results of the thyroid are displayed using pseudo colors. Due to variation of the rendering results in different frames, it is difficult for radiologists to manually select the qualified frame image quickly and efficiently. The purpose of this study is to find the qualified rendering result in the thyroid elastogram. This paper employs an efficient thyroid ultrasound image segmentation algorithm based on neutrosophic graph cut to find the qualified rendering images. Firstly, a thyroid ultrasound image is mapped into neutrosophic set, and an indeterminacy filter is constructed to reduce the indeterminacy of the spatial and intensity information in the image. A graph is defined on the image and the weight for each pixel is represented using the value after indeterminacy filtering. The segmentation results are obtained using a maximum-flow algorithm on the graph. Then the anatomic structure is identified in thyroid ultrasound image. Finally the rendering colors on these anatomic regions are extracted and validated to find the frames which satisfy the selection criteria. To test the performance of the proposed method, a thyroid elastogram dataset is built and totally 33 cases were collected. An experienced radiologist manually evaluates the selection results of the proposed method. Experimental results demonstrate that the proposed method finds the qualified rendering frame with 100% accuracy. The proposed scheme assists the radiologists to diagnose the thyroid diseases using the qualified rendering images.

  13. A longitudinal, mixed methods investigation of newly qualified nurses' workplace stressors and stress experiences during transition.

    Science.gov (United States)

    Halpin, Yvonne; Terry, Louise M; Curzio, Joan

    2017-11-01

    To investigate transition in newly qualified nurses through an exploration of their stressors and stress experiences during their first 12 months postqualifying. Globally, thousands of new nurses qualify annually. They are crucial for the profession and healthcare service delivery. Work-related stress has multiple serious consequences, yet there is a lack of robust, empirical evidence that directly analyses newly qualified nurses and the stress they feel and experience in the workplace. Understanding what causes newly qualified nurses' stress is vital to retaining and nurturing this vital component of the workforce. Longitudinal, explanatory sequential mixed methods, cohort study. At the point of qualification (n = 288), 6 months postqualifying (n = 107) and 12 months postqualifying (n = 86), newly qualified nurses completed the Nursing Stress Scale, with 14 completing a one-to-one interview at 12 months postqualifying. Data were collected from 2010 - 2012. Inferential statistics, "thematic analysis" and "side-by-side comparisons in a discussion" were used for analysis. Workload was consistently the highest reported stressor with inadequate staffing and managing multiple role demands given as explanations. Incivility within the workplace was a noted stressor. Conversely, being part of "a good team" provided a civil, supportive, facilitative work environment. Entering nurse education with previous healthcare experience had a mediating effect on the reported frequency of stressors. Newly qualified nurses encounter multiple work-related stressors over their first 12 months postqualifying, which are intrinsically entwined with their transition. Employing organizations need to be more proactive in managing their workload and addressing workplace incivility. © 2017 John Wiley & Sons Ltd.

  14. Nursing educator perspectives of overseas qualified nurses' intercultural clinical communication: barriers, enablers and engagement strategies.

    Science.gov (United States)

    Philip, Susan; Manias, Elizabeth; Woodward-Kron, Robyn

    2015-09-01

    To understand the intercultural communication experiences and associated communication training needs of overseas qualified nurses in the Australian healthcare system from the unique perspectives of nurse educators teaching in accredited bridging programmes. Overseas qualified nurses are an integral part of the nursing workforce in migration destination countries. Communication training needs are more complex when there are cultural, ethnic and language differences between nurses, other health professionals and patients. A qualitative, exploratory research design using semi-structured interviews. All (nine) organisations involved in conducting the Australian Health Practitioner Regulation Agency approved preregistration bridging programmes for overseas qualified nurses within the state of Victoria, Australia, were involved in the study. Participants were 12 nurse educators employed in these organisations. Thematic analysis was undertaken. Three macro themes emerged about the overseas qualified nurses' intercultural communication: (1) pre-existing barriers and enablers to intercultural communication, for example, nurses' reluctance to engage in communicative strategies that build rapport with patients, (2) transitional behaviours and impact on communication, including maintenance of perceived cultural hierarchies between health professionals and (3) development of communicative competence, including expanding one's repertoire of conversational gambits. The findings point to the domains and causes of communication challenges facing overseas qualified nurses in new healthcare settings as well as strategies that the nurse educators and nurses can adopt. Communication cannot be merely regarded as a skill that can be taught in a didactic programme. Comprehensive understanding is needed about the sociocultural dimensions of these nurses' orientation, which can impact on how they communicate in their new healthcare settings. The findings can act as triggers for discussion

  15. 78 FR 8833 - The Family and Medical Leave Act

    Science.gov (United States)

    2013-02-06

    ... creates a new qualifying exigency leave category for parental care. In military caregiver leave, the Final... covered employers to take job- protected, unpaid leave, or to substitute appropriate accrued paid leave... CFR Part 825 The Family and Medical Leave Act; Final Rule #0;#0;Federal Register / Vol. 78 , No. 25...

  16. Target language use in Modern Language classrooms: perception and change among newly qualified teachers in Scotland

    OpenAIRE

    Lynch, Michael Patrick

    2015-01-01

    In this thesis I investigate the practices and perceptions of some Newly Qualified Teachers (NQTs) of modern foreign languages (MFL) in Scotland in relation to how they use the target language (L2). I seek to answer the questions “In what different ways do student teachers of modern languages use the target language in Scottish secondary school classrooms?’, ‘What reasons do they give for how they use it?” and “In what way(s), if any, do newly qualified teachers of modern language...

  17. Going beyond "highly-qualified personnel" to "value-added personnel"

    Science.gov (United States)

    Nantel, Marc; Fox, Bradley; Gelsthorpe, Leanne; Hamilton, Roxy; Marshall, Robert; Williamson, Guida

    2005-10-01

    Employers clamour for more "Highly-Qualified Personnel" (HQP) to hire, and photonics is no exception. The challenge facing all new graduates lies in what actually constitutes a Highly-Qualified Person. Yesterday, an HQP was often understood to be a graduate with a Bachelor's, Master's or Ph.D. degree. Today, industry is demanding that an HQP be either a university or college graduate with strong academic standing AND a sound business and communications skill set. In this paper, we introduce the concept of "Value-Added Personnel" (VAP), which marries both scientific and "soft-skills" aspects, and we present a new program in Ontario to produce VAPs.

  18. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  19. 78 FR 35155 - Establishing a List of Qualifying Pathogens Under the Food and Drug Administration Safety and...

    Science.gov (United States)

    2013-06-12

    ... is thought to be a chromosomally encoded mutation in the target enzyme, although alternative... of qualifying pathogens. E. Candida Species Candida species are fungi (specifically, yeast) that are...

  20. Attrition during graduate medical education: medical school perspective.

    Science.gov (United States)

    Andriole, Dorothy A; Jeffe, Donna B; Hageman, Heather L; Klingensmith, Mary E; McAlister, Rebecca P; Whelan, Alison J

    2008-12-01

    To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates. Retrospective cohort study. Single medical institution. Recent US allopathic medical school graduates. Attrition from initial GME program. Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition. Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.

  1. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Science.gov (United States)

    2012-07-23

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

  2. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Science.gov (United States)

    2013-08-16

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the states that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

  3. 26 CFR 26.2652-2 - Special election for qualified terminable interest property.

    Science.gov (United States)

    2010-04-01

    ... executor) may elect to treat the trust as two separate trusts, one of which has a zero inclusion ratio by... leaving $4 million in trust for the benefit of T's surviving spouse, S. On January 16, 1995, T's executor filed T's Form 706 on which the executor elects to treat the entire trust as qualified terminable...

  4. 26 CFR 1.405-2 - Deduction of contributions to qualified bond purchase plans.

    Science.gov (United States)

    2010-04-01

    ...), (9), and (10) and 404(e) shall also apply. (c) Accrual method taxpayers. In the case of a taxpayer using the accrual method of accounting, a contribution to a qualified bond purchase plan will be deemed paid on the last day of the year of accrual if— (1) During the taxable year of accrual the taxpayer...

  5. 12 CFR 24.6 - Examples of qualifying public welfare investments.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Examples of qualifying public welfare investments. 24.6 Section 24.6 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY... finance small businesses or small farms, including minority- and women-owned small businesses or small...

  6. 48 CFR 809.270 - Qualified products for convenience/labor-saving foods.

    Science.gov (United States)

    2010-10-01

    ... convenience/labor-saving foods. 809.270 Section 809.270 Federal Acquisition Regulations System DEPARTMENT OF... 809.270 Qualified products for convenience/labor-saving foods. (a) Each VISN Nutrition and Food Service representative is authorized to establish a common VISN QPL for convenience and labor-saving foods...

  7. Return to Learning, Return to Work: Helping Low-Qualified Adults Out of Unemployment. Briefing Note

    Science.gov (United States)

    Cedefop - European Centre for the Development of Vocational Training, 2013

    2013-01-01

    Since 2008, the question uppermost in policymakers' minds has understandably been the explosive growth of youth unemployment. But the crisis has also severely affected low-qualified adults, who face the highest rate of unemployment across Europe. A recent Cedefop study confirms that work-based training programmes can address the particular needs…

  8. Indiana Teachers' Perspectives on Testing Accommodations for Limited English Proficient Students Taking the Graduation Qualifying Exam

    Science.gov (United States)

    Hetler, Angela Dawn

    2010-01-01

    This qualitative case study examines teachers' perspectives on testing accommodations for Limited English Proficient (LEP) students taking Indiana's Graduation Qualifying Exam (GQE). The Indiana Department of Education (IDOE) states that the purpose of testing accommodations is to "level the playing field" between LEP students and their…

  9. 78 FR 33233 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Science.gov (United States)

    2013-06-04

    ... employee choice environment and to make the systems and operational changes required for SHOP enrollment... requested that HHS clarify how the transitional employee choice policy would affect the employer... qualified employees and their dependents and implements a transitional policy regarding employees' choice of...

  10. 38 CFR 21.6519 - Eligibility of qualified veterans for employment and counseling services.

    Science.gov (United States)

    2010-07-01

    ... veterans for employment and counseling services. 21.6519 Section 21.6519 Pensions, Bonuses, and Veterans... employment and counseling services. (a) General. A qualified veteran for whom vocational rehabilitation and achievenment of a vocational goal are reasonably feasible may be provided the employment and counseling...

  11. 6 CFR 25.6 - Procedures for designation of qualified anti-terrorism technologies.

    Science.gov (United States)

    2010-01-01

    ...-terrorism technologies. 25.6 Section 25.6 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY REGULATIONS TO SUPPORT ANTI-TERRORISM BY FOSTERING EFFECTIVE TECHNOLOGIES § 25.6 Procedures for designation of qualified anti-terrorism technologies. (a) Application Procedure. Any person, firm or other...

  12. 26 CFR 1.1275-6 - Integration of qualifying debt instruments.

    Science.gov (United States)

    2010-04-01

    ... § 1.483-4 or § 1.1275-4(c) (certain contingent payment debt instruments issued for nonpublicly traded... the qualifying debt instrument. A financial instrument that hedges currency risk is not a § 1.1275-6... denominated in pounds, the swap hedges only interest rate risk, not currency risk. Therefore, the transaction...

  13. Preparing Special Educators Highly Qualified in Content: Alternative Route Certification for Unlicensed Teachers in Rural Georgia

    Science.gov (United States)

    Childre, Amy L.

    2014-01-01

    The shortage of highly qualified special educators is most pronounced in rural schools serving populations characterized by poverty, low achievement, disability, and cultural diversity. The result is often untrained teachers serving students with the greatest education needs. This article describes efforts by a university in rural middle Georgia…

  14. 26 CFR 1.25-4T - Qualified mortgage credit certificate program (Temporary).

    Science.gov (United States)

    2010-04-01

    ... designed to ensure that only those individuals who could not otherwise purchase a residence will benefit... may be issued in connection with the qualified rehabilitation of a residence part of the cost of which... surrendered to other issuers during the calendar year, (v) The date and amount of any previous elections under...

  15. 26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

    Science.gov (United States)

    2010-04-01

    ..., DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Rules for Computing Credit for Investment in Certain Depreciable Property § 1.48-12 Qualified rehabilitated building; expenditures incurred after December 31, 1981... section 48(g) and this section) is section 38 property. Property that is section 38 property by reason of...

  16. 47 CFR Appendix A to Part 400 - Minimum Grant Awards Available to Qualifying States

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF COMMERCE, AND NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION E-911 GRANT PROGRAM Pt. 400, App. A Appendix A to Part 400—Minimum Grant Awards Available to Qualifying States State name Minimum E-911grant award Alabama $686,230.25 Alaska 500,000.00 American Samoa...

  17. An Exploration of Changes in Thinking in the Transition from Student Teacher to Newly Qualified Teacher

    Science.gov (United States)

    Haggarty, Linda; Postlethwaite, Keith

    2012-01-01

    For newly qualified teachers (NQTs), the induction period of support is an important phase which has the potential to deepen learning that has already taken place in initial teacher education (ITE) as well as preparing the NQT for future learning. A particularly crucial time in the induction process is the first term of teaching, when NQTs are…

  18. 40 CFR 35.4190 - How does my group identify a qualified technical advisor?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false How does my group identify a qualified technical advisor? 35.4190 Section 35.4190 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS...: (1) Demonstrated knowledge of hazardous or toxic waste issues, relocation issues, redevelopment...

  19. 26 CFR 1.856-9 - Treatment of certain qualified REIT subsidiaries.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Treatment of certain qualified REIT subsidiaries. 1.856-9 Section 1.856-9 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Real Estate Investment Trusts § 1.856-9 Treatment of certain...

  20. 40 CFR 73.81 - Qualified conservation measures and renewable energy generation.

    Science.gov (United States)

    2010-07-01

    ...)) without increasing the use by the customer of any fuel other than qualified renewable energy, industrial waste heat, or, pursuant to paragraph (b)(5) of this section, industrial waste gases; (ii) Is... pursuant to § 73.82(c); or (5) Utilization of industrial waste gases, unless the applicant has certified...

  1. Encounters of Newly Qualified Teachers with Micro-Politics in Primary Schools in Zimbabwe

    Science.gov (United States)

    Magudu, Snodia; Gumbo, Mishack

    2017-01-01

    This article demonstrates, through the example of Zimbabwe, the complexities of micro-political learning during induction. It reports on the experiences of ten newly qualified teachers with micro-politics or power relations in their schools during induction and locates these experiences within the broader context of their professional development.…

  2. Skills upgrading for newly qualified surgeon: Is the district hospital in ...

    African Journals Online (AJOL)

    With adequate surgical activity in these settings, the trainee's confidence is boosted to the point of independence. This skill acquisition is a continuous process, especially so for those who qualify from an exit training program like the one at the University of Nairobi (UON). The continuity is maintained for two years after.

  3. 26 CFR 1.1202-2 - Qualified small business stock; effect of redemptions.

    Science.gov (United States)

    2010-04-01

    ... purchased from the decedent's estate, beneficiary (whether by bequest or lifetime gift), heir, surviving.... Stock acquired by a taxpayer is not qualified small business stock if, in one or more purchases during... corporation purchases (directly or indirectly) more than a de minimis amount of its stock from the taxpayer or...

  4. 26 CFR 301.6361-1 - Collection and administration of qualified taxes.

    Science.gov (United States)

    2010-04-01

    ... chapter 1 (and the civil and criminal sanctions provided by subtitle F, or by title 18 of the United States Code (relating to crimes and criminal procedure), with respect to such collection and... for tax of another State or political subdivision—(i) In general. A credit allowable under a qualified...

  5. 76 FR 71450 - Deduction for Qualified Film and Television Production Costs; Correction

    Science.gov (United States)

    2011-11-18

    ... Deduction for Qualified Film and Television Production Costs; Correction AGENCY: Internal Revenue Service... Register on Wednesday, October 19, 2011 (76 FR 64816) relating to deductions for the cost of producing film and television productions. DATES: This correction is effective on November 18, 2011, and is...

  6. 76 FR 64879 - Deduction for Qualified Film and Television Production Costs

    Science.gov (United States)

    2011-10-19

    ... Deduction for Qualified Film and Television Production Costs AGENCY: Internal Revenue Service (IRS... regulations relating to deductions for the costs of producing film and television productions. Those temporary... production costs. (a) * * * (1) * * * (ii) [The text of this proposed amendment to Sec. 1.181- 1(a)(1)(ii) is...

  7. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Science.gov (United States)

    2010-10-01

    ... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...

  8. Newly Qualified Teachers' Professional Digital Competence: Implications for Teacher Education

    Science.gov (United States)

    Gudmundsdottir, Greta Björk; Hatlevik, Ove Edvard

    2018-01-01

    The professional digital competence (PDC) of teachers is of growing importance in classrooms, now that digital resources and digital media are becoming important parts of teachers' everyday practice. This study explores how newly qualified teachers are prepared to use information and communication technology (ICT) in their initial teacher…

  9. The Utilisation of Highly Qualified Personnel. Venice Conference, 25th-27th October 1971.

    Science.gov (United States)

    Organisation for Economic Cooperation and Development, Paris (France).

    This document reports the highlights of an international conference designed to study the utilization of highly qualified personnel. Following the opening addresses by various participants, discussion documents and basic reports are presented. Four areas of concern include the state of employment and employment policy, the conditions and aims of…

  10. 77 FR 462 - Regulation of Fuels and Fuel Additives: Identification of Additional Qualifying Renewable Fuel...

    Science.gov (United States)

    2012-01-05

    ... sources--qualifying as cellulosic biofuel: [cir] Thermochemical pyrolysis. [cir] Thermochemical... covercrops, algal oil, biogenic waste oils/fats/greases, non-food grade corn oil, Canola/rapeseed oil, and... from annual covercrops, algal oil, biogenic waste oils/fats/greases, or non- food grade corn oil using...

  11. 49 CFR 213.305 - Designation of qualified individuals; general qualifications.

    Science.gov (United States)

    2010-10-01

    ... college level engineering program, supplemented by special on the job training emphasizing the techniques... engineering program, supplemented by special on the job training emphasizing the techniques to be employed in... 49 Transportation 4 2010-10-01 2010-10-01 false Designation of qualified individuals; general...

  12. 47 CFR 13.201 - Qualifying for a commercial operator license or endorsement.

    Science.gov (United States)

    2010-10-01

    ... class of license or endorsement specified below must pass, or otherwise receive credit for, the... endorsement. 13.201 Section 13.201 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.201 Qualifying for a commercial operator license or endorsement...

  13. 42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.

    Science.gov (United States)

    2010-10-01

    ... actuary who is a member of the American Academy of Actuaries. Applicants may use qualified outside actuaries, including (but not limited to) actuaries employed by the plan administrator or an insurer providing benefits under the plan. If an applicant uses an outside actuary, the attestation can be submitted...

  14. 26 CFR 1.381(c)(25)-1 - Deficiency dividend of a qualified investment entity.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Deficiency dividend of a qualified investment entity. 1.381(c)(25)-1 Section 1.381(c)(25)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Insolvency Reorganizations § 1.381(c)(25...

  15. 3 CFR 13495 - Executive Order 13495 of January 30, 2009. Nondisplacement of Qualified Workers Under Service...

    Science.gov (United States)

    2010-01-01

    ... contractor and its subcontractors shall, except as otherwise provided herein, in good faith offer those... by law, regulations in the Federal Acquisition Regulation to provide for inclusion of the contract.... Nondisplacement of Qualified Workers Under Service Contracts 13495 Order 13495 Presidential Documents Executive...

  16. 76 FR 58460 - Information Collection; Qualified Products List for Long-Term Retardant for Wildland Firefighting

    Science.gov (United States)

    2011-09-21

    ... adequate types and quantities of qualified fire chemical products available to accomplish fire management... made from these lists. To initiate an evaluation, product manufacturers (or authorized suppliers) enter... Substances and Their Threshold Planning Quantities''. A risk assessment, performed at manufacturer expense...

  17. The Importance of School Leaders' Engagement in Socialising Newly Qualified Teachers into the Teaching Profession

    Science.gov (United States)

    Engvik, Gunnar; Emstad, Anne Berit

    2017-01-01

    This article focuses on the importance of school leaders' commitment to socialising newly qualified teachers (NQTs) into the teaching profession. Framed by a social constructivist perspective, the article is based on four challenges novice teachers face as described by four school leaders. The aim is to illuminate how school leaders have…

  18. 26 CFR 1.163-11T - Allocation of certain prepaid qualified mortgage insurance premiums (temporary).

    Science.gov (United States)

    2010-04-01

    ... insurance premiums (temporary). 1.163-11T Section 1.163-11T Internal Revenue INTERNAL REVENUE SERVICE... insurance premiums (temporary). (a) Allocation—(1) In general. As provided in section 163(h)(3)(E), premiums... section applies whether the qualified mortgage insurance premiums are paid in cash or are financed...

  19. Job satisfaction of overseas-qualified nurses working in Australian hospitals.

    Science.gov (United States)

    Timilsina Bhandari, K K; Xiao, L D; Belan, I

    2015-03-01

    The aims of this study were to explore factors associated with the job satisfaction of overseas-qualified nurses working in public hospitals in South Australia and to compare whether factors associated with job satisfaction of overseas nurses from English-speaking backgrounds differed from those from non-English-speaking backgrounds. Overseas-qualified nurses have become an essential part of the nursing workforce in Australia. Although this nurse population has different expectations and values in relation to their jobs when compared with local nurses, studies on job satisfaction among overseas nurses are scarce. A cross-sectional survey using the Job Satisfaction of Overseas-Qualified Nurses questionnaire was conducted in five major public hospitals in South Australia. One hundred and fifty-one overseas-qualified nurses completed the questionnaire. Four factors were found to influence job satisfaction: Supportive work environment, interpersonal relationships, communication in English, and salary and salary-related benefits. Communication in English was the predominant factor that was associated with job satisfaction in nurses from non-English-speaking backgrounds. This group of nurses also showed a negative correlation between length of stay in Australia and satisfaction with their work environment. Participants' responses to open-ended questions revealed issues relating to discrimination and racism. Supportive work environment, interpersonal relationships, communication in English, and salary and salary-related benefits were major factors associated with job satisfaction in overseas-qualified nurses in this study. Nurses from non-English-speaking backgrounds faced additional challenges in communication in the workplace and in dealing with issues of discrimination and racism. Nurses from non-English-speaking backgrounds need to be supported early in their employment, especially with their communication skills. Consideration also needs to be given to the education

  20. The effects of medical tourism: Thailand's experience.

    Science.gov (United States)

    NaRanong, Anchana; NaRanong, Viroj

    2011-05-01

    To explore the positive and negative effects of medical tourism on the economy, health staff and medical costs in Thailand. The financial repercussions of medical tourism were estimated from commerce ministry data, with modifications and extrapolations. Survey data on 4755 foreign and Thai outpatients in two private hospitals were used to explore how medical tourism affects human resources. Trends in the relative prices of caesarean section, appendectomy, hernia repair, cholecystectomy and knee replacement in five private hospitals were examined. Focus groups and in-depth interviews with hospital managers and key informants from the public and private sectors were conducted to better understand stakeholders' motivations and practices in connection with these procedures and learn more about medical tourism. Medical tourism generates the equivalent of 0.4% of Thailand's gross domestic product but has exacerbated the shortage of medical staff by luring more workers away from the private and public sectors towards hospitals catering to foreigners. This has raised costs in private hospitals substantially and is likely to raise them in public hospitals and in the universal health-care insurance covering most Thais as well. The "brain drain" may also undermine medical training in future. Medical tourism in Thailand, despite some benefits, has negative effects that could be mitigated by lifting the restrictions on the importation of qualified foreign physicians and by taxing tourists who visit the country solely for the purpose of seeking medical treatment. The revenue thus generated could then be used to train physicians and retain medical school professors.

  1. 29 CFR 2520.104-46 - Waiver of examination and report of an independent qualified public accountant for employee...

    Science.gov (United States)

    2010-07-01

    ... qualified public accountant for employee benefit plans with fewer than 100 participants. 2520.104-46 Section... Requirements § 2520.104-46 Waiver of examination and report of an independent qualified public accountant for... public accountant to conduct an examination of the financial statements of the plan; (2) Include within...

  2. 12 CFR 617.7315 - What records must the qualified lender maintain on behalf of the CRC?

    Science.gov (United States)

    2010-01-01

    ... on behalf of the CRC? 617.7315 Section 617.7315 Banks and Banking FARM CREDIT ADMINISTRATION FARM... must the qualified lender maintain on behalf of the CRC? A qualified lender must maintain a complete file of all requests for CRC reviews, including participation in state mediation programs, the minutes...

  3. 26 CFR 20.2039-2 - Annuities under “qualified plans” and section 403(b) annuity contracts.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Annuities under âqualified plansâ and section 403(b) annuity contracts. 20.2039-2 Section 20.2039-2 Internal Revenue INTERNAL REVENUE SERVICE... AUGUST 16, 1954 Gross Estate § 20.2039-2 Annuities under “qualified plans” and section 403(b) annuity...

  4. A missing piece of the workforce puzzle. The experiences of internationally qualified nurses in New Zealand: a literature review.

    Science.gov (United States)

    Jenkins, Brittany Lauren; Huntington, Annette

    2015-01-01

    To analyse the literature regarding the context and experiences of internationally qualified registered nurses, particularly Filipino and Indian nurses, who have transitioned to New Zealand. Internationally qualified nurses are a significant proportion of the nursing workforce in many developed countries including New Zealand. This is increasingly important as populations age, escalating demand for nurses. Understanding the internationally qualified nurse experience is required as this could influence migration in a competitive labour market. Examination of peer-reviewed research, policy and discussion documents, and technical reports. A systematic literature search sought articles published between 2001 and 2014 using Google Scholar, CINAHL, and Medline. Articles were critically appraised for relevance, transferability, and methodological rigour. Fifty-one articles met inclusion criteria and demonstrate internationally qualified nurses face significant challenges transitioning into New Zealand. The internationally qualified nurse experience of transitioning into a new country is little researched and requires further investigation.

  5. Medical physics and challenges faced in Africa

    International Nuclear Information System (INIS)

    Nakatudde, R.

    2010-01-01

    Individual medical physicists have presented many challenges which have greatly inhibited their input in patient care and management. To improve the role and recognition of medical physicists in Africa, FAMPO was established. This is the Federation of African Medical Physics Organisations. Its main role is to bridge the gap between individual medical physicists, existing medical physicist bodies and the International Organisation of Medical Physics (IOMP). It is a non profit making organisation. A qualified medical physicist is an individual who is competent to practice independently one or more of the sub fields of medical physics. i.e. therapeutic radiological, diagnostic radiological, medical nuclear and medical health. Their time should on average be distributed equally among three areas, clinical service and consultation, research and development, and teaching. All diagnostic and radiotherapy centres should have a well established comprehensive quality assurance programme in place, which should involve machine installation and calibration, source delivery and safety, operational procedures, clinical dosimetry and the whole treatment planning process. This should be followed according to national and international recommendations. A study was carried out to identify the challenges faced by medical physicists in Africa and the objectives of the study were; To identify the number of qualified medical physicists and their working experience in hospitals in African countries. To identify the level of involvement of medical physicists in the three areas of Nuclear medicine, Radiology and Radiotherapy in hospitals in African countries.To identify countries with recognised professional bodies governing medical physicists in African countries.To identify the challenges faced by medical physicists in African countries Methods and materials The study was conducted on thirteen medical physicists from seven African countries. i.e. Nigeria, Kenya, Libya, Tanzania, Zambia

  6. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

    Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

  7. International students in United States’ medical schools: does the medical community know they exist?

    Directory of Open Access Journals (Sweden)

    Jashodeep Datta

    2012-06-01

    Full Text Available Background: Matriculation of international students to United States’ (US medical schools has not mirrored the remarkable influx of these students to other US institutions of higher education. Methods: While these students’ numbers are on the rise, the visibility for their unique issues remains largely ignored in the medical literature. Results: These students are disadvantaged in the medical school admissions process due to financial and immigration-related concerns, and academic standards for admittance also continue to be significantly higher compared with their US-citizen peers. Furthermore, it is simply beyond the mission of many medical schools – both public and private – to support international students’ education, especially since federal, state-allocated or institutional funds are limited and these institutions have a commitment to fulfill the healthcare education needs of qualified domestic candidates. In spite of these obstacles, a select group of international students do gain admission to US medical schools and, upon graduation, are credentialed equally as their US-citizen counterparts by the Accreditation Council for Graduate Medical Education (ACGME. However, owing to their foreign citizenship, these students have visa requirements for post-graduate training that may adversely impact their candidacy for residency placement. Conclusion: By raising such issues, this article aims to increase the awareness of considerations pertinent to this unique population of medical students. The argument is also made to support continued recruitment of international students to US medical schools in spite of these impediments. In our experience, these students are not only qualified to tackle the rigors of a US medical education, but also enrich the cultural diversity of the medical student body. Moreover, these graduates could effectively complement the efforts to augment US physician workforce diversity while contributing to

  8. Essential attributes and qualifiers of primary health care - doi:10.5020/18061230.2012.p3

    Directory of Open Access Journals (Sweden)

    Andréa Sílvia Walter de Aguiar

    2012-11-01

    Full Text Available Historically, the primary health care (PHC has been associated with the first level of care from a health system and characterized by the kind of professional that in it operates, where is expected a predominance of specialists in this area. However, the major limitation for this type of characterization is that the profile of professionals engaged in this service may vary from country to country. Several theoretical and conceptual landmarks proposed approaches and indicators to assess and characterize the APS. In 1978, the American Institute of Medicine suggested an approach in which listed its attributes such as accessibility, integrality, coordination, continuity and responsibility. This was an important landmark in an attempt to outline a normative approach to measure it. However, most indicators and specific definition was not suggested. The selected indicators required a high level of performance, were difficult to be achieved, and focused on the capacity of services and not in its concrete realization(1.A 1996 report, from the same institution, defined PHC as the provision of integrated services and accessible by clinicians who are responsible for attending a large majority of personal care needs, developing a continued partnership with patients and working within family and community. This definition does not include the first contact and focuses on individual attention.The Canadian Medical Association, in 1996, considered the APS as a front door of the health system and community interventions included in the definition of the functions of APS. In the same year was published a Charter for General Practice / Family Medicine in Europe (Letter to General Practice / Family Medicinein Europe, which describes 12 characteristics: general, accessible, integrated,continuous, as a team, holistic, personalized, targeted for the family and the community, coordinated, confidential and protectress(2.Donabedian(3 systematized a group of important

  9. Medical Management

    Science.gov (United States)

    ... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  10. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  11. [Medical negligence].

    Science.gov (United States)

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  12. Medical Illustration

    Science.gov (United States)

    ... as medical books, journals, magazines, pharma or biotech marketing, films, online video, exhibits, posters, wall charts, educational ... of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  13. Educating Hungarian medical librarians in special literature.

    Science.gov (United States)

    Jantsits, G

    1974-01-01

    In Hungary the completion of a thirty-month course is required of those who wish to qualify as medium-level librarians. Medical librarians are given a special course which differs from the general course in that it covers the subjects of medical terminology and information in special literature. The latter subject is accorded the highest number of teaching hours, since the subject matter is vast and since, in addition to theory, much time must be spent on exercises and the presentation of reference books. The students become familiar with the main Hungarian and foreign information systems in the medical and related fields and with special bibliographies, encyclopedias, handbooks, and dictionaries. We take special care to familiarize students with the abstracting journals and indices. For several semesters they have homework and lesson exercises in the use of the Hungarian Medical Bibliography and Index Medicus.

  14. Motivation for career choice and job satisfaction of GP trainees and newly qualified GPs across Europe: a seven countries cross-sectional survey.

    Science.gov (United States)

    Roos, Marco; Watson, Jessica; Wensing, Michel; Peters-Klimm, Frank

    2014-07-01

    Recruitment to general practice is a major concern in many countries. Cross-national exploration of motivation for career choice and career satisfaction could help inform workforce planning. Our aim was to explore motivation for career choice and job satisfaction of GP trainees and newly qualified GPs (NQGP) across seven European countries. We surveyed GP trainees and recently qualified GPs in the Czech Republic, Denmark, Germany, Italy, Norway, Portugal and the United Kingdom using a web-based questionnaire. The number of individuals who responded was 3722 (2533 GP trainees; 1189 NQGP). The most frequently cited reasons for choosing GP were 'compatibility with family life' (59.5%), 'challenging medically broad discipline' (58.9%), 'individual approach to people' (40.1%), 'holistic approach' (37.8%) and 'autonomy and independence' (30.4%). Despite differences in workload, work-life balance and earnings, overall job satisfaction was high, with over 80% saying that they would choose to be a doctor again; of these 78.4% would choose to be a GP again. In our sample reasons for choosing general practice as a career were strongly positive, with compatibility with family life the most frequently cited reason overall. This has implications for workforce planning. Further qualitative studies are needed to explore issues raised in more detail.

  15. Examining educators of the deaf as "highly qualified" teachers: roles and responsibilities under IDEA and NCLB.

    Science.gov (United States)

    Luft, Pamela

    2008-01-01

    Educators of the deaf were long considered "highly qualified" if they obtained state licensure from approved deaf education programs. But the No Child Left Behind Act (2001) redefined qualifications based on core academic content areas, without recognizing disability-specific expertise. NCLB's reauthorization will provide opportunities for examining definitions of "highly qualified" and ensuring that both general and special educators are appropriately prepared. Under the Individuals With Disabilities Education Act, educators of the deaf are primarily responsible for supporting implementation of each assigned student's individualized education program. When done skillfully and knowledgeably, IEP execution maximizes learning outcomes, and therefore would support NCLB mandates for improved student achievement. Instead of academic attainment alone, the primary "qualification" of educators of the deaf should be training and expertise in providing communication, learning, and assistive technology supports that allow access to academic content and, ultimately, address deaf students' historical underachievement.

  16. Improvement of technique of a jerk of the qualified sportswomen in weightlifting

    Directory of Open Access Journals (Sweden)

    Oksana Solodka

    2016-12-01

    Full Text Available Purpose: the improvement of technical preparedness of the qualified female weight-lifters taking into account the group model characteristics of technique of a jerk. Material & Methods: analysis and synthesis of data of scientific and methodical literature, pedagogical experiment, method of mathematical statistics. Results: the revealed shortcomings of technique of the execution of a jerk of the qualified female weight-lifters were, considering the group model characteristics of technique of a jerk of the first group of weight categories. Complexes of compensatory exercises were offered for the purpose of correction. Conclusions: the performance of complexes of the compensatory exercises, which are directed to the improvement of competitive exercise of a jerk of bar, allowed to increase the number of successfully executed raising of bar, for 10,3–19,8%, according to initial indicators of number of rises, and also to receive positive shifts in motive structure of a jerk of bar.

  17. Selling medical travel to US patient-consumers: the cultural appeal of website marketing messages.

    Science.gov (United States)

    Sobo, Elisa J; Herlihy, Elizabeth; Bicker, Mary

    2011-04-01

    More US-based patients than ever are travelling abroad for medical or dental services. Beyond financial incentives, what cultural factors have supported this trend? Because of their interest in selling medical travel, medical travel agencies (MTAs) have vested interests in this question. To find out how they are answering it, an ethnographic content analysis of MTA websites was undertaken. Beyond themes promoting a 'worry-free experience' of 'legitimate services', themes linking healthcare consumerism to culturally specific identity ideals and self-creation/representation processes predominated. Themes relating to the demonstration of social position, savvy expression of good consumer judgment, and achievement of libertarian ideals figured highly. However, various inconsistencies (including an appeal to tourism in some but not other situations) suggested that medical travel involves, for the US-based consumer, a complex act of juggling context-specific self-identity desires and expectations in relation to healthcare. The potential impact of prevailing discourses on 'self-construction-in-practice' was explored. Findings enhance understanding of the care seeking process as experienced within the context of globalized, mass-mediated healthcare consumerism. They also point to the need for finer-grained distinctions than the global gloss 'medical travel' offers.

  18. Strategies for Retaining Highly Qualified & Experienced Technical Teachers in Teaching Profession in Katsina State, Nigeria

    OpenAIRE

    Saifullahi Kasim Tafida; Che Kum Clement; Md. Abu Raihan

    2015-01-01

    The objective of this study is to identify the strategies for retaining highly qualified & experienced technical teachers of technical and vocational educational institutions in Katsina State of Nigeria. Two research questions were formulated to guide the study. A 26 items survey questionnaire was developed and used to elicit responses from technical education administrators, technical education principals/vice principals and technical teachers in technical and vocational education institutio...

  19. Air Force Officer Qualifying Test Form T: Initial Item-, Test-, Factor-, and Composite-Level Analyses

    Science.gov (United States)

    2016-12-01

    used to qualify applicants for ROTC and OTS officer commissioning programs. The Pilot, Combat Systems Officer (CSO), and Air Battle Manager ( ABM ...AIR FORCE RESEARCH LABORATORY 711 HUMAN PERFORMANCE WING, AIRMAN SYSTEMS DIRECTORATE, WRIGHT-PATTERSON AIR FORCE BASE, OH 45433 AIR FORCE MATERIEL...Warfighter Interface Division Airman Systems Directorate This report is published in the interest of scientific and technical information exchange, and

  20. From space qualified fiber optic gyroscope to generic fiber optic solutions available for space application

    Science.gov (United States)

    Buret, Thomas; Ramecourt, David; Napolitano, Fabien

    2017-11-01

    The aim of this article is to present how the qualification of the Fiber Optic Gyroscope technology from IXSEA has been achieved through the qualification of a large range of optical devices and related manufacturing processes. These qualified optical devices and processes, that are now fully mastered by IXSEA through vertical integration of the technology, can be used for other space optical sensors. The example of the SWARM project will be discussed.

  1. Marriage and gender inequality: work–family arrangements of Portuguese and British highly qualified women

    OpenAIRE

    Rosa, Rodrigo; Lorga, Catarina; Lyonette, Clare

    2016-01-01

    This article examines work–family reconciliation processes in order to understand if, over the course of marital life, women become socially closer or further away from their partner. Drawing on work–life interviews with highly qualified women in Portugal and Britain, we compare these processes in two societies with different historical and social backgrounds. Findings reveal three main configurations of social (in)equality which emerge during married life: growing inequality i...

  2. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment

    OpenAIRE

    Ziętarska, Monika; Krawczyk-Lipiec, Joanna; Kraj, Leszek; Zaucha, Renata; Małgorzewicz, Sylwia

    2017-01-01

    Aim of the study Cancer is usually associated with impaired nutritional status, which is one of the factors contributing to the deterioration of the results of surgery, chemotherapy, or radiotherapy. The aim of this study was the assessment of the nutritional status of patients with CRC qualified to chemotherapy. Material and methods Seventy-five persons aged 40–86 years with colorectal cancer were examined. To evaluate the nutritional status NRS 2002, SGA, SCRINIO Working Group classificatio...

  3. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment

    OpenAIRE

    Monika Ziętarska; Joanna Krawczyk-Lipiec; Leszek Kraj; Renata Zaucha; Sylwia Małgorzewicz

    2017-01-01

    Aim of the study . Cancer is usually associated with impaired nutritional status, which is one of the factors contributing to the deterioration of the results of surgery, chemotherapy, or radiotherapy. The aim of this study was the assessment of the nutritional status of patients with CRC qualified to chemotherapy. Material and methods : Seventy-five persons aged 40–86 years with colorectal cancer were examined. To evaluate the nutritional status NRS 2002, SGA, SCRINIO Working Group...

  4. Experience with neutron flux monitoring systems qualified for post-accident monitoring

    International Nuclear Information System (INIS)

    Shugars, H.G.; Miller, J.F.

    1995-01-01

    In this paper we discuss the environmental requirements for excore neutron flux monitors that are qualified for use during and after postulated accidents in Pressurized Water Reactors (PWRs). We emphasize PWRs designed in the United States, which are similar to those used also in parts of Western Europe and Eastern Asia. We then discuss design features of the flux monitoring systems necessary to address the environmental, functional, and regulatory requirements, and the experience with these systems. (author). 9 refs, 2 figs

  5. Application of a qualified RETRAN model to plant transient evaluation support

    International Nuclear Information System (INIS)

    Sedano, P.G.; Mata, P.; Alcantud, F.; Serra, J.; Castrillo, F.

    1989-01-01

    This paper presents the applicability and usefulness of a complete and well qualified plant transient code and model to support in depth evaluation of anomalous plant transients. Analyses of several operational and abnormal transients that ocurred during the first three cycles of Cofrentes (BWR-6) NPP are presented. This application demonstrated the need of a very detailed and adjusted simulation of the control systems as well as the convenience of having as complete as possible data adquisition system. (orig.)

  6. Application of a qualified RETRAN model to plant transient evaluation support

    International Nuclear Information System (INIS)

    Sedano, P.G.; Mata, P.; Alcantud, F.; Serra, J.

    1989-01-01

    This paper presents the applicability and usefulness of a complete and well qualified plant transient code and model to support in depth evaluation of anomalous plant transients. Analyses of several operational and abnormal transients occurred during the first three cycles of Cofrentes (BWR-6) NPP are presented. This application remarked the need of a very detailed and adjusted simulation of the control systems as well as the convenience of having an as complete as possible data acquisition system

  7. Capacity market design and renewable energy: Performance incentives, qualifying capacity, and demand curves

    Energy Technology Data Exchange (ETDEWEB)

    Botterud, Audun; Levin, Todd; Byers, Conleigh

    2018-01-01

    A review of capacity markets in the United States in the context of increasing levels of variable renewable energy finds substantial differences with respect to incentives for operational performance, methods to calculate qualifying capacity for variable renewable energy and energy storage, and demand curves for capacity. The review also reveals large differences in historical capacity market clearing prices. The authors conclude that electricity market design must continue to evolve to achieve cost-effective policies for resource adequacy.

  8. The research of tactics of the competitive activity of the qualified sportswomen in long jumps

    OpenAIRE

    Grebenyuk, Oleg

    2016-01-01

    Grebenyuk A. Purpose: to research features of competitive tactics of the qualified sportswomen in long jumps from the running start. Material & Methods: such methods were applied the in researches: analysis of scientific and methodical literature, pedagogical supervision, content analysis (analysis of protocols of competitions). Results of 152 jumpers in length, who executed 886 attempts, are analyzed for the solution of the stated purpose. Results: options of competitive tactics of the q...

  9. Can Social Robots Qualify for Moral Consideration? Reframing the Question about Robot Rights

    Directory of Open Access Journals (Sweden)

    Herman T. Tavani

    2018-03-01

    Full Text Available A controversial question that has been hotly debated in the emerging field of robot ethics is whether robots should be granted rights. Yet, a review of the recent literature in that field suggests that this seemingly straightforward question is far from clear and unambiguous. For example, those who favor granting rights to robots have not always been clear as to which kinds of robots should (or should not be eligible; nor have they been consistent with regard to which kinds of rights—civil, legal, moral, etc.—should be granted to qualifying robots. Also, there has been considerable disagreement about which essential criterion, or cluster of criteria, a robot would need to satisfy to be eligible for rights, and there is ongoing disagreement as to whether a robot must satisfy the conditions for (moral agency to qualify either for rights or (at least some level of moral consideration. One aim of this paper is to show how the current debate about whether to grant rights to robots would benefit from an analysis and clarification of some key concepts and assumptions underlying that question. My principal objective, however, is to show why we should reframe that question by asking instead whether some kinds of social robots qualify for moral consideration as moral patients. In arguing that the answer to this question is “yes,” I draw from some insights in the writings of Hans Jonas to defend my position.

  10. APPROACH TO SYNTHESIS OF PASSIVE INFRARED DETECTORS BASED ON QUASI-POINT MODEL OF QUALIFIED INTRUDER

    Directory of Open Access Journals (Sweden)

    I. V. Bilizhenko

    2017-01-01

    Full Text Available Subject of Research. The paper deals with synthesis of passive infra red (PIR detectors with enhanced detection capability of qualified intruder who uses different types of detection countermeasures: the choice of specific movement direction and disguise in infrared band. Methods. We propose an approach based on quasi-point model of qualified intruder. It includes: separation of model priority parameters, formation of partial detection patterns adapted to those parameters and multi channel signal processing. Main Results. Quasi-pointmodel of qualified intruder consisting of different fragments was suggested. Power density difference was used for model parameters estimation. Criteria were formulated for detection pattern parameters choice on the basis of model parameters. Pyroelectric sensor with nine sensitive elements was applied for increasing the signal information content. Multi-channel processing with multiple partial detection patterns was proposed optimized for detection of intruder's specific movement direction. Practical Relevance. Developed functional device diagram can be realized both by hardware and software and is applicable as one of detection channels for dual technology passive infrared and microwave detectors.

  11. Towards Qualifiable Code Generation from a Clocked Synchronous Subset of Modelica

    Directory of Open Access Journals (Sweden)

    Bernhard Thiele

    2015-01-01

    Full Text Available So far no qualifiable automatic code generators (ACGs are available for Modelica. Hence, digital control applications can be modeled and simulated in Modelica, but require tedious additional efforts (e.g., manual reprogramming to produce qualifiable target system production code. In order to more fully leverage the potential of a model-based development (MBD process in Modelica, a qualifiable automatic code generator is needed. Typical Modelica code generation is a fairly complex process which imposes a huge development burden to any efforts of tool qualification. This work aims at mapping a Modelica subset for digital control function development to a well-understood synchronous data-flow kernel language. This kernel language allows to resort to established compilation techniques for data-flow languages which are understood enough to be accepted by certification authorities. The mapping is established by providing a translational semantics from the Modelica subset to the synchronous data-flow kernel language. However, this translation turned out to be more intricate than initially expected and has given rise to several interesting issues that require suitable design decisions regarding the mapping and the language subset.

  12. TopWorx/GO switch new generation nuclear qualified proximity position sensors

    International Nuclear Information System (INIS)

    Merrifield, G.

    2011-01-01

    An overview of the benefits of installing TopWorx/GO Nuclear Qualified Proximity Position Sensors instead of traditional mechanical switches. Mechanical switches have been the standard for the nuclear industry for years, but that is only because of lack of competition. Because of multiple moving parts, three-piece design, and new low current control systems, mechanical switches are susceptible to a host of environmental factors that cause them to break and/or fail. TopWorx/GO Switch is a smaller, rugged, dependable, one-piece Stainless Steel proximity position sensor that that exceeds CANDU and Global Qualification Levels, easily replacing mechanical switches. It is the only position sensor to meet or exceed Westinghouse AP 1000 specifications as well. Nuclear facilities save money in maintenance reductions, extended PM's and reduction in 'Man REM' hours. This is achieved by not having to service and replace GO Switch position sensors as often as mechanical switches, since their qualified life is 100 years +1 Post Accident submerged. Plant safety is increased due to less switch failure, higher qualification testing levels, repeatability and longer qualified life. (author)

  13. HIGHLY QUALIFIED WORKING FORCE – KEY ELEMENT OF INNOVATIVE DEVELOPMENT MODEL

    Directory of Open Access Journals (Sweden)

    M. Avksientiev

    2014-12-01

    Full Text Available Highly qualified working force is a central element of intensive development model in modern society. The article surveys the experience of countries that managed to transform their economy to the innovative one. Ukrainian economy cannot stand aside processes that dominate the world economy trends, thus we are to use this experience to succeed in future. Today any government of the world is facing challenges that occur due to transformation of the economy into informational one. This type of economy causes its transformation form extensive to intensive one. The main reasons under that is limitation of nature resources, material factors of production. Thus this approach depends much on the quality of working force. Unfortunately in Ukraine there is a misbalance in specialist preparation. This puts additional pressure on the educational sphere also. In order to avoid this pressure we are to conduct reforms in education sphere. Nowadays, in the world views and concepts of governmental role in the social development are changing. This why, even at times of economic recession educational costs are not reduced under the new economical doctrine in the EU. Highly qualified specialists, while creating new products and services play role of engineers in XXI century. They are to lead their industries to world leading positions. From economic point of view, highly qualified specialists benefit society with higher income rates, taxation and thus, increasing the living standards in society. Thus, the majority if modern scientists prove the importance of highly trained working force for more effective economic development.

  14. [Medical technology and medical education].

    Science.gov (United States)

    von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

    2010-08-01

    The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

  15. Medical device software: defining key terms.

    Science.gov (United States)

    Pashkov, Vitalii; Gutorova, Nataliya; Harkusha, Andrii

    one of the areas of significant growth in medical devices has been the role of software - as an integral component of a medical device, as a standalone device and more recently as applications on mobile devices. The risk related to a malfunction of the standalone software used within healthcare is in itself not a criterion for its qualification or not as a medical device. It is therefore, necessary to clarify some criteria for the qualification of stand-alone software as medical devices Materials and methods: Ukrainian, European Union, United States of America legislation, Guidelines developed by European Commission and Food and Drug Administration's, recommendations represented by international voluntary group and scientific works. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. the legal regulation of software which is used for medical purpose in Ukraine limited to one definition. In European Union and United States of America were developed and applying special guidelines that help developers, manufactures and end users to difference software on types standing on medical purpose criteria. Software becomes more and more incorporated into medical devices. Developers and manufacturers may not have initially appreciated potential risks to patients and users such situation could have dangerous results for patients or users. It is necessary to develop and adopt the legislation that will intend to define the criteria for the qualification of medical device software and the application of the classification criteria to such software, provide some illustrative examples and step by step recommendations to qualify software as medical device.

  16. Medical physics practice and training in Ghana.

    Science.gov (United States)

    Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw

    2016-06-01

    Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Qualified Coatings in Nuclear Power Plants. Commercial products; Qualified Coatings in Nuclear Power Plants. Commercial products. Pinturas homologadas en centrales nucleares. Productos comerciales

    Energy Technology Data Exchange (ETDEWEB)

    Barcena, J.; Nunez, B.; Romero, M.; Baladiam, M.

    2014-07-01

    Recently, the supplier of paints that were qualified for use in nuclear applications as protective coatings have ceased to supply in Spain the paints that was used in areas or components with special requirements for nuclear power plants (NPPs). This lack of the common commercial products called for the search for and homologation of other products. A study was performed on the current status of the homologation of commercial products for NPPs and on the codes and standards governing them. The criteria to be met have been defined and the results of the tests performed on the selected paints have been compared against the established criteria so as to allow the homologation of the paints. (Author)

  18. Changes in sickness absenteeism following the introduction of a qualifying day for sickness benefit--findings from Sweden Post

    DEFF Research Database (Denmark)

    Voss, M; Floderus, B; Diderichsen, F

    2001-01-01

    AIMS: In 1993, a qualifying day without sickness benefit was introduced to the Swedish sickness benefit system. The aim of the present study is to investigate sickness absenteeism before and after the introduction of the qualifying day, in the light of conditions inside and outside working life....... METHODS: The study was based on 1,952 female and 2,229 male employees of Sweden Post. Sickness absence was measured by sickness incidence one year before and one year after the introduction of the qualifying day (sick-leave events/person days at risk). Information about explanatory factors was collected...

  19. History and development of medical physics and medical physicist in Japan

    International Nuclear Information System (INIS)

    Toyofuku, F.

    2014-01-01

    The history of medical physics in Japan dates back to the mid-1950's when radioisotope sources such as cobalt-60 were initiated into hospitals. In 1961, a total of about 30 medical physics researchers created a sub-committee of medical physics under the Japan Radiological Society (JRS), which flourished throughout the decade, and the number of members exceeded to more than 200 in 1970. Although there were great advances in medical technologies, the number of members of the medical physics community did not grow for the next two decades from 1980 to 2000. Then, the JRS began to officially recognize medical physicists as a professional group in 1987. Qualifications of candidacy for the examination included having the education equivalent of a Bachelor of Science/Engineering and being a member of the JRS. For the first official examination, 70 medical physicists were approved by the JRS. As of 2013, there are currently 700 medical physicists, however, the number of practicing clinical medical physicists remains only about 150. The main reason for this limited number of medical physicists is that the certification is not recognized as a national license and therefore is challenging to find professional employment as qualified medical personnel at hospitals. (author)

  20. 26 CFR 1.188-1 - Amortization of certain expenditures for qualified on-the-job training and child care facilities.

    Science.gov (United States)

    2010-04-01

    ... qualified on-the-job training and child care facilities. 1.188-1 Section 1.188-1 Internal Revenue INTERNAL... qualified on-the-job training and child care facilities. (a) Allowance of deduction—(1) In general. Under... operation of a qualified on-the-job training or child care facility or are integrally related facilities...

  1. The effects of radiation on various materials and the qualification tests required for their use in medical devices

    International Nuclear Information System (INIS)

    Landfield, H.

    1980-01-01

    Many polymers used in the medical field show various degrees of degradation after radiation exposure either by visual or physical measurements. The general effects of radiation on such medical polymers are reviewed and discussed as well as the tests used to qualify their performance. (author)

  2. Cost Effectiveness of On-site versus Off-site Depression Collaborative Care in Rural Federally Qualified Health Centers

    Science.gov (United States)

    Pyne, Jeffrey M.; Fortney, John C.; Mouden, Sip; Lu, Liya; Hudson, Teresa J; Mittal, Dinesh

    2018-01-01

    Objective Collaborative care for depression is effective and cost-effective in primary care settings. However, there is minimal evidence to inform the choice of on-site versus off-site models. This study examined the cost-effectiveness of on-site practice-based collaborative care (PBCC) versus off-site telemedicine-based collaborative care (TBCC) for depression in Federally Qualified Health Centers (FQHCs). Methods Multi-site randomized pragmatic comparative cost-effectiveness trial. 19,285 patients were screened for depression, 14.8% (n=2,863) screened positive (PHQ9 ≥10) and 364 were enrolled. Telephone interview data were collected at baseline, 6-, 12-, and 18-months. Base case analysis used Arkansas FQHC healthcare costs and secondary analysis used national cost estimates. Effectiveness measures were depression-free days and quality-adjusted life years (QALYs) derived from depression-free days, Medical Outcomes Study SF-12, and Quality of Well Being scale (QWB). Nonparametric bootstrap with replacement methods were used to generate an empirical joint distribution of incremental costs and QALYs and acceptability curves. Results Mean base case FQHC incremental cost-effectiveness ratio (ICER) using depression-free days was $10.78/depression-free day. Mean base case ICERs using QALYs ranged from $14,754/QALY (depression-free day QALY) to $37,261/QALY (QWB QALY). Mean secondary national ICER using depression-free days was $8.43/depression-free day and using QALYs ranged from $11,532/QALY (depression-free day QALY) to $29,234/QALY (QWB QALY). Conclusions These results support the cost-effectiveness of the TBCC intervention in medically underserved primary care settings. Results can inform the decision about whether to insource (make) or outsource (buy) depression care management in the FQHC setting within the current context of Patient-Centered Medical Home, value-based purchasing, and potential bundled payments for depression care. The www.clinicaltrials.gov # for

  3. Medical marijuana.

    OpenAIRE

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...

  4. Improvement of the training system of medical and pharmaceutical specialists at medical college of Saratov State Medical University

    Directory of Open Access Journals (Sweden)

    Popkov V.M.

    2015-06-01

    Full Text Available The development of high-technological medical care in Russia has improved the quality of rendering of medical aid to the population, but at the same time the lack of efficient, qualified specialists has been revealed. Today graduates of professional educational institution are characterized by the knowledge in theory and inefficient practical experience, while the employer is interested in the optimal combination of these qualities. All of these facts lead to the necessity of introducing into the educational process technologies of dual training as a tool of approximation theory to practice Saratov. Medical University may share the experience of introduction and organization of elements of the complex educational system in the process of realization of the programs of secondary professional education through the creation of educational-productive cluster on the bases of clinics.

  5. A challenge to unqualified medical confidentiality.

    Science.gov (United States)

    Bozzo, Alexander

    2018-04-01

    Medical personnel sometimes face a seeming conflict between a duty to respect patient confidentiality and a duty to warn or protect endangered third parties. The conventional answer to dilemmas of this sort is that, in certain circumstances, medical professionals have an obligation to breach confidentiality. Kenneth Kipnis has argued, however, that the conventional wisdom on the nature of medical confidentiality is mistaken. Kipnis argues that the obligation to respect patient confidentiality is unqualified or absolute, since unqualified policies can save more lives in the long run. In this paper, I identify the form of Kipnis's argument and present a challenge to it. I conclude that, as matters stand now, a qualified confidentiality policy is the more rational choice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Medical Terminology.

    Science.gov (United States)

    Mercer County Community Coll., Trenton, NJ.

    This document is one of a series of student workbooks developed for workplace skill development courses or workshops by Mercer County Community College (New Jersey) and its partners. Designed to help employees of medical establishments learn medical terminology, this course provides information on basic word structure, body parts, suffixes and…

  7. Worst-case prediction of normal operating containment temperatures for environmentally qualified equipment

    International Nuclear Information System (INIS)

    Krasnopoler, M.J.; Sundergill, J.E.

    1991-01-01

    Due to issues raised in NRC Information Notice No. 87-65, a southern US nuclear plant was concerned about thermal aging of environmentally qualified (EQ) equipment located in areas of elevated containment temperatures. A method to predict the worst-case monthly temperatures at various zones in the containment and calculate the qualified life using this monthly temperature was developed. Temperatures were predicted for twenty locations inside the containment. Concern about the qualified life of EQ equipment resulted from normal operating temperatures above 120F in several areas of the containment, especially during the summer. At a few locations, the temperature exceeded 140F. Also, NRC Information Notice No. 89-30 reported high containment temperatures at three other nuclear power plants. The predicted temperatures were based on a one-year containment temperature monitoring program. The monitors included permanent temperature monitors required by the Technical Specifications and temporary monitors installed specifically for this program. The temporary monitors were installed near EQ equipment in the expected worst-case areas based on design and operating experience. A semi-empirical model that combined physical and statistical models was developed. The physical model was an overall energy balance for the containment. The statistical model consists of several linear regressions that conservatively relate the monitor temperatures to the bulk containment temperature. The resulting semi-empirical model predicts the worst-case monthly service temperatures at the location of each of the containment temperature monitors. The monthly temperatures are the maximum expected because they are based on the historically worst-case atmospheric data

  8. [Cognitive emotion regulation of patients qualified for implantation of heart rhythm control device].

    Science.gov (United States)

    Ziętalewicz, Urszula; Jędrzejczyk, Jan; Mojkowski, Włodzimierz; Mojkowski, Dariusz

    2016-11-25

    The aim of the artificial heart stimulation is not only saving lives, but also improvement of the quality of life of patients with cardiac arrhythmias. One of the key dimensions of quality of life is psychological functioning. Until now, little research assess this dimension in patients before the implantation of the heart rhythm control device. The aim of the study was to assess the severity of depression and anxiety and the frequency of the used cognitive emotion regulation strategies and to examine the relationship between them. The study group consisted of 60 people qualified for pacemaker implantation (42 PM patients and 18 ICD): 15 women and 45 men ranging in age from 43 to 85. To assess cognitive emotion regulation strategies Cognitive Emotion Regulation Questionnaire was used, and to assess the severity of depression and anxiety - Mood Assessment Questionnaire. Patients with PM more often than patients with ICD use the strategy of Positive Reappraisal (U = 231.50, p = 0.045). There were no statistically significant differences in the frequency of use of other strategies and severity of depression and anxiety. In PM patients there are negative correlations between the severity of depression and anxiety and the use of Acceptance ( τ = -0.380), a Positive Reappraisal ( τ = -0.278), Positive Refocusing ( τ = -0.366) and between the level of anxiety and Putting into Perspective ( τ = -0.402). In ICD patients there was a positive relationship between anxiety and Cathastrophizing ( τ = 0.324). The severity of depression and anxiety, and emotion regulation strategies in patients qualified for PM implantation in comparison with patients qualified for ICD implantation are similar. Both groups of patients show a good adaptation of the psychological.

  9. IE Information Notice No. 85-82: Diesel generator differential protection relay not seismically qualified

    International Nuclear Information System (INIS)

    Jordan, E.L.

    1992-01-01

    Licensees of BWR and PWR nuclear generating stations have reported using a high-speed differential protection relay that has been declared by the manufacturer to be not seismically qualified for the service intended. The relay, GE Model 12CFD, which is being used for emergency diesel generator protection against electrical shorts and grounds at the generator output, has not been seismically qualified to operate in the de-energized state for this application. Generally, the relay operates in the de-energized position before EDG operation. However, it then operates in the energized position whenever the EDG provides an electrical output to essential Class IE components. The safety concern of this issue involves an inadvertent activation of the normally de-energized relay from a seismic event. Momentary activation of the relay, in the circuits examined, blocks the automatic start feature of the EDG during certain emergency plant conditions through operation of another relay in the system. The NRC review of the problems concluded that the relays should be seismically qualified in their energized and de-energized states to preclude their spurious activation during a seismic event. Additionally, review of GE's GER 3069 report, ''Relay Protection of Class IE Systems,'' shows that the 12CFD differential relays were successfully tested for 3.5 g in the energized modes and only 0.75 g in the de-energized mode. Review of GE's GER 3069 report also revealed that GE type IJD differential relays do meet seismic requirements in all modes of operation mentioned above and is the GE recommendation for replacement of the differential relay in question

  10. Learning Styles of Pilots Currently Qualified in United States Air Force Aircraft

    Science.gov (United States)

    Kanske, Craig A.

    2001-01-01

    Kolb's Learning Style Inventory was used to identify the predominant learning styles of pilots currently qualified in United States Air Force aircraft. The results indicate that these pilots show a significant preference for facts and things over people and feelings. By understanding the preferred learning styles of the target population, course material can be developed that take advantage of the strengths of these learning styles. This information can be especially useful in the future design of cockpit resource management training. The training program can be developed to demonstrate both that there are different learning styles and that it is possible to take advantage of the relative strengths of each of these learning styles.

  11. The rhythm and tempo of the game of highly qualified teams

    Directory of Open Access Journals (Sweden)

    V’yacheslav Mulik

    2015-06-01

    Full Text Available Purpose: to set indicators of rhythm and tempo of the game teams of high qualification. Material and Methods: analysis of the scientific-methodical literature, registration of technical-tactical actions, methods of mathematical statistics. The study of competitive activities was conducted with participating teams of world championship 2014. Results: the acticle shows indicators of the rhythm and tempo of the game of well-qualified teams. Conclusions: teams-winners have surpassed teams that concede in terms of indicators of passes the ball, shots at goal, the rhythm of the game, tempo of game.

  12. Les travailleurs statutaires peu qualifiés dans la modernisation des entreprises publiques

    OpenAIRE

    Cultiaux, John; Scius, Marc

    2012-01-01

    Cet article a pour objectif de présenter certains résultats issus de recherches-action menées entre 2001 et 2008 auprès de travailleurs statutaires peu qualifiés et de représentants syndicaux de deux entreprises publiques belges. Endossant un positionnement de cliniciens du travail, nous mettons en évidence les traits essentiels de l’expérience singulière de ces travailleurs mais aussi des circonstances dans lesquelles ils ont fait face aux changements. Observer la modernisation de leur point...

  13. Qualifying Elbow Meters for High Pressure Flow Measurements in an Operating Nuclear Power Plant

    International Nuclear Information System (INIS)

    Chan, A.M.; Maynard, K.J.; Ramundi, J.; Wiklung, E.

    2006-01-01

    To support the installation and use of elbow meters to measure the high pressure emergency coolant injection flow in an operating nuclear station, a test program was performed to qualify: (i) the 'hot' tapping procedure for field application and (ii) the use of elbow meters for accurate flow measurements over the full range of station ECI flow conditions. This paper describes the design conditions and major components of a flow loop used for the elbow meter calibrations. Typical test results are presented and discussed. (authors)

  14. Aspirations to become an anaesthetist: longitudinal study of historical trends and trajectories of UK-qualified doctors' early career choices and of factors that have influenced their choices.

    Science.gov (United States)

    Emmanouil, Beatrice; Goldacre, Michael J; Lambert, Trevor W

    2017-07-25

    It is important to inform medical educators and workforce planners in Anaesthesia about early career choices for the specialty, factors that influence them and to elucidate how recent choices of men and women doctors relate to the overall historical trends in the specialty's popularity. We analysed longitudinal data on career choice, based on self-completed questionnaires, from national year-of-qualification cohorts of UK-trained doctors from 1974 to 2012 surveyed one, three and 5 years post-qualification. Career destination data 10 years post-qualification were used for qualifiers between 1993 and 2002, to investigate the association between early choice and later destinations. In years 1, 3 and 5 post-qualification, respectively, 59.9% (37,385), 64.6% (31,473), and 67.2% (24,971) of contactable doctors responded. There was an overall increase, from the early to the later cohorts, in the percentage of medical graduates who wished to enter anaesthesia: for instance year 1 choices rose from 4.6 to 9.4%, comparing the 1974 and 2012 cohorts. Men were more likely than women to express an early preference for a career in anaesthesia: for example, at year 3 after qualification anaesthesia was the choice of 10.1% of men and 7.9% of women. There was a striking increase in the certainty with which women chose anaesthesia as their future career specialty in recent compared to earlier cohorts, not reflected in any trends observed in men choosing anaesthesia. Sixty percent of doctors who were anaesthetists, 10 years after qualifying, had specified anaesthesia as their preferred specialty when surveyed in year 1, 80% in year 3, and 92% in year 5. Doctors working as anaesthetists were less likely than those working in other hospital specialties to have specified, as strong influences on specialty choice, 'experience of the subject' as students, 'inclinations before medical school', and 'what I really want to do'. Men anaesthetists were more influenced in their specialty

  15. Postgraduate Medical Physics Academic Programmes. Endorsed by the International Organization for Medical Physics (IOMP)

    International Nuclear Information System (INIS)

    2013-01-01

    The safe and effective implementation of technology in radiation medicine requires expert medical physics support. In order to fulfil their duties, medical physicists working as health professionals should demonstrate competency in their area of specialization by obtaining the appropriate educational qualification and clinical competency training in one or more aspects of medical physics. At the international level, there are very few established, accredited academic education programmes for medical physics students, and no international guidelines exist which provide the recommended requirements, outline and structure of such a programme. An increasing number of Member States with a 'critical mass' of medical physicists are seeking support to initiate their own national postgraduate education programmes. This publication, therefore, seeks to provide guidelines for the establishment of a postgraduate academic education programme in medical physics, which could also be used to achieve harmonized standards of competence worldwide. This publication was developed in support of the internationally harmonized guidelines given in IAEA Human Health Series No. 25 on the requirements for academic education and clinical training of clinically qualified medical physicists. In addition to academic education, medical physicists should obtain specialized clinical training. The IAEA has published three Training Course Series publications with accompanying handbooks, which provide guidelines and references to training material for clinical training programmes for medical physicists specializing in radiation oncology (TCS-37), diagnostic radiology (TCS-47) and nuclear medicine (TCS-50)

  16. IE Information No. 86-104: Unqualified butt splice connectors identified in qualified penetrations

    International Nuclear Information System (INIS)

    Jordan, E.L.

    1992-01-01

    During an NRC equipment qualification (EQ) inspection at Dresden Nuclear Power Station, May 19--23, 1986, a deficiency was discovered concerning a lack of similarity between tested and installed nylon insulated butt splices in EQ qualified GE electrical penetrations. commonwealth Edison sent four sample splices removed from Quad Cities Nuclear Power Station to Wyle Laboratory to further substantiate their qualification for use in a harsh environment. These splices were identical to those installed at Dresden. During the testing performed at Wyle Laboratory December 4--5, 1986, all four samples exhibited excessive leakage currents to ground when exposed to a steam environment. Commonwealth Edison consequently declared the splices unqualified and shut down its Quad Cities Unit 1 to rework the splices by wrapping them with previously qualified tape. Dresden Unit 2 has similarly reworked the splices by wrapping them with tape. Duane Arnold Energy Center also has commenced a shutdown in order to make repairs. The short circuits that occurred appeared to start by condensation entering the splice between the wire insulation and the nylon tubing. The arcing caused insulation degradation that then allowed arcs to pass through the insulation to the enclosure

  17. The lived experience of newly qualified radiographers (1950-1985): An oral history of radiography

    International Nuclear Information System (INIS)

    Decker, Sola

    2009-01-01

    The preparedness for practice of newly qualified healthcare professionals (including radiographers) has been the focus of attention in recent years as the practice environment continues to place great demands on its workforce. This paper reports an aspect of the findings from an oral history project on the career history of radiographers conducted as an academic research investigating the changes that have occurred in radiography and the impact these have had on the profession and the practice of radiography. The main focus of this paper is the lived experience of the informants of the oral history project as newly qualified radiographers. The findings are discussed in the context of current practice environment and developments in radiography. Analysis of the textual materials generated from informants' oral historical accounts, suggest radiographers trained in this time frame perceived their training as 'fit for purpose. The findings further suggest there is a general norm of 'get-on-with-it' as a coping strategy which is still prevalent in the profession today. The paper concludes by drawing on lessons that can be learned from the lived experiences of radiographers' oral historical accounts.

  18. Factors influencing prospective mother with prenatal qualified doctor care among the reproductive women in Bangladesh.

    Science.gov (United States)

    Kiser, Humayun; Nasrin, Tasmina

    2018-12-01

    Maternal and child mortality are the key indicators of health and development of the country. Maternal and child health are interconnected to prenatal care. Consulting a doctor at the prenatal stage will not only ensure mother's and her unborn babies' safety, but also has a great influence to reduce the maternal and infant mortality. In this paper, an attempt has been made to analyze the status of prenatal care provided by the qualified doctor among pregnant mothers in Bangladesh. Data and required information of 8793 reproductive women were collected from the Bangladesh Demographic and Health Survey (BDHS) 2014. Logistic regression model has been used to identify the most significant determinants of the prenatal doctor visits. In this research, it is found that prenatal cares by a qualified doctor during pregnancy depend on several social and demographic characteristics of a woman. It is observed that women staying both urban and rural areas have similar behaviour of caring regarding their pregnancy related complications. Beside this Respondent's age, education, her husband's education and the number of ever born children have significant contribution on prenatal doctor visit. On the other hand, division, religion, husband's desire for children has no effect on it. Overall the model is able to predict 71.65% women into their appropriate group based on these factors.

  19. New technologies applied to radiation protection training: Rp course for technical qualified expert

    International Nuclear Information System (INIS)

    Llorente Herranz, Cristina; Rodriguez, M.; Marco Arboli, Marisa

    2008-01-01

    This paper shows the development and results of the first Course for technical qualified expert in radiation protection (RP) using the advantages of Communication and Information Technologies (CITs). This project in modality b-learning has born as a result of the RP specialised course demand, the necessity of working-private life balance and working-training time combination as well as the geographic widespread of those interested. The methodology selected has been b-learning (blended learning), which consists of a mixture of e-learning plus face-to-face learning. The RP course for technical qualified RP expert has been designed for 10 weeks using online learning methodology and 2 days of face-to-face learning in a radioactive facility to take account practical sessions and the final knowledge evaluation. A multidisciplinary team of experts has elaborated the RP programme and the docent material, following national normative. The material consists of: a) Multimedia material with theoretical content to be visualised online; b) Additional material to be un-load or printed; c) Practical exercises within multimedia content; d) Practical online and face-to-face sessions. (author)

  20. Psychological Properties and Stress Tolerance of High-Qualified Athletes Specializing in Athletic Walking

    Directory of Open Access Journals (Sweden)

    Vasyl Vasylyuk

    2018-04-01

    Full Text Available In the field of sports, there is a strong interest in the behavioral strategies of professional athletes, thus the study of the psychological characteristics of highly skilled athletes is a very topical issue. The article raises the question of the characteristics of the sports environment and the manifestations of stress among athletes. In the paper the psychological features of the personalities of highly qualified athletes who specialize in athletic walking on a scale of neuroticism and extraversion are investigated and the level of neuro-psychological stability of highly skilled athletes specializing in athletic walking is revealed. The main factors of stress in sports activities are: intense competition during a sporting contestation aimed at establishing a record or achieving victory over the rival; maximum physical and psychological stress during the contestation; systematic, long and intense training, which significantly affect the daily regime and everyday life. Two types of stress among athletes are singled out: social-emotional and training. A study of 12 highly qualified athletes who specialize in athletic walking showed that most of them (50 % have ambivert abilities. They are concordants and normostenics that are characterized by significant emotional stability, good adaptability, resistance to external influences. However, among the respondents there were some with low and below average neuropsychic stability.

  1. A space-qualified experiment integrating HTS digital circuits and small cryocoolers

    International Nuclear Information System (INIS)

    Silver, A.; Akerling, G.; Auten, R.

    1996-01-01

    High temperature superconductors (HTS) promise to achieve electrical performance superior to that of conventional electronics. For application in space systems, HTS systems must simultaneously achieve lower power, weight, and volume than conventional electronics, and meet stringent space qualification and reliability requirements. Most effort to date has focused on passive RF/microwave applications. However, incorporation of active microwave components such as amplifiers, mixers, and phase shifters, and on-board high data rate digital signal processing is limited by the power and weight of their spacecraft electronic and support modules. Absence of data on active HTS components will prevent their utilization in space. To validate the feasibility in space of HTS circuits and components based on Josephson junctions, one needs to demonstrate HTS circuits and critical supporting technologies, such as space-qualified packaging and interconnects, closed-cycle cryocooling, and interface electronics. This paper describes the packaging, performance, and space test plan of an integrated, space-qualified experimental package consisting of HTS Josephson junction circuits and all the supporting components for NRL's high temperature superconductor space experiment (HTSSE-II). Most of the technical challenges and approaches are equally applicable to passive and active RF/microwave and digital electronic components, and this experiment will provide valuable validation data

  2. Qualifying commercial grade instruments for use in nuclear power generating stations

    International Nuclear Information System (INIS)

    Lamothe, R.J.; Scally, C.R.

    1983-01-01

    Nuclear environmental qualification of instrumentation has been successfully accomplished by many commercial grade equipment manufacturers. This paper was prepared as a guide to those manufacturers who want some insight into a qualification program. The areas addressed are the regulations and documents, the qualification program, and a case history of a chart recorder qualifications. The principal standards relating to a nuclear qualification program are IEEE Std. 323-1974 IEEE Standard for Qualifying Class 1E Equipment for Nuclear Power Generating Stations, IEEE Std. 344-1975 IEEE Recommended Practices for Seismic Qualification of Class 1E Equipment for Nuclear Power Generating Stations and 10CFR50.49. Previously NUREG 0588 Interim Staff Position on Environmental Qualification of Safety-Related Equipment. These define the intent and purpose of the qualification. The qualification program itself consists of several distinct parts which require explanation, including the determination of qualified life, choice of test samples, selection of appropriate acceptance criteria, aging program, radiation testing, seismic testing, abnormal environment tests and others. The case history illustrates the qualification program and the thought processes involved

  3. A versatile electrical penetration design qualified to IEEE Std. 317-1983

    International Nuclear Information System (INIS)

    Lankenau, W.; Wetherill, T.M.

    1994-01-01

    Although worldwide demand for new construction of nuclear power stations has been on a decline, the available opportunities for the design and construction of qualified electrical penetrations continues to offer challenges, requiring a highly versatile design. Versatility is necessary in order to meet unique customer requirements within the constraints of a design basis qualified to IEEE Std. 317-1983. This paper summarizes such a versatile electrical penetration designed, built and tested to IEEE Std. 317-1983. The principal features are described including major materials of construction. Some of the design constraints such as sealing requirements, and conductor density (including numerical example) are discussed. The requirements for qualification testing of the penetration assembly to IEEE Std. 317-1983 are delineated in a general sense, and some typical test ranges for preconditioning, radiation exposure, and LOCA are provided. The paper concludes by describing ways in which this versatile design has been adapted to meet unique customer requirements in a variety of nuclear power plants

  4. Analysis of the knowledge and opinions of students and qualified dentists regarding the use of computers.

    Science.gov (United States)

    Castelló Castañeda, Coral; Ríos Santos, Jose Vicente; Bullón, Pedro

    2008-01-01

    Dentists are currently required to make multiple diagnoses and treatment decisions every day and the information necessary to achieve this satisfactorily doubles in volume every five years. Knowledge therefore rapidly becomes out of date, so that it is often impossible to remember established information and assimilate new concepts. This may result in a significant lack of knowledge in the future, which would jeopardize the success of treatments. To remedy this situation and to prevent it, we nowadays have access to modern computing systems, with an extensive data base, which helps us to retain the information necessary for daily practice and access it instantaneously. The objectives of this study are therefore to determine how widespread the use of computing is in this environment and to determine the opinion of students and qualified dentists as regards its use in Dentistry. 90 people were chosen to take part in the study, divided into the following groups (students) (newly qualified dentists) (experts). It has been demonstrated that a high percentage (93.30%) use a computer, but that their level of computing knowledge is predominantly moderate. The place where a computer is used most is the home, which suggests that the majority own a computer. Analysis of the results obtained for evaluation of computers in teaching showed that the participants thought that it saved a great deal of time and had great potential for providing an image (in terms of marketing) and they considered it a very innovative and stimulating tool.

  5. Exploring selection and recruitment processes for newly qualified nurses: a sequential-explanatory mixed-method study.

    Science.gov (United States)

    Newton, Paul; Chandler, Val; Morris-Thomson, Trish; Sayer, Jane; Burke, Linda

    2015-01-01

    To map current selection and recruitment processes for newly qualified nurses and to explore the advantages and limitations of current selection and recruitment processes. The need to improve current selection and recruitment practices for newly qualified nurses is highlighted in health policy internationally. A cross-sectional, sequential-explanatory mixed-method design with 4 components: (1) Literature review of selection and recruitment of newly qualified nurses; and (2) Literature review of a public sector professions' selection and recruitment processes; (3) Survey mapping existing selection and recruitment processes for newly qualified nurses; and (4) Qualitative study about recruiters' selection and recruitment processes. Literature searches on the selection and recruitment of newly qualified candidates in teaching and nursing (2005-2013) were conducted. Cross-sectional, mixed-method data were collected from thirty-one (n = 31) individuals in health providers in London who had responsibility for the selection and recruitment of newly qualified nurses using a survey instrument. Of these providers who took part, six (n = 6) purposively selected to be interviewed qualitatively. Issues of supply and demand in the workforce, rather than selection and recruitment tools, predominated in the literature reviews. Examples of tools to measure values, attitudes and skills were found in the nursing literature. The mapping exercise found that providers used many selection and recruitment tools, some providers combined tools to streamline process and assure quality of candidates. Most providers had processes which addressed the issue of quality in the selection and recruitment of newly qualified nurses. The 'assessment centre model', which providers were adopting, allowed for multiple levels of assessment and streamlined recruitment. There is a need to validate the efficacy of the selection tools. © 2014 John Wiley & Sons Ltd.

  6. Cardiac Medications

    Science.gov (United States)

    ... cholesterol from circulating in the blood. Watch an animation of how statins work. Reason for Medication Used ... Kindle Fire Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  7. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  8. Medical Cyclotrons

    Science.gov (United States)

    Friesel, D. L.; Antaya, T. A.

    Particle accelerators were initially developed to address specific scientific research goals, yet they were used for practical applications, particularly medical applications, within a few years of their invention. The cyclotron's potential for producing beams for cancer therapy and medical radioisotope production was realized with the early Lawrence cyclotrons and has continued with their more technically advanced successors — synchrocyclotrons, sector-focused cyclotrons and superconducting cyclotrons. While a variety of other accelerator technologies were developed to achieve today's high energy particles, this article will chronicle the development of one type of accelerator — the cyclotron, and its medical applications. These medical and industrial applications eventually led to the commercial manufacture of both small and large cyclotrons and facilities specifically designed for applications other than scientific research.

  9. Medical imaging

    International Nuclear Information System (INIS)

    Loshkajian, A.

    2000-01-01

    This didactical book presents the medical imaging techniques: radiography, scanner, nuclear magnetic resonance (NMR). Examples are given for the most common pathologies in all domains of medicine. (J.S.)

  10. Medical Imaging.

    Science.gov (United States)

    Barker, M. C. J.

    1996-01-01

    Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

  11. Medical education.

    Science.gov (United States)

    Krishnan, P

    1992-01-01

    In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people.

  12. Medical tourism

    OpenAIRE

    Abbas Ghanbari; Khadijeh Zirak Moradlu; Morteza Ramazani

    2014-01-01

    Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism pot...

  13. Medical Applications

    OpenAIRE

    Biscari, C.; Falbo, L.

    2016-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on ...

  14. Medical radiation

    International Nuclear Information System (INIS)

    1992-01-01

    This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

  15. Medical negligence.

    OpenAIRE

    Rosen, M.

    1992-01-01

    The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malpractice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the standard of care the law required of him in the particular circumstances and that he acted with guilt and therefore can be blamed for the deed. This paper describes medical practitioner negligence and reviews relevant cases.

  16. Radiation protection in medical applications

    International Nuclear Information System (INIS)

    Maldonado M, H.

    2008-12-01

    The justification of the practices is the fundamental principle on which rests the peaceful use of ionizing radiations. They actually contain as aspirations to improve the quality of people's lives, contributing to sustainable development through environmental protection, so that the sources security and the individuals protection will be conditions which are not and should can not be operated. For medical applications is a highly illustrative example of this, since both for the diagnosis and therapy, the goal is to achieve what is sought for the white tissue, secured the least possible damage to the neighboring tissues so that in turn reduce the negative effects for the patient. As a basis for achieving the above, it is essential to have qualified personnel in all areas incidents, for example users, workers, officials and staff members. There are a variety of specialists in the field of medical applications as, nuclear chemistry, nuclear engineering, radiation protection, medical physics, radiation physics and others. Among the human resource in the country must make up the majority are medical radiologists, highlighting gaps in the number of radiotherapy and nuclear medicine but specially in the medical physics, who is in some way from a special viewpoint of the formal school, new to the country. This is true for the number of facilities which are in the country. The radiation protection responsibilities in medical applications focus primarily on two figures: the radiology safety manager, who is primarily dedicated to the protection of occupationally exposed personnel and the public, and the medical physicist whose functions are geared towards the radiological protection of the patient. The principal legislation in the medical applications area has been enacted and is monitored by the Health Secretary and National Commission on Nuclear Safety and Safeguards, entities that have reached agreements to avoid overlap and over-regulation. Medical applications in the

  17. Quality of Work-Life Programs in U.S. Medical Schools: Review and Case Studies

    Science.gov (United States)

    Otto, Ann; Bourguet, Claire

    2006-01-01

    Quality of work life is being recognized more and more as a driving factor in the recruitment and retention of highly qualified employees. Before Northeastern Ohio Universities College of Medicine began development of its QWL initiative, it surveyed other medical schools across the U.S. to determine benchmarks of best practices in these programs.…

  18. Applying the International Medical Graduate Program Model to Alleviate the Supply Shortage of Accounting Doctoral Faculty

    Science.gov (United States)

    HassabElnaby, Hassan R.; Dobrzykowski, David D.; Tran, Oanh Thikie

    2012-01-01

    Accounting has been faced with a severe shortage in the supply of qualified doctoral faculty. Drawing upon the international mobility of foreign scholars and the spirit of the international medical graduate program, this article suggests a model to fill the demand in accounting doctoral faculty. The underlying assumption of the suggested model is…

  19. Medical education for "Dreamers": Barriers and opportunities for undocumented immigrants.

    Science.gov (United States)

    Kuczewski, Mark G; Brubaker, Linda

    2014-12-01

    Medical schools should amend their admissions policies to welcome applications from qualified undocumented immigrants, often called "Dreamers." The recent creation of the Deferred Action for Childhood Arrivals (DACA) program of the U.S. Citizenship and Immigration Service removes the key obstacles to securing a license and residency eligibility for such medical school graduates. As a result, to deny application to Dreamers of DACA status represents a kind of unjustified discrimination and violates the basic ethical principle of the equality of human beings. In addition, the medical profession's duty of beneficence to patients compels medical schools to develop the talents of any and all qualified applicants so as to produce the most competent, diverse physician workforce that best represents contemporary U.S. society. Furthermore, social justice calls for medical schools to produce physicians inclined to serve populations that have traditionally been underserved, including some minority and immigrant populations. An examination of the characteristics of those granted DACA status suggests that they are a potential source of future physicians likely to be helpful in addressing these needs. The authors of this Perspective discuss the remaining challenges facing Dreamers who want to attend medical school in the United States and possible means of overcoming these hurdles. The authors' views are based on principles of social justice, their recognition of the duty to treat Dreamer applicants fairly and justly, and their belief that physicians have an obligation primarily to the patients they serve that entails developing the best health care workforce possible.

  20. Knowledge level estimation of medical workers participating in rendering of emergency medical aid to children at a pre-hospital stage

    Directory of Open Access Journals (Sweden)

    V.M. Popkov

    2010-06-01

    Full Text Available Purpose: Estimation of qualifying preparation of the doctors participating in rendering of emergency medical aid to children. Material: On the basis of the developed test cards the analysis of doctors' knowledge level of the first help on the basic questions of emergency medicine is carried out. 120 doctors are interrogated. Results compared depending on age, work experience and presence of a qualifying professional category. Results: As a whole answers of respondents were distributed as follows: unsatisfactorily - 2,6 %; satisfactorily - 7,9 %; well - 18,4 %; perfectly - 71,1 %. Distinctions in a dale of right answers on separate sections of knowledge depending on the experience and a qualifying professional category are established. The conclusion: The weakest places in preparation of experts of the first help on which it is necessary to pay special attention in courses of postdegree preparation are revealed

  1. Medical tourism

    Directory of Open Access Journals (Sweden)

    Abbas Ghanbari

    2014-08-01

    Full Text Available Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism potentials. In this survey, the researcher investigated the existing potentials of Zanjan province based on descriptive - analytical tourism in offering and providing medical services and accommodation. The survey reports that offered services in tourism were not acceptable and satisfactory.

  2. Generic requirements specification for qualifying a commercially available PLC for safety-related applications in nuclear power plants. Final report

    International Nuclear Information System (INIS)

    Ostenso, A.; May, R.

    1996-12-01

    This is a specification for qualifying a commercially available PLC for application to safety systems in nuclear power plants. The specifications are suitable for evaluating a particular PLC product line as a platform for safety-related applications, establishing a suitable qualification test program, and confirming that the manufacturer has a quality assurance program that is adequate for safety-related applications or is sufficiently complete that, with a reasonable set of compensatory actions, it can be brought into conformance. The specification includes requirements for: (1) quality assurance measures applied to the qualification activities, (2) documentation to support the qualification, and (3) documentation to provide the information needed for applying the qualified PLC platform to a specific application. The specifications are designed to encompass a broad range of safety applications; however, qualifying a particular platform for a different range of applications can be accomplished by appropriate adjustments to the requirements

  3. The use of joint reinforcement in qualifying masonry walls in nuclear power plants

    International Nuclear Information System (INIS)

    Harris, H.G.; Becica, I.J.; Chokshi, N.C.; Con, V.N.; Hamid, A.A.

    1984-01-01

    Wire joint reinforcement has been traditionally used in block masonry walls for crack control and to provide continuity for multiple wythe walls. In a number of nuclear power plants, vertically unreinforced masonry walls that failed to meet the code allowable stresses for unreinforced masonry were qualified using joint reinforcement as a structural steel to carry lateral loads in the horizontal direction. It is the objective of this paper to examine the adequacy of this approach for seismic load application. A state-of-the-art review of available test data and code design provisions will be presented. It is concluded that the use of joint reinforcement to resist tensile stresses due to seismic loading is questionable because of the lack of test data available and especially the characterization of the cyclic behavior of joint reinforced masonry walls. Further research in this area is recommended

  4. Referees check robots after qualifying match at regional robotic competition at KSC

    Science.gov (United States)

    1999-01-01

    Referees check the robots on the floor of the playing field after a qualifying match of the 1999 Southeastern Regional robotic competition at Kennedy Space Center Visitor Complex . Thirty schools from around the country have converged at KSC for the event that pits gladiator robots against each other in an athletic-style competition. The robots have to retrieve pillow- like disks from the floor, as well as climb onto the platform (with flags) and raise the cache of pillows to a height of eight feet. KSC is hosting the event being sponsored by the nonprofit organization For Inspiration and Recognition of Science and Technology, known as FIRST. The FIRST robotics competition is designed to provide students with a hands-on, inside look at engineering and other professional careers.

  5. Student teams maneuver robots in qualifying match at regional robotic competition at KSC

    Science.gov (United States)

    1999-01-01

    All four robots, maneuvered by student teams behind protective walls, converge on a corner of the playing field during qualifying matches of the 1999 Southeastern Regional robotic competition at Kennedy Space Center Visitor Complex . Thirty schools from around the country have converged at KSC for the event that pits gladiator robots against each other in an athletic-style competition. The robots have to retrieve pillow- like disks from the floor, as well as climb onto the platform (with flags) and raise the cache of pillows to a height of eight feet. KSC is hosting the event being sponsored by the nonprofit organization For Inspiration and Recognition of Science and Technology, known as FIRST. The FIRST robotics competition is designed to provide students with a hands-on, inside look at engineering and other professional careers.

  6. Balance carried out on an alpha waste incinerator in order to qualify its filtration system

    International Nuclear Information System (INIS)

    Cartier, R.; Burghofer, P.; Tregoures, A.; Maurel, J.M.; Vendel, J.

    1991-01-01

    A balance was carried out on a pilot incinerator of inactive solid waste running at 4 kg/h. Various measurements were taken in order to qualify the prefiltration system of the incineration process operating by pyrolysis, afterburning and calcination: determining the ventilation characteristics of the plant (gas flow rates and residence time) and the physico-chemical characteristics of the effluent (mass flow and granulometric range of particles, chemical composition of gases). Various methods of sampling and of analyzing the gases were adopted and a thermochemical model was produced. Its results are reasonably close to the experimental measurements. The emission consists of submicronic particles and porous layers are the best adapted cleaning system

  7. Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

    Science.gov (United States)

    Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

    2017-01-01

    This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

  8. Statistical factors to qualify the superconducting magnets for the SSC based on warm/cold correlations

    International Nuclear Information System (INIS)

    Kim, K.; Devred, A.; Coles, M.; Tompkins, J.

    1993-05-01

    All of the SSC production magnets will be measured at room temperature (warm), but only a fraction of these will be measured at liquid helium temperature (cold). The fractional information will then be analyzed to determine warm acceptance criteria for the field quality of the SSC magnets. Regarding predictors of the field quality based on partial information, there are several observations and studies based on the warm/cold correlation. A different facet of the acceptance test is production control, which interprets the warm/cold correlation to adjust the process parameters. For these applications, we are evaluating statistical techniques relying on asymptotic estimators of the systematic errors and random errors, and their respective confidence intervals. The estimators are useful to qualify the population magnets based on a subset of sample magnets. We present the status of our work, including: (i) a recapitulation of analytic formulas, (ii) a justification based on HERA magnet experience, and (iii) a practical interpretation of these estimators

  9. Thermal shock tests to qualify different tungsten grades as plasma facing material

    Science.gov (United States)

    Wirtz, M.; Linke, J.; Loewenhoff, Th; Pintsuk, G.; Uytdenhouwen, I.

    2016-02-01

    The electron beam device JUDITH 1 was used to establish a testing procedure for the qualification of tungsten as plasma facing material. Absorbed power densities of 0.19 and 0.38 GW m-2 for an edge localized mode-like pulse duration of 1 ms were chosen. Furthermore, base temperatures of room temperature, 400 °C and 1000 °C allow investigating the thermal shock performance in the brittle, ductile and high temperature regime. Finally, applying 100 pulses under all mentioned conditions helps qualifying the general damage behaviour while with 1000 pulses for the higher power density the influence of thermal fatigue is addressed. The investigated reference material is a tungsten product produced according to the ITER material specifications. The obtained results provide a general overview of the damage behaviour with quantified damage characteristics and thresholds. In particular, it is shown that the damage strongly depends on the microstructure and related thermo-mechanical properties.

  10. Qualifying tests for TRIAM-1M superconducting toroidal magnetic field coil

    Energy Technology Data Exchange (ETDEWEB)

    Nakanura, Yukio; Hiraki, Naoji; Nakamura, Kazuo; Tanaka, Masayoshi; Nagao, Akihiro; Kawasaki, Shoji; Itoh, Satoshi

    1984-09-01

    In the strong toroidal magnetic field experimental facility ''TRIAM-1M'' currently under construction, construction of the superconducting toroidal magnetic field coil and the following qualifying tests conducted on the full-scale superconducting toroidal magnetic field coil actually fabricated are described: (1) coil excitation test, (2) superconducting stability test, (3) external magnetic field application test, and (4) high-speed excitation test. On the basis of these test results, stability was evaluated of the superconducting coil being operated in the tokamak device. In normal tokamak operation, there occurs no normal conduction transition. At the time of plasma disruption, though this transition takes place in part of the coil, the superconducting state is immediately restored. By its electromagnetic force analysis, the superconducting coil is also stable in structure.

  11. Qualifying of Employees for Communica­tion of Knowledge - Internal Training and Training of Educators

    Directory of Open Access Journals (Sweden)

    Nevenka Bevk

    2001-12-01

    Full Text Available In the period of privatisation of NLB d.d. and accession and integration in the European Union, we here at NLB d.d. are more than ever before aware that we will only be able to retain our competitive advantage or even further increase it with a well qualified personnel. Above all, we see our key opportunity to reach this goal in training end educating internal educators, who will be capa­ ble of communicating the acquired knowledge to others, too, either directly at their job posts, via seminars, workshops or in any other form. Therefore we will pay much attention to continuous search for new internal educators as well as to further training and educating of the existing ones and we'll encourage gathering knowl edge in various new forms and methods.

  12. Data base EQDB - data base of the qualified equipment's for NPP

    International Nuclear Information System (INIS)

    Rovny, K.

    2009-01-01

    In the contribution, there is presented the project of the data base for qualified equipment's for nuclear power plants. The data base is operated by the 'Certification body which certified the products - the chosen equipment's for nuclear power plants', reg. No. P-028, at VUJE, Inc. Trnava. Data base will serve to the designers, the operators of the nuclear power plants and the workers from Nuclear regulatory authority of the Slovak Republic as a source of information about the state of concrete type equipment's qualification. In the first part of the contribution, there is information about the legislation and technical requirements for equipment's qualification, the way of demonstration and importance of the qualification for the operator. In the next part, there is presented the own structure of data base and the works with own data base regarding the examples of concrete equipment's. The data base will be accessible after the free registration on address WWW.EQDB.sk from 1.5.2009

  13. 32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

    Science.gov (United States)

    2010-07-01

    ... EDIS shall ensure that a qualified medical authority conducts or verifies a medical evaluation for use... to the questions posed in the original referral. The written report shall include: (i) Demographic... initial parental permission, EDIS must: (i) Obtain parental permission for the additional activities. (ii...

  14. Medical Applications

    CERN Document Server

    Biscari, C.

    2014-12-19

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  15. Medical Applications

    International Nuclear Information System (INIS)

    Biscari, C; Falbo, L

    2014-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field

  16. Medical emplotment

    DEFF Research Database (Denmark)

    Mønsted, Troels Sune

    ’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...

  17. Role and responsibilities of medical physicists in radiological protection of patients

    International Nuclear Information System (INIS)

    Niroomand-Rad, A.

    2001-01-01

    The paper provides a brief history of the International Organization for Medical Physics (IOMP), followed by some general comments on the radiological protection of patients. The importance of establishing scientific guidelines and professional standards is emphasized, as is the need to ensure the protection of patients undergoing radiation therapy. The responsibility of qualified medical physicists in the protection of patients in nuclear medicine and in diagnostic and interventional radiology is also discussed. (author)

  18. Predicting the STEM outcomes of academically qualified women: A longitudinal examination of social cognitive career theory

    Science.gov (United States)

    Wasson, Jillian Woodford

    There is a well-documented gender disparity in science, technology, engineering, and mathematics (STEM) fields, which has been the focus of research for several decades (i.e., Betz & Hackett, 1981; Ceci & Williams, 2009, 2010; Wang, Eccles, & Kenny, 2013). Questions as to why this is the case are not new; however, with the growing body of research, there seem to be more questions than answers. This study drew primarily from the vocational psychology literature, particularly Social Cognitive Career Theory, building on previous literature in this area by examining differences in career choices made over time by qualified women across different stages in the education-to-career pathway. The results of the present study indicate that among qualified women many of the SCCT personal and contextual variables are relevant to STEM career development. Moreover, findings from the present study support the hypothesis (Lent et al., 1994) that personal, environmental, and behavioral variables affect one another. An important aspect of the SCCT model is the acknowledgment that at any given point in time, certain variables will carry different weight (Lent et al., 1994). The current study provides further support for this and underscores the necessity of understanding and framing career development as a process, unfolding across several developmental stages. These findings, their generalizability, and implications for practice should be carefully considered in the context of several limitations that this sample was influenced by: limitations in reliability and selection of variables, lack of diversity within the sample, as well as the extraneous variables related to overall economic and political backdrop.

  19. Experiences in the management of technical competencies and suitability of qualified experts

    International Nuclear Information System (INIS)

    Smith, David M.

    2008-01-01

    The UK Defence Science and Technology Laboratory (Dstl) RPA Body was established to provide radiation protection advice to the UK Ministry of Defence and other UK Government organisations. It consists of around 20 individually certificated Qualified Experts (known as Radiation Protection Advisers (RPA) in the terminology of UK legislation) 15 health physicists (HP), and other support staff. The RPA Body operates to procedures that satisfy the requirements of the UK Heath and Safety Executive (HSE) (the primary regulator in the UK for radiation protection legislation) and as such is recognised by the HSE as an RPA Body. Individual RPAs, HPs and support staff are only appointed to the RPA Body when they are deemed suitable and can satisfy the various general and specific operational roles within the Body. The criteria and procedures for establishing suitability of a candidate to a role are described. In addition to the basic underpinning knowledge for RPAs (the equivalent of the 'qualified expert' defined in Article 1 of the Basic Safety Standards Directive 96/29/EURATOM, candidates for appointment to the RPA Body are required to demonstrate competence and suitability in specialist areas as determined by the business needs of Dstl RPA Body. The criteria and assessment processes are described. The technical management of the RPA Body is illustrated, stressing the importance of the selection and allocation of suitable individuals to specific tasks, using a competency matrix. Experience to date with the RPA Body processes has been very positive; the arrangements are sufficiently flexible such as to accommodate the changing legislative requirements and the business needs of the RPA Body. There are many additional benefits arising to Dstl and its customers as a result of operation as an RPA Body. (author)

  20. Smoking prevalence among qualified nurses in the Republic of Ireland and their role in smoking cessation.

    Science.gov (United States)

    O'Donovan, Geraldine

    2009-06-01

    Smoking is the leading preventable cause of premature mortality, killing approximately 6000 people in Ireland each year. On 29 March 2004, the Republic of Ireland became the first country in the world to ban smoking in all workplaces, including bars and restaurants. This study took place after the introduction of this smoking ban. An admission to hospital provides an opportunity to help people stop smoking. Nurses' role and wide availability puts them in a prime position to encourage people to quit smoking. To examine the smoking prevalence among qualified nurses at a large university teaching hospital in Cork Southern Ireland and their role in smoking cessation. This was a descriptive cross-sectional study using a calculated sample of 430 qualified nurses (with a 70% response rate). A structured questionnaire was used. It was found that 21% (n = 63) of nurses were smokers, 23% (n = 70) were ex-smokers and 56% (n = 167) were non-smokers. The highest prevalence of smokers was found in the age groups 20-25 years (28%, n = 17) and 26-30 years (34%, n = 21). Nurses working within psychiatric care (47.4%) and coronary care (33.3%) had the highest smoking prevalence among the nurses who smoked. The study found that there was a significant difference between the attitudes of smokers and non-smokers, 89% (n = 211) of non-smokers strongly agreed that cigarette smoke represents a major risk to health in comparison with only 65% (n = 41) of smokers. Only 14% (n = 43) of the nurses surveyed had received training in smoking cessation. Lack of time (74%) and lack of training (65%) were the two main reasons given by nurses for not giving smoking cessation advice to patients. Nurses' potential in preventive health care has been largely under-utilized. Lack of time and training are major factors inhibiting nurses' role in smoking cessation with their patients.