Health Service Areas (HSAs) are a compromise between the 3000 counties and the 50 states. An HSA may be thought of as an area that is relatively self-contained with respect to hospital care and may cross over state boundries.
Sun, Shufang; Hoyt, William T; Brockberg, Dustin; Lam, Jaime; Tiwari, Dhriti
Psychological services are culturally encapsulated for dominant cultural groups, and racial minorities underutilize treatment even though they suffer from more severe psychological distress. Sociocultural factors such as acculturation (one's adaptation into mainstream group) and enculturation (one's adherence to culture of heritage) are hypothesized to affect minorities' attitudes toward seeking psychological services. This meta-analysis examined 3 methods to assess acculturation/enculturation-unidimensional acculturation, bidimensional acculturation, and bidimensional enculturation as predictors of help-seeking attitudes (HSAs)-both positive and negative attitudes-among racial and ethnic minorities in 207 samples drawn from 111 research reports. The omnibus correlations between acculturation/enculturation variables and HSAs were quite small, but in the predicted direction. Moderator analyses suggested a more nuanced understanding of the association between bidimensional enculturation and positive HSAs: This association was significant (r = -.14 95% CI[-.18, -.09]) for Asians and Asian Americans, but very close to zero and nonsignificant for other racial minority groups (African Americans, Latino Americans, and others). In addition, the domain of acculturation/enculturation assessed was predictive of effect size, with enculturation measures containing a higher proportion of cognitive items (e.g., items that assess cultural values and beliefs) showing stronger (more negative) associations with positive HSAs. Post hoc analyses indicated that certain Asian cultural values, including emotional self-control, conformity to social norms, and collectivism, showed especially high negative associations with positive HSAs. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
California Natural Resource Agency — Federal Water Contract Service Area boundaries are incorporated boundaries of districts having contracts with the U.S. Bureau of Reclamation (Reclamation), within...
NSGIC Education | GIS Inventory — Boundaries of current public water supplier's (PWS) service areas. This data set contains the present service area boundary of the water system and does not contain...
U.S. Department of Health & Human Services — This file is derived from the calendar year inpatient claims data. The records contain number of discharges, length of stay, and total charges summarized by provider...
NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...
NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...
... company to be other than such company's study area, the Commission will consider that proposed definition... definition of a service area served by a rural telephone company. (2) The Commission shall issue a Public... to consider a definition of a service area served by a rural telephone company that is different from...
Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.Assessment......Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.......Assessment of development potential for individual localities using a place-based approach is in line with EU policies for rural development thereby setting a competitive framework for local development. This paper addresses place bound approaches in relation to service adjustment and discusses how local resources...... and place bound potentials are identified and how they are addressed in plans for future development. The paper draws on a study on service adjustments in rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are decided, how they are managed by rural communities...
U.S. Environmental Protection Agency — This web service contains the following layers: Mandatory Class 1 Federal Area polygons and Mandatory Class 1 Federal Area labels in the United States. The polygon...
Silva, Islane C.S.; Silva, Iasmim M.S.; Júnior, Cláudio L.R.; Silva, Isvânia S.; Gonzalez, Kethyllém M.; Melo, Francisca A.; Lima, Fernando R.A.
The measurement of the exposure rate of the sectors of a nuclear medicine service (NMS), with the purpose of establishing safety to the service workers and the public, classifying the areas according to the monitoring is presented. Following the studies on the classifications of the areas of a Nuclear Medicine service provided by the category regulatory standard, 3.05 CNEN-NN, measures were taken in all sectors of the NMS in order to classify the areas in: Free, controlled and supervised according to with the exposure level. As a measurement instrument, a Geiger-Muller counter of the digital type was used. The results obtained show a correlation with the Brazilian norm satisfactorily, referring to the exposure rate of the studied SMN sectors
The creation in ENSA of the new Business Development Management is meant to leverage ENSA's activities by taking advantage of the previous experience gained by the services area to have a much more active presence than before in both the national and international market for goods and services of the nuclear industry. The Management's activities go beyond the traditional, mature activity of large nuclear components manufacturing developed in ENSA since it was founded. This article details the activities of this new Management and its future projection. (Author)
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas. (b...
Crane, M.; Mackenzie, R.; Millsom, D.; Zelazny, M.
The Area Message Service (AMS) is a TCP/IP based messaging service currently in use at SLAC. A number of projects under development here at SLAC require and application level interface to the 4.3BSD UNIX socket level communications functions using TCP/IP over ethernet. AMS provides connection management, solicited message transfer, unsolicited message transfer, and asynchronous notification of pending messages. AMS is written completely in ANSI 'C' and is currently portable over three hardware/operating system/network manager platforms, VAX/VMS/Multinet, PC/MS-DOS/Pathworks, VME 68K/pSOS/pNA. The basic architecture is a client-server connection where either end of the interface may be the server. This allows for connections and data flow to be initiated from either end of the interface. Included in the paper are details concerning the connection management, the handling of the multi-platform code, and the implementation process
Crane, M.; Mackenzie, R.; Millsom, D.; Zelazny, M.
The Area Message Service (AMS) is a TCP/IP based messaging service currently in use at SLAC. A number of projects under development here at SLAC require an application level interface to the 4.3BSD UNIX socket level communications functions using TCP/IP over ethernet. AMS provides connection management, solicited message transfer, unsolicited message transfer, and asynchronous notification of pending messages. AMS is written completely in ANSI open-quote C close-quote and is currently portable over three hardware/operating system/network manager platforms, VAX/VMS/Multinet, PC/MS-DOS/Pathworks, VME 68K/pSOS/pNA. The basic architecture is a client-server connection where either end of the interface may be the server. This allows for connections and data flow to be initiated from either end of the interface. Included in the paper are details concerning the connection management, the handling of the multi-platform code, and the implementation process
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service delivery areas. 628.405 Section 628... TITLE II OF THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.405 Service delivery... evaluate the degree to which a proposed service delivery area meets criteria established by the Governor...
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Area of service. 130.310 Section 130.310 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS DEVELOPMENT CENTERS § 130.310 Area of service. The AA/SBDC shall designate in writing the Area of Service of each...
..., maintenance, debt service, and reserve requirements. Such guarantees from developers will meet the... 7 Agriculture 12 2010-01-01 2010-01-01 false Service area requirements. 1780.11 Section 1780.11... AGRICULTURE (CONTINUED) WATER AND WASTE LOANS AND GRANTS General Policies and Requirements § 1780.11 Service...
.... Except for incumbent BRS licenses, BRS service areas are Basic Trading Areas (BTAs) or additional service... in places where Rand McNally has not defined BTAs: American Samoa; Guam; Gulf of Mexico Zone A; Gulf of Mexico Zone B; Gulf of Mexico Zone C; Northern Mariana Islands; Mayaguez/Aguadilla-Ponce, Puerto...
Full Text Available Intensification of public transport in urban areas due to increased mobility at regional and national levels, discrepancies among urban areas with same population and lack of statistical data related to performance and quality of public transport services are the main determinants of this paper. A separation line must be drawn between quality of services and performance indicators of public transport system. Service quality is a multi subjective outcome of an array of intangible variables. Service quality can be approached from four directions: consumer, vehicle performance (including the human operator, specialized company in passenger transport, and the Government (local Councils. Availability, comfort and convenience are the two main indicators that must be evaluated by citizens as being with high grades for a good quality of urban transport services. The instrument used to gather data is the preference survey.
... Cellular Geographic Service Area (CGSA) of a cellular system is the geographic area considered by the FCC... application for modification of the CGSA using FCC Form 601, a depiction of what the carrier believes the CGSA... location and the locus of points where the predicted or measured median field strength finally drops to 32...
Full Text Available As practice shows us, at the present time ecosystem services are recognized by humanity, but unfortunately are undervalued compared to their full potential. Most of planet's ecosystems are degradated by anthropic activity of humankind. It is almost impossible to say that there are no areas affected by human activity, however, the Protected Areas are a good opportunity, so the assessing of ecosystem services in Protected Areas can be a solution to the problem of economic growth. At present, there are few consistent informations on economic value of ecosystem services in Romania, on the basis of which can be adopted some sustainable financing policies of activities in Protected Areas. The premise from which we start is that a proper management of natural capital will allow biodiversity conservation and human well-being if it find appropriate economic instruments. For this reason, studies of economic research on the contribution of those ecosystem services to the communities welfare may constitute credible means for decision-makers, demonstrating the Protected Areas importance. This paper, based on the study of international and national literature, examines the state of knowledge on the economic and environmental valences of ecosystem services. The growing interest of researchers regarding the economic valuation of ecosystem services related to Protected Areas is visible through the many studies carried out at international level. Although national scientific research relating to ecosystem services is at the beginning, concerns researchers economists and ecologists have been directed toward this recess, of ecosystem services. The reason for we should assign an economic value to ecosystem services is to ensure that their value is included actively in decision-making and is not ignored because "is still available". Briefly, the paper start with an overview of the main definition of ecosystem services. From the point of economic value view, the paper
Pilelienė, Lina; Grigaliūnaitė, Viktorija
In tough competitive conditions of Lithuanian mobile services market, customer satisfaction becomes one of the most important factors for customer retention and attraction. Lithuanian mobile market can be described as being in a maturity stage of its life-cycle: the prices and services of different mobile operators are quite similar. However, the network coverage and signal strength differs – main differences can be observed in rural areas of the country. Therefore, the scientific...
Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A
Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.
... cellular market or in the Gulf of Mexico Coastal Zone (GMCZ), to allow one or more SAB extensions into the... of the cellular market boundary, but within the service area as calculated using the methods of § 22... section, SABs may be extended into adjacent cellular markets if such extensions are de minimis, are...
T. Elmqvist; H. Setala; S.N. Handel; S. van der Ploeg; J. Aronson; J.N. Blignaut; E. Gomez-Baggethun; D.J. Nowak; J. Kronenberg; R. de Groot
Cities are a key nexus of the relationship between people and nature and are huge centers of demand for ecosystem services and also generate extremely large environmental impacts. Current projections of rapid expansion of urban areas present fundamental challenges and also opportunities to design more livable, healthy and resilient cities (e.g. adaptation to climate...
Qin, Xiaochun; Shen, Yi; Shao, Shegang
A lot of research works have been made concerning highway service area or solar technology and acquired great achievements. However, unfortunately, few works have been made combining the two topics together of highway service areas and solar energy saving to make a systemic research on solar technology application for highway service area. In this paper, taking West Lushan highway low-carbon service area in Jiangxi Province of China as the case study, the advantages, technical principles, and...
Full Text Available In January 2001, approximately 23 x 106 ha of land in the U.S. National Forest System were slated to remain roadless and protected from timber extraction under the Final Roadless Conservation Rule. We examined the potential contributions of these areas to the conservation of biodiversity. Using GIS, we analyzed the concordance of inventoried roadless areas (IRAs with ecoregion-scale biological importance and endangered and imperiled species distributions on a scale of 1:24,000. We found that more than 25% of IRAs are located in globally or regionally outstanding ecoregions and that 77% of inventoried roadless areas have the potential to conserve threatened, endangered, or imperiled species. IRAs would increase the conservation reserve network containing these species by 156%. We further illustrate the conservation potential of IRAs by highlighting their contribution to the conservation of the grizzly bear (Ursos arctos, a wide-ranging carnivore. The area created by the addition of IRAs to the existing system of conservation reserves shows a strong concordance with grizzly bear recovery zones and habitat range. Based on these findings, we conclude that IRAs belonging to the U.S. Forest Service are one of the most important biotic areas in the nation, and that their status as roadless areas could have lasting and far-reaching effects for biodiversity conservation.
Pereira, Paulo; Depellegrin, Daniel; Misiune, Ieva; Cerda, Artemi
Maps are fundamental to understand the spatial pattern of natural and human impacts on the landscape (Brevik et al., 2016; Lavado Contador et al., 2009; Pereira et al., 2010a,b). Urban areas are subjected to an intense human pressure (Beniston et al., 2015), contributing to the degradation of the ecosystems, reducing their capacity to provide services in quality and quantity (Requier-Desjardins et al., 2011; Zhang et al., 2011). Environments that can provide a high number and quality of ecosystem services (ES) must be identified and managed correctly, since are spaces that can mitigate the impacts of human settlements and improve their quality. thus is of major importance have identify the areas that can provide better ES (Deppelegrin and Pereira, 2015). The aim of this work is to identify areas with high ES potential in Vilnius city. Here, we identified a total of 4 different land uses, agricultural areas (32.48%), water bodies (1.46%), forest and semi-natural (31.91%) areas and artificial surfaces (34.16%). CORINE land cover 2006 was used as base information to classify ES potential. The assessment of each land cover potential was carried out using expert assessment. Each land use type was ranked from 0 (no potential) to 5 (High potential). In this work the sum of total regulating, providing and cultural ES were assessed. The areas with optimal ES were the ones with the sum of all ranks equal or higher than the 3rd Quartil of each distribution. After identifying these areas, data was mapped using ArcGIS software. The results showed that on average Vilnius city has a higher potential for regulating services (20.35±15.92), followed by cultural (14.43±8.81) and providing (14.26±8.87). There was a significant correlation among the different type of services. Regulating vs cultural (0.92, p<0.001), regulating vs providing (0.72, p<0.001) and providing vs cultural (0.65, p<0.001). The results of Morans I autocorrelation index showed that regulating (Z-score: 10
Full Text Available This paper deals with wastewater treatment systems placed in motorway service areas (MSAs. In the years 2008-2009 eight of such facilities installed on the stretch of the A2 motorway between Poznań and Nowy Tomyśl were examined and analyzed. The system consists of a septic tank, a submerged aerated biofilter and an outflow filter. The volume of traffic on the highway was analyzed, the amount of water use was measured and peak factors were calculated. On this basis it was concluded that the inflows to the wastewater treatment systems in many cases exceeded the nominal design values.
Gao, Jianping; Pan, Junkui; Hu, Ning; Xie, Chengzuo
Bioretention can be an effective measure for stormwater treatment. However, there is a lack of systematic analysis of the impact of bioretention design parameters on hydrologic performance. Herein, SWMM and RECARGA models were applied to generate the typical annual rainfall runoff and simulate the water balance of the bioretention system in an expressway service area. The purpose of the investigation was to identify key design parameters for the bioretention system and delineate the priorities in developing the design. Results showed that the average groundwater recharge ratios for bioretention basins with and without an underdrain were 58.29% and 92.27%, respectively, the average overflow ratios were 4.13% and 4.19%, the average evapotranspiration ratios were 4.48% and 4.47%, and the average outflow ratio for bioretention with an underdrain was 33.94%. The ratio of the bioretention area to drainage area, and the saturated infiltration rates of planting soil and native soil were the main factors influencing water balance, while the underdrain diameter and gravel layer depth exerted little effect. Based on the impact analysis, multivariate nonlinear regression models of runoff reduction rate for two types of bioretention basin were established, which both exhibited high determination coefficients and acceptable Nash-Sutcliffe coefficients.
West, R T; Howard, F H
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
Tayyab Ikram Shah
Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood
Full Text Available With the objective of choosing a practical and valid method to delimit health service areas of regional health service centres to build a regional basic health service network, we first drew lessons from traditional geographic methods of delimiting trade areas and then applied two methods to delimit health service areas, i.e. the proximal method and the gravity method. We verified the effectiveness of these methods by an index of similarity with the aid of real in-patient data. Calculation of the similarity indices shows that health service areas delimited by the proximal method has an 87.3% similarity to the real health service area, while the gravity method gives 88.6%. Our conclusion is that both methods are suitable for delimiting health service areas at regional health service centres, but find that the proximal method is more practicable in operational terms for delimiting health service areas in region health planning.
A health savings account (HSA) plan, when properly understood, can be a great tool for managing health care costs for employers. It also can be a great tool for employees who want to save for future medical costs. Unfortunately, most presentations and articles about HSA plans skip the details and there are many administrative and compliance complexities, as would be expected with any plan that involves a tax break. This article provides ten points human resource (HR) and benefit professionals should know when considering whether to add an HSA plan. In this collective learning curve, the more accurately employers address questions, the happier their employees will be with their new plans.
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cellular rural service area licenses subject to... Procedures § 22.228 Cellular rural service area licenses subject to competitive bidding. Mutually exclusive initial applications for Cellular Rural Service Area licenses are subject to competitive bidding. The...
Full Text Available A lot of research works have been made concerning highway service area or solar technology and acquired great achievements. However, unfortunately, few works have been made combining the two topics together of highway service areas and solar energy saving to make a systemic research on solar technology application for highway service area. In this paper, taking West Lushan highway low-carbon service area in Jiangxi Province of China as the case study, the advantages, technical principles, and application methods of solar energy technology for highway service area including solar photoelectric technology and solar water heating technology were discussed based on the analysis of characteristics of highway low-carbon service area; the system types, operation mode, and installing tilt angle of the two kinds of solar systems suitable for highway service areas were confirmed. It was proved that the reduction of the cost by electricity savings of solar system was huge. Taking the investment of the solar systems into account, the payback period of solar photoelectric systems and solar water heating systems was calculated. The economic effect of the solar systems in West Lushan highway service area during the effective operation periods was also calculated and proved very considerable.
Lai, Jennifer C; Feng, Sandy; Vittinghoff, Eric; Roberts, John P
We previously reported that national liver distribution is highly concentrated in 6 US centers, and this raises the possibility of expedited placement. Therefore, we evaluated all national offers of nationally placed livers (n=1625) to adult wait-list candidates from February 2005 to January 2010. We developed a model to predict national utilization pathways; pathways exceeding the best-fit linear unbiased predictions by ≥3 standard errors were defined as preferred. All 51 donation service areas (DSAs) placed 1 or more livers nationally, but the percentage per DSA ranged from 1% to 36%. Of 2830 possible national DSA-center pathways, 87% were used. Five hundred eighty livers (36%) were accepted on the first national offer. Four DSAs accounted for 47% of first-national-offer livers, and 44% of these were accepted by a single center. In comparison with first-offer livers using nonpreferred pathways, first offers along a preferred pathway were offered to fewer status 1 candidates (19% versus 61%) and had lower median model for end-stage liver disease (MELD) scores (22 versus 36, Poffer to non-status 1 candidates with MELD scores less than their local transplant MELD scores. Although this practice may facilitate liver placement, it raises the possibility of expedience trumping patient need. Here we propose changes to the national liver distribution system that will help to balance equity, efficiency, and transparency. Copyright © 2013 American Association for the Study of Liver Diseases.
Full Text Available Under conditions of constantly growing competition, what is becoming a key problem is keeping the previously acquired clients. Their trust in the provider and regularly repeated purchases are an expression of the efficiency of marketing activities conducted by companies. What is becoming a measure of success is the satisfaction and loyalty of buyers. Companies spend a lot of money to attract clients and the competition keeps trying to take away their clients. A lost client means not just the loss of a future order – this is the loss of revenues equal to the value of all products which a particular buyer could purchase in his entire life. On top of that comes the cost of acquiring new client to replace the old one. TARP research shows that the cost of acquiring a new client is five times higher than the cost of pleasing an existing client (Kotler, 2006. In the publication the significance of the relations with the client are discussed with regard to efficient marketing strategy. Moreover, the results of client satisfaction surveys and market analysis taking into consideration the revenues from sale of services in the area of micronization are presented.
... 7 Agriculture 2 2010-01-01 2010-01-01 false Area Director, Marketing Services Office... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... Regulations Administration § 27.11 Area Director, Marketing Services Office; responsibility. Subject to this...
Egoh, Benis N; Reyers, Belinda; Rouget, Mathieu; Richardson, David M
Grasslands provide many ecosystem services required to support human well-being and are home to a diverse fauna and flora. Degradation of grasslands due to agriculture and other forms of land use threaten biodiversity and ecosystem services. Various efforts are underway around the world to stem these declines. The Grassland Programme in South Africa is one such initiative and is aimed at safeguarding both biodiversity and ecosystem services. As part of this developing programme, we identified spatial priority areas for ecosystem services, tested the effect of different target levels of ecosystem services used to identify priority areas, and evaluated whether biodiversity priority areas can be aligned with those for ecosystem services. We mapped five ecosystem services (below ground carbon storage, surface water supply, water flow regulation, soil accumulation and soil retention) and identified priority areas for individual ecosystem services and for all five services at the scale of quaternary catchments. Planning for individual ecosystem services showed that, depending on the ecosystem service of interest, between 4% and 13% of the grassland biome was required to conserve at least 40% of the soil and water services. Thirty-four percent of the biome was needed to conserve 40% of the carbon service in the grassland. Priority areas identified for five ecosystem services under three target levels (20%, 40%, 60% of the total amount) showed that between 17% and 56% of the grassland biome was needed to conserve these ecosystem services. There was moderate to high overlap between priority areas selected for ecosystem services and already-identified terrestrial and freshwater biodiversity priority areas. This level of overlap coupled with low irreplaceability values obtained when planning for individual ecosystem services makes it possible to combine biodiversity and ecosystem services in one plan using systematic conservation planning. Copyright © 2011 Elsevier Ltd. All
... LEGAL SERVICES CORPORATION Notice and Request for Comments: LSC merger of the migrant service... Services Corporation. ACTION: Notice and Request for Comments--LSC merger of the migrant service areas in... Alabama migrant service areas. Grants for these individual service areas have been awarded to Texas Rio...
U.S. Department of Health & Human Services — The following data is being made available to applicants to the Medicare Shared Savings Program (Shared Savings Program), in order to allow them to calculate their...
...-1121. If comments are sent by electronic means, please do not send duplicate comments via regular mail... Information Relay Service (FIRS) at 1-800-877-8339 between 8:00 a.m. and 8:00 p.m., Eastern Standard Time...
...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority...-wildfire threats to human safety, property and critical natural or cultural resources on National Forest... efforts to improve cost efficiencies. These cost issues affect the Forest Service BAER program since...
This report presents a series of observations of tourists' experiences with kiosks providing traveler information services at rural tourism areas. The kiosks were assessed in five areas: reliability visibility, usability, usefulness, and adaptability...
Verhagen, Willem; Kukkala, Aija S.; Moilanen, Atte; van Teeffelen, Astrid J.A.; Verburg, Peter H.
Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas
Young, S; Erdem, S A
It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.
A consolidated progress report for 1976 prepared for countries in the NDS service area. It is intended to encourage a closer relationship between Member States and provide for a wider circulation of unpublished progress reports from countries within the Nuclear Data Section service area
Fenwick, J.W.; Dowell, L.J.
The service areas for electric power substations can be estimated using a Cellular Automata (CA) model. The CA model is a discrete, iterative process whereby substations acquire service area by claiming neighboring cells. The service area expands from a substation until a neighboring substation service area is met or the substation`s total capacity or other constraints are reached. The CA-model output is dependent on the rule set that defines cell interactions. The rule set is based on a hierarchy of quantitative metrics that represent real-world factors such as land use and population density. Together, the metrics determine the rate of cell acquisition and the upper bound for service area size. Assessing the CA-model accuracy requires comparisons to actual service areas. These actual service areas can be extracted from distribution maps. Quantitative assessment of the CA-model accuracy can be accomplished by a number of methods. Some are as simple as finding the percentage of cells predicted correctly, while others assess a penalty based on the distance from an incorrectly predicted cell to its correct service area. This is an initial report of a work in progress.
In fragile states context of climate change vulnerability, poverty and lack of infrastructure, the ability of ecosystem services to provide for numerous human needs is indispensable. The focus of this paper is describing the prospects for ecosystem services provision in fragile states’ urban areas. This paper presents a distinct approach by analyzing actors with capacity to provide ecosystem services in urban areas: government, international partners and citizens. Using infrastructure investm...
Sites in the Gulf States Utilities service are considered for cogeneration feasibility studies. The sources of steam considered for the Orange, Texas and Geismar, Lake Charles, and North Baton Rouge, Louisiana sites include oil, coal, HTGR steamers, consolidated nuclear steam system, atmospheric fluidized-bed coal combustion, and coal gasification. Concepts concerning cogeneration fuel systems were categorized by technical applicability as: current technology (pulverized coal-fired boilers and fuel oil-fired boilers), advanced technology under development (HTGR steamers and the CNSS), and advanced technology for future development (atmospheric fluidized-bed boilers and coal gasification). In addition to providing data on cogeneration plant generally useful in the US, the study determined the technical and economic feasibility of steam and electric power cogeneration using coal and nuclear fuels for localized industrial complexes. Details on site selection, plant descriptions, cost estimates, economic analysis, and plant schedule and implementation. (MCW)
Hummel, C.; Provenzale, A.; Van der Meer, J.; Wijnhoven, S.; Nolte, A.; Poursanidis, D.; Janss, G.; Jurek, M.; Andresen, M.; Poulin, B.; Kobler, J.; Beierkuhnlein, C.; Honrado, J.; Razinkovas, A.; Stritih, A.; Bargmann, T.; Ziemba, A.; Bonet-García, F.; Adamescu, M.C.; Janssen, G.; Hummel, H.
Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers,
Full Text Available Green areas in cities and their ecosystem services (ES offer residents various benefits. The range of services depends on biodiversity of a green space. The aim was to determine the relationship between biodiversity in different categories of green areas in the city and the ecosystem services, which appear in it. We made 108 relevés in the autumn and spring time, within nine categories of green areas in the Municipality of Ljubljana. In each category the range of ES was assessed based on field analysis and compared with literature assessed ecosystem services. Results showed that the category of forests differ from others. Other categories were similar to each other, in particular grassland categories. Also, a positive relationship linkage was found - more plant species mean more assessed ecosystem services in a specific green infrastructure category.
Noel Torres Júnior
Full Text Available As in many developing countries, the service sector in Brazil is responsible for generating income and employment for a significant portion of the population. Due to this economic relevance, service organizations are faced with an increasingly demanding and competitive market. This demand greater innovation and business planning. Despite this, the process of service development remains a relatively unexplored subject in the literature. Several issues regarding the planning and management remain without clear ideas or propositions that guide their appropriate treatment. The result of this situation, the methods and techniques that help design the services are not properly disseminated. These are scattered through the literature of operations management services. Given this framework, the light of a review of the literature and concerning the elements that compose the service project according to the works of Machuca, Zamora-Gonzalez and Aguilar-Escobar (2007 and Edvardsson (1997, the present work points and examine the methods and techniques suggested by many authors and works on the area of Service Operations. It was found that the knowledge about the methods and techniques is diffuse. This knowledge is concentrated on the design process and determining the location of services.
Apr 20, 1991 ... ledge of health and other services by black elderly persons in two townships in the Cape ... people live) and open areas were not included in the sampling plan. .... Khayelitsha are generally less well iriformed on these matters.
This document presents documentation regarding tourist intercept surveys for traveler information services in rural areas. It documents data collection functions and information dissemination functions, and provides an interpretive description of tra...
This document presents information regarding data collection and dissemination functions for traveler information services in rural areas. It documents data collection functions and information dissemination functions, and provides an interpretive de...
This report documents results from surveys which were conducted for qualitatively assessing the use of traveler information services in rural areas. The focus of the surveys was to identify those factors which influence travel planning and thus impro...
Tereshchenko, Iu A; Zakharinskaia, O N
The authors present organizational and functional structure of occupational therapeutic service in Krasnoyarsk area, major functional divisions of the territorial occupational therapeutic center and their activities. The article covers analysis of changes in levels and structure of occupational morbidity, defines main ways to optimize occupational therapeutic service for the territorial workers.
Electric Service Areas, Electric Servic Area - given to us from GA power and Planters Electric - distributed by the EMA Director, Val Ashcraft, Published in 2008, 1:2400 (1in=200ft) scale, Effingham County Government.
NSGIC Local Govt | GIS Inventory — Electric Service Areas dataset current as of 2008. Electric Servic Area - given to us from GA power and Planters Electric - distributed by the EMA Director, Val...
Gabriela Teixeira Duarte
Full Text Available Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services-carbon stock and sediment retention-and a biodiversity proxy-habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention
Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira
Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services-carbon stock and sediment retention-and a biodiversity proxy-habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution.
Durán, América P.; Casalegno, Stefano; Marquet, Pablo A.; Gaston, Kevin J.
Protected areas are increasingly considered to play a key role in the global maintenance of ecosystem processes and the ecosystem services they provide. It is thus vital to assess the extent to which existing protected area systems represent those services. Here, for the first time, we document the effectiveness of the current Chilean protected area system and its planned extensions in representing both ecosystem services (plant productivity, carbon storage and agricultural production) and biodiversity. Additionally, we evaluate the effectiveness of protected areas based on their respective management objectives. Our results show that existing protected areas in Chile do not contain an unusually high proportion of carbon storage (14.9%), agricultural production (0.2%) or biodiversity (11.8%), and also represent a low level of plant productivity (Normalized Difference Vegetation Index of 0.38). Proposed additional priority sites enhance the representation of ecosystem services and biodiversity, but not sufficiently to attain levels of representation higher than would be expected for their area of coverage. Moreover, when the species groups were assessed separately, amphibians was the only one well represented. Suggested priority sites for biodiversity conservation, without formal protection yet, was the only protected area category that over-represents carbon storage, agricultural production and biodiversity. The low representation of ecosystem services and species’ distribution ranges by the current protected area system is because these protected areas are heavily biased toward southern Chile, and contain large extents of ice and bare rock. The designation and management of proposed priority sites needs to be addressed in order to increase the representation of ecosystem services within the Chilean protected area system. PMID:24376559
Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
Nana SHI; Jinyan ZHAN; Feng WU; Jifu DU
According to the ecosystem assessment framework developed by the Millennium Ecosystem Assessment (MA), this paper designs an evaluation system of ecosystem services in Poyang Lake area. On the basis of relevant variables disaggregated to 1 km grid using the gridded 1 km, this paper employs factor analysis to extract a number of factors which characterize the ecosystem services of Poyang Lake area. The extracted principal component are then represented onto 1 km ×1 km grids by spatial clustering analysis to recognize and identify the minimal but consistent mapping units for ecosystem services which can be used to delimit the boundaries of ecological service zones. The research identifies ten ecosystem service zones in Poyang Lake area according to the consistent principle of core ecosystem service unit.Four kinds of core ecosystem services including supporting function, provisioning function, regulating function and cultural function are identified and represented. The research results could provide both spatially and temporally valuable decision-making information for sustainable ecosystem management in the targeted area.
Percy, Andrew; Carr-Hill, Roy; Dixon, Paul; Jamison, James Q.
Describes study of administrative data from Northern Ireland on the costs of family and child care services, using small area utilization modeling, to derive a new set of needs indicators that could be used within the family and child care capitation funding formula. Argues that small area utilization modeling produces a fairer and more equitable…
BARNES, JOHN O., JR.
THE NEED FOR AN ADULT EDUCATION PROGRAM IN THE MARSHALL COUNTY (TENNESSEE) HIGH SCHOOL SERVICE AREA WAS STUDIED THROUGH QUESTIONNAIRES COMPLETED BY 207 ADULTS, EXAMINATION OF SCHOOL AND GOVERNMENT RECORDS, AND PERSONAL INTERVIEWS. IT WAS FOUND THAT OVER HALF OF THE AREA RESIDENTS WERE NOT HIGH SCHOOL GRADUATES, AND THAT MANY ADULTS DESIRED MORE…
... Traffic Service Routes; Windsor Locks Area; CT AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... coordinate for one point in the description of area navigation (RNAV) route T-300. DATES: Effective date 0901... action under 1 CFR part 51, subject to the annual revision of FAA Order 7400.9 and publication of...
... DEPARTMENT OF ENERGY Western Area Power Administration Desert Southwest Customer Service Region... CONTACT: Mr. Jack Murray, Rates Manager, Desert Southwest Customer Service Region, Western Area Power... Customer Service Region Network Integration Transmission Service Rate Schedules PD-NTS3 and INT-NTS3 for P...
... Migrant Service Area Beginning January 1, 2012 AGENCY: Legal Services Corporation. ACTION: Notice and Request for Comments. SUMMARY: The Legal Services Corporation will eliminate the West Virginia migrant service area, i.e., MWV effective January 1, 2012, because any eligible migrant population in West...
Full Text Available Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.
Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman
Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas. PMID:29140983
Hummel, Christiaan; Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman
Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.
El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E
Background Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of these areas. What does this paper add? The present study demonstrates that a substantial proportion of people living with CLD and
Goldstein, Joshua Howard; Tallis, Heather; Cole, Aaron; Schill, Steven; Martin, Erik; Heiner, Michael; Paiz, Marie-Claire; Aldous, Allison; Apse, Colin; Nickel, Barry
Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of "green" economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces), leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES) are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country's extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds) total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate potential conflicts
Joshua Howard Goldstein
Full Text Available Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of "green" economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces, leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country's extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate
Levis, C. A.; Wang, C.-W.; Yamamura, Y.; Reilly, C. H.; Gonsalvez, D. J.
An implicit relationship is derived which relates the topocentric separation of two satellites required for a given level of single-entry protection to the separation and orientation of their service areas. The results are presented explicitly for circular beams and topocentric angles. A computational approach is given for elliptical beams and for use with longitude and latitude variables. It is found that the geocentric separation depends primarily on the service area separation, secondarily on a parameter which characterizes the electrical design, and only slightly on the mean orbital position of the satellites. Both linear programming and mixed integer programming algorithms are implemented. Possible objective function choices are discussed, and explicit formulations are presented for the choice of the sum of the absolute deviations of the orbital locations from some prescribed 'ideal' location set. A test problem involving six service areas is examined with results that are encouraging with respect to applying the linear programming procedure to larger scenarios.
Sautkin, I. S.; Rogova, T. V.
The article is devoted to the identification and analysis of cultural ecosystem services of recreational areas from the different forest plant functional groups in the suburbs of Kazan. The study explored two cultural ecosystem services supplied by forest plants by linking these services to different plant functional traits. Information on the functional traits of 76 plants occurring in the forest ecosystems of the investigated area was collected from reference books on the biological characteristics of plant species. Analysis of these species and traits with the Ward clustering method yielded four functional groups with different potentials for delivering ecosystem services. The results show that the contribution of species diversity to services can be characterized through the functional traits of plants. This proves that there is a stable relationship between biodiversity and the quality and quantity of ecosystem services. The proposed method can be extended to other types of services (regulating and supporting). The analysis can be used in the socio-economic assessment of natural ecosystems for recreation and other uses.
Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan
There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.
Scolozzi, Rocco; Schirpke, Uta; Morri, Elisa; D'Amato, Dalia; Santolini, Riccardo
An ecosystem services-based SWOT analysis is proposed in order to identify and quantify internal and external factors supporting or threatening the conservation effectiveness of protected areas. The proposed approach concerns both the ecological and the social perspective. Strengths and weaknesses, opportunities and threats were evaluated based on 12 selected environmental and socio-economic indicators for all terrestrial Italian protected areas, belonging to the Natura 2000 network, and for their 5-km buffer area. The indicators, used as criteria within a multi-criteria assessment, include: core area, cost-distance between protected areas, changes in ecosystem services values, intensification of land use, and urbanization. The results were aggregated for three biogeographical regions, Alpine, Continental, and Mediterranean, indicating that Alpine sites have more opportunities and strengths than Continental and Mediterranean sites. The results call attention to where connectivity and land-use changes may have stronger influence on protected areas, in particular, whereas urbanization or intensification of agriculture may hamper conservation goals of protected areas. The proposed SWOT analysis provides helpful information for a multiple scale perspective and for identifying conservation priorities and for defining management strategies to assure biodiversity conservation and ecosystem services provision. Copyright © 2014 Elsevier Ltd. All rights reserved.
Li, Cui-ling; Zhao, Kai; Li, Hui; Farah, Omar Ibrahim; Wang, Jiao-jiao; Sun, Rong-ze; Zhang, Hui-ping
This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM) and Toxoplasma gondii (IgM), respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of birth defect or other adverse pregnancy outcomes should be
Full Text Available OBJECTIVE: This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. METHODS: Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. RESULTS: A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM and Toxoplasma gondii (IgM, respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. CONCLUSION: Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of
Goerler, W; Benz, A [Technische Werke der Stadt Stuttgart A.G. (F.R. Germany)
In congested areas the line construction engineer has to cope with a great variety of difficulties - amenity problems, line crossings, and road crossings. The authors describe the prerequisites for and the construction of a HV shared-service line of approx. 25 km in the congested area of Stuttgart, where several three-phase and single- phase a.c. systems are run on one set of pylons.
Daněk, Jan; Vačkář, David; Lorencová, Eliška
Roč. 10, 1-2 (2017), s. 99-112 ISSN 1803-2451 R&D Projects: GA MŠk(CZ) LO1415 Institutional support: RVO:67179843 Keywords : ecosystem services * economic valuation * Protected Landscape Areas * forest ecosystems Subject RIV: EH - Ecology, Behaviour OBOR OECD: Environmental sciences (social aspects to be 5.7)
Wang, Lijun; Li, Bin; Qian, Jianguo; Cao, Shaoping; He, Dehua; Zheng, Yunxin
In 2011, Shanghai Medical Equipment Management Quality Control Center launched the fifth after-sale service satisfaction survey for medical devices in Shanghai area. There are 8 classes medical devices involving in the survey. This paper demonstrates the investigation results of monitoring devices which are from different manufacturers.
Jun 2, 2014 ... related problem, being consumer-oriented with diverse dimensions ... The order of importance of the factors is need, enabling, predisposing and health services. 11 variables .... influence utilization behavior, they have the advantage of reminding .... area and also from the researcher's personal knowledge.
Estuaries provide multiple ecosystem services from which humans benefit. Currently, thirty-six Great Lakes estuaries in the United States and Canada are designated as Areas of Concern (AOCs) due to a legacy of chemical contamination, degraded habitat, and non-point-source polluti...
Foko, Thato E
Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...
Cattapan, Paolo; Passarelli, Mariacarmela; Petrone, Michele
This paper contributes to the literature on innovation brokerage by analysing the effects of brokerage activities on the innovation and growth of small and medium-sized enterprises (SMEs). The authors provide a detailed description of the Technology Transfer Service (TTS), credited as a European best-practice innovation broker, at Area Science…
This article presents the findings of a study that was undertaken in Kampala City, Uganda, in nine libraries belonging to the private sector, government, academic and diplomatic- related institutions. The aim of the study was to establish trends in marketing library services in urban areas with a view to identify marketing ...
Kawulok, M.; Sulimowski, Z.
Due to ground deformations caused by underground mining, building structures in mining areas are frequently subjected to considerable deformations and damage to the finishing and structural elements. As a consequence, serviceable values of such structures are distinctly diminished, and in extreme cases, seriously damaged structures may be exempted from further service. These problems are not duly represented in the existing building standard codes. It is also important to determine relationship between damage stage and value of the building, and hence the strategy for reconstruction or renovation works. The paper presents proposals concerning serviceability criteria of building structures in mining areas, in terms of basic standard requirements valid in building in Poland, as well as proposals of Eurocodes. Building structures under consideration have been divided into structures designed to resist mining influences and existing structures, not adapted to conform to these influences at the design and erection stages
Full Text Available Background - The ICDS is world’s largest community-based child nutrition and development programme aimed at holistic development of children (0-6 years, expectant and nursing mothers through the Anganwadi centers (AWC. Improvement in nutritional and health status of their beneficiaries to prevent morbidities and mortalities due to malnutrition is one of the important objectives of ICDS. Objectives: To determine the availability and extent of utilization of AWC services by the beneficiaries, and to study factors influencing utilization and reasons for non/under utilization. Methodology: A community based cross-sectional study conducted in three well defined adopted urban field practice areas of a rural tertiary health care facility in Wardha, Maharashtra. A cluster comprising of 40 households was identified in each area to provide 140 study participants. Epi-info-3.7.1 for univariate and SYSTAT-12 used for multivariate analysis. Results: Overall 89.29% of beneficiaries utilized one or more services of AWC. Working women and those with lower socio-economic status had significantly and independently lower/non utilization of AWC services. Conclusions: Most of the study participants were aware and utilized the services of AWC. Among the women not utilizing the services; the reasons for non-utilization need to be addressed for optimal utilization of AWCs.
Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F
The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.
Dyson, Kate; Kruger, Estie; Tennant, Marc
This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Full Text Available Protected areas around the world are increasingly being recognized for their potential to protect various ecosystem services in addition to biodiversity. We carried out an ecosystem services (ES assessment at the Rizoelia National Forest Park, a biodiversity hotspot in Cyprus. For ES assessment we used TESSA v.1.1 and an ES matrix-approach to map the capacity of habitat types in the area. According to TESSA the most important ES provided by the study area are aesthetic benefits, recreation/ tourism, biodiversity, global climate regulation, and environmental education. Total Carbon stock was estimated to 14247.327 tonnes and the total number of annual visits was 14471. There were no statistically significant differences in the number of visits among visitation periods but there were statistically significant differences among National Holidays, Weekends and Weekdays. We identified that plantations had the highest capacity for most groups of services particularly where their understory comprises semi-natural habitat types rich in biodiversity. This is the first study in Cyprus which provides a preliminary quantification of ES in a protected area context using widely employed tools. The paper discusses how these findings can help decision-makers to plan direct future restoration and management actions to the benefit of a wide range of stakeholders.
Full Text Available Abstract In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments; promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers; selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals; placement (programmes should match participants to areas in order to maximize participant satisfaction and
Bärnighausen, Till; Bloom, David E
In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes
According to the current IEEE 802.11 wireless LAN standards, IEEE 802.11 ad hoc networks have the limitation that all STAs (Stations) are in the one-hop transmission range of each other. In this paper, to alleviate the limitation of IEEE 802.11 ad hoc networks we propose the efficient method for selecting the most appropriate pseudo AP (Access Point) from among the set of ad hoc STAs and extending the service area of IEEE 802.11 ad hoc networks by the pseudo AP's relaying the internal traffic of IEEE 802.11 ad hoc networks. Numerical examples show that the proposed method significantly extends the service area of IEEE 802.11 ad hoc networks.
A wide-area service water system is required to be more resistant to emergency situations, e.g., drought and hazards, and meet consumers' diversifying needs in each area, while stably supplying water at ordinary times by utilizing purification plants located in places within its system and piping networks in the water area. Fuji Electric is providing information management systems for wide-area service water systems, developed based on the company's abundant system know-hows accumulated for a long time and latest techniques. They are characterized by (1) Web monitoring, aided by an intranet system, (2) high-speed data transmission by a digital transmission system, (3) open network environments, and (4) emergency calling of the staff, and management of stock materials. The system allows to monitor operating conditions within the area on real time, needless to say, and business administration with civil minimum taken into consideration, e.g., stabilizing water quality by coordinating the purification plants within the system. (translated by NEDO)
Full Text Available The article herein deals with a topic of current interest, not only because the latest economic and social phenomena within the context of globalized crisis in the world, but also from the perspective of the evolution and specific processes in the medical area in Romania. The writer accomplishes a journey into the various medical systems in national economies, by analyzing the features of each type of system and the opportunity for a ‘capitalist’ vision related to the healthcare services in general. The dental medical services share a series of characteristics that help them be better defined from the point of view of provider-customer relation. Thus, it becomes evident that, for Romania, the process initiated in 2006 meaning liberalization of practicing the dental doctor profession represents a natural way of developing the market specific to such services. From this perspective, this issue targets the mentalities level only – to impose quality standards on the market and to witness the offer-demand balance, both deriving from the specific nature itself of the dental services. The involvement of the authorities at Health Department into developing a health insurance policy in the dental field and the support of the private initiative in the underserved areas are the main targets of the ‘reform’.
Braekers, K.; Caris, A.; Janssens, G.K.
This paper deals with the operational planning of drayage operations in the service area of intermodal container terminals. Drayage operations refer to the full truckload container transpot activities that take place on a regional scale around these terminals. They involve the transport of loaded and empty containers between container terminals, container depots, consignees and shippers. Drayage operations are mostly performed by truck and constitute a large part of total costs of an intermo...
Dubois, Gregoire; Hartley, Andrew; Peedell, Stephen; de Jesus, Jorge; Ó Tuama, Éamonn; Cottam, Andrew; May, Ian; Fisher, Ian; Nativi, Stefano; Bertrand, Francis
The Digital Observatory for Protected Areas (DOPA) is a biodiversity information system currently developed as an interoperable web service at the Joint Research Centre of the European Commission in collaboration with other international organizations, including GBIF, UNEP-WCMC, Birdlife International and RSPB. DOPA is designed to assess the state and pressure of Protected Areas (PAs) and to prioritize them accordingly, in order to support decision making and fund allocation processes. To become an operational web service allowing the automatic monitoring of protected areas, DOPA needs to be able to capture the dynamics of spatio-temporal changes in habitats and anthropogenic pressure on PAs as well as the changes in the species distributions. Because some of the most valuable natural ecosystems and species on the planet cover large areas making field monitoring methods very difficult for a large scale assessment, the automatic collection and processing of remote sensing data are processes at the heart of the problem. To further be able to forecast changes due to climate change, DOPA has to rely on an architecture that enables it to communicate with the appropriate modeling web services. The purpose of this presentation is to present the architecture of the DOPA with special attention to e-Habitat, its web processing service designed for assessing the irreplaceability of habitats as well as for the modeling of habitats under different climate change scenarios. The use of open standards for spatial data and of open source programming languages for the development of the core functionalities of the system are expected to encourage the participation of the scientific community beyond the current partnerships and to favour the sharing of such an observatory which could be installed at any other location. Acknowledgement: Part of this work is funded under the 7th Framework Programme by the EuroGEOSS (www.eurogeoss.eu) project of the European Commission. The views
Full Text Available The objectives of this research were 1 to study the current and the expected Conditions of school management effectiveness, Buriram Office of Primary Educational Service Area 4 and 2 to construct administrative strategies of such schools. Eighty of directors, board chairpersons, teachers and parents were sampled. The instruments for data collection were 5-level rating scale questionnaires with the IOC value between 0.60–1.00 and the reliability value of 0.88 and in-depth interview forms. Quantitative data were analyzed by computer and qualitative data were inductively analyzed. The findings were as follows: 1. The current conditions school management effectiveness, Buriram Office of Primary Educational Service Area 4 was moderate while the expected conditions was high. By means of expected condition can be listed from high to low were atmosphere and environment management, administration, learning management and participation. 2. Strategies for effective management of schools under the Office of Educational Service Area 4 consists of four elementary Bachelor’s strategy is the first strategic development, management efficiency. 2 learners develop strategies to meet educational standards. Strategy 3: create an atmosphere and environment conducive to development. Strategy 4 and the joint cooperation of network.
Full Text Available High mountain areas are experiencing some of the earliest and greatest impacts of climate change. However, knowledge on how climate change impacts multiple ecosystem services that benefit different stakeholder groups remains scattered in the literature. This article presents a review of the literature on climate change impacts on ecosystem services benefiting local communities and tourists in high mountain areas. Results show a lack of studies focused on the global South, especially where there are tropical glaciers, which are likely to be the first to disappear. Climate change impacts can be classified as impacts on food and feed, water availability, natural hazards regulation, spirituality and cultural identity, aesthetics, and recreation. In turn, climate change impacts on infrastructure and accessibility also affect ecosystem services. Several of these impacts are a direct threat to the lives of mountain peoples, their livelihoods and their culture. Mountain tourism is experiencing abrupt changes too. The magnitude of impacts make it necessary to strengthen measures to adapt to climate change in high mountain areas.
Ethelwynn L. Stellenberg
Full Text Available Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured population in the Western Cape, South Africa. Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6% was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01, accessibility (p = < 0.01 and the use of health services was found to be significant using the Chi-square (χ² test. Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.
Stellenberg, Ethelwynn L
Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.
Verhagen, Willem; Kukkala, Aija S; Moilanen, Atte; van Teeffelen, Astrid J A; Verburg, Peter H
Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas of unique demand-supply connections (flow zones). We tested ways to account for ES demand and flow zones to identify priority areas in the European Union. We mapped the capacity and demand of a global (carbon sequestration), a regional (flood regulation), and 3 local ESs (air quality, pollination, and urban leisure). We used Zonation software to identify priority areas for ESs based on 6 tests: with and without accounting for ES demand and 4 tests that accounted for the effect of ES flow zone. There was only 37.1% overlap between the 25% of priority areas that encompassed the most ESs with and without accounting for ES demand. The level of ESs maintained in the priority areas increased from 23.2% to 57.9% after accounting for ES demand, especially for ESs with a small flow zone. Accounting for flow zone had a small effect on the location of priority areas and level of ESs maintained but resulted in fewer flow zones without ES maintained relative to ignoring flow zones. Accounting for demand and flow zones enhanced representation and distribution of ESs with local to regional flow zones without large trade-offs relative to the global ES. We found that ignoring ES demand led to the identification of priority areas in remote regions where benefits from ES capacity to society were small. Incorporating ESs in conservation planning should therefore always account for ES demand to identify an effective priority network for ESs. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.
Lakhani, Ali; McDonald, Donna; Zeeman, Heidi
Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research
Ronchi, Silvia; Salata, Stefano
Recently, in Italy, a legislative proposal has been set to reform the role and the functions of natural protected areas promoting their aggregation (or the abolition) pursuing a better efficiency for their administration and economic saving. The system of natural protected areas is composed of different conservation levels: there are the Natural parks, established in the ‘80 by national or regional institution for the safeguard of natural elements, the Natura 2000 -Habitat 92/43/CEE promoted by European Union, with conservation measures for maintaining or restoring habitats and species of Communitarian interest, and the local parks of supra-municipal interest (namely PLIS) created by single municipalities or their aggregation aimed at limiting the soil sealing process. The hierarchical level of protection has determined differences in the management of the areas which leads to various approaches and strategies for biodiversity conservation and integrity. In order to assess strengths and weaknesses of the legislative initiative, the new management framework should be designed, considering the ecosystem characteristics of each natural protected area to define the future opportunities and critics, rather than, in the extreme case, remove the level of protection due to the absence of valuable ecosystem conditions. The paper provides an operative support to better apply the legislative proposal investigating the dynamics that affect all protected areas using the land take process as a major threat to biodiversity conservation in natural zones. The land take process is explored using the Land Use Change analysis (LUCa) as a possible way to determine the impact and the environmental effects of land transitions. LUCa is also useful to determine the loss of protected zones capacity to support Ecosystem Services. Finally, the assessment of the Ecosystem Services Capacity (ESC) index expresses the ability of each LULC to provide ES and, in particular, the Ecological
Full Text Available Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001. In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022. The urban comprehensive score also exceeded that of the suburbs (P<0.001. In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this
Talpalariu, C.; Talpalariu, J.; Vaja, N.; Matei, C.
This system is intended for the protection of personnel working in those areas of the Reactor Building and Service Building where high gamma radiation fields are expected. A detector, sensitive to gamma radiation, is installed in each of the areas to be monitored. The detector will send a signal, proportional to the radiation level in the area, to a corresponding electronic module (Alarm Unit), where the signal will be amplified and checked against alarm set points for possible alarming conditions. In case the field exceeds the alarm set values, the Alarm Unit will produce a signal that will trigger the field alarms (Horn and Beacon) located in the area where the condition occurred. Each Alarm Unit will send a numerical input to central computer command. he system is required to accomplish the following tasks: - Monitors the level of gamma radiation in those areas of the Station where high radiation fields are expected; - Provides a continuous and centralized display of the radiation level in each of the monitored areas. The display shall be in exposure rate units (R/h); - Provides a visual and audible alarm in each monitored areas; Allows the control room operator to check at any time the radiation levels and alarm conditions in each of the monitored areas; - Control room operator shall be alerted of any alarm conditions that occurs in the Station. A typical monitoring loop is composed of the following components: Detector Assembly type: CI-MA - 522 two channels, two ranges; Horn and Beacon Assembly; Remote Indicating Meter with Warning Lights; Central computer; common equipment for all 40 loops. (authors)
Pawit Muhammad Yusup
Full Text Available The problem of poverty in rural areas cannot be separated from the following aspects: poverty, lack of education facilities, low level of entrepreneurial skills, health, lack of learning facilities, population distribution, infrastructure and facilities are inadequate, access to information, and other aspects that are still limited. The Village Library and Community Library as part of the affordable infrastructure and learning facilities are, not yet available in every village. This study tried to introduce pilot models Appropriate Technology Implementation Services Book through Rural Libraries and the community library to a number of poor people in the village. The result could contribute in improving the skills of a number of rural poor in entrepreneurship-based reading. This service models can be applied in other similar villages.
Full Text Available Abstract Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives. In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations. We reviewed program results (descriptions of recruitment, retention, and participant satisfaction, program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas, and program impacts (effectiveness in influencing health systems and health outcomes
Biedron, William S.
Since 1990 there has been a rapid increase in the demand for communication services, especially local and wide area network (LAN/WAN) oriented services. With the introduction of the DFB laser transmitter, hybrid-fiber-coax (HFC) cable plant designs, ATM transport technologies and rf modems, new LAN/WAN services can now be defined and marketed to residential and business customers over existing cable TV systems. The term metropolitan area network (MAN) can be used to describe this overall network. This paper discusses the technical components needed to provision these services as well as provides some perspectives on integration issues. Architecture at the headend and in the backbone is discussed, as well as specific service definitions and the technology issues associated with each. The TCP/IP protocol is suggested as a primary protocol to be used throughout the MAN.
Palmier, Andréa Clemente; Andrade, Danielle Alves; Campos, Ana Cristina Viana; Abreu, Mauro Henrique Nogueira Guimarães; Ferreira, Efigênia Ferreira
To evaluate the association between the proportion of tooth extractions, socioeconomic indicators, and the availability of oral health services in an underprivileged area of Brazil. An ecological study was carried out in 52 municipalities in the state of Minas Gerais, Brazil. The socioeconomic indicators employed were criteria for health care resources allocation, municipal human development index, Theil index, Gini coefficient, and sanitation conditions. Concerning the availability of oral health services, the following were considered: number of inhabitants, number of dental surgeons living in the city, number of dentists working in the public services, and number of municipal oral health care teams. The utilization of oral health services was evaluated using the indicators recommended by the Health Ministry's Basic Care Package (Pacto da Atencão Básica in Portuguese) and the number of procedures carried out in the primary care setting. The 17 variables assessed were grouped into factorial components, which were then analyzed in terms of their relationship with the dependent variable, tooth extractions. The following six components explained 73.5% of the overall variance: socioeconomic conditions, social inequality, Basic Care Package indicators, number of procedures carried out, ratio of dentists to inhabitants, and coverage of the Family Health Strategy. Inequalities in income distribution (P = 0.031) and coverage by the Family Health Strategy (P = 0.015) contributed significantly to explain the difference in the proportion of tooth extractions in the different municipalities under study. The dental loss observed in the region is largely explained by socioeconomic factors and aspects related to the organization of oral health services.
Smith, S M; Campbell, N C
There is a paucity of research into rural health care services. In particular little is known about the provision of specialist cancer services for patients who live in remote rural areas of the UK. This study set out to investigate current models of medical and clinical oncology care in Scotland. A national survey with key health professionals was conducted to identify rural oncology schemes currently in operation. Detailed quantitative data about the schemes together with qualitative data on how health professionals view current models of care were collected by a computer-assisted telephone survey. Schemes that currently provide outpatient and chemotherapy oncology services for remote rural patients fell into three categories: central clinics (5); shared care outreach clinics with chemotherapy provision (11); and shared care outreach clinics without chemotherapy provision (7). All radiotherapy was conducted at central clinics (5). Widely varying practices in delivery of cancer care were found across the country. The main issues for professionals about current models of care involved expertise, travelling and accessibility (for patients), communication and expansion of the rural service. Nation-wide consistency in cancer care has still to be achieved. Travelling for treatment was seen to take its toll on all patients but particularly for the very remote, elderly and poor. Most professionals believe that an expansion of rural services would be of benefit to these patients. It is clear, however, that the proper infrastructure needs to be in place in terms of local expertise, ensured quality of care, and good communication links with cancer centres before this could happen.
Marcelli, Marco; Madonia, Alice; Tofani, Anna; Molino, Chiara; Manfredi Frattarelli, Francesco
Natural Capital evaluation is emerging as a fundamental tool to support the management of natural resources. Indeed, the achievement of the compatibility among their multiple uses, often in conflict in coastal areas, is a priority to avoid the increasing undesirable effects which threat both ecosystems and human health and well-being. It represents the scientific basis for actions needed to enhance the conservation and sustainable use of those systems and their contribution to human well-being. Furthermore the Millennium Ecosystem Assessment (called by Kofi Annan in 2000), assessed the consequences of ecosystem change for human well-being, and in particular, the analysis method has been centered on the linkages between "ecosystem services" and human well-being. This "Ecosystem Approach" allows to evaluate the consequences of ecosystems changes on human well-being through the assessment of the Ecosystem Services (ES), which are defined as "the benefits that people obtain from ecosystems". These include provisioning services (food, water, timber, etc.), regulating services (climate, floods, disease, etc.); cultural services (recreational, aesthetic and spiritual benefits) and supporting services (soil formation, photosynthesis, nutrient cycling, etc.) Also the reference guidelines for European Environmental Policy (Marine Strategy Framework Directive 2008/56 / EC - MSFD; Maritime Spatial Planning Directive 2014/89 / EC - MSP) are based on the principle of the Ecosystem Approach to define the monitoring criteria of marine and maritime space management ecosystems. The assessment of ES provided by Natural Capital cannot overlook the integration of ecological data with economic and socio-cultural ones, since they are considered as the direct and indirect contributions to human well-being provided by ecosystems. Cultural Ecosystem Services (CES), often omitted in the cost-benefit impact studies, has been receiving increasing interest from the scientific community in order
Full Text Available This paper deals with the application of High Altitude Platforms for the provision of third generation mobile services in sparsely-populated areas or in developing countries. It focuses on the behavior of large cells provided via a multiple HAP deployment and shows the possibilities of using small cells located inside these large cells to serve hot-spot areas. The impact of the different types of HAP antenna masks and their adjustment on cell capacity and the quality of coverage is presented. The main parameter of the antenna radiation pattern under investigation is the power roll-off at the cell edge. Optimal values of this parameter are presented for different scenarios. Simulations of system level parameters were based on an iteration loops approach.
Valentini, Francesco; Ninin, Pierre
CERN hosts a number of other experimental areas with a rich research program ranging from fundamental physics to medical applications. The risk assessments have shown a large palette of potential hazards (radiological, electrical, chemical, laser, etc.) that need to be properly mitigated in order to ensure the safety of personnel working inside these areas. A Personnel Protection System, typically, accomplishes this goal by implementing a certain number of heterogeneous functionalities as interlocks of critical elements, management of a local HMI, data monitoring and interfacing with RFID badge readers. Given those requirements, reducing system complexity and costs are key parameters to be optimized in the solution. This paper is aimed at summarizing the findings, in terms of costs, complexity and maintenance reduction, offered by a technology from National Instruments® based on cRIO controllers and a new series of SIL-3 certified safety I/O modules. A use case based on a service for the protection of Class ...
The general directions of the European Community concerning lead resulted to be useful for analysing the biologic impact on the population living in an industrial immission area and for differentiating within this locality affected and non-affected residential districts. Consequently the social-hygienic and regional-hygienic measures are limited and justified territorially. The environmental parameters, their relation to the distance at which an industrial plant is situated and the blood lead values are indicated. Recommendations are given, which concern the protection of health and even the reconstruction of the residential area by immission-reducing measures. It was found that the lead impact on children is higher than that on grown-ups. Tables illustrate the symptomatology of lead impacts, its relation to blood lead concentration, the degree of impact measured in children and grown-ups and the corresponding necessary measures as auxiliary methods for the Public Health Service and the physicians.
Kok, Maryse C; Namakhoma, Ireen; Nyirenda, Lot; Chikaphupha, Kingsley; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Theobald, Sally
facilitate communication and dialogue, increase trust and manage expectations and thereby improve interpersonal relationships between HSAs and actors in the community and health sector. This would maximize the value of HSAs' unique intermediary position and support them to deliver equitable health services. This is particularly important in rural areas, where HSAs often constitute the only point of contact with health services, yet report limited support from the health system.
Pescaroli, G.; Magni, M.
Many studies discuss the economic and technical aspects of flood warnings. Less attention has been given to the social and behavioural patterns that affect alert services. In particular, the literature focuses on warnings activated in river basins or marine environments without providing clear evidence on Mediterranean coastal areas, even though these are subjected to growing flood risk related to climate change. This paper is a first attempt to bridge this gap. Our research develops an in-depth analysis of the village of Cesenatico on the Adriatic Sea coast. Here the municipality adopted two complementary warning systems: a siren and an alert via short message service (SMS). The analysis focuses on a survey conducted in 2011 and 2012 with 228 participants. The relationships between social and behavioural variables and warning services are investigated as well as flood preparedness and information dissemination. Qualitative evidence from informal interviews is used to support the understanding of key responses. The conclusions show how different social and behavioural patterns can influence the effectiveness and use of warning systems, regardless of the technology adopted and the structural mitigation measures implemented. Education, training and accountability are seen to be critical elements for implementation. Finally, the statistical output is used to suggest new questions and new directions for research.
Pescaroli, G.; Magni, M.
Many studies discuss the economic and technical aspects of flood warnings. Less attention has been given to the social and psychological patterns that affect alert services. In particular, the literature focuses on warnings activated in river basins or marine environments without providing clear evidence of relevance to Mediterranean coastal areas, even though these are subjected to growing flood risk related to climate change. This paper is a first attempt to bridge this gap. Our research develops an in- depth analysis of the village of Cesenatico on the Adriatic Sea coast. Here the municipality adopted two complementary warning systems: a siren and an alert via Short Message Service (SMS). The analysis focuses on a survey conducted in 2011 and 2012 with 228 participants. The relationships between social and behavioural variables and warning services are investigated, and so are flood preparedness and information dissemination. Qualitative evidence from informal interviews is used to support the understanding of key responses. The conclusions show how different social and behavioural patterns can influence the effectiveness and use of warning systems, regardless of the technology adopted and the structural mitigation measures implemented. Education, training and accountability are seen to be critical elements for improvement. Finally, the statistical output is used to suggest new questions and new directions for research.
Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470
Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.
Full Text Available The article looks at the underexplored area of light goods vehicle (LGV operation. Specifically, it is investigated to what extent various location based services (LBS can be applied in the context of LGV operation in order to improve their environmental friendliness in urban areas. In doing so, LBS applied in real time navigation, dynamic fleet management, freight tracking and monitoring, hazardous materials transport, location-specific tolls and taxes and geo-eco-driving are described in relation to their usefulness in LGV operation as well as the potential in reducing LGV-originating pollution. Where available, real world examples of such applications are given. The discussion reveals particular significance in that context of real time navigation and dynamic fleet management, which are widely applicable solutions in LGVs operation. Freight monitoring and tracking, including hazardous materials transport, have been also found to be of an importance due, yet with a more limited applicability. As regards location-specific tolls and taxes, and geo-eco-driving, significant potential of these LBS has been identified, yet due to their very limited applicability in general, no robust conclusions could be drawn. Last but not least, a significant gap in the detailed knowledge regarding the area has been revealed and directions for further research have been suggested.
Shariatmadar, Mehran; Narasimhan, Vasantha
This paper reviews the studies which were undertaken jointly by Telesat and Industry Canada to provide an estimate of the market opportunities for residential multi-media services in the rural and small urban areas of Canada. This study is part of the Advanced Satcom program, a Ka-band satellite system proposal which is currently in the implementation proposal phase by the government and the Canadian space industry of which Telesat is an active member. Advanced Satcom extends the reach of terrestrial information highways to the remote and sparsely populated parts of the country in a cost-effective manner and thus provides a ubiquitous coverage of the information highways to all Canadians. Therefore, the rural and small urban markets are believed to be good opportunities for the Advanced Satcom. Although the results are primarily intended for fixed residential applications, they can also be used as input to market opportunity studies for wideband mobile applications.
Leukert, K.; Telser, H.; Vaterlaus, S.; Mahler, P.
This report for the Swiss Federal Office of Energy (SFOE) takes a look at the results of a study made on the willingness to pay for public services and quality of supply in the electricity area. First, the starting point of the study and definitions of quality of supply and security of supply are noted. The methods used in the study are presented and macro-economic aspects are reviewed. The costs of black-outs are examined and the carrying out of surveys in the electricity market is discussed. The results of surveys made in households and commercial enterprises concerning the willingness to pay for security of supply and the costs incurred when supplies fail are presented and discussed. The report is completed with a comprehensive list of references and an appendix containing the results of the various tests and surveys made.
Mariela Verónica Rocca
Full Text Available This article deals with the State regulation of drinking water and sanitation services in the Metropolitan Area of Buenos Aires. Its main objective is to identify the continuities and ruptures in State regulation during the transition from private management (1993-2006 to renationalisation and State management (2006 onwards. The concept of “State capacities” (both administrative and relational is used to assess regulatory performance. For the administrative capacities, the correspondence between the design and resources of the agencies, as well as the differences between their formal functions and actual practices, is examined. For the relational capacities, the policies of the National Government and its interaction with both the water and sanitation companies and the regulatory and control agencies are considered. The analysis is based on official documents, legislation and statistics, company balance sheets and reports, newspaper articles and semi-structured interviews.
Full Text Available The use of QR codes accelerates the sharing of information and provides more practical access to information. In today's information age, in the limited area unlimited information, data and contents can be transferred with using QR code. This study examines how consumers use QR code technology using by the service sector and aim of inform consumers about their perception and usage levels. In the application part of the study, 180 consumers responded the survey questions. The t-test, ANOVA, variance analysis and regression analysis method were used to test hypotheses established in the research. Thus, factors affecting the perceptions of consumers on QR code technology have been identified. The finance and banking sectors have been identified as the sectors in which consumers use the QR code most frequently, and the speed and availability factors for this sector have been analyzed separately.
Full Text Available Abstract Background The importance of Small Area Variation Analysis for policy-making contrasts with the scarcity of work on the validity of the statistics used in these studies. Our study aims at 1 determining whether variation in utilization rates between health areas is higher than would be expected by chance, 2 estimating the statistical power of the variation statistics; and 3 evaluating the ability of different statistics to compare the variability among different procedures regardless of their rates. Methods Parametric bootstrap techniques were used to derive the empirical distribution for each statistic under the hypothesis of homogeneity across areas. Non-parametric procedures were used to analyze the empirical distribution for the observed statistics and compare the results in six situations (low/medium/high utilization rates and low/high variability. A small scale simulation study was conducted to assess the capacity of each statistic to discriminate between different scenarios with different degrees of variation. Results Bootstrap techniques proved to be good at quantifying the difference between the null hypothesis and the variation observed in each situation, and to construct reliable tests and confidence intervals for each of the variation statistics analyzed. Although the good performance of Systematic Component of Variation (SCV, Empirical Bayes (EB statistic shows better behaviour under the null hypothesis, it is able to detect variability if present, it is not influenced by the procedure rate and it is best able to discriminate between different degrees of heterogeneity. Conclusion The EB statistics seems to be a good alternative to more conventional statistics used in small-area variation analysis in health service research because of its robustness.
Geeta S. Pardeshi
Full Text Available Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC, Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27% had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms.
Wong, Edwin S; Liu, Chuan-Fen
In the U.S., economic conditions are intertwined with labor market decisions, access to health care, health care utilization and health outcomes. The Veterans Affairs (VA) health care system has served as a safety net provider by supplying free or reduced cost care to qualifying veterans. This study examines whether local area labor market conditions, measured using county-level unemployment rates, influence whether veterans obtain health care from the VA. We used survey data from the Behavioral Risk Factor Surveillance System in years 2000, 2003 and 2004 to construct a random sample of 73,964 respondents self-identified as veterans. VA health service utilization was defined as whether veterans received all, some or no care from the VA. Hierarchical ordered logistic regression was used to address unobserved state and county random effects while adjusting for individual characteristics. Local area labor market conditions were defined as the average 12-month unemployment rate in veterans' county of residence. The mean unemployment rate for veterans receiving all, some and no care was 5.56%, 5.37% and 5.24%, respectively. After covariate adjustment, a one percentage point increase in the unemployment rate in a veteran's county of residence was associated with an increase in the probability of receiving all care (0.34%, p-value = 0.056) or some care (0.29%, p-value = 0.023) from the VA. Our findings suggest that the important role of the VA in providing health care services to veterans is magnified in locations with high unemployment.
The objective of this thesis was to analyse the data of pollutant parameters for waste water from the service stations situated in the operative area of the Viikinmäki and Suomenoja WWTPs in the Helsinki Region Environmental Services Authority (HSY). The main reason for this analysis was that HSY wanted to know about the quality of waste water discharged from the service stations into the influent of its WWTPs. The number of cars used in Finland is increasing day by day; hence, au...
Housne Ara Begum
Full Text Available Bangladesh has one of the highest maternal mortality rates (MMR in the world. The estimated lifetime risk of dying from pregnancy and childbirth related causes in Bangladesh is about 100 times higher compare to developed countries. However, utilization of maternal health care services (MHCS is notably low. This study examines the socio-economic determinants of utilization of MHCS in some slum areas of Dhaka city. The overall utilization was 86.3% of women; however, utilization of different sorts of MHCS was very low, i.e., the mean utilization was found to be 2.25 out of 5 MHCS. Indicator wise, ANC, TT, institutional delivery, delivery assistance by health professional and PNC were received by 61.3%, 80.4%, 12.6%, 33.2% and 55.4% of women respectively. Variation was observed with different socio-economic variables. Multiple regression model could explain 38% of variance (P<0.001. Among the significant determinants, order of last birth negatively explained the most variance (15.2%. Similarly, distance between home and clinic was found to affect the utilization negatively. Besides, some respondents’ socio economic variables had a significant positive effect on MHCS utilization. To reduce maternal mortality in disadvantaged women in slum areas, this study might suggest a few pointers while considering formulation of policies and planning. Ibrahim Med. Coll. J. 2010; 4(2: 44-48
Ferrandiz, Ana; Scallan, Gavin
The available bit rate (ABR) service allows connections to exceed their negotiated data rates during the life of the connections when excess capacity is available in the network. These connections are subject to flow control from the network in the event of network congestion. The ability to dynamically adjust the data rate of the connection can provide improved utilization of the network and be a valuable service to end users. ABR type service is therefore appropriate for the transmission of bursty LAN traffic over a wide area network in a manner that is more efficient and cost effective than allocating bandwdith at the peak cell rate. This paper describes the ABR service and discusses if it is realistic to operate a LAN like service over a wide area using ABR.
Full Text Available Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM, which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS. Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy.
Full Text Available Intensive spatial processes taking place around metropolitan areas leads to many economic, structural and social changes in their surroundings. The small towns and rural areas located in the outer zone of metropolitan areas are most affected by this functional changes. In the outer zone of a big urban canters appears a lot of new competing possibilities on the labor market and a comprehensive commercial, service and cultural offer to smaller centres. One of the most competitive advantage of the metropolitan zones becomes modern shopping centres being established in the most accessible places, providing a comprehensive shopping-services and even cultural-recreational offer.
Lopez-Hoffman, Laura; Semmens, Darius J.; Diffendorfer, Jay
Species that migrate through protected and wilderness areas and utilize their resources, deliver ecosystem services to people in faraway locations. The mismatch between the areas that most support a species and those areas where the species provides most benefits to society can lead to underestimation of the true value of protected areas such as wilderness. We present a method to communicate the “off-site” value of wilderness and protected areas in providing habitat to migratory species that, in turn, provide benefits to people in distant locations. Using northern pintail ducks (Anas acuta) as an example, the article provides a method to estimate the amount of subsidy – the value of the ecosystem services provided by a migratory species in one area versus the cost to support the species and its habitat elsewhere.
Rea, Luca; Pompei, Sergio; Valenti, Alessandro; Matera, Francesco; Zema, Cristiano; Settembre, Marina
We report an experimental investigation about the Virtual Private LAN Service technique to guarantee the quality of service in the metro/core network and also in the presence of access bandwidth bottleneck. We also show how the virtual private network can be set up for answering to a user request in a very fast way. The tests were performed in a GMPLS test bed with GbE core routers linked with long (tens of kilometers) GbE G.652 fiber links.
Sima, Mihaela; Micu, Dana; Dragota, Carmen-Sofia; Mihalache, Sorin
undertaken with key institutions focusing on environmental, health and urban development issues. The survey was conducted in order to identify the local authorities' perception and needs on climate change information and the importance of climate services for the city and institution's activity. Generally, the results suggest that the selected institutions are poorly aware of the potential impacts of climate change and associated extremes in the area, but they showed a real interest for future climate estimations necessary to undertake reliable adaptation measures. At institutional level, do not exist specialized departments (job positions) to tackle or manage climate information and climate-related aspects, this not being a pressing or priority issue for the city. The climate services aspects are seen with interest mainly in supplying climate scenarios and models for a relatively short term (next 10 or 15 years), the climate information being in this way included in the local planning strategies.
... Health Inspection Service's Wildlife Services (APHIS-WS) program is making a policy decision on how to... this definition. Otherwise, APHIS will refer all requests for operational assistance with urban rodent...
Liao, Yangzhe; Leeson, Mark S; Higgins, Matthew D
Wireless body area sensor networks (WBASNs) are becoming an increasingly significant breakthrough technology for smart healthcare systems, enabling improved clinical decision-making in daily medical care. Recently, radio frequency ultra-wideband technology has developed substantially for physiological signal monitoring due to its advantages such as low-power consumption, high transmission data rate, and miniature antenna size. Applications of future ubiquitous healthcare systems offer the prospect of collecting human vital signs, early detection of abnormal medical conditions, real-time healthcare data transmission and remote telemedicine support. However, due to the technical constraints of sensor batteries, the supply of power is a major bottleneck for healthcare system design. Moreover, medium access control (MAC) needs to support reliable transmission links that allow sensors to transmit data safely and stably. In this Letter, the authors provide a flexible quality of service model for ad hoc networks that can support fast data transmission, adaptive schedule MAC control, and energy efficient ubiquitous WBASN networks. Results show that the proposed multi-hop communication ad hoc network model can balance information packet collisions and power consumption. Additionally, wireless communications link in WBASNs can effectively overcome multi-user interference and offer high transmission data rates for healthcare systems.
Hiser, Jennifer; Nayga, Rodolfo M., Jr.; Capps, Oral, Jr.
Online food shopping is not only one of the newest innovations in grocery shopping but also one of the many services integrating the changing needs of consumers and the increasing use of modern technology. A survey was conducted in the Bryan/College Station area of Texas to determine a quantitative profile of consumers, via logit analysis, who are familiar with the concept of online food shopping and who are willing to use an online food shopping service. Older people, females, major shoppers...
Full Text Available The article presents selected aspects of the implementation of the EU’s SmartMove project, which aims to promote feeder public transport systems in rural areas through the implementation of an active marketing campaign (AMC. Campaigns of this type are connected with providing general and personalized information concerning the functioning of public transport services. In the article, characteristics of one of the implementation areas of the project are presented, namely, the Liszki district near Cracow. Transport services were also evaluated. In addition, selected results are presented from a survey that was conducted among residents of the area from the point of view of the implementation of the AMC. The results concerned data about the means of transport that were currently used for travelling, the knowledge of bus services, the reasons for their use and the factors that might encourage residents to use public transport
Kadar, K S; McKenna, L; Francis, K
Ageing and problems concerning the aged are an increasing and concerning reality in developing and underdeveloped countries such as Indonesia. Improving service quality is important to promote and maintain wellness of older persons, especially in rural areas. To explore programs and services offered to the elderly in a rural area of Indonesia to support them in promoting and maintaining their wellness. To describe roles and practices of health professionals and teams responsible for delivering services to older people. Action research was used with mixed method data collection (interview and survey). Results demonstrated that activities related to the elderly health programs were limited due to budget and facilities. Practices of health staff for elderly in the community focused on intervention tasks, rather than prevention. Lack of available information on the range of programs and services implemented in Indonesia for the elderly in community settings was a limitation of this study. Programs and services for older people have been implemented in Indonesia. However, these do not yet meet their needs, especially in rural areas. There is a need for greater focus on health promotion and illness prevention. Findings contribute to development of international knowledge in community health nursing, as these issues may not be only relevant to Indonesia. It is timely for governments, including in Indonesia, to evaluate health workforce needs in the community and appropriate educational qualifications for delivering optimal health services for older people. © 2014 International Council of Nurses.
Full Text Available This study aimed to 1 investigate the cause of conflict which in the secondary schools under the Secondary School under the Office of Secondary Educational Service Area 20, 2 study the conflict management method which administrators applied in Secondary School under the Office of Secondary Educational Service Area 20, and 3 develop conflict management model for Secondary School under the Office of Secondary Educational Service Area 20. The participants were 115 school administrators (44 school directors and 71 deputy directors which were selected by random sampling technique. The research instruments included a questionnaire, which reliability value was 0.97, and an interview schedule that were administered to the respondents. The data were analyzed by frequency, percentage, mean, and standard deviation. The result of the study showed that: 1. the causes of conflict in Secondary School under the Office of Secondary Educational Service Area 20 in overall was at the high level with the mean of 4.21, the internal conflict was at the high level with the mean of 4.22, and the external conflict was at the high level with the mean of 4.19. 2. Overall, conflict management method used by administrators in Secondary School under the Office of Secondary Educational Service Area 20was at a high level. Considering each aspect, the compromising method was the highest level at 4.48. 3. Developing conflict management model in Secondary School under the Office of Secondary Educational Service Area 20 were the collaboration and making understand method. These should be used for conflict management to achieve the success and to reach the standard which including responsibility, accountability, equality, teamwork, and communication competence.
Wong, Michelle; Wolff, Craig; Collins, Natalie; Guo, Liang; Meltzer, Dan; English, Paul
Significant illness is associated with biological contaminants in drinking water, but little is known about health effects from low levels of chemical contamination in drinking water. To examine these effects in epidemiological studies, the sources of drinking water of study populations need to be known. The California Environmental Health Tracking Program developed an online application that would collect data on the geographic location of public water system (PWS) customer service areas in California, which then could be linked to demographic and drinking water quality data. We deployed the Water Boundary Tool (WBT), a Web-based geospatial crowdsourcing application that can manage customer service boundary data for each PWS in California and can track changes over time. We also conducted a needs assessment for expansion to other states. The WBT was designed for water system operators, local and state regulatory agencies, and government entities. Since its public launch in 2012, the WBT has collected service area boundaries for about 2300 individual PWS, serving more than 90% of the California population. Results of the needs assessment suggest interest and utility for deploying such a tool among states lacking statewide PWS service area boundary data. Although the WBT data set is incomplete, it has already been used for a variety of applications, including fulfilling legislatively mandated reporting requirements and linking customer service areas to drinking water quality data to better understand local water quality issues. Development of this tool holds promise to assist with outbreak investigations and prevention, environmental health monitoring, and emergency preparedness and response.
Sachin S Mumbare
Full Text Available Background: Utilization of Ante natal care (ANC services is poor in the tribal areas, causing increased maternal morbidity and mortality. Objective: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. Design: Cross-sectional study. Materials and Methods: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. Results: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. Conclusion: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.
Full Text Available The objectives of developing an implementation guideline to international standard school for schools under secondary educational service area office 25 were ; 1 to study present and problem an implementation guideline to international standard school for schools under secondary educational service area office 25 and 2 to develop an implementation guideline to international standard school for schools under secondary educational service area office 25. There were 68 samples ; administrators, deputy administrators, head of quality management systems, and academic teachers by purposive sampling. The tools used to collect the data were the five level scale questionnaire and structured interviews. Data were analyzed using mean, standard deviation, and descriptive analysis. The researcher set the research by 2 phase. The first phase educated present and problem an implementation guideline to international standard school for schools under secondary educational service area office 25. The research was assessed feasibility of developing an implementation guideline to international standard school for schools under secondary educational service area office 25 by 5 experts. The research results were: 1. The present and problem an implementation guideline to international standard school for schools under secondary educational service area office 25 found that the overall present were at the high level and each one was at the high level. The overall problem were at the low and each one was at the moderate 2 aspects ; The leadership and the focus on personnel. Then it was at the low level. 2. Developing an implementation guideline to international standard school for schools under secondary educational service area office 25 found that 1 the leadership had set with the vision, values, performance of the school’s senior leadership, including good governance of the school, implementation of the ethics law, and responsibility for the community, 2 strategic
The primary function of the 300 Area is the production and preparation of the fuel and target elements required for the 100 Area production reactors. Uranium slugs and lithium-aluminium alloy control and blanket rods are prepared in separate structures. Other facilities include a test pile, a physics assembly laboratory, an office and change house, an electrical substation, and various service facilities such as rail lines, roads, sewers, steam and water distribution lines, etc. The 700 Area contains housing and facilities for plant management, general plant services, and certain technical activities. The technical buildings include the Main Technical Laboratory, the Waste Concentration Building, the Health Physics Headquarters, and the Health Physics Calibration building. Sections of this report describe the following: development of the 300-M Area; selection and description of process; design of main facilities of the 300 Area; development of the 700-A Area; design of the main facilities of the 700 Area; and general services and facilities, including transportation, plant protection, waste disposal and drainage, site work, pilot plants, storage, and furniture and fixtures.
Scott, David M; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan
The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists' delivery of public health services. To assess Iowa and North Dakota pharmacists' practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.
Scott, David M.; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan
Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking. PMID:28042356
Bandibas, J. C.; Takarada, S.
Timely identification of areas affected by natural disasters is very important for a successful rescue and effective emergency relief efforts. This research focuses on the development of a cost effective and efficient system of identifying areas affected by natural disasters, and the efficient distribution of the information. The developed system is composed of 3 modules which are the Web Processing Service (WPS), Web Map Service (WMS) and the user interface provided by J-iView (fig. 1). WPS is an online system that provides computation, storage and data access services. In this study, the WPS module provides online access of the software implementing the developed frequency based change detection algorithm for the identification of areas affected by natural disasters. It also sends requests to WMS servers to get the remotely sensed data to be used in the computation. WMS is a standard protocol that provides a simple HTTP interface for requesting geo-registered map images from one or more geospatial databases. In this research, the WMS component provides remote access of the satellite images which are used as inputs for land cover change detection. The user interface in this system is provided by J-iView, which is an online mapping system developed at the Geological Survey of Japan (GSJ). The 3 modules are seamlessly integrated into a single package using J-iView, which could rapidly generate a map of disaster areas that is instantaneously viewable online. The developed system was tested using ASTER images covering the areas damaged by the March 11, 2011 tsunami in northeastern Japan. The developed system efficiently generated a map showing areas devastated by the tsunami. Based on the initial results of the study, the developed system proved to be a useful tool for emergency workers to quickly identify areas affected by natural disasters.
Rachel A Neugarten
Full Text Available The importance of ecosystems for supporting human well-being is increasingly recognized by both the conservation and development sectors. Our ability to conserve ecosystems that people rely on is often limited by a lack of spatially explicit data on the location and distribution of ecosystem services (ES, the benefits provided by nature to people. Thus there is a need to map ES to guide conservation investments, to ensure these co-benefits are maintained. To target conservation investments most effectively, ES assessments must be rigorous enough to support conservation planning, rapid enough to respond to decision-making timelines, and often must rely on existing data. We developed a framework for rapid spatial assessment of ES that relies on expert and stakeholder consultation, available data, and spatial analyses in order to rapidly identify sites providing multiple benefits. We applied the framework in Madagascar, a country with globally significant biodiversity and a high level of human dependence on ecosystems. Our objective was to identify the ES co-benefits of biodiversity priority areas in order to guide the investment strategy of a global conservation fund. We assessed key provisioning (fisheries, hunting and non-timber forest products, and water for domestic use, agriculture, and hydropower, regulating (climate mitigation, flood risk reduction and coastal protection, and cultural (nature tourism ES. We also conducted multi-criteria analyses to identify sites providing multiple benefits. While our approach has limitations, including the reliance on proximity-based indicators for several ES, the results were useful for targeting conservation investments by the Critical Ecosystem Partnership Fund (CEPF. Because our approach relies on available data, standardized methods for linking ES provision to ES use, and expert validation, it has the potential to quickly guide conservation planning and investment decisions in other data-poor regions.
Andriamaro, Luciano; Cano, Carlos Andres; Grantham, Hedley S.; Hole, David; Juhn, Daniel; McKinnon, Madeleine; Rasolohery, Andriambolantsoa; Steininger, Marc; Wright, Timothy Max
The importance of ecosystems for supporting human well-being is increasingly recognized by both the conservation and development sectors. Our ability to conserve ecosystems that people rely on is often limited by a lack of spatially explicit data on the location and distribution of ecosystem services (ES), the benefits provided by nature to people. Thus there is a need to map ES to guide conservation investments, to ensure these co-benefits are maintained. To target conservation investments most effectively, ES assessments must be rigorous enough to support conservation planning, rapid enough to respond to decision-making timelines, and often must rely on existing data. We developed a framework for rapid spatial assessment of ES that relies on expert and stakeholder consultation, available data, and spatial analyses in order to rapidly identify sites providing multiple benefits. We applied the framework in Madagascar, a country with globally significant biodiversity and a high level of human dependence on ecosystems. Our objective was to identify the ES co-benefits of biodiversity priority areas in order to guide the investment strategy of a global conservation fund. We assessed key provisioning (fisheries, hunting and non-timber forest products, and water for domestic use, agriculture, and hydropower), regulating (climate mitigation, flood risk reduction and coastal protection), and cultural (nature tourism) ES. We also conducted multi-criteria analyses to identify sites providing multiple benefits. While our approach has limitations, including the reliance on proximity-based indicators for several ES, the results were useful for targeting conservation investments by the Critical Ecosystem Partnership Fund (CEPF). Because our approach relies on available data, standardized methods for linking ES provision to ES use, and expert validation, it has the potential to quickly guide conservation planning and investment decisions in other data-poor regions. PMID:28006005
Full Text Available Four kinds of service types are defined in IEEE 802.16. In order to provide the Quality of Service (Qos for different services, the system must use a reasonable resource allocation method and scheduling algorithm to efficiently and fairly allocate bandwidth resources. Although in the IEEE 802.16 MAC, for the uplink real-time polling service (rtPS and non-real-time polling service (nrtPS business type of data transmission are used to polling, but do not provide business-based services. In this paper, the distinction between priority service of rtPS and nrtPS is carried out, and the simulation experiment is used to analyze the performance characteristics of the protocol under the distinction of high and low priority. Wherein the theoretical values of the average delay and the information packets are compared with the experimental values. The average query cycle and throughput are also evaluated. Which proves the validity of the improved service strategy and improves the service characteristics of the system.
Kim, Minseop; Garcia, Antonio R; Yang, Shuyan; Jung, Nahri
Relying on data from a nationally representative sample of youth involved in the child welfare system (CWS) in 1999-2000 (the National Survey of Child and Adolescent Well-Being, Cohort 1) and 2008-2009 (Cohort 2), this study implemented a diverse set of disparity indicators to estimate area-socioeconomic disparities in mental health (MH) services use and changes in area-socioeconomic disparities between the two cohorts. Our study found that there are area-socioeconomic disparities in MH service use, indicating that the rates of MH service use among youth referred to the CWS differ by area-socioeconomic positions defined by county-level poverty rates. We also found that area-socioeconomic disparities increased over time. However, the magnitude of the increase varied widely across disparity measures, suggesting that there are different conclusions about the trend and magnitude of area-socioeconomic disparities, depending upon which disparity measures are implemented. A greater understanding of the methodological differences among disparity measures is warranted, which will in turn impact how interventions are designed to reduce socioeconomic disparities among children in the CWS. Copyright © 2018. Published by Elsevier Ltd.
Full Text Available Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH reach the vulnerable population in the ethnic health organizations’ (EHOs and community-based organizations’ (CBHOs service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in
Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin
Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations' (EHOs) and community-based organizations' (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Despite the chronic conflict in Burma/Myanmar, this report provides evidence of the substantive
Ecosystem services of wetlands are relevant when considering management decisions and assessing restoration success. However, many services (e.g., biochemistry, wildlife habitat) are difficult to quantify and value (e.g., monetize), requiring non-use valuations (e.g., indicators)...
Heather A. Sander; Robert G. Haight
A need exists to increase both knowledge and recognition of the values associated with ecosystem services and amenities. This article explores the use of hedonic pricing as a tool for eliciting these values. We take a case study approach, valuing several services provided by ecosystems, namely aesthetic quality (views), access to outdoor recreation, and the benefits...
Ecosystem services and amenities are undeniable valuable. However, their values are poorly recognized and, as a result, ecosystem services and amenities tend to be treated as though valueless. A need thus exists to increase both knowledge and recognition of these values. In this ...
Roberts, C. Michael; Seiger, Anil; Ingham, Jane
Objective: The views of patients with Chronic Obstructive Pulmonary Disease (COPD) about three key services (non-invasive ventilation [NIV], early discharge schemes and rehabilitation) were sought in order to inform recommendations for the delivery of optimum care within a national programme of hospital COPD service development. Design: Four focus…
Ferraro, Paul J.; Hanauer, Merlin M.
To develop effective environmental policies, we must understand the mechanisms through which the policies affect social and environmental outcomes. Unfortunately, empirical evidence about these mechanisms is limited, and little guidance for quantifying them exists. We develop an approach to quantifying the mechanisms through which protected areas affect poverty. We focus on three mechanisms: changes in tourism and recreational services; changes in infrastructure in the form of road networks, health clinics, and schools; and changes in regulating and provisioning ecosystem services and foregone production activities that arise from land-use restrictions. The contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare. PMID:24567397
Paul L. Lucas
Full Text Available The United Nations’ discussions on defining a new set of post-2015 development goals focus on poverty eradication and sustainable development. Biodiversity and ecosystem services are essential for poverty eradication, which is also one of the foundations of the Strategic Plan for Biodiversity of the Convention on Biological Diversity (CBD. Based on an assessment of current proposals of goals and targets, and a quantitative pathway analysis to meet long term biodiversity and food security goals, this paper discusses how biodiversity and ecosystem services can be integrated into a broad set of goals and targets, and concludes with relevant target areas and means of implementation for which specific targets need to be defined. Furthermore, it responds to the call of the CBD to consider the Strategic Plan for Biodiversity and the related Aichi biodiversity targets in the post-2015 development agenda. The paper’s analysis identifies three overlapping but also supplemental ways to integrate biodiversity and ecosystem services in the post-2015 agenda: integrated goals, goals addressing earth system functioning and goals addressing environmental limits. It further concludes seven target areas to be included under the goals to address biodiversity and ecosystem services in the context of food and agriculture: access to food, demand for agricultural products, sustainable intensification, ecosystem fragmentation, protected areas, essential ecosystem services and genetic diversity. The Strategic Plan for Biodiversity provides a good basis for integrating biodiversity and ecosystem services in the post-2015 development agenda. Many Aichi targets address the proposed target areas and the means of implementation discussed, while they need to be complemented with targets that specifically address human well-being, as well as institutions and governance.
Full Text Available Freshwater is arguably one of Earth’s most threatened natural resources, on which more than 7 billion people depend. Pressures on freshwater resources from infrastructure, resource development, agricultural pollution and deforestation are mounting, particularly in developing countries. To date, conservation responses such as Protected Areas (PAs have not typically targeted freshwater ecosystems and their services, and thus little is known about the effectiveness of these efforts in protecting them. This paper proposes and pilots an innovative freshwater services metrics framework to quantify the representation of potential freshwater services in PAs under conditions of scarce data, with a pilot application for Cambodia. Our results indicate that conservation actions have more effectively represented potential freshwater regulation services than potential freshwater provisioning services, with major rivers remaining generally unprotected. Results from the framework are then used to propose a series of context and region specific management options to improve the conservation of freshwater services in Cambodia. There is an acute need for such management options, as the country’s food security depends largely on important freshwater ecosystems such as the Tonle Sap Lake and the deep water pools systems of the Mekong River. The framework proposed can be applied in other countries or large river basins to explore the degree of representation of freshwater services within PAs systems, under conditions of sparse data.
History and present status od Swedish regulations in the field of NPP inspection and in-service inspection are described. The presentation focuses on the development of regulations and establishing new ones. A description of different organisations involved is included
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challenge has been to integrate ecology with economics to better understand the effects of human policies and acti...
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challange has been to integrate ecology with economics to better understand the effects of human policies and acti...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The EnviroAtlas Potential...
Chopra, Prem; Hamilton, Bridget; Castle, David; Smith, Jenny; Mileshkin, Cris; Deans, Michael; Wynne, Brad; Prigg, Glenn; Toomey, Nigel; Wilson, Michael
The objectives of this paper are to provide an overview of recovery-focused models of care and discuss the implementation of the Strengths Model at St. Vincent's Mental Health Melbourne (SVMH), Victoria, Australia. The implementation of the Strengths Model at SVMH is discussed with particular emphasis on the process of implementation, service implications, practical challenges and dilemmas that have arisen, and proposed evaluation. Recovery-focused care is feasible and can enhance current practice of mental health services.
McCabe, Karen E; Ling, Jonathan; Wilson, Graeme B; Crosland, Ann; Kaner, Eileen F S; Haighton, Catherine A
UK society is ageing. Older people who drink alcohol, drink more than those from previous generations, drink more frequently than other age groups and are more likely to drink at home and alone. Alcohol problems in later life however are often under-detected and under-reported meaning older people experiencing alcohol problems have high levels of unmet need. This study sought to identify existing services within South of Tyne, North East England to capture the extent of service provision for older drinkers and identify any gaps. The Age UK definition of 'older people' (aged 50 and over) was used. Services were contacted by telephone, managers or their deputy took part in semi-structured interviews. Forty six service providers were identified. Only one provided a specific intervention for older drinkers. Others typically provided services for age 18+. Among providers, there was no definitive definition of an older person. Data collection procedures within many organisations did not enable them to confirm whether older people were accessing services. Where alcohol was used alongside other drugs, alcohol use could remain unrecorded. To enable alcohol services to meet the needs of older people, greater understanding is needed of the patterns of drinking in later life, the experiences of older people, the scale and scope of the issue and guidance as to the most appropriate action to take. An awareness of the issues related to alcohol use in later life also needs to be integrated into commissioning of other services that impact upon older people. © Royal Society for Public Health 2015.
Payne, Richard; Kuchibhatla, Maragatha N.
Abstract Background: Experts and national organizations recommend that hospices work to increase service to African Americans, a group historically underrepresented in hospice. Objective: The study objective was to describe strategies among hospices in North and South Carolina to increase service to African Americans and identify hospice characteristics associated with these efforts. Methods: The study was a cross-sectional survey using investigator-developed scales to measure frequency of community education/outreach, directed marketing, efforts to recruit African American staff, cultural sensitivity training, and goals to increase service to African Americans. We used nonparametric Wilcoxon tests to compare mean scale scores by sample characteristics. Results: Of 118 eligible hospices, 79 (67%) completed the survey. Over 80% were at least somewhat concerned about the low proportion of African Americans they served, and 78.5% had set goals to increase service to African Americans. Most were engaged in community education/outreach, with 92.4% reporting outreach to churches, 76.0% to social services organizations, 40.5% to businesses, 35.4% to civic groups, and over half to health care providers; 48.0% reported directed marketing via newspaper and 40.5% via radio. The vast majority reported efforts to recruit African American staff, most often registered nurses (63.75%). Nearly 90% offered cultural sensitivity training to staff. The frequency of strategies to increase service to African Americans did not vary by hospice characteristics, such as profit status, size, or vertical integration, but was greater among hospices that had set goals to increase service to African Americans. Conclusions: Many hospices are engaged in efforts to increase service to African Americans. Future research should determine which strategies are most effective. PMID:26840854
Full Text Available Urbanization, and the resulting land use/cover change, is a primary cause of the degradation of coastal wetland ecosystems. Reclamation projects are seen as a way to strike a balance between socioeconomic development and maintenance of coastal ecosystems. Our aim was to understand the ecological changes to Jiangsu’s coastal wetland resulting from land use change since 1977 by using remote sensing and spatial analyses. The results indicate that: (1 The area of artificial land use expanded while natural land use was reduced, which emphasized an increase in production-orientated land uses at the expense of ecologically important wetlands; (2 It took 34 years for landscape ecological security and 39 years for ecosystem services to regain equilibrium. The coastal reclamation area would recover ecological equilibrium only after a minimum of 30 years; (3 The total ecosystem service value decreased significantly from $2.98 billion per year to $2.31 billion per year from 1977 to 2014. Food production was the only one ecosystem service function that consistently increased, mainly because of government policy; (4 The relationship between landscape ecological security and ecosystem services is complicated, mainly because of the scale effect of landscape ecology. Spatial analysis of changing gravity centers showed that landscape ecological security and ecosystem service quality became better in the north than the south over the study period.
Blusi, Madeleine; Asplund, Kenneth; Jong, Mats
The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion . The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.
Thorsson, Johann; Petursdottir, Thorunn
Soils are one of the main fundamental bodies of terrestrial ecosystems. Soil functions contribute substantially to the ecosystem services humans and all other living beings depend on. Current soil threats are in most cases related to anthropogenic impacts and derived environmental pressures. For instance, overexploitation has in many cases damaged ecosystem resilience, affected current equilibrium and caused severe soil degradation. The resulting dysfunctional ecosystems are incapable of providing necessary ecosystem services. In such cases ecosystem restoration is necessary to restore ecosystem functions and ecological succession. The Mt. Hekla area in Iceland is an example of land suffering from accelerated erosion amplified by anthropogenic impacts. The area is 900 km2 located in South Iceland in the vicinity of the volcano Mt. Hekla. Today over 40% of the area is classified as eroded but historical documents indicate that vast part of the area were fertile and vegetated at the time of settlement, 1100 years ago; hence was able to withstand the geological disturbances occurring prior to the arrival of man as is obvious from the pristine woody patches still remaining. Severe soil degradation followed the large-scale deforestation and overgrazing that took place within the area. The initial land degradation event is considered to have occurred in the 11th century, but has been ongoing since then in several episodes. The Þjórsá glacial river flows through the area and carries enormous amounts of sediments every year. After the deforestation, the ecosystem resilience was damaged and the land left exposed to the elements. Eventually large scale wind erosion started, followed with water erosion and increased impact of freeze-thaw processes. The Soil Conservation Service of Iceland started working in the area in the early 20th century and land reclamation operations have been ongoing until this day. Considerable successes have been made as is manifested in the fact
Lee, S. J.; Lee, W. K.
The study on the analysis of carbon storage capacity of urban green spaces with increasing urban forest. Modern cities have experienced rapid economic development since Industrial Revolution in the 18th century. The rapid economic growth caused an exponential concentration of population to the cities and decrease of green spaces due to the conversion of forest and agricultural lands to build-up areas with rapid urbanization. As green areas including forests, grasslands, and wetlands provide diverse economic, environmental, and cultural benefits, the decrease of green areas might be a huge loss. Also, the process of urbanization caused pressure on the urban environment more than its natural capacity, which accelerates global climate change. This study tries to see the relations between carbon budget and ecosystem services according to the urbanization. For calculating carbon dynamics, this study used VISIT(Vegetation Integrated Simulator for trace gases) model. And the value that ecosystem provides is explained with the concept of ecosystem service and calculated by InVEST model. Study sites are urban and peri-urban areas in Northeast Asia. From the result of the study, the effect of the urbanization can be understood in regard to carbon storage and ecosystem services.
Full Text Available The informative society is seen as the central element of rural development at the beginning of the third millennium and the development of information technology and communication in villages has always been considered in current summits across the world. Nowadays, information and communication technology service offices are the basis of electronic government. Therefore, recognition of these offices is necessary for sustainable rural development. The purpose of this research was a comparative analysis between the current situation and the desirable situation of e-government services in the rural districts of the Hamedan province as perceived by their directors (Hamedan, Bahar and Famenin Counties. The study population consists of 91 respondents who were chosen and studied through the census method. The findings of this research study consist of two sections. The items related to satisfaction with the activities in information and communication technology service offices were prioritized in the first section. Moreover, the current and the desirable conditions for electronic service provision were identified. The gap between these two were analyzed in the second section. The results indicate that there is a significant difference between these two conditions of electronic service provisions in rural areas. This significant difference was recognized through the paired T test at the 0.05 level with 6.33 value that illustrates the existence of a gap between these two situations. Electronic government, information technology and communication, information and communication technology service offices
Full Text Available Background: Biodiversity plays a critical role in improving the quality of life and resilience of poor urban communities in Durban. Objectives: However, the rapid densification that is taking place in the ‘rural periphery’ of the city is impacting significantly on the integrity of ecosystems, which provide valuable ecosystem services. It is also changing the relations between people and the environment. Mzinyathi and eSkebheni, in the north-west of Durban, are peri-urban areas located on Ingonyama Trust land and hence they are governed by both the traditional authority and the eThekwini Municipality. The settlement pattern is changing rapidly here as middle and upper income residents move into the area, changing the way of life from being rural and ‘traditional’ to urban and ‘modern’. Method: This paper focused on the nexus of rapid urban growth, dual governance systems, biodiversity loss and cultural change in these two areas. It adopted a qualitative methodology and social constructivist approach. Data on the value of environmental services in the area was collected through interviewing the traditional authority, provincial and municipal planners and environmentalists, and household members. Results: The paper revealed that environmental services are constructed in multiple ways within a particular socio-historical and political context, that they have value to peri-urban communities, and that their function and use is changing as a result of the ‘modernisation’ of the area. The impact of the dual governance system and traditional land allocation process on environmental services is significant. This has implications for long term sustainability, for the quality of life of peri-urban residents and for planning and urban governance.
Empowerment Zones and Enterprise Districts, Municipal Service Area - area defined by Ordinance that provides for the City jurisdiction related to development and future growth, Published in 2009, 1:24000 (1in=2000ft) scale, City of Topeka Government.
NSGIC Local Govt | GIS Inventory — Empowerment Zones and Enterprise Districts dataset current as of 2009. Municipal Service Area - area defined by Ordinance that provides for the City jurisdiction...
Full Text Available This work deals with a technology for data exchange XML Web Services and its application to specific tasks. One of the applications created allows you to monitor and control the real thermal process through a number of client devices, independent of the operating system, the type or their location. The thermal process can be controlled, for example, by another process, a website or a mobile phone. The system is designed from its base and contains three main parts. The hardware part consists from a measuring card, actuators and temperature sensors. The core application is a server that is running the XML Web Service, Windows Service and SQL Server. Client software for mobile phones and web sites was also created.
Khatun, Fatema; Heywood, Anita E; Hanifi, Syed Manzoor Ahmed; Rahman, M Shafiqur; Ray, Pradeep K; Liaw, Siaw-Teng; Bhuiya, Abbas
Traditional gender roles result in women lagging behind men in the use of modern technologies, especially in developing countries. Although there is rapid uptake of mobile phone use in Bangladesh, investigation of gender differences in the ownership, access and use of mobile phones in general and mHealth in particular has been limited. This paper presents gender differentials in the ownership of mobile phones and knowledge of available mHealth services in a rural area of Bangladesh. We interviewed 4915 randomly selected respondents aged 18 years and above. Associations between gender and knowledge of available mHealth services, use of existing mHealth services and intentions to use mHealth services in the future were examined by multivariate logistic regression analysis, controlling for the effect of categorised covariates. Of the 4915 respondents to the survey, 61.8% of men (1213/1964) and 34.4% of women (1015/2951) owned a mobile phone. For men, mobile phone ownership was highest among those aged 18-29 years (n = 663, 76.3%), and for women among those aged 30-39 years (n = 825, 44.7%). A higher proportion of men owned phones compared to women, irrespective of socioeconomic status (SES) as indicated by asset index (p mHealth services was lower among women than men; however, intention to use mHealth services in the future was high for both genders, irrespective of age, education and socioeconomic status. Compared to men, women are less likely to own a mobile phone and less aware of available mHealth services, despite high intention to use mHealth among both genders. To optimise the use of mHealth services and to achieve equity of use, uptake strategies should target women, with a focus on the poorer and less educated groups.
Víctor Manuel Alcantar Enríquez
Full Text Available This research, consisting of a descriptive study with a non-experimental design, involved an analysis to determine the validity and reliability of an instrument composed of seventeen items aimed at assessing the quality of service in the financial area of a public university by means of four variables: tangibility, reliability, responsiveness and empathy. The methodological strategy included the design of the measuring instrument; verification of the validity of content and construct; and analysis of internal consistency by means of Cronbach’s alpha. The instrument was applied to 152 users of the service, attaining a reliability coefficient of 0.943. The results show that with respect to specific concepts, the questions were clear; nevertheless we found it necessary to relocate items and rename variables, which resulted in a valid and reliable instrument for measuring the quality of service in the context under study.
... groups and women are given the opportunity to participate in the provision of spectrum-based services... members of minority groups and women.'' One of the principal means by which the Commission fulfills these... definitions for auctions of these licenses. We seek comment on whether we should define an entrepreneur as an...
Lohmann, N.; Wolf, K.; Hull, R.; Mendling, J.; Tai, S.
During the previous years, we presented several results concerned with various issues related to the correctness of models for business processes and services (i. e., interorganizational business processes). For most of the results, we presented tools and experimental evidence for the computational
Rully Adi Nugroho
Full Text Available Service-learning has gained substantial recognition as an effective type of pedagogy and has enhanced civic education across the disciplines, however remains a lack of understanding of this type of learning in Indonesia. The goals of the study were (1 to explore the forms of local knowledge systems practiced in Semarang Regency and how they are used in resources conservation using service-learning method, (2 to foster student engagement with the community, and (3 to promote student awareness of community resources that are directly relevant to local knowledge system issues. The success of the service-learning projects in meeting these goals was assessed via qualitative analysis of student reflective papers and classroom presentations. The results indicated there were local knowledges that were still successfully in use, but often only very locally. Furthermore, the results also indicated that the service-learning projects promoted students’ valuable academic skills, including communication, team-building, and critical thinking, built their self-esteem, their awareness of community needs and resources, and demonstrated the relevance of course content to real life.
... in an Indian Health Service health center, a Native Hawaiian health center, a public hospital, a migrant health center, a community health center, a nursing facility, a rural health clinic, or in a... under this section. (Approved by the Office of Management and Budget under control number 0915-0047) [50...
Sotomayor, Maria Angelica
Colombia is one of the most active Latin American countries in incorporating private sector participation (PSP) in managing water utilities. One of the community's main concerns is that reforms that treat water and sanitation services as an economic asset rather than as a social good and that allow providers to apply commercial (profit-oriented) criteria, may tend to restrict access to the...
Arch, B N; Thurston, M N
Deaths and injuries related to fires are largely preventable events. In the UK, a plethora of community-based fire safety initiatives have been introduced over the last 25 years, often led by fire and rescue services, to address this issue. This paper focuses on one such initiative--home safety assessments (HSAs). Cheshire Fire and Rescue Service (in England) implemented a uniquely large-scale HSA intervention. This paper assesses its effectiveness. The impact of HSAs was assessed in relation to three outcomes: accidental dwelling fires (ADFs), ADFs contained and injuries arising from ADFs. A two-period comparison in fire-related rates of incidences in Cheshire between 2002 and 2011 was implemented, using Poisson regression and adjusting for the national temporal trend using a control group comprising the 37 other English non-metropolitan fire-services. Significant reductions were observed in rates of ADFs [incidence rate ratios (IRR): 0.79, 95% confidence interval (CI): 0.74-0.83, P fires contained to room of origin. There is strong evidence to suggest that the intervention was successful in reducing domestic fires and related injuries.
Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare
(1) To determine the percentage of the population in England that has access to a general practitioner (GP) premises within a 20 min walk (the accessibility); (2) explore the relationship between the walking distance to a GP premises and urbanity and social deprivation and (3) compare accessibility of a GP premises to that of a community pharmacy--and how this may vary by urbanity and social deprivation. This area-level analysis spatial study used postcodes for all GP premises and community pharmacies in England. Each postcode was assigned to a population lookup table and Lower Super Output Area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe, or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score 2010). Living within a 20 min walk of a GP premises. Overall, 84.8% of the population is estimated to live within a 20 min walk of a GP premises: 81.2% in the most affluent areas, 98.2% in the most deprived areas, 94.2% in urban and 19.4% in rural areas. This is consistently lower when compared with the population living within a 20 min walk of a community pharmacy. Our study shows that the vast majority of the population live within a 20 min walk of a GP premises, with higher proportions in the most deprived areas--a positive primary care law. However, more people live within a 20 min walk of a community pharmacy compared with a GP premises, and this potentially has implications for the commissioning of future services from these healthcare providers in England. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Brown, Alison; Santilli, Mario; Scott, Belinda
Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data. The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks. Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks. The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines. The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management. The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Diek, Sanne; de Jong, Rogier; Braun, Daniela; Böhler, Jonas; Schaepman, Michael
Soils play an important role in the benefits offered by ecosystems services. In densely populated Switzerland soils are a scarce resource, with high pressure on services ranging from urban expansion to over-utilization. Key change drivers include erosion, soil degradation, land management change and (chemical) pollution, which should be taken into consideration. Therefore there is an emerging need for an integrated, sustainable and efficient system assessing the management of soil and land as a resource. The use of remote sensing can offer spatio-temporal and quantitative information of extended areas. In particular imaging spectroscopy has shown to perfectly complement existing sampling schemes as secondary information for digital soil mapping. Although only the upper-most layer of soil interacts with light when using reflectance spectroscopy, it still can offer valuable information that can be utilized by farmers and decision makers. Fully processed airborne imaging spectrometer data from APEX as well as land cover classification for the agricultural area in Lyss were available. Based on several spectral analysis methods we derived multiple soil properties, including soil organic matter, soil texture, and mineralogy; complemented by vegetation parameters, including leaf area index, chlorophyll content, pigment distribution, and water content. The surface variables were retrieved using a combination of index-based and physically-based retrievals. Soil properties in partly to fully vegetated areas were interpolated using regression kriging based methods. This allowed the continuous assessment of potential soil functions as well as non-contiguous maps of abundances of combined soil and vegetation parameters. Based on a simple regression model we could make a rough estimate of ecosystem services. This provided the opportunity to look at the differences between the interpolated soil function maps and the non-contiguous (but combined) vegetation and soil function maps
Tobagi, Fouad A.; Dalgic, Ismail; Pang, Joseph
The design and implementation of interface units for high speed Fiber Optic Local Area Networks and Broadband Integrated Services Digital Networks are discussed. During the last years, a number of network adapters that are designed to support high speed communications have emerged. This approach to the design of a high speed network interface unit was to implement package processing functions in hardware, using VLSI technology. The VLSI hardware implementation of a buffer management unit, which is required in such architectures, is described.
Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at
Full Text Available Abstract Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i Telecollaboration and teleconsultation services between remotely located healthcare providers, ii telemedicine services in emergencies, iii home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G, and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances
Michelle E Portman
Full Text Available Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity.
Full Text Available This paper discusses the convergence of digital broadcasting and Internet technologies, by elaborating on the design, implementation, and performance evaluation of a hybrid terrestrial/satellite networking infrastructure, enabling triple-play services access in rural areas. At local/district level, the paper proposes the exploitation of DVB-T platforms in regenerative configurations for creating terrestrial DVB/IP backhaul between the core backbone (in urban areas and a number of intermediate communication nodes distributed within the DVB-T broadcasting footprint (in rural areas. In this way, triple play services that are available at the core backbone, are transferred via the regenerative DVB-T/IP backhaul to the entire district and can be accessed by rural users via the corresponding intermediate node. On the other hand, at regional/national level, the paper proposes the exploitation of a satellite interactive digital video broadcasting platform (DVB S2/RCS as an overlay network that interconnects the regenerative DVB-T/IP platforms, as well as individual users, and services providers, to each other. Performance of the proposed hybrid terrestrial/satellite networking environment is validated through experimental tests that were conducted under real transmission/reception conditions (for the terrestrial segment and via simulation experiments (for the satellite segment at a prototype network infrastructure.
Crespo de Carvalho, J.; Silva, J.; O'Neill, H.
Logistics and supply chain management is an area that evolved deeply in the past years, integrating develop-ments of other areas of knowledge, both entrepreneurial and general. In this paper, a perspective of the evolu-tion of logistics and supply chain management is somehow designed. Traditionally, one may find logistics and supply chain management in friction with marketing and claiming for its own space. Nowadays, it seems difficult to see internal (logistics) versus external (marketing) w...
Martin Hnik; Marek Babiuch
This work deals with a technology for data exchange XML Web Services and its application to specific tasks. One of the applications created allows you to monitor and control the real thermal process through a number of client devices, independent of the operating system, the type or their location. The thermal process can be controlled, for example, by another process, a website or a mobile phone. The system is designed from its base and contains three main parts. The hardware part consists f...
Sommanustweechai, Angkana; Putthasri, Weerasak; Nwe, Mya Lay; Aung, Saw Thetlya; Theint, Mya Min; Tangcharoensathien, Viroj; Wynn, San Shway
Myanmar is classified as critical shortage of health workforce. In responses to limited number of trained health workforce in the hard-to-reach and remote areas, the MOH trained the Community Health Worker (CHW) as health volunteers serving these communities on a pro bono basis. This study aimed to assess the socio-economic profiles, contributions of CHW to primary health care services and their needs for supports to maintain their quality contributions in rural hard to reach areas in Myanmar. In 2013, cross-sectional census survey was conducted on all three groups of CHW classified by their training dates: (1) prior to 2000, (2) between 2000 and 2011, and (3) more recently trained in 2012, who are still working in 21 townships of 17 states and regions in Myanmar, using a self-administered questionnaire survey in the Burmese language. The total 715 CHWs from 21 townships had completely responded to the questionnaire. CHWs were trained to support the work of midwives in the sub-centres and health assistant and midwives in rural health centres (RHCs) such as community mobilization for immunization, advocates of safe water and sanitation, and general health education and health awareness for the citizens. CHWs were able to provide some of the services by themselves, such as treatment of simple illnesses, and they provided services to 62 patients in the last 6 months. Their contributions to primary health care services were well accepted by the communities as they are geographically and culturally accessible. However, supports from the RHC were inadequate in particular technical supervision, as well as replenishment of CHW kits and financial support for their work and transportation. In practice, 6 % of service provided by CHWs was funded by the community and 22 % by the patients. The CHW's confidence in providing health services was positively associated with their age, education, and more recent training. A majority of them intended to serve as a CHW for more than
Mercuri, Mathew; Birch, Stephen; Gafni, Amiram
Allocating resources on the basis of population need is a health care policy goal in many countries. Thus, resources must be allocated in accordance with need if stakeholders are to achieve policy goals. Small area methods have been presented as a means for revealing important information that can assist stakeholders in meeting policy goals. The purpose of this review is to examine the extent to which small area methods provide information relevant to meeting the goals of a needs-based health care policy. We present a conceptual framework explaining the terms 'demand', 'need', 'use' and 'supply', as commonly used in the literature. We critically review the literature on small area methods through the lens of this framework. 'Use' cannot be used as a proxy or surrogate of 'need'. Thus, if the goal of health care policy is to provide equal access for equal need, then traditional small area methods are inadequate because they measure small area variations in use of services in different populations, independent of the levels of need in those populations. Small area methods can be modified by incorporating direct measures of relative population need from population health surveys or by adjusting population size for levels of health risks in populations such as the prevalence of smoking and low birth weight. This might improve what can be learned from studies employing small area methods if they are to inform needs-based health care policies. © 2013 John Wiley & Sons Ltd.
Amir Mozafar Amini
Full Text Available Nowadays, Internet access and use of information resources in all human societies are experiencing a rising trend, and different communities are used each with multiple infrastructures due to the benefits of ICT. The present study was based on applied research. In this research, a hybrid approach involving quantitative methods (survey and qualitative (observation, interviews was used. Statistical population of this study consists of two parts, the first part responsible for rural ICT offices, with a population of 125 people using Cochran Formula 80 subjects were selected as first sample, and the second part of the rural of first sample villages with a population of 84,836 people using Cochran formula and randomized-comparative method were studied as second sample. The questionnaire was subjected to reliability testing by using data collection in the pilot study with Cronbach’s Alpha value 0.73 to 0.95 for all variables. SPSS statistical software was used to analysis the data. The results of the study indicate that the overall performance of the agencies providing services to the rural was lower-middle in the offices in banking services has received first place, and the final ranking in the provision of health services. The results of study showed that rural employment, level education and family size effect on the rate of rural ICT offices.
The electrical sector has traditionally been organized as a natural monopoly. The intensity in capital of the grid and the public service obligation of electrical distribution led to the creation of electrical companies with exclusive territorial concessions. This approach has recently been challenged because of its failure to electrify remote rural villages in developing countries. A new set of solutions appeared under the umbrella of Decentralized Rural Electrification (DRE) thanks to technological innovations that replace collective infrastructures with individual systems. However, the widespread deployment of decentralized technologies remains impaired by numerous obstacles at various levels: institutional, legal, organizational, social, financial... New models that take into account the specificities of DRE must now be imagined. The study of two case studies in Morocco and India provide insightful examples of possible strategies to accelerate the deployment of DRE and therefore attain the objectives of rural electrification. Two major policies stand out: public service delegation and the approach of delivering equipment by the public market. Even though these models are too recent to conclude on their viability and permanence, they provide guidelines for the public and private players of the sector to generalize the access to electrical services to rural populations in developing countries, and contribute to their development. (author)
It is now widely recognised that a potential recruitment crisis is looming in the provision of primary care physicians for remote rural areas of the United Kingdom. Anecdotal evidence suggests that rural registrar, associate and principal vacancies are becoming increasingly difficult to fill and for many rural GPs locums are an impossible dream. Many practitioners are no longer prepared to work in areas where out-of-hours cooperatives are not available. We are now faced with the very real possibility that in some remote areas of the Scottish Highlands and Islands the recruitment of suitable GPs may no longer be possible. So what are the alternatives? In October 1999 I visited a community in the mountains of northern New Mexico which has had to deal with this very problem.
Mitton-Kukner, Jennifer; Orr, Anne Murray
In this paper we describe four ways secondary pre-service teachers appeared to be developing assessment practices during field experience, after taking a content area literacy course. This paper arises from a multi-year study exploring pre-service and beginning content area teachers' use of literacy strategies in teaching mathematics, science, and…
Ioannis N. Mavridis
Full Text Available The concept of stereotactically standard areas (SSAs within human brain nuclei belongs to the knowledge of the modern field of stereotactic brain microanatomy. These are areas resisting the individual variability of the nuclear location in stereotactic space. This paper summarizes the current knowledge regarding SSAs. A mathematical formula of SSAs was recently invented, allowing for their robust, reproducible, and accurate application to laboratory studies and clinical practice. Thus, SSAs open new doors for the application of stereotactic microanatomy to highly accurate brain targeting, which is mainly useful for minimally invasive neurosurgical procedures, such as deep brain stimulation.
Mavridis, Ioannis N
The concept of stereotactically standard areas (SSAs) within human brain nuclei belongs to the knowledge of the modern field of stereotactic brain microanatomy. These are areas resisting the individual variability of the nuclear location in stereotactic space. This paper summarizes the current knowledge regarding SSAs. A mathematical formula of SSAs was recently invented, allowing for their robust, reproducible, and accurate application to laboratory studies and clinical practice. Thus, SSAs open new doors for the application of stereotactic microanatomy to highly accurate brain targeting, which is mainly useful for minimally invasive neurosurgical procedures, such as deep brain stimulation.
Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S.; Peiro, S.
To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs
José Carlos MACÍA ARCE
Full Text Available One of the pillars of the technological revolution that began in the seventies was the development of the Internet. This network has evolved in such a way that it now forms a complex structure that radically changed the social and economic dynamics at the end of century XX. Nowadays, new technologies allow anything from communication and information exchange to the realization of complex financial transactions, all from anywhere in the world and almost instantaneously. In spite of the widespread use of the Internet, there are still territories and inhabitants, mostly emplaced in remote rural areas, who live outside of this technological revolution. By contrast, urban areas enjoy a privileged position in the dissemination of the information society by concentrating most of the telecommunications infrastructure and monopolize the most qualified people. But there are many disparities in terms of diffusion of new technologies and these will transfer, in turn, to the enterprise sector which is the subject of this research. The differences in the use of new technologies and more specifically the use of advanced services on the Internet are related to the sector where the population is employed and its level of training. One of the advanced services offered by the Network is teleworking. Nowadays there are companies that offer their employees the opportunity to develop their professional activities outside their headquarters, using their homes as an alternative or call centers enabled with computers and Internet access. The purpose of this research is the study of the consumption of Internet advanced services by companies in the metropolitan area of Madrid, analyzing the spread of telework in more detail,a potential offered by new technologies and which may modify the current pattern of mobility in the main urban areas because it is from here where big companies are guiding the global economy.
... designated for travel by snowmobiles from the access points to the frozen surface of Blue Mesa Reservoir... History of Curecanti National Recreation Area The Blue Mesa Dam and Reservoir, Morrow Point Dam and... as Blue Mesa Lake). The high-water mark is defined as the point at which the reservoir is at maximum...
Sep 4, 2013 ... RURAL AREA IN SOUTH AFRICA: THE CASE STUDY OF THORNDALE ... Social Network for Environment & Development, P. O. Box CT 3441, Cantonments,. Accra ... the Savannah biome of the Bushbuckridge region in the Limpopo Province, South ...... Oklahoma City, Oklahoma: World Neighbors: 1985.
Mitton Kukner, Jennifer; Murray Orr, Anne
The focus of this qualitative multi-year case study is on preservice teachers' experiences related to the development of their literacy practices in teaching high school science, math, social studies and other content area courses during their final field placement in a teacher education program. Results indicate tangible indicators of overall…
Tatiana Vyacheslavovna Tikhonova
Full Text Available Features and condition of existing system of especially protected natural territories of the Komi Republic are presented in this paper. Their specific environmental problems are defined. Strong sides and weaknesses of functioning and management of objects of special protection are provided. For approbation of a complex of methods of steady exploitation of this territory modeling objects of special protection are allocated and the economic assessment is carried out them. Potential recipients of benefits from use of bioresources and ecosystem services on modeling objects arerevealed. Theterritories possessing a reservefor increasein use of their resources and services are presented. Offers on strategy of development of a control system of especially protected natural territories of the Komi Republic are developed. Development strategy of control system ofespecially protected natural territories is consisting of someinstitutional decisions. This acceptance of federal-regional agreement about management control;creating of regional rules, which regulatethe usage of natural resources in especially protected natural territories; application of an integrated approach to the use of territories, which provide the bases to increase recreation and tourist industry; transfer buffer zone territories to biosphere reservation.
Llena Puy, M C; Ausina Márquez, V
We describe and analize the activities we carried out in a surgery from a preventive dentistry unit. Longitudinal descriptive study from 1993 since 1994. Health Area 8 from the Valencian Autonomous Region. Children from 3 to 14 year-old attendant to the preventive dentistry unit's surgery (2.497). We visited 5.012 children. The highest percentage of population corresponded to the zona 4, where began at first the preventive service. The activities distribution was as follow: oral explorations and plaque control (100%), fluoride topic aplication (90.38%), diet control (36.81%), pit and fisure sealants (6.46%), profilaxis (8.71%), radiological diagnosis (6.46%), dental emergencies (2.17%). The users origin was: 38.88% school oral explorations made over 6- and 10-year-old children; 63.71% from self-request; and 16.45% sent by other health professionals. 41.42% were continuated visits. Demand of preventive dental services is very high in our health area, although incorporation of therapeutic techniques is wished by the population. This demand increase as well as the surgery is closer to the user. People from big cities are stubborn using these services from smallest villages, even having transport facilities. Children start coming to the consults between 5-6 year-old, keeping an acceptable control until 12 approximately.
Zeller, Scott; Calma, Nicole; Stone, Ashley
Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the "regional dedicated emergency psychiatric facility," which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the "Alameda Model" on boarding times and hospitalization rates for psychiatric patients in area EDs. Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus
Liao, Yangzhe; Leeson, Mark S.; Higgins, Matthew D.
Wireless body area sensor networks (WBASNs) are becoming an increasingly significant breakthrough technology for smart healthcare systems, enabling improved clinical decision-making in daily medical care. Recently, radio frequency ultra-wideband technology has developed substantially for physiological signal monitoring due to its advantages such as low-power consumption, high transmission data rate, and miniature antenna size. Applications of future ubiquitous healthcare systems offer the pro...
Liao, Yangzhe; Leeson, Mark S.; Higgins, Matthew D.
Wireless body area sensor networks (WBASNs) are becoming an increasingly significant breakthrough technology for smart healthcare systems, enabling improved clinical decision-making in daily medical care. Recently, radio frequency (RF) ultra-wideband (UWB) technology has developed substantially for physiological signal monitoring due to its advantages such as low power consumption, high transmission data rate, and miniature antenna size. Applications of future ubiquitous healthcare systems of...
Full Text Available The aim of this article is to describe the state of the acoustic climate at the rest and service areas (MOPs situated by A4 motorway in Silesia The analysis includes the research results conducted at these parking lots from May till August 2010. The research was conducted with the digital noise meter, which was connected with the computer during measurement. The research results indicate the essential differences in the noise intensity between the particular rest and service area reaching up to 12 dB(A, in spite of the similar value of the traffic noise in all of the places where the research was conducted. It was assumed that the level of noise on each of the parking lots should be similar to standing norms for the recreation areas i.e. below 55 dB(A. The research conducted at 4 MOPs indicated that only at two of them, MOP Halemba and Wirek, these norms are fulfilled. The lack of the proper anti-noise protection in the form of the sound absorbing screens at the parking lots situated by the motorway causes the situation in which the level of noise at the places devoted to rest highly decreases the possibility to relax before the next stage of a journey.
Sharma, D; Pokharel, H P; Budhathoki, S S; Yadav, B K; Pokharel, R K
Half a million women die every year due to pregnancy and childbirth in the world. Among these death, 99% occur in the low and middle income countries. Antenatal care (ANC) provides an opportunity to deliver different services which are important in improving maternal survival. A descriptive cross sectional study was conducted from September 2012 - February 2013 among 400 married women of reproductive age group. A pre-tested structured questionnaire were used and data were analyzed using Statistical Package for Social Science(SPSS) for windows version 18.0. Frequency, crude and adjusted odds ratios and confidence intervals were performed. Nearly 27% had four or more antenatal health care utilization(ANC) visits on appropriate time according to schedule of World Health Organization(WHO). In logistic regression, ANC users were found to be more/less likely to be in age group 20 - 35 years (AOR =2.825, 95% CI: 1.166-6.843), education of spouse (AOR 0.361, 95% CI : 0.130-1.000), occupation of spouse (AOR = 0.261, 95% CI: 0.093 -0.739), monthly income of family > 20,000Nrs (AOR = 2.190, 95% CI: 1.041-4.606), planned pregnancy (AOR = 2.417, 95% CI: 1.047 -5.609), death of child (AOR = 3.153, 95% CI: 1.112 -8.944). This study demonstrated low antenatal care service utilization. Hence, there is a need to increase the availability and accessibility of antenatal care to all women.
Sharkey, Joseph R
Geographic access to healthy food resources remains a major focus of research that examines the contribution of the built environment to healthful eating. Methods used to define and measure spatial accessibility can significantly affect the results. Considering the implications for marketing, policy, and programs, adequate measurement of the food environment is important. Little of the published work on food access has focused on rural areas, where the burden of nutrition-related disease is greater. This article seeks to expand our understanding of the challenges to measurement of potential spatial access to food resources in rural areas in the U.S. Key challenges to the accurate measurement of the food environment in rural areas include: (1) defining the rural food environment while recognizing that market factors may be changing; (2) describing characteristics that may differentiate similar types of food stores and food-service places; and (3) determining location coordinates for food stores and food-service places. In order to enhance measurements in rural areas, "ground-truthed" methodology, which includes on-site observation and collection of GPS data, should become the standard for rural areas. Measurement must also recognize the emergence of new and changing store formats. Efforts should be made to determine accessibility, in terms of both proximity to a single location and variety of multiple locations within a specified buffer, from origins other than the home, and consider multipurpose trips and trip chaining. The measurement of food access will be critical for community-based approaches to meet dietary needs. Researchers must be willing to take the steps necessary for rigorous measurement of a dynamic food environment.
The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described
Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L
Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.
Kamieniecki, S.; Milbrath, L.W.
A number of major findings have emerged from this analysis. Although most people have heard or read about the Nuclear Fuel Services plant at West Valley, few exhibit a high level of knowledge about the issue area. A clear majority of residents living in the region are concerned about the presence of the facility. Many are particularly concerned about the health dangers that can result from radioactive contamination of the environment. People want to see something done about the facility, but do not know exactly what. When forced to choose one out of three possible alternatives, twice as many people preferred to ''completely remove the plant and restore the area'' than either of the two remaining alternatives. People who are concerned about the facility tend to favor removal of the plant and restoration of the area. Nearly three-fourths of West Valley area residents who believe that the plant did not employ enough people to significantly help the economy of the region favor removal of the facility and restoration of the area. The results of this study may help policymakers choose the most acceptable course of action
Full Text Available The purposes of this research were 1 to study the elements and indicators students desirable characteristics for schools ; 2 to study the present condition and the desirable of students desirable characteristics for schools ; and 3 to develop guidelines to enhance students desirable characteristics for schools under the office of Udornthani primary education service area 1. Research and development. Method was divided into three phases for the purposes of research. The samples were 296 teachers and school administrators, using stratified random sampling. Instruments used were questionnaire, assessment elements and indicators, interview form and assessment guidelines. Data were analyzed using mean, standard devitation and modified priority needs index. Research findings were as follows: 1. There were 3 elements of students desirable characteristics for schools consisted of discipline, learning and commitment to work. Discipline consisted of four indicators, learning consisted of indicators and commitment to work consisted of two indicators. 2. The current situation of students desirable characteristics for schools under the office of Udornthani primary education service area 1, overall at a high level, considering each element, discipline was the highest, followed by learning and the lowest was commitment to work as well. In desirable situation the same relults on the current situation. 3. Guidelines to enhance students desirable characteristics for schools under the office of Udornthani primary education service area 1 consisted of 7 guidelines: 1 the policy clearly ; 2 providing specialized committees ; 3 creating a common understanding ; 4 targeting clearly ; 5 the environmental moral ; 6 supervision, monitoring and evaluation ; and 7 creating a network of parents and the community.
Alisjahbana, A; Williams, C; Dharmayanti, R; Hermawan, D; Kwast, B E; Koblinsky, M
The Regionalization of Perinatal Care, an intervention study carried out in Tanjungsari, a subdistrict in rural West Java, aimed to develop a comprehensive maternal health program to improve maternal and perinatal health outcomes. The main inputs included training at all levels of the health care system (informal and formal) and the establishment of birthing homes in villages to make services more accessible. Special attention was given to referral, transportation, communication and appropriate case management, A social marketing program was conducted to inform people of the accessible birthing homes for clean delivery, located near the women, and with better transportation and communications to referral facilities should complications arise. The study design was longitudinal, following all pregnant women from early pregnancy until 42 days postpartum in an intervention and a comparison area. The population was +/- 90,000 in the intervention area and 40,000 in the comparison area. Inclusion criteria were all mother and infant units delivered between June 1st, 1992 and May 31st, 1993. Analysis showed the following results: Most women sought antenatal care (> 95%). In Tanjungsari, nearly 90% sought such care from professional providers as versus 75% in the control area of Cisalak. Most women with bleeding or bleeding and edema during pregnancy sought professional assistance in both the study and control areas. However, fever for more than 3 days received more attention in the study area versus control area (93 vs. 69%). Greater than 85% of deliveries in both areas were conducted by TBAs. However, in the study area, nearly one-third of those with intrapartum complications (17%) delivered in a health facility compared to one-tenth in the control area. This meant a hospital delivery, primarily with assistance of a doctor or doctor/midwife combination. Overall referral rates by TBAs were low -13% of women with complications in Tanjungsari and 6% in Cisalak. More women
Leukert, K.; Telser, H.; Vaterlaus, S.; Mahler, P.
This report for the Swiss Federal Office of Energy (SFOE) takes a look at the results of a study made on the willingness to pay for public services and quality of supply in the electricity area. First, the starting point of the study and definitions of quality of supply and security of supply are noted. The methods used in the study are presented and macro-economic aspects are reviewed. The costs of black-outs are examined and the carrying out of surveys in the electricity market is discussed. The results of surveys made in households and commercial enterprises concerning the willingness to pay for security of supply and the costs incurred when supplies fail are presented and discussed. The report is completed with a comprehensive list of references and an appendix containing the results of the various tests and surveys made.
Huang, Huan-Chun; Yun, Ying-Xia; Miao, Zhan-Tang; Hao, Cui; Li, Hong-yuan
Based on the modified Logistic-CA model, and taking the coastal area of Tianjin as a case, this paper simulated the spatial evolution patterns of ecosystem services as affected by the urban expansion in 2011-2020 under the scenarios of historical extrapolation, endogenous development, and exogenous development. Overall, the total ecosystem services of the study area under the three scenarios were generally the same, and the functional region with the lowest level ecosystem services had the identical spatial pattern. However, the spatial evolution patterns of the ecosystem services of the study area under the three scenarios had a great difference. The functional regions with lower-level ecosystem services grew in a cross-shaped pattern, with the Tanggu downtown as a center, and finally formed a full connectivity area along the Haihe River and coastal zone.
Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A
Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare
Full Text Available The fact that tourists who visit Bucovina relate more and more to quality standards promoted by the EU, forces the guesthouses administrators to point a big part of their attention towards creating a memorable holiday atmosphere. Since we intend, periodically, to check the balance of power between visitors' expectations and what the area can offer in terms of tourism, the accommodations from Vama and Pojorîta – Bucovina’s standard in hospitality - were subjected to a careful qualitative analysis, in the period April-May 2014. Although we could highlight a number of positive aspects on the local hospitality, cleanliness and the traditional aspects present in the guesthouses, some improvements regarding mainly the qualifications and fidelity of staff, touristic signalling and accessibility, leisure diversification, feedback and inducting a home sentiment to tourists are, however, required.
Full Text Available This paper aims at understanding how a better relationship between infrastructures and landscapes can be established, by encouraging new ways to experience and effectively use the places that are located near the infrastructural nodes. The work starts from the identification of a specific case study: the landscape in-between the cities of Milan and Turin, that are connected by the infrastructural bundle made of the three lines of the regional / historical railways, the motorway and the new tracks of the high speed train. The research highlights cultural heritage sites and places of interest, points out a series of areas and routes that connect them with the infrastructure. The Milan 2015 Expo could in this sense be a very powerful catalyst, by encouraging these intermodal uses of the infrastructural bundle to reach and truly experience the agricultural and cultural landscapes located around it.
Wang, D. G.; Sun, L.; Tan, Y. H.; Shi, A. Q.; Cheng, J.
Taking the mangrove ecosystem of Ximen Island National Marine Specially Protected Areas as the research object, the ecological service value of the mangrove forest was evaluated and analyzed using a market value method, an ecological value method and a carbon tax method. The results showed that the ecosystem service value of the mangrove forest on Ximen Island is worth a total of 16,104,000 CNY/a. Among the value of individual ecosystem services, the direct value of material production function and leisure function reached 1,385,000 CNY/a, with a ratio of 8.6%. The indirect value of disturbance regulation, gas regulation, water purification, habitat function and culture research reached 14,719,000 CNY/a, with a ratio of 91.4%. Among the above sub-items, the proportion of disturbance regulation value, habitat function value and cultural research function value reached 78.8%, which reflects the important scientific value and ecological value of the Ximen Island mangrove ecosystem, especially its vital importance in providing a habitat for birds and playing a role in disaster prevention and mitigation.
Agustin, I. W.; Sumantri, Y.
Malang was a great city that has the characteristics of diverse industries and it was spread in each district. Industry was one of the activities that have the characteristics of the movement with the goal of shipping and distribution. The vehicles used are large vehicles such as trucks and trailers. Problems related to the road’s performance that is the emergence of several points of delay and congestion due to the movement and the volume of vehicles as well as the limited capacity of existing roads. It encourages researchers to do research related to the effect of the industrial vehicle movements on the performance of existing roads in the city of Malang. The main purpose of the research is to analyze the effect of industrial vehicles movement on the road’s level of service of industrial area and to find out alternative solutions to improve the road’s level of service of industrial area. The research used multiple linear regression and do something analysis. The results showed that the types of industry in the city of Malang are ILMETTA, IATT, Agrokim, Sentra and Large Industries. Determining the location of the main observation based on the distribution of industry, have a major impact directly on the street, and the class of the national road are located in Sunandar Priyo Sudarmo Street. Existing land use in Sunandar Priyo Sudarmo Street are industrial, healthcare, office and it dominated by trade and services. Related to the variables that affect the movement of industrial vehicles are the number of employees (X3) and the delivery frequency (X6). The road’s level of service of Sunandar Priyo Sudarmo Street are D and E. While the effect of industrial vehicles movement on the road’s level of service which ranged from 13.77 per cent to 22.13 per cent of the total volume of vehicles on the road. Some referrals will be used to handle the problems that the road widening and the selection of alternative routes for the industrial vehicles.
Full Text Available The purpose of study were ; 1 to determine the Academic Management on small school Model ; 2 to Develop of Academic Management on small school model Under the office of Udonthani Educational Service Area 2. The research Methodology consisted of four steps ; 1 Analyzing the documentary research ; 2 developing the academic management on small school factors and Indicators with Delphi Technique by verifying of 21 experts ; 3 seeking the advices and the feedbacks from nine experts in Udonthani using focus group discussion ; 4 evaluating the 110 school Administrators opinions in Udonthani. The analysis of the data was accomplished by computation of percentage, mean, standard deviation, median and interquartile ranges. Based on the findings to the study; it was concluded that: 1 The group of experts represented the three factors were ; a A development school Record of students ; b A development attribute of student ; c care forward successes with 15 Indicators. 2 Based on group discussion, all experts strongly agreed with the used and Integration of three factors of academic management on small school Model. 3 Overall, the at 110 school demonstrations in Udonthani agreed with academic management on small school model at high level. 4 A development of academic management on small school model in the office of Udonthani Educational Service Area 2 ; a A development school Record of students with 5 indicators ; b A development attribute of student with 6 indicators ; c Care Forward Successes with 4 indicators.
Pilloy, W.J.; Hellwig, D.; Schaeffer, A.; Hoffmann, P.; Lens, V.
Aim: Demonstration of bi-directional PET data transmission, interactive display and co-registration, for the purpose of correlative imaging, treatment planning and teaching. Material and Method: In the year 2000, the initial problem to attend was to provide an effective PET service to a hospital (in Luxemburg) which lies 150 km away from a PET center (in another country). Once this solved, the procedure was expanded (in 2001) to co-registration with CT/MRI scans performed locally, and with radiotherapy simulation CT performed in another center 25 km away (in 2002). Equipment from various vendors was used (Siemens, Adac, GE, Hermes). With preliminary agreement of the national medical aid, patients are sent from the Nuclear Medicine Dept of the Centre Hospitalier in Luxemburg (CHL) to the Dept NM of the Saarland University Medical Center for PET examination. The digital data are then sent from the Siemens PET camera to a PC connected to the LAN, and then to a FTP server (Healthnet). The data are similarly collected by a PC of the hospital network in Luxemburg, and transferred to a Hermes NM station. The Dicom PET data are converted on the fly to Interfile, displayed interactively as any other tomographic data, printed and available on the NM image server. Since 2001, the PET data are co-registered with whole-body CT data recorded at CHL according to a specific protocol (see other paper of this group). Now in 2002, we are busy implementing the co-registration of PET data and simulation CT data obtained from the Centre Baclesse (CFB, 25 km from CHL) for the treatment planning of brain tumours (input into an ADAC system). Furthermore, we plan to send the data (after deletion of their digital ID) to a (South African) university which does not yet dispose of a PET camera, to allow the training of their registrars. Results: For the end-user clinician at CHL and CFB , the PET data have the quality of 'live data', which can be examined interactively, along with other imaging
Hall, Jenny; Skinner, Fiona; Tilley, Phil; MacRury, Sandra
Diabetes prevalence in Scotland is 5.3%, with type 2 diabetes accounting for 86.7% of all cases in the National Health Service Highlands health board area and 85.7% in the Western Isles. Structured education is a key component in the management of this chronic disease. However, current group session models are less feasible in lower-population non-urban environments due to distance, participant numbers and access to appropriately trained healthcare professionals. Group sessions may also be a less attractive option in small communities, where people tend to have close day-to-day personal contact. This study assesses the access and delivery preferences of remote and rural service users in the Highlands and Western Isles to structured diabetes education programs. The study used a mixed methods approach of focus groups and questionnaires with people with type 2 diabetes in the Highlands and Islands of Scotland. Both modes of participation were designed to explore perception of diabetes knowledge, diabetes education and use of technology. One-to-one delivery was the delivery method of choice; however, there was a preference for a digital approach over group education sessions. Service users expressed a strong desire to be able to learn at their own pace, when and where they wanted to, and with no requirement to travel. To address these requirements an online resource, providing access to both learning sessions and trusted sources of information, was the preferred mode of delivery. People with type 2 diabetes living in remote and rural areas of the Scottish Highlands and Islands who already use the internet are receptive to the use of digital technology for delivery of diabetes education and are interested in learning more about management of their condition through this medium. They believe that a technology approach will provide them with more control over the pace of learning, and where and when this learning can take place.
Hoang, Ha; Le, Quynh; Ogden, Kathryn
Understanding the needs of rural women in maternity care and service models available to them is significant for the development of effective policies and the sustainability of rural communities. Nevertheless, no systematic review of studies addressing these needs has been conducted. To synthesise the best available evidence on the experiences of women's needs in maternity care and existing service models in rural areas. Literature search of ten electronic databases, digital theses, and reference lists of relevant studies applying inclusion/exclusion criteria was conducted. Selected papers were assessed using standardised critical appraisal instruments from JBI-QARI. Data extracted from these studies were synthesised using thematic synthesis. 12 studies met the inclusion criteria. There were three main themes and several sub-themes identified. A comprehensive set of the maternity care expectations of rural women was reported in this review including safety (7), continuity of care (6) and quality of care (6), and informed choices needs (4). In addition, challenges in accessing maternity services also emerged from the literature such as access (6), risk of travelling (9) and associated cost of travel (9). Four models of maternity care examined in the literature were medically led care (5), GP-led care (4), midwifery-led care (7) and home birth (6). The systematic review demonstrates the importance of including well-conducted qualitative studies in informing the development of evidence-based policies to address women's maternity care needs and inform service models. Synthesising the findings from qualitative studies offers important insight for informing effective public health policy. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Full Text Available In recent years, Bangladesh government has accomplished the ambitious project of establishing hospitals 18,000 Community Health Clinics in sub-districts across the country. Operating under the affiliation of the government hospitals, these community health clinics aim to provide free healthcare services and to increase health-awareness among the extreme poor communities in the rural areas. However, a great proportion of the people are still not well aware of the services offered by the community health clinics. Thus, it is imperative to identify the factors of awareness regarding the community clinics. Research-based evidence is necessary to improve the efficacy and service coverage of community clinics among key population.Cross-sectional data of size 11,673 women aged 15 to 49 years living in rural settings across seven divisions were extracted from the latest Bangladesh Demographic and Health Survey 2014. The main outcome measures of our study were awareness and utilization of Community Clinic Services (CCs. Descriptive statistics were used to present the baseline socio-demographic and economic characteristics; Chi-square test and logistic regression were performed to identify the factors associated with awareness of community clinics.About one-third (36.7% of the women were aware of community clinics. Geographical location, level of education, household wealth status and frequency of reading newspaper were found to be significantly associated with awareness about community clinic services. Services reported to be obtained in the community clinics include family planning, immunization, tetanus, antenatal care, vitamin A, and health care for children and child growth monitoring. In the multivariate logistic regression, the odds of awareness among participants with primary education [p<0.001, AOR = 1.255, 95%CI = 1.107-1.357], secondary qualification [p<0.001, AOR = 1.370, 95%CI = 1.242-1.510] and tertiary [p<0.001, AOR = 1.526, 95%CI = 1
Full Text Available Recently, a wide range of quantitative research on the identification of environmental flow requirements (EFRs has been conducted. However, little focus is given to EFRs to maintain multiple ecosystem services in oasis areas. The present study quantifies the EFRs in oasis areas of Tarim Basin, Xinjiang, Northwest China on the basis of three ecosystem services: (1 maintenance of riverine ecosystem health, (2 assurance of the stability of oasis–desert ecotone and riparian (Tugai forests, and (3 restoration of oasis–desert ecotone groundwater. The identified consumptive and non-consumptive water requirements are used to quantify and determine the EFRs in Qira oasis by employing the summation and compatibility rules (maximum principle. Results indicate that the annual maximum, medium, and minimum EFRs are 0.752 × 108, 0.619 × 108, and 0.516 × 108 m3, respectively, which account for 58.75%, 48.36%, and 40.29% of the natural river runoff. The months between April and October are identified as the most important periods to maintain the EFRs. Moreover, the water requirement for groundwater restoration of the oasis–desert ecotone accounts for a large proportion, representing 48.27%, 42.32%, and 37.03% of the total EFRs at maximum, medium, and minimum levels, respectively. Therefore, to allocate the integrated EFRs, focus should be placed on the water demand of the desert vegetation’s groundwater restoration, which is crucial for maintaining desert vegetation to prevent sandstorms and soil erosion. This work provides a reference to quantify the EFRs of oasis areas in arid regions.
Sun, Xiao; Crittenden, John C; Li, Feng; Lu, Zhongming; Dou, Xiaolin
Urban expansion can lead to land use changes and, hence, threatens the ecosystems. Understanding the effects of urbanization on ecosystem services (ESs) can provide scientific guidance for land use planning and the protection of ESs. We established a framework to assess the spatial distributions of ESs based on land use changes in the Atlanta Metropolitan area (AMA) from 1985 to 2012. A new comprehensive ecosystem service (CES) index was developed to reflect the comprehensive level of ESs. Associated with the influential factors, we simulated the business as usual scenario in 2030. Four alternative scenarios, including more compact growth (MCG), riparian vegetation buffer (RVB), soil conservation (SC), and combined development (CD) scenarios were developed to explore the optimal land use strategies which can enhance the ESs. The results showed that forest and wetland had the greatest decreases, while low and high intensity built-up lands had the greatest increases. The values of CES and most of ESs decreased significantly due to the sprawling expansion of built-up land. The scenario analysis revealed that the CD scenario performs best in CES value, while it performs the worst in food supply. Compared with the RVB and SC scenarios, MCG scenario is a more optimal land use strategy to enhance the ESs without at the expense of food supply. To integrate multiple ESs into land use planning and decision making, corresponding land management policies and ecological engineering measures should be implemented to enhance: (1) the water yield and water purification in urban core counties, (2) the carbon storage, habitat quality, and recreational opportunity in counties around the core area, and (3) the soil conservation and food supply in surrounding suburban counties. The land use strategies and ecological engineering measures in this study can provide references for enhancing the ESs in the AMA and other metropolitan areas. Copyright © 2017 Elsevier B.V. All rights reserved.
Rioust, E.; Deroubaix, J. F.; Barroca, B.; Bonierbale, T.; de Gouvello, B.; Deutsch, J. C.; Hubert, G.
This paper considers the resilience perspective as an approach for understanding social and political vulnerabilities of urban services. The authors examine to what extend uncertainty due to climate change may affect the resilience of these urban services. The resilience perspective is increasingly used for analysing social groups' capacities to adapt to and live with disturbances. A lot of work on resilience has focused on the capacity to absorb shocks and still maintain functions. But there is also another aspect of resilience, which leads to take into account systems vulnerabilities and to aim at understanding their equilibrium and re-organization capacity. The purpose with this paper is to assess sewage systems capacities to adapt to climate change. Indeed, climate change could cause an increase of extreme rain events and, as a matter of consequence, an increase of sewer overflows and flooding of urbanised areas. Sewer systems have to cope with this change that may gravely affect urban planning. In recent studies of political science, risk management has been considered as a public policy involving and resulting from complex social, political and technical processes (Gilbert et al. 2003). From this point of view, the management of wastewaters and storm waters has to be considered not only as a technical but also as a political and a social system. Therefore, political science can be a fruitful perspective to understand the stakeholders perceptions of uncertainty and the way they are going to integrate this issue in their practices. The authors analyse the adaptive capacities of two sewer systems located in the Parisian suburban area. The chosen areas are highly populated. Each network is managed within a political and administrative unit called "Département". Both authorities of these "Départements" implement a public sewage service. Nonetheless these networks are connected and part of the greater Paris sewage policy. In both areas a real time control of
Full Text Available Background: The quality of dentist’s communication skills is considered as one of important aspects on the quality of dental health services assessment. During the initial interview conducted at Ketabang, Dupak, and Kepadangan community dental health services at Surabaya and Sidoarjo, Indonesia, it appeared that eighty percent of initial respondents were not satisfied with the communication aspect. Community Dental Health Services (CDHS need to assess the communication performances based on community characteristics in effort to promote the quality and effectiveness of the denta health services. Purpose: The objective of this study was to analyze patient’s expectation values priorities on dentists' communication performances in CDHS that located in urban and rural area. Methods: The study was conducted in Ketabang Surabaya, Dupak Surabaya and Kepadangan Sidoarjo CDHSs. The participants were 400 patients above 18 years old. Participants were assessed their expectation value using the communication performances of dental health services questionnaire. Results: Patients in urban CDHS appeared that there were two priority aspects which had high values, namely the clarity of instructions and the dentist’s ability of active listening to the patient, while patients in rural CDHS revealed that the clarity of instructions and dentist-patient relationship were the aspects with high values. Conclusion: Patients in CDHS that located in rural area expect more dentist-patient interpersonal relationship performance than patients in CDHS located in urban area. This finding becomes a valuable information for CDHS to develop communication strategies based on community characteristics.Latar belakang: Kualitas komunikasi dari dokter gigi merupakan salah satu aspek penting dalam penilaian kualitas layanan suatu sarana pelayanan kesehatan. Pada wawancara pendahuluan yang dilaksanakan di puskesmas Ketabang, Dupak dan Kepadangan di Surabaya dan Sidoarjo
Hansen, Rieke; Pauleit, Stephan
Green infrastructure (GI) and ecosystem services (ES) are promoted as concepts that have potential to improve environmental planning in urban areas based on a more holistic understanding of the complex interrelations and dynamics of social-ecological systems. However, the scientific discourses around both concepts still lack application-oriented frameworks that consider such a holistic perspective and are suitable to mainstream GI and ES in planning practice. This literature review explores how multifunctionality as one important principle of GI planning can be operationalized by approaches developed and tested in ES research. Specifically, approaches developed in ES research can help to assess the integrity of GI networks, balance ES supply and demand, and consider trade-offs. A conceptual framework for the assessment of multifunctionality from a social-ecological perspective is proposed that can inform the design of planning processes and support stronger exchange between GI and ES research.
Prem Lal Chauhan
Full Text Available Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the knowledge, awareness, and utilization pattern of services under JSY among the beneficiaries in rural area of Shimla, Himachal Pradesh, India. Materials and Methods: This cross-sectional study was conducted among the 78 JSY beneficiaries residing in the rural field practice area of Indira Gandhi Medical College Shimla, Himachal Pradesh, India. These beneficiaries were interviewed with pretested, predesigned, semi-structured close ended questionnaire by house-to-house visits, after obtaining informed consent. Results: Majority of the JSY beneficiaries (50; 64% were in the age group of 20–25 years and 43 (55.1% of them heard about the JSY scheme before the present pregnancy. Anganwadi workers 78 (100% and female health workers (62; 79.5% were the main sources of information. More than half of the study participants (44; 56% had good knowledge about the scheme and 42 (53.85% registered their name in health institution during thefirst trimester of last pregnancy. Forty-four (56.4% beneficiaries had undergone three antenatal checkups and only 11 (14.1% of them received three postnatal (PN visits. All the beneficiaries received the JSY incentives 1-week the following delivery. Conclusions: Awareness regarding the JSY scheme, early antenatal registration, minimum three antenatal care visits, and three PN visits is still low among rural women which needs strengthening through intensification of IEC activities.
Stephen Schey; Jim Francfort
Battelle Energy Alliance, LLC, managing and operating contractor for the U.S. Department of Energy's Idaho National Laboratory, is the lead laboratory for U.S. Department of Energy Advanced Vehicle Testing. Battelle Energy Alliance, LLC contracted with Intertek Testing Services, North America (ITSNA) to collect data on federal fleet operations as part of the Advanced Vehicle Testing Activity's Federal Fleet Vehicle Data Logging and Characterization study. The Advanced Vehicle Testing Activity study seeks to collect data to validate the utilization of advanced electric drive vehicle transportation. This report focuses on the Golden Gate National Recreation Area (GGNRA) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of plug-in electric vehicles (PEVs) into the agencies' fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (PHEV) (collectively PEVs) can fulfill the mission requirements. GGNRA identified 182 vehicles in its fleet, which are under the management of the U.S. General Services Administration. Fleet vehicle mission categories are defined in Section 4, and while the GGNRA vehicles conduct many different missions, only two (i.e., support and law enforcement missions) were selected by agency management to be part of this fleet evaluation. The selected vehicles included sedans, trucks, and sport-utility vehicles. This report will show that battery electric vehicles and/or PHEVs are capable of performing the required missions and providing an alternative vehicle for support vehicles and PHEVs provide the same for law enforcement, because each has a sufficient range for individual trips and time is available each day for charging to accommodate multiple trips per day. These
Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M
The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.
Kawungezi, Peter Chris; AkiiBua, Douglas; Aleni, Carol; Chitayi, Michael; Niwaha, Anxious; Kazibwe, Andrew; Sunya, Elizabeth; Mumbere, Eliud W; Mutesi, Carol; Tukei, Cathy; Kasangaki, Arabat; Nakubulwa, Sarah
Globally every year 529,000 maternal deaths occur, 99% of this in developing countries. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa. Recent findings reveal maternal mortality ratio of 435:100,000 live births and neonatal mortality rate of 29 deaths per 1000 live births in Uganda; these still remain a challenge. Women in rural areas of Uganda are two times less likely to attend ANC than the urban women. Most women in Uganda have registered late ANC attendance, averagely at 5.5 months of pregnancy and do not complete the required four visits. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. This study was set to identify the factors associated with late booking and inadequate utilization of Antenatal Care services in upcountry areas of Uganda. Cross-sectional study design with mixed methods of interviewer administered questionnaires, focus group discussions and key informant interviews. Data was entered using Epidata and analyzed using Stata into frequency tables using actual tallies and percentages. Ethical approval was sought from SOM-REC MakCHS under approval number "#REC REF 2012-117" before conducting the study. A total of four hundred one were enrolled with the majority being in the age group 20 - 24 years (mean age, 25.87 ± 6.26). Health workers played a great role (72.04%), followed by the media (15.46%) and friends (12.50%) in creating awareness about ANC. A significant number of respondents went to TBAs with reasons such as "near and accessible", "my husband decided", and "they are the only people I know". 37.63% of the respondents considered getting an antenatal Card as an importance of ANC. 71 (19.67%) respondents gave a wrong opinion (late) on booking time with reasons like demands at work, no problems during pregnancy, advised by friends, just to get a card, long distance and others didn't know
Liu, Ya Ru; Wang, Cong; Yan, Li Jiao
Under the rapid urbanization, quantitatively assessing the impacts of land use and cover change (LUCC) on ecosystem service is of great significance for regional ecological environment construction. Based on the land use maps of Shangqiu City (as the typical agricultural area of North China Plain) in the year of 1990, 2005 and 2015, the spatio-temporal dynamics of land use and ecosystem service were analyzed, and the impacts of LUCC on ecosystem services was quantified with the impact assessment model. The results showed that, from 1990 to 2015, farmland and construction land area, which covered more than 95% of the total area of the research area, changed the most in quantity as -104.38 and 201.59 km 2 respectively, while forestland, grassland and water area changed the most by 79.3%, -73.7% and -24.2%, respectively. The total value of ecosystem service continuously decreased by 1.005 billion yuan, among which the value of hydrolo-gical regulation service suffered the most. The value of ecosystem service (ESV) presented an increasing trend in the west and a decreasing trend in the east. Extending from the center of the city to the outside, the value of ecosystem services was "high-low-high" in the east to west direction. The rate of farmland and water area contributed more than 95% to the total ecosystem service value, which had the greatest impact. The main drivers for the changes of land use and ESV in Shangqiu were population pressure, economic growth, regional policy, and urban planning. In the urban and rural development planning of Shangqiu City, more attention should be paid to the protection of na-tural resources and rational adjustment of the land use structure to realize sustainable development based on the harmony of economy, society and environment.
Full Text Available [b]Introduction. [/b]One of the aspects considered in a debate preceding the establishment of the new retirement age in Poland, was the health condition of the Polish population. A steady increase in the average life expectancy, observed for several years, is much higher in the cities than in the country. One of the reasons for this might be a limited availability of health services in rural areas. [b]Objective[/b]. The aim of the study is to assess the scale of income-related inequalities in the access to health services in rural areas, and subsequently to assess the impact of having to give up some medical services on the subjective perception of health condition by rural inhabitants. [b]Materials and methods.[/b] Individual data derived from the European Health Interview Survey (EHIS conducted in 2009 constituted the basis for the presented analysis. The concentration index was used to measure the income-related inequalities in the use of medical services. The ordered logit model was used to verify the hypothesis that the availability of health services has an impact on the health condition. [b]Results.[/b] Significant differences in the distribution of medical services utilization with regard to income, were found only in the case of hospital services. People with low income stay in hospital more often. The obtained inequality indices show a lack of income-related inequality in the use of outpatient services. The performed analyses confirm a negative impact of giving up this type of services on the health condition of residents of rural areas. [b]Conclusions.[/b] The availability of medical services is an important determinant of the health condition. Too few medical institutions and scarce medical personnel limits the use of these services, and not only for people with low income.
Matsumura, Kouji; Antoku, Yasuaki; Inoue, Reika; Kobayashi, Mariko; Hanada, Eisuke; Iwasaki, Yasutaka; Kumagai, Yasushi; Iwamoto, Haruya; Tsuchihashi, Saburo; Iwaki, Miho; Kira, Jun-ichi; Nose, Yoshiaki
A service information system using the Internet, which connected the various people who are related to medical treatment and nursing welfare, was constructed. An intractable neurological disease patient who lives in the Onga district, Fukuoka, Japan, and the people who are related to the service were chosen as test users in an experimental model. The communicated service information was divided into open-use data (electronic bulletin board, welfare service, medical care service, and link to private company service home page) and closed-use data (the individual patient's hysterics). The open data server was installed in an Internet service provider The open data could be accessed not only by the patient, but also by the family, information center, companies, hospitals, and nursing commodity store related to patient's nursing and medical treatment. Closed data server was installed in an information center (public health center). Only patient and information center staff can access the closed data. Patients should search and collect the service information of various medical and welfare services by themselves. Therefore, services prepared for the patient are difficult to know, and they cannot be sufficiently utilized. With the use of this information system, all usable service information became accessible, and patients could easily use it. The electronic bulletin board system (BBS) was used by patients for knowing each other or each others' family, and was used as a device for exchange of wisdom. Also, the questions for the specialist, such as doctor, dentist, teacher, physical therapist, care manager, welfare office staff member, and public health nurse, and the answers were shown on the BBS. By arranging data file, a reference of various patients in question and answer, which appeared in this BBS, was made as "advisory hints" and was added to the open data. The advisory hints became the new service information for the patients and their family. This BBS discovered
Oladipo, Jimoh Ayanda
Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.
Dhungel, R.; Chen, Y.; Maltos, R.; Sivakumaran, K.; Aguilar, A.; Harmon, T. C.
California's Central Valley (CV) water crisis has increased in severity due to a prolonged drought. The drought is directly contributing to the overexploitation of groundwater, along with deficiency in agricultural, recreational and aesthetic water services. The population of the CV, home to about 6.5 million people, is projected to be 12 million by 2040. Balancing water demand between municipal use, agricultural supply, and other ecosystem services, will be challenging for this region in perpetuity. In the heart of CV lies the San Joaquin River (SJR) where Friant Dam is the main low-elevation reservoir regulating water release. The Friant Dam's reservoir fulfills agricultural, municipal and industrial water needs through the Friant-Kern and Madera canals, as well as through the mainstem SJR. The SJR restoration project (SJRRP) is a recent development that is imposing additional demands on water releases in order to restore sustainable aquatic habitat for Chinook salmon and other species on the mainstem below the Friant Dam. The Chinook require adequate flow to moderate river temperature, particularly during hot summer and fall months. Temperatures on CV rivers exhibit strong diurnal and seasonal patterns, and can rise to harmful levels when flows are inadequate. In this study, we developed a framework that allows for assessing the effectiveness and implied costs of ecosystem services provided by a restored SJR in a semi-arid agriculture-dominant area. This is done by explicitly linking economics-based farmers' model with a reduced-form hydrological model that is loosely coupled to a physical-based stream-temperature model, specifically CE-QUAL-W2. The farmers' model is based on positive mathematical program approach calibrated with twenty proxy crops for year 2005. The river-hydrology is simulated by a vector autoregression model that incorporates daily flow variability. We study the mandated release policies by the SJR restoration project, along with hypothetical
Perry, Henry B; Ross, Allen G; Fernand, Facile
Limited information is available regarding the causes of under-five mortality in nearly all of the countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading causes of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies else-where in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause of death. Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45% of all under-five deaths, followed by enteric diseases, present in 21% of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41% of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51% of the deaths, and enteric diseases in 30%. Deaths were concentrated during the first few months of life, with 35% occurring during the first month. Among the neonatal deaths, 27% occurred on the first day of life, and 80% occurred during the first 10 days of life. In the Albert Schweitzer Hospital program area--and presumably in other areas of Haiti as well--priority needs to be given to the prevention of and the early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for more, similar standardized assessments to guide local
Stenius-Ayoade, Agnes; Haaramo, Peija; Erkkilä, Elisabet; Marola, Niko; Nousiainen, Kirsi; Wahlbeck, Kristian; Eriksson, Johan G
Homelessness is associated with increased morbidity, mortality and health care use. The aim of this study was to examine the role of mental disorders in relation to the use of 1) daytime primary health care services and 2) after hours primary health care emergency room (PHER) services among homeless shelter users in the Helsinki Metropolitan Area, Finland. The study cohort consists of all 158 homeless persons using the four shelters operating in the study area during two selected nights. The health records were analyzed over a period of 3 years prior to the sample nights and data on morbidity and primary health care visits were gathered. We used negative binomial regression to estimate the association between mental disorders and daytime visits to primary health care and after hours visits to PHERs. During the 3 years the 158 homeless persons in the cohort made 1410 visits to a physician in primary health care. The cohort exhibited high rates of mental disorders, including substance use disorders (SUDs); i.e. 141 persons (89%) had a mental disorder. We found dual diagnosis, defined as SUD concurring with other mental disorder, to be strongly associated with daytime primary health care utilization (IRR 11.0, 95% CI 5.9-20.6) when compared with those without any mental disorder diagnosis. The association was somewhat weaker for those with only SUDs (IRR 4.9, 95% CI 2.5-9.9) or with only other mental disorders (IRR 5.0, 95% CI 2.4-10.8). When focusing upon the after hours visits to PHERs we observed that both dual diagnosis (IRR 14.1, 95% CI 6.3-31.2) and SUDs (11.5, 95% CI 5.7-23.3) were strongly associated with utilization of PHERs compared to those without any mental disorder. In spite of a high numbers of visits, we found undertreatment of chronic conditions such as hypertension and diabetes. Dual diagnosis is particularly strongly associated with primary health care daytime visits among homeless persons staying in shelters, while after hours visits to primary
Haun, Markus W; Sklenarova, Halina; Zimmermann-Schlegel, Verena; Herzog, Wolfgang; Hartmann, Mechthild
Clinically relevant distress and unmet psychosocial needs frequently occur in the course of cancer diseases. Particularly for thinly populated rural areas in Germany rates of distressed patients and uptake of community-based psycho-oncology services are unknown. Determination of a) the proportion of cancer patients with psychosocial distress and unmet needs and b) the utilisation of community-based psycho-oncology services in thinly populated rural areas. Prospective cross-sectional study of 229 cancer patients (colon, breast, prostate cancer) living in thinly populated rural areas. Indicators for clinically relevant distress and utilisation of psychosocial services were assessed by applying screening instruments. We conducted descriptive and multivariate analyses. More than one third of all cancer patients (39.3%) in thinly populated areas exhibited clinically relevant distress. However, only 15.6% of distressed patients consulted community-based psycho-oncology services. Most frequently, medical or psychological psychotherapists were contacted. Information deficits of patients and attending physicians alongside dispositional factors emerged as the main reasons for non-utilisation. This study presents first data on psycho-oncology care in rural areas in Germany stratifying the degree of urbanisation in line with the standards of the European Commission. Concerning limitations, we only accounted for structural service coverage, leaving aside other indicators for socio-spatial deprivation.
Kong, Kee Poo
The study is a survey of the different kinds of voluntary rural service (service-learning) corps of students from the institutions of higher education in Malaysia. The history, organization, and activities of the service corps are examined, and this type of student social action is viewed with reference to the role of higher education in the…
Latif, Rabia; Abbas, Haider; Assar, Saïd
Wireless Body Area Networks (WBANs) have emerged as a promising technology that has shown enormous potential in improving the quality of healthcare, and has thus found a broad range of medical applications from ubiquitous health monitoring to emergency medical response systems. The huge amount of highly sensitive data collected and generated by WBAN nodes requires an ascendable and secure storage and processing infrastructure. Given the limited resources of WBAN nodes for storage and processing, the integration of WBANs and cloud computing may provide a powerful solution. However, despite the benefits of cloud-assisted WBAN, several security issues and challenges remain. Among these, data availability is the most nagging security issue. The most serious threat to data availability is a distributed denial of service (DDoS) attack that directly affects the all-time availability of a patient's data. The existing solutions for standalone WBANs and sensor networks are not applicable in the cloud. The purpose of this review paper is to identify the most threatening types of DDoS attacks affecting the availability of a cloud-assisted WBAN and review the state-of-the-art detection mechanisms for the identified DDoS attacks.
Full Text Available Early intervention through hearing screening can reduce the negative impact of hearing loss for children. Optimal outcomes are achieved when an appropriate screening protocol is selected, a pathway for follow up care is established, and when a hearing conservation component is included. This study aimed to describe the outcomes of a hearing screening service provided to grade one learners in urban areas at Durban. A cross-sectional design was employed. Learners (n=241 were conveniently sampled from six randomly selected schools. They were screened using otoscopy, tympanometry and pure tone audiometry. Fifty eight participants (24% obtained a refer result, with 33% referred for diagnostic assessments, 29% for middle ear pathology and 38% for cerumen management. Findings further revealed that only 33% of referrals were followed up indicating poor compliance. Association between test results and income levels (P=0.38 as well as distance to the nearest health care facility (P=0.22 did not influence test outcomes. School aged children do present with common ear problems. Appropriate protocol selection, ensuring compliance to recommendations and education on hearing conservation are essential components of any health initiative.
Del Solar, J; Hudson, S; Stephenson, T
A sequencing batch reactor (SBR) treating the effluent of a motorway service station in the south of England situated on a major tourist route was investigated. Wastewater from the kitchens, toilets and washrooms facilities was collected from the areas on each side of the motorway for treatment on-site. The SBR was designed for a population equivalent (p.e.) of 500, assuming an average flow of 100 m3/d, influent biochemical oxygen demand (BOD) of 300 mg/l, and influent suspended solids (SS) of 300 mg/l. Influent monitoring over 8 weeks revealed that the average flow was only 65 m3/d and the average influent BOD and SS were 480 mg/l and 473 mg/l respectively. This corresponded to a high sludge loading rate (F:M) of 0.42 d(-1) which accounted for poor performance. Therefore the cycle times were extended from 6 h to 7 h and effluent BOD improved from 79 to 27 mg/l.
Teixeira, Caroline San Severino; Cabral, Antônio Carlos Vieira
To determine differences in some nutritional aspects of pregnant women assisted at prenatal care services in a country town and in a metropolitan area. Pregnant women received prenatal care in the city of Belo Horizonte (BH), metropolitan area, and Paula Cândido (PC), a country town. A Food Frequency Questionnaire (FFQ) containing socioeconomic information and information about eating habits was applied. In addition,weight and height were measured on the occasion of the visits and the women were ask to give their prepregnancy weight for subsequent BMI calculation. Data were analyzed according to region and trimester of pregnancy using the SPSS software version 15.0, the t-test to compare averages and the chi-square test of independence, with the level of significance set at 5%. 240 pregnant women were included, 90 from the country town and 150 from the metropolitan area. Of these, most were married (BH = 56.6%; PC = 46.6%) and did not work outside the home (BH = 54.0%; PC = 84.4%). They predominantly had 3-4 meals/ day during the 1st and 2nd quarters (BH = 54.0 and 46%; PC = 66.7 and 63.3%, respectively) and had 5-6 meals/day during Q3 in BH (44%). There was significant weight gain only in the 1st quarter (BH: 58,0%; PC: 53.3%). Weight gain versus eating habits was significant for the variables "lunch or dinner away from home" for the 1st quarter in BH (p = 0.006), "How many times they consume milk" in the 1 st quarter in PC (p = 0.03), and "How many times they consume junk food" in the 3rd quarter in BH (p = 0.009). Pregnant woman showed proper eating habits in both regions despite the prevalence of pregestational overweight in BH and a low level of education and income, especially in the country town, an indicator that may be unfavorable for the nutrition of pregnant women during this period. Studies of association between eating habits and newborn health will provide more information about nutrition during pregnancy.
Wanga Z. Zembe-Mkabile
Full Text Available Background: Malawi has achieved a remarkable feat in reducing its under-5 mortality in time to meet its MDG 4 target despite high levels of poverty, low female literacy rates, recurrent economic crises, a severe shortage of human resources for health, and poor health infrastructure. The country's community-based delivery platform (largely headed by Health Surveillance Assistants, or HSAs has been well established since the 1960s, although their tasks and responsibilities have evolved from surveillance to health promotion and prevention, and more recently to include curative services. However, the role of and the form that community involvement takes in community-based service delivery in Malawi is unclear. Design: A qualitative rapid appraisal approach was utilised to explore the role of community involvement in the HSA programme in Malawi to better understand how the various community providers intersect to support the delivery of integrated community case management by HSAs. Twelve focus group discussions and 10 individual interviews were conducted with HSAs, HSA supervisors, mothers, members of village health committees (VHCs, senior Ministry of Health officials, district health teams, and implementing partners. Results: Our findings reveal that HSAs are often deployed to areas outside of their village of residence as communities are not involved in selecting their own HSAs in Malawi. Despite this lack of involvement in selection, the high acceptance of the HSAs by community members and community accountability structures such as VHCs provide the programme with legitimacy and credibility. Conclusions: This study provides insight into how community involvement plays out in the context of a government-managed professionalised community service delivery platform. It points to the need for further research to look at the impact of removing the role of HSA selection and deployment from the community and placing it at the central level.
Esan, Oluwaseun T; Fatusi, Adesegun O
The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chi-square tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps.
Silva, Islane C.S.; Silva, Iasmim M.S.; Júnior, Cláudio L.R.; Silva, Isvânia S.; Gonzalez, Kethyllém M.; Melo, Francisca A. [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear; Vieira, Wilson J.; Lopes Filho, Ferdinand de J. [Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco (IFPE), Recife, PE (Brazil); Lima, Fernando R.A. [Centro Regional de Ciências Nucleares do Nordeste (CRCN-NE/CNEN), Recife, PE (Brazil)
The measurement of the exposure rate of the sectors of a nuclear medicine service (NMS), with the purpose of establishing safety to the service workers and the public, classifying the areas according to the monitoring is presented. Following the studies on the classifications of the areas of a Nuclear Medicine service provided by the category regulatory standard, 3.05 CNEN-NN, measures were taken in all sectors of the NMS in order to classify the areas in: Free, controlled and supervised according to with the exposure level. As a measurement instrument, a Geiger-Muller counter of the digital type was used. The results obtained show a correlation with the Brazilian norm satisfactorily, referring to the exposure rate of the studied SMN sectors.
Seo, Jin Young; Chao, Ying-Yu; Yeung, Ka Man; Strauss, Shiela M
Most nail salon workers in the greater New York City area are Asian immigrant women. They are exposed daily to potentially toxic chemicals and hazards in their workplace, making them more vulnerable for possible health problems. The study's primary purpose was to identify factors influencing past year healthcare utilization among Asian immigrant women working in nail salons. A cross-sectional study was conducted based on a modification of Andersen's behavioral model of healthcare utilization in which 148 Korean and Chinese immigrant women currently working in nail salons were surveyed. The questionnaire included: (1) individual health determinants, (2) health service utilization in the past year, and (3) work environment, work-related health concerns, and work-related health problems. Descriptive statistics and multivariate logistic regression models assessed factors related to past year healthcare utilization. Women who had health insurance (p < .01), a usual source of care (p < .01), low educational attainment (p < .05), and more work-related health symptoms (p < .05) were more likely to visit a primary care provider. Women who had health insurance (p < .01), a usual source of care (p < .05), and low educational attainment (p < .05), were also more likely to visit a woman's health provider. Korean (rather than Chinese) women (p < .05) and women who perceived themselves to be in fair/poor health (p < .05) were more likely to see a traditional provider of Eastern medicine. Asian immigrant women who work in nail salons have workplace health and safety concerns. They generally use Western rather than traditional medicine, with different factors related to these two types of medicine.
Clements, Tom; Milner-Gulland, E J
The potential impacts of payments for environmental services (PES) and protected areas (PAs) on environmental outcomes and local livelihoods in developing countries are contentious and have been widely debated. The available evidence is sparse, with few rigorous evaluations of the environmental and social impacts of PAs and particularly of PES. We measured the impacts on forests and human well-being of three different PES programs instituted within two PAs in northern Cambodia, using a panel of intervention villages and matched controls. Both PES and PAs delivered additional environmental outcomes relative to the counterfactual: reducing deforestation rates significantly relative to controls. PAs increased security of access to land and forest resources for local households, benefiting forest resource users but restricting households' ability to expand and diversify their agriculture. The impacts of PES on household well-being were related to the magnitude of the payments provided. The two higher paying market-linked PES programs had significant positive impacts, whereas a lower paying program that targeted biodiversity protection had no detectable effect on livelihoods, despite its positive environmental outcomes. Households that signed up for the higher paying PES programs, however, typically needed more capital assets; hence, they were less poor and more food secure than other villagers. Therefore, whereas the impacts of PAs on household well-being were limited overall and varied between livelihood strategies, the PES programs had significant positive impacts on livelihoods for those that could afford to participate. Our results are consistent with theories that PES, when designed appropriately, can be a powerful new tool for delivering conservation goals whilst benefiting local people. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.
Full Text Available Abstract Background Malaria chemoprophylaxis compliance is suboptimal among French soldiers despite the availability of free malaria chemoprophylaxis and repeated health education before, during and after deployment to malaria endemic areas. Methods In 2007, a randomized controlled study was performed among a cohort of French soldiers returning from Côte d'Ivoire to assess the feasibility and acceptability of sending a daily short message service (SMS reminder message via mobile device to remind soldiers to take their malaria chemoprophylaxis, and to assess the impact of the daily reminder SMS on chemoprophylaxis compliance. Malaria chemoprophylaxis consisted of a daily dose of 100 mg doxycycline monohydrate, which began upon arrival in Côte d'Ivoire and was to be continued for 28 days following return to France. Feasibility and acceptability were assessed by questionnaire. Cohort members were followed for a 28 day period, with compliance assessed by use of an electronic medication monitoring device, from which several indicators were developed: daily proportion of compliant individuals, average number of pills taken, and early discontinuation. Results Among 424 volunteers randomized to the study, 47.6% were assigned to the SMS group and 52.3% to the control group. Approximately 90% of subjects assigned to the SMS group received a daily SMS at midday during the study. Persons of the SMS group agreed more frequently that SMS reminders were very useful and that the device was not annoying. Compliance did not vary significantly between groups across the compliance indicators. Conclusion SMS did not increase malaria chemoprophylaxis compliance above baseline, likely because the persons did not benefit from holidays after the return and stayed together. So the reminder by SMS was noted by all subjects of the study. Another study should be done to confirm these results on soldiers going on holidays from employment after return or with individual
Advincula-Carpenter, Marietta M.
To gather curriculum planning information, the Research, Planning and Development Division of Milwaukee Area Technical College (MATC) conducts student surveys biennially. Responses of 579 MATC students enrolled in consumer and hospitality services division (CHSD) programs to the 1994 survey were compared with those of the 5,071 students…
Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan
The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…
Long, Larry D.
Fraternities and sororities promote the ideals of scholarship, leadership, service, and friendship. Little or no research, however, has demonstrated that college students who join fraternal organizations actually grow in these areas as a result of their fraternal experience. The purpose of this descriptive study was to assess the extent to which…
Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S. [Hospital General de Soria (Spain); Peiro, S. [Fundacion de Investigacion en Servicios de Salud Valencia (Spain)
To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs.
Full Text Available This study aimed: 1 study the present state and adverse conditions of administration with the participation of the basic education in schools. 2 Development of a participatory Management approach of the Committee for Basic Education school under the Nongbualamphu Primary Educational Service Area Office 2. Split data into 2 phases. Phase 1: The sample used for this research consisted of 128 members of the committee on basic education in school under the Nongbualamphu Primary Educational Service Area Office 2. Selected by using stratified random sampling. Instruments used included a set of rating scale questionnaires. Phase 2: Data from the interviews using a structured questionnaire and focus group discussion. The basic statistics used for analyzing the collected data were percentage, means and standard deviation. The results of this study were as follows: 1. On the present state administration with the participation of the basic education commission in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall participation in management is moderate. Considering the individual aspects, found that the academic administration overall participation in management and budget management were moderate. The personnel management and general and administrative overall participation in management at a high level. 2. Adverse conditions of administration with the participation of the school board for basic education in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall in a high level. Considering the individual aspects, found that the school board in basic education is desirable to participate in the management of all aspects. 3. Development of a participatory management approach of the committee for basic education school under the Nongbualamphu Primary Educational Service Area Office 2 is a developmental process management principles PDCA, 5 steps. Step 1: Creating a common understanding Step
Landry, Michel D; Verrier, Molly C; Williams, A Paul; Zakus, David; Deber, Raisa B
Ambulatory physical therapy (PT) services in Canada are required to be insured under the Canada Health Act, but only if delivered within hospitals. The present study analyzed strategic responses used by hospitals in the Greater Toronto Area (GTA) to deliver PT services in an environment of fiscal constraint. Key informant interviews (n = 47) were conducted with participants from all hospitals located within the GTA. Two primary strategic responses were identified: (1) "load shedding" through the elimination or reduction of services, and (2) "privatization" through contracting out or creating internal for-profit subsidiary clinics. All hospitals reported reductions in service delivery between 1996 and 2003, and 15.0% (7/47 hospitals) fully eliminated ambulatory services. Although only one of 47 hospitals contracted out services, another 15.0% (7/47) reported that for-profit subsidiary clinics were created within the hospital in order to access other more profitable forms of quasi-public and private funding. Strategic restructuring of services, aimed primarily at cost containment, may have yielded short-term financial savings but has also created a ripple effect across the continuum of care. Moreover, the rise of for-profit subsidiary clinics operating within not-for-profit hospitals has emerged without much public debate and with little research to evaluate its impact.
Full Text Available Strategic water source areas are those areas that have a relatively high natural runoff in the region of interest, which is made accessible for supporting the region’s population or economy. These areas contribute substantially to development needs...
Conclusions: The service could address most of the medical, psychosocial, and supportive needs of the patients and reduce their pain and symptoms. The interface between institutional-based care and home care needs more exploration and prospective studies.
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challenge has been to integrate ecology with economics to better understand the effects of human policies and acti...
Paratransit systems are created to improve mobility, employment opportunities, and : access to community services for individuals who are mentally or physically : disadvantaged. Though essential for the community, paratransit systems are more : expen...
Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area
Full Text Available Background: Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim: To determine stroke survivors’ levels of community reintegration, quality of life (QOL, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method: This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results: A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73 and 58% (n = 62 had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55% caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001 and QOL (r = 0.51, p < 0.0001. A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001. Conclusion: Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.
Perry, Henry B; King-Schultz, Leslie W; Aftab, Asma S; Bryant, John H
Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS) in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not even greater, levels of health inequities exist. These inequities
Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M
Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving
Andrade, Laura Helena; Viana, Maria Carmen; Tófoli, Luis Fernando Farah; Wang, Yuan-Pang
Recent population-based studies in Latin American and the Caribbean (LAC) countries brought evidence of the growing burden of mental illness in this region. The objective of this study is to examine determinants of health service utilization by individuals with psychiatric disorders in a defined area in the city of São Paulo, Brazil. Data were derived from São Paulo Catchment Area Study (SP-ECA), a cross-sectional household prevalence survey, based on a representative adult sample (N=1,464) living in two defined boroughs. The psychiatric diagnosis was assessed through the CIDI 1.1 interview, yielding ICD-10 diagnoses. The past-month use of health services--for general medical (GM) care and mental health (MH) care sectors--was investigated in their relationship with sociodemographic features, insurance coverage, GM conditions, and psychiatric morbidity. Nearly one-third (32.2%) of the total sample used health services in the last month: 29.0% attended GM care and 7.8% used MH care. Logistic regression models showed that being female, older than 60 years, having private insurance coverage, and presence of psychiatric morbidity increased the level GM care seeking in the total sample. For those with 12-month psychiatric disorders, the determinants for GM sector use were female gender, age 45-59 years old, and private insurance coverage, whereas separated, divorced, or widowed women had the highest odds (OR 9.9; 95% CI: 2.7-36.5) for using MH service. Low-income people were less likely to seek MH services. The major contribution of this article is to underscore the impact of MH on health care systems, in a LAC country where service use information is scarce. The main finding is that inequalities in the access to MH care occurred, with low-income people having less likelihood of receiving treatment for their mental disorder. Access to health service in this catchment area reflected the great degree of deregulation and lack of integration. Additional efforts should
Jackson, L.T.B.; van de Vijver, F.J.R.; Molokoane, D.H.
Orientation: The study addresses the question of how employees of the South African Police Service (SAPS) cope with intercultural relations in an increasingly diverse organisation. Research purpose: A dual-process model of diversity outcomes was tested in which a distinction is made between a
Ponizy, Lidia; Majchrzak, Weronika; Zwierzchowska, Iwona
The quality of life of big city dwellers depends on the use of green infrastructure. The idea of a compact city, opposed to urban sprawl, can lead to reduced access to green areas and increased demand for cultural services provided through urban green infrastructure. Considering the above, the aim of the paper was to identify the supply of and demand for cultural ecosystem services related to the urban green spaces in densely built-up urban areas. To find out how important the ability to use green areas for dwellers of the densely built-up areas is, the questionnaire interviews with the residents of the area of the Old Town of Poznan were conducted. Questions in the survey concerned the amount of green spaces and their availability, the way of use, types of activity, factors limiting the use and factors encouraging to visit green spaces and the motives for using green areas away from inhabitants’ place of residence. Respondents claim that there is not enough greenery, especially associated with housing and street side greenery; the amount of parks (which they use most) is slightly higher, in their opinion. Limitations that influence utilising green spaces concern both greenery itself (e.g. insufficient recreational infrastructure, neglected green areas) as well as respondent’s issues (e.g. lack of free time). Improvements to recreational infrastructure and more well-kept green spaces would encourage respondents to utilise it more often. Active participation of inhabitants in developing and maintaining their closest neighbourhood would allow to enlarge green spaces in housing areas and make them more customized to the residents’ needs and requirements in terms of functionality and aesthetic.
Maulik, PK; Kallakuri, S; Devarapalli, S; Vadlamani, VK; Jha, V; Patel, A
BACKGROUND: About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress,...
Gunantara, N.; Sudiarta, P. K.; Prasetya, AAN A. I.; Dharma, A.; Gde Antara, I. N.
Access point (AP) is part of a Wireless Local Access Network (WLAN) with its communications using WiFi. AP is used to transmit and receive data to users/clients. The ability of AP to serve users/clients depends on many factors. Moreover, if AP is applied in conditions inside the building. In this study, AP is installed at two points inside the building and then measured in the form of the received signal level (RSL) and service coverage area. One AP measured its performance by 26 measurement points and the other AP measured its performance by 20 measurement points. When AP has measured its performance then another AP position is switched off. Based on the measurement result, the received signal level value is the highest value is about -47 dBm at a distance of 3.2 m, while the lowest is about -79 dBm at a 9.21 m because it is on barrier 2 walls. While based on service coverage area, the area which is far away from the AP then the quality of service becomes bad because the transmitted signal is weakening caused by the distance and the loss of the wall.
U.S. Environmental Protection Agency — This EnviroAtlas dataset contains polygons depicting the geographic areas of market-based programs, referred to herein as markets, and projects addressing ecosystem...
Rego, Inês; Russo, Giuliano; Gonçalves, Luzia; Perelman, Julian; Pita Barros, Pedro
In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the changes brought to their workload. This paper provides a descriptive statistical analysis of physicians' responses. In connection to the crisis, our surveyed physicians perceived an increase in demand but a decrease of supply of public health services, as well as an increase in the supply of health services by the private sector. Damaging government policies for the public sector, and the rise of private services and insurance providers were identified as game changers for the sector. Physicians reported a decrease in public remuneration (- 30.5%) and a small increase of public sector hours. A general reduction in living standard was identified as the main adaptation strategy to the crisis. Passion for the profession, its independence and flexibility, were the most frequently mentioned compensating factors. A percentage of 15% of physicians declared considering migration as a possibility for the near future. The crisis has brought non-negligible changes to physicians' working conditions and to the wider market for medical services in Portugal. The physicians' intrinsic motivation for the professions helped counterbalance salary cuts and deteriorating working conditions.
Jiyoon Park; Solhee Kim; Kyo Suh
Unmanned aerial vehicles (UAV, drones) used as delivery vehicles have received increasing attention due to their mobility and accessibility to remote areas. The purpose of this study is to evaluate the environmental impacts of drone versus motorcycle delivery and to compare the expected environmental improvements due to drone delivery in urban and rural areas. In addition, the potential environmental contributions of electric motorcycles were assessed to determine the effects of introducing t...
Cai, Yuan-Bin; Zhang, Hao; Pan, Wen-Bin; Chen, Yan-Hong; Wang, Xiang-Rong
This paper quantifies the allocation of ecosystem services value (ESV) associated with land use pattern and qualitatively examined impacts of land use changes and socio-economic factors on spatiotemporal variation of ESV in the Natural Wetland Distribution Area (NWDA), Fuzhou city, China. The results showed that total ESV of the study area decreased from 4,332.16 × 10(6) RMB Yuan in 1989 to 3,697.42 × 10(6) RMB Yuan in 2009, mainly due to the remarkable decreases in cropland (decreased by 55.3 %) and wetland (decreased by 74.2 %). Forest, water, and wetland played major roles in providing ecosystem services, accounting for over 90 % of the total ESV. Based on time series Landsat TM/ETM+ imagery, geographic information system, and historical data, analysis of the spatiotemporal variation of ESV from 1989 to 2009 was performed. It indicated that rapid expansion of urban areas along the Minjiang River resulted in significant changes in land use types, leading to a dramatic decline in ecosystem services. Meanwhile, because of land scarcity and unique ecosystem functions, the emergency of wetland and cropland protection in built-up area has become an urgent task of local authorities to the local government. Furthermore, there was still a significant negative correlation between ESV of cropland and wetland and the GDP. The results suggest that future planning of land use pattern should control encroachment of urban areas into cropland and wetland in addition to scientific and rational policies towards minimizing the adverse effects of urbanization.
Chu, Ching-Lin; Chiang, Chung-Hsin; Wu, Chin-Chin; Hou, Yuh-Ming; Liu, Jiun-Horng
Chiayi is a rural county located in southwestern Taiwan, and the effectiveness of its early intervention service system for autism spectrum disorders was studied in detail. A total of 71 children with autism spectrum disorders ( n = 35) and developmental delay ( n = 36) aged 2.5 years were referred from the only Early Intervention Reporting and Referral Center in Chiayi and followed up at 4 years. Results showed relatively low and varied services of early intervention for both groups during two time-point periods and a relative lack of specific early intervention programs for children with autism spectrum disorders. It was found, however, that cognitive abilities were increased for autism spectrum disorders and developmental delay groups. Additionally, the Early Learning Score at the initial evaluation could contribute to the high learner autism spectrum disorders subgroup. Parental socio-economic level was also determined to benefit the high learner developmental delay subgroup.
Carolina Monsalve Castro
Full Text Available In recent years, the hotel industry has been facing an increment of travelers willing to enjoy better conditions in tourist destinations. The demanding changes in tourist preferences, and the increasing range of offers that they find to meet their needs, has made the hotel industry to focus its attention to service. Therefore, in this document, the principles that impact the evaluation of a quality service are analyzed. This research takes a sample of 384 small and medium size hotel companies’ guests. A Likert type questionnaire is applied. Its evaluation is conducted through SPSS software through bivariate analysis. In the results, influential aspects were identified such as: encouraging customer loyalty, special offers, innovation, premises and equipment, human talent training, among others.
Prem Lal Chauhan; Dineshwar Dhadwal; Anjali Mahajan
Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY) on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the kno...
Cho, Jungwoo; You, Myoungsoon; Yoon, Yoonjin
In highly urbanized area where traffic condition fluctuates constantly, transportation infrastructure is one of the major contributing factors to Emergency Medical Service (EMS) availability and patient outcome. In this paper, we assess the impact of traffic fluctuation to the EMS first response availability in urban area, by evaluating the k-minute coverage under 21 traffic scenarios. The set of traffic scenarios represents the time-of-day and day-of-week effects, and is generated by combining road link speed information from multiple historical speed databases. In addition to the k-minute area coverage calculation, the k-minute population coverage is also evaluated for every 100m by 100m grid that partitions the case study area of Seoul, South Korea. In the baseline case of traveling at the speed limit, both the area and population coverage reached nearly 100% when compared to the five-minute travel time national target. Employing the proposed LoST (Loss of Serviceability due to Traffic) index, which measures coverage reduction in percentage compared to the baseline case, we find that the citywide average LoST for area and population coverage are similar at 34.2% and 33.8%. However, district-wise analysis reveals that such reduction varies significantly by district, and the magnitude of area and population coverage reduction is not always proportional. We conclude that the effect of traffic variation is significant to successful urban EMS first response performance, and regional variation is evident among local districts. Complexity in the urban environment requires a more adaptive approach in public health resource management and EMS performance target determination.
Full Text Available In highly urbanized area where traffic condition fluctuates constantly, transportation infrastructure is one of the major contributing factors to Emergency Medical Service (EMS availability and patient outcome. In this paper, we assess the impact of traffic fluctuation to the EMS first response availability in urban area, by evaluating the k-minute coverage under 21 traffic scenarios. The set of traffic scenarios represents the time-of-day and day-of-week effects, and is generated by combining road link speed information from multiple historical speed databases. In addition to the k-minute area coverage calculation, the k-minute population coverage is also evaluated for every 100m by 100m grid that partitions the case study area of Seoul, South Korea. In the baseline case of traveling at the speed limit, both the area and population coverage reached nearly 100% when compared to the five-minute travel time national target. Employing the proposed LoST (Loss of Serviceability due to Traffic index, which measures coverage reduction in percentage compared to the baseline case, we find that the citywide average LoST for area and population coverage are similar at 34.2% and 33.8%. However, district-wise analysis reveals that such reduction varies significantly by district, and the magnitude of area and population coverage reduction is not always proportional. We conclude that the effect of traffic variation is significant to successful urban EMS first response performance, and regional variation is evident among local districts. Complexity in the urban environment requires a more adaptive approach in public health resource management and EMS performance target determination.
Clements, Tom; Milner-Gulland, E J
The potential impacts of payments for environmental services (PES) and protected areas (PAs) on environmental outcomes and local livelihoods in developing countries are contentious and have been widely debated. The available evidence is sparse, with few rigorous evaluations of the environmental and social impacts of PAs and particularly of PES. We measured the impacts on forests and human well-being of three different PES programs instituted within two PAs in northern Cambodia, using a panel of intervention villages and matched controls. Both PES and PAs delivered additional environmental outcomes relative to the counterfactual: reducing deforestation rates significantly relative to controls. PAs increased security of access to land and forest resources for local households, benefiting forest resource users but restricting households’ ability to expand and diversify their agriculture. The impacts of PES on household well-being were related to the magnitude of the payments provided. The two higher paying market-linked PES programs had significant positive impacts, whereas a lower paying program that targeted biodiversity protection had no detectable effect on livelihoods, despite its positive environmental outcomes. Households that signed up for the higher paying PES programs, however, typically needed more capital assets; hence, they were less poor and more food secure than other villagers. Therefore, whereas the impacts of PAs on household well-being were limited overall and varied between livelihood strategies, the PES programs had significant positive impacts on livelihoods for those that could afford to participate. Our results are consistent with theories that PES, when designed appropriately, can be a powerful new tool for delivering conservation goals whilst benefiting local people. El Impacto de los Pagos por Servicios Ambientales y Áreas Protegidas sobre la Subsistencia Local y la Conservación del Bosque en el Norte de Camboya Resumen Los impactos
Bishwajit, Ghose; Hoque, Md Rakibul; Yaya, Sanni
In Bangladesh, similar to its other South Asian counterparts, shortage of health workers along with inadequate infrastructure constitute some of the major obstacles for the equitable provision of reproductive healthcare services, particularly among the marginalized and underserved neighbourhoods. However, given the rapidly expanding broadband communication and mobile phone market in the country, the application of eHealth and mHealth technologies offer a window of opportunities to minimise the impact of socioeconomic barriers and promote the utilization of maternal healthcare services thereby. In the present study we aimed to investigate 1) the prevalence of usage of mobile phones for seeking childbirth services, 2) neighbourhood and socioeconomic disparities in the use, and 3) association between using mobile phones and the uptake of postnatal care among mothers and neonates. Data for the present study came from Bangladesh Urban Health Survey 2013. Study subjects were 9014 married women aged between 15 and 49 years. The overall rate of use of mobile phone was highest in City Corporation non-Slum areas (16.2%) and lowest in City Corporation Slum areas (7.4%). The odds of using mobile for seeking childbirth services were significantly higher among those who were living in non-slum areas, and lower among those who never attended school and lived in poorer households. Results also indicated that women in the slum areas who used mobile phone for childbirth service seeking, were 4.3 times [OR = 4.250;95% CI = 1.856-9.734] more likely to receive postnatal care for themselves, and those from outside the city-corporation areas were 2.7 times [OR = 2.707;95% CI = 1.712-4.279] more likely to receive postnatal care for the newborn. Neighbourhood, educational and economic factors were significantly associated with the mobile phone utilization status among urban women. Promoting access to better education and sustainable income earning should be regarded as an
Bonney, Andrew; Mayne, Darren J; Jones, Bryan D; Bott, Lawrence; Andersen, Stephen E J; Caputi, Peter; Weston, Kathryn M; Iverson, Don C
Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities. The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable. The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (pdisadvantage was associated with increasing prevalence of overweight (pdisadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males. It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.
Full Text Available Unmanned aerial vehicles (UAV, drones used as delivery vehicles have received increasing attention due to their mobility and accessibility to remote areas. The purpose of this study is to evaluate the environmental impacts of drone versus motorcycle delivery and to compare the expected environmental improvements due to drone delivery in urban and rural areas. In addition, the potential environmental contributions of electric motorcycles were assessed to determine the effects of introducing this new type of vehicle. Changes in the national electricity generation plan were also examined. The results showed that global warming potential (GWP per 1 km delivery by drone was one-sixth that of motorcycle delivery, and the particulates produced by drone delivery were half that of motorcycle delivery. The actual environmental impact reduction in consideration of the delivery distance was 13 times higher in a rural area than in an urban area. Increasing the use of environmentally friendly electricity systems, such as solar and wind power, would further enhance the environmental effects of a drone delivery system.
Aftab Asma S
Full Text Available Abstract Background Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. Methods We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. Results We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. Conclusion These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not
Full Text Available The research aimed to 1 examine the current conditions, problems and academic administration of basic education schools under the office of Sakon Nakhon educational service area office 3, 2 develop the academic administration model of basic educational schools under the office of Sakon Nakhon educational service area office 3. The study was divided into 2 phases. Phase 1: Study the researches and literatures concerning the framework, the current conditions and the problems of academic administration to gain the concept for constructing a set of questionnaire. The questionnaire was then used to collect data from 50 administrators, 83 heads of academic sections and 198 heads of learning areas ; and interviewed the administrators of 5 schools that ranked top-five of the national education test scores (O-NET and were certified by the office of educational standard assurance and quality assessment in the third-round inspection. Phase 2: Construct the model of educational administration of basic education schools under the office of Sakon Nakhon educational service area office 3, held a focus group discussion of which the participants were 2 educational administrators and 5 school directors on the constructed model, evaluated the educational administration models of the schools under the office of Sakon Nakhon educational service area office 3 by 30 school administrators and teachers. The instruments used to collect data were a set of questionnaire, interviewing forms, recording forms and evaluating forms. The data were analyzed by a computer application. The statistics used to analyze the data were percentage, mean and standard deviation. The results were as follows: 1 The current conditions of academic administration of basic education schools under the office of Sakon Nakhon educational service area office 3, overall, were at a high level. The highest mean was the development of the learning process. The problems of academic administration, overall
Shedlin, M G; Shulman, L
This paper reports on research designed to assess access to care by Latino immigrant populations in the New York area. A qualitative approach and methods were employed, involving focus groups with PLWAs (persons living with AIDS) and affected men and women from Mexico, the Dominican Republic and Central America to explore the perceptions, beliefs, experiences and knowledge of HIV care issues. A total of 57 men and women participated, ranging in age from 19-61. Results included detailed information on cultural meanings of HIV/AIDS; experience of stigma and rejection; gendered health-seeking behaviour; testing issues; and satisfaction with services. Data support the conclusion that to be effective in reaching and providing services to these immigrant groups, it is crucial to understand the environment from which they come and the impact of immigration. Poverty, repressive governments, lack of education/literacy, ethnicity, class, colour-based stigma and cultural norms are crucial factors in determining their attitudes, motivations, decisions and behaviour. AIDS agencies were seen to play a crucial role in connecting PLWAs to services and resources. The key elements for the provision of services to this population appear to be those that build on cultural norms and network human and institutional resources.
The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.
Maria Giovanna Guedes Farias
Full Text Available Objective. Analyze the use of concept maps as didactic and pedagogical tools, from an experiment conducted in the classroom, in the disciplines Specialized Sources and Information Services of the graduation in Librarianship. Method. The methodological approach is characterized by its applied nature, exploratory and observation. Data were collected from the students by applying a questionnaire, and analysis took place with the help of content analysis techniques. Results. The most students see the conceptual maps as facilitators of knowledge construction, and view the use of these in different contexts, like the librarian activities. Conclusions. The use of concept maps as didactic and pedagogical tools can foster in students the enhancement of learning and reflection on the establishment of a route for the shared construction of new knowledge, adding previous knowledge and transforming them for use in cognitive fill gaps.
Full Text Available Abstract Background Under-5-years child mortality remains high in rural China. Integrated management of childhood illness (IMCI was introduced to China in 1998, but only a few rural areas have been included. This study aimed at assessing the current situation of the health system of rural health care and evaluating the clinical competency of village doctors in management of childhood illnesses prior to implementing IMCI programme in remote border rural areas. Methods The study was carried out in the border areas of Puer prefecture of Yunnan province. There were 182 village doctors in the list of the health bureau in these border areas. Of these, 154 (84.6% were recruited into the study. The local health system components were investigated using a qualitative approach and analyzed with triangulation of information from different sources. The clinical component was assessed objectively and quantitatively presented using descriptive statistics. Results The study found that the New Rural Cooperative Medical Scheme (NRCMS coordinated the health insurance system and the provider service through 3 tiers: village doctor, township and county hospitals. The 30 RMB per person per year premium did not cover the referral cost, and thereby decreased the number of referrals. In contrast to available treatment facilities and drug supply, the level of basic medical education of village doctors and township doctors was low. Discontent among village doctors was common, especially concerning low rates of return from the service, exceptions being procedures such as injections, which in fact may create moral hazards to the patients. Direct observation on the assessment and management of paediatric patients by village doctors revealed inadequate history taking and physical examination, inability to detect potentially serious complications, overprescription of injection and antibiotics, and underprescription of oral rehydration salts and poor quality of counseling
Full Text Available The Internet-of-Things (IoT landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN, the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP, which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA infrastructures and the Extensible Authentication Protocol (EAP protocol. For this integration, we use the Constrained Application Protocol (CoAP to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN.
Garcia-Carrillo, Dan; Marin-Lopez, Rafael; Kandasamy, Arunprabhu; Pelov, Alexander
The Internet-of-Things (IoT) landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN), the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN) offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP), which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA) infrastructures and the Extensible Authentication Protocol (EAP) protocol. For this integration, we use the Constrained Application Protocol (CoAP) to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN.
Full Text Available A gambling or “game” phenomenon can be observed in the complex relationship between sources and receptors of ecological compensation among multiple stakeholders. This paper investigates the problem of gambling to determine payment amounts, and details a method to estimate the ecological compensation amount related to water resources in the Wuxijiang River reservoir area in China. Public statistics and first-hand data obtained from a field investigation were used as data sources. Estimation of the source and receptor amount of ecological compensation relevant to the water resource being investigated was achieved using the contingent valuation method (CVM. The ecological compensation object and its benefit and gambling for the Wuxijiang River water source area are also analyzed in this paper. According to the results of a CVM survey, the ecological compensation standard for the Wuxijiang River was determined by the CVM, and the amount of compensation was estimated. Fifteen blocks downstream of the Wuxijiang River and 12 blocks in the water source area were used as samples to administer a survey that estimated the willingness to pay (WTP and the willingness to accept (WTA the ecological compensation of Wuxijiang River for both nonparametric and parametric estimation. Finally, the theoretical value of the ecological compensation amount was estimated. Without taking other factors into account, the WTP of residents in the Wuxi River water source was 297.48 yuan per year, while the WTAs were 3864.48 yuan per year. The theoretical standard of ecological compensation is 2294.39–2993.81 yuan per year. Under the parameter estimation of other factors, the WTP of residents in the Wuxi River water source area was 528.72 yuan per year, while the WTA was 1514.04 yuan per year. The theoretical standard of ecological compensation is 4076.25–5434.99 yuan per year. The main factors influencing the WTP ecological compensation in the Wuxi River basin are
A gambling or "game" phenomenon can be observed in the complex relationship between sources and receptors of ecological compensation among multiple stakeholders. This paper investigates the problem of gambling to determine payment amounts, and details a method to estimate the ecological compensation amount related to water resources in the Wuxijiang River reservoir area in China. Public statistics and first-hand data obtained from a field investigation were used as data sources. Estimation of the source and receptor amount of ecological compensation relevant to the water resource being investigated was achieved using the contingent valuation method (CVM). The ecological compensation object and its benefit and gambling for the Wuxijiang River water source area are also analyzed in this paper. According to the results of a CVM survey, the ecological compensation standard for the Wuxijiang River was determined by the CVM, and the amount of compensation was estimated. Fifteen blocks downstream of the Wuxijiang River and 12 blocks in the water source area were used as samples to administer a survey that estimated the willingness to pay (WTP) and the willingness to accept (WTA) the ecological compensation of Wuxijiang River for both nonparametric and parametric estimation. Finally, the theoretical value of the ecological compensation amount was estimated. Without taking other factors into account, the WTP of residents in the Wuxi River water source was 297.48 yuan per year, while the WTAs were 3864.48 yuan per year. The theoretical standard of ecological compensation is 2294.39-2993.81 yuan per year. Under the parameter estimation of other factors, the WTP of residents in the Wuxi River water source area was 528.72 yuan per year, while the WTA was 1514.04 yuan per year. The theoretical standard of ecological compensation is 4076.25-5434.99 yuan per year. The main factors influencing the WTP ecological compensation in the Wuxi River basin are annual income and age. The
A gambling or “game” phenomenon can be observed in the complex relationship between sources and receptors of ecological compensation among multiple stakeholders. This paper investigates the problem of gambling to determine payment amounts, and details a method to estimate the ecological compensation amount related to water resources in the Wuxijiang River reservoir area in China. Public statistics and first-hand data obtained from a field investigation were used as data sources. Estimation of the source and receptor amount of ecological compensation relevant to the water resource being investigated was achieved using the contingent valuation method (CVM). The ecological compensation object and its benefit and gambling for the Wuxijiang River water source area are also analyzed in this paper. According to the results of a CVM survey, the ecological compensation standard for the Wuxijiang River was determined by the CVM, and the amount of compensation was estimated. Fifteen blocks downstream of the Wuxijiang River and 12 blocks in the water source area were used as samples to administer a survey that estimated the willingness to pay (WTP) and the willingness to accept (WTA) the ecological compensation of Wuxijiang River for both nonparametric and parametric estimation. Finally, the theoretical value of the ecological compensation amount was estimated. Without taking other factors into account, the WTP of residents in the Wuxi River water source was 297.48 yuan per year, while the WTAs were 3864.48 yuan per year. The theoretical standard of ecological compensation is 2294.39–2993.81 yuan per year. Under the parameter estimation of other factors, the WTP of residents in the Wuxi River water source area was 528.72 yuan per year, while the WTA was 1514.04 yuan per year. The theoretical standard of ecological compensation is 4076.25–5434.99 yuan per year. The main factors influencing the WTP ecological compensation in the Wuxi River basin are annual income and age
Today, some 1.1 billion people in developing countries have inadequate access to water, and 2.6 billion lack basic sanitations. These twin deficits were rooted in institutions and political choices, not in water’s availability. Household water requirements represent a tiny fraction of water use, usually less than 5% of the total, but there is tremendous inequality in access to clean water and to sanitation at a household level. In high-income areas of cities in Asia, Latin America and Sub-Sah...
Özlem DOĞAN TEMUR
Full Text Available With developing technology statistical information and data sources become a very important issues and from primary school it has become necessary to gain the skills for making interpreting and making sense of data. These skills consist of collecting information, arrangement and analysis of collected data and the interpretation of the results. The duty of guiding students in their process of making statistical information meaningful falls upon teachers. This study, whose aim was to investigate prepared course content for sub-learning area in grade 1-4 math course and obtained experiences by pre-service elementary teachers in the schools they went as a part of teaching practice course, was conducted with nine fourth-year students attending an undergraduate program of elementary teaching in a state university during 2013-2014 academic year. Pre-service teachers were each asked to prepare and conduct a lesson plan suitable for the lesson outcomes and the level of the classes that they were to teach. Their applications were assessed by semi-structured observation form about data teaching developed by the researchers. It was observed that pre-service teachers could not reflect given lesson outcomes on the topic of data to the lessons they prepared to teach during their teaching practice. In the implementations, it was noted that pre-service teachers could not effectively include students in both collecting and arrangement as well as interpretation processes of the information and that they taught in teacher-centered manner although they prepared a correct activity. It was also noted that pre-service teachers could not well enough differentiate category and concept of variable in table and graph activities.
Inês Rego; Giuliano Russo; Luzia Gonçalves; Julian Perelman; Pedro Pita Barros
Introduction: In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. Material and Methods: A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the...
de Carvalho, Wladithe Organ; Galvao Cesar, Chester Luiz; Carandina, Luana [UNESP; de Azevedo Barros, Marilisa Berti; Goi Porto Alves, Maria Cecilia; Goldbaum, Moises
Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the São Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes.Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in ...
Dr. K.W.C.U.K Kendangamuwa
Full Text Available Abstract Introduction 5S is the stepping stone for many quality improvement concepts and its roots date back to 16th century. When successfully implemented 5S gives many benefits to the organization as well as its stakeholders. Though 5S itself has a tool to sustain most of the organizations find it difficult to sustain the 5S practice over the time. Therefore the objective of this study was to find out the factors contributing to sustainability of 5S programmes in Government Hospitals in RDHS area Kurunegala. Methodology This study was a descriptive cross sectional study with two components. First component was to identify the 5S sustaining hospitals from not sustaining hospitals by validated evaluation sheet. Second component was to determine the factors contributing to sustainability of 5S programmes in selected study setting. Self-administrated questionnaire was used for this purpose. Total study population was 543 employees of all the categories of hospital staff. Calculated sample size was 422 and 375 were responded to the questionnaire giving response rate of 88.9. Results The study revealed that the implemented 5S programmes were sustaining in eight hospitals out of ten i.e. sustaining rate was 80. When it considered the degree of sustainability 50 of the selected hospitals reported more than 70 sustainability. This was considered as favourable trend in government health sector in healthcare quality point of view. Ten factors were studied as contributing factors for the 5S sustainability. Socio- demographic factors were also considered. Those ten factors were top management commitment leadership of the organization commitment of middle amp frontline managers commitment amp satisfaction of employees training amp changing attitude of employees motivation of employees organizational culture group cohesiveness community participation and customer satisfaction. Study revealed that organizational leadership customer satisfaction community
Muhammad, Tufail; Kim, Kwan Myung
Human-induced threats serve as potential hazards to cultural heritage assets, especially in developing areas where the local community, in general, is a deprived class. Sustainable tourism development is acknowledged as an economic activity to ensure careful management of assets along with local community empowerment and participation. As such, ICT-enabled development is applied in rural development projects to promote sustainable rural livelihood, but success is still limited due to a lack of community involvement and sharing in the economic gains of tourism. With this perspective in mind, the present study focuses on emerging marketing models (e-commerce) that can provide new business ventures for local communities by identifying critical online marketing elements driven by local residents.
Full Text Available Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities.The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable.The prevalence of overweight or obesity was 79.2% (males and 65.8% (females; increased with age to 74 years; and was higher in rural (74% versus urban areas (71.4% (p<0.001. Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001, obesity (p<0.0001 and overweight or obesity (p<0.0001 in women and obesity (p<0.0001 in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024 and overweight or obesity (p = 0.4896 in males.It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.
Leon T.B. Jackson
Full Text Available Orientation: The study addresses the question of how employees of the South African Police Service (SAPS cope with intercultural relations in an increasingly diverse organisation. Research purpose: A dual-process model of diversity outcomes was tested in which a distinction is made between a positive (work-related stream that links positive diversity conditions through active coping to work outcomes and a relatively independent health related stream of negative antecedents, mediating passive coping skills and ill-health related outcomes. Motivation for the study: To test the viability of a dual-process model to understand diversity outcomes in the workplace. Research design, approach and methods: A convenience sample (n= 158 was recruited from members of the SAPS in Gauteng, using a cross-sectional design. Instruments used in previous acculturation research were adapted to measure contextual factors, coping and diversity outcomes. Main findings: A very good fit for the proposed hypothetical model was found. Approach coping partially mediated the relationship between positive acculturation conditions and the subjective experience of work success whereas avoidance coping fully mediated the relationship between discrimination, and ill-health symptoms are related to ill-health symptoms. Practical/managerial implications: Mainstream-facilitating conditions and discrimination influence individual coping styles, which in turn impact on ill-health and the subjective experience of work success. In addition, ill-health also impacts negatively on work-success experiences amongst the sampled SAPS members. It would thus make sense for the SAPS to sanction discrimination. Contribution/value added: A variation of the mediated dual-process model for diversity (Jackson & Van de Vijver, in press, using coping strategies as mediators was supported. The model adds new insights in diversity in organisations.
Marthe L. Derkzen
Full Text Available Urban commons are under pressure. City development has led to the encroachment and ecological degradation of urban open space. Although there is growing insight that urban ecosystems need to be protected, there is hardly any attention for the consequences (of both pressures and protection efforts for vulnerable human population groups. We aim to understand how urban development affects the well-being of the urban poor, through shifts in ecosystem services (ES and people's responses to these shifts. We performed household interviews and group mapping sessions in seven urban lake communities in Bangalore, India. Changes at Bangalore's lakes can be summarized by three trends: privatization followed by conversion, pollution followed by degradation, and restoration followed by gentrification. Over time, this resulted in a shift in the types of ES supplied and demanded, the nature of use, and de facto governance: from provisioning, communal and public; to cultural, individual, and private. Lake dwellers responded by finding (other sources of income, accepting lower quality or less accessible ES, and/or completely stopping the use of certain ES. The consequences of ecosystem change for people's well-being differ depending on a household's ability to adapt and on individual circumstances, land tenure and financial capital in particular. To guarantee a future for Bangalore's lakes, restoration seems the only viable option. Although beautiful lake parks may be a solution for the well-off and not-too-poor, leaving the very poor without options to adapt to the new circumstances puts them at risk of becoming even more marginalized. We show that ecosystem degradation and restoration alike can impact the well-being of the urban poor. People's experiences allowed us to couple ecosystem change to well-being through ES and adaptation strategies. Hence, we revealed multiple cause-effect relations. Understanding these relations contributes to sustainable urban
Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J
To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.
Full Text Available Abstract Background HIV voluntary counseling and testing (VCT is considered an effective prevention method of HIV infection. In order to understand the VCT environment and enhance the effective delivery of VCT services in a country, an accurate assessment of the current status of VCT services is very important. Methods From July 2006 to June 2007, we conducted a cross-sectional survey using a face to face interview among 2676 VCT clients from a high risk area in Shenyang city, China. Results The major demographic characteristics among 2,676 VCT clients were: 41.1% were in the age range 20 to 30 years; 73.1% were males; and 67.1% had attained the level of junior high school education. The primary information source for VCT services was mass media like television (TV and newspaper in 88.9%. 34.3% were afraid of the result of infection which was the main barrier to accept VCT services among 540 participants answering the question. 75.2% were motivated by recently acquired knowledge about HIV. 47.9% had 3 or more male sex partners, 62.3% had used condoms sometimes, and 14.5% had been infected with a STD. 2.8% of the participants identified themselves as men who have sex with men (MSM. The main demographic characteristics of MSM did not differ from the total group of participants except with respect to age: 63.5% reported having one male sex partner in the preceding 12 months, 44.6% reported never using condoms in the preceding 12 months, and only 2.7% reported a history of sexually transmitted disease. Conclusion Public education offered by health workers in hospitals, private clinics and other medical institutions needs to be strengthened. Given the results from this study, we recommend: (1 making VCT a routine part of health services, especially in areas where many high-risk individuals live; (2 improving the information sources and increasing the understanding of HIV and HIV-infected individuals; (3 enhancing international collaboration in
Jonathan D King
during enhanced outreach services are plausible explanations for the changing patterns of intestinal parasite prevalence. The extent of intestinal protozoa infections suggests poor water quality or unsanitary water collection and storage practices and warrants targeted intervention.
King, Jonathan D; Endeshaw, Tekola; Escher, Elisabeth; Alemtaye, Genetu; Melaku, Sileabatt; Gelaye, Woyneshet; Worku, Abebe; Adugna, Mitku; Melak, Berhanu; Teferi, Tesfaye; Zerihun, Mulat; Gesese, Demelash; Tadesse, Zerihun; Mosher, Aryc W; Odermatt, Peter; Utzinger, Jürg; Marti, Hanspeter; Ngondi, Jeremiah; Hopkins, Donald R; Emerson, Paul M
The SAFE strategy aims to reduce transmission of Chlamydia trachomatis through antibiotics, improved hygiene, and sanitation. We integrated assessment of intestinal parasites into large-scale trachoma impact surveys to determine whether documented environmental improvements promoted by a trachoma program had collateral impact on intestinal parasites. We surveyed 99 communities for both trachoma and intestinal parasites (soil-transmitted helminths, Schistosoma mansoni, and intestinal protozoa) in South Gondar, Ethiopia. One child aged 2-15 years per household was randomly selected to provide a stool sample of which about 1 g was fixed in sodium acetate-acetic acid-formalin, concentrated with ether, and examined under a microscope by experienced laboratory technicians. A total of 2,338 stool specimens were provided, processed, and linked to survey data from 2,657 randomly selected children (88% response). The zonal-level prevalence of Ascaris lumbricoides, hookworm, and Trichuris trichiura was 9.9% (95% confidence interval (CI) 7.2-12.7%), 9.7% (5.9-13.4%), and 2.6% (1.6-3.7%), respectively. The prevalence of S. mansoni was 2.9% (95% CI 0.2-5.5%) but infection was highly focal (range by community from 0-52.4%). The prevalence of any of these helminth infections was 24.2% (95% CI 17.6-30.9%) compared to 48.5% as found in a previous study in 1995 using the Kato-Katz technique. The pathogenic intestinal protozoa Giardia intestinalis and Entamoeba histolytica/E. dispar were found in 23.0% (95% CI 20.3-25.6%) and 11.1% (95% CI 8.9-13.2%) of the surveyed children, respectively. We found statistically significant increases in household latrine ownership, use of an improved water source, access to water, and face washing behavior over the past 7 years. Improvements in hygiene and sanitation promoted both by the SAFE strategy for trachoma and health extension program combined with preventive chemotherapy during enhanced outreach services are plausible explanations for the
Nassehi, M. Mehdi
Local Area Networks are in common use for data communications and have enjoyed great success. Recently, there is a growing interest in using a single network to support many applications in addition to traditional data traffic. These additional applications introduce new requirements in terms of volume of traffic and real-time delivery of data which are not met by existing networks. To satisfy these requirements, a high-bandwidth tranmission medium, such as fiber optics, and a distributed channel access scheme for the efficient sharing of the bandwidth among the various applications are needed. As far as the throughput-delay requirements of the various application are concerned, a network structure along with a distributed channel access are proposed which incorporate appropriate scheduling policies for the transmission of outstanding messages on the network. A dynamic scheduling policy was devised which outperforms all existing policies in terms of minimizing the expected cost per message. A broadcast mechanism was devised for the efficient dissemination of all relevant information. Fiber optic technology is considered for the high-bandwidth transmisison medium.
Renata Bortolasse Miguel
Full Text Available The lethality of malaria in the extra-Amazonian region is more than 70 times higher than in Amazonia itself. Recently, several studies have shown that autochthonous malaria is not a rare event in the Brazilian southeastern states in the Atlantic Forest biome. Information about autochthonous malaria in the state of Rio de Janeiro (RJ is scarce. This study aims to assess malaria cases reported to the Health Surveillance System of the State of Rio de Janeiro between 2000-2010. An average of 90 cases per year had parasitological malaria confirmation by thick smear. The number of malaria notifications due to Plasmodium falciparum increased over time. Imported cases reported during the period studied were spread among 51% of the municipalities (counties of the state. Only 35 cases (4.3% were autochthonous, which represents an average of 3.8 new cases per year. Eleven municipalities reported autochthonous cases; within these, six could be characterised as areas of residual or new foci of malaria from the Atlantic Forest system. The other 28 municipalities could become receptive for transmission reintroduction. Cases occurred during all periods of the year, but 62.9% of cases were in the first semester of each year. Assessing vulnerability and receptivity conditions and vector ecology is imperative to establish the real risk of malaria reintroduction in RJ.
Full Text Available This research aimed 1 to study the components of guidelines of the development and the supporting learning resources by the community participatory of case study for the schools under Secondary Education Service Area Office 24 and 2 to investigate guidelines of guidelines of the development and the supporting learning resources by the community participatory of case study for the schools under Secondary Education Service Area Office 24. This research was conducted into two phases. The first phase was investigated the components and indicators of guidelines of the development and the supporting learning resources by the community participatory of case study for the schools under Secondary Education Service Area Office 24. The samples group were five respondents to provide the information by an assessment form. The second phase was conducted to find out the guidelines of development and supporting learning resources by community participatory of case study which included four steps. The first step was the focus group of case study schools with best practice. The samples were fourteen key informants from 2 schools. There were school directors, deputy director of academic administration, head of learning, village leaders, wisdom villagers and religious leaders. The data were collected by using focus group discussion form. The second step was draft the develop management guideline of academic administration. The sample group were 7 professionals. The data were collected by using the evaluation from of propriety/feasibility/utility of the develop management guideline of academic administration. The data were analyzed in average ( and standard deviation (S.D.. The third step was group discussion for evaluated the applying of the develop management guideline of academic administration. The samples group were 14 key informants from 2 schools. There were school directors, deputy director of academic administration, head of learning, village leaders
Missall, S.; Welp, M.; Thevs, N.; Abliz, A.; Halik, Ü.
The city of Aksu, situated at the northern fringe of the Taklimakan Desert in the northwest of China, is exposed to periodic severe dust and sand storms. In 1986, local authorities decided to establish a peri-urban shelterbelt plantation, the so-called Kökyar Protection Forest. It was realised as a patchwork of poplar shelterbelts and orchards. The total area of the plantation reached 3800 ha in 2005. This endeavour was made possible by the annual mass mobilisation of Aksu citizens, based on the Chinese regulation of the "National Compulsory Afforestation Campaigns". Establishment costs amounted to ca. CNY 60 000 ha-1 (ca. USD 10 000 ha-1). The regulating ecosystem services provided by Kökyar Protection Forest clearly reduce dust and sand storm impacts on Aksu City. Permanent maintenance of the plantation is facilitated by leasing orchard plots to private fruit farmers. This system ensures forest tending, reduces government expenses, and provides incomes to farmers. From the perspective of the local economy, annual farming net benefits generated by Kökyar fruit farmers more than compensate annual government grants for maintenance, resulting in an overall monetary net benefit of at least CNY 10 500 ha-1 (ca. USD 1600 ha-1) on the long-term average. The intended regulating ecosystem services can thus be provided to the citizens of Aksu without payments for ecosystem services or other financial burdens. For a more complete understanding of Kökyar Protection Forest, future research should be directed towards quantifying the effect of its regulating ecosystem services, and on investigating the negative downstream consequences of its water consumption.
Azmat, Syed Khurram; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Hameed, Waqas; Khan, Omar Farooq; Abbas, Ghazunfer; Temmerman, Marleen; Munroe, Erik
Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed. A cross-sectional baseline household survey was conducted with randomly selected 3,998 married women of reproductive age (MWRA) in the Chakwal, Mianwali, and Bhakkar districts of Punjab. The data were analyzed on SPSS 17.0 using simple descriptive and logistic regression. Most of the women had low socio-economic status and were younger than 30 years of age. Four-fifths of the women consulted private sector health facilities for reproductive health services; proximity, availability of services, and good reputation of the provider were the main predicators for choosing the facilities. Husbands were reported as the key decision maker regarding health-seeking and family planning uptake. Overall, the current contraceptive use ranged from 17% to 21% across the districts: condoms and female sterilization were widely used methods. Woman's age, husband's education, wealth quintiles, spousal communication, location of last delivery, and favorable attitude toward contraception have an association with current contraceptive use. Unmet need for contraception was 40.6%, 36.6%, and 31.9% in Chakwal, Mianwali, and Bhakkar, respectively. Notably, more than one fifth of the women across the districts expressed willingness to use quality, affordable long-term family planning services in the future. The baseline results highlight the need for quality, affordable long-term family planning
Morris, Stephen; Hoffman, Alex; Hunter, Rachael M.; Boaden, Ruth; McKevitt, Christopher; Perry, Catherine; Pursani, Nanik; Rudd, Anthony G.; Turner, Simon J.; Tyrrell, Pippa J.; Wolfe, Charles D.A.; Fulop, Naomi J.
Background and Purpose— In 2010, Greater Manchester and London centralized acute stroke care into hyperacute units (Greater Manchester=3, London=8), with additional units providing ongoing specialist stroke care nearer patients’ homes. Greater Manchester patients presenting within 4 hours of symptom onset were eligible for hyperacute unit admission; all London patients were eligible. Research indicates that postcentralization, only London’s stroke mortality fell significantly more than elsewhere in England. This article attempts to explain this difference by analyzing how centralization affects provision of evidence-based clinical interventions. Methods— Controlled before and after analysis was conducted, using national audit data covering Greater Manchester, London, and a noncentralized urban comparator (38 623 adult stroke patients, April 2008 to December 2012). Likelihood of receiving all interventions measured reliably in pre- and postcentralization audits (brain scan; stroke unit admission; receiving antiplatelet; physiotherapist, nutrition, and swallow assessments) was calculated, adjusting for age, sex, stroke-type, consciousness, and whether stroke occurred in-hospital. Results— Postcentralization, likelihood of receiving interventions increased in all areas. London patients were overall significantly more likely to receive interventions, for example, brain scan within 3 hours: Greater Manchester=65.2% (95% confidence interval=64.3–66.2); London=72.1% (71.4–72.8); comparator=55.5% (54.8–56.3). Hyperacute units were significantly more likely to provide interventions, but fewer Greater Manchester patients were admitted to these (Greater Manchester=39%; London=93%). Differences resulted from contrasting hyperacute unit referral criteria and how reliably they were followed. Conclusions— Centralized systems admitting all stroke patients to hyperacute units, as in London, are significantly more likely to provide evidence-based clinical
Full Text Available The research aimed to 1 study problems of strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4 ; and 2 propose the guidelines for strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4. The study was carried out in 2 phases. In phase 1, it focused on the study and analysis of the strategic implementation problems and phase 2 studied the best practice schools. The informants for the interview in phase 1 comprised 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools. They were selected by the use of purposive sampling technique. The population in the study of the strategic implementation problems in basic educational institutions in phase 1 consisted of 543 school administrators and teachers who were involved in strategy implementation from 181 schools under Khonkaen Primary Educational Service Area Office 4 in academic year 2014. The study samples were 217 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools under Khonkaen Primary Educational Service Area Office 4. The samples were selected by the use of stratified sampling technique. The informants of the phase 2 study were 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized best practice schools obtained from purposive sampling technique. The research instruments used for data collection consisted of 2 sets of questionnaires. The Set 1 questionnaire was the 5-point Likert scale on the levels of the problems in implementation with item discrimination at 0.60 – 1.00 and reliability of the whole questionnaire at .9359. The questionnaire contained 3 parts with 65 items. The Set 2 questionnaire comprised 2 parts with 10 items regarding
Cross, Roger; Bonney, Andrew; Mayne, Darren J; Weston, Kathryn M
Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia. Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence. Glycaemic risk categories were defined as HbA1c 5.0-5.99% (lowest risk), 6.0-7.49% (intermediate risk) and ≥7.5% (highest risk). Logistic regression models were fit with glycaemic risk category as the outcome variable and IRSD as the study variable, adjusting for age and sex. Results Data from 29064 individuals were analysed. Higher disadvantage was associated with belonging to a higher glycaemic risk category in the fully adjusted model (most disadvantaged vs least disadvantaged quintile; odds ratio 1.74, 95% confidence interval 1.58, 1.93; Pdisadvantage was a significant correlate of increased glycaemic-related risk. Geocoded clinical data can inform more targeted use of health service resources, with the potential for improved health care equity and cost-effectiveness. What is known about the topic? The rapid increase in the prevalence of Type 2 diabetes (T2D), both globally and nationally within Australia, is a major concern for the community and public health agencies. Individual socioeconomic disadvantage is a known risk factor for abnormal glucose metabolism (AGM), including T2D. Although small-area-level socioeconomic disadvantage is a known correlate of AGM in Australia, less is known of the association of area-level disadvantage and glycaemic-related risk in individuals with AGM. What does this paper add? This study demonstrates a robust association between small-area
Consolidated progress report for 1975 on nuclear data activities in the NDS service area: Argentina, Bangladesh, Brazil, Bulgaria, Hungary, India, Iran, Iraq, Israel, Pakistan, Poland, Romania, South Africa, Yugoslavia
A consolidated progress report for 1975 on nuclear data activities in the NDS service area is presented for the following countries: Argentina, Bangladesh, Brazil, Bulgaria, Hungary, India, Iran, Iraq, Israel, Pakistan, Poland, Romania, South Africa, Yugoslavia
Resende, F M; Fernandes, G W; Andrade, D C; Néder, H D
Considering that the economic valuation of ecosystem services is a useful approach to support the conservation of natural areas, we aimed to estimate the monetary value of the benefits provided by a protected area in southeast Brazil, the Serra do Cipó National Park. We calculated the visitor's willingness to pay to conserve the ecosystems of the protected area using the contingent valuation method. Located in a region under intense anthropogenic pressure, the Serra do Cipó National Park is mostly composed of rupestrian grassland ecosystems, in addition to other Cerrado physiognomies. We conducted a survey consisting of 514 interviews with visitors of the region and found that the mean willingness to pay was R$ 7.16 year-1, which corresponds to a total of approximately R$ 716,000.00 year-1. We detected that per capita income, the household size, the level of interest in environmental issues and the place of origin influenced the likelihood that individuals are willing to contribute to the conservation of the park, as well as the value of the stated willingness to pay. This study conveys the importance of conserving rupestrian grassland and other Cerrado physiognomies to decision makers and society.
Full Text Available The research aimed to 1 study the factors and indicators of mentoring internal supervision for schools, 2 study the current state and the desirable state of mentoring internal supervision for schools, and 3 study the guidelines on the operation of mentoring internal supervision for the schools under Roi-Et Office of Primary Education Service Area 2. The research was divided into 3 phases. In phase 1 the informants comprised 5 certified experts. In phase 2 the sample comprised 488 government teachers under Roi-Et Office of Primary Education Service Area 2, btained through multi-stage random sampling. In phase 3 the informants comprised school directors, school deputy directors and supervisor teachers under Roi-Et Office of Primary Education Service Area 2, totally 9 persons. The research instruments onsisted of 1 a questionnaire having the discrimination from 0.34 to 0.79 and the total reliability of 0.87, 2 a structured interview form, and 3 a suitability and feasibility assessment form for the guidelines on the operation of mentoring internal supervision. The analysis of data employed percentage, the mean and standard deviation. The results are as follows: 1. There are 4 factors of the guidelines on mentoring internal supervision for schools. They are: preparation of mentoring supervision, with 12 indicators ; management of mentoring supervision, with 12 indicators ; operation of mentoring supervision, with 14 indicators ; and evaluation of mentoring supervision, with 10 indicators, all of which had been evaluated by the experts as, on the whole, very suitable. 2. The current state of the mentoring internal supervision for schools, on the whole and factor by factor, was in the moderate level in every factor. Meanwhile, the desirable state of mentoring internal supervision for schools, on the whole, was in the high level. When considered factor by factor, the factor with the highest mean is management of mentoring supervision. The factor with
Olafsson, G; Sigurdsson, J A
To examine the access, workload, duties, commitments and quality standards of primary care physicians (GPs) resulting from out-of-hours service. All GPs (n = 96) in rural Iceland. Answers to a postal survey. The participation rate was 80%. The GPs estimated that in 97% of the cases they could be contacted within 5 minutes in an emergency. Under usual circumstances (weather conditions) and within a distance of 10 km, 70% of them could reach the patient within 30 minutes of receiving the call. In severe weather conditions, 50% of the GPs in smaller districts (650-6000 inhabitants) estimated that it could take up to 5 hours or more to reach the patient (which could happen once a year). In the least populated districts, 84% of the GPs had to be on call 14 days or more per month. Serious emergencies (involving special training such as cardiac resuscitation or tracheal intubation) were relatively rare, and GPs expressed the necessity for regular refresher courses in such fields. Modern telecommunication networks guarantee good access to out-of-hours service. The workload and on-call duties are great and do not comply with European Union (EU) recommendations regarding minimal rest time. If GPs in rural areas are to be expected to provide frontline health care, including in severe emergency situations, regular training courses are needed.
Full Text Available A production of „HSW“ in block of flats areas by solar collectors means a real alternative to the traditional way of heating by fossil fuels (coal, gas. With this method, it’s possible to save ca. 50 % of energy from the net of the central service of the heat, what can reduce the production of pollutants in the locality, or it can enable to increase the quantity of customers without claims for the restructuralization of the central source. Because Slovakia is the producer of quality solar collectors it’s suitable to use them just for this reason, which could be projected into the price reduction of relatively expensive present systems. On the other side, when using the flat roofs on the block of flats, other useful places are hot occupied and the heating source is nearby the place of it sconsumption. In this case, a collaboration of the solar system and the Central Service of Heat is especially suitable in time with a shortage of the solar radiation.
Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka
About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists - ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti-stigma campaign using multi-media approaches was conducted across the villages at the outset of the project. A pre-post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. The intervention led to individuals being screened for common mental
Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha; Vadlamani, Vamsi Krishna; Jha, Vivekanand; Patel, Anushka
Background About 25% of the Indian population experience common mental disorders (CMD) but only 15–25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile–technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence–based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. Methods The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists – ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti–stigma campaign using multi–media approaches was conducted across the villages at the outset of the project. A pre–post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Results Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. Conclusions The intervention
Chandran, Kumar; Hampton, Karla E.; Hecht, Kenneth; Grumbach, Jacob M.; Kimura, Amanda T.; Braff-Guajardo, Ellen; Brindis, Claire D.
Introduction Recent legislation requires schools to provide free drinking water in food service areas (FSAs). Our objective was to describe access to water at baseline and student water intake in school FSAs and to examine barriers to and strategies for implementation of drinking water requirements. Methods We randomly sampled 24 California Bay Area public schools. We interviewed 1 administrator per school to assess knowledge of water legislation and barriers to and ideas for policy implementation. We observed water access and students’ intake of free water in school FSAs. Wellness policies were examined for language about water in FSAs. Results Fourteen of 24 schools offered free water in FSAs; 10 offered water via fountains, and 4 provided water through a nonfountain source. Four percent of students drank free water at lunch; intake at elementary schools (11%) was higher than at middle or junior high schools (6%) and high schools (1%). In secondary schools when water was provided by a nonfountain source, the percentage of students who drank free water doubled. Barriers to implementation of water requirements included lack of knowledge of legislation, cost, and other pressing academic concerns. No wellness policies included language about water in FSAs. Conclusion Approximately half of schools offered free water in FSAs before implementation of drinking water requirements, and most met requirements through a fountain. Only 1 in 25 students drank free water in FSAs. Although schools can meet regulations through installation of fountains, more appealing water delivery systems may be necessary to increase students’ water intake at mealtimes. PMID:22765930
Deng, Jian; Sun, Pingsheng; Zhao, Fazhu; Han, Xinhui; Yang, Gaihe; Feng, Yongzhong
Studies on the ecological conservation behavior of farmers usually focus on individual and socio-economic characteristics without consideration of the underlying psychological constructs, such as farmers' intention and perceptions. This study uses the theory of planned behavior (TPB), a typical social psychology construct, to analyze the factors affecting the intention and behavior of farmers for conserving the ecological achievements from payment for ecosystem service (PES) programs in eco-environmentally fragile areas. Questionnaires based on TPB were administered to 1004 farmers from the Grain to Green Program area in the Loess Plateau, China, with the resulting dataset used to identify the underlying factors determining farmers' intention and behavior based on the structural equation model. The results show that the farmers' intention and behavior toward conserving ecological achievements were explained well by TPB. The farmers'behavior was significantly positively affected by their intention toward conserving ecological achievements, and their intention was significantly influenced by their attitude (positive or negative value of performance), the subjective norm (social pressure in engaging behavior), and perceived behavioral control (perceptions of their ability). The farmers' degree of support for PES programs and their recognition of environmental effects were the factors that most influenced the farmers' attitude. Pressure from neighbors was the most potent driver of the subjective norm. Meanwhile, perceptions of their ability to perform the behavior were the most potent factors affecting intention and it was mostly driven by the farmers' feelings toward environmental improvement and perceived ability (time and labor) to participate in ecological conservation. The drivers of attitude, subjective norm, and perceived behavioral control can be used by policy makers to direct farmers' intention and behavior toward conserving ecological achievements in fragile
Missall, S.; Welp, M.; Thevs, N.; Abliz, A.; Halik, Ü.
The city of Aksu, situated at the northern fringe of the Taklimakan Desert in northwest China, is exposed to severe periodic dust and sand storms. In 1986, local authorities decided to establish a peri-urban shelterbelt plantation, the so-called Kökyar Protection Forest, with the aim of reducing dust and sand storm impacts on Aksu City by the regulating ecosystem services provided by the plantation. It was realised as a patchwork of poplar shelterbelts and orchards. The total area of the plantation reached 3800 ha in 2005. The Kökyar Protection Forest is used as a case study to answer the following question: under which institutional frameworks and to which financial conditions can peri-urban shelterbelts be established and maintained? The endeavour of planting the shelterbelt was made possible by the annual mass mobilisation of Aksu citizens, based on the Chinese regulation of the "National Compulsory Afforestation Campaigns". Establishment costs amounted to ca. CNY 60 000 ha-1 (ca. USD 10 000 ha-1). Permanent maintenance of the plantation is facilitated by leasing orchard plots to private fruit farmers. From the perspective of the local economy, annual farming net benefits generated by Kökyar fruit farmers more than compensate for annual government grants for maintenance, resulting in an average overall monetary net benefit of at least CNY 10 500 ha-1 (ca. USD 1600 ha-1) in the long term. For a more complete understanding of Kökyar Protection Forest, future research should be directed towards quantifying the effect of its regulating ecosystem services and on investigating the negative downstream consequences of its water consumption.
Turbyville, Joseph C; Dunford, James C; Nelson, Michael R
Insect venom hypersensitivity can pose a threat to personnel deployed to a combat zone but the exposure risk in Afghanistan is currently unknown. This study was designed to assess the threat of Hymenoptera stings and associated allergic reactions in Afghanistan. Hymenoptera species were collected during a deployment to southern Afghanistan from June 2010 through January 2011. The literature was also reviewed to determine species of medically important Hymenoptera recorded in the region. The U.S. Army theater electronic medical data system was mined for ICD-9 codes associated with insect stings to determine the number of theater medical clinic encounters addressing insect sting reactions. Three species of flying hymenoptera were commonly encountered during the study period: Vespa orientalis L., Polistes wattii Cameron, and Vespula germanica (F.). A literature review also confirms the presence of honeybees (Apidae), numerous velvet ant (Mutillidae) species, and various ant (Formicidae) species all capable of stinging. No evidence was identified to suggest that fire ants (Solenopsis ssp.) are a threat in the region. Based on electronic medical records from the U.S. Central Command area of operations over a 2-year period, roughly 1 in 500 clinic visits involved a patient with a diagnosis of insect bite or sting. Cross-reactive members of all five flying Hymenoptera species commonly assessed for in Hymenoptera allergy evaluations are present in Afghanistan. The review of in-theater medical records confirms that insect stings pose an environmental threat to deployed service members.
Luisa R. Blanco
Full Text Available For this study, we conducted seven focus groups in the Los Angeles area with a total of 70 participants (42 Latinos and 28 African Americans recruited from three senior centers and a church. There was a wide variety of responses in relation to the usage of financial services among participants. We found that although some participants seem to participate more in the formal financial sector and show a higher level of sophistication when managing their finances, other participants’ use of formal financial institutions is minimal. Among African American participants, we found several instances in which individuals feel very comfortable using banks. Lower levels of participation in the formal financial sector were found among the lower income Latino participants. In relation to barriers to participate in the financial sector, supply was not an issue, but demand and behavioral factors seem more important. Overall, no participants saved very much on a regular basis. We also find that participants in general do not want to ask their children for money, and also do not want to save and accumulate wealth to leave to their children.
Full Text Available The main aim of this paper was to examine the effect of strategic leadership factors of administrators on school effectiveness under the Office of Maha Sarakham Primary Educational Service Area 3. The designed research survey was utilized to investigate the strategic leadership behavior of administrators and school effectiveness, followed by comparing both key variables in terms of school size. Further exploration was carried out to validate the goodness-of-fit of a structural equation model of the strategic leadership factors of administrators affecting school effectiveness. Finally, the direct, indirect, and total effect of strategic leadership factors affecting school effectiveness were identified. In total, 510 samples comprised of administrators and teachers were selected as respondents. The research instrument was a 5-point rating scale questionnaire. Data were analyzed using both descriptive and inferential statistics. The results revealed that administrators showed a high level of strategic leadership behavior in their administration but the overall school effectiveness was at the moderate level. In addition, the findings also indicated that all the comparisons of either the strategic leadership of administrators or school effectiveness were significantly different according to school size, respectively. Furthermore, a structural equation model of strategic leadership factors affecting school effectiveness was fitted. Finally, the direct effect, indirect effect, and overall effect of the administrators' strategic leadership had no significant impact on school effectiveness at the .05 level.
Puthuchira Ravi, Rejoice; Athimulam Kulasekaran, Ravishankar
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.
Adkins, S.K.; Alford, D.R.; Barnette, A.B.
The Management Services Section provides coordinated professional administrative services to the Fusion Energy Division (FED), allowing the work of technical professionals to be more fully concentrated in their areas of specialty. Services are provided in general administration, personnel, financial management, communications (including text and graphics generation), management information, library, safety, quality assurance, and nonprogrammatic engineering services. Highlights of the past year included adoption of the Procurement Module in the FED Management Information System (MIS) for use by the entire Laboratory, completion of the Personnel Module of the MIS, greatly increased personnel recruiting activity, and increased industrial subcontracting activity
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Choo, Wai K; McGeary, Katie; Farman, Colin; Greyling, Andre; Cross, Stephen J; Leslie, Stephen J
This study aimed to examine whether general practitioner (GP) practice locations in remote and rural areas affected the pattern of direct access echocardiography referral and to assess any variations in echocardiographic findings. All referrals made by all GP practices in the Scottish Highlands over a 36-month period were analysed. Referral patterns were examined according to distance and rurality based on the Scottish Government's Urban-Rural Classification. Reasons for referral and cardiac abnormality detection rates were also examined. In total, 1188 referrals were made from 49 different GP practices; range of referral rates was 0.3-20.1 per 1000 population with a mean of 6.5 referrals per 1000 population. Referral rates were not significantly different between urban and rural practices after correction for population size. There was no correlation between the referral rates and the distance from the centre (r2=0.004, p=0.65). The most common reason for referral was the presence of new murmur (46%). The most common presenting symptom was breathlessness (44%). Overall, 28% of studies had significant abnormal findings requiring direct input from a cardiologist. There was no clear relationship between referral rates and cardiac abnormality detection rates (r2=0.07, p=0.37). The average cardiac abnormality detection rate was 56%, (range 52-60%), with no variation based on rurality (p=0.891). In this cohort, rurality and distance were not barriers to an equitable direct access echocardiography service. Cardiac abnormality detection rates are consistent with that of other studies.
Comp, David J.
The National Security Education Program, established under the National Security Education Act of 1991, has had a post-funding service requirement in the Federal Government for undergraduate scholarship and graduate fellowship recipients since its inception. The service requirement, along with the concern that the National Security Education…
Koike, Soichi; Furui, Yuji
The objective of this study was to examine the effects of home-based long-term care insurance services on an increase in care need levels and discuss its policy implications. We analyzed care need certification and long-term care service use data for 3006 non-institutionalized elderly persons in a Tokyo ward effective as of October 2009 and 2010. Individual care need assessment intervals and their corresponding changes in care need level were calculated from data at two data acquisition points of care need assessment. Those who had been certified but did not use any long-term care insurance service were defined as the control group. The Cox proportionate hazard model was used to determine whether the use of a long-term care insurance service is associated with increased care need level. After adjusting for sex, age, and care need level, the hazard ratio for the probability of increased care need level among service users was calculated as 0.75 (95% confidence interval, 0.64-0.88; p Home-based long-term care service use may prevent an increase in care need level. Administrative data on care need certification and services use could be an effective tool for evaluating the long-term care insurance system. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Vermont Center for Geographic Information — (Link to Metadata) A ZIP Code Tabulation Area (ZCTA) is a statistical geographic entity that approximates the delivery area for a U.S. Postal Service five-digit...
This pilot test work plan presents the scope of an in situ enhanced biological degradation, or "bioventing", pilot test for treatment of gasoline- contaminated soils at the Base Exchange Service Station (BXSS...
Full Text Available This speech, given in Istanbul on 3 December 1993 during a visit to Turkey, starts with an overview of public library services in Britain Following information on services offered to rural areas; the author refers a report published in 1993. This report highlights the main topics under discussion in Britain currently: (1 it is recognized that a modern public library is a very complicated organization serving a large clientele aiming to meet their very many requirements; (2 volunteers, new technologies and modern management and marketing techniques should be utilized to improve the services to rural areas; (3 although services to rural areas pose specific problems, people who live in these areas have the right to demand equal services; (4 although only some services can be offered directly, in rural areas, everyone should have equal opportunities in reaching all library and information services; (5 cooperation with local people by library authorities can be a solution to some of the problems. Bu konferans, genel anlamda kütüphanelerin ve kütüphanecilerin karşı karşıya bulunduğu sorunlar üzerinde yoğunlaşmakla birlikte, ele alınan konular Büyük Britanya 'daki kütüphanelerle özellikle de halk kütüphaneleri ile sınırlı kalmaktadır. Ancak kütüphanecilik, evrensel bir kavram olduğundan Britanya'daki kütüphanelerin sorunları, az ya da çok tüm ülke kütüphaneleri tarafından paylaşılmaktadır. Göz önünde bulundurulması gereken en önemli konu, genel kütüphanecilik hizmetlerinin, küçük yerleşim birimleri itibariyle de yaygınlaştırılmasının gerektiğidir. Ve bu konuyla ilgili olarak, çağdaş iletişim araçlarının inkar edilemez bir rolü sözkonusu olmaktadır. Kütüphanecilik hizmetlerinden herkesin eşit oranda yararlanabilme hakkı vardır. Bu hizmetlerden yararlanabildiği ve kültür seviyesinin daha yüksek olduğu
Full Text Available Asthma remains poorly studied in homeless children. We sought to estimate the prevalence of asthma-like symptoms (ALS and to identify the factors associated with ALS and healthcare service utilisation.A cross-sectional survey of a random sample of sheltered homeless families was conducted by interviewing 801 parents of children (0-12 years in 17 languages. ALS were defined as wheezing or night cough without fever during the previous year. Poisson regression models with robust error variance were used to compute prevalence ratios (PR for factors associated with ALS and healthcare service utilisation for ALS.The prevalence of ALS among the children was 19.9%. Poor housing sanitation was significantly associated with ALS, as being born in the European Union. Most of the children with ALS had used healthcare services (85.4%. The main barriers to accessing such services were having lived in France for less than 49 months, having difficulties in French and living in poor housing conditions.ALS prevalence seemed lower than in the general child population, possibly because of the children's origins. Environmental factors associated with ALS point to the need to improve the indoor environment of family shelters. The relatively high rate of healthcare service utilisation should not overshadow existing barriers.
The shifting focus of service from the 1980s to 2000s has proved that IT not only lowers the cost of service but creates avenues to enhance and increase revenue through service. The new type of service, e-service, is mobile, flexible, interactive, and interchangeable. While service science provides an avenue for future service researches, the specific research areas from the IT perspective still need to be elaborated. This book introduces a novel concept-service mining-to address several research areas from technology, model, management, and application perspectives. Service mining is defined as "a systematical process including service discovery, service experience, service recovery, and service retention to discover unique patterns and exceptional values within the existing services." The goal of service mining is similar to data mining, text mining, or web mining, and aims to "detect something new" from the service pool. The major difference is the feature of service is quite distinct from the mining targe...
Tuesday 19 October 2004 Please note that the distribution and collection of mail are likely to be disrupted on Tuesday, October 19, 2004, because of traffic and other restrictions enforced on that day in connection with CERN's fiftieth anniversary celebrations. The service may be completely interrupted in certain areas. Group TS-FM, Tel. 77551
Please remember to read your dosimeter at least once a month. Regular read-outs are vital to ensure that your personal dose is periodically monitored. Dosimeters should be read even if you have not visited the controlled areas. Dosimetry Service - Tel. 7 2155 http://cern.ch/rp-dosimetry
Please remember to read your dosimeter at least once a month. Regular read-outs are vital to ensure that your personal dose is periodically monitored. Dosimeters should be read even if you have not visited the controlled areas. Dosimetry Service Tel. 7 2155 http://cern.ch/rp-dosimetry
Please remember to read your dosimeter at least once a month. Regular read-outs are vital to ensure that your personal dose is periodically monitored. Dosimeters should be read even if you have not visited the controlled areas. Dosimetry Service - Tel. 72155 http://cern.ch/rp-dosimetry
Pinto, Maria; Fernandez-Marcial, Viviana; Gomez-Camarero, Carmen
This research explores the extent of service quality in Spanish university science and technology libraries, based on the expectations and perceptions of their users: faculty and researchers. Users' information behavior is analyzed with the specially designed BiQual tool, which reveals specific needs such as the greater importance of electronic…
Keith Stockmann; Nathaniel Anderson; Jesse Young; Ken Skog; Sean Healey; Dan Loeffler; Edward Butler; J. Greg Jones; James Morrison
Global forests capture and store significant amounts of carbon through photosynthesis. When carbon is removed from forests through harvest, a portion of the harvested carbon is stored in wood products, often for many decades. The United States Forest Service (USFS) and other agencies are interested in accurately accounting for carbon flux associated with harvested wood...
Report on Health Manpower and Programs in Ohio: Part Two. Allied Health, Area Health Education Centers, Dentistry, Emergency Medical Services, Nursing, Optometry, Pharmacy, Podiatry, and Veterinary Medicine.
Ohio Board of Regents, Columbus.
Information on health occupations educational programs in Ohio and current and projected employment needs for health professionals are presented. The following health fields are examined: allied health, dentistry, emergency medical service, nursing, optometry, pharmacy, podiatry, and veterinary medicine. Issues and trends affecting each field are…
Padilla, Brenda Lisa
This study highlights the development of a graduate training program at The Wright Institute in Berkeley, CA, which provides assessment services for undocumented immigrants seeking asylum. This program focuses on the needs of a general asylum seeking population, with a specific relevance to some of the populations that may be served in the…
Geneva Area City Schools, OH.
Five curriculum units for the second grade level focus on: (1) clothing producers and suppliers, and the clothing industry; (2) postal service workers and the postal system; (3) janitorial workers; (4) workers who build, furnish, and maintain homes and the housing industry; and (5) various community workers. Behavioral unit objectives emphasize…
Mathis, J.; Laurenza, E.
This paper focuses on the services and investment features of the recently concluded free trade agreement between the European Union and its Member States, of the one part, and the Republic of Korea, of the other part. This agreement is an early example of a new scheduling approach adopted by the
Full Text Available The aim of the study was to survey perceptions of quality of (primary health care services provided in rural communities in the Limpopo province. Ten focus groups discussions were held with community members chosen by convenience from public places from four villages in the central region of the Limpopo Province. The sample included 42 women and 34 men (76 participants. Results indicated perceived quality discussed within the following categories: (1 conduct of staff (reception, communication, discrimination, care and compassion, respect for privacy, (2 technical care (examination, explanation of treatment, responsiveness, treatment outcomes, (3 health care facility, (4 health care organisation, (5 drugs (availability, explanation, effectiveness, payment, and (6 waiting time. The findings suggest some satisfaction with free basic and preventive health care and social services provided but there is a need to look closely into the interpersonal dimension of the services provided, provision of medication with adequate explanation to patients on the medication given, and on structural aspects, there is need for the government to give support to the clinics to provide adequate services. Improving drug availability, interpersonal skills (including attitudes towards patients and technical care have been identified as the three main priorities for enhancing perceived quality of primary health care and health policy action.
The formation of human resources in the area of imaging diagnosed and therapeutic of the Universidad de Costa Rica and its contribution to the services of radiology, radiotherapy and nuclear medicine: period 1969 - 2007
Mendez Avila, Maria Catalina
The formation of human resources in the area of imaging diagnosed and therapeutic at the Universidad de Costa Rica, was carried out during the last 38 years and has been necessary to realize an assessment of that trajectory and value the impact it has had, the race today, in radiodiagnostic services, radiotherapy and nuclear medicine. The present work was carried out in order of providing to the Escuela de Tecnologias en Salud, the Universidad de Costa Rica, radiology services, radiotherapy, nuclear medicine and all those involved and interested in the area, a documented and rigorous analysis regarding the trajectory and characterization of the different stages of historical development of human resources training in imaging diagnosed and therapeutic. Also, suffered changes in the curriculum are considered in accordance with historical events and service needs. The analysis of each curriculum was performed and used for training of technicians and graduates in nuclear medicine and ionizing radiation, as well as the curriculum for the training of bachelors and degrees in imaging diagnosed and therapeutics, as part of the curriculum evolution in the formation of human resources. The strengths, deficiencies and challenge in each curriculum were presented, determining in this way how the changes made to the curriculum meet the needs and demands of radiology services, nuclear medicine and radiotherapy. (author) [es
their internal auditing function in the areas of professional excellence, quality of service and Students and teachers Media Internal Audit Service Navbar Toggle Home About the Staff Risk Assessment and Planning Internal Audit Process Search for Search Home The mission of the Fermilab Internal Audit Service
Castro, Antonio J.; Martín-López, Berta; López, Enrique
Protected areas are essential for conserving biodiversity, and these lands have traditionally been set aside for this purpose alone. However, the increasing global demand for agricultural and forestry commodities creates conflict and tradeoffs between dedicating land for conservation versus food...
An, Sung Min; Kim, Sung Chul
Satisfaction of the patient against the medical service in department of radiology and it evaluated the different recognition of radiological technologist and patient, and investigates it's improvement direction. It sent the reply the above the which is a usual result in question result of the most that, the receipt process it was complicated in the portion which is insufficient. 'The receipt process is complication', 'waiting time is long' and ' don't radiation protection for patient and guardian'. Also these a facts was recognizing patients and radiological technologist all. And the effort of the radiological technologist is necessary with the method which reduces a recognition difference. The periodical medical service satisfaction investigates and must endeavor in reform measure preparation
Glory Mmasetjana Lekganyane
Full Text Available This article seeks to juxtapose the current services and programmes that deal with the prevention of teenage pregnancies and the teenage motherhood notion in South Africa and Slovenia. The paper looks at the situation in both countries and tries to detect the main problems in the two cases and therefore proposes changes on the basis of what is known about the two countries. In other words, we describe the situation, identify problems and suggest solutions. Teenage pregnancy and teenage motherhood are always viewed as inseparable and as a discourse that exists due to a variety of social and sociological variables. The notion of teenage pregnancy and teenage motherhood is assessed against related theories and scholastic (secondary evidence. Finally, it is argued that intervention services and programmes that are linked with the life perspective of teenagers and teenage mothers yield positive results.
Colflesh, J.A.; Kruse, P.W.; Merluzzi, R.A.
Combustion Engineering (C-E) is a large diversified manufacturer of products and services for the energy field. At this time, C-E has supplied the nuclear steam supply systems for eleven operating nuclear power plants with two additional units currently undergoing start-up testing. The focus of C-E's commitment in the nuclear power plant services area is the Nuclear Services organization within the Nuclear Power Systems Division. The Nuclear Services organization provides services on a timely cost efficient basis; and dedicates resources to developing new products and services which are truly responsive to the needs of operating power plants world wide. In the paper, C-E's capabilities and experience in the field of nuclear services are described. Highlighted are our capabilities in the areas of transition management services, operating services and engineering services
Gallant, Alisa L.; Euliss, Ned H.; Browning, Zac
Pollination is a critical ecosystem service affected by various drivers of land-use change, such as policies and programs aimed at land resources, market values for crop commodities, local land-management decisions, and shifts in climate. The United States is the world's most active market for pollination services by honey bees, and the Northern Great Plains provide the majority of bee colonies used to meet the Nation's annual pollination needs. Legislation requiring increased production of biofuel crops, increasing commodity prices for crops of little nutritional value for bees in the Northern Great Plains, and reductions in government programs aimed at promoting land conservation are converging to alter the regional landscape in ways that challenge beekeepers to provide adequate numbers of hives for national pollination services. We developed a spatially explicit model that identifies sites with the potential to support large apiaries based on local-scale land-cover requirements for honey bees. We produced maps of potential apiary locations for North Dakota, a leading producer of honey, based on land-cover maps representing (1) an annual time series compiled from existing operational products and (2) a realistic scenario of land change. We found that existing land-cover products lack sufficient local accuracy to monitor actual changes in landscape suitability for honey bees, but our model proved informative for evaluating effects on suitability under scenarios of land change. The scenario we implemented was aligned with current drivers of land-use change in the Northern Great Plains and highlighted the importance of conservation lands in landscapes intensively and extensively managed for crops.
Geiger, Martin Josef; Sevaux, Marc; Sörensen, Kenneth
This book presents novel methodological approaches and improved results of metaheuristics for modern services. It examines applications in the area of transportation and logistics, while other areas include production and financial services.
Thu, Nguyen Thi Hoai; Wilson, Andrew; McDonald, Fiona
Motivation is an important driver for health professionals to maintain their professional competencies, continue in the workforce and make a positive contribution to their workplace. While there is some research about the motivation of health workers in low- to middle-income countries, maternal morbidity and mortality remains high and this can be lowered by improving the quality of maternal health services and the training and maintenance of the skills of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods. The study consisted of a survey using a self-administered questionnaire of 240 health workers in five districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23-item motivation instrument based on the Kenyan health context, modified for Vietnamese language and culture. The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = -0.14, P = 0.03), ability to perform key tasks (β = 0.22, P = 0.001) and shift schedule (β = -0.13, P = 0.05). Motivation was higher in health workers self-identifying as competent or who were enabled to provide more maternal care services. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have the opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to
Concerning this reporting policy , the OCHAMPUS ADP Manual, Chapter 2,Addendum F, Page 2.F-23, C-6, April 6, 1993 is quoted I as follows: 2 I U...Secretary of Defense (HA), Health Services I Financing (HSF), ATTN: Dr. Velthuis, Coordinated Care Policy , Rm IB657, The Pentagon, DC 20301-1200 (1) Office...Nt Lr IN nL- .c 0. 4cU ,.4 -. 4 a - L uJ UO,, W z0s 0 ". Lu 4c - F 30 0 0o 0 0 0c cA cnCD C N. 9e 6, *4J Li* - 4 44 (ry LI A 4 .CL C-0 I is a a - 4c
Pan, Bingbing; Towne, Samuel D; Chen, Yuxing; Yuan, ZhaoKang
The main aim of the New-type Rural Cooperative Medical System (NRCMS) put into effect in 2003 was to reduce financial barriers in accessing health care services among vulnerable populations. The aim of this study was to assess the association between NRCMS and income related inequality in hospital utilization among rural inhabitants in Jiangxi Province, China. A multistage stratified random cluster sampling method was adopted to select 1838, 1879, and 1890 households as participants in 2003/2004, 2008 and 2014, respectively. The Erreygers Concentration index (EI) of two measures of hospital inpatient care including admission to hospital and hospital avoidance, were calculated to measure income-related inequality. The decomposition of the EI was performed to characterize the contributions of socioeconomic and need factors to the measured inequality. An affluent-focused (pro-rich) inequity was observed for hospital admission adjusting for need factors over time. The level of inequity for hospital admission decreased dramatically, while hospital avoidance decreased marginally, and with a high value (EI, -0.0176) in 2008. The implementation of the NRCMS was associated with decreased inequity in 2008 and in 2014, but the associations were limited. Income contributed the most to the inequality of hospital utilization each year. The coverage of the NRCMS expanded to cover nearly all rural inhabitants in Jiangxi province by 2014 and was associated with a very small reduction in inequalities in admission to hospital. In order to increase equitable access to health care, additional financial protections for vulnerable populations are needed. Improving the relatively low level of medical services in township hospitals, and low rate of reimbursement and financial assistance with the NRCMS is recommended. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e
METROPOLITAN AREA NETWORKS AND MPLSRequirements of Metropolitan Area Network ServicesMetropolitan Area Network OverviewThe Bandwidth DemandThe Metro Service Provider's Business ApproachesThe Emerging Metro Customer Expectations and NeedsSome Prevailing Metro Service OpportunitiesService Aspects and RequirementsRoles of MPLS in Metropolitan Area NetworksMPLS PrimerMPLS ApplicationsTRAFFIC ENGINEERING ASPECTS OF METROPOLITAN AREA NETWORKSTraffic Engineering ConceptsNetwork CongestionHyper Aggregation ProblemEasing CongestionNetwork ControlTactical versus Strategic Traffic EngineeringIP/ATM Overl
Mao, Qi-zheng; Huang, Gan-lin; Wu, Jian-guo
Maintaining and improving ecosystem services in urban areas and human well-being are essential for sustainable development and therefore constitute an important topic in urban ecology. Here we reviewed studies on ecosystem services in urban areas. Based on the concept and classification of urban ecosystem services, we summarized characteristics of urban ecosystem services, including the human domination, high demand of ecosystem services in urban areas, spatial heterogeneity and temporal dynamics of ecosystem services supply and demand in urban areas, multi-services of urban green infrastructures, the socio-economic dimension of ecosystem services supply and ecosystem disservices in urban areas. Among different urban ecosystem services, the regulating service and cultural service are particularly indispensable to benefit human health. We pointed out that tradeoffs among different types of ecosystem services mostly occur between supportive service and cultural service, as well as regulating service and cultural service. In particular, we emphasized the relationship between landscape design (i.e. green infrastructure) and ecosystem services supply. Finally, we discussed current gaps to link urban ecosystem services studies to landscape design and management and pointed out several directions for future research in urban ecosystem services.
While making extensive use of the possibilities dynamic programming as an optimization method has to offer, a planning method for the common operation and the extension of a nuclear park and a high-voltage network for a service area of a large size is worked out in a system-analytical manner in this thesis. With the aid of the computer programmes developed, those decisions concerning construction and operation of power plant and network are looked for which result within appr. 10 years of planning in a minimum of overall generating and transmission costs. (orig./LN) [de
Lowden, D. W.
Disbonds simulated in a composite helicopter rotor blade were profiled using eddy currents. The method is inherently accurate and reproducible. An algorithm is described for calculating disbond margin. Disbond area is estimated assuming in-service disbondments exhibit circular geometry.
Grieco, Niccolò; Sesana, Giovanni; Corrada, Elena; Ieva, Francesca; Paganoni, Annamaria; Marzegalli, Maurizio
Since 2001, the urban area of Milan has been operating a network among 23 cardiac care units, the 118 dispatch centre (national free number for medical emergencies), and the county government health agency called Group for Prehospital Cardiac Emergency. In order to monitor the network activity, time to treatment, and clinical outcome, a periodic survey, called MOMI(2), was repeated two or three times a year. Each survey lasted 30 days and was repeated in comparable periods. Data were stratified for hospital admission mode. We collected data concerning 708 consecutive ST-elevation myocardial infarction (STEMI) patients (male 72.6%; mean age 64.4 years). In these six surveys, we observed a high rate of primary percutaneous coronary intervention (73.2%) and a mortality rate of 6.3%. Using advanced statistical models, we identified age, Killip class, and the symptom onset-to-balloon time as most relevant prognostic factors. Nonparametric test showed that the modality of hospital admittance was the most critical determinant of door-to-balloon time. 12-lead ECG tele-transmission and activation of a fast track directly to the catheterization laboratory are easy action to reduce time to treatment. The experience of the Milan network for cardiac emergency shows how a network coordinating the community, rescue units, and hospitals in a complex urban area and making use of medical technology contributes to the health care of patients with STEMI.
Bergeron, M.P.; Bugliosi, E.F.
Two adjacent burial areas were excavated in a clay-rich till at a radioactive waste disposal site near West Valley in Cattaraugus County, N.Y.: (1) which contains mainly low-level radioactive wastes generated onsite by a nuclear fuel reprocessing plant, has been in operation since 1966; and (2) which contains commercial low-level radioactive wastes, was operated during 1963-75. Groundwater below the upper 3 meters of till generally moves downward through a 20- to 30-meter thick sequence of tills underlain by lacustrine and kame-delta deposits of fine sand and silt. Groundwater in the weathered, upper 3 meters of till can move laterally for several meters before either moving downward into the kame-delta deposits or discharging to the land surface. A two-dimensional finite-element model that simulates two vertical sections was used to evaluate hydrologic factors that control groundwater flow in the till. Conditions observed during March 1983 were reproduced accurately in steady-state simulations that used four isotropic units of differing hydraulic conductivity to represent two fractured and weathered till units near land surfaces, an intermediate group of isolated till zones that contain significant amounts of fine sand and silt, and a sequence of till units at depths that have been consolidated by overburden pressure. Recharge rates used in the best-fit simulation ranged from 1.4 cm/yr along smooth, sloping or compacted surfaces to 3.8 cm/yr near swampy areas. Values of hydraulic conductivity and infiltration used in the calibrated best-fit model were nearly identical to values used in a previous model analysis of the nearby commercial-waste burial area. Results of the model simulations of a burial pit assumed to be filled with water indicate that water near the bottom of the burial pit would migrate laterally in the shallow, weathered till for 5 to 6 meters before moving downward into the unweathered till, and water near the top of the pit would move laterally
Full Text Available In this paper we suggest a promising solution to come over the problems of delivering e-learning to areas with lack or deficiencies in infrastructure for Internet and mobile communication. We present a simple, reasonably priced and efficient communication platform for providing e-learning. This platform is based on wireless ad-hoc networks. We also present a preemptive routing protocol suitable for real-time video communication over wireless ad-hoc networks. Our results show that this routing protocol can significantly improve the quality of the received video. This makes our suggested system not only good to overcome the infrastructure barrier but even capable of delivering a high quality e-learning material.
Cinza Sanjurjo, S; Cabarcos Ortiz de Barrón, A; Nieto Pol, E; Torre Carballada, J A
To establish the characteristics of the deceased in intaked patients by heart failure. A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with cualitative and cuantitative measures, chi-cuadrado and t-student. 248 patients were accepted for the study, with the mortality rate rising 8.6% (21 patients). We did not observed differences between sexes, but the median age in death patients was greater than other patients. The median income was 5 days, letter than study population. The hypertension prevalence (30 vs. 42.6%, p = 0.27) and ischemic cardiopathy (30 vs. 27.7%, p = 0.82) did not showed differences with the population. The hypertension prevalence in women (16.7 vs. 35.7%, p = 0.21) and the ischemic cardiopathy prevalence in men (50 vs. 21.4%, p = 0.20) did not showed differences. It made echocardiography in 21.0% of death patients, p = 0.76. The systolic disfunction prevalence was bigger in death patients (80 vs. 41.3%), this difference was not significant statistically. The older patients showed letter survival. We did not observe any influence of sex or left ventricular systolic function on mortality in patients with heart failure.
A Bayesian-Based Approach to Marine Spatial Planning: Evaluating Spatial and Temporal Variance in the Provision of Ecosystem Services Before and After the Establishment Oregon's Marine Protected Areas
Black, B.; Harte, M.; Goldfinger, C.
Participating in a ten-year monitoring project to assess the ecological, social, and socioeconomic impacts of Oregon's Marine Protected Areas (MPAs), we have worked in partnership with the Oregon Department of Fish and Wildlife (ODFW) to develop a Bayesian geospatial method to evaluate the spatial and temporal variance in the provision of ecosystem services produced by Oregon's MPAs. Probabilistic (Bayesian) approaches to Marine Spatial Planning (MSP) show considerable potential for addressing issues such as uncertainty, cumulative effects, and the need to integrate stakeholder-held information and preferences into decision making processes. To that end, we have created a Bayesian-based geospatial approach to MSP capable of modelling the evolution of the provision of ecosystem services before and after the establishment of Oregon's MPAs. Our approach permits both planners and stakeholders to view expected impacts of differing policies, behaviors, or choices made concerning Oregon's MPAs and surrounding areas in a geospatial (map) format while simultaneously considering multiple parties' beliefs on the policies or uses in question. We quantify the influence of the MPAs as the shift in the spatial distribution of ecosystem services, both inside and outside the protected areas, over time. Once the MPAs' influence on the provision of coastal ecosystem services has been evaluated, it is possible to view these impacts through geovisualization techniques. As a specific example of model use and output, a user could investigate the effects of altering the habitat preferences of a rockfish species over a prescribed period of time (5, 10, 20 years post-harvesting restrictions, etc.) on the relative intensity of spillover from nearby reserves (please see submitted figure). Particular strengths of our Bayesian-based approach include its ability to integrate highly disparate input types (qualitative or quantitative), to accommodate data gaps, address uncertainty, and to
He, Tian; Lu, Yan; Cui, Yanping; Luo, Yabo; Wang, Min; Meng, Wei; Zhang, Kaijie; Zhao, Feifei
Market-based watershed protection instruments can effectively improve water quality at various catchment scales. Two payments for watershed services (PWS) programs for water quality improvement have been successively implemented in the Huai River catchment and its sub-watershed, the Shaying River catchment, in Henan Province since 2009. To detect changes in water quality in response to PWS schemes, nonparametric statistical approaches were used to analyze gradual and abrupt trends in water quality, focusing on chemical oxygen demand (COD) and ammonia-nitrogen (NH3-N) at 26 monitoring stations in the Huai River watershed during 2006-2013. The nonparametric Mann-Kendall test and the Theil-Sen estimator were used to identify trends and their magnitudes in weekly water quality observations and the Pettitt test was applied to change-point analysis of water quality time series. We found decreasing concentration trends in the weekly water quality data set in this catchment, with water quality at most stations affected by the PWS schemes. The COD and NH3-N concentrations decreased at 26 stations by an average of 0.05 mg/L wk and 0.01 mg/L wk, respectively, from 2006 to 2013. Meanwhile, the mean concentrations of COD and NH3-N decreased at the 26 stations by an average of 18.03 mg/L and 4.82 mg/L, respectively, after the abrupt change points of the time-series trends of these two pollutants. We also estimated annual reductions in COD and NH3-N for each station based on average flow observations using the Theil-Sen approach along with the resulting economic benefits from 2009 to 2010. The COD and NH3-N reductions were 14604.50 and 6213.25 t/y, respectively, in the Huai River catchment in Henan Province. The total economic benefits of reductions in these two pollutants were 769.71 million ¥ in 2009 and 2010, accounting for 0.08% and 0.06%, respectively, of the GDP in the entire Huai River watershed of Henan Province. These results provide new insights into the linkages
Full Text Available Background: According to UN projection India’s population will reach 1.53 billion by the year 2050 and will be the highest population in the world. The success of the present RCH-II programme relies on the acceptance of contraceptive methods in reproductive age group. Objective: To determine the prevalence, type of contraceptive used and reasons for not accepting contraceptives in rural Maharashtra. Methodology: A cross sectional study was carried out in field practice area of a rural tertiary health care hospital in Wardha district of Maharashtra, India. Married women in the reproductive age group of 15 to 49 years were the study participants. Results: Out of total 378 women respondents 223(58.99% were contraceptive acceptors. 62.78% women accepted permanent method of contraception. Among the temporary methods most commonly accepted was Cupper-T by 20.62% women. Commonest reason for not accepting contraceptives was desire of children in 30.32% women followed by fear of side effects in 18.06%. Conclusion: Many factors like desire for children; especially a male child, fear of side effects of contraceptives, breastfeeding, attended the menopause…etc converge to shape a woman’s attitudes about the use of and the need for contraception.
Bouguettaya, Athman; Daniel, Florian
Web services and Service-Oriented Computing (SOC) have become thriving areas of academic research, joint university/industry research projects, and novel IT products on the market. SOC is the computing paradigm that uses Web services as building blocks for the engineering of composite, distributed applications out of the reusable application logic encapsulated by Web services. Web services could be considered the best-known and most standardized technology in use today for distributed computing over the Internet.Web Services Foundations is the first installment of a two-book collection coverin
Alzira Karla Araújo da Silva
Full Text Available Identifica as bibliotecas virtuais da Região Nordeste do Brasil diagnosticando o serviço de referência online e sua estrutura. Destaca os tipos de bibliotecas e o papel da biblioteca virtual omo guia e orientador dos usuários remotos da Internet, através do atendimento pelo correio eletrônico. Ressalta o Serviço de Referência Virtual como um serviço que permite a interação entre informação-bibliotecário-usuário no ambiente virtual. Tem como abordagem metodológica um estudo qualitativo, realizado através da observação dos sites da Biblioteca Central Reitor Macedo Costa (Bahia, Biblioteca Temática do Empreendedor–SEBRAE (Paraíba, Sistema de Bibliotecas da Universidade Federal da Paraíba (Paraíba e Biblioteca da Universidade de Fortaleza – Unifor (Ceará e das informações coletadas a partir de um questionário respondido pelos responsáveis por essas bibliotecas. Os resultados apontam a presença do serviço de referência e do bibliotecário nas duas primeiras bibliotecas virtuais e apenas do bibliotecário nas duas últimas. Confirma o fato de que nas bibliotecas virtuais da Região Nordeste os serviços de referência online estão ganhando espaço e utilizando as ferramentas tecnológicas, com destaque para o correio eletrônico. Fortalece a afirmação de que essas bibliotecas precisam do uso das novas tecnologias, a fim de atender as solicitações dos usuários remotos com eficiência e precisão. Contribui para a análise e futuras implantações de serviços de referência online e para o repensar do papel do serviço nas bibliotecas virtuais.It identifies the libraries online of the Northeast Area of Brazil diagnosing the service of reference online and its operation structure. It highlights the types of libraries and the paper of librarie online as guide the remote users' of the Internet, through the attendance by mail electronic. It stands out the Service of Reference Online as a service that allows the
Department of Homeland Security — This feature class represents electric power Control Areas. Control Areas, also known as Balancing Authority Areas, are controlled by Balancing Authorities, who are...
911 Call Center (PSAP) Service Areas, Master coverage of "atom" features used as a source to generate several derivative layers for the Sheriff RMS and E-911 map rolls. Cover is painstakingly maintained interactively by GIS staff. All atom boundaries are snapped to the road centerline cover, Published in 2008, 1:1200 (1in=100ft) scale, Sedgwick County Government.
NSGIC Local Govt | GIS Inventory — 911 Call Center (PSAP) Service Areas dataset current as of 2008. Master coverage of "atom" features used as a source to generate several derivative layers for the...
Farm Service Agency, Department of Agriculture — The AgSat Areas of Interest map contains area polygons where satellite imagery will be collected for the Farm Service Agency (FSA) to provide imagery coverage for...
stigma and discrimination. The focus of ... behaviour and stigma, including holding alternative ... with mental health problems avoid seeking help from health services. This is .... issues of risk of harm to self or others by providing HSAs with the ...
Annotated bibliography on selected areas of coal mining research and development. Report prepared for the Committee on Science and Technology, US House of Representatives, Ninety-Sixth Congress, First Session by the Congressional Research Service, Library of Congress
The Congressional Research Service has completed an annotated bibliography on coal mining research and development. Although the completion of the study was delayed in order to permit CRS analysts to search the libraries of Bituminous Coal, Research Inc., and the Bureau of Mines in the Pittsburgh area, current re-emphasis on the use of coal as an energy source indicates a sustained relevance. The bibliography presents key references to coal-mining R and D under six subject headings keyed to issues of central concern in coal production: (1) mine health and safety, (2) methane recovery, (3) 1-hour rescuer, (4) use of diesels underground, (5) coal preparation, and (6) manpower development in coal mining.
Bureau of Domestic Business Development (DOC), Washington, DC.
This publication is designed to provide the business community with information on growing markets for many business and consumer services. Divided into two parts, the document overview in part I identifies two service area problems: lagging productivity gains and rapidly rising prices of services. The overview states, however, that service sector…
Bouguettaya, Athman; Daniel, Florian
Web services and Service-Oriented Computing (SOC) have become thriving areas of academic research, joint university/industry research projects, and novel IT products on the market. SOC is the computing paradigm that uses Web services as building blocks for the engineering of composite, distributed applications out of the reusable application logic encapsulated by Web services. Web services could be considered the best-known and most standardized technology in use today for distributed computing over the Internet. This book is the second installment of a two-book collection covering the state-o
Earth Data Analysis Center, University of New Mexico — This file contains a feature class depicting National Forest System land parcels that have a Congressionally designated boundary. Examples include National...
... the United States Virgin Islands, American Samoa, and the Gulf of Mexico, which have been assigned...) 173. 10 (Puerto Rico and U.S. Virgin Islands) 50 (Puerto Rico and U.S. Virgin Islands) 174. 11... Northeast 1-11, 54. EAG002 Mid-Atlantic 12-26, 41, 42, 44-53, 70. EAG003 Southeast 27-40, 43, 69, 71-86, 88...
Full Text Available Land surface characteristics, including soil type, terrain slope, and antecedent soil moisture, have significant impacts on surface runoff during heavy precipitation in highly urbanized areas. In this study, a Linear Spectral Mixture Analysis (LSMA method is modified to extract high-precision impervious surface, vegetation, and soil fractions. In the modified LSMA method, the representative endmembers are first selected by combining a high-resolution image from Google Earth; the unmixing results of the LSMA are then post-processed to reduce errors of misclassification with Normalized Difference Built-up Index (NDBI and Normalized Difference Vegetation Index (NDVI. The modified LSMA is applied to the Landsat 8 Operational Land Imager (OLI image from 18 October 2015 of the main urban area of Guangzhou city. The experimental result indicates that the modified LSMA shows improved extraction performance compared with the conventional LSMA, as it can significantly reduce the bias and root-mean-square error (RMSE. The improved impervious surface, vegetation, and soil fractions are used to calculate the composite curve number (CN for each pixel according to the Soil Conservation Service curve number (SCS-CN model. The composite CN is then adjusted with regional data of the terrain slope and total 5-day antecedent precipitation. Finally, the surface runoff is simulated with the SCS-CN model by combining the adjusted CN and real precipitation data at 1 p.m., 4 May 2015.
Ohio State Univ., Columbus. Center for Vocational and Technical Education.
The purpose of the teacher's guide is to encourage the primary student to expand his or her awareness of jobs within the community. The role of the service station worker is examined, with emphasis on the goods and services provided. Subject areas for which the materials in this guide have potential are social studies, art, and language. Each set…
Gray, B. Allison
On January 19, 2009, the day before his historic inauguration, President Obama and his wife, Michelle, commemorated Martin Luther King Day by volunteering for various community service projects around the Washington, DC, area. A record number of Americans also participated in the King Day of Service, joining in over 13,000 projects, more than…
Full Text Available Dynamic changes in traditional technologies and rising of new technologies call for development of new services. If service providers want to stay on information technologies market, they must keep track with this trend and adjust their services to customer requirements or develop new services. New applications will mainly depend on communication bandwidth and end users ability to handle it. If network providers will be able to ensure necessary bandwidth, there will be nothing that can stop service providers and developers in new service development. People know about growing necessity of new service and ask for them, but they hardly understand that the most important thing for service providers is merchantability and economic return of resources they gave to the developmentand implementation. By the lack of flexible development environment that is able to develop, test and provide final service for operation, new service development is not easy. There are different new service design procedures for various technological and user areas. This is the reason why this paper provides brief description of new service development procedure from technological and administrative point of view.
Flexible route paratransit services may complement as well as compete with conventional public transportation services (that : have fixed routes and schedules). Flexible routes are especially suitable for service areas or time periods with low demand...
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Which areas are COLA areas? 591.207 Section 591.207 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living...
As from 1st of July 2002, responsibility for running the Fax Service will be transfered to the Printer Service. Future requests for machines, toner and breakdown should be sent to Printer.Support@cern.ch - tel 78888. Telephone Service
The energy-related services are the major sales promotion. Customized electricity and district heat supply technology and services for the newly developed residential area Boerkhauser Feld at Solingen-Aufderhoehe; Die Dienstleistung bringt den (Verkaufs-)Erfolg. Strom- und Waermeversorgung fuer Wohngebiet Boerkhauser Feld in Solingen-Aufderhoehe
The firm COMUNA-metall, Herford, is the contractor and service provider for installation and operation of the electricity and district heat supply systems based on a modular cogeneration plant (CHP system). The residential area will eventually encompass about 450 residential units, all buildings are low-energy houses. The article explains the systems and gives an initial performance report covering 100 existing residential units. (orig./CB) [German] Die Firma COMUNA-metall, Herford, hat als Dienstleister die Erstellung und den Betrieb einer Strom- und Nahwaermeversorgung mit Kraft-Waerme-Kopplung fuer das Wohngebiet uebernommen, das nach Fertigstellung ca. 450 Wohneinheiten in Niedrigenergiebauweise umfassen wird. Der Beitrag schildert die technischen Einrichtungen und eine erste Leistungsbilanz im Bauabschnitt mit 100 Wohneinheiten. (orig./CB)
Avlonitis, Viktor; Hsuan, Juliana
The purpose of this research is to investigate the studies on service modularity with a goal of informing service science and advancing contemporary service systems research. Modularity, a general systems property, can add theoretical underpinnings to the conceptual development of service science...... in general and service systems in particular. Our research is guided by the following question: how can modularity theory inform service system design? We present a review of the modularity literature and associated concepts. We then introduce the contemporary service science and service system discourse...
This article consists of a collection of slides from the author's conference presentation. Some of the specific areas/topics discussed include: Convergence in home networks, home service scenarios; Home wired network architectures, CapEx and OpEx; Residential Gateway; Optical fiber types;
National Oceanic and Atmospheric Administration, Department of Commerce — An anchorage area is a place where boats and ships can safely drop anchor. These areas are created in navigable waterways when ships and vessels require them for...
Virvou, Maria; Jain, Lakhmi
Multimedia services are now commonly used in various activities in the daily lives of humans. Related application areas include services that allow access to large depositories of information, digital libraries, e-learning and e-education, e-government and e-governance, e-commerce and e-auctions, e-entertainment, e-health and e-medicine, and e-legal services, as well as their mobile counterparts (i.e., m-services). Despite the tremendous growth of multimedia services over the recent years, there is an increasing demand for their further development. This demand is driven by the ever-increasing desire of society for easy accessibility to information in friendly, personalized and adaptive environments. In this book at hand, we examine recent Recommendation Services. Recommendation services appear in the mobile environment, medicine/biology, tourism, education, and so on. The book includes ten chapters, which present various recently developed recommendation services. This research book is directed to professors...
This work explores the ways in which academic librarians specializing in areas related to user services consider the courses they took as part of obtaining their library and information science (LIS) degree prepared them to deal with issues of customer service in their current work. Effective customer service is a central aspect of accomplishing…
Lystbæk, Christian Tang
perspectives on the potential impact of public service performance measurement offer a range of contradictory propositions. Its alleged benefits include public assurance, better functioning of supply markets for public services, and direct improvements of public services. But the literature also demonstrates...... the existence of significant concern about the actual impact, the costs and unintended consequences associated with performance measurement. Performance measurement and management have been part of the political agenda within the public sphere since their adoption in the post-Second World War period...... of political masters and their mistresses rather than public service. Another area of concern is the cost of performance measurement. Hood & Peters (2004:278) note that performance measurement is likely to “distract middle- and upper-level officials, create massive paperwork, and produce major unintended...
Lystbæk, Christian Tang
that performance measurement serves as “rituals of verification” which promotes the interests of political masters and their mistresses rather than public service. Another area of concern is the cost of performance measurement. Hood & Peters (2004:278) note that performance measurement is likely to “distract...... measurement suggests a range of contested and contradictory propositions. Its alleged benefits include public assurance, better functioning of supply markets for public services, and direct improvements of public services. But the literature also demonstrates the existence of significant concern about...... the actual impact, the costs and unintended consequences associated with performance measurement. This paper identifies the main rationales and rationalities in the scholarly discourse on public services performance measurement. It concludes with some suggestions on how to deal with the many rationales...
Guzmán-González, A F; Navajas-Luque, F; de la Torre-Fernández, J
The objective was to describe and evaluate a new communication protocol of reporting critical results applied to Microbiology in a health area of Andalusia. The size and type of the critical values of Microbiology are analyzed for primary care patients. A new computerized reporting system was analyzed, in real time, through Diraya Digital Health Records, which integrates the analytical test module (MPA). The protocol is complemented, in collaboration with the Information Technology (IT), with the Junta de Andalucía short message service (SMS) "WebMovil". The total number of notices of critical results by the new protocol in 2012 was 817. The number of critical values for primary care was 570, of which 90 were for Microbiology. The most frequent notice was by isolation in the stool culture (n = 51; 56.67%). The prevalence of the critical values of Microbiology in primary care was 0.45/100. The average time of notifications was 13 minutes. The success rate of notifications was 97.7% and 0% obtained in the number of withdrawals. In 99.93% of cases the contact with the patient was stated and in 98.55% the medical intervention was also confirmed. Communication by a computerized system linked to the SMS technology showed a reduction in the time of notification, and produced additional benefits, such as eliminating the risk of error when there is no repetition of information from the recipient received by the laboratory. Furthermore, the use of SMS messages ensures that doctors on duty always receive information immediately.
Ajotikar, Vaishali M.; Ali, Dr.M. M
The paper attempts to study empirically dealers point of view on the 7ps i.e. marketing mix for laboratory services. The primary data was collected from dealers by administering interview schedules on 7ps of laboratory service marketing. This data collected was tabulated, analyzed and intepretated so as to suitably arrive at findings. High score for statements: laboratory services are prompt, services are rendered on cash basis to patients, laboratory has collection centers in different area...
Andréa Clemente Palmier
services in an underprivileged area of Brazil. METHODS: An ecological study was carried out in 52 municipalities in the state of Minas Gerais, Brazil. The socioeconomic indicators employed were criteria for health care resources allocation, municipal human development index, Theil index, Gini coefficient, and sanitation conditions. Concerning the availability of oral health services, the following were considered: number of inhabitants, number of dental surgeons living in the city, number of dentists working in the public services, and number of municipal oral health care teams. The utilization of oral health services was evaluated using the indicators recommended by the Health Ministry's Basic Care Package (Pacto da Atencão Básica in Portuguese and the number of procedures carried out in the primary care setting. The 17 variables assessed were grouped into factorial components, which were then analyzed in terms of their relationship with the dependent variable, tooth extractions. RESULTS: The following six components explained 73.5% of the overall variance: socioeconomic conditions, social inequality, Basic Care Package indicators, number of procedures carried out, ratio of dentists to inhabitants, and coverage of the Family Health Strategy. Inequalities in income distribution (P = 0.031 and coverage by the Family Health Strategy (P = 0.015 contributed significantly to explain the difference in the proportion of tooth extractions in the different municipalities under study. CONCLUSIONS: The dental loss observed in the region is largely explained by socioeconomic factors and aspects related to the organization of oral health services.
Ali Ramezani Ghotbabadi; Setareh Feiz; Rohaizat Baharun
Service quality measurement is one of the significant measurement tools for firms to understand consumers’ needs and wants by analyzing the experience of consumers and customers’ satisfaction on the services provided. Although there is no general agreement on one particular model used as the measurement of service quality perceived, there are some effective models offered by researchers during decades of study in this area. In the recent years, researchers believe that service quality is mult...
Proposal for the award of a contract for the design, supply, installation and commissioning of a ventilation and air conditioning system for the ECN3 experimental area and the TCC8 and GHN300 service tunnels and for the dismantling of the existing system
Proposal for the award of a contract for the design, supply, installation and commissioning of a ventilation and air conditioning system for the ECN3 experimental area and the TCC8 and GHN300 service tunnels and for the dismantling of the existing system
This is a directory of law firms that provide services to the independent energy industry. The directory lists the firm's name, address, telephone and FAX numbers, and the name of a contact person. Included is a description of the specialties or services offered by the firm in the area of independent energy projects; some of these include regulatory, tax, fuel supply, operations and maintenance, environmental, real estate, government contracts and bankruptcy
Ecosystem goods and services are the many life-sustaining benefits we receive from nature and contribute to environmental and human health and well-being. Ecosystem-focused research will develop methods to measure ecosystem goods and services.
... topic data in XML format. Using the Web service, software developers can build applications that utilize MedlinePlus health topic information. The service accepts keyword searches as requests and returns relevant ...
Sørensen, Lene Tolstrup; Nicolajsen, Hanne Westh
This article discusses the challenges in relation to an ongoing project named converged advanced mobile media platform (CAMMP), where all the different stakeholders need to have a saying in the service development for the upcoming rich, mobile broadcasting services....
Hassan M K Ghomrawi
Full Text Available Efforts to reduce racial disparities in total hip replacement (THR have focused mainly on patient behaviors. While these efforts are no doubt important, they ignore the potentially important role of provider- and system-level factors, which may be easier to modify. We aimed to determine whether the patterns of interaction among physicians around THR episodes differ in communities with low versus high concentrations of black residents.We analyzed national Medicare claims from 2008 to 2011, identifying all fee-for-service beneficiaries who underwent THR. Based on physician encounter data, we then mapped the physician referral networks at the hospitals where beneficiaries' procedures were performed. Next, we measured two structural properties of these networks that could affect care coordination and information sharing: clustering, and the number of external ties. Finally, we estimated multivariate regression models to determine the relationship between the concentration of black residents in the community [as measured by the hospital service area (HSA] served by a given network and each of these 2 network properties.Our sample included 336,506 beneficiaries (mean age 76.3 ± SD, 63.1% of whom were women. HSAs with higher concentrations of black residents tended to be more impoverished than those with lower concentrations. While HSAs with higher concentrations of black residents had, on average, more acute care beds and medical specialists, they had fewer surgeons per capita than those with lower concentrations. After adjusting for these differences, we found that HSAs with higher concentrations of black residents were served by physician referral networks that had significantly higher within-network clustering but fewer external ties.We observed differences in the patterns of interaction among physicians around THR episodes in communities with low versus high concentrations of black residents. Studies investigating the impact of these differences
In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795
Full Text Available Development of postindustrial society and services revolution created numerous changes in size of consumer demand, consumer reaction and priorities. Continuous change on the side of demand and offer must follow changes in marketing orientation. Leader in that change is services marketing which by knowing services range and all the changes builds a new concept called Relationship Marketing.
Department of Housing and Urban Development — Revitalization areas are HUD-designated neighborhoods in need of economic and community development and where there is already a strong commitment by the local...
Federal Laboratory Consortium — The 700 Area of the Hanford Site is located in downtown Richland.Called the Federal Office Building, the Richland Operations Site Manager and the Richland Operations...
Aneja, Sanjay; Smith, Benjamin D.; Gross, Cary P.; Wilson, Lynn D.; Haffty, Bruce G.; Roberts, Kenneth; Yu, James B.
Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.
Aneja, Sanjay [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Smith, Benjamin D. [University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Gross, Cary P. [Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Department of General Internal Medicine, Yale University School of Medicine, New Haven, CT (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Haffty, Bruce G. [Cancer Institute of New Jersey, New Brunswick, NJ (United States); Roberts, Kenneth [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Yu, James B., E-mail: email@example.com [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States)
Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.
Chafcouloff, S.; Michel, G.; Trice, M.; Clark, G.; Cosad, C.; Forbes, K.
Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs
Chafcouloff, S.; Michel, G.; Trice, M. [Schlumberger Integrated Project Management Group, Montrouge (France); Clark, G. [Schlumberger Testing Services, Aberdeen (United Kingdom); Cosad, C.; Forbes, K. [Schlumberger Integrated Project Management Group, Aberdeen (United Kingdom)
Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs
Full Text Available Increasing revenue per user is very important for mobile operators because of shrinking growth from mobile voice services on a number of markets. At the same time, a more powerful platform enabling advanced mobile data services has emerged. Therefore, mobile data services offer great possibilities to operators in the future. Marketing plays the key role in offering new and existing data services. Experiences in launching various services, primarily a comparison of Japanese and other experiences, shows that different strategies and marketing mix employed in launching data services can lead to different business results in this area. The needs and preferences of Croatian mobile users are explored in this paper, especially in the following areas: the most used and potentially most interesting data services, a preferred way of paying for these services, the importance of transaction security in mobile payments and a comparison of the use of and interest in such services by users with more advanced mobile terminals and those with older mobile phones. Results imply that a strong and attractive presence of these services in the media is crucial to success. It is also important to communicate clearly the benefits of these services, along with lower prices (or promotional periods as well as easy activation and use. Last but not least: the existence of attractive content and applications (where fair arrangements among all providers of these services is the main prerequisite is essential for a faster adoption and use of these services.
This is a directory of suppliers of products and services in the area of cogeneration. The subheadings of this directory include developers and owner operators, system packagers, manufacturers of prime movers, equipment manufacturers, instruments and controls manufacturing, consulting services, appraisal and valuation, computer services, environmental services, feasibility services, hydrology, marketing, measurements, meteorology, regulatory and licensing, research, testing, training and personnel, engineering and construction, operations and maintenance, and insurance, financial and legal services
... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Service test. 228.24 Section 228.24 Banks and... REINVESTMENT (REGULATION BB) Standards for Assessing Performance § 228.24 Service test. (a) Scope of test. The service test evaluates a bank's record of helping to meet the credit needs of its assessment area(s) by...
Andersen, Jonas Lohmann Elkjær; Landex, Alex
In the planning of public transport catchment areas of stops are often included to estimate potential number of travellers. There are different approaches to GIS-based catchment area analyses depending on the desired level of detail. The Circular Buffer approach is the fundamental, but also....../from stations. The article also shows how the refinement of the Service Area approach with additional time resistance results in smaller catchment areas when the feeder routes cross stairs. It is concluded that GIS-based catchment area analyses are a multiple decision support tool for planning of public...... transport where the level of detail can be suited to the purpose....
Lécué, F.; Goncalves da Silva, Eduardo; Ferreira Pires, Luis
Dynamic composition of web services is a promising approach and at the same time a challenging research area for the dissemination of service-oriented applications. It is widely recognised that service semantics is a key element for the dynamic composition of Web services, since it allows the
Olson, Lucretia Maria
This manual contains student assignments in the financial services area of the marketing process. The individualized competency-based materials are intended to enhance and supplement instruction or to provide the basis for a course of instruction by the teacher-coordinator. Information on skills needed in jobs in financial marketing is first…
The book is intended to provide valuable input to the Universal Service Agency .... Figure 1 is not, of course, drawn to scale for South Africa. .... Such uneconomic customers and areas are mainly found in rural, peripheral, and less favoured regions. ... The United Kingdom is a good example of the enduring nature of this task.
Please note the following opening hours of the Service: From 31st July onwards: Every morning from 8:30 to 12:00 The Service is closed in the afternoons. We should like to remind you that dosimeters cannot be sent to customers by internal mail. Short-term dosimeters (VCTs) must always be returned to the Service after use and must not be left on the racks in the experimental areas or in the secretariats. Dosimetry Service Tel 72155 Bldg. 24 E 011 Dosimetry.firstname.lastname@example.org http://cern.ch/rp-dosimetry
Henten, Anders; Vad, Torben
A recent Danish survey found that, in terms of the internationalisation of services, international WTO negotiations in this area will have to focus on a large number of issues. Moreover, the survey also highlighted the fact that many problems still exist within the European Union. Outlining a num...... a number of the barriers that companies face on foreign markets, the survey's overall results indicate that many of these obstacles prevent the internationalisation of services.......A recent Danish survey found that, in terms of the internationalisation of services, international WTO negotiations in this area will have to focus on a large number of issues. Moreover, the survey also highlighted the fact that many problems still exist within the European Union. Outlining...
Petersen, Rikke Munck
This paper argues that drone filming can substantiate our understanding of multisensorial experiences of quiet areas and urban landscapes. Contrary to the distanced gaze often associated with the drone, this paper discusses drone filming as an intimate performativity apparatus that can affect...... perception as a result of its interrelationships between motion, gaze, and sound. This paper uses four films, one of which is a drone flyover, to launch a discussion concerning a smooth and alluring gaze, a sliding gaze that penetrates landscapes, and site appearance. Films hold the capacity to project both...... and transcendence can facilitate a deeper understanding of intimate sensations, substantiating their role in the future design and planning of urban landscapes. Hence, it addresses the ethics of an intimacy perspective (of drone filming) in the qualification of quiet areas....
Parry, Glenn; McLening, Marc; Caldwell, Nigel; Thompson, Rob
A pizza restaurant must provide product, in the form of the food and drink, and service in the way this is delivered to the customer. Providing this has distinct operational challenges, but what if the restaurant also provides a home delivery service? The service becomes deployed as the customer is no-longer co-located with the production area. The business challenge is complicated as service needs to be delivered within a geographic region, to time or the pizza will be cold, and within a cost that is not prohibitive. It must also be responsive to short term demand; needing to balance the number of staff it has available to undertake deliveries against a forecast of demand.
Newspaper librarians discussed the public use of their newspapers' libraries. Policies run the gamut from well-staffed public information services, within or outside the newspaper library, to no service at all to those outside the staff of the paper. Problems of dealing with tax and law enforcement agencies were covered, as well as cooperative…
Following a reorganization in Building 55, please note that the Registration Service is now organised as follows : Ground floor: access cards (76903). 1st floor : registration of external firms’ personnel (76611 / 76622); car access stickers (76633); biometric registration (79710). Opening hours: 07-30 to 16-00 non-stop. GS-SEM Group General Infrastructure Services Department
As part of the upgrade of telephone services, the CERN exchange switches will be updated on Thursday 2 June between 7.00 p.m. and midnight. Telephone services may be affected and possibly even disrupted during this operation.
Sharpton, James L.
This curriculum guide provides cleaning services instructional materials for a ninth- and tenth-grade Coordinated Vocational Education and Training: Home and Community Services program. It includes 2 sections and 11 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities,…
... 32 National Defense 6 2010-07-01 2010-07-01 false Area office. 1602.4 Section 1602.4 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.4 Area office. The Selective Service Office which is responsible for all administrative and operational support...
William A. Gould; Maya Quinones; Mariano Solorzano; Waldemar Alcobas; Caryl Alarcon
Protection of natural areas is essential to conserving biodiversity and maintaining ecosystem services. Benefits and services provided by natural areas are complex, interwoven, life-sustaining, and necessary for a healthy environment and a sustainable future (Daily et al. 1997). They include clean water and air, sustainable wildlife populations and habitats, stable...
Shimomura, Yoshiki; Tomiyama, Tetsuo
Intensification of service and knowledge contents within product life cycles is considered crucial for dematerialization, in particular, to design optimal product-service systems from the viewpoint of environmentally conscious design and manufacturing in advanced post industrial societies. In addition to the environmental limitations, we are facing social limitations which include limitations of markets to accept increasing numbers of mass-produced artifacts and such environmental and social limitations are restraining economic growth. To attack and remove these problems, we need to reconsider the current mass production paradigm and to make products have more added values largely from knowledge and service contents to compensate volume reduction under the concept of dematerialization. Namely, dematerialization of products needs to enrich service contents. However, service was mainly discussed within marketing and has been mostly neglected within traditional engineering. Therefore, we need new engineering methods to look at services, rather than just functions, called "Service Engineering." To establish service engineering, this paper proposes a modeling technique of service.
Andersen, Lotte Bøgh; Kristensen, Nicolai; Pedersen, Lene Holm
This article extends the framework of Le Grand (2003, 2010) to encompass responsiveness, and the main argument is that the combination of employee motivation, user capacity, and models of public service provision potentially has serious implications for responsiveness across service areas. Although...... research on employee motivation thrives, especially in the public service motivation (PSM) literature, few studies have investigated user capacity empirically, and we know little about the combination of PSM, user capacity and models of service provision. Analyzing four central service areas (day care......, schools, hospitals, and universities), we find variations in both user capacity and PSM. Taking this variation as a point of departure we discuss what implications different combinations of employee motivation, user capacity, and models of public service provision may have for responsiveness....
Department of Housing and Urban Development — CDBG activity related to public services, including senior services, legal services, youth services, employment training, health services, homebuyer counseling, food...
Hollenbeck, Brent K; Hollingsworth, John M; Dunn, Rodney L; Zaojun Ye; Birkmeyer, John D
Relative to outpatient surgery in hospital settings, ambulatory surgery centers (ASCs) are more efficient and associated with a lower cost per case. However, these facilities may also spur higher overall procedure utilization and thus lead to greater overall health care costs. The authors used the State Ambulatory Surgery Database from the State of Florida to identify Medicare-aged patients undergoing 4 common ambulatory procedures in 2006, including knee arthroscopy, cystoscopy, cataract removal, and colonoscopy. Hospital service areas (HSAs) were characterized according to ASC market share, that is, the proportion of residents undergoing outpatient surgery in these facilities. The authors then examined relationships between ASC market share and rates of each procedure. Age-adjusted rates of ambulatory surgery ranged from 190.5 cases per 1000 to 320.8 cases per 1000 in HSAs with low and high ASC market shares, respectively (P market share. The greatest difference, both in relative and absolute terms, was observed for patients undergoing cystoscopy. In areas of high ASC market share, the age-adjusted rate of cystoscopy was nearly 3-fold higher than in areas with low ASC market share (34.5 vs 11.9 per 1000 population; P elderly. Whether ASCs are meeting unmet clinical demand or spurring overutilization is not clear.
SCK-CEN's department of Safeguards and Physics Measurements provides a wide variety of internal and external services including dosimetry, calibration, instrumentation, whole body counting, safeguards and non-destructive analysis. Main developments in these areas in 1999 are described
Batagan, Lorena; Pocovnicu, Adrian; Capisizu, Sergiu
A characteristic of today's society is the increasing use of modern information and communication technologies in all areas. Computer applications, called e-services, are being developed to provide efficient access to services, electronically. Quality management systems are needed to provide a consistent way to select, evaluate, prioritize and…
National Oceanic and Atmospheric Administration, Department of Commerce — Sound velocity profile data were collected using sound velocimeter in the St. Clair and St. Mary rivers in the Great Lakes area by the NAVIGATION RESPONSE TEAM 4...
Turner, Katrine Grace; Odgaard, Mette Vestergaard; Bøcher, Peder Klith
We made a spatial analysis of 11 ecosystem services at a 10 km × 10 km grid scale covering most of Denmark. Our objective was to describe their spatial distribution and interactions and also to analyze whether they formed specific bundle types on a regional scale in the Danish cultural landscape....... We found clustered distribution patterns of ecosystem services across the country. There was a significant tendency for trade-offs between on the one hand cultural and regulating services and on the other provisioning services, and we also found the potential of regulating and cultural services...... to form synergies. We identified six distinct ecosystem service bundle types, indicating multiple interactions at a landscape level. The bundle types showed specialized areas of agricultural production, high provision of cultural services at the coasts, multifunctional mixed-use bundle types around urban...
Department of Homeland Security — Means of delivering value to customers by facilitating outcomes customers want to achieve without the ownership of specific costs and risks. The term 'service' is...
Steen, M.W.A.; Iacob, Maria Eugenia; Lankhorst, M.M.; Jonkers, H.; Zoet, M.; Engelsman, W.; Versendaal, J.; Proper, H.A.; Debije, L.; Gaaloul, K.; Lankhorst, M.
The development of enterprise services involves making design decisions at different levels, ranging from strategic to infrastructural choices, and concerning many different aspects, ranging from customer interaction to information registration concerns. In order to support an agile development
...: communication, security, and services. In the area of communication, we developed a new computing infrastructure for partitioning protocols between the primary processor and an embedded co processor...
Ruiz-Frau, A.; Gelcich, S.; Hendriks, I.E.; Duarte, Carlos M.; Marbà , N.
areas; a type of service research bias, provisioning and regulating services have received extensive attention while cultural services remain understudied; a type of discipline bias, the ecological aspects of SGES have been well documented while economic
James R. Wright MD, PhD
Full Text Available Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta’s debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an “unhappy shotgun marriage” by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context.
Peter R. Robichaud; Hakjun Rhee; Sarah A. Lewis
Over 1200 post-fire assessment and treatment implementation reports from four decades (1970s-2000s) of western US forest fires have been examined to identify decadal patterns in fire characteristics and the justifications and expenditures for the post-fire treatments. The main trends found were: (1) the area burned by wildfire increased over time and the rate of...
Laura J. Ax-Fultz
Full Text Available Businesses leverage excellent customer service to improve profitability. Although not profit-driven, libraries should leverage excellent customer service to achieve their unique missions. Evaluating and improving customer service practices will help a library determine if it is successfully serving its customers. The library should review three areas to improve customer service: the physical space of the library, how library employees work with library policies, and the communication skills of the library staff. By using the Take Five model, the library can make immediate, no-cost changes or plan for future improvements by taking just five minutes, every day, to assess specific areas. Over a few weeks or months, these small changes will result in better customer service.
U.S. Department of Health & Human Services — The Find Shortage Areas: Health Professional Shortage Area (HPSA) and Medically Underserved Area/Population (MUA/P) by Address tool helps you determine if a specific...
Pre-hospital electrocardiogram triage with tele-cardiology support is associated with shorter time-to-balloon and higher rates of timely reperfusion even in rural areas: data from the Bari- Barletta/Andria/Trani public emergency medical service 118 registry on primary angioplasty in ST-elevation myocardial infarction.
Brunetti, Natale Daniele; Di Pietro, Gaetano; Aquilino, Ambrogio; Bruno, Angela I; Dellegrottaglie, Giulia; Di Giuseppe, Giuseppe; Lopriore, Claudio; De Gennaro, Luisa; Lanzone, Saverio; Caldarola, Pasquale; Antonelli, Gianfranco; Di Biase, Matteo
We report the preliminary data from a regional registry on ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty in Apulia, Italy; the region is covered by a single public health-care service, a single public emergency medical service (EMS), and a single tele-medicine service provider. Two hundred and ninety-seven consecutive patients with STEMI transferred by regional free public EMS 1-1-8 for primary-PCI were enrolled in the study; 123 underwent pre-hospital electrocardiograms (ECGs) triage by tele-cardiology support and directly referred for primary-PCI, those remaining were just transferred by 1-1-8 ambulances for primary percutaneous coronary intervention (PCI) (diagnosis not based on tele-medicine ECG; already hospitalised patients, emergency-room without tele-medicine support). Time from first ECG diagnostic for STEMI to balloon was recorded; a time-to-balloon primary-PCI). Pre-hospital triage with tele-cardiology ECG in an EMS registry from an area with more than one and a half million inhabitants was associated with shorter time-to-balloon and higher rates of timely treated patients, even in 'rural' areas. © The European Society of Cardiology 2014.
Charnay, J.; Chosson, L.; Croize, M.; Ducloux, A.; Flores, S.; Jarroux, D.; Melka, J.; Morgue, D.; Mottin, C.
This service assures the treatment and diffusion of the scientific information and the management of the scientific production of the institute as well as the secretariat operation for the groups and services of the institute. The report on documentation-library section mentions: the management of the documentation funds, search in international databases (INIS, Current Contents, Inspects), Pret-Inter service which allows accessing documents through DEMOCRITE network of IN2P3. As realizations also mentioned are: the setup of a video, photo database, the Web home page of the institute's library, follow-up of digitizing the document funds by integrating the CD-ROMs and diskettes, electronic archiving of the scientific production, etc
The offices of the Social Service are now on the 1st floor of Building 33 (Reception), exactly one floor above the old location. We remind you that the team, consisting of two social workers, a psychologist (external consultant, 1 day/week) and an administrative assistant, is at the disposal of all members of the personnel, whatever their status, as well as to their family members. Advice and support in the following areas are offered : · information on integration in the local area; · assistance in dealing with the relevant authorities/services; · consultations with a view to resolving problems of a personal, family or professional nature, such as problems of dependency (alcohol, drugs) relationship or behavioral problems (stress, depression, eating disorders), etc.; · support in facing new situations (maternity, divorce, bereavement, job change, separation from family/familiar surroundings); · assistance with decision making relating to family, personal or profes...
The work deals with the definition of the word cloud computing, cloud computing models, types, advantages, disadvantages, and comparing SaaS solutions such as: Google Apps and Office 365 in the area of electronic communications. The work deals with the use of cloud computing in the corporate practice, both good and bad practice. The following section describes the methodology for choosing the appropriate cloud service organization. Another part deals with analyzing the possibilities of SaaS i...
In recent years there have beenchanges in marketing focus. For ‘50s we may say itwas period of mass marketing, for ‘70s the time ofmarketing segmentation, and ‘90s representsperiod of personalized marketing. Today’s accent ison the concept of relationship. Importance ofrelationship marketing, in the area of services, isdirectly linked with principle that customer’ssatisfaction and loyalty are closely related toprofitability. This article presents analysis of newservice paradigm which foregrou...
Full Text Available Background: A new cadre of village-based frontline health workers, called Accredited Social Health Activists (ASHAs, was created in India. However, coverage of selected community-based maternal, newborn and child health (MNCH services remains low. Objective: This article describes the process of development and formative evaluation of a complex mHealth intervention (ImTeCHO to increase the coverage of proven MNCH services in rural India by improving the performance of ASHAs. Design: The Medical Research Council (MRC framework for developing complex interventions was used. Gaps were identified in the usual care provided by ASHAs, based on a literature search, and SEWA Rural's1 three decades of grassroots experience. The components of the intervention (mHealth strategies were designed to overcome the gaps in care. The intervention, in the form of the ImTeCHO mobile phone and web application, along with the delivery model, was developed to incorporate these mHealth strategies. The intervention was piloted through 45 ASHAs among 45 villages in Gujarat (population: 45,000 over 7 months in 2013 to assess the acceptability, feasibility, and usefulness of the intervention and to identify barriers to its delivery. Results: Inadequate supervision and support to ASHAs were noted as a gap in usual care, resulting in low coverage of selected MNCH services and care received by complicated cases. Therefore, the ImTeCHO application was developed to integrate mHealth strategies in the form of job aid to ASHAs to assist with scheduling, behavior change communication, diagnosis, and patient management, along with supervision and support of ASHAs. During the pilot, the intervention and its delivery were found to be largely acceptable, feasible, and useful. A few changes were made to the intervention and its delivery, including 1 a new helpline for ASHAs, 2 further simplification of processes within the ImTeCHO incentive management system and 3 additional web
Zanini, E.; Freppaz, M.; Stanchi, S.; Bonifacio, E.; Egli, M.
The high spatial variability of soils is a relevant issue at local and global scales, and determines the complexity of soil ecosystem functions and services. This variability derives from strong dependencies of soil ecosystems on parent materials, climate, relief and biosphere, including human impact. Although present in all environments, the interactions of soils with these forming factors are particularly striking in mountain areas.
Landex, Alex; Hansen, Stephen; Andersen, Jonas Lohmann Elkjær
The paper presents a method to examine the catchment areas for stops in high quality public transport systems based on the street network in the examined area. This is achieved by implementing the Service Area functions from the ArcGIS extension Network Analyst. The method is compared to a more...
... 32 National Defense 6 2010-07-01 2010-07-01 false Area. 1605.51 Section 1605.51 National Defense... ORGANIZATION Local Boards § 1605.51 Area. (a) The Director of Selective Service shall divide each State into local board areas and establish local boards. There shall be at least one local board in each county...
Green, Cheri A
Full Text Available There is ongoing debate with regard to the levels of service provision in urban and rural areas. However, progress with respect to the delivery of planned services can only be efficiently and equitably measured once benchmarks for different areas...
Considerações sobre o planejamento para a qualidade de serviços e os fatores de sucesso de novos empreendimentos Planning for quality in the service area and critical factors for success in new enterprises
Tupanangyr Gomes Filho
Full Text Available Propomos neste artigo destacar algumas ferramentas que contribuem para o desenvolvimento de pequenos e médios negócios no setor de serviços. Destacamos a metodologia para uma Estratégia de Operações como uma ferramenta de sobrevivência na prestação de serviços. O artigo abrange também o aspecto das características necessárias ao empreendedor de sucesso.The authors suggest some tools to contribute to the development of small and medium businesses in the service sector. We call attention to the development of an Operation Strategy as a tool for survival in the business. The article also covers the personal character of the successful entrepreneur.
Selen, Willem; Roos, Göran; Green, Roy
Bringing together some of the world’s leading thinkers, academics and professionals to provide practitioners, students and academicians with comprehensive insights into implementing effective service innovation. This book presents service innovation holistically and systemically across various service areas, including health, education, tourism, hospitality, telecommunications, and retail. It addresses contemporary issues through conceptual and applied contributions across industry, academia, and government, providing insights for improved practice and policy making. Featuring cutting-edge research contributions, practical examples, implementations and a select number of case studies across several growth service industries, this book also includes examples of failed service innovation attempts in order to demonstrate a balanced view of the topic and to make clear the pitfalls to be avoided. Culminating in a suggested step-by-step guide to enable service organization’s managers to understand and implemen...
Department of Veterans Affairs — This Service provides access to Tramatic Brain injury patient data consult notes. The service also provides one write service method writeNote. The Service supports...
Briti ettevõttest International Financial Services, mis viib maailmas läbi kampaaniat PPP (Public Private Partnership) ja PFI (Private Finance Initiative) - erasektori ja avaliku sektori vahelise koostöö reklaamimiseks ja edendamiseks. Firma esindajad kohtusid Eesti ametnikega
Fynes, Brian; Lally, Anne Marie
ABSTRACT Identifying the nature of service experiences is recognised As being of primary importance in the shaping of an enhanced competitive position for industry; however service managers often have difficulty articulating the true nature of their service concept. The definition of service concept is a fundamental part of the strategic advantage seeking Processes of service design, service development and service innovation. In response to the competitive Imperative for improved product/...
... 39 Postal Service 1 2010-07-01 2010-07-01 false Headquarters and areas. 223.1 Section 223.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RELATIONSHIPS AND COMMUNICATION CHANNELS § 223.1 Headquarters and areas. Headquarters provides policy guidance, procedures, and...
This is a directory of companies providing products and services in the area of geothermal power. The subheadings of the directory include developers and owner operators, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services
This is a directory of companies providing products and services in the area of hydroelectric power. The subheadings of the directory include developers and owner operators, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services
This annual November-December issue of the Nuclear Plant Journal serves as directory of information resources on products and services related to the nuclear power industry. The directory consists of over 3,000 products and services submitted by over 300 suppliers worldwide during October and November 2003. The issue is divided into 4 main areas: Products and Services, Corporate Capabilities, and Suppliers
This is a directory of companies providing products and services in the area of wind power. The subheadings of the directory include developers and owner operators, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services
Purpose: The paper aims to describe the application of two key service quality frameworks for improving the delivery of postgraduate research supervision. The services quality frameworks are used to identify key areas of overlap between services marketing practice and postgraduate supervision that can be used by the supervisor to improve research…
AJRH Managing Editor
Keywords: Madagascar, Maternal and Child health services, Service availability and readiness assessment, Public health facilities. Résumé ..... Table 2: Percentage of Health Facilities Equipped with Tracer Items for Antenatal Care Services Among Facilities. Providing this ... 32 CSBs, due to its location in a tourist area.
Reuther, Anne; Otto, Ione
Milwaukee Area Technical College, Wisconsin, has four campuses, each with its own food service operation that, combined, serve nearly 3,000 people daily. Several food service-related programs are part of the curriculum. Cost containment and customer satisfaction are the two overriding goals of the food service programs. (MLF)
First annual food service index. Should be helpful in guiding administrators in the management of their individual food service operation. Especially designed to be of assistance in planning and evaluating food service facilities and in pinpointing areas of opportunity for food marketing managers. (Author/EA)
This is a directory of companies providing products and services in the area of photovoltaics. The subheadings of the directory include developers and distributors, equipment manufacturers, measuring instruments and controls, consulting services, engineering and construction, operation and maintenance, project management, repair, and financial and legal services
Svendsen, Gunnar Lind Haase
abandoned. One outcome has been closings of schools in remote rural areas. This evidently contributes to exacerbate depopulation in these areas. To stop this tendency, we need new models for high-quality, cost effective public services in rural areas as those as we find in Denmark. This chapter introduces...... ideological roots in history pointing at 19th c. national civic movements and an early 20th c. transnational Garden City movement within urban planning as crucial. Drawing on contemporary case studies of multifunctional centers in Holland and Denmark, I then suggest that public and private donors should...... invest in multifunctional centers in which the local public school is the dynamo. This in order to increase local levels of social as well as human capital. Ideally, such centers should contain both public services such as school, library and health care, private enterprises as hairdressers and banks...
Olga Margarita Arias
Full Text Available Se presentan en este artículo experiencias recogidas durante la estadía en la Biblioteca Estatal y Universitaria de Baja Sajonia, llevada a cabo por la autora, como personal bibliotecario de la Universidad de Buenos Aires en el marco del Proyecto Fomec 719 para el mejoramiento de la enseñanza superior. Se ilustra acerca del nuevo edificio de la biblioteca, los servicios prestados y se comentan algunos proyectos que lleva adelante la biblioteca. Finalmente, se explican los lineamientos de la formación de bibliotecarios en Alemania.In this article the author explains her experiences at the Lower Saxony University Library, as library staff of the Universidad de Buenos Aires, under the Fomec Project 719, for the improvement of higher education. Concepts about the planning and construction of the new building are also presented, as well as services and various current projects of the library. Finally, a brief explanation of the education for librarians in Germany is sketched.
Olga Margarita Arias
Full Text Available Se presentan en este artículo experiencias recogidas durante la estadía en la Biblioteca Estatal y Universitaria de Baja Sajonia, llevada a cabo por la autora, como personal bibliotecario de la Universidad de Buenos Aires en el marco del Proyecto Fomec 719 para el mejoramiento de la enseñanza superior. Se ilustra acerca del nuevo edificio de la biblioteca, los servicios prestados y se comentan algunos proyectos que lleva adelante la biblioteca. Finalmente, se explican los lineamientos de la formación de bibliotecarios en Alemania = In this article the author explains her experiences at the Lower Saxony University Library, as library staff of the Universidad de Buenos Aires, under the Fomec Project 719, for the improvement of higher education. Concepts about the planning and construction of the new building are also presented, as well as services and various current projects of the library. Finally, a brief explanation of the education for librarians in Germany is sketched.
... Director, Bureau of Enforcement, any Area Representative or the Director, Bureau of Economics and Agreements Analysis [now BTA], submit copies of requested original service contracts or their associated...
In this video-films services of the VUJE, a. s. are presented. The company VUJE provides reconstruction and modernization of nuclear installations, research, development and production of equipment for nuclear power plants and electric industry, development of diagnostic methods, training on simulator of reactor, increase of reactor safety, preparation of documentation about NPP for the Nuclear Regulatory Authority of the Slovak Republic, measures for radiation protection and protection of the environment as well as development and application of information technologies.
Konaklama İşletmelerinde Kat Hizmetleri Çalışanlarının Hizmet İçi Eğitim Kalite Algısı ile Motivasyon Düzeyleri Arasındaki İlişki: İstanbul Bölgesinde Bir Araştırma(Relationship Between In-Service Training Quality Perception and Motivation Factors of Hospitality Businesses Housekeeping Employees: A Research In Istanbul Area
Full Text Available Hospitality businesses that establish innovative initiatives in order to create a value against competitive conditions that occur today, started implementing in-service training techniques by concluding the fact that an increase in motivations of employees result in a linear improvement in productivity and quality in services. In our survey, we examined the relationship and its power between in-service training and intrinsic job motivational factors and also between in-service training and extrinsic job motivational factors in hospitality businesses that apply in-service training programs in Istanbul area. Surveys were conducted on 110 housekeeping employees of two hospitality businesses’; scales of in-service training quality perception, intrinsic job motivational factors and extrinsic job motivational factors are being used. Data that was collected by this sample are analyzed by factor, correlation and regression analysis. Within the framework of the research it is concluded that there is a linear relationship between in-service training and intrinsic job motivational factors and also between in-service training and extrinsic job motivational factors.
Full Text Available This presentation highlights the use of systematic conservation planning to identify priority areas for managing the health of freshwater ecosystems and their associated biodiversity and ecosystem services....
Department of Housing and Urban Development — This dataset and map service provides information on the U.S. Housing and Urban Development's (HUD) low to moderate income areas. The term Low to Moderate Income,...
The purpose of the paper is to present and evaluate the notion of service scenarios. A service is work done by a service executor in interaction with a service consumer. A service scenario is a model of a service system and the roles that are played by the actors participating and interacting...... during the execution of a service. The model represents the roles and the interactions between the participants. Service scenarios can be used to model specific services and roles played by human beings and IT systems in the execution of services. The use of service scenarios is demonstrated by means...... of a case study in a public library. The case study indicates that service systems should be understood as socio-technical systems in which service executors and service consumers co-create value in mutual interaction with each other and with a set of shared resources....
You can now consult the new CERN Housing Service website which includes information relating to the CERN hostels booking rules, special negotiated rates for hotels in the local area, rental offers from the local private sector, etc.: https://espace.cern.ch/hostel-service/default.aspx Please contact the CERN Housing Service team if you have any queries (reception in Building 39, 74481). GS-SEM Group Infrastructure and General Services Department
You can now consult the new CERN Housing Service website which includes information relating to the CERN hostel booking rules, special negotiated rates for hotels in the local area, rental offers from the local private sector, etc.: https://espace.cern.ch/hostel-service/default.aspx Please contact the CERN Housing Service team if you have any queries (reception in Building 39, 74481). GS-SEM Group Infrastructure and General Services Department