WorldWideScience

Sample records for service assessment record

  1. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    Science.gov (United States)

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  2. Electronic Medical Record Service

    Data.gov (United States)

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

  3. Nuclear Electric's central dose record service

    International Nuclear Information System (INIS)

    Goldfinch, E.P.; Mullarkey, D.T.; McWhan, A.W.; Risk, G.; Vaughan, L.

    1991-01-01

    This paper describes the conception, development and operation of the Nuclear Electric Central Dose Record Service, including the initial philosophy considered necessary for a database for a large multi-site organisation, the setting up of the data and current routine operation. Lessons learned are briefly described. CDRS holds 35,000 records in a high security environment. The database includes records of radiation doses received by contractor's employees working at Nuclear Electric sites as well as dose records and dose histories for classified and non classified Nuclear Electric employees. (Author)

  4. The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

    Science.gov (United States)

    Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

    2018-01-01

    Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. 76 FR 52378 - Privacy Act; System of Records: State-76, Personal Services Contractor Records

    Science.gov (United States)

    2011-08-22

    ... Services Contractor Records SUMMARY: Notice is hereby given that the Department of State proposes to create a new system of records, Personal Services Contractor Records, State-76, pursuant to the provisions... July 20, 2011. It is proposed that the new system be named ``Personal Services Contractor Records.'' It...

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

    African Journals Online (AJOL)

    Ngulup

    The principal records management unit within the Department of Corporate Services ... ies services (15), Finance and Accounting (3); however, only 59 participated in it. Data col- ...... records and public-sector financial management.

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

    African Journals Online (AJOL)

    This article explores the role of records management in the delivery of public service in ... to the Corporate Services Division at the Ministry of Health headquarters. ... delays in access and use of records; lack of a elaborate electronic records ...

  8. 9 CFR 156.3 - Kind of service; records.

    Science.gov (United States)

    2010-01-01

    ... the products intended for certification. The inspector shall keep such records of the temperatures... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Kind of service; records. 156.3 Section 156.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF...

  9. The NRPB's new dosimeter and dose record keeping services

    International Nuclear Information System (INIS)

    Dennis, J.A.; Marshall, T.O.; Shaw, K.B.

    1976-01-01

    A new automated dosimeter and record keeping service which the National Radiological Protection Board (UK) intends to introduce in 1977 is described. The automated system, based on a thermoluminescent dosimeter, will be linked to a fully computerised record keeping system with automatic printing of dose records and Transfer Records operated at its Headquarters at Harwell. The new system will dispense with much manual labour which in the past has introduced inevitable errors and incurred increasing costs. (U.K.)

  10. Library Services Funding Assessment

    Science.gov (United States)

    Lorig, Jonathan A.

    2004-01-01

    The Glenn Technical Library is a science and engineering library that primarily supports research activities at the Glenn Research Center, and provides selected services to researchers at all of the NASA research centers. Resources available in the library include books, journals, CD-ROMs, and access to various online sources, as well as live reference and inter-library loan services. The collection contains over 77,000 books, 800,000 research reports, and print or online access to over 1,400 journals. Currently the library operates within the Logistics and Technical Information Division, and is funded as an open-access resource within the GRC. Some of the research units at the GRC have recently requested that the library convert to a "pay-for-services" model, in which individual research units could fund only those journal subscriptions for which they have a specific need. Under this model, the library would always maintain a certain minimum level of pooled-expense services, including the ready reference and book collections, and inter-library loan services. Theoretically the "pay-for-services" model would encourage efficient financial allocation, and minimize the extent to which paid journal subscriptions go unused. However, this model also could potentially negate the benefits of group purchases for journal subscriptions and access. All of the major journal publishers offer package subscriptions that compare favorably in cost with the sum of individual subscription costs for a similar selection of titles. Furthermore, some of these subscription packages are "consortium" purchases that are funded collectively by the libraries at multiple NASA research centers; such consortia1 memberships would be difficult for the library to pay, if enough GRC research units were to withdraw their pooled contributions. cost of collectively-funded journal access with the cost of individual subscriptions. My primary task this summer is to create the cost dataset framework, and

  11. Good governance, service delivery and records: the African tragedy ...

    African Journals Online (AJOL)

    A paper tasked to establish the relationship between records, good governance and service delivery, especially in Africa, runs into immediate definitional ambiguities. This is because good governance and service delivery mean different things to different African leaders. Moreover, even the most criminal and tyrannical ...

  12. Automation of Field Operations and Services (AFOS) National Weather Service (NWS) Service Records and Retention System (SRRS) Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Service Records and Retention System (SRRS) is historical digital data set DSI-9949, a collection of products created by the U.S. National Weather Service (NWS) and...

  13. Good governance, service delivery and records: the African tragedy

    African Journals Online (AJOL)

    mpho ngoepe

    A transparent and accountable government conducts its business openly ... party to boast about its service delivery record but also to allow international ... members of public and private bodies need strong and explicit ethics to prevent bribery, ... have actually carried out the actions and transactions that they had to execute,.

  14. 32 CFR 1900.13 - Fees for record services.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Fees for record services. 1900.13 Section 1900.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC...-printed (if available) Per 100 pages 5.00 Published (if available) Per item NTIS (2) Application of...

  15. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  16. Rethinking Student Services: Assessing and Improving Service Quality.

    Science.gov (United States)

    Zammuto, Raymond F.; And Others

    1996-01-01

    A study investigated the quality of services in four student enrollment services administrative sub-units (recruiting, admissions, records and registration, financial aid) at a public comprehensive university, using student and staff evaluations and program evaluations. Specific changes needed to improve service delivery are identified and…

  17. Gateway National Weather Service (NWS) Service Records and Retention System (SRRS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Service Records Retention System (SRRS) was developed to store weather observations, summaries, forecasts, warnings, and advisories provided by the U.S. National...

  18. NRPB TLD and dose record keeping service - further progress

    International Nuclear Information System (INIS)

    Greenslade, E.

    1979-01-01

    Various aspects of the National Radiological Protection Board's service are described. An increasing number of UK employers are transferring from film monitors, and record keeping is now provided for both large and small groups of workers. Data entry directly from punched cards prepared by the larger employers has reduced initial costs and therefore carries a reduced registration fee for these users. Computerized dose record keeping allows automatic retrieval of cumulative dose information from any NRPB record of previous employment, thus safeguarding itinerant workers. Warning Dose Reports are issued automatically when cumulative dose totals reach or exceed 60% of a limit, or when a dose rate greater than 0.1 rem per 4 weeks is recorded. Flexibility in wearing period results in dosemeter economy and reduces laboratory work load. High recorded doses can be checked by UV stimulation of both disks to confirm the accuracy of the previous measurement. Employers are provided with a comprehensive and accurate monitoring package, fulfilling HSE requirements and exempting employers from their former responsibility to keep their own comprehensive records. (UK)

  19. Beneficial Effects of Two Types of Personal Health Record Services Connected With Electronic Medical Records Within the Hospital Setting.

    Science.gov (United States)

    Lee, Jisan; Kim, James G Boram; Jin, Meiling; Ahn, Kiwhan; Kim, Byungjun; Kim, Sukwha; Kim, Jeongeun

    2017-11-01

    Healthcare consumers must be able to make decisions based on accurate health information. To assist with this, we designed and developed an integrated system connected with electronic medical records in hospitals to ensure delivery of accurate health information. The system-called the Consumer-centered Open Personal Health Record platform-is composed of two services: a portal for users with any disease and a mobile application for users with cleft lip/palate. To assess the benefits of these services, we used a quasi-experimental, pretest-posttest design, assigning participants to the portal (n = 50) and application (n = 52) groups. Both groups showed significantly increased knowledge, both objective (actual knowledge of health information) and subjective (perceived knowledge of health information), after the intervention. Furthermore, while both groups showed higher information needs satisfaction after the intervention, the application group was significantly more satisfied. Knowledge changes were more affected by participant characteristics in the application group. Our results may be due to the application's provision of specific disease information and a personalized treatment plan based on the participant and other users' data. We recommend that services connected with electronic medical records target specific diseases to provide personalized health management to patients in a hospital setting.

  20. Assessment of customer satisfaction in transportation service ...

    African Journals Online (AJOL)

    Assessment of customer satisfaction in transportation service delivery: The case of three terminals of Anbassa City Bus service enterprise. ... Fullscreen Fullscreen Off. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

  1. 37 CFR 201.3 - Fees for registration, recordation, and related services, special services, and services...

    Science.gov (United States)

    2010-07-01

    ... by the Licensing Division. (b) Definitions. For purposes of this section, the following definitions...) (minimum: 1/2 hour) 41.25 (15) Recordation of document, including a Notice of Intention to Enforce (NIE... Additional domain names (per group of 10) 30 (17) Recordation of a Notice of Intention to Make and Distribute...

  2. Assessing the privacy policies in mobile personal health records.

    Science.gov (United States)

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs.

  3. Integration services to enable regional shared electronic health records.

    Science.gov (United States)

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

  4. Service Availability and Readiness Assessment of Maternal ...

    African Journals Online (AJOL)

    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.

  5. Requirements for the approval of dosimetry services under the Ionising Radiations Regulations 1985: Pt. 3: Coordination and record-keeping

    International Nuclear Information System (INIS)

    1991-01-01

    Guidance for dosimetry services on the requirements for approval by the Health and Safety Executive (HSE) is provided in three parts. This part sets out the procedures and criteria that will be used by HSE in the assessment of dosimetry services seeking approval for coordination and record keeping. (author)

  6. Assessing product service systems (PSS)

    DEFF Research Database (Denmark)

    Hsuan, Juliana; McAloone, Tim C.; Neugebauer, Line

    We apply a management tool to classify different integrated PSS within the context of Danish maritime industry. We investigate how a firm should organize its operations to manage the transition from being a manufacturing to a servitizing company, and to provide a guideline for strategic positioni...... and planning of the balance between product sales and service activities....

  7. Service Quality and Process Maturity Assessment

    Directory of Open Access Journals (Sweden)

    Serek Radomir

    2013-12-01

    Full Text Available This article deals with service quality and the methods for its measurement and improvements to reach the so called service excellence. Besides older methods such as SERVQUAL and SERPERF, there are also shortly described capability maturity models based on which the own methodology is developed and used for process maturity assessment in organizations providing technical services. This method is equally described and accompanied by examples on pictures. The verification of method functionality is explored on finding a correlation between service employee satisfaction and average process maturity in a service organization. The results seem to be quite promising and open an arena for further studies.

  8. 75 FR 75546 - Financial Management Service; Privacy Act of 1974, as Amended; System of Records

    Science.gov (United States)

    2010-12-03

    ... DEPARTMENT OF THE TREASURY Financial Management Service; Privacy Act of 1974, as Amended; System of Records AGENCY: Financial Management Service, Treasury. ACTION: Notice of proposed new system of records. SUMMARY: In accordance with the Privacy Act of 1974, as amended, the Financial Management Service...

  9. Management of Records of the Judicial Service Committee of the ...

    African Journals Online (AJOL)

    ... the most useful in meeting the committee's aim and objectives. Management of records of the committee leaves a lot to be desired. . The committee should appreciate the importance of records management in their organization. Finally, the Committee should adopt the use of ICT'S in managing their records and archives.

  10. Assessment of patient's satisfaction with healthcare services ...

    African Journals Online (AJOL)

    Assessment of patient's satisfaction with healthcare services obtained from a ... to identify deficiencies and improve on the quality of health services rendered. ... by the doctor or nurse (r = 0.315, p<0.001) and a significant negative correlation ...

  11. STATISTICS IN SERVICE QUALITY ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Dragana Gardašević

    2012-09-01

    Full Text Available For any quality evaluation in sports, science, education, and so, it is useful to collect data to construct a strategy to improve the quality of services offered to the user. For this purpose, we use statistical software packages for data processing data collected in order to increase customer satisfaction. The principle is demonstrated by the example of the level of student satisfaction ratings Belgrade Polytechnic (as users the quality of institutions (Belgrade Polytechnic. Here, the emphasis on statistical analysis as a tool for quality control in order to improve the same, and not the interpretation of results. Therefore, the above can be used as a model in sport to improve the overall results.

  12. 42 CFR 482.24 - Condition of participation: Medical record services.

    Science.gov (United States)

    2010-10-01

    ... anesthesia services. (B) An updated examination of the patient, including any changes in the patient's... practitioners' orders, nursing notes, reports of treatment, medication records, radiology, and laboratory...

  13. [Quality indicators for the assessment of ST-segment elevation acute myocardial infarction (STEMI) networks. How hospital discharge records could be integrated with Emergency medical services data: the Emilia-Romagna STEMI network experience].

    Science.gov (United States)

    Pavesi, Pier Camillo; Guastaroba, Paolo; Casella, Gianni; Berti, Elena; De Palma, Rossana; Di Bartolomeo, Stefano; Di Pasquale, Giuseppe

    2015-09-01

    The assessment of the regional network for ST-segment elevation acute myocardial infarction (STEMI) is fundamental for quality assurance. Since 2011 all Italian Health Authorities, in addition to hospital discharge records (HDR), must provide a standardized information flow (ERD) about emergency department (ED) and emergency medical system (EMS) activities. The aim of this study was to evaluate whether data integration of ERD with HDR may allow the development of appropriate quality indicators. Patients admitted to coronary care units (CCU) for STEMI between January 1 to December 31, 2013, were identified from the regional HDR database. All data were linked to those of the regional ERD database. Four quality indicators were defined: 1) rates of EMS activation, 2) rates of EMS direct transfer to the catheterization laboratory (Cath-lab), 3) transfer rates from a Spoke to a Hub hospital with angioplasty facilities, and 4) median time spent in ED. In 2013, 2793 patients with STEMI were admitted to the CCU. Of these, 1684 patients (60%) activated EMS and were transported to Spoke or Hub hospitals; 955 (57%) entered directly in CCU/Cath-lab; 677 were transferred directly to a Hub hospital ED without being admitted to a Spoke hospital. The median ED time in Hub hospital was 47 min (IQR 24-136) and in Spoke hospital 53 min (IQR 30-131). The integration among administrative data banks (i.e., HDR with ERD) allowed the assessment of the regional STEMI network and the identification of potentially useful quality indicators. Their easy availability should enable comparisons with local, national and international standards, and may favor quality improvement.

  14. Environmental Agents Service (EAS) Registry System of Records

    Data.gov (United States)

    Department of Veterans Affairs — The Environmental Agent Service (EAS) Registries is the information system encompassing the Ionizing Radiation Registry (IRR), the Agent Orange Registry (AOR), and...

  15. Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-03-01

    Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups

  16. Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-01-01

    Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of

  17. Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

    Science.gov (United States)

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-09-08

    To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO

  18. Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

    Science.gov (United States)

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of

  19. Ecosystem services as assessment endpoints for ecological risk assessment.

    Science.gov (United States)

    Munns, Wayne R; Rea, Anne W; Suter, Glenn W; Martin, Lawrence; Blake-Hedges, Lynne; Crk, Tanja; Davis, Christine; Ferreira, Gina; Jordan, Steve; Mahoney, Michele; Barron, Mace G

    2016-07-01

    Ecosystem services are defined as the outputs of ecological processes that contribute to human welfare or have the potential to do so in the future. Those outputs include food and drinking water, clean air and water, and pollinated crops. The need to protect the services provided by natural systems has been recognized previously, but ecosystem services have not been formally incorporated into ecological risk assessment practice in a general way in the United States. Endpoints used conventionally in ecological risk assessment, derived directly from the state of the ecosystem (e.g., biophysical structure and processes), and endpoints based on ecosystem services serve different purposes. Conventional endpoints are ecologically important and susceptible entities and attributes that are protected under US laws and regulations. Ecosystem service endpoints are a conceptual and analytical step beyond conventional endpoints and are intended to complement conventional endpoints by linking and extending endpoints to goods and services with more obvious benefit to humans. Conventional endpoints can be related to ecosystem services even when the latter are not considered explicitly during problem formulation. To advance the use of ecosystem service endpoints in ecological risk assessment, the US Environmental Protection Agency's Risk Assessment Forum has added generic endpoints based on ecosystem services (ES-GEAE) to the original 2003 set of generic ecological assessment endpoints (GEAEs). Like conventional GEAEs, ES-GEAEs are defined by an entity and an attribute. Also like conventional GEAEs, ES-GEAEs are broadly described and will need to be made specific when applied to individual assessments. Adoption of ecosystem services as a type of assessment endpoint is intended to improve the value of risk assessment to environmental decision making, linking ecological risk to human well-being, and providing an improved means of communicating those risks. Integr Environ Assess Manag

  20. 32 CFR 1700.6 - Fees for records services.

    Science.gov (United States)

    2010-07-01

    ... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.6 Fees for... for fee waivers or reductions may be appealed to the Director of the Intelligence Staff, or his... Photocopy (standard or legal) Per page .10 Microfiche Per frame .20 Pre-printed (if available) Per 100 pages...

  1. Government services: sector skills assessment 2012

    OpenAIRE

    Parry, Jon; Ojo, Adegbola

    2012-01-01

    The aim of this report is to provide authoritative labour market intelligence (LMI) for the Government Services sector to inform the strategic decision making of national governments in the development of employment and skills policy. It is one of 15 UK Sector Skills Assessment (SSA) reports produced by Sector Skills Councils and the UK Commission for Employment and Skills.

  2. 75 FR 77044 - Financial Management Service; Privacy Act of 1974, as Amended; System of Records

    Science.gov (United States)

    2010-12-10

    ... DEPARTMENT OF THE TREASURY Financial Management Service; Privacy Act of 1974, as Amended; System of Records AGENCY: Financial Management Service, Treasury. ACTION: Withdrawal of a Privacy Act Notice... behalf of the Financial Management Service. DATES: December 10, 2010. FOR FURTHER INFORMATION CONTACT...

  3. Global approach of mean service satisfaction assessment

    Directory of Open Access Journals (Sweden)

    Ahmed Dooguy Kora

    2014-01-01

    Full Text Available A theoretical expression for mobile service satisfaction assessment has been proposed. Mobile networks users’ satisfaction is a major concern for the operators and regulators. Therefore a certain level of network qualification is required to be offered to consumers by operators thanks to the decisions initiated by the regulation authority. For the assessment of the level of satisfaction, several methodologies and tools (measuring and monitoring have emerged. Ranking in two broad categories, namely the objective and subjective methods, both have advantages as well as disadvantages. This Letter has proposed a unified approach to evaluate more objectively users’ level of satisfaction of a service based on the most common network key performance indicators (KPIs rate following the different methods. This approach's main advantage is that it has taken advantages of the different positive aspects of the existing methods and outperformed their limitations thanks to the introduced concept of global KPI. In addition, the size of samples according to each method has been considered. A mean service satisfaction theoretical expression has been proposed to regulation authority, consumers association and operators as common base of service satisfaction assessment.

  4. DEEPENING SERVICES MARKET INTEGRATION - A CRITICAL ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Jacques Pelkmans

    2007-12-01

    Full Text Available The greatest asset of the European Union is undoubtedly its internal market. However, the internal market is not completed: it suffers from a giant hole with respect to many services. The present contribution addresses the status of services in the internal market and, in particular, the horizontal liberalisation (or, the lack of it of services outside the two large sectors which greatly deepened market integration (6 modes of transport and 3 financial services markets. Because a horizontal perspective on services in the EU is still little understood, it is briefly summarized what services really are and how their regulatory logic in the internal market can help to classify them. The (strong economic case for deepening services market integration is built on recent empirical economic analysis as well as simulation. This is followed by a discussion, with flowchart, of the Bolkestein draft directive, against the backdrop of the frustrating lack of, or at best, selective progress on services for decades. A survey of economic impact studies of the draft directive is provided, too, underpinning its importance even when the infamous origin principle is taken out. Some light is subsequently shed on the tumultuous politicisation of the services debate. Emphasis is laid on the socio-economic context (which, it is submitted, sharpened the discussion at times into polarisation and a series of other factors such as the diversity of the national regulatory frameworks of services and the labour employed, the complexity of the draft directive, the potentially radical nature of the origin principle (especially for those not aware of the case law of the ECJ, the dominant role of the EP and the opportunism of leading national politicians. Finally, directive 2006/123 –meanwhile in force – is explained and briefly assessed. Apart from the conspicuous manifestation of 'Angst' in drafting the directive, the (de merits are set out. The conclusion is that a badly

  5. Centralized TLD service and record keeping in Canada

    International Nuclear Information System (INIS)

    Grogan, D.; Ashmore, J.P.; Bradley, R.P.

    1979-01-01

    A centralized automated TLD service operated by the Department of National Health and Welfare went into operation in May 1977 to monitor radiation workers throughout Canada. Twenty-thousand employees from a wide range of disciplines are enrolled and the number will be increased to fifty thousand by September l978. A prototype of the system, operational from September 1976 to May 1977 for three-thousand people, has already been described. A description of technical and operational highlights is presented as well as a description of problems experienced during the first full year of operation. Details of costs, conversion logistics, operational performance and technical problems are included. A comparison of the advantages and disadvantages of changing from film dosimetry to TLD in a nationwide context is detailed. The dose meter read-out unit is interfaced, through video terminals, with a time-sharing computer system programmed to provide direct access to the Canadian National Dose Registry. Details of this linkage are described, as are the computer programmes for routine processing of raw batch data. The centralized TLD service interactively linked with the National Dose Registry provides a comprehensive occupational monitoring programme invaluable for regulatory control. (author)

  6. Assessment and recording of radiation doses to workers

    International Nuclear Information System (INIS)

    1986-01-01

    The assessment and recording of the radiation exposure of workers in activities involving radiation risks are required for demonstrating compliance with institutional dose limitations and for a number of other complementary purposes. A significant proportion of the labor force involved in radiation work is currently represented by those specialised workers who operate as itinerant contractors for different nuclear installations and in different countries. In order to ensure that the exposure of these workers is adequately and consistently controlled and kept within acceptable limits, there is a need for the criteria and methods for dose assessment and recording to be harmonised throughout the different countries. An attempt in that direction has been made in this report, which has been prepared by a group of experts convened by the Committee on Radiation Protection and Public Health of the OECD Nuclear Energy Agency. Its primary purpose is to describe recommended technical procedures for an unified approach to the assessment and recording of worker doses. The report is published under the responsibility of the Secretary-General of the OECD, and does not commit Member governments

  7. Service water system aging assessment - Phase I

    International Nuclear Information System (INIS)

    Jarrell, D.B.; Zimmerman, P.W.; Gore, M.L.

    1988-01-01

    The Service Water System (SWS) represents the final heat transfer loop between decay heat generated in the nuclear core and the safe dispersal of that heat energy in the environment. It is the objective of this investigation to demonstrate that aging phenomena can be identified and quantified such that aging degradation of system components can be detected and mitigated prior to the reduction of system availability to below an acceptable threshold. The approach used during the Phase I task was to (1) perform a literature search of government and private sector reports which relate to service water, aging related degradation, and potential methodologies for analysis; (2) assemble a data base which contains all the commercial power plants in the US, their Service Water System configuration, characteristics, and water source; (3) obtain and examine the available service water data from large generic data bases, i.e. NPRDS, LER, NPE, inspection reports, and other relevant plant reference data; (4) perform a fault tree analysis of a typical plant service water systems to examine failure propagation and understand specific input requirements of probabilistic risk analyses; (5) develop an in-depth questionnaire protocol for examining the information resource at a power plant which is not available through data base query and visit a central station power plant and solicit the required information; (6) analyze the information obtained from the in-depth plant interrogation and draw contrasts and conclusions with the data base information; (7) utilize the plant information to perform an interim assessment of service water system degradation mechanisms and focus future investigations. This paper addresses the elements of this task plan numbered 1, 3, 6, and 7. The remaining items are detailed in the phase-I report

  8. 77 FR 7184 - Public Availability of the National Archives and Records Administration FY 2011 Service Contract...

    Science.gov (United States)

    2012-02-10

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Public Availability of the National Archives and... Administration. ACTION: Notice of public availability of FY 2011 Service Contract Inventory. SUMMARY: In...), the National Archives and Records Administration (NARA) is publishing this notice to advise the public...

  9. Lifetime assessment of service-exposed components

    International Nuclear Information System (INIS)

    Kalwa, G.; Weber, H.

    1988-01-01

    A longtime prognosis on the operation of creep-exposed components requires a lifetime analysis. The basis for such an analysis can be improved by an analysis of microstructure and material properties. Actually the grade of material exhaustion has to be regarded as proper assessment quantity. However, stress and time safety also are valuable assessment quantities which should be taken into consideration, especially when the grade of exhaustion is uncertain because of inaccurate input parameters. A correct assessment of the damage state cannot be made without taking into consideration the failure mechanism which has to be assumed for a specific component. With respect to creep the most critical component of a steamline system is the pipe bend because of the risk of large damage events. For this case component metallography by replicas is suggested as preventive test method. The continuation of service of a creep damage pipe bend cannot be recommended. (orig./MM) [de

  10. Climate Services for Development Planning and Implementation: A Framework for Assessing and Valuing Climate Services

    Science.gov (United States)

    Anderson, G.

    2012-04-01

    Climate Services for Development Planning and Implementation: A Framework for Assessing and Valuing Climate Services Anderson, Glen D. While weather forecasting products have been available globally for decades, the full suite of climate services - including historical and real time observational meteorological data, daily, weekly, and seasonal forecasts, and longer-term climate projections - has only been under development in the last 15 to 20 years. Climate services have been developed and implemented quite quickly in developed countries for public and private sector users. However, diffusion of these tools in developing countries has been slower for several reasons related to 1) lack of awareness of the opportunities and benefits of climate services; 2) spotty record of managing local weather and climate data; and 3) limited resources to build and sustain capacity in providing climate services. The Climate Services Partnership (CSP) was formed during the International Conference on Climate Services (ICCS) in October 2011. The CSP seeks to improve the provision and development of climate services worldwide. During the ICCS, three working groups were formed to carry out the work program of the CSP leading up to the second ICCS in Berlin in September 2012. The Economic Valuation of Climate Services Working Group, chaired by John Zillman and myself, is collaborating on several activities to demonstrate the benefits of climate services and help providers prioritize opportunities for expanding the use of climate services. The proposed paper will provide an overview of the Working Group's activities leading up to the next ICCS and describe specific work that is underway and expected to be completed prior to the EGU meetings. The focal point of the Working Group's activities is the development of matrix to help identify and value the best opportunities for using climate services. Different categories of climate services will be listed in rows and potential users of

  11. N.R.P.B.'s new record-keeping service and thermoluminescent dosemeter

    International Nuclear Information System (INIS)

    Dennis, J.A.; Marshall, T.O.; Shaw, K.B.; Kendall, G.M.

    1977-01-01

    With the approval of the Health and Safety Executive the National Radiological Protection Board is introducing a radiation dose record keeping service in association with a thermoluminescent dosimeter. This service will relieve employers of the responsibility for maintaining and keeping dose records. Both the record keeping and dosimeter systems are described, including the documents which will be produced for employers. The thermoluminescent dosimeter is more accurate and less sensitive to environmental factors than the film dosimeter, which it replaces. It also reduces the consumption of materials and, with automated processing, is labour saving. (author)

  12. Relationship between parent held child records for immunisations, parental recall and health service.

    LENUS (Irish Health Repository)

    Jessop, L

    2011-03-01

    Parent held child records (PHCR) were introduced in Ireland in 2008. This study investigated the relationship between the PHCR, parental recall and regional Health Service Executive (HSE) records for immunisation uptake. It used the Lifeways cohort study of 1070 singleton children to compare immunisation data from PHCR at one year, parental recall at five years and information from the HSE. When compared to HSE records, full recording of primary immunisations in the PHCR was reported for 695 of 749 (92.8%) children. Parental recall was correct for 520 of 538 (96.7%) children. Of the 307 completed PHCRs, 207 (75.9%) agreed with the HSE records. Agreement between the three sources for primary immunisations was 74-93% but was not statistically significant. Agreement was 91% (p < 0.001) for measles, mumps and rubella (MMR) vaccines between parental recall and HSE records. PHCRs underestimated and parental recall overestimated immunisation status when compared with HSE records.

  13. A software tool for ecosystem services assessments

    Science.gov (United States)

    Riegels, Niels; Klinting, Anders; Butts, Michael; Middelboe, Anne Lise; Mark, Ole

    2017-04-01

    The EU FP7 DESSIN project is developing methods and tools for assessment of ecosystem services (ESS) and associated economic values, with a focus on freshwater ESS in urban settings. Although the ESS approach has gained considerable visibility over the past ten years, operationalizing the approach remains a challenge. Therefore, DESSSIN is also supporting development of a free software tool to support users implementing the DESSIN ESS evaluation framework. The DESSIN ESS evaluation framework is a structured approach to measuring changes in ecosystem services. The main purpose of the framework is to facilitate the application of the ESS approach in the appraisal of projects that have impacts on freshwater ecosystems and their services. The DESSIN framework helps users evaluate changes in ESS by linking biophysical, economic, and sustainability assessments sequentially. It was developed using the Common International Classification of Ecosystem Services (CICES) and the DPSIR (Drivers, Pressures, States, Impacts, Responses) adaptive management cycle. The former is a standardized system for the classification of ESS developed by the European Union to enhance the consistency and comparability of ESS assessments. The latter is a well-known concept to disentangle the biophysical and social aspects of a system under study. As part of its analytical component, the DESSIN framework also integrates elements of the Final Ecosystem Goods and Services-Classification System (FEGS-CS) of the US Environmental Protection Agency (USEPA). As implemented in the software tool, the DESSIN framework consists of five parts: • In part I of the evaluation, the ecosystem is defined and described and the local stakeholders are identified. In addition, administrative details and objectives of the assessment are defined. • In part II, drivers and pressures are identified. Once these first two elements of the DPSIR scheme have been characterized, the claimed/expected capabilities of a

  14. Nuclear plant service water system aging degradation assessment: Phase 1

    International Nuclear Information System (INIS)

    Jarrell, D.B.; Johnson, A.B. Jr.; Zimmerman, P.W.; Gore, M.L.

    1989-06-01

    The initial phase of an aging assessment of nuclear power plant service water systems (SWSs) was performed by the Pacific Northwest Laboratory to support the Nuclear Regulatory Commission Nuclear Plant Aging Research (NPAR) program. The SWS was selected for study because of its essential role in the mitigation of and recovery from accident scenarios involving the potential for core-melt. The objectives of the SWS task under the NPAR program are to identify and characterize the principal aging degradation mechanisms relevant to this system and assess their impact on operational readiness, and to provide a methodology for the mitigation of aging on the service water aspect of nuclear plant safety. The first two of these objectives have been met and are covered in this Phase 1 report. A review of available literature and data-base information indicated that motor operated valve torque switches (an electro-mechanical device) were the prime suspect in component service water systems failures. More extensive and detailed data obtained from cooperating utility maintenance records and personnel accounts contradicted this conclusion indicating that biologic and inorganic accumulation and corrosive attack of service water on component surfaces were, in fact, the primary degradation mechanisms. A review of the development of time dependent risk assessment (aging) models shows that, as yet, this methodology has not been developed to a degree where implementation is reliable. Improvements in the accuracy of failure data documentation and time dependent risk analysis methodology should yield significant gains in relating aging phenomena to probabilistic risk assessment. 23 refs., 8 figs., 10 tabs

  15. "Check This out": Assessing Customer Service at the Circulation Desk

    Science.gov (United States)

    Long, Dallas

    2012-01-01

    The access services staff at Milner Library, Illinois State University, designed a customer service assessment to evaluate how effectively the department was carrying out its mission statement. Areas of assessment included the department's waiting times, helpfulness, and courtesy. The assessment activity focused on circulation services, which is…

  16. Applying the theory of constraints to the logistics service of medical records of a hospital

    Directory of Open Access Journals (Sweden)

    Víctor-G. Aguilar-Escobar

    2016-09-01

    Full Text Available Management of patient records in a hospital is of major importance, for its impact both on the quality of care and on the associated costs. Since this process is circular, the prevention of the building up of bottlenecks is especially important. Thus, the objective of this paper was to analyze whether the Theory of Constraints (TOC can be useful to the logistics of medical records in hospitals. The paper is based on a case study conducted about the 2007-2011 period in the Medical Records Logistics Service at the Hospital Universitario Virgen Macarena in Seville (Spain. From April 2008, a set of actions in the clinical record logistics system were implemented based on the application of TOC principles. The results obtained show a significant increase in the level of service and employee productivity, as well as a reduction of cost and the number of patients’ complaints.

  17. Experience of introducing a new database for an approved coordination and record keeping service

    International Nuclear Information System (INIS)

    Garratt, N. J.

    2011-01-01

    The Health Protection Agency (and its predecessors) has many years experience of running Approved Dosimetry Services, including coordination and record keeping. This paper describes the experiences gained whilst introducing a new web-based system for coordination and record keeping to replace the ageing mainframe database. This includes the planning of the project, the migration of the data between the two systems, parallel running of all the operational tasks and lessons learned during the process. (authors)

  18. Effect of the Length of Traffic Flow Records on the Estimate of a Bridge Service Life

    Directory of Open Access Journals (Sweden)

    Krejsa Jan

    2016-12-01

    Full Text Available The service life of bridges is significantly affected by fatigue of used material induced by heavy vehicles. Therefore, precise determination of the vehicle weight is of crucial importance for the calculation of fatigue damage and the prediction of the bridge serviceability. This paper investigates accuracy of the determination of fatigue depending on the length of traffic flow recording. The presented data were obtained from the measurements carried out on a bridge of the Prague Highway Ring. The analysis reveals that the optimal length of traffic recording is about 30 days.

  19. Digital Communication and Records in Service Provision and Supervision: Regulation and Practice.

    Science.gov (United States)

    Cavalari, Rachel N S; Gillis, Jennifer M; Kruser, Nathan; Romanczyk, Raymond G

    2015-10-01

    While the use of computer-based communication, video recordings, and other "electronic" records is commonplace in clinical service settings and research, management of digital records can become a great burden from both practical and regulatory perspectives. Three types of challenges commonly present themselves: regulatory requirements; storage, transmission, and access; and analysis for clinical and research decision-making. Unfortunately, few practitioners and organizations are well enough informed to set necessary policies and procedures in an effective, comprehensive manner. The three challenges are addressed using a demonstrative example of policies and procedural guidelines from an applied perspective, maintaining the unique emphasis behavior analysts place upon quantitative analysis. Specifically, we provide a brief review of federal requirements relevant to the use of video and electronic records in the USA; non-jargon pragmatic solutions to managing and storing video and electronic records; and last, specific methodologies to facilitate extraction of quantitative information in a cost-effective manner.

  20. Integrating traditional nursing service orientation content with electronic medical record orientation.

    Science.gov (United States)

    Harton, Brenda B; Borrelli, Larry; Knupp, Ann; Rogers, Necolen; West, Vickie R

    2009-01-01

    Traditional nursing service orientation classes at an acute care hospital were integrated with orientation to the electronic medical record to blend the two components in a user-friendly format so that the learner is introduced to the culture, processes, and documentation methods of the organization, with an opportunity to document online in a practice domain while lecture and discussion information is fresh.

  1. 49 CFR 1002.1 - Fees for records search, review, copying, certification, and related services.

    Science.gov (United States)

    2010-10-01

    ... public interest because it is likely to contribute significantly to public understanding of the... the rate of $41.00 per hour. (c) Service involved in checking records to be certified to determine authenticity, including clerical work, etc., identical thereto, at the rate of $28.00 per hour. (d) Photocopies...

  2. Assessment of the effectiveness of guidance services in senior ...

    African Journals Online (AJOL)

    Guidance Service Assessment Questionnaire for Teacher/Students (GSAQTS) was used to measure the extent of guidance services and their perception of it. ... to counsellor, and a misconception of the counsellors role has made guidance ...

  3. Privacy Impact Assessment for the Wellness Program Medical Records

    Science.gov (United States)

    The Wellness Program Medical Records System collects contact information and other Personally Identifiable Information (PII). Learn how this data is collected, used, accessed, the purpose of data collection, and record retention policies.

  4. IMPLEMENTING A VALUE ASSESSMENT TOOL FOR SERVICE INNOVATION IDEAS

    OpenAIRE

    TOR HELGE AAS

    2010-01-01

    There has not been much discussion of how firms may assess the value of service innovation projects ex-ante in the extant research literature. This paper theoretically derives a value assessment tool for service innovation ideas called QSI (tool for pre-Qualification of Service Innovation projects). Thereafter QSI is implemented in three firms and it is explored to what degree the implementation improved managerial decision making on service innovation projects and investments. The findings i...

  5. How to implement live video recording in the clinical environment: A practical guide for clinical services.

    Science.gov (United States)

    Lloyd, Adam; Dewar, Alistair; Edgar, Simon; Caesar, Dave; Gowens, Paul; Clegg, Gareth

    2017-06-01

    The use of video in healthcare is becoming more common, particularly in simulation and educational settings. However, video recording live episodes of clinical care is far less routine. To provide a practical guide for clinical services to embed live video recording. Using Kotter's 8-step process for leading change, we provide a 'how to' guide to navigate the challenges required to implement a continuous video-audit system based on our experience of video recording in our emergency department resuscitation rooms. The most significant hurdles in installing continuous video audit in a busy clinical area involve change management rather than equipment. Clinicians are faced with considerable ethical, legal and data protection challenges which are the primary barriers for services that pursue video recording of patient care. Existing accounts of video use rarely acknowledge the organisational and cultural dimensions that are key to the success of establishing a video system. This article outlines core implementation issues that need to be addressed if video is to become part of routine care delivery. By focussing on issues such as staff acceptability, departmental culture and organisational readiness, we provide a roadmap that can be pragmatically adapted by all clinical environments, locally and internationally, that seek to utilise video recording as an approach to improving clinical care. © 2017 John Wiley & Sons Ltd.

  6. Military Service Records and Unit Histories: A Guide to Locating Sources

    Science.gov (United States)

    2012-07-26

    records, therefoa- e , written authorization from the veta -an or ne.’Ct of kin is not rEqUired. However, in ordet" to protect the privacy of the...line E -mail: MPR.center@nara.gov Older military personnel records (generally prior to World War I, depending on the service branch) are located at...AFB, DC 20032-5000 E -mail: afhso.research@pentagon.af.mil http://www.afhso.af.mil/ (202) 404-2264 National Museum of the U.S. Air Force 1100

  7. One year of a thermoluminescent dosemeter and dose record keeping service

    International Nuclear Information System (INIS)

    Dennis, J.A.

    1979-01-01

    A brief description is given of the National Radiological Protection Board's (NRPB) thermoluminescent dosemeter. The automated processing of these dosemeters is linked to a computer-based system of dose records. The postal system is currently used by about 10% of the establishments for which the NRPB provides a personnel monitoring service, but it will soon be extended to other establishments. The distributions of individual whole body doses in 1977 are tabulated. The significant advantage of this new system lies in the improvements in accuracy, completeness, and convenience to the employers of record keeping. (U.K.)

  8. Assessment of Customer Satisfaction in Transportation Service ...

    African Journals Online (AJOL)

    Administrator

    Definition of Service. As quoted by Palmer and Cole (1995: 38), Kotler and. Armstrong define services as “Any activity or benefit that one party can offer to another that is essentially intangible ... Kotler (1999: 55) define quality as “The totality of features and ... of satisfying that expectation and getting competitive advantage.

  9. Multimedia Health Records: user-centered design approach for a multimedia uploading service.

    Science.gov (United States)

    Plazzotta, Fernando; Mayan, John C; Storani, Fernando D; Ortiz, Juan M; Lopez, Gastón E; Gimenez, Gastón M; Luna, Daniel R

    2015-01-01

    Multimedia elements add value to text documents by transmitting information difficult to express in words. In healthcare, many professional and services keep this elements in their own repositories. This brings the problem of information fragmentation in different silos which hinder its access to other healthcare professionals. On the other hand patients have clinical data of their own in different formats generated in different healthcare organizations which is not accessible to professionals within our healthcare network. This paper describes the design, development and implementation processes of a service which allows media elements to be loaded in a patient clinical data repository (CDR) either through an electronic health record by professionals (EHR) or through a personal health record (PHR) by patients, in order to avoid fragmentation of the information.

  10. Service Quality and Customer Satisfaction: An Assessment and Future Directions.

    Science.gov (United States)

    Hernon, Peter; Nitecki, Danuta A.; Altman, Ellen

    1999-01-01

    Reviews the literature of library and information science to examine issues related to service quality and customer satisfaction in academic libraries. Discusses assessment, the application of a business model to higher education, a multiple constituency approach, decision areas regarding service quality, resistance to service quality, and future…

  11. Public Hospital Spending in England: Evidence from National Health Service Administrative Records

    OpenAIRE

    Kelly, E.; Stoye, G.; Vera-Hernández, M.

    2016-01-01

    © 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

  12. Public hospital spending in England: Evidence from National Health Service administrative records

    OpenAIRE

    Kelly, Elaine; Stoye, George; Vera-Hernández, Marcos

    2015-01-01

    Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after...

  13. A critical assessment of early warning score records in 168,000 patients

    DEFF Research Database (Denmark)

    Pedersen, Niels Egholm; Rasmussen, Lars Simon; Petersen, John Asger

    2018-01-01

    critically assessed NEWS data recorded over 12 months. This observational study included NEWS records from adult inpatients hospitalized in the Capital Region of Denmark during 2014. Physiological variables and the use of supplementary oxygen (NEWS variables) were recorded. We identified implausible records...

  14. Assessment of Customer Satisfaction in Transportation Service ...

    African Journals Online (AJOL)

    Administrator

    adequate capacity that can meet and satisfy their requirements and reached at .... Tengstron (2005), bus services are flexible, cost effective and equitable mode of ...... attention, it could not be continued and currently there is no adequate ...

  15. Assessing international trade in healthcare services

    OpenAIRE

    Herman, Lior

    2009-01-01

    Growing evidence indicates that international trade in healthcare services is growing. Nevertheless, a major literature gap exists with regard to the nature of international healthcare trade and its extent. Taking a comprehensive approach, this research examines the magnitude, directions, patterns of specialisation, growth and other aspects related to international trade in healthcare services. Within this framework, trade is analysed with regard to cross border trade, consumption of healthca...

  16. Experimental assessment of ecosystem services in agriculture

    DEFF Research Database (Denmark)

    Sandhu, Harpinder; Porter, John Roy; Wratten, Steve

    2013-01-01

    Ecosystem services are the resources and processes supplied by natural ecosystems which benefit humankind (for example, pollination of crops by insects, or water filtration by wetlands). They underpin life on earth, provide major inputs to many economic sectors and support our lifestyles. Agricul......Ecosystem services are the resources and processes supplied by natural ecosystems which benefit humankind (for example, pollination of crops by insects, or water filtration by wetlands). They underpin life on earth, provide major inputs to many economic sectors and support our lifestyles....... Agricultural and urban areas are by far the largest users of ecosystems and their services and (for the first time) this book explores the role that ecosystem services play in these managed environments. The book also explores methods of evaluating ecosystem services, and discusses how these services can...... be maintained and enhanced in our farmlands and cities. This book will be useful to students and researchers from a variety of fields, including applied ecology, environmental economics, agriculture and forestry, and also to local and regional planners and policy makers....

  17. Considering abortion: a 12-month audit of records of women contacting a Pregnancy Advisory Service.

    Science.gov (United States)

    Rowe, Heather J; Kirkman, Maggie; Hardiman, E Annarella; Mallett, Shelley; Rosenthal, Doreen A

    2009-01-19

    To characterise the demographic and psychosocial circumstances of women contacting Victoria's largest public pregnancy advisory service (PAS). Audit of PAS electronic records for the 12 months from 1 October 2006 to 30 September 2007. De-identified data were extracted from a comprehensive electronic database used for recording consultations. Summary statistics and measures of association. During the 12 months, 5462 women contacted PAS; records were created for 3827 women, and data were available in more than 80% of records for 77% (13/17) of items. Over half of the women receiving pregnancy support from PAS (60%) were 18-29 years old; 12% lived outside the metropolitan area; 51% held a health care card, and smaller percentages faced housing, financial, or drug and alcohol problems; 16% reported violence, but 71% described partners as involved and supportive. Most (79%) made contact within 2 weeks of discovering pregnancy, and 72% were referred by a general practitioner. Later gestation at contact was associated with younger age (P abortion were the desire to delay pregnancy (23%) and family completion (18%); 42% already had at least one child. Twenty-three women reported that the pregnancy was the result of rape. Ten per cent had mental health problems, and smaller numbers faced access barriers and had special needs. This PAS responds to demand from women with diverse social and personal circumstances. Findings provide evidence for policy, prevention and service development.

  18. Posters as assessment strategies: focusing on service users.

    Science.gov (United States)

    Crawley, Loretta; Frazer, Kate

    This article debates whether posters as an assessment strategy in health professionals' education programmes can benefit learners, academics, and service users. Evidence suggests that service-user involvement benefits learning by developing students' communication, partnership and advocacy skills. The authors debate the value of posters as an assessment strategy in postgraduate diploma nursing programmes delivered in an Irish School of Nursing, Midwifery and Health Systems. It is argued that assessment strategies should not only examine programme theory and practice but should also benefit the people that will be using the service. Although the assessment strategy used in these programmes aimed to benefit service users, additional work is required for assessment to be truly inclusive of service users.

  19. E-Services quality assessment framework for collaborative networks

    Science.gov (United States)

    Stegaru, Georgiana; Danila, Cristian; Sacala, Ioan Stefan; Moisescu, Mihnea; Mihai Stanescu, Aurelian

    2015-08-01

    In a globalised networked economy, collaborative networks (CNs) are formed to take advantage of new business opportunities. Collaboration involves shared resources and capabilities, such as e-Services that can be dynamically composed to automate CN participants' business processes. Quality is essential for the success of business process automation. Current approaches mostly focus on quality of service (QoS)-based service selection and ranking algorithms, overlooking the process of service composition which requires interoperable, adaptable and secure e-Services to ensure seamless collaboration, data confidentiality and integrity. Lack of assessment of these quality attributes can result in e-Service composition failure. The quality of e-Service composition relies on the quality of each e-Service and on the quality of the composition process. Therefore, there is the need for a framework that addresses quality from both views: product and process. We propose a quality of e-Service composition (QoESC) framework for quality assessment of e-Service composition for CNs which comprises of a quality model for e-Service evaluation and guidelines for quality of e-Service composition process. We implemented a prototype considering a simplified telemedicine use case which involves a CN in e-Healthcare domain. To validate the proposed quality-driven framework, we analysed service composition reliability with and without using the proposed framework.

  20. Product-line administration: a framework for redefining medical record department services.

    Science.gov (United States)

    Postal, S N

    1990-06-01

    Product-line administration is a viable approach for managing medical records services in an environment that demands high quantity and quality service levels. Product-line administration directs medical record department team members to look outside of the department and seek input from the customers it is intended to serve. The feedback received may be alarming at first, as the current state of products usually reveals a true lack of customer input. As the planning, defining, managing, and marketing phases are implemented, the road will not be easy and rewards will be slow to come. Product-line administration does not provide quick fixes, but it does provide long-term problem resolution as products are refined and new products developed to meet customer needs and expectations. In addition to better meeting the needs of the department's external customers, the department's internal customers' needs and expectations will be addressed. The participative management approach will help nurture each team member's creativity. The team members will have the opportunity to reach their full potential while reaping the rewards and benefits of providing products and services that meet the needs and expectations of all department customers. The future of the health care industry promises more changes as the country moves toward some form of prospective payment in the ambulatory setting. Reactive management and the constant struggle to catch up can no longer be accepted as a management approach. It is imperative that the medical record department be viewed as a business with product lines composed of quality products. The planning, defining, managing, and marketing components of product-line administration afford responsiveness to the current situation and the development of quality products that will ensure that medical record departments are prepared for the future.

  1. 42 CFR 35.17 - Fees and charges for copying, certification, search of records and related services.

    Science.gov (United States)

    2010-10-01

    ... OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General... by a non-Service physician, clinic, or hospital, in which case the record will be forwarded only to the physician, clinic, or hospital concerned. (3) When the service or document is requested by an...

  2. Obfuscatable multi-recipient re-encryption for secure privacy-preserving personal health record services.

    Science.gov (United States)

    Shi, Yang; Fan, Hongfei; Xiong, Guoyue

    2015-01-01

    With the rapid development of cloud computing techniques, it is attractive for personal health record (PHR) service providers to deploy their PHR applications and store the personal health data in the cloud. However, there could be a serious privacy leakage if the cloud-based system is intruded by attackers, which makes it necessary for the PHR service provider to encrypt all patients' health data on cloud servers. Existing techniques are insufficiently secure under circumstances where advanced threats are considered, or being inefficient when many recipients are involved. Therefore, the objectives of our solution are (1) providing a secure implementation of re-encryption in white-box attack contexts and (2) assuring the efficiency of the implementation even in multi-recipient cases. We designed the multi-recipient re-encryption functionality by randomness-reusing and protecting the implementation by obfuscation. The proposed solution is secure even in white-box attack contexts. Furthermore, a comparison with other related work shows that the computational cost of the proposed solution is lower. The proposed technique can serve as a building block for supporting secure, efficient and privacy-preserving personal health record service systems.

  3. Strategies for service-learning assessment in dental hygiene education.

    Science.gov (United States)

    Burch, Sharlee

    2013-10-01

    A large body of literature exists on the instructional pedagogy known as service-learning. Service-learning is a teaching and learning approach characterized by the dental hygiene student's practical application of academic studies and occurs within a community setting, to the benefit of both the student and community. Dental hygiene educators use service-learning to enhance student knowledge and application of oral health curriculum. This manuscript reports on the importance of service-learning assessment to the National Dental Hygiene Research Agenda as well as the future of the profession of dental hygiene and the successful strategies in service-learning evaluation available for utilization by dental hygiene educators.

  4. 77 FR 49859 - Proposed Traffic Records Program Assessment Advisory

    Science.gov (United States)

    2012-08-17

    ... decision-making. States need timely, accurate, complete, and uniform traffic records to identify and.... This document provides information on the contents, capabilities, and data quality attributes of an... comments and additional information, see http://www.regulations.gov . Note that all comments received will...

  5. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

    Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

  6. Delivering a lifelong integrated electronic health record based on a service oriented architecture.

    Science.gov (United States)

    Katehakis, Dimitrios G; Sfakianakis, Stelios G; Kavlentakis, Georgios; Anthoulakis, Dimitrios N; Tsiknakis, Manolis

    2007-11-01

    Efficient access to a citizen's Integrated Electronic Health Record (I-EHR) is considered to be the cornerstone for the support of continuity of care, the reduction of avoidable mistakes, and the provision of tools and methods to support evidence-based medicine. For the past several years, a number of applications and services (including a lifelong I-EHR) have been installed, and enterprise and regional infrastructure has been developed, in HYGEIAnet, the Regional Health Information Network (RHIN) of the island of Crete, Greece. Through this paper, the technological effort toward the delivery of a lifelong I-EHR by means of World Wide Web Consortium (W3C) technologies, on top of a service-oriented architecture that reuses already existing middleware components is presented and critical issues are discussed. Certain design and development decisions are exposed and explained, laying this way the ground for coordinated, dynamic navigation to personalized healthcare delivery.

  7. Assessment report for Hanford analytical services quality assurance plan

    International Nuclear Information System (INIS)

    Taylor, L.H.

    1994-11-01

    This report documents the assessment results of DOE/RL-94-55, Hanford Analytical Services Quality Assurance Plan. The assessment was conducted using the Requirement and Self-Assessment Database (RSAD), which contains mandatory and nonmandatory DOE Order statements for the relevant DOE orders

  8. Assessing the physical service setting: a look at emergency departments.

    Science.gov (United States)

    Steinke, Claudia

    2015-01-01

    To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

  9. Evaluating intersectoral collaboration: a model for assessment by service users

    Directory of Open Access Journals (Sweden)

    Bengt Ahgren

    2009-02-01

    Full Text Available Introduction: DELTA was launched as a project in 1997 to improve intersectoral collaboration in the rehabilitation field. In 2005 DELTA was transformed into a local association for financial co-ordination between the institutions involved. Based on a study of the DELTA service users, the purpose of this article is to develop and to validate a model that can be used to assess the integration of welfare services from the perspective of the service users. Theory: The foundation of integration is a well functioning structure of integration. Without such structural conditions, it is difficult to develop a process of integration that combines the resources and competences of the collaborating organisations to create services advantageous for the service users. In this way, both the structure and the process will contribute to the outcome of integration. Method: The study was carried out as a retrospective cross-sectional survey during two weeks, including all the current service users of DELTA. The questionnaire contained 32 questions, which were derived from the theoretical framework and research on service users, capturing perceptions of integration structure, process and outcome. Ordinal scales and open questions where used for the assessment. Results: The survey had a response rate of 82% and no serious biases of the results were detected. The study shows that the users of the rehabilitation services perceived the services as well integrated, relevant and adapted to their needs. The assessment model was tested for reliability and validity and a few modifications were suggested. Some key measurement themes were derived from the study. Conclusion: The model developed in this study is an important step towards an assessment of service integration from the perspective of the service users. It needs to be further refined, however, before it can be used in other evaluations of collaboration in the provision of integrated welfare services.

  10. Assessment of Extension Service Delivery on Improved Cassava ...

    African Journals Online (AJOL)

    Extension service delivery is too often merely seen as a vehicle for spreading scientific and technical progress and technology transfer. In the real sense, however, dissemination of knowledge is not a one way affair from scientists to producers. The study was conducted to assess extension service delivery on improved ...

  11. Social Filters in Assessing Higher Education Services Market

    Science.gov (United States)

    Shkurkin, Anatoly; Lutsenko, Ekaterina; Bazhenova, Natalia; Bazhenov, Ruslan; Bogachenko, Natalia

    2016-01-01

    The main goal of this work is to reveal social filters in the system of assessing the higher education services market. On the basis of the institutional interpretation of market relations, mechanisms and features of asymmetries formation in the educational services market are investigated. The role of the institutional environment ensuring…

  12. Assessing STD Partner Services in State and Local Health Departments.

    Science.gov (United States)

    Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

    2018-02-07

    State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

  13. Assessing Transition Service for Handicapped Youth: A Cooperative Interagency Approach.

    Science.gov (United States)

    Stodden, Robert A.; Boone, Rosalie

    1987-01-01

    The article presents a cooperative interagency approach for assessing effectiveness of programs and services to facilitate the transition of handicapped students from school to adult community living. Features of the model include cooperative planning at the policy level, implementation level, and direct service level; and collaboration by state…

  14. Quality Assessment of Family Planning Services in Ife/Ijesa ...

    African Journals Online (AJOL)

    Context: Medical audit in healthcare has a goal to monitor and upgrade the standard of health care in a setting. Whether a client will accept, use effectively and continue to practice contraception depends on the quality of services rendered. Objective: To assess the quality of our family planning services as perceived by our ...

  15. Income Tax Preparation Assistance Service Learning Program: A Multidimensional Assessment

    Science.gov (United States)

    Aldridge, Richard; Callahan, Richard A.; Chen, Yining; Wade, Stacy R.

    2015-01-01

    The authors present a multidimensional assessment of the outcomes and benefits of an income tax preparation assistance (ITPA) service learning program. They measure the perceived proximate benefits at the delivery of the service program, the actual learning outcome benefits prior to graduation, and the perceived long-term benefits from a…

  16. assessment of emergency medical services in the ashanti region

    African Journals Online (AJOL)

    2015-09-01

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

  17. Assessment of women savings and credit cooperative services in ...

    African Journals Online (AJOL)

    Assessment of women savings and credit cooperative services in Zuway Dugda District, south east Ethiopia. ... Journal of Business and Administrative Studies ... and to the improvement of decision making power of members at family level.

  18. Ecosystem services as assessment endpoints for ecological risk assessment

    Science.gov (United States)

    Ecosystem services (ES) are defined as the outputs of ecological processes that contribute to human welfare or have the potential to do so in the future, and include the production of food and drinking water, purification of air and water, pollination, and nutrient cycling. The n...

  19. Modern recording systems for services able to meet the competition; Moderne Erfassungssysteme fuer wettbewerbsfaehige Dienstleistungen

    Energy Technology Data Exchange (ETDEWEB)

    Drumm, M.

    2000-07-01

    Modern recording systems form the basis for competitive services. They are, however, only successful when integrated precisely into a lean running organization. By means of practical examples the necessity to place great emphasis on the costs of a system besides the investment costs when deciding about a recording system, will be examined. The significant changes on the energy market and the increasing demand of the housing economy for a comprehensive offer of services from the supply industry are main initiators for a whole new line of businesses on the supply economy sector. The great challenge for the supply industry lies in the task to install lean and effective system which are on one hand reliable and easy to handle for the whole duration of the contract and on the other hand are so cost efficient, that an adequate profitability can be ensured (see also: 'The secret winners', Zfk October 1999). A decisive factor for this reason is the metering technology, which has to ensure for the whole duration of the contract that correct consumption values are registered, on the basis of which as fast and punctual as possible a legally safe invoicing can be prepared. (orig.) [German] Moderne Erfassungssysteme bilden die Grundlage fuer wettbewerbsfaehige Dienstleistungen, die jedoch erst bei sauberer Einbindung in eine schlanke Ablauforganisation erfolgreich sind. Anhand von Praxisbeispielen wird die Notwendigkeit betrachtet, bei der Entscheidung fuer ein Erfassungssystem neben den Investitionskosten den Systemkosten entscheidendes Gewicht zu verleihen. (orig.)

  20. Assessing service quality satisfying the expectations of library customers

    CERN Document Server

    Hernon, Peter; Dugan, Robert

    2015-01-01

    Academic and public libraries are continuing to transform as the information landscape changes, expanding their missions into new service roles that call for improved organizational performance and accountability. Since Assessing Service Quality premiered in 1998, receiving the prestigious Highsmith Library Literature Award, scores of library managers and administrators have trusted its guidance for applying a customer-centered approach to service quality and performance evaluation. This extensively revised and updated edition explores even further the ways technology influences both the experiences of library customers and the ways libraries themselves can assess those experiences.

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

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

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

  2. Evidence Regarding Teaching and Assessment of Record-Keeping Skills in Training of Dental Students.

    Science.gov (United States)

    Amos, Kate J; Bearman, Margaret; Palermo, Claire

    2015-10-01

    The aim of this study was to assess the literature on teaching and assessing dental students' record-keeping skills prior to qualification to practice independently as a dentist. A systematic literature review was performed using Ovid MEDLINE and SCOPUS. Keywords used in the search included dental, record, audit, education, and assessment. Electronic search results were screened for publications that targeted undergraduate dental training, related to a record-keeping education intervention, and were published in English and available in full text. Six studies met the inclusion and exclusion criteria. Data extraction and quality assessment were performed, and research findings were compared across the included studies. These six articles addressed the techniques used to teach and assess record-keeping skills in a pre-qualification context. The techniques included supervisor audits, peer audits, lectures, tutorials, research assignments, case reports, record-keeping templates, and checklists of required record components. The use of record audit as part of teaching and evaluation dominated these articles; it was used as the assessment method in five of the six studies. All methods of record-keeping training in studies published to date were found effective in improving student record-keeping skills. However, there was insufficient evidence to determine whether certain methods were more effective than others.

  3. Development, implementation, and evaluation of a hybrid electronic medical record system specifically designed for a developing world surgical service.

    Science.gov (United States)

    Laing, G L; Bruce, J L; Skinner, D L; Allorto, N L; Clarke, D L; Aldous, C

    2014-06-01

    The Pietermaritzburg Metropolitan Trauma Service previously successfully constructed and implemented an electronic surgical registry (ESR). This study reports on our attempts to expand and develop this concept into a multi-functional hybrid electronic medical record (HEMR) system for use in a tertiary level surgical service. This HEMR system was designed to incorporate the function and benefits of an ESR, an electronic medical record (EMR) system, and a clinical decision support system (CDSS). Formal ethical approval to maintain the HEMR system was obtained. Appropriate software was sourced to develop the project. The data model was designed as a relational database. Following the design and construction process, the HEMR file was launched on a secure server. This provided the benefits of access security and automated backups. A systematic training program was implemented for client training. The exercise of data capture was integrated into the process of clinical workflow, taking place at multiple points in time. Data were captured at the times of admission, operative intervention, endoscopic intervention, adverse events (morbidity), and the end of patient care (discharge, transfer, or death). A quarterly audit was performed 3 months after implementation of the HEMR system. The data were extracted and audited to assess their quality. A total of 1,114 patient entries were captured in the system. Compliance rates were in the order of 87-100 %, and client satisfaction rates were high. It is possible to construct and implement a unique, simple, cost-effective HEMR system in a developing world surgical service. This information system is unique in that it combines the discrete functions of an EMR system with an ESR and a CDSS. We identified a number of potential limitations and developed interventions to ameliorate them. This HEMR system provides the necessary platform for ongoing quality improvement programs and clinical research.

  4. Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness.

    Science.gov (United States)

    Bramesfeld, A; Stegbauer, C

    2016-10-01

    The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

  5. Assessment of COPD-related outcomes via a national electronic medical record database.

    Science.gov (United States)

    Asche, Carl; Said, Quayyim; Joish, Vijay; Hall, Charles Oaxaca; Brixner, Diana

    2008-01-01

    The technology and sophistication of healthcare utilization databases have expanded over the last decade to include results of lab tests, vital signs, and other clinical information. This review provides an assessment of the methodological and analytical challenges of conducting chronic obstructive pulmonary disease (COPD) outcomes research in a national electronic medical records (EMR) dataset and its potential application towards the assessment of national health policy issues, as well as a description of the challenges or limitations. An EMR database and its application to measuring outcomes for COPD are described. The ability to measure adherence to the COPD evidence-based practice guidelines, generated by the NIH and HEDIS quality indicators, in this database was examined. Case studies, before and after their publication, were used to assess the adherence to guidelines and gauge the conformity to quality indicators. EMR was the only source of information for pulmonary function tests, but low frequency in ordering by primary care was an issue. The EMR data can be used to explore impact of variation in healthcare provision on clinical outcomes. The EMR database permits access to specific lab data and biometric information. The richness and depth of information on "real world" use of health services for large population-based analytical studies at relatively low cost render such databases an attractive resource for outcomes research. Various sources of information exist to perform outcomes research. It is important to understand the desired endpoints of such research and choose the appropriate database source.

  6. Complaints and compliments assessment in developing service delivery measurement

    Directory of Open Access Journals (Sweden)

    Norshahrizan Nordin

    2018-05-01

    Full Text Available Excellent healthcare services delivered to patients would not necessarily entail an excellent patient service fulfillment, fulfill patient expectations, and attain high satisfaction levels. Hence, patient satisfaction is multifactorial and difficult to measure. Appliance of satisfaction model, service dissatisfaction and satisfaction feedback are able to translate the nonlinear attributes for a more accurate service dissatisfaction and satisfaction feedback assessment. Service recipients of experienced Inpatient and Outpatient (IOPs can be translated into levels of compliments and complaints to describe degrees of patient satisfaction and dissatisfaction, respectively. Compliments and complaints voiced by patients should be taken seriously. As a result, the translation of service satisfaction and service dissatisfaction based on compliments and complaints from patients in the form of satisfaction index SCi and dissatisfaction index SCa introduced a new theoretical concept of concurrent and balance measurement in evaluating customer (VOC or VOPs feedback. In normal practice, the service improvement is usually based on complaints or dissatisfaction aspect, but the compliments or satisfaction aspect on the same service delivery was always neglected. In this study, the formulation which was based on a non-linear assessment, not only amplified the effectiveness in communicating patients’ compliments and complaints in a more receptive manner but also corresponded with Kano model.

  7. Nesting behavior of Palila, as assessed from video recordings

    Science.gov (United States)

    Laut, M.E.; Banko, P.C.; Gray, E.M.

    2003-01-01

    We quantified nesting behavior of Palila (Loxiodes bailleui), an endangered Hawaiian honeycreeper, by recording at nests during three breeding seasons using a black-and-white video camera connected to a Videocassette recorder. A total of seven nests was observed. We measured the following factors for daylight hours: percentage of time the female was on the nest (attendance), length of attendance bouts by the female, length of nest recesses, and adult provisioning rates. Comparisons were made between three stages of the 40-day nesting cycle: incubation (day 1-day 16), early nestling stage (day 17-day 30 [i.e., nestlings ??? 14 days old]), and late nestling stage (day 31-day 40 [i.e., nestlings > 14 days old]). Of seven nests observed, four fledged at least one nestling and three failed. One of these failed nests was filmed being depredated by a feral cat (Felis catus). Female nest attendance was near 82% during the incubation stage and decreased to 21% as nestlings aged. We did not detect a difference in attendance bout length between stages of the nesting cycle. Mean length of nest recesses increased from 4.5 min during the incubation stage to over 45 min during the late nestling stage. Mean number of nest recesses per hour ranged from 1.6 to 2.0. Food was delivered to nestlings by adults an average of 1.8 times per hour for the early nestling stage and 1.5 times per hour during the late nestling stage and did not change over time. Characterization of parental behavior by video had similarities to but also key differences from findings taken from blind observations. Results from this study will facilitate greater understanding of Palila reproductive strategies.

  8. Assessing the record and causes of Late Triassic extinctions

    Science.gov (United States)

    Tanner, L.H.; Lucas, S.G.; Chapman, M.G.

    2004-01-01

    Accelerated biotic turnover during the Late Triassic has led to the perception of an end-Triassic mass extinction event, now regarded as one of the "big five" extinctions. Close examination of the fossil record reveals that many groups thought to be affected severely by this event, such as ammonoids, bivalves and conodonts, instead were in decline throughout the Late Triassic, and that other groups were relatively unaffected or subject to only regional effects. Explanations for the biotic turnover have included both gradualistic and catastrophic mechanisms. Regression during the Rhaetian, with consequent habitat loss, is compatible with the disappearance of some marine faunal groups, but may be regional, not global in scale, and cannot explain apparent synchronous decline in the terrestrial realm. Gradual, widespread aridification of the Pangaean supercontinent could explain a decline in terrestrial diversity during the Late Triassic. Although evidence for an impact precisely at the boundary is lacking, the presence of impact structures with Late Triassic ages suggests the possibility of bolide impact-induced environmental degradation prior to the end-Triassic. Widespread eruptions of flood basalts of the Central Atlantic Magmatic Province (CAMP) were synchronous with or slightly postdate the system boundary; emissions of CO2 and SO2 during these eruptions were substantial, but the contradictory evidence for the environmental effects of outgassing of these lavas remains to be resolved. A substantial excursion in the marine carbon-isotope record of both carbonate and organic matter suggests a significant disturbance of the global carbon cycle at the system boundary. Release of methane hydrates from seafloor sediments is a possible cause for this isotope excursion, although the triggering mechanism and climatic effects of such a release remain uncertain. ?? 2003 Elsevier B.V. All rights reserved.

  9. Assessment of the administration of healthcare service delivery in ...

    African Journals Online (AJOL)

    The study examined the structure and mode of administration in Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria; and also assessed the impact of the structure and mode of administration on the service delivery in the hospital. These were with a view to assessing the administration of healthcare ...

  10. Assessing customer satisfaction for improving NOAA's climate products and services

    Science.gov (United States)

    Meyers, J. C.; Hawkins, M. D.; Timofeyeva, M. M.

    2009-12-01

    NOAA's National Weather Service (NWS) Climate Services Division (CSD) is developing a comprehensive climate user requirements process with the ultimate goal of producing climate services that meet the needs of NWS climate information users. An important part of this effort includes engaging users through periodical surveys conducted by the Claes Fornell International (CFI) Group using the American Customer Satisfaction Index (ACSI). The CFI Group conducted a Climate Services Satisfaction (CSS) Survey in May of 2009 to measure customer satisfaction with current products and services and to gain insight on areas for improvement. The CSS Survey rates customer satisfaction on a range of NWS climate services data and products, including Climate Prediction Center (CPC) outlooks, drought monitoring, and ENSO monitoring and forecasts, as well as NWS local climate data services. In addition, the survey assesses the users of the products to give the NWS insight into its climate customer base. The survey also addresses specific topics such as NWS forecast category names, probabilistic nature of climate products, and interpretation issues. The survey results identify user requirements for improving existing NWS climate services and introducing new ones. CSD will merge the survey recommendations with available scientific methodologies and operational capabilities to develop requirements for improved climate products and services. An overview of the 2009 survey results will be presented, such as users' satisfaction with the accuracy, reliability, display and functionality of products and services.

  11. 78 FR 28622 - Notice of Approval of Record of Decision for Extending F-Line Streetcar Service to Fort Mason...

    Science.gov (United States)

    2013-05-15

    ...] Notice of Approval of Record of Decision for Extending F-Line Streetcar Service to Fort Mason Center... Environmental Impact Statement (Final EIS) for extending the F-Line historic streetcar service to Fort Mason... turnaround terminus at the Fort Mason Center; and installing appurtenant features such as signals, crossings...

  12. Improving Service Coordination and Reducing Mental Health Disparities Through Adoption of Electronic Health Records.

    Science.gov (United States)

    McGregor, Brian; Mack, Dominic; Wrenn, Glenda; Shim, Ruth S; Holden, Kisha; Satcher, David

    2015-09-01

    Despite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients' privacy and confidentiality. However, these goals must not detract from continuing to challenge the notion that behavioral health and general medical health should be treated as separate and distinct. Ultimately, utilization of EHRs among behavioral health care providers will improve the coordination of services and overall patient care, which is essential to reducing mental health disparities.

  13. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

    Hamel, D.R. [Department of Agriculture-Forest Service, Washington, DC (United States)

    1990-12-31

    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  14. A systematic map of ecosystem services assessments around European agroforestry

    DEFF Research Database (Denmark)

    Fagerholm, Nora; Torralba Viorreta, Mario; Burgess, Paul J.

    2016-01-01

    the knowledge field and provide the first systematic synthesis of ecosystem services research in relation to European agroforestry. We reviewed 71 scientific publications from studies conducted in farmland and forest ecosystems with various types of agroforestry management. Each publication was systematically......, typical clusters of similar research approaches were identified. The results show that ecosystem service assessment of European agroforestry is currently focused on the spatially extensive wood pastures in the Mediterranean, Atlantic, and Continental agricultural mosaic landscapes. A specific emphasis has...

  15. Data records of biophysical products in the Copernicus Global Land Service

    Science.gov (United States)

    Bydekerke, L.; Smets, B.; Swinnen, E.; Lacaze, R. N.; Calvet, J. C.; Baret, F.; camacho De Coca, F.; Roujean, J. L.; Tansey, K.; Coelho, S.; Jann, A.; Paulik, C.; Verger, A.

    2014-12-01

    From 1stJanuary 2013, the Copernicus Global Land service provides continuously a set of bio-geophysical variables describing, over the whole globe, the vegetation dynamic, the energy budget at the continental surface and some components of the water cycle. These generic products serve numerous applications such as agriculture and food security monitoring, weather forecast, climate change impact studies, water, forest and natural resources management. The portfolio contains Essential Climate Variables like Leaf Area Index (LAI), the Fraction of PAR absorbed by the vegetation (FAPAR), surface albedo, Land Surface Temperature, soil moisture, burnt areas, areas of water bodies, and additional vegetation indices. They are generated daily on a reliable and automatic basis from Earth Observation satellite data. Beside this timely production, the available historical archives, up to 16 years for SPOT-VEGETATION, have been processed using the same innovative algorithms. For a number of ECVs, the algorithms are adapted to work with NOAA-AVHRR as input to extend the time series up to 1982. The service continuity is provided in two parallel paths. On one hand, the existing retrieval methodologies are adapted to use the new PROBA-V sensor, fully consistent with SPOT-VEGETATION, and as such extends the time-series at 1km spatial resolution. On the other hand, the operation is moving to the finer resolution of PROBA-V (300m), while maintaining consistency with the 1km series. The data records are documented in terms of the physical methodologies, the technical properties, and the results of validation exercises. The service performs a continuous quality monitoring on three levels: technical, scientific and cross-cutting, following where possible the rules of CEOS/LPV and comparing with both in-situ and other datasets, e.g. MODIS. The service is improved through feedback from an independent expert team performing regular independent reviews and providing user feedback. All

  16. A service for the application of data quality information to NASA earth science satellite records

    Science.gov (United States)

    Armstrong, E. M.; Xing, Z.; Fry, C.; Khalsa, S. J. S.; Huang, T.; Chen, G.; Chin, T. M.; Alarcon, C.

    2016-12-01

    A recurring demand in working with satellite-based earth science data records is the need to apply data quality information. Such quality information is often contained within the data files as an array of "flags", but can also be represented by more complex quality descriptions such as combinations of bit flags, or even other ancillary variables that can be applied as thresholds to the geophysical variable of interest. For example, with Level 2 granules from the Group for High Resolution Sea Surface Temperature (GHRSST) project up to 6 independent variables could be used to screen the sea surface temperature measurements on a pixel-by-pixel basis. Quality screening of Level 3 data from the Soil Moisture Active Passive (SMAP) instrument can be become even more complex, involving 161 unique bit states or conditions a user can screen for. The application of quality information is often a laborious process for the user until they understand the implications of all the flags and bit conditions, and requires iterative approaches using custom software. The Virtual Quality Screening Service, a NASA ACCESS project, is addressing these issues and concerns. The project has developed an infrastructure to expose, apply, and extract quality screening information building off known and proven NASA components for data extraction and subset-by-value, data discovery, and exposure to the user of granule-based quality information. Further sharing of results through well-defined URLs and web service specifications has also been implemented. The presentation will focus on overall description of the technologies and informatics principals employed by the project. Examples of implementations of the end-to-end web service for quality screening with GHRSST and SMAP granules will be demonstrated.

  17. An Assessment of Recovsat Utilization for Different Service Typologies

    Directory of Open Access Journals (Sweden)

    Zulema Lopes Pereira

    2012-12-01

    Full Text Available This piece of research is focused on service recovery and uses the RECOVSAT instrument to obtain data from a sample of complaining customers. The study comprises three main stages. The first stage includes a descriptive analysis of the incidence and consequences of complaints in several categories of services. A Factor Analysis is performed in the second stage to compare the factor structure that emerged from the obtained data with that proposed by RECOVSAT. Finally, several regression models are used in the last stage to assess the influence of service recovery dimensions on the overall satisfaction, intention to repurchase and recommendation.

  18. Emergency residential care settings: A model for service assessment and design.

    Science.gov (United States)

    Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

    2018-02-01

    There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

    Directory of Open Access Journals (Sweden)

    Freda Mold

    2015-12-01

    Full Text Available Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1 Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2 Whether online access to records improves patient safety and health outcomes; (3 Whether record access increases disparities across social classes and between genders; and (4 Improving efficiency. The challenges for practice are: (1 How to incorporate online access into clinical workflow; (2 The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

  20. 17 CFR 250.93 - Accounts and records of mutual and subsidiary service companies.

    Science.gov (United States)

    2010-04-01

    ..., memoranda, papers, books, and other records in such manner and preserve them for such periods, as are... (a) records other than accounts, (b) records required by state law, (c) subaccounts or supporting...

  1. Assessing Interprofessional Education Collaborative Competencies in Service-Learning Course.

    Science.gov (United States)

    Sevin, Alexa M; Hale, Kenneth M; Brown, Nicole V; McAuley, James W

    2016-03-25

    Objective. To investigate the effect of an interprofessional service-learning course on health professions students' self-assessment of Interprofessional Education Collaborative (IPEC) competencies. Design. The semester-long elective course consisted of two components: a service component where students provided patient care in an interprofessional student-run free clinic and bi-weekly workshops in which students reflected on their experiences and discussed roles, team dynamics, communication skills, and challenges with underserved patient populations. Assessment. All fifteen students enrolled in the course completed a validated 42-question survey in a retrospective post-then-pre design. The survey instrument assessed IPEC competencies in four domains: Values and Ethics, Roles and Responsibilities, Interprofessional Communication, and Teams and Teamwork. Students' self-assessment of IPEC competencies significantly improved in all four domains after completion of the course. Conclusion. Completing an interprofessional service-learning course had a positive effect on students' self-assessment of interprofessional competencies, suggesting service-learning is an effective pedagogical platform for interprofessional education.

  2. Assessing the demographic and public service impacts of repository siting

    International Nuclear Information System (INIS)

    Murdock, S.H.; Hamm, R.R.

    1983-01-01

    Demographic and public service impacts are likely to be among the most evident of those changes resulting from nuclear waste repository development. Knowledge of the characteristics of such impacts and of the means to assess them is critical. The first section of this chapter examines those likely to be unique to repositories. The second section describes the alternatives for assessing such impacts and the particular difficulties likely to affect the assessments. Given the state of development of techniques for assessing impacts and the range of factors that must be considered, perhaps their best use is as a means of sensitizing decision makers to the potential implications of their decisions. 2 tables

  3. A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

    Science.gov (United States)

    Plever, Sally; McCarthy, Irene; Anzolin, Melissa; Emmerson, Brett; Khatun, Mohsina

    2016-02-01

    The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland. Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service. Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%. Significant improvements were made over a 3-year period by all mental health services involved in the collaborative, supporting the application of a quality improvement methodology to drive change across mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  4. Family Health Strategy: assessment and reasons for searching of health service by users

    Directory of Open Access Journals (Sweden)

    Loeste de Arruda-Barbosa

    2011-12-01

    Full Text Available Objective: To assess the evaluation of the users regarding the family health services and identify the main reasons that led them to seek such services. Methods: A descriptive study with qualitative approach, carried out in 5 Family Health Units with 25 users of theFamily Health Strategy (FHS of the city of Crato-CE, Brazil. The study took place from March to April 2009. Semi-structured interview was applied and recorded. We used thetechnique of thematic content analysis. Results: We found that the users of the FHS have great dissatisfaction, especially on the organization and access to health services, evaluating the family health as inefficient, although bringing care closer to the population, primarily through home visits. It was clear also that there is a search to the service mainly supported by curative vision and the acquisition of medicines. Conclusions: The subjects evaluate the organization and access to healthcare services as unsatisfactory, but value the actions, when there is a bond with the health team. However, there is still demand for health services, based on the search for medicines and medical consultation. Thus, it is necessary to improve services of the Family Health Strategy in Crato, with a view to ensure quality, accessibilityand greater resolution of health services.

  5. Efficiency Assessment of Inbound Tourist Service Using Data Envelopment Analysis

    Directory of Open Access Journals (Sweden)

    Han-Shen Chen

    2018-06-01

    Full Text Available The successful and sustainable development of inbound tourism necessitates a long-term commitment, balancing between tourism supply and tourist demands. This study manipulated a performance appraisal of tourism service quality in Taiwan with Data Envelopment Analysis (DEA by employing input and output constructs to assess service quality efficiency. The empirical results of the estimation of technical efficiency (TE revealed that (1 the domestic tourism market is competitive, but still needs enhancements for tourism service; (2 Mainland Chinese tourists had the highest score among all foreign tourists, followed by Hong Kong and Macau tourists, tourists from other countries, Japanese tourists, and South Korean tourists; and (3 South Korean tourists had higher travel expenditure than others, but felt less satisfaction with travel services, which can be regarded as inefficient. Tourists from other countries had lower travel expenditure, but had higher satisfaction levels, which was considered efficient based on input and output index. The findings could contribute to bridging the gap between research and practice in assessing the efficiency of inbound tourist service. Tourism practitioners should be aware of tourists’ needs and interests, as these could be key fundamentals for improving tourists’ satisfaction with Taiwan’s service offerings.

  6. Worldwide telemedicine services based on distributed multimedia electronic patient records by using the second generation Web server hyperwave.

    Science.gov (United States)

    Quade, G; Novotny, J; Burde, B; May, F; Beck, L E; Goldschmidt, A

    1999-01-01

    A distributed multimedia electronic patient record (EPR) is a central component of a medicine-telematics application that supports physicians working in rural areas of South America, and offers medical services to scientists in Antarctica. A Hyperwave server is used to maintain the patient record. As opposed to common web servers--and as a second generation web server--Hyperwave provides the capability of holding documents in a distributed web space without the problem of broken links. This enables physicians to browse through a patient's record by using a standard browser even if the patient's record is distributed over several servers. The patient record is basically implemented on the "Good European Health Record" (GEHR) architecture.

  7. The Electronic Health Record Objective Structured Clinical Examination: Assessing Student Competency in Patient Interactions While Using the Electronic Health Record.

    Science.gov (United States)

    Biagioli, Frances E; Elliot, Diane L; Palmer, Ryan T; Graichen, Carla C; Rdesinski, Rebecca E; Ashok Kumar, Kaparaboyna; Galper, Ari B; Tysinger, James W

    2017-01-01

    Because many medical students do not have access to electronic health records (EHRs) in the clinical environment, simulated EHR training is necessary. Explicitly training medical students to use EHRs appropriately during patient encounters equips them to engage patients while also attending to the accuracy of the record and contributing to a culture of information safety. Faculty developed and successfully implemented an EHR objective structured clinical examination (EHR-OSCE) for clerkship students at two institutions. The EHR-OSCE objectives include assessing EHR-related communication and data management skills. The authors collected performance data for students (n = 71) at the first institution during academic years 2011-2013 and for students (n = 211) at the second institution during academic year 2013-2014. EHR-OSCE assessment checklist scores showed that students performed well in EHR-related communication tasks, such as maintaining eye contact and stopping all computer work when the patient expresses worry. Findings indicated student EHR skill deficiencies in the areas of EHR data management including medical history review, medication reconciliation, and allergy reconciliation. Most students' EHR skills failed to improve as the year progressed, suggesting that they did not gain the EHR training and experience they need in clinics and hospitals. Cross-institutional data comparisons will help determine whether differences in curricula affect students' EHR skills. National and institutional policies and faculty development are needed to ensure that students receive adequate EHR education, including hands-on experience in the clinic as well as simulated EHR practice.

  8. New technology in dietary assessment: a review of digital methods in improving food record accuracy.

    Science.gov (United States)

    Stumbo, Phyllis J

    2013-02-01

    Methods for conducting dietary assessment in the United States date back to the early twentieth century. Methods of assessment encompassed dietary records, written and spoken dietary recalls, FFQ using pencil and paper and more recently computer and internet applications. Emerging innovations involve camera and mobile telephone technology to capture food and meal images. This paper describes six projects sponsored by the United States National Institutes of Health that use digital methods to improve food records and two mobile phone applications using crowdsourcing. The techniques under development show promise for improving accuracy of food records.

  9. Structural condition assessment of in-service wood

    Science.gov (United States)

    Robert J. Ross; Brian K. Brashaw; Xiping Wang

    2006-01-01

    Wood is used extensively for both interior and exterior applications in the construction of a variety of structures (residential, agricultural, commercial, government, religious). The deterioration of an in-service wood member may result from a variety of causes during the life of a structure. It is important, therefore, to periodically assess the condition of wood...

  10. Assessment of resources and services of the Nigerian Arabic ...

    African Journals Online (AJOL)

    The study assessed resources and services of the Nigeria Arabic Language Village (NALV) Library, Ngala. Four objectives and four research questions guided the study. Survey research design was adopted. The target population of the study was 1,030, out of which, 206 was drawn as the sample for the study. The data ...

  11. Integrated assessment of ecosystem services in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Frélichová, Jana; Vačkář, David; Pártl, Adam; Loučková, Blanka; Lorencová, Eliška

    2014-01-01

    Roč. 8, jun (2014), s. 110-117 ISSN 2212-0416 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0073; GA TA ČR TD010066 Institutional support: RVO:67179843 Keywords : ecosystems * ecosystem services * integrated assessment * database * valuation * Czech Republic Subject RIV: EH - Ecology, Behaviour

  12. The individualised needs for service assessment (INSA) for children ...

    African Journals Online (AJOL)

    Drawing on a similar logic structure to that characterising the Needs for Care Assessment of the British Medical Research Council, these data are linked to produce a need status, for example unmet need, no need and met need. The INSA may be suitable for use by service providers, planners, policy makers, researchers, ...

  13. Assessing users satisfaction with service quality in Slovenian public library

    Directory of Open Access Journals (Sweden)

    Igor Podbrežnik

    2016-07-01

    Full Text Available Purpose: A research was made into user satisfaction with regard to the quality of library services in one of the Slovenian public libraries. The aim was to establish the type of service quality level actually expected by the users, and to determine their satisfaction with the current quality level of available library services.Methodology: The research was performed by means of the SERVQUAL measuring tool which was used to determine the size and direction of the gap between the detected and the expected quality of library services among public library users.Results: Different groups of users provide different assessments of specific quality factors, and a library cannot satisfy the expectations of each and every user if most quality factors display discrepancies between the estimated perception and expectations. The users expect more reliable services and more qualified library staff members who would understand and allocate time for each user’s individual needs. The largest discrepancies from the expectations are detected among users in the under-35 age group and among the more experienced and skilled library users. The results of factor analysis confirm the fact that a higher number of quality factors can be explained by three common factors affecting the satisfaction of library users. A strong connection between user satisfaction and their assessment of the integral quality of services and loyalty has been established.Research restrictions: The research results should not be generalised and applied to all Slovenian public libraries since they differ in many important aspects. In addition, a non-random sampling method was used.Research originality/Applicability: The conducted research illustrates the use of a measuring tool that was developed with the aim of determining the satisfaction of users with the quality of library services in Slovenian public libraries. Keywords: public library, user satisfaction, quality of library services, user

  14. A review of electronic medical record keeping on mobile medical service trips in austere settings.

    Science.gov (United States)

    Dainton, Christopher; Chu, Charlene H

    2017-02-01

    Electronic medical records (EMRs) may address the need for decision and language support for Western clinicians on mobile medical service trips (MSTs) in low resource settings abroad, while providing improved access to records and data management. However, there has yet to be a review of this emerging technology used by MSTs in low-resource settings. The aim of this study is to describe EMR systems designed specifically for use by mobile MSTs in remote settings, and accordingly, determine new opportunities for this technology to improve quality of healthcare provided by MSTs. A MEDLINE, EMBASE, and Scopus/IEEE search and supplementary Google search were performed for EMR systems specific to mobile MSTs. Information was extracted regarding EMR name, organization, scope of use, platform, open source coding, commercial availability, data integration, and capacity for linguistic and decision support. Missing information was requested by email. After screening of 122 abstracts, two articles remained that discussed deployment of EMR systems in MST settings (iChart, SmartList To Go), and thirteen additional EMR systems were found through the Google search. Of these, three systems (Project Buendia, TEBOW, and University of Central Florida's internally developed EMR) are based on modified versions of Open MRS software, while three are smartphone apps (QuickChart EMR, iChart, NotesFirst). Most of the systems use a local network to manage data, while the remaining systems use opportunistic cloud synchronization. Three (TimmyCare, Basil, and Backpack EMR) contain multilingual user interfaces, and only one (QuickChart EMR) contained MST-specific clinical decision support. There have been limited attempts to tailor EMRs to mobile MSTs. Only Open MRS has a broad user base, and other EMR systems should consider interoperability and data sharing with larger systems as a priority. Several systems include tablet compatibility, or are specifically designed for smartphone, which may be

  15. Leading change: introducing an electronic medical record system to a paramedic service.

    Science.gov (United States)

    Baird, Shawn; Boak, George

    2016-05-03

    Purpose Leaders in health-care organizations introducing electronic medical records (EMRs) face implementation challenges. The adoption of EMR by the emergency medical and ambulance setting is expected to provide wide-ranging benefits, but there is little research into the processes of adoption in this sector. The purpose of this study is to examine the introduction of EMR in a small emergency care organization and identify factors that aided adoption. Design/methodology/approach Semi-structured interviews with selected paramedics were followed up with a survey issued to all paramedics in the company. Findings The user interfaces with the EMR, and perceived ease of use, were important factors affecting adoption. Individual paramedics were found to have strong and varied preferences about how and when they integrated the EMR into their practice. As company leadership introduced flexibility of use, this enhanced both individual and collective ability to make sense of the change and removed barriers to acceptance. Research limitations/implications This is a case study of one small organization. However, there may be useful lessons for other emergency care organizations adopting EMR. Practical implications Leaders introducing EMR in similar situations may benefit from considering a sense-making perspective and responding promptly to feedback. Originality/value The study contributes to a wider understanding of issues faced by leaders who seek to implement EMRs in emergency medical services, a sector in which there has been to date very little research on this issue.

  16. Assessing the market for long-term care services.

    Science.gov (United States)

    Rice, J A; Taylor, S

    1984-02-01

    Traditionally, long-term care services have been used by a diverse marketplace. The chronically ill, developmentally disabled, mentally ill and aging population has looked to long-term care support services as a means of physical and emotional support. Much of the time these services were housed together for the sake of efficiency. The enormous burden these services are creating on the economy, and the growing aging population, have forced the recognition that long-term care service delivery systems must change. Alternate programming for long-term care services that reach out into the community and into individual homes is becoming an attractive approach to meeting the growing demands of the marketplace. Home health, specialized housing and creative funding mechanisms such as HMOs, are examples of initiatives undertaken by healthcare organizations that view diversification as a vehicle for survival. Market research techniques that have been used in other industries are being adapted to the healthcare industry to ensure the proper mix of services that are demanded by older, more knowledgeable consumers. The programs of the future will be market driven, with the ability of the individual to pay for such services playing a significant role. The healthcare provider of today is in a position to serve the community in new ways. By becoming an integral link in the long-term care system and by developing new programs, the organization can serve as a catalyst for change. It is up to the governing bodies and managers of these facilities to become visionaries and to accept responsibility for assessing the market for long-term care services and to guide their organization into the future.

  17. Patient-perceived hospital service quality: an empirical assessment.

    Science.gov (United States)

    Pai, Yogesh P; Chary, Satyanarayana T; Pai, Rashmi Yogesh

    2018-02-12

    Purpose The purpose of this paper is to appraise Pai and Chary's (2016) conceptual framework for measuring patient-perceived hospital service quality (HSQ). Design/methodology/approach A structured questionnaire was used to obtain data from teaching, public and corporate hospital patients. Several tests were conducted to assess the instrument's reliability and validity. Pai and Chary's (2016) nine dimensions for measuring HSQ were examined in this paper. Findings The tests confirm that Pai and Chary's (2016) conceptual framework is reliable and valid. The study also establishes that the nine dimensions measure HSQ. Practical implications The framework empowers managers to assess service quality in any hospital settings, corporate, public and teaching, using an approach that is superior to the existing HSQ scales. Originality/value This paper helps researchers and practitioners to assess HSQ from patient perspectives in any hospital setting.

  18. The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.

    Science.gov (United States)

    Mold, Freda; Ellis, Beverley; de Lusignan, Simon; Sheikh, Aziz; Wyatt, Jeremy C; Cavill, Mary; Michalakidis, Georgios; Barker, Fiona; Majeed, Azeem; Quinn, Tom; Koczan, Phil; Avanitis, Theo; Gronlund, Toto Anne; Franco, Christina; McCarthy, Mary; Renton, Zoë; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Jones, Simon; Rafi, Imran

    2012-01-01

    Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.

  19. 46 CFR 11.304 - Substitution of training for required service, use of training-record books, and use of towing...

    Science.gov (United States)

    2010-10-01

    ... training-record books, and use of towing officer assessment records. 11.304 Section 11.304 Shipping COAST... of training-record books, and use of towing officer assessment records. (a) Satisfactory completion... training of a candidate must be documented in a Coast Guard-accepted training-record book. (f) Except as...

  20. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Science.gov (United States)

    2012-01-01

    Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical

  1. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Directory of Open Access Journals (Sweden)

    Cashmore Aaron W

    2012-08-01

    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  2. The Westgate Service and Related Referral, Assessment, and Treatment Processes.

    Science.gov (United States)

    Bennett, Alice L

    2015-12-01

    The formerly named "Dangerous and Severe Personality Disorder" (DSPD) units are no longer standalone services within the criminal justice system in England and Wales. These sites now provide personality disorder treatment services in the high-security prison estate as part of the new national Offender Personality Disorder (OPD) Pathway Strategy. The OPD Pathway intends to take responsibility for the assessment, treatment, and management of offenders who are likely to have a personality disorder and who present a high risk of re-offending (men and women) and serious harm to others (men). Further PD treatment and progression services are being commissioned in lower security prisons and in the community as part of the new PD Strategy. While the suitability criteria for the two male high-security PD treatment sites are the same, the individual units have their own assessment and treatment methods. This article aims to communicate the referral, assessment, and treatment methods employed within the prison-based Westgate Personality Disorder Treatment Service, HMP Frankland. © The Author(s) 2014.

  3. Assessing Urban Forest Structure, Ecosystem Services, and Economic Benefits on Vacant Land

    Directory of Open Access Journals (Sweden)

    Gunwoo Kim

    2016-07-01

    Full Text Available An urban forest assessment is essential for developing a baseline from which to measure changes and trends. The most precise way to assess urban forests is to measure and record every tree on a site, but although this may work well for relatively small populations (e.g., street trees, small parks, it is prohibitively expensive for large tree populations. Thus, random sampling offers a cost-effective way to assess urban forest structure and the associated ecosystem services for large-scale assessments. The methodology applied to assess ecosystem services in this study can also be used to assess the ecosystem services provided by vacant land in other urban contexts and improve urban forest policies, planning, and the management of vacant land. The study’s findings support the inclusion of trees on vacant land and contribute to a new vision of vacant land as a valuable ecological resource by demonstrating how green infrastructure can be used to enhance ecosystem health and promote a better quality of life for city residents.

  4. ASSESSMENT OF LOGISTICS MANAGEMENT IN GHANA HEALTH SERVICE

    Directory of Open Access Journals (Sweden)

    john frimpong manso

    2013-08-01

    Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain.  Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system.  Two categories of participants that is, the key players of health logistics management and end-users were involved in the study.  Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the

  5. Assessing Satisfaction with Selected Student Services Using SERVQUAL, a Market-Driven Model of Service Quality.

    Science.gov (United States)

    Ruby, Carl A.

    1998-01-01

    Demonstrates how the use of SERVQUAL, a market-driven assessment model adapted from business, can be used to study student satisfaction with four areas of support services hypothetically related to enrollment management. The sample included 748 students enrolled in general education courses at ten different private institutions. (Contains 27…

  6. Record of Assessment Moderation Practice (RAMP): Survey Software as a Mechanism of Continuous Quality Improvement

    Science.gov (United States)

    Johnson, Genevieve Marie

    2015-01-01

    In higher education, assessment integrity is pivotal to student learning and satisfaction, and, therefore, a particularly important target of continuous quality improvement. This paper reports on the preliminary development and application of a process of recording and analysing current assessment moderation practices, with the aim of identifying…

  7. Assessing family planning service-delivery skills in Kenya.

    Science.gov (United States)

    Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

    1997-06-01

    This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

  8. Assessing the implementation of a bedside service handoff on an academic hospitalist service.

    Science.gov (United States)

    Wray, Charlie M; Arora, Vineet M; Hedeker, Donald; Meltzer, David O

    2018-06-01

    Inpatient service handoffs are a vulnerable transition during a patients' hospitalization. We hypothesized that performing the service handoff at the patients' bedside may be one mechanism to more efficiently transfer patient information between physicians, while further integrating the patient into their hospital care. We performed a 6-month prospective study of performing a bedside handoff (BHO) at the service transition on a non-teaching hospitalist service. On a weekly basis, transitioning hospitalists co-rounded at patient's bedsides. Post-handoff surveys assessed for completeness of handoff, communication, missed information, and adverse events. A control group who performed the handoff via email, phone or face-to-face was also surveyed. Chi-square and item-response theory (IRT) analysis assessed for differences between BHO and control groups. Narrative responses were elicited to qualitatively describe the BHO. In total, 21/31 (67%) scheduled BHOs were performed. On average, 4 out of 6 eligible patients experienced a BHO, with a total of 90 patients experiencing a BHO. Of those asked to perform the BHO, 52% stated the service transition took 31-60 min compared to 24% in the control group. Controlling for the nesting of observations within physicians, IRT analysis found that BHO respondents had statistically significant greater odds of: reporting increased patient awareness of the service handoff, more certainty in the plan for each patient, less discovery of missed information, and less time needed to learn about the patient on the first day compared to control methods. Narrative responses described a more patient-centered handoff with improved communication that was time-consuming and often logistically difficult to implement. Despite its time-intensive nature, performing the service handoff at the patient's bedside may lead to a more complete and efficient service transition. Published by Elsevier Inc.

  9. Assessing Dryland Ecosystem Services in Xinjiang, Northwest China

    Science.gov (United States)

    Siew, T. F.; Brauman, K. A.; Zuo, L.; Doll, P. M.

    2014-12-01

    Dryland ecosystems, including grassland, forest, and irrigated cropland, cover about 41% of earth's land area and are inhabited by over two billion people. In drylands, particularly arid and semiarid areas, the production of ecosystem services is primarily constrained by freshwater availability. Often, water allocated to production by one ecosystem or of one ecosystem service negatively impacts other ecosystems or ecosystem services (ESS). The challenge is to determine how much water should be allocated to which ecosystems (natural and manmade) such that multiple ESS are maximized, thus improving overall well-being. This strategic management decision must be supported by knowledge about spatial and temporal availability of water and its relationship to production (location and scale) of ESS that people receive. We assess the spatial and temporal relationships between water availability and ESS production in Xinjiang, Northwest China. We address four questions: (1) What services are produced by which ecosystems with water available? (2) Where are these services produced? (3) Who uses the services produced? (4) How the production of services changes with variability of water available? Using existing global, national, and regional spatial and statistical data, we assess food, fiber, livestock, and wood production as well as unique forest landscapes (as a proxy for aesthetic appreciation and habitats for unique animals and plants) and protection from dust storms. Irrigation is necessary for crop production in Xinjiang. The production of about 4.2 million tons of wheat and 500,000 tons of cotton requires more than 2 km3 of water each year. This is an important source of food and income for local residents, but the diverted water has negative and potentially costly impacts on downstream forests that potentially provide aesthetic services and protection from dust. Our analyses also show that cropland had increased by about 1.6 million ha from 1987 to 2010, while

  10. Automated signal quality assessment of mobile phone-recorded heart sound signals.

    Science.gov (United States)

    Springer, David B; Brennan, Thomas; Ntusi, Ntobeko; Abdelrahman, Hassan Y; Zühlke, Liesl J; Mayosi, Bongani M; Tarassenko, Lionel; Clifford, Gari D

    Mobile phones, due to their audio processing capabilities, have the potential to facilitate the diagnosis of heart disease through automated auscultation. However, such a platform is likely to be used by non-experts, and hence, it is essential that such a device is able to automatically differentiate poor quality from diagnostically useful recordings since non-experts are more likely to make poor-quality recordings. This paper investigates the automated signal quality assessment of heart sound recordings performed using both mobile phone-based and commercial medical-grade electronic stethoscopes. The recordings, each 60 s long, were taken from 151 random adult individuals with varying diagnoses referred to a cardiac clinic and were professionally annotated by five experts. A mean voting procedure was used to compute a final quality label for each recording. Nine signal quality indices were defined and calculated for each recording. A logistic regression model for classifying binary quality was then trained and tested. The inter-rater agreement level for the stethoscope and mobile phone recordings was measured using Conger's kappa for multiclass sets and found to be 0.24 and 0.54, respectively. One-third of all the mobile phone-recorded phonocardiogram (PCG) signals were found to be of sufficient quality for analysis. The classifier was able to distinguish good- and poor-quality mobile phone recordings with 82.2% accuracy, and those made with the electronic stethoscope with an accuracy of 86.5%. We conclude that our classification approach provides a mechanism for substantially improving auscultation recordings by non-experts. This work is the first systematic evaluation of a PCG signal quality classification algorithm (using a separate test dataset) and assessment of the quality of PCG recordings captured by non-experts, using both a medical-grade digital stethoscope and a mobile phone.

  11. Patients' quality assessment of ambulatory obstetric and gynaecological services.

    Science.gov (United States)

    Bojar, I; Wdowiak, L; Ostrowski, T

    2005-01-01

    The quality could be assessed from two perspectives: internal and external. From the internal perspective the quality means being consistent with particular conditions and standards. The external perspective is based on relative assessment of the product made by a client who is also aware of other competitors' offer. Despite the professional assessment which is focused on providing health services according to medical and managerial correctness, patient's assessment is also relevant. Measuring patient's satisfaction is additional method of health services quality assessment. The aim of the study was to estimate patients' opinion on quality of ambulatory obstetric and gynaecological services. The study was conducted in 11 obstetric and gynaecological out-patient clinics of Lublin in September and October 2003. The study tool was an author's questionnaire. Patients were asked to assess such areas as registration before visit, their relationship with nurses and gynaecologists and other aspects of services provision like intimacy assurance and respecting Patient's Rights. The collected data was statistically analysed. 635 patients took part in the study. The biggest groups in the studied population were women at the age of 20-30 years, married, living in cities and secondary educated. It was found that around half of the population is satisfied and 2.2% of them are unsatisfied with the fact that they have chosen particular out-patient clinic. More than 70% of women had positive opinion of following aspects influencing general opinion about service quality: politness of reception desk staff, opening hours, the length of time before a patient is seen by the specialist, intimacy assurance and respect for Patient's Rights in the practice. 80% of patients were satisfied with the relationship with nurses and 3.3% were unsatisfied with it. Eight patients out of ten were satisfied with gynaecological care, less than 2% were unsatisfied. The studied women had also high opinion

  12. Assessment of Residential History Generation Using a Public-Record Database

    Directory of Open Access Journals (Sweden)

    David C. Wheeler

    2015-09-01

    Full Text Available In studies of disease with potential environmental risk factors, residential location is often used as a surrogate for unknown environmental exposures or as a basis for assigning environmental exposures. These studies most typically use the residential location at the time of diagnosis due to ease of collection. However, previous residential locations may be more useful for risk analysis because of population mobility and disease latency. When residential histories have not been collected in a study, it may be possible to generate them through public-record databases. In this study, we evaluated the ability of a public-records database from LexisNexis to provide residential histories for subjects in a geographically diverse cohort study. We calculated 11 performance metrics comparing study-collected addresses and two address retrieval services from LexisNexis. We found 77% and 90% match rates for city and state and 72% and 87% detailed address match rates with the basic and enhanced services, respectively. The enhanced LexisNexis service covered 86% of the time at residential addresses recorded in the study. The mean match rate for detailed address matches varied spatially over states. The results suggest that public record databases can be useful for reconstructing residential histories for subjects in epidemiologic studies.

  13. Record-keeping as an Alternative Method οf Assessment

    Directory of Open Access Journals (Sweden)

    Androniki Kouvdou

    2010-02-01

    Full Text Available The basic topic of this chapter is the description of an alternative method of assessment which supplements traditional objective techniques (i.e. testing, while counterbalancing their limitations. This alternative method, known as ‘record-keeping’, involves the systematic collection and recording of information about learner progress and aims at providing a more complete and valid formative assessment of their developmental abilities in specified areas. More particularly, this chapter presents a small-scale case study, which was carried out in the sixth grade of a primary school and lasted three months. The subjects of this case study were four twelve-year-old learners and its purpose was to investigate the potential of ‘record-keeping’ as an alternative method of assessing oracy skills in the foreign language. The data that derived from the case study reinforce the usefulness and validity of the particular method of assessment. The goals of the experimental assessment design, which entailed the recording and gradual development of learner oracy skills as well as the enhancement of motivation and awareness of their relevant sub-skills, were accomplished to a considerable degree. Additionally, the learners responded positively to the implemented assessment project, while being actively involved in it, which further substantiates its effectiveness. Alternative assessment, however, is a large area, whose full potential of implementation calls for further investigation.

  14. Wheelchair Seating Assessment and Intervention: A Comparison Between Telerehabilitation and Face-to-Face Service

    Science.gov (United States)

    Barlow, Ingrid G; Liu, Lili; Sekulic, Angela

    2009-01-01

    This study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10) and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural). Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen face-to-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete. PMID:25945159

  15. A Method for Assessing Quality of Service in Broadband Networks

    DEFF Research Database (Denmark)

    Bujlow, Tomasz; Riaz, M. Tahir; Pedersen, Jens Myrup

    2012-01-01

    Monitoring of Quality of Service (QoS) in high-speed Internet infrastructure is a challenging task. However, precise assessments must take into account the fact that the requirements for the given quality level are service-dependent. Backbone QoS monitoring and analysis requires processing of large...... taken from the description of system sockets. This paper proposes a new method for measuring the Quality of Service (QoS) level in broadband networks, based on our Volunteer-Based System for collecting the training data, Machine Learning Algorithms for generating the classification rules and application...... and provide C5.0 high-quality training data, divided into groups corresponding to different types of applications. It was found that currently existing means of collecting data (classification by ports, Deep Packet Inspection, statistical classification, public data sources) are not sufficient and they do...

  16. Let's Make a Movie: Investigating Pre-Service Teachers' Reflections on Using Video Recorded Role Playing Cases in Turkey

    Science.gov (United States)

    Koc, Mustafa

    2011-01-01

    This study examined the potential consequences of using student-filmed video cases in the study of classroom management in teacher education. Pre-service teachers in groups were engaged in video-recorded role playing to simulate classroom memoirs. Each group shared their video cases and interpretations in a class presentation. Qualitative data…

  17. Assessment of Patients’ Perception of Telemedicine Services Using the Service User Technology Acceptability Questionnaire

    Directory of Open Access Journals (Sweden)

    Claudio Dario

    2016-06-01

    Full Text Available Introduction: The purpose of this paper is to assess if similar telemedicine services integrated in the management of different chronic diseases are acceptable and well perceived by patients or if there are any negative perceptions. Theory and methods: Participants suffering from different chronic diseases were enrolled in Veneto Region and gathered into clusters. Each cluster received a similar telemedicine service equipped with different disease-specific measuring devices. Participants were patients with diabetes (n = 163, chronic obstructive pulmonary disease (n = 180, congestive heart failure (n = 140 and Cardiac Implantable Electronic Devices (n = 1635. The Service User Technology Acceptability Questionnaire (SUTAQ was initially translated, culturally adapted and pretested and subsequently used to assess patients’ perception of telemedicine. Data were collected after 3 months and after 12 months from the beginning of the intervention. Data for patients with implantable devices was collected only at 12 months. Results: Results at 12 months for all clusters are similar and assessed a positive perception of telemedicine. The SUTAQ results for clusters 2 (diabetes, 5 (COPD and 7 (CHF after 3 months of intervention were confirmed after 12 months. Conclusions: Telemedicine was perceived as a viable addition to usual care. A positive perception for telemedicine services isn’t a transitory effect, but extends over the course of time.

  18. Assessment of Patients' Perception of Telemedicine Services Using the Service User Technology Acceptability Questionnaire.

    Science.gov (United States)

    Dario, Claudio; Luisotto, Elena; Dal Pozzo, Enrico; Mancin, Silvia; Aletras, Vassilis; Newman, Stanton; Gubian, Lorenzo; Saccavini, Claudio

    2016-06-01

    The purpose of this paper is to assess if similar telemedicine services integrated in the management of different chronic diseases are acceptable and well perceived by patients or if there are any negative perceptions. Participants suffering from different chronic diseases were enrolled in Veneto Region and gathered into clusters. Each cluster received a similar telemedicine service equipped with different disease-specific measuring devices. Participants were patients with diabetes (n = 163), chronic obstructive pulmonary disease (n = 180), congestive heart failure (n = 140) and Cardiac Implantable Electronic Devices (n = 1635). The Service User Technology Acceptability Questionnaire (SUTAQ) was initially translated, culturally adapted and pretested and subsequently used to assess patients' perception of telemedicine. Data were collected after 3 months and after 12 months from the beginning of the intervention. Data for patients with implantable devices was collected only at 12 months. Results at 12 months for all clusters are similar and assessed a positive perception of telemedicine. The SUTAQ results for clusters 2 (diabetes), 5 (COPD) and 7 (CHF) after 3 months of intervention were confirmed after 12 months. Telemedicine was perceived as a viable addition to usual care. A positive perception for telemedicine services isn't a transitory effect, but extends over the course of time.

  19. A transaction assessment method for allocation of transmission services

    Science.gov (United States)

    Banunarayanan, Venkatasubramaniam

    The purpose of this research is to develop transaction assessment methods for allocating transmission services that are provided by an area/utility to power transactions. Transmission services are the services needed to deliver, or provide the capacity to deliver, real and reactive power from one or more supply points to one or more delivery points. As the number of transactions increase rapidly in the emerging deregulated environment, accurate quantification of the transmission services an area/utility provides to accommodate a transaction is becoming important, because then appropriate pricing schemes can be developed to compensate for the parties that provide these services. The Allocation methods developed are based on the "Fair Resource Allocation Principle" and they determine for each transaction the following: the flowpath of the transaction (both real and reactive power components), generator reactive power support from each area/utility, real power loss support from each area/utility. Further, allocation methods for distributing the cost of relieving congestion on transmission lines caused by transactions are also developed. The main feature of the proposed methods is representation of actual usage of the transmission services by the transactions. The proposed method is tested extensively on a variety of systems. The allocation methods developed in this thesis for allocation of transmission services to transactions is not only useful in studying the impact of transactions on a transmission system in a multi-transaction case, but they are indeed necessary to meet the criteria set forth by FERC with regard to pricing based on actual usage. The "consistency" of the proposed allocation methods has also been investigated and tested.

  20. Assessing the Impact of Imperfect Diagnosis on Service Reliability

    DEFF Research Database (Denmark)

    Grønbæk, Lars Jesper; Schwefel, Hans-Peter; Kjærgaard, Jens Kristian

    2010-01-01

    , representative diagnosis performance metrics have been defined and their closed-form solutions obtained for the Markov model. These equations enable model parameterization from traces of implemented diagnosis components. The diagnosis model has been integrated in a reliability model assessing the impact...... of the diagnosis functions for the studied reliability problem. In a simulation study we finally analyze trade-off properties of diagnosis heuristics from literature, map them to the analytic Markov model, and investigate its suitability for service reliability optimization....

  1. [Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service].

    Science.gov (United States)

    de Winter, R F P; de Groot, M H; van Dassen, M; Deen, M L; de Beurs, D P

    The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour. AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague. METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering. RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide. CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

  2. Family history record and hereditary cancer risk perception according to National Cancer Institute criteria in a Spanish medical oncology service: a retrospective study.

    Science.gov (United States)

    Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel

    2012-01-01

    Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.

  3. Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice.

    Science.gov (United States)

    Ferber, R; Millman, R; Coppola, M; Fleetham, J; Murray, C F; Iber, C; McCall, V; Nino-Murcia, G; Pressman, M; Sanders, M

    1994-06-01

    The objective assessment of patients with a presumptive diagnosis of obstructive sleep apnea (OSA) has primarily used attended polysomnographic study. Recent technologic advances and issues of availability, convenience and cost have led to a rapid increase in the use of portable recording devices. However, limited scientific information has been published regarding the evaluation of the efficacy, accuracy, validity, utility, cost effectiveness and limitations of this portable equipment. Attaining a clear assessment of the role of portable devices is complicated by the multiplicity of recording systems and the variability of clinical settings in which they have been analyzed. This paper reviews the current knowledge base regarding portable recording in the assessment of OSA, including technical considerations, validation studies, potential advantages and disadvantages, issues of safety, current clinical usage and areas most in need of further study.

  4. Ethical Implications of the Electronic Health Record: In the Service of the Patient.

    Science.gov (United States)

    Sulmasy, Lois Snyder; López, Ana María; Horwitch, Carrie A

    2017-08-01

    Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met. The profession has a responsibility to identify and address this mismatch. This position paper by the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee does not address EHR design, user variability, meaningful use, or coding requirements and other government and payer mandates per se; these issues are discussed in detail in ACP's Clinical Documentation policy. This paper focuses on EHRs and the patient-physician relationship and patient care; patient autonomy, privacy and confidentiality; and professionalism, clinical reasoning and training. It explores emerging ethical challenges and concerns for and raised by physicians across the professional lifespan, whose ongoing input is crucial to the development and use of information technology that truly serves patients.

  5. Assessment of Customer Service in Academic Health Care Libraries (ACSAHL): an instrument for measuring customer service.

    Science.gov (United States)

    Crossno, J E; Berkins, B; Gotcher, N; Hill, J L; McConoughey, M; Walters, M

    2001-04-01

    In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries. Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys. Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results. ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas.

  6. Performance Assessment for e-Government Services: An Experience Report

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yan; Zhu, Liming; Gorton, Ian

    2007-08-14

    The transformation and integration of government services, enabled by the use of new technologies such as application servers and Web services, is fundamental to reduce the cost of government and improving service outcomes to citizens. Many core Government information systems comprise applications running on legacy mainframes, databases and transaction processing monitors. As Governments worldwide provide direct access over the Internet to these legacy applications from the general public, they may be exposed to workloads well above the origin design parameters of these back-end systems. This creates a significant risk of high profile failures for Government agencies whose newly integrated systems become overloaded. In this paper we describe how we conducted a performance assessment of a business-critical, Internet-facing Web services that integrated new and legacy systems from two Australian Government agencies. We leveraged prototype tools from our own research along with known techniques in performance modeling. We were able to clearly demonstrate that the existing hardware and software would be adequate to handle the predicted workload for the next financial year. We were also able to do ‘what-if’ analysis and predict how the system can perform with alternative strategies to scale the system. We conclude by summarizing the lessons learnt, including the importance of architecture visibility, benchmarking data quality, and measurement feasibility due to issues of outsourcing, privacy legislation and cross-agency involvement.

  7. An Assessment of Customer Behaviours Regarding the Romanian Postal Services

    Directory of Open Access Journals (Sweden)

    Cristinel Constantin

    2015-09-01

    Full Text Available During the time the long distance communication has been one of the most important needs of the humanity. In the absence of telecommunication the postal services have been the main way of sending messages between people and other entities. Taking into account the importance of this market we assessed the nowadays coordinates of the Romanian postal market by conducting a research meant to identify the trends of postal services, the stage of competition and the customers’ behaviours regarding these services. The results show that the market is in developing process, with an increasing number of competitors but with a low number of significant competitors able to provide services on a large scale. In this context, the National Company Posta Romana remains the main market player but its positions are strongly threatened by private competitors especially on those market segments with high profitability. In order to defend its positions the national company has to put in practice proper marketing strategies focused mainly on the development of partnerships both with the senders and recipients of different postal deliveries, especially those ones with a higher attractiveness for the competitors.

  8. ARAC: a computer-based emergency dose-assessment service

    International Nuclear Information System (INIS)

    Sullivan, T.J.

    1990-01-01

    Over the past 15 years, the Lawrence Livermore National Laboratory's Atmospheric Release Advisory Capability (ARAC) has developed and evolved a computer-based, real-time, radiological-dose-assessment service for the United States Departments of Energy and Defense. This service is built on the integrated components of real-time computer-acquired meteorological data, extensive computer databases, numerical atmospheric-dispersion models, graphical displays, and operational-assessment-staff expertise. The focus of ARAC is the off-site problem where regional meteorology and topography are dominant influences on transport and dispersion. Through application to numerous radiological accidents/releases on scales from small accidental ventings to the Chernobyl reactor disaster, ARAC has developed methods to provide emergency dose assessments from the local to the hemispheric scale. As the power of computers has evolved inversely with respect to cost and size, ARAC has expanded its service and reduced the response time from hours to minutes for an accident within the United States. Concurrently the quality of the assessments has improved as more advanced models have been developed and incorporated into the ARAC system. Over the past six years, the number of directly connected facilities has increased from 6 to 73. All major U.S. Federal agencies now have access to ARAC via the Department of Energy. This assures a level of consistency as well as experience. ARAC maintains its real-time skills by participation in approximately 150 exercises per year; ARAC also continuously validates its modeling systems by application to all available tracer experiments and data sets

  9. Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

    Science.gov (United States)

    Ben-Assuli, Ofir; Leshno, Moshe

    2016-09-01

    In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

  10. Initial development of the recovery-oriented services assessment: A collaboration with peer-provider consultants.

    Science.gov (United States)

    Lodge, Amy C; Kuhn, Wendy; Earley, Juli; Stevens Manser, Stacey

    2018-06-01

    The Recovery Self-Assessment (RSA) is a reliable and valid tool used to measure recovery-oriented services. Recent studies, however, suggest that the length and reading level of the RSA makes its routine use in service settings difficult. Recognizing the importance of including people with lived experience of a mental health challenge in research processes and the need to enhance the utility of tools that measure recovery-oriented services, this paper describes an innovative researcher-peer provider consultant multistep process used to revise the provider version of the RSA to create a new instrument-the Recovery-Oriented Services Assessment (ROSA). The authors conducted an exploratory factor analysis (EFA) with principal axis factoring extraction and direct oblimin rotation to evaluate the underlying structure of the provider RSA using data from mental health employees (n = 323). To triangulate the findings of the EFA, quantitative and qualitative data were collected from peer provider consultants (n = 9) on the importance of and language of RSA items. EFA results indicated that a 1-factor solution provided the best fit and explained 48% of the total variance. Consultants triangulated EFA results and recommended the addition of 2 items and language revisions. These results were used to develop the ROSA-a 15-item instrument measuring recovery-oriented services with accessible language. Two versions of the ROSA were developed: a staff version and a people-in-services version. The ROSA may provide organizations with a more accessible way to measure the extent to which their services are recovery oriented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. 17 CFR 200.80e - Appendix E-Schedule of fees for records services.

    Science.gov (United States)

    2010-04-01

    ... EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Information and Requests.... Regular service. Paper copies of original paper copies, or from microfiche accessible to the contractor...

  12. Impact of improved recording of work-relatedness in primary care visits at occupational health services on sickness absences: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Atkins, Salla; Ojajärvi, Ulla; Talola, Nina; Viljamaa, Mervi; Nevalainen, Jaakko; Uitti, Jukka

    2017-07-26

    Employment protects and fosters health. Occupational health services, particularly in Finland, have a central role in protecting employee health and preventing work ability problems. However, primary care within occupational health services is currently underused in informing preventive activities. This study was designed to assess whether the recording of work ability problems and improvement of follow-up of work-related primary care visits can reduce sickness absences and work disability pensions after 1 year. A pragmatic trial will be conducted using patient electronic registers and registers of the central pensions agency in Finland. Twenty-two occupational health centres will be randomised to intervention and control groups. Intervention units will receive training to improve recording of work ability illnesses in the primary care setting and improved follow-up procedures. The intervention impact will be assessed through examining rates of sickness absence across intervention and control clinics as well as before and after the intervention. The trial will develop knowledge of the intervention potential of primary care for preventing work disability pensions and sickness absence. The use of routine patient registers and pensions registers to assess the outcomes of a randomised controlled trial will bring forward trial methodology, particularly when using register-based data. If successful, the intervention will improve the quality of occupational health care primary care and contribute to reducing work disability. ISRCTN Registry reference number ISRCTN45728263 . Registered on 18 April 2016.

  13. Usability of mobile phone food records to assess dietary intake in adolescents

    Science.gov (United States)

    Mobile technologies are emerging as a valuable tool to collect and assess dietary intake. Adolescents readily accept and adopt new technologies, hence, a food record application (FRapp) may provide an accurate mechanism to monitor dietary intake. We examined the usability of a FRapp in 17 free-livin...

  14. In the Thick of It: Using Tablets for Recording and Assessment

    Science.gov (United States)

    Tyler, Toby

    2017-01-01

    Numerous professionals have written about the need for investigations at the heart of learning to engage and inspire, and to maximize impact upon learning. This article asks if children can use tablets to record their investigations while they are still "in the thick" of them, and also provide valuable assessment data? "In the thick…

  15. 18 CFR 367.58 - Property record system required for service company property.

    Science.gov (United States)

    2010-04-01

    ... to show the nature of each addition to or retirement of service company property, the related total... required for service company property. 367.58 Section 367.58 Conservation of Power and Water Resources... COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED...

  16. 75 FR 17763 - National Park Service Benefits-Sharing Final Environmental Impact Statement Record of Decision

    Science.gov (United States)

    2010-04-07

    ... management in connection with the allocation of benefits from valuable discoveries, inventions, and other... share the benefits with the National Park Service. Another alternative prohibits scientific research... Service and researchers who study material associated with a Scientific Research and Collecting Permit to...

  17. Life assessment of gas turbine blades after long term service

    Energy Technology Data Exchange (ETDEWEB)

    Auerkari, Pertti; Salonen, Jorma [VTT, Espoo (Finland); Maekinen, Sari [Helsingin Energia, Helsinki (Finland); Karvonen, Ikka; Tanttari, Heikki [Lappeenrannan Laempoevoima, Lappeenranta (Finland); Kangas, Pekka [Neste Oil, Kilpilahti (Finland); Scholz, Alfred [Technische Univ. Darmstadt (Germany); Vacchieri, Erica [Ansaldo Richerche, Genoa (Italy)

    2010-07-01

    Turbine blade samples from three land based gas turbines have been subjected to systematic condition and life assessment after long term service (88000 - 109000 equivalent operating hours, eoh), when approaching the nominal or suggested life limits. The blades represent different machine types, materials and design generations, and uncooled blading outside the hottest front end of the turbine, i.e. blades with relatively large size and considerable expected life. For a reasonable assessment, a range of damage mechanisms need to be addressed and evaluated for the impact in the residual life. The results suggested significant additional safe life for all three blade sets. In some cases this could warrant yet another life cycle comparable to that of new blades, even after approaching the nominal end of life in terms of recommended equivalent operating hours. This is thought to be partly because of base load combined cycle operation and natural gas fuel, or modest operational loading if the design also accounted for more intensive cycling operation and more corrosive oil firing. In any case, long term life extension is only appropriate if not intervened by events of overloading, overheating or other sudden events such as foreign object damage (FOD), and if supported by the regular inspection and maintenance program to control in-service damage. Condition based assessment therefore remains an important part of the blade life management after the decision of accepted life extension. (orig.)

  18. Using the NASA Task Load Index to Assess Workload in Electronic Medical Records.

    Science.gov (United States)

    Hudson, Darren; Kushniruk, Andre W; Borycki, Elizabeth M

    2015-01-01

    Electronic medical records (EMRs) has been expected to decrease health professional workload. The NASA Task Load Index has become an important tool for assessing workload in many domains. However, its application in assessing the impact of an EMR on nurse's workload has remained to be explored. In this paper we report the results of a study of workload and we explore the utility of applying the NASA Task Load Index to assess impact of an EMR at the end of its lifecycle on nurses' workload. It was found that mental and temporal demands were the most responsible for the workload. Further work along these lines is recommended.

  19. Assessment of nursing records on cardiopulmonary resuscitation based on the utstein model

    Directory of Open Access Journals (Sweden)

    Daiane Lopes Grisante

    2014-01-01

    Full Text Available Cross-sectional study that assessed the quality of nursing records on cardiopulmonary resuscitation. Forty-two patients’ charts were reviewed in an intensive care unit, using the Utstein protocol. There was a predominance of men (54.8%, aged from 21-70 years old (38.1%, correction of acquired heart diseases (42.7%, with more than one pre-existing device (147. As immediate cause of cardiac arrest, hypotension predominated (48.3% and as the initial rhythm, bradycardia (37.5%. Only the time of death and time of arrest were recorded in 100% of the sample. Professional training in Advanced Life Support was not recorded. The causes of arrest and initial rhythm were recorded in 69% and 76.2% of the sample. Chest compressions, patent airway obtainment and defibrillation were recorded in less than 16%. Records were considered of low quality and may cause legal sanctions to professionals and do not allow the comparison of the effectiveness of the maneuvers with other centers.

  20. Making Earth Science Data Records for Use in Research Environments (MEaSUREs) Projects Data and Services at the GES DISC

    Science.gov (United States)

    Vollmer, Bruce E.; Ostrenga, D.; Savtchenko, A.; Johnson, J.; Wei, J.; Teng, W.; Gerasimov, I.

    2011-01-01

    NASA's Earth Science Program is dedicated to advancing Earth remote sensing and pioneering the scientific use of satellite measurements to improve human understanding of our home planet. Through the MEaSUREs Program, NASA is continuing its commitment to expand understanding of the Earth system using consistent data records. Emphasis is on linking together multiple data sources to form coherent time-series, and facilitating the use of extensive data in the development of comprehensive Earth system models. A primary focus of the MEaSUREs Program is the creation of Earth System Data Records (ESDRs). An ESDR is defined as a unified and coherent set of observations of a given parameter of the Earth system, which is optimized to meet specific requirements for addressing science questions. These records are critical for understanding Earth System processes; for the assessment of variability, long-term trends, and change in the Earth System; and for providing input and validation means to modeling efforts. Seven MEaSUREs projects will be archived and distributed through services at the Goddard Earth Sciences Data and Information Services Center (GES DISC).

  1. Fitness-for-service and defect tolerance assessment - solutions for cracked components to remain in service

    International Nuclear Information System (INIS)

    Nguyen, Ninh; De Beer, Eric

    2013-01-01

    This paper describes the application of the FFS/DTA methodology to assist plant asset managers in dealing with cracks that have been detected in in-service components, particularly those in the power, petrochemical, mining and transport industries. Several state-of-the-art structural integrity assessment proce-dures such as AS/NZS 3788, BS7910, R5-R6 and API-579-1/ ASME FFS-1 are described and discussed; and their application to practical situations using the principles of FFS/DTA is illustrated through a series of selected case studies. The usefulness, effectiveness and versatility of this fracture-mechanics based methodology for examination of in-service cracked components is amply demonstrated.

  2. Duplicate Recording of Contracts in the Mechanization of Contract Administration Services System

    National Research Council Canada - National Science Library

    Lane, F

    1996-01-01

    ... in more than one of the system's data bases. We also evaluated whether the Mechanization of Contract Administration Services system had adequate controls to detect and prevent duplicate contract payments, and whether database errors...

  3. Nuclear plant service water system aging degradation assessment

    International Nuclear Information System (INIS)

    Jarrell, D.B.; Larson, L.L.; Stratton, R.C.; Bohn, S.J.; Gore, M.L.

    1992-10-01

    This report discusses the second phase of the aging assessment of nuclear plant service water systems (SWSs) which was performed by the Pacific Northwest Laboratory (PNL) to support the US Nuclear Regulatory Commission's (NRC's) Nuclear Plant Aging Research (NPAR) program. The SWS was selected for study because of its essential role in the mitigation of and recovery from accident scenarios involving the potential for core-melt, and because it is subject to a variety of aging mechanisms. The objectives of the SWS task under the NPAR program are to identify and characterize the principal age-related degradation mechanisms relevant to this system, to assess the impact of aging degradation on operational readiness, and to provide a methodology for the management of aging on the service water aspect of nuclear plant safety. The primary degradation mechanism in the SWSs as stated in the Phase I assessment and confirmed by the analysis in Phase II, is corrosion compounded by biologic and inorganic accumulation. It then follows that the most effective means for mitigating degradation in these systems is to pursue appropriate programs to effectively control the water chemistry properties when possible and to use biocidal agents where necessary. A methodology for producing a complete root-cause analysis was developed as a result of needs identified in the Phase I assessment for a more formal procedure that would lend itself to a generic, standardized approach. It is recommended that this, or a similar methodology, be required as a part of the documentation for corrective maintenance performed on the safety-related portions of SWSs to provide an accurate focus for effective management of aging

  4. A banner year in southern Alberta : shallow gas, CBM drive service houses to record years

    International Nuclear Information System (INIS)

    Colbourne, C.

    2005-01-01

    The effect of increased oil and gas activity on the service and supply industry in Alberta was evaluated. The service and supply industry is benefiting from booms in shallow gas drilling and coalbed methane exploration. Big Country Energy Services is a pipeline installation company that now has over 40 on-going projects with crews ranging in size from 10 to 70 personnel. A shortage of skilled labour has affected the company's ability to meet demand. Manufacturing companies such as Production Control Services, a self-contained parts manufacturer that specializes in plunger lift service and optimizing and servicing gas wells, is also seeing an increase in business, particularly due to recent activity in the coalbed methane sector. The company services both new and existing wells in the region. Managers at Ronco Oilfield Hauling Ltd., who work with many junior companies, believe that this season will be one of the most successful of all time. It was suggested that an increase in energy demand from countries like China will keep the demand for North American oil high. However, trends have indicated a reduction in exploration in Alberta, while new exploration activity appears to be increasing in northern Canada. Officials at Ronco have predicted that in 10 to 15 years most new oil activity will be in the northern regions as well as in northeastern British Columbia. It was also noted that soaring fuel costs have had an impact on the service and supply industry, particularly in businesses responsible for collecting and disposing of drilling fluids from rigs. Companies specializing in gas well optimization in low-pressure situations have also benefited from increased activity. However, issues concerning under-qualified workers and personnel shortages have affected a wide variety of businesses in the industry. 3 figs

  5. The provision and impact of online patient access to their electronic health records (EHR and transactional services on the quality and safety of health care: systematic review protocol

    Directory of Open Access Journals (Sweden)

    Freda Mold

    2013-09-01

    Full Text Available Background Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR. International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.Objective To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.Method Two reviewers independently searched 11 international databases during the period 1999–2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion .A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis.Prospero (International Prospective Register of Systematic Reviews registration number: crd42012003091.

  6. METAL STRUCTURES SURVIVABILITY ASSESSMENT WHEN SIMULATING SERVICE CONDITIONS

    Directory of Open Access Journals (Sweden)

    O. M. Gibalenko

    2016-04-01

    Full Text Available Purpose. The research is aimed at improving the quality and reliability of measures of primary and secondary protection of metal structures at manufacturing companies, to prolong the service life of cyclically loaded structures of production facilities taking into account the corrosion level of danger. Methodology. Authors proposed to use the principles of process approach for statement and realization of management problems of operational service life in corrosion environments. The principles of ensuring reliability on the level of corrosion danger include justification of stages sequence for survivability assessment of a structural metalwork based on the strategy of DMAIC (define, measure, analyze, improve, control: definitions, measurements, analysis, improvement and monitoring of measures of primary and secondary corrosion protection. Findings. Providing control measures from corrosion according to the criterion of corrosion danger allows providing requirements of reliability of structural metalwork based on calculated provisions of the limiting conditions method and solving the problems of management in technological safety during the expected service life of structural objects. Originality. The developed strategy of maintenance of the industrial facilities on an actual state includes the process approach to resource management by creation of system for the account and the functional controlling, risk analysis and regulation of technological safety in production facilities of the enterprises. Realization of the principles of process approach to management of technological safety at the object level is directed to perfecting of tools and methods of anticorrosive protection, extension of a resource taking into account indexes of survivability (, and justification of program measures to ensure the reliability of enterprises(PER. Practical value. On the basis of process approach to quality and reliability management, generalizations of the

  7. A methodology for adaptable and robust ecosystem services assessment

    Science.gov (United States)

    Villa, Ferdinando; Bagstad, Kenneth J.; Voigt, Brian; Johnson, Gary W.; Portela, Rosimeiry; Honzák, Miroslav; Batker, David

    2014-01-01

    Ecosystem Services (ES) are an established conceptual framework for attributing value to the benefits that nature provides to humans. As the promise of robust ES-driven management is put to the test, shortcomings in our ability to accurately measure, map, and value ES have surfaced. On the research side, mainstream methods for ES assessment still fall short of addressing the complex, multi-scale biophysical and socioeconomic dynamics inherent in ES provision, flow, and use. On the practitioner side, application of methods remains onerous due to data and model parameterization requirements. Further, it is increasingly clear that the dominant “one model fits all” paradigm is often ill-suited to address the diversity of real-world management situations that exist across the broad spectrum of coupled human-natural systems. This article introduces an integrated ES modeling methodology, named ARIES (ARtificial Intelligence for Ecosystem Services), which aims to introduce improvements on these fronts. To improve conceptual detail and representation of ES dynamics, it adopts a uniform conceptualization of ES that gives equal emphasis to their production, flow and use by society, while keeping model complexity low enough to enable rapid and inexpensive assessment in many contexts and for multiple services. To improve fit to diverse application contexts, the methodology is assisted by model integration technologies that allow assembly of customized models from a growing model base. By using computer learning and reasoning, model structure may be specialized for each application context without requiring costly expertise. In this article we discuss the founding principles of ARIES - both its innovative aspects for ES science and as an example of a new strategy to support more accurate decision making in diverse application contexts.

  8. A methodology for adaptable and robust ecosystem services assessment.

    Directory of Open Access Journals (Sweden)

    Ferdinando Villa

    Full Text Available Ecosystem Services (ES are an established conceptual framework for attributing value to the benefits that nature provides to humans. As the promise of robust ES-driven management is put to the test, shortcomings in our ability to accurately measure, map, and value ES have surfaced. On the research side, mainstream methods for ES assessment still fall short of addressing the complex, multi-scale biophysical and socioeconomic dynamics inherent in ES provision, flow, and use. On the practitioner side, application of methods remains onerous due to data and model parameterization requirements. Further, it is increasingly clear that the dominant "one model fits all" paradigm is often ill-suited to address the diversity of real-world management situations that exist across the broad spectrum of coupled human-natural systems. This article introduces an integrated ES modeling methodology, named ARIES (ARtificial Intelligence for Ecosystem Services, which aims to introduce improvements on these fronts. To improve conceptual detail and representation of ES dynamics, it adopts a uniform conceptualization of ES that gives equal emphasis to their production, flow and use by society, while keeping model complexity low enough to enable rapid and inexpensive assessment in many contexts and for multiple services. To improve fit to diverse application contexts, the methodology is assisted by model integration technologies that allow assembly of customized models from a growing model base. By using computer learning and reasoning, model structure may be specialized for each application context without requiring costly expertise. In this article we discuss the founding principles of ARIES--both its innovative aspects for ES science and as an example of a new strategy to support more accurate decision making in diverse application contexts.

  9. A methodology for adaptable and robust ecosystem services assessment.

    Science.gov (United States)

    Villa, Ferdinando; Bagstad, Kenneth J; Voigt, Brian; Johnson, Gary W; Portela, Rosimeiry; Honzák, Miroslav; Batker, David

    2014-01-01

    Ecosystem Services (ES) are an established conceptual framework for attributing value to the benefits that nature provides to humans. As the promise of robust ES-driven management is put to the test, shortcomings in our ability to accurately measure, map, and value ES have surfaced. On the research side, mainstream methods for ES assessment still fall short of addressing the complex, multi-scale biophysical and socioeconomic dynamics inherent in ES provision, flow, and use. On the practitioner side, application of methods remains onerous due to data and model parameterization requirements. Further, it is increasingly clear that the dominant "one model fits all" paradigm is often ill-suited to address the diversity of real-world management situations that exist across the broad spectrum of coupled human-natural systems. This article introduces an integrated ES modeling methodology, named ARIES (ARtificial Intelligence for Ecosystem Services), which aims to introduce improvements on these fronts. To improve conceptual detail and representation of ES dynamics, it adopts a uniform conceptualization of ES that gives equal emphasis to their production, flow and use by society, while keeping model complexity low enough to enable rapid and inexpensive assessment in many contexts and for multiple services. To improve fit to diverse application contexts, the methodology is assisted by model integration technologies that allow assembly of customized models from a growing model base. By using computer learning and reasoning, model structure may be specialized for each application context without requiring costly expertise. In this article we discuss the founding principles of ARIES--both its innovative aspects for ES science and as an example of a new strategy to support more accurate decision making in diverse application contexts.

  10. Web Service for Positional Quality Assessment: the Wps Tier

    Science.gov (United States)

    Xavier, E. M. A.; Ariza-López, F. J.; Ureña-Cámara, M. A.

    2015-08-01

    In the field of spatial data every day we have more and more information available, but we still have little or very little information about the quality of spatial data. We consider that the automation of the spatial data quality assessment is a true need for the geomatic sector, and that automation is possible by means of web processing services (WPS), and the application of specific assessment procedures. In this paper we propose and develop a WPS tier centered on the automation of the positional quality assessment. An experiment using the NSSDA positional accuracy method is presented. The experiment involves the uploading by the client of two datasets (reference and evaluation data). The processing is to determine homologous pairs of points (by distance) and calculate the value of positional accuracy under the NSSDA standard. The process generates a small report that is sent to the client. From our experiment, we reached some conclusions on the advantages and disadvantages of WPSs when applied to the automation of spatial data accuracy assessments.

  11. Evaluating Student Self-Assessment through Video-Recorded Patient Simulations.

    Science.gov (United States)

    Sanderson, Tammy R; Kearney, Rachel C; Kissell, Denise; Salisbury, Jessica

    2016-08-01

    The purpose of this pilot study was to determine if the use of a video-recorded clinical session affects the accuracy of dental hygiene student self-assessment and dental hygiene instructor feedback. A repeated measures experiment was conducted. The use of the ODU 11/12 explorer was taught to students and participating faculty through video and demonstration. Students then demonstrated activation of the explorer on a student partner using the same technique. While faculty completed the student assessment in real time, the sessions were video recorded. After completing the activation of the explorer, students and faculty completed an assessment of the student's performance using a rubric. A week later, both students and faculty viewed the video of the clinical skill performance and reassessed the student's performance using the same rubric. The student videos were randomly assigned a number, so faculty reassessed the performance without access to the student's identity or the score that was initially given. Twenty-eight students and 4 pre-clinical faculty completed the study. Students' average score was 4.68±1.16 on the first assessment and slightly higher 4.89±1.45 when reviewed by video. Faculty average scores were 5.07±2.13 at the first assessment and 4.79±2.54 on the second assessment with the video. No significant differences were found between the differences in overall scores, there was a significant difference in the scores of the grading criteria compared to the expert assessment scores (p=0.0001). This pilot study shows that calibration and assessment without bias in education is a challenge. Analyzing and incorporating new techniques can result in more exact assessment of student performance and self-assessment. Copyright © 2016 The American Dental Hygienists’ Association.

  12. Health Libraries and Information Services in Tanzania: A Strategic Assessment.

    Science.gov (United States)

    Haruna, Hussein; Mtoroki, Majaliwa; Gerendasy, Dan D; Detlefsen, Ellen G

    The intention of the Government of Tanzania is to establish more health information resource canters in all health facilities. With this regard, health information science personnel are needed to provide adequate and accurate health information services. However, availability of these personnel remains to be a challenge because of their non-existence. To identify the current status and local impact of health sciences libraries and user perception of these libraries, as a prerequisite to the development of a competence-based curriculum for health information science training in Tanzania. A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers, and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and universities from both government and nongovernment entities in Tanzania. A focus group approach was used to gather data from respondents. Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, and low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field. The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania. Copyright © 2016 Icahn School of

  13. 77 FR 15033 - Privacy Act Systems of Records; APHIS Veterinary Services User Fee System

    Science.gov (United States)

    2012-03-14

    ... animals, animal products, birds, germ plasm, organisms, and vectors. VS incurs costs associated with... exportation of animals, animal products, birds, germ plasm, organisms, and vectors. Categories of records in... role-based access given on a need-to-know basis. Retention and disposal: Electronic data is maintained...

  14. 42 CFR 486.106 - Condition for coverage: Referral for service and preservation of records.

    Science.gov (United States)

    2010-10-01

    ... performed for Medicare beneficiaries are ordered by a doctor of medicine or doctor of osteopathy and records... performed only on the order of a doctor of medicine or doctor of osteopathy licensed to practice in the... or doctor of osteopathy, and (2) Such physician's written, signed order specifies the reason an X-ray...

  15. AECB workshop on seismic hazard assessment in Southern Ontario. Recorded proceedings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    A workshop on seismic hazard assessment in southern Ontario was conducted on June 19-21, 1995. The purpose of the workshop was to review available geological and seismological data which could affect earthquake occurrence in southern Ontario and to develop a consensus on approaches that should be adopted for characterization of seismic hazard. The workshop was structured in technical sessions to focus presentations and discussions on four technical issues relevant to seismic hazard in southern Ontario, as follows: The importance of geological and geophysical observations for the determination of seismic sources; Methods and approaches which may be adopted for determining seismic sources based on integrated interpretations of geological and seismological information. Methods and data which should be used for characterizing the seismicity parameters of seismic sources. Methods for assessment of vibratory ground motion hazard. This document presents transcripts from recordings made of the presentations and discussion from the workshop. It will be noted, in some sections of the document, that the record is incomplete. This is due in part to recording equipment malfunction and in part due to the poor quality of recording obtained for certain periods.

  16. AECB workshop on seismic hazard assessment in Southern Ontario. Recorded proceedings

    International Nuclear Information System (INIS)

    1995-01-01

    A workshop on seismic hazard assessment in southern Ontario was conducted on June 19-21, 1995. The purpose of the workshop was to review available geological and seismological data which could affect earthquake occurrence in southern Ontario and to develop a consensus on approaches that should be adopted for characterization of seismic hazard. The workshop was structured in technical sessions to focus presentations and discussions on four technical issues relevant to seismic hazard in southern Ontario, as follows: The importance of geological and geophysical observations for the determination of seismic sources; Methods and approaches which may be adopted for determining seismic sources based on integrated interpretations of geological and seismological information. Methods and data which should be used for characterizing the seismicity parameters of seismic sources. Methods for assessment of vibratory ground motion hazard. This document presents transcripts from recordings made of the presentations and discussion from the workshop. It will be noted, in some sections of the document, that the record is incomplete. This is due in part to recording equipment malfunction and in part due to the poor quality of recording obtained for certain periods

  17. Economic assessment of the general thoracic surgery outpatient service.

    Science.gov (United States)

    Jones, David R; Vaughters, Ann B R; Smith, Philip W; Daniel, Thomas M; Shen, K Robert; Heinzmann, Janet L

    2006-09-01

    One aspect of the definition of institutional value for any program is based on the return on investment (ROI) for that program. Program requests for future resource allocations depend, in part, on that information. The purpose of this project was to determine the ROI for initial outpatient visits only for our General Thoracic Surgery (GTS) program. The number of GTS outpatient visits, studies, and requested consultations ordered by GTS surgeons only was determined after review of the hospital database and office records for the calendar year 2003. Only charges associated with the initial outpatient visits (no inpatient or physician charges) were included. Charges were based on hospital finance department data. The ROI for GTS outpatient services was calculated using total hospital costs and hospital collections. There were 689 initial outpatient GTS visits. The majority were for lung cancer (48%), benign lung diseases (21%), and esophageal diseases (14%). Total outpatient charges were 1.25M dollars and by disease process were lung cancer (644,000 dollars), benign lung disease (90,000 dollars), esophageal disease (159,000 dollars), and other (357,000 dollars). The most significant hospital charges were the following: radiology (850,000 dollars), laboratory studies (82,000 dollars), gastrointestinal medicine studies (59,000 dollars), and cardiology (42,000 dollars). Total operational costs for the GTS clinic were 415,000 dollars and hospital collections were 513,000 dollars, yielding an ROI of 98,000 dollars or an operating margin of 19%. An operating margin of 19% for GTS outpatient services is better than most Fortune 500 companies. Acquisition of this type of information by GTS surgeons may be helpful for future program development and institutional resource allocation.

  18. Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management

    Centers for Disease Control (CDC) Podcasts

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management. In May 2014, the United States recorded the largest number of reported measles cases since 1994 and the number continues to rise. Most cases reported have been acquired in the U.S. and are associated with importations from countries where measles is still common. This highly contagious, acute viral illness spreads quickly in unvaccinated populations once reaching the U.S. The recent measles outbreaks highlight the importance of maintaining high vaccination coverage in the U.S. and ensuring age-appropriate vaccination for international travelers. During this COCA call, clinicians will learn the status of measles in the U.S. and CDC vaccination recommendations and guidelines for patient assessment and management.

  19. Assessment of veterinary services in central Ethiopia: A case study ...

    African Journals Online (AJOL)

    services, and black-market drug dealers were found to be challengers associated .... veterinary service, private veterinarians, traditional healers and NGOs mainly ... timeliness, effectiveness and affordability of the veterinary service providers.

  20. Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services.

    Science.gov (United States)

    Woelfel, Joseph A; Carr-Lopez, Sian M; Delos Santos, Melanie; Bui, Ann; Patel, Rajul A; Walberg, Mark P; Galal, Suzanne M

    2014-02-01

    To assess Medicare beneficiaries' willingness-to-pay (WTP) for medication therapy management (MTM) services and determine sociodemographic and clinical characteristics influencing this payment amount. A cross-sectional, descriptive study design was adopted to elicit Medicare beneficiaries' WTP for MTM. Nine outreach events in cities across Central/Northern California during Medicare's 2011 open-enrollment period. A total of 277 Medicare beneficiaries participated in the study. Comprehensive MTM was offered to each beneficiary. Pharmacy students conducted the MTM session under the supervision of licensed pharmacists. At the end of each MTM session, beneficiaries were asked to indicate their WTP for the service. Medication, self-reported chronic conditions, and beneficiary demographic data were collected and recorded via a survey during the session. The mean WTP for MTM was $33.15 for the 277 beneficiaries receiving the service and answering the WTP question. WTP by low-income subsidy recipients (mean ± standard deviation; $12.80 ± $24.10) was significantly lower than for nonsubsidy recipients ($41.13 ± $88.79). WTP was significantly (positively) correlated with number of medications regularly taken and annual out-of-pocket drug costs. The mean WTP for MTM was $33.15. WTP for MTM significantly varied by race, subsidy status, and number of prescription medications taken. WTP was significantly higher for nonsubsidy recipients than subsidy recipients, and significantly positively correlated with the number of medications regularly taken and the beneficiary rating of the delivered services.

  1. Rodent model for assessing the long term safety and performance of peripheral nerve recording electrodes

    Science.gov (United States)

    Vasudevan, Srikanth; Patel, Kunal; Welle, Cristin

    2017-02-01

    Objective. In the US alone, there are approximately 185 000 cases of limb amputation annually, which can reduce the quality of life for those individuals. Current prosthesis technology could be improved by access to signals from the nervous system for intuitive prosthesis control. After amputation, residual peripheral nerves continue to convey motor signals and electrical stimulation of these nerves can elicit sensory percepts. However, current technology for extracting information directly from peripheral nerves has limited chronic reliability, and novel approaches must be vetted to ensure safe long-term use. The present study aims to optimize methods to establish a test platform using rodent model to assess the long term safety and performance of electrode interfaces implanted in the peripheral nerves. Approach. Floating Microelectrode Arrays (FMA, Microprobes for Life Sciences) were implanted into the rodent sciatic nerve. Weekly in vivo recordings and impedance measurements were performed in animals to assess performance and physical integrity of electrodes. Motor (walking track analysis) and sensory (Von Frey) function tests were used to assess change in nerve function due to the implant. Following the terminal recording session, the nerve was explanted and the health of axons, myelin and surrounding tissues were assessed using immunohistochemistry (IHC). The explanted electrodes were visualized under high magnification using scanning electrode microscopy (SEM) to observe any physical damage. Main results. Recordings of axonal action potentials demonstrated notable session-to-session variability. Impedance of the electrodes increased upon implantation and displayed relative stability until electrode failure. Initial deficits in motor function recovered by 2 weeks, while sensory deficits persisted through 6 weeks of assessment. The primary cause of failure was identified as lead wire breakage in all of animals. IHC indicated myelinated and unmyelinated axons

  2. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Directory of Open Access Journals (Sweden)

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  3. Linking a research register to clinical records in older adults' mental health services: a mixed-methods study.

    Science.gov (United States)

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities. This was a two-stage cross-sectional observational study. In phase one, focus groups with service users, carers and clinicians informed a framework for clinicians to explain C4C to those on their caseload. In phase two, clinicians explained C4C to 26 service users (and carers where applicable). These conversations were recorded, and their content was analysed. Service users and carers were then interviewed to provide further feedback on their conversations with clinicians. A total of 31 service users, 24 carers and 13 clinical staff took part across the two phases. In phase one, service users and carers sought assurance of the right to refuse participation in further studies (after joining C4C). Clinicians expressed concerns over legal and practical implications of ascertaining mental capacity and best interest. In phase two, clinicians' explanations were less thorough than similar explanations given to younger adults with psychosis. Clinicians omitted details of service users' right to stipulate contact arrangements, which was significantly associated with whether service users/carers agreed to join. Common reasons for joining C4C included altruism and the chance to speak to new people. Few participants refused to join, but reasons included avoidance of stress (potentially alleviated through the presence of a carer). Implementing C4C in older adults' services requires clinicians to deliver concise, simple explanations to individuals and their carers where applicable. Older adults can be suspicious of unsolicited contact; thus

  4. Multichannel Recorder for Low Frequency Signals: Application of Oscilloscope as Integrated Mobile Service for a Smartphone

    Directory of Open Access Journals (Sweden)

    Michal Kochlan

    2016-01-01

    Full Text Available Data acquisition and processing are well known for some time. Many applications use powerful hardware to acquire, process, and visualize signal waveforms. But there are some applications that do not have to perform high resolution signal acquisition and process large amount of data, for example, low frequency applications of embedded design and applications for remote power grid monitoring. The paper describes special system for low frequency signal data sample acquisition, processing, and visualization implemented as a service on Android-based smart device. The service makes smart device functioning as an oscilloscope or arbitrary waveform generator which is accessible remotely through Bluetooth. The design respects low power consumption requirements, simplicity, and user friendliness in application design. Application scenario was implemented as wireless data acquisition system for power grid monitoring.

  5. Performance Assessment of Aggregation Control Services for Demand Response

    DEFF Research Database (Denmark)

    Bondy, Daniel Esteban Morales; Costanzo, Giuseppe Tommaso; Heussen, Kai

    2014-01-01

    Aggregation algorithms that provide services to the grid via demand side management are moving from research ideas to the market. With the diversity of the technology delivering such services, it becomes essential to establish transparent performance standards from a service delivery perspective...... of the quality of service provided by an aggregation control algorithm. By a detailed case study we present and an application of the index, comparing the performance of two different control architectures for demand side management delivering a distribution grid service....

  6. Assessing explicit error reporting in the narrative electronic medical record using keyword searching.

    Science.gov (United States)

    Cao, Hui; Stetson, Peter; Hripcsak, George

    2003-01-01

    Many types of medical errors occur in and outside of hospitals, some of which have very serious consequences and increase cost. Identifying errors is a critical step for managing and preventing them. In this study, we assessed the explicit reporting of medical errors in the electronic record. We used five search terms "mistake," "error," "incorrect," "inadvertent," and "iatrogenic" to survey several sets of narrative reports including discharge summaries, sign-out notes, and outpatient notes from 1991 to 2000. We manually reviewed all the positive cases and identified them based on the reporting of physicians. We identified 222 explicitly reported medical errors. The positive predictive value varied with different keywords. In general, the positive predictive value for each keyword was low, ranging from 3.4 to 24.4%. Therapeutic-related errors were the most common reported errors and these reported therapeutic-related errors were mainly medication errors. Keyword searches combined with manual review indicated some medical errors that were reported in medical records. It had a low sensitivity and a moderate positive predictive value, which varied by search term. Physicians were most likely to record errors in the Hospital Course and History of Present Illness sections of discharge summaries. The reported errors in medical records covered a broad range and were related to several types of care providers as well as non-health care professionals.

  7. Charging for hospital pharmaceutical services: flat free based on the medication record.

    Science.gov (United States)

    Wyatt, B K

    1979-03-01

    A 200-bed hospital's change in pricing drug products from a cost-plus-fee system to a flat fee per dose based on the medication administration record (MAR) is described. With the flat-fee system, drug charges are not recorded when the drug is dispensed by the pharmacy; data for charging doses are obtained directly from the MAR forms generated by the nursing staff. Charges are 55 cents per oral or suppository dose and $3.00 per injection dose. Drugs administered intravenously, topical drugs, injections costing more than $10.00 per dose, and miscellaneous nondrug items are still charged on a cost-plus-fee basis. Man-hours are saved in the pharmacy department because of the elimination of the pricing function and maintenance of price lists. The need for nursing staff to charge for any doses administered from emergency or Schedule II floor-stock supplies is eliminated. The workload for business office personnel is reduced because the number of individual charges is less than with the cost-plus charging system. The system is accepted by patients and third-party payers and has made a complete unit dose drug distribution system possible at lower cost.

  8. [Level of completion of the prehospital care and transfer record as a quality indicator in an emergency medical service].

    Science.gov (United States)

    Ballestros Peña, Sendoa; Lorrio Palomino, Sergio; Ariz Zubiaur, Mónica

    2012-11-01

    BASICS: A Prehospital Care and Transfer Recording (PCTR) is an out-of-hospital medical recording. This paper was made to assess and compare the level of fulfillment of the basic parameters of the PCTR developed by the Life Support Units with nurses (Life Support Units with Nurse, LSUwN and without nurses (Basic Life Support Units, BLSU) from SAMUR Bilbao in 2010. A descriptive, retrospective and comparative study was performed by analysing a randomized sample of 660 PCTR (precision 3%), aiming to check the fulfillment of the basic data. 98.33% of total recordings were readable. In overall, fulfillment rate was 90.31% (CI 89.24- 97.3 71%) of all basic parameters for LSUwN PCTR and 84.81% (CI 83.56 to 86%) for BLSU. 34.1% of PCTR were completely and correctly fulfilled. The LSUwN scored significantly better (p < 0.000). There were recording failures in "date and time", "address" and "physical examination". There were differences between the recording of clinical and administrative information (88.64% vs 86.72%, p = 0.02). In order to consider a parameter has optimal, it has to reach 100% of fulfillment. If it doesn't, and its score reaches no more than 80%, it should be reviewed. In this case, the results would be considered acceptable, but the administrative items of BLSU records, and allergies in both units should be strengthened. LSUwN has obtained better scores. The need of recording clinical information must be instilled as evidence of quality care.

  9. Assessment of quality of care in family planning services in Jimma ...

    African Journals Online (AJOL)

    Background: Providing quality of care in family planning services is an important task for care providers so as to increase service utilization and coverage; however, little is known about the existing quality of care in such services. Objective: To assess quality of care in family planning services in Jimma Zone, southwest ...

  10. 25 CFR 20.404 - What information is contained in a social services assessment?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What information is contained in a social services assessment? 20.404 Section 20.404 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.404 What...

  11. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Directory of Open Access Journals (Sweden)

    Kenneth J. Bagstad

    2014-06-01

    Full Text Available Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service, sinks (biophysical or anthropogenic features that deplete or alter service flows, users (user locations and level of demand, and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems' capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for

  12. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Science.gov (United States)

    Bagstad, Kenneth J.; Villa, Ferdinando; Batker, David; Harrison-Cox, Jennifer; Voigt, Brian; Johnson, Gary W.

    2014-01-01

    Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service), sinks (biophysical or anthropogenic features that deplete or alter service flows), users (user locations and level of demand), and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems’ capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES) methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for economic

  13. Elastodynamic spot testing - assessing serviceability of aging elastomer parts

    International Nuclear Information System (INIS)

    Gracie, B.; Metcalfe, R.; Wensel, R.

    1995-01-01

    The properties of all polymers change with time as a function of their environment. Traditional practice has been to replace these parts according to generic time limits based on estimates of worst case material properties and conditions. This is overly-conservative in many cases, and creates unnecessary maintenance work and costs for replacement and disposal. Much of this could be avoided if the serviceability of elastomeric parts such as seals, diaphragms, gaskets, cable insulation and hoses could be reassessed on a routine basis. Elastodynamic spot testing offers a way to do this. Parts can be sampled while in service or storage to compare their as-new and used (or aged) elastodynamic properties. This data can usually be correlated with the results of functional tests to prove that material properties have not degraded to the point where the part could fail. This spot testing is similar to a micro-hardness test, but includes stress-relaxation and subsequent recovery. It provides a nondestructive means to assess the effective age of the material at a point, or several points, on a part. Sampling of hardness alone is rarely sufficient to know whether a part is still functional because this overlooks the material's viscoelastic and strength properties. An elastodynamic spot tester has been used to test different sizes, shapes and hardnesses of elastomeric parts at different levels of strain, i.e., indentation depths. An initial test program has given informative relaxation and recovery data, showing repeatability and comparing well with finite element analysis of the indentation process. Tests of aged 0-rings and diaphragms have revealed different elastodynamic properties, depending on the elastomer compound and aging conditions. (author)

  14. The utility of the historical record in assessing future carbon budgets

    Science.gov (United States)

    Millar, R.; Friedlingstein, P.; Allen, M. R.

    2017-12-01

    It has long been known that the cumulative emissions of carbon dioxide (CO2) is the most physically relevant determiner of long-lived anthropogenic climate change, with an approximately linear relationship between CO2-induced global mean surface warming and cumulative emissions. The historical observational record offers a way to constrain the relationship between cumulative carbon dioxide emission and global mean warming using observations to date. Here we show that simple regression analysis indicates that the 1.5°C carbon budget would be exhausted after nearly three decades of current emissions, substantially in excess of many estimates from Earth System Models. However, there are many reasons to be cautious about carbon budget assessments from the historical record alone. Accounting for the uncertainty in non-CO2 radiative forcing using a simple climate model and a standard optimal fingerprinting detection attribution technique gives substantial uncertainty in the contribution of CO2 warming to date, and hence the transient climate response to cumulative emissions. Additionally, the existing balance between CO2 and non-CO2 forcing may change in the future under ambitious mitigation scenarios as non-CO2 emissions become more (or less) important to global mean temperature changes. Natural unforced variability can also have a substantial impact on estimates of remaining carbon budgets. By examining all warmings of a given magnitude in both the historical record and past and future ESM simulations we quantify the impact unforced climate variability may have on estimates of remaining carbon budgets, derived as a function of estimated non-CO2 warming and future emission scenario. In summary, whilst the historical record can act as a useful test of climate models, uncertainties in the response to future cumulative emissions remain large and extrapolations of future carbon budgets from the historical record alone should be treated with caution.

  15. Forest Service programs, authorities, and relationships: A technical document supporting the 2000 USDA Forest Service RPA Assessment

    Science.gov (United States)

    Ervin G. Schuster; Michael A. Krebs

    2003-01-01

    The Forest and Rangeland Renewable Resources Planning Act (RPA) of 1974, as amended, directs the Forest Service to prepare and update a renewable resources assessment that would include "a description of Forest Service programs and responsibilities , their interrelationships, and the relationship of these programs and responsibilities to public and private...

  16. NOAA's Web Service for the New York Offshore Biogeographic Assessment

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This web service provides key ecological data layers in the New York Bight via the Internet and which can be loaded into client side GIS software. The web service...

  17. Customer premises services market demand assessment 1980 - 2000: Volume 2

    Science.gov (United States)

    Gamble, R. B.; Saporta, L.; Heidenrich, G. A.

    1983-01-01

    Potential customer premises service (CPS), telecommunication services, potential CPS user classes, a primary research survey, comparative economics, market demand forcasts, distance distribution of traffic, segmentation of market demand, and a nationwide traffic distribution model are discussed.

  18. assessment of clients' satisfaction with health service deliveries

    African Journals Online (AJOL)

    Abrham

    showed that the overall client satisfaction level with the health services rendered at ... Therefore, the Hospital management should understand these weak service areas and plan for a better .... for use”, which means the consumer's perception.

  19. Defining asthma and assessing asthma outcomes using electronic health record data: a systematic scoping review.

    Science.gov (United States)

    Al Sallakh, Mohammad A; Vasileiou, Eleftheria; Rodgers, Sarah E; Lyons, Ronan A; Sheikh, Aziz; Davies, Gwyneth A

    2017-06-01

    There is currently no consensus on approaches to defining asthma or assessing asthma outcomes using electronic health record-derived data. We explored these approaches in the recent literature and examined the clarity of reporting.We systematically searched for asthma-related articles published between January 1, 2014 and December 31, 2015, extracted the algorithms used to identify asthma patients and assess severity, control and exacerbations, and examined how the validity of these outcomes was justified.From 113 eligible articles, we found significant heterogeneity in the algorithms used to define asthma (n=66 different algorithms), severity (n=18), control (n=9) and exacerbations (n=24). For the majority of algorithms (n=106), validity was not justified. In the remaining cases, approaches ranged from using algorithms validated in the same databases to using nonvalidated algorithms that were based on clinical judgement or clinical guidelines. The implementation of these algorithms was suboptimally described overall.Although electronic health record-derived data are now widely used to study asthma, the approaches being used are significantly varied and are often underdescribed, rendering it difficult to assess the validity of studies and compare their findings. Given the substantial growth in this body of literature, it is crucial that scientific consensus is reached on the underlying definitions and algorithms. Copyright ©ERS 2017.

  20. Assessment of the invasive status of newly recorded cactus species in the central Tugela River basin

    Directory of Open Access Journals (Sweden)

    Michael D. Cheek

    2015-12-01

    Full Text Available Background: Current distribution information on cacti in the Tugela River basin in KwaZulu-Natal, South Africa, is scant. Accordingly, surveys in this region substantially improve our understanding of regional invasions by this succulent group. The identification of new or extended invasions requires (reassessments of their invasion status and consideration of possible management interventions. Objectives: To identify and collect cacti either not previously recorded or poorly known in the central Tugela River basin, and to assess their invasion status. Method: A 40 km section of tertiary road was travelled through the topocadastral square 2830 CC, from the R74 main road northward across the Bloukrans River towards the Tugela River. Herbarium specimens were collected to vouch for new instances of naturalisation of cacti, the colony sizes of which were estimated and invasion stages determined. An applicable weed risk assessment model was used to determine the threat status of one cactus species not previously evaluated for South Africa. Based on the South African Plant Invaders Atlas database records and field observations, management recommendations were suggested for six cacti species. Results: The first naturalised population of Opuntia microdasys in KwaZulu-Natal was detected, as was the first confirmed South African record of Echinopsis oxygona. Four populations of Peniocereus serpentinus were also found, ranging in size from several square metres to 0.4 ha. Echinopsis oxygona generated a score that falls into the reject category of the risk assessment model used. Conclusion: It is recommended that E. oxygona be added to the Species Under Surveillance for Possible Eradication or Containment Targeting list to investigate whether this species requires formal legal listing and the development of a specific eradication plan. Immediate action from local authorities is recommended for the manual removal of P. serpentinus and O. microdasys

  1. Geospatial Services in Special Libraries: A Needs Assessment Perspective

    Science.gov (United States)

    Barnes, Ilana

    2013-01-01

    Once limited to geographers and mapmakers, Geographic Information Systems (GIS) has taken a growing central role in information management and visualization. Geospatial services run a gamut of different products and services from Google maps to ArcGIS servers to Mobile development. Geospatial services are not new. Libraries have been writing about…

  2. Development and Assessment of Service Learning Projects in General Biology

    Science.gov (United States)

    Felzien, Lisa; Salem, Laura

    2008-01-01

    Service learning involves providing service to the community while requiring students to meet learning goals in a specific course. A service learning project was implemented in a general biology course at Rockhurst University to involve students in promoting scientific education in conjunction with community partner educators. Students were…

  3. [Analgesic quality in a postoperative pain service: continuous assessment with the cumulative sum (cusum) method].

    Science.gov (United States)

    Baptista Macaroff, W M; Castroman Espasandín, P

    2007-01-01

    The aim of this study was to assess the cumulative sum (cusum) method for evaluating the performance of our hospital's acute postoperative pain service. The period of analysis was 7 months. Analgesic failure was defined as a score of 3 points or more on a simple numerical scale. Acceptable failure (p0) was set at 20% of patients upon admission to the postanesthetic recovery unit and at 7% 24 hours after surgery. Unacceptable failure was set at double the p0 rate at each time (40% and 14%, respectively). The unit's patient records were used to generate a cusum graph for each evaluation. Nine hundred four records were included. The rate of failure was 31.6% upon admission to the unit and 12.1% at the 24-hour postoperative assessment. The curve rose rapidly to the value set for p0 at both evaluation times (n = 14 and n = 17, respectively), later leveled off, and began to fall after 721 and 521 cases, respectively. Our study shows the efficacy of the cusum method for monitoring a proposed quality standard. The graph also showed periods of suboptimal performance that would not have been evident from analyzing the data en block. Thus the cusum method would facilitate rapid detection of periods in which quality declines.

  4. Wheelchair Seating Assessment and Intervention: A Comparison between Telerehabilitation and Face-to-Face Service

    Directory of Open Access Journals (Sweden)

    Ingrid G Barlow

    2009-09-01

    Full Text Available This study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10 and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural. Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen face-to-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete. Keywords: Telerehabilitation, Telehealth, Videoconferencing, Wheelchair Seating, Outcomes, Rehabilitation

  5. Assessment of 10-Year Global Record of Aerosol Products from the OMI Near-UV Algorithm

    Science.gov (United States)

    Ahn, C.; Torres, O.; Jethva, H. T.

    2014-12-01

    Global observations of aerosol properties from space are critical for understanding climate change and air quality applications. The Ozone Monitoring Instrument (OMI) onboard the EOS-Aura satellite provides information on aerosol optical properties by making use of the large sensitivity to aerosol absorption and dark surface albedo in the UV spectral region. These unique features enable us to retrieve both aerosol extinction optical depth (AOD) and single scattering albedo (SSA) successfully from radiance measurements at 354 and 388 nm by the OMI near UV aerosol algorithm (OMAERUV). Recent improvements to algorithms in conjunction with the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) and Atmospheric Infrared Sounder (AIRS) carbon monoxide data also reduce uncertainties due to aerosol layer heights and types significantly in retrieved products. We present validation results of OMI AOD against space and time collocated Aerosol Robotic Network (AERONET) measured AOD values over multiple stations representing major aerosol episodes and regimes. We also compare the OMI SSA against the inversion made by AERONET as well as an independent network of ground-based radiometer called SKYNET in Japan, China, South-East Asia, India, and Europe. The outcome of the evaluation analysis indicates that in spite of the "row anomaly" problem, affecting the sensor since mid-2007, the long-term aerosol record shows remarkable sensor stability. The OMAERUV 10-year global aerosol record is publicly available at the NASA data service center web site (http://disc.sci.gsfc.nasa.gov/Aura/data-holdings/OMI/omaeruv_v003.shtml).

  6. Assessing Ecosystem Services and Multifunctionality for Vineyard Systems

    Directory of Open Access Journals (Sweden)

    Klara J. Winkler

    2017-04-01

    Full Text Available Vineyards shape important economic, cultural, and ecological systems in many temperate biomes. Like other agricultural systems, they can be multifunctional landscapes that not only produce grapes, but also for example serve as wildlife habitat, sequester carbon, and are places of rich traditions. However, research and management practices often focus mostly on individual, specific ecosystem services, without considering multifunctionality. Therefore, we set out to meet four research objectives: (1 evaluate how frequently the ecosystem services approach has been applied in vineyard systems; (2 identify which individual ecosystem services have been most frequently studied in vineyard systems, (3 summarize knowledge on the key ecosystem services identified in (2, and (4 illustrate approaches to multifunctionality in vineyards to inform more holistic land management. For research objective (1, we identified 45 publications that used the term “ecosystem services” in relation to vineyards, but found that only seven fully apply the ecosystem service concept to their research. For research objective (2, we operationalized the Common International Classification of Ecosystem Services (CICES for 27 ecosystem services in vineyards, in order to consider provisioning, regulating, and cultural services through an analysis of more than 4,000 scientific papers that mentioned individual services. We found the six most frequently studied ecosystem services included (1 cultivated crops, (2 filtration, sequestration, storage and accumulation by the vineyards, (3 pest control and (4 disease control, (5 heritage, cultural and (6 scientific services. For research objective (3, we found that research on these six single ecosystem services is highly developed, but relationships between single ecosystem services are less studied. Therefore, we suggest that greater adoption of the ecosystem services approach could help scientists and practitioners to acknowledge the

  7. Assessing the completeness of the fossil record using brachiopod Lazarus taxa

    Science.gov (United States)

    Gearty, W.; Payne, J.

    2012-12-01

    Lazarus taxa, organisms that disappear from the fossil record only to reappear later, provide a unique opportunity to assess the completeness of the fossil record. In this study, we apply logistic regression to quantify the associations of body size, geographic extent, and species diversity with the probability of being a Lazarus genus using the Phanerozoic fossil record of brachiopods. We find that both the geographic range and species diversity of a genus are inversely associated with the probability of being a Lazarus taxon in the preceding or succeeding stage. In contrast, body size exhibits little association with the probability of becoming a Lazarus taxon. A model including species diversity and geographic extent as predictors performs best among all combinations examined, whereas a model including only shell size as a predictor performs the worst - even worse than a model that assumes Lazarus taxa are randomly drawn from all available genera. These findings suggest that geographic range and species richness data can be used to improve estimates of extensions on the observed fossil ranges of genera and, thereby, better correct for sampling effects in estimates of taxonomic diversity change through the Phanerozoic.

  8. Year-to-year correlation, record length, and overconfidence in wind resource assessment

    Directory of Open Access Journals (Sweden)

    N. Bodini

    2016-08-01

    Full Text Available Interannual variability of wind speeds presents a fundamental source of uncertainty in preconstruction energy estimates. Our analysis of one of the longest and geographically most widespread extant sets of instrumental wind-speed observations (62-year records from 60 stations in Canada shows that deviations from mean resource levels persist over many decades, substantially increasing uncertainty. As a result of this persistence, the performance of each site's last 20 years diverges more widely than expected from the P50 level estimated from its first 42 years: half the sites have either fewer than 5 or more than 15 years exceeding the P50 estimate. In contrast to this 10-year-wide interquartile range, a 4-year-wide range (2.5 times narrower was found for "control" records where statistical independence was enforced by randomly permuting each station's historical values. Similarly, for sites with capacity factor of 0.35 and interannual variability of 6  %, one would expect 9 years in 10 to fall in the range 0.32–0.38; we find the actual 90  % range to be 0.27–0.43, or three times wider. The previously un-quantified effect of serial correlations favors a shift in resource-assessment thinking from a climatology-focused approach to a persistence-focused approach: for this data set, no improvement in P50 error is gained by using records longer than 4–5 years, and use of records longer than 20 years actually degrades accuracy.

  9. Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management

    Centers for Disease Control (CDC) Podcasts

    2014-06-30

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management. In May 2014, the United States recorded the largest number of reported measles cases since 1994 and the number continues to rise. Most cases reported have been acquired in the U.S. and are associated with importations from countries where measles is still common. This highly contagious, acute viral illness spreads quickly in unvaccinated populations once reaching the U.S. The recent measles outbreaks highlight the importance of maintaining high vaccination coverage in the U.S. and ensuring age-appropriate vaccination for international travelers. During this COCA call, clinicians will learn the status of measles in the U.S. and CDC vaccination recommendations and guidelines for patient assessment and management.  Created: 6/30/2014 by : National Center for Immunization and Respiratory Diseases; Division of Viral Diseases; Healthcare Preparedness Activity (HPA); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 6/30/2014.

  10. Similarity and pleasantness assessments of water-fountain sounds recorded in urban public spaces.

    Science.gov (United States)

    Ekman, Maria Rådsten; Lundén, Peter; Nilsson, Mats E

    2015-11-01

    Water fountains are potential tools for soundscape improvement, but little is known about their perceptual properties. To explore this, sounds were recorded from 32 fountains installed in urban parks. The sounds were recorded with a sound-field microphone and were reproduced using an ambisonic loudspeaker setup. Fifty-seven listeners assessed the sounds with regard to similarity and pleasantness. Multidimensional scaling of similarity data revealed distinct groups of soft variable and loud steady-state sounds. Acoustically, the soft variable sounds were characterized by low overall levels and high temporal variability, whereas the opposite pattern characterized the loud steady-state sounds. The perceived pleasantness of the sounds was negatively related to their overall level and positively related to their temporal variability, whereas spectral centroid was weakly correlated to pleasantness. However, the results of an additional experiment, using the same sounds set equal in overall level, found a negative relationship between pleasantness and spectral centroid, suggesting that spectral factors may influence pleasantness scores in experiments where overall level does not dominate pleasantness assessments. The equal-level experiment also showed that several loud steady-state sounds remained unpleasant, suggesting an inherently unpleasant sound character. From a soundscape design perspective, it may be advisable to avoid fountains generating such sounds.

  11. Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity: Refining risk assessments for work-related wrist disorders.

    Science.gov (United States)

    Dahlqvist, Camilla; Nordander, Catarina; Granqvist, Lothy; Forsman, Mikael; Hansson, Gert-Åke

    2018-01-01

    Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable. To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning. Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions. The group mean EMG amplitudes for resisted wrist extension were 1.2-1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip. The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.

  12. Deriving a Set of Privacy Specific Heuristics for the Assessment of PHRs (Personal Health Records).

    Science.gov (United States)

    Furano, Riccardo F; Kushniruk, Andre; Barnett, Jeff

    2017-01-01

    With the emergence of personal health record (PHR) platforms becoming more widely available, this research focused on the development of privacy heuristics to assess PHRs regarding privacy. Existing sets of heuristics are typically not application specific and do not address patient-centric privacy as a main concern prior to undergoing PHR procurement. A set of privacy specific heuristics were developed based on a scoping review of the literature. An internet-based commercially available, vendor specific PHR application was evaluated using the derived set of privacy specific heuristics. The proposed set of privacy specific derived heuristics is explored in detail in relation to ISO 29100. The assessment of the internet-based commercially available, vendor specific PHR application indicated numerous violations. These violations were noted within the study. It is argued that the new derived privacy heuristics should be used in addition to Nielsen's well-established set of heuristics. Privacy specific heuristics could be used to assess PHR portal system-level privacy mechanisms in the procurement process of a PHR application and may prove to be a beneficial form of assessment to prevent the selection of a PHR platform with a poor privacy specific interface design.

  13. Validation of a Delirium Risk Assessment Using Electronic Medical Record Information.

    Science.gov (United States)

    Rudolph, James L; Doherty, Kelly; Kelly, Brittany; Driver, Jane A; Archambault, Elizabeth

    2016-03-01

    Identifying patients at risk for delirium allows prompt application of prevention, diagnostic, and treatment strategies; but is rarely done. Once delirium develops, patients are more likely to need posthospitalization skilled care. This study developed an a priori electronic prediction rule using independent risk factors identified in a National Center of Clinical Excellence meta-analysis and validated the ability to predict delirium in 2 cohorts. Retrospective analysis followed by prospective validation. Tertiary VA Hospital in New England. A total of 27,625 medical records of hospitalized patients and 246 prospectively enrolled patients admitted to the hospital. The electronic delirium risk prediction rule was created using data obtained from the patient electronic medical record (EMR). The primary outcome, delirium, was identified 2 ways: (1) from the EMR (retrospective cohort) and (2) clinical assessment on enrollment and daily thereafter (prospective participants). We assessed discrimination of the delirium prediction rule with the C-statistic. Secondary outcomes were length of stay and discharge to rehabilitation. Retrospectively, delirium was identified in 8% of medical records (n = 2343); prospectively, delirium during hospitalization was present in 26% of participants (n = 64). In the retrospective cohort, medical record delirium was identified in 2%, 3%, 11%, and 38% of the low, intermediate, high, and very high-risk groups, respectively (C-statistic = 0.81; 95% confidence interval 0.80-0.82). Prospectively, the electronic prediction rule identified delirium in 15%, 18%, 31%, and 55% of these groups (C-statistic = 0.69; 95% confidence interval 0.61-0.77). Compared with low-risk patients, those at high- or very high delirium risk had increased length of stay (5.7 ± 5.6 vs 3.7 ± 2.7 days; P = .001) and higher rates of discharge to rehabilitation (8.9% vs 20.8%; P = .02). Automatic calculation of delirium risk using an EMR algorithm identifies patients at

  14. A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

    Directory of Open Access Journals (Sweden)

    Shamim Haider

    2014-03-01

    Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

  15. A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

    Directory of Open Access Journals (Sweden)

    Shamim Haider

    2014-03-01

    Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

  16. 7 CFR 800.71 - Fees assessed by the Service.

    Science.gov (United States)

    2010-01-01

    ... representative plus an administrative fee per hundredweight) (CWT) 0.04 (iii) Lots sampled online during loading... service representative) 510.00 (5) Online customized data EGIS service: (i) One data file per week for 1...), 79a(1)), as amended by Pub. L. 97-35, 95 Stat. 371, 372) [45 FR 15810, Mar. 11, 1980; 45 FR 55119, Aug...

  17. A Model Assessing Relevant Factors in Building Minority Library Service.

    Science.gov (United States)

    Bonin, Kenneth Roy

    1983-01-01

    Presents research design applicable to definition of minority library service needs for any minority language group in Canada, focusing on French-speaking population outside Quebec. Profiles of the target group's population, culture, needs, and library services are highlighted. Five sources are given. (EJS)

  18. An Assessment of Customer Service in the Nigeria ...

    African Journals Online (AJOL)

    This study examined customer services in the Nigeria telecommunication industry by comparing Zain and MTN companies. Primary data were collected from a total of 60 respondents. Data collected were on consumer service elements such as: reliability, delivery frequency, delivery accuracy, quality of salespeople, ...

  19. Algorithms for assessing person-based consistency among linked records for the investigation of maternal use of medications and safety

    Directory of Open Access Journals (Sweden)

    Duong Tran

    2017-04-01

    Quality assessment indicated high consistency among linked records. The set of algorithms developed in this project can be applied to similar linked perinatal datasets to promote a consistent approach and comparability across studies.

  20. A spatial assessment of ecosystem services in Europe - Phase II

    DEFF Research Database (Denmark)

    Maes, Joachim; Hauck, Jennifer; Paracchini,, Maria Luisa

    forests several times per year and they expressed their willingness to pay to continue doing so. The visitor statistics that were used in this study confirmed the usefulness of the ROS approach (Recreation Opportunity Spectrum) to identify areas in terms of their accessibility and potential to provide......, mapping and valuation. Linking the maps of ecosystem service supply to monetary valuation allowed an analysis of the expected impact of policy measures on benefits derived from ecosystem services. The recreation case, which Marianne participated in, presents evidence that millions of people visited...... recreation services. In addition, PRESS-2 presents a spatial analysis of city population density and green urban areas....

  1. An exploration of service user involvement in the assessment of students

    International Nuclear Information System (INIS)

    Naylor, S.; Harcus, J.; Elkington, M.

    2015-01-01

    Introduction: This paper is an exploration of service user involvement in assessing first year diagnostic radiography students' ability to practise and interact with the public safely prior to attending placement. Service users took the role of patients during a simulation exercise undertaken in a general X-ray room. In recent years the importance of involving service users in all aspects of healthcare has been promoted; this includes being involved in the education of healthcare workers. The evaluation of service user involvement in the education of healthcare workers is limited, as is any literature about service user involvement outside nursing, mental health, and social work. Method: Feedback was obtained via email and face to face via a focus group from academic staff, service users and students using open questions. Results: The benefits of service user involvement were that it made the exercise more relevant and meaningful. It was perceived as a valuable exercise for the students to interact with service users in terms of developing, and for assessing, patient care, communication and positioning skills. The service users valued the experience. Issues highlighted include travel to the venue and the physical demands on the service user. Concerns highlighted by previous authors of preparation of the service users for their role, and remuneration had been addressed prior to the exercise. Conclusion: There is increasing diversity in the ways in which service users are involved in education. Service user involvement as patients in a simulation exercise for student assessment was deemed successful in this setting. - Highlights: • There is limited literature about service user involvement outside nursing, mental health and social work. • There are benefits to involving service users in the assessment of student diagnostic radiographers. • There are challenges to involving service users in the assessment of student diagnostic radiographers

  2. Use of SERVQUAL to assess clinicians' satisfaction with the blood transfusion service.

    Science.gov (United States)

    Raspollini, E; Pappalettera, M; Riccardi, D; Parravicini, A; Sestili, S; Rebulla, P; Sirchia, G

    1997-01-01

    Limited information is available on the level of satisfaction of clinicians with services delivered by blood banks. The purpose of this study was to evaluate the satisfaction of clinicians with our blood transfusion service. We prepared a questionnaire based on SERVQUAL, a method used to measure customers' appreciation of quality of service, by assessing the gap between perceived and expected quality. The questionnaire consisted of 14 items grouped according to five dimensions of quality of service: assurance, empathy, responsiveness, reliability, tangibles. Clinicians were asked to give two scores on a scale from 1 to 7 for each item, score (e) representing what they expected from an 'excellent' service, score (r) how they graded the service received. We considered wide differences in scores of service expectation and receipt for a question to be indicative of either service above expected levels (r > e) or service below expectation (r SERVQUAL was useful to gather information on the level of clinicians' satisfaction with our transfusion service.

  3. Assessing the In-Service Needs of Basic School Natural Science ...

    African Journals Online (AJOL)

    ... that no significant associations existed. It was recommended among other things that in-service training courses be used as platforms in upgrading the teachers' knowledge and skills. Additionally, in-service course organizers should first assess the in-service needs of participants before providing the appropriate support ...

  4. A framework and approach for assessing the value of personal health records (PHRs).

    Science.gov (United States)

    Johnston, Douglas; Kaelber, David; Pan, Eric C; Bu, Davis; Shah, Sapna; Hook, Julie M; Middleton, Blackford

    2007-10-11

    Personal Health Records (PHRs) are a rapidly expanding area of medical informatics due to the belief that they may improve health care delivery and control costs of care. The PHRs in use or in development today support a myriad of different functions, and consequently offer different value propositions. A comprehensive value analysis of PHRs has never been conducted; such analysis is needed to identify those PHR functions that yield the greatest value to PHR stakeholders. Here we present a framework that could serve as a foundation for determining the value of PHR functions and thereby help optimize PHR development. While the value framework is specific to the domain of PHRs, the authors have successfully applied the associated evaluation methodology in assessing other health care information technologies.

  5. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Directory of Open Access Journals (Sweden)

    Paula Dhiman

    Full Text Available The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD. However the quality of family health information in primary care records is unclear.To assess the availability and quality of family history of CHD documented in electronic primary care records.Cross-sectional study.537 UK family practices contributing to The Health Improvement Network database.Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st January 1998 and 31(st December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively.In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25, however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88. Of the 140,058 patients with a positive family history recorded (9% of total cohort, age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration.Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  6. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Science.gov (United States)

    Dhiman, Paula; Kai, Joe; Horsfall, Laura; Walters, Kate; Qureshi, Nadeem

    2014-01-01

    The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD). However the quality of family health information in primary care records is unclear. To assess the availability and quality of family history of CHD documented in electronic primary care records. Cross-sectional study. 537 UK family practices contributing to The Health Improvement Network database. Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st) January 1998 and 31(st) December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively. In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25)), however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88)). Of the 140,058 patients with a positive family history recorded (9% of total cohort), age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration. Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  7. Value Retention, Service Life, Use Intensity and Long-Term Productivity of Wood Chippers as Obtained from Contractor Records

    Directory of Open Access Journals (Sweden)

    Raffaele Spinelli

    2017-12-01

    Full Text Available Acknowledging the absence of up-to-date empirical data on the value retention, service life and annual use of chipping machinery, in 2017 the authors surveyed the records kept by 50 contractors offering biomass chipping services. The machine fleet and operations in this survey could be taken as representative for most of Europe, where the biomass sector is well established and is facing further expansion. Data collection included the whole chipping unit, comprised of chipper, carrier and loader. Manually-fed units were excluded from the survey. The data pointed at a service life up to and exceeding 10,000 h and 10 years, which relieved any concerns about poor durability. Value retention was good, and may exceed that of other mainstream forestry equipment. Engine power was the main explanatory variable in any models to predict purchase price and productivity. The effect of this variable could explain most of the variability (>80% in the purchase price and productivity data. Results also pointed at the essential equivalence in price and productivity between PTO-driven (i.e., tractor powered and independent-engine chippers, once differences in engine power are accounted for. However, the distribution of purchase price between different components of the chipping unit was different between the two unit types, with the chipper accounting for a larger proportion of the total investment in independent-engine units. Machine power was also different, with most PTO-driven units being significantly smaller than independent-engine units, due to the limitations of existing tractors. Furthermore, half of the carriers assigned to a PTO-driven unit were subject to flexible use, i.e., they were not solely used for chipping work.

  8. Assessing the Value Dimensions of Outsourced Maintenance Services

    DEFF Research Database (Denmark)

    Toossi, Amir; Lockett, Helen Louise; Raja, Jawwad

    2013-01-01

    Purpose – The purpose of this paper is to investigate the diverse nature of tangible and intangible value dimensions that contribute to customers’ perception of value from outsourced maintenance services. Design/methodology/approach – A multiple case study approach has been adopted. Repertory grid......, an in-depth structured interviewing technique, has been used in order to draw out the respondents’ hidden constructs in evaluating outsourced maintenance services. Data have been collected from four customer organizations of outsourced maintenance services, and a total of 33 interviews have been...... undertaken. Findings – The paper has identified a range of tangible and intangible value dimensions that are of importance in maintenance outsourcing decision making. The most important value dimensions for maintenance outsourcing were found to be specialist knowledge, accessibility (of the service provider...

  9. REST Service - Resource Assessment Investigation of the Mariana Archipelago (RAIOMA)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data service represents a subset of fisheries research carried out by the Pacific Island Fisheries Science Center (PIFSC) in the Mariana Archipelago. Specific...

  10. Assessment of Extension Service Delivery on Improved Cassava ...

    African Journals Online (AJOL)

    SH

    1Department of Agricultural Extension and Rural Development, Landmark University, Omu –Aran, Kwara. State. 2Department ... production technologies among cassava farmers in Osun State, Nigeria. Multistage ... included fertilizer procurement, agrochemicals, cooperative facilities, social networks, tractor hiring services,.

  11. Assessment of Patient Satisfaction with Pharmaceutical Services in ...

    African Journals Online (AJOL)

    Prof. Kongola

    Key words: Pharmaceutical services, patient satisfaction, Dar es Salaam. INTRODUCTION ... business venture and therefore customer ... Factors that influenced patients to go to particular pharmacies. .... identified as affecting the utilization of.

  12. Assessment of Emergency Obstetric Care Services in Ibadan ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    ORIGINAL RESEARCH ARTICLE ... Nigeria's high maternal mortality has been attributed to poor utilization of obstetric care services to handle ... Poor obstetric outcome in middle and low-income ... Evidence also showed that access to.

  13. Service reliability assessment using failure mode and effect analysis ...

    African Journals Online (AJOL)

    user

    Statistical Process Control Teng and Ho (1996) .... are still remaining left on modelling the interaction between impact of internal service failure and ..... Design error proofing: development of automated error-proofing information systems, Proceedings of.

  14. Assessing, mapping and quantifying cultural ecosystem services at community level

    NARCIS (Netherlands)

    Plieninger, T.; Dijks, S.; Oteros Rozas, E.; Bieling, C.

    2013-01-01

    Numerous studies underline the importance of immaterial benefits provided by ecosystems and especially by cultural landscapes, which are shaped by intimate human–nature interactions. However, due to methodological challenges, cultural ecosystem services are rarely fully considered in ecosystem

  15. Predicting Pre-Service Teachers' Intention of Implementing Peer Assessment for Low-Achieving Students

    Science.gov (United States)

    Yim, Su Yon; Cho, Young Hoan

    2016-01-01

    Despite the benefits of peer assessment, many teachers are not willing to implement it, particularly for low-achieving students. This study used the theory of planned behaviour to predict pre-service teachers' intention to use peer assessment for low-achieving students. A total of 229 pre-service teachers in Singapore participated in the survey…

  16. Beyond Assessment: Conducting Theoretically Grounded Research on Service-Learning in Gerontology Courses.

    Science.gov (United States)

    Kruger, Tina M; Pearl, Andrew J

    2016-01-01

    Service-learning is a useful pedagogical tool and high-impact practice, providing multiple benefits. Gerontology (and other) courses frequently include service-learning activities but lack theory-based, intentional research on outcomes. Here, the authors define service-learning and contextualize it in higher education, provide an overview of research and assessment in service-learning and gerontology courses, demonstrate the shortcomings of program evaluations, and offer suggestions for future research to advance and generate theory.

  17. Assessing service quality in business-to-business relationships within the international telecommunications carrier market.

    OpenAIRE

    2012-01-01

    M.Comm. The objectives of this study are : To determine customers' perception of service quality of international telecommunications carrier services delivered by Telkom in the business-tobusiness relationships with carriers in Europe; To establish whether differences in service quality exist among the selected business customers; To identify and examine customers' needs and expectations regarding the service delivery by Telkom; To assess how well Telkom is currently performing relative to...

  18. Implantable loop recorders for assessment of syncope: increased diagnostic yield and less adverse outcomes with the latest generation devices.

    Science.gov (United States)

    Bartoletti, A; Bocconcelli, P; De Santo, T; Ghidini Ottonelli, A; Giuli, S; Massa, R; Svetlich, C; Tarsi, G; Corbucci, G; Tronconi, F; Vitale, E

    2013-08-01

    Aim of the study was to compare the diagnostic yield of implantable loop recorders (ILR) of two successive generations for the assessment of syncope. Data on patients who had undergone ILR implantation for unexplained syncope in four Italian public hospitals were retrospectively acquired from the Medtronic Clinical Service database. After implantation, routine follow-up examinations were performed every 90 days, while urgent examinations were carried out in the event of syncope recurrence. The following findings were regarded as diagnostic: ECG documentation of a syncope recurrence; documentation of any of the arrhythmias listed by the current guidelines as diagnostic findings even if asymptomatic. Between November 2002 and March 2010, 107 patients received an ILR (40 Medtronic Reveal® Plus; 67 Medtronic Reveal® DX/XT) and underwent at least one follow-up examination. Diagnoses were made in 7 (17.5%) and 24 (35.8%) (P=0.043) patients, with a median time of 228 and 65 days, respectively. Three (42.9%) and 21 (87.5%) (P=0.029) diagnoses were based on automatically detected events, while adverse outcomes occurred in 6 and in 1 (P=0.01) patients, respectively. Our results show that the new-generation device offer a higher diagnostic yield, mainly as a result of its improved automatic detection function, and is associated with fewer adverse outcomes.

  19. Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

    Science.gov (United States)

    Thatte, Nandita; Choi, Yoonjoung

    2015-04-01

    Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be

  20. Influence of service life on Life Cycle Assessments

    NARCIS (Netherlands)

    van Nunen, H.; Hendriks, N.A.; Erkelens, P.A.

    2003-01-01

    Environmental assessment is part of present decision making. But, because of difficulties the assessments are not as profound as could be. Life Cycle Assessment (LCA) is a cradle-to-grave approach and consequently a time factor is embedded. Until now this time factor is fixed and calculations are

  1. Assessment of a pioneer metabolic information service in Brazil.

    Science.gov (United States)

    Brustolin, Silvia; Souza, Carolina; Puga, Ana Cristina; Refosco, Lilia; Pires, Ricardo; Peres, Rossana; Giugliani, Roberto

    2006-01-01

    The Information Service on Inborn Errors of Metabolism (SIEM), a pioneer toll-free service in both Brazil and South America, is based in Porto Alegre, Southern Brazil. SIEM has been operating since October 2001 providing support to health care professionals involved in the diagnosis and management of suspected metabolic diseases. We analyzed the demographic and clinical characteristics of the 376 consults received and followed in the first two and half years of SIEM. Our results show that the suspicion of a metabolic disease was most often associated with neurological symptoms. Among the consults, 24.4% were eventually confirmed as inborn errors of metabolism (IEM), with organic acidurias and amino acid disorders being the two most frequent diagnostic groups. Our conclusion shows this kind of service to provide helpful support to the diagnosis and acute management of IEM, especially to health professionals working in developing countries who are often far from reference centers.

  2. Chapter 1: Assessing pollinator habitat services to optimize conservation programs

    Science.gov (United States)

    Iovanna, Richard; Ando , Amy W.; Swinton, Scott; Hellerstein, Daniel; Kagan, Jimmy; Mushet, David M.; Otto, Clint R.; Rewa, Charles A.

    2017-01-01

    Pollination services have received increased attention over the past several years, and protecting foraging area is beginning to be reflected in conservation policy. This case study considers the prospects for doing so in a more analytically rigorous manner, by quantifying the pollination services for sites being considered for ecological restoration. The specific policy context is the Conservation Reserve Program (CRP), which offers financial and technical assistance to landowners seeking to convert sensitive cropland back to some semblance of the prairie (or, to a lesser extent, forest or wetland) ecosystem that preceded it. Depending on the mix of grasses and wildflowers that are established, CRP enrollments can provide pollinator habitat. Further, depending on their location, they will generate related services, such as biological control of crop pests, recreation, and aesthetics. While offers to enroll in CRP compete based on cost and some anticipated benefits, the eligibility and ranking criteria do not reflect these services to a meaningful degree. Therefore, we develop a conceptual value diagram to identify the sequence of steps and associated models and data necessary to quantify the full range of services, and find that critical data gaps, some of which are artifacts of policy, preclude the application of benefit-relevant indicators (BRIs) or monetization. However, we also find that there is considerable research activity underway to fill these gaps. In addition, a modeling framework has been developed that can estimate field-level effects on services as a function of landscape context. The approach is inherently scalable and not limited in geographic scope, which is essential for a program with a national footprint. The parameters in this framework are sufficiently straightforward that expert judgment could be applied as a stopgap approach until empirically derived estimates are available. While monetization of benefit-relevant indicators of yield

  3. How to assess quality in your sexual health service.

    Science.gov (United States)

    Hathorn, Emma; Land, Lucy; Ross, Jonathan D C

    2011-10-01

    Previous improvements in NHS have largely focused on increasing service capacity to ensure the provision of universal, comprehensive healthcare at the point of need in the UK. However, public expectations of the NHS are changing, triggered by increased access to information and media coverage of a series of lapses in quality and geographical inequity of care. The NHS also faces the challenges posed by a changing family structure, an ageing population, advancing technology and economic uncertainty. To meet these challenges, improvements in quality rather than just quantity have become a focus of the new NHS. This article provides an overview of quality and how to measure it in sexual health services.

  4. The Assessment of Hotel Services in Poiana Brasov Resort

    Directory of Open Access Journals (Sweden)

    Baltescu C.A.

    2014-12-01

    Full Text Available The choice of a holiday destination is determined by the features of the existing accommodation offer. The quality of hotel services provided influence the attracted customer segment, the satisfaction degree of consumption, the loyalty degree for the accommodation unit and destination, and also the economic-financial performance of the company. This article analyzes the opinions of tourists staying in Poiana Braşov resort regarding their consumption experience in one of the most representative hotels of the resort. The results obtained show customers’ expectations, satisfaction degree after consumption and future ways for adapting and improving hotel services.

  5. ORBDA: An openEHR benchmark dataset for performance assessment of electronic health record servers.

    Directory of Open Access Journals (Sweden)

    Douglas Teodoro

    Full Text Available The openEHR specifications are designed to support implementation of flexible and interoperable Electronic Health Record (EHR systems. Despite the increasing number of solutions based on the openEHR specifications, it is difficult to find publicly available healthcare datasets in the openEHR format that can be used to test, compare and validate different data persistence mechanisms for openEHR. To foster research on openEHR servers, we present the openEHR Benchmark Dataset, ORBDA, a very large healthcare benchmark dataset encoded using the openEHR formalism. To construct ORBDA, we extracted and cleaned a de-identified dataset from the Brazilian National Healthcare System (SUS containing hospitalisation and high complexity procedures information and formalised it using a set of openEHR archetypes and templates. Then, we implemented a tool to enrich the raw relational data and convert it into the openEHR model using the openEHR Java reference model library. The ORBDA dataset is available in composition, versioned composition and EHR openEHR representations in XML and JSON formats. In total, the dataset contains more than 150 million composition records. We describe the dataset and provide means to access it. Additionally, we demonstrate the usage of ORBDA for evaluating inserting throughput and query latency performances of some NoSQL database management systems. We believe that ORBDA is a valuable asset for assessing storage models for openEHR-based information systems during the software engineering process. It may also be a suitable component in future standardised benchmarking of available openEHR storage platforms.

  6. ORBDA: An openEHR benchmark dataset for performance assessment of electronic health record servers

    Science.gov (United States)

    Sundvall, Erik; João Junior, Mario; Ruch, Patrick; Miranda Freire, Sergio

    2018-01-01

    The openEHR specifications are designed to support implementation of flexible and interoperable Electronic Health Record (EHR) systems. Despite the increasing number of solutions based on the openEHR specifications, it is difficult to find publicly available healthcare datasets in the openEHR format that can be used to test, compare and validate different data persistence mechanisms for openEHR. To foster research on openEHR servers, we present the openEHR Benchmark Dataset, ORBDA, a very large healthcare benchmark dataset encoded using the openEHR formalism. To construct ORBDA, we extracted and cleaned a de-identified dataset from the Brazilian National Healthcare System (SUS) containing hospitalisation and high complexity procedures information and formalised it using a set of openEHR archetypes and templates. Then, we implemented a tool to enrich the raw relational data and convert it into the openEHR model using the openEHR Java reference model library. The ORBDA dataset is available in composition, versioned composition and EHR openEHR representations in XML and JSON formats. In total, the dataset contains more than 150 million composition records. We describe the dataset and provide means to access it. Additionally, we demonstrate the usage of ORBDA for evaluating inserting throughput and query latency performances of some NoSQL database management systems. We believe that ORBDA is a valuable asset for assessing storage models for openEHR-based information systems during the software engineering process. It may also be a suitable component in future standardised benchmarking of available openEHR storage platforms. PMID:29293556

  7. ORBDA: An openEHR benchmark dataset for performance assessment of electronic health record servers.

    Science.gov (United States)

    Teodoro, Douglas; Sundvall, Erik; João Junior, Mario; Ruch, Patrick; Miranda Freire, Sergio

    2018-01-01

    The openEHR specifications are designed to support implementation of flexible and interoperable Electronic Health Record (EHR) systems. Despite the increasing number of solutions based on the openEHR specifications, it is difficult to find publicly available healthcare datasets in the openEHR format that can be used to test, compare and validate different data persistence mechanisms for openEHR. To foster research on openEHR servers, we present the openEHR Benchmark Dataset, ORBDA, a very large healthcare benchmark dataset encoded using the openEHR formalism. To construct ORBDA, we extracted and cleaned a de-identified dataset from the Brazilian National Healthcare System (SUS) containing hospitalisation and high complexity procedures information and formalised it using a set of openEHR archetypes and templates. Then, we implemented a tool to enrich the raw relational data and convert it into the openEHR model using the openEHR Java reference model library. The ORBDA dataset is available in composition, versioned composition and EHR openEHR representations in XML and JSON formats. In total, the dataset contains more than 150 million composition records. We describe the dataset and provide means to access it. Additionally, we demonstrate the usage of ORBDA for evaluating inserting throughput and query latency performances of some NoSQL database management systems. We believe that ORBDA is a valuable asset for assessing storage models for openEHR-based information systems during the software engineering process. It may also be a suitable component in future standardised benchmarking of available openEHR storage platforms.

  8. Multi-Institutional Sharing of Electronic Health Record Data to Assess Childhood Obesity.

    Directory of Open Access Journals (Sweden)

    L Charles Bailey

    Full Text Available To evaluate the validity of multi-institutional electronic health record (EHR data sharing for surveillance and study of childhood obesity.We conducted a non-concurrent cohort study of 528,340 children with outpatient visits to six pediatric academic medical centers during 2007-08, with sufficient data in the EHR for body mass index (BMI assessment. EHR data were compared with data from the 2007-08 National Health and Nutrition Examination Survey (NHANES.Among children 2-17 years, BMI was evaluable for 1,398,655 visits (56%. The EHR dataset contained over 6,000 BMI measurements per month of age up to 16 years, yielding precise estimates of BMI. In the EHR dataset, 18% of children were obese versus 18% in NHANES, while 35% were obese or overweight versus 34% in NHANES. BMI for an individual was highly reliable over time (intraclass correlation coefficient 0.90 for obese children and 0.97 for all children. Only 14% of visits with measured obesity (BMI ≥95% had a diagnosis of obesity recorded, and only 20% of children with measured obesity had the diagnosis documented during the study period. Obese children had higher primary care (4.8 versus 4.0 visits, p<0.001 and specialty care (3.7 versus 2.7 visits, p<0.001 utilization than non-obese counterparts, and higher prevalence of diverse co-morbidities. The cohort size in the EHR dataset permitted detection of associations with rare diagnoses. Data sharing did not require investment of extensive institutional resources, yet yielded high data quality.Multi-institutional EHR data sharing is a promising, feasible, and valid approach for population health surveillance. It provides a valuable complement to more resource-intensive national surveys, particularly for iterative surveillance and quality improvement. Low rates of obesity diagnosis present a significant obstacle to surveillance and quality improvement for care of children with obesity.

  9. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    Directory of Open Access Journals (Sweden)

    Aveledi Blandine

    2009-12-01

    Full Text Available Abstract Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC. Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC and family planning (FP. Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive. Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1 providing necessary equipment and renovations to health facilities; 2 improving supply management systems; 3 providing comprehensive competency

  10. Faculty and Student Assessment of the Citadel Library User Services.

    Science.gov (United States)

    Maynard, J. Edmund

    The focus of this study was a survey of faculty and student use/needs of library services and user education at Daniel Library, the Citadel, the Military College of South Carolina. More specifically, the study sought to determine user information needs and how the library staff should adapt for meeting the educational and research needs of its…

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

    African Journals Online (AJOL)

    Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. Conclusions: The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for ...

  12. An Assessment of School Library Resources and Services in ...

    African Journals Online (AJOL)

    The paper evaluates the availability of library resources and services in selected secondary schools. Data were collected from 300 respondents who participated in this study through completion of questionnaire and participation in interview sessions. The findings of this study show that available library resources and ...

  13. Using the critical incident survey to assess hospital service quality.

    Science.gov (United States)

    Longo, B; Connor, G; Barnhart, T

    1993-01-01

    This survey was designed to determine "standards of excellence" in hospital services as defined by (a) former patients, (b) physicians, (c) hospital employees, and (d) corporate insurance subscribers. One hundred forty-seven (147) patients, 188 employees, and 20 corporate subscribers were interviewed by telephone, and 52 physicians were interviewed in their offices. The interview consisted of a single question: "Can you think of a time when, as a patient/employee/employer/physician, you had a particularly satisfying or dissatisfying experience with a local hospital?" Reported incidents were reviewed, and 239 "critical incidents" were identified. These incidents were classified into 12 descriptive categories relating to the underlying factors in the incident reports. Six focus groups were later held with participants segregated by the population pool they represented. These groups were asked to develop definitions of "excellence" in hospital service quality and standards for service which would "exceed expectations." The focus groups created 122 standards of excellence, which were classified into 43 categories. Overall, the largest percentages of corporate, physician, and employee critical incidents were classified as "Administrative Policy" issues. Patients most often reported "Nurturing" incidents as critical to their perceptions of hospital service quality.

  14. Assessment of veterinary extension services to livestock farmers in ...

    African Journals Online (AJOL)

    The study examined operational modes of providing veterinary extension services to livestock farmers in Egba-Division, Ogun-State Nigeria. Information was obtained from 120 livestock farmers and 8 extension agents selected through multi-stage random sampling technique with the use of both structured questionnaire ...

  15. An assessment of policies and services provision to the physically ...

    African Journals Online (AJOL)

    The researcher recommended among others that Academic library policy must be redesigned to include disability resources and services in conformity with ALA standard and Library management should create a disability liaison office on the ground floor of their multiple storey buildings and affiliate such offices with any ...

  16. Assessment of Parents' Satisfaction with Paediatric Surgery Services ...

    African Journals Online (AJOL)

    Ademuyıwa O Adesoji

    Items 1 - 14 ... Services at a Tertiary Hospital in South West Nigeria: A Quality Control ... literate parents of paediatric post-op patients were serially recruited from the pediatric .... such as poor electricity and water supply in a survey of dental.

  17. Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

    Directory of Open Access Journals (Sweden)

    D Pillay

    2017-10-01

    Full Text Available Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ, Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities. Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective

  18. Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

    Science.gov (United States)

    Pillay, D; Morroni, C; Pleaner, M; Adeogba, O; Chersich, M; Naidoo, N; Mullick, S; Rees, H

    2017-10-01

    Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA) in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ), Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities). Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective decision

  19. 42 CFR 93.224 - Research record.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Research record. 93.224 Section 93.224 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH...

  20. Summary Record of the 15th Meeting of the Working Group on Risk Assessment (WGRISK)

    International Nuclear Information System (INIS)

    2015-01-01

    The main mission of the working group on risk assessment (WGRISK) is to advance the understanding and utilisation of probabilistic safety assessment (PSA) in ensuring the continued safety of nuclear installations in member countries. While PSA methodology has matured greatly over the years, further work is required. WGRISK has been active in several of these areas, including: human reliability; software reliability; low power and shutdown risk. In order to maintain a current perspective, the working group collaborates and assists other working groups within the CSNI, such as operating experience and organisational factors as well as keeping close co-ordination with other international organisations. Over the past twenty years, the NEA PWG5 and now WGRISK have looked at the technology and methods used for identifying contributors to risk and assessing their importance. Work during much of this period was concentrated on Level-1 PSA methodology. In recent years the focus has shifted into more specific PSA methodologies and risk-informed applications. This document summarizes the content of the 15. Meeting of WGRISK: - presentation of the new WGRISK Bureau, - Approval of the 14. WGRISK Meeting Summary Record [NEA/SEN/SIN/WGRISK (2013)1], - Use and Development of PSA in NEA Member Countries and by other International Organisations, - Report by the WGRISK Secretariat on the current WGRISK programme of work, actions taken by CSNI and CNRA and other recent developments in OECD/NEA, - Development of BPGs on failure mode taxonomy for reliability assessment of digital I and C systems for PSA [Task 2010-3], - Update Use of OECD Data Project Products in PSA [Task 2011-1], - Status report on the common WGHOF/WGRISK HRA Task, - Outcome on the International Workshop on PSA of Natural External Hazards Including Earthquakes, April 2014 [Task 2012-1], - Status report on the International Workshop on Fire PRA [Task 2012-2], - PSA insights relating to the loss of electrical sources

  1. The Influence of Resettlement of the Capital of Probolinggo Regency Toward Service Quality of Police Record (SKCK (Study in Probolinggo Resort Police

    Directory of Open Access Journals (Sweden)

    Erlinda Puspitasari

    2014-02-01

    Full Text Available This study examined the influence of resettlement of the capital of Probolinggo Regency toward service quality of Police Record (SKCK in Probolinggo Resort Police. Probolinggo Resort Police (Polres is one government agencies that experiencing resettlement of the location from Probolinggo City to Kraksaan district. It is expected that by this resettlement, public service processes would become ‘better and in high quality’. The study used quantitative research method with explanatory approach to test the hypothesis that has been set. Dependent variable in this study are resettlement of the capital of regency (X with the variables: affordability, recoverability and replicability. While the dependent variable in this study are the service quality of Police Record (SKCK (Y with the indicators: tangibles, reliability, responsiveness, assurance and empathy. The study used multiple linear regression method of analysis. The study revealed that the resettlement of the capital of regency variable (X which consist of three variables such as affordability (X1, recoverability (X2 and replicability variable (X3 influence significantly toward service quality of the Police Record (SKCK in Probolinggo Resort Police (Polres. Keywords: The Resettlement, The Capital of Regency, Service Quality, Police Record (SKCK, Probolinggo Resort Police.

  2. A review of official data obtained from dog control records generated by the dog control service of county cork, Ireland during 2007

    Science.gov (United States)

    2012-01-01

    Background There are no peer reviewed data on dog control records from an official agency in Ireland. In order to address this, a total of 2,669 official dog control service records generated during 2007 by Cork County Council dog control service were reviewed. Results Over 70 percent of records related to unwanted dogs and dogs not under their owners control. Stray dogs were collected by the service regularly throughout the year but with notable increase in voluntary surrenders by owners from January through to April. The majority of dogs collected or surrendered were male (2:1 ratio), of medium size, described as having a friendly temperament and were not wearing a neck collar. The Crossbreed and Greyhound breeds were more frequently collected as strays, while Greyhounds and German Shepherds were more frequently voluntarily surrendered by their owner. Restricted breeds such as Pit Bull terriers, German Shepherds and Rottweilers were more frequently reported by members of the public for aggressive behaviour while the only restricted breed reported for biting or snapping was the German Shepherd. Conclusions Routine recording of dog control services in County Cork provide data on responsible dog ownership including the licensing of breeds, and surrender of owned dogs and the collection of stray dogs. Data capture and utilisation of dog control services by local authorities has potential to inform policy on responsible dog ownership and education programmes. PMID:22681751

  3. Performance assessment of junior public health nurse in maternal and child health services in a district of Kerala, India

    Directory of Open Access Journals (Sweden)

    Achampattu Mridulal

    2015-01-01

    Full Text Available Background: Performance assessment of health services provided to maternal and child population is an important area of concern especially in developing countries including India. Aim: This study was conducted to assess the performance of Junior Public Health Nurses (JPHN on services provided to maternal and child health at sub-centers in Malappuram district of Kerala, India. Methods: Maternal and child health services were assessed based on record analysis and interviewing JPHN in 30 randomly selected sub-centers using a predesigned questionnaire prepared according to Indian Public Health Standards for sub-centers. The work performed by the JPHNs was graded as excellent, very good, good, satisfactory, and poor based on the standard guidelines. Results: Population covered by the 30 JPHNs at their sub-centers ranges from 5050 to 9869. Services were excellent in all the sub-centers for tetanus toxoid immunization and institutional deliveries. Although antenatal care (ANC registration was excellent in 70% of the sub-centers, it was poor for the 1 st trimester ANC registration in 50% of sub-centers. In the case of referral services and postnatal care (PNC, 27% and 33% of the centers were excellent, respectively. 50% of the centers have had poor performance in PNC. Detection of beneficiaries for immunization by JPHNs was excellent in 60% of the sub-centers. Measles and full immunization coverage was poor in 40% of sub-centers. Around 77% JPHNs attended in-service training, and 90% of them could prepare sub-center annual action-plan. Conclusion: There is a variation in performance of JPHNs at a sub-district level which highlights the importance of further studies to elucidate the factors associated with it.

  4. "An Assessment of Ecosystem Services of the Everest Region, Nepal"

    OpenAIRE

    Tamang, Bikram

    2011-01-01

    Land use and land cover changes in the region were analyzed on the basis of information extracted from satellite image data. Based on this information, it is clearly noticed that the different land use classes have changed their forms and degrees in different time periods due to the driving forces such as national park activities, influx of Tibetan refugees, climate change and growth of tourism. Furthermore, the landscapes dynamics and their relation to the provisioning of ecosystem services ...

  5. Shuttle bus services quality assessment Tangerang Selatan toward smart city

    Science.gov (United States)

    Fassa, Ferdinand; Sitorus, Fredy Jhon Philip; Adikesuma, Tri Nugraha

    2017-11-01

    Around the world, shuttle bus operation played the significant role to accommodate transportation for commuting bus passengers. Shuttle Bus services in cities are provided by various bus agencies with kinds of own specific purposes. For instance, at Tangerang Selatan, Indonesia, it was said that shuttle bus In Trans Bintaro is run and operated by private bus companies hire by Bintaro developer. The aim of this research is to identify factors of satisfaction of shuttle bus service in Kota Tangerang Selatan, Indonesia. Several factors are used to analyze sums of 20 parameters performance indicators of Shuttle Bus. A face to face interview using a questionnaire (N=200) was used to collect data on October and March 2017. Likert and diagram Cartesian were used to model the all the parameters. This research succeeded in finding some categories of Shuttle bus service attributes such as accessibility, comfort, and safety. Users agreed that eight indicators in shuttle bus have the excellent achievement, while three indicators on performance remain low and should receive more attention especially punctuality of the bus.

  6. A comprehensive assessment of cardiovascular autonomic control using photoplethysmograms recorded from the earlobe and fingers

    International Nuclear Information System (INIS)

    Kiselev, A R; Mironov, S A; Karavaev, A S; Kulminskiy, D D; Prokhorov, M D; Skazkina, V V; Borovkova, E I; Ponomarenko, V I; Shvartz, V A

    2016-01-01

    We compare the spectral indices of photoplethysmogram variability (PPGV) estimated using photoplethysmograms recorded from the earlobe and the middle fingers of the right and left hand and analyze their correlation with similar indices of heart rate variability (HRV) in 30 healthy subjects (26 men) aged 27 (25, 29) years (median with inter-quartile ranges) at rest and under the head-up tilt test. The following spectral indices of PPGV and HRV were compared: mean heart rate (HR), total spectral power (TP), high-frequency (HF) and low-frequency (LF) ranges of TP in percents (HF% and LF%), LF/HF ratio, and spectral coherence. We assess also the index S of synchronization between the LF oscillations in HRV and PPGV. The constancy of blood pressure (BP) and moderate increase of HR under the tilt test indicate the presence of fast processes of cardiovascular adaptation with the increase of the sympathetic activity in studied healthy subjects. The impact of respiration on the PPGV spectrum (accessed by HF%) is less than on the HRV spectrum. It is shown that the proportion of sympathetic vascular activity (accessed by LF%) is constant in the PPGV of three analyzed PPGs during the tilt test. The PPGV for the ear PPG was less vulnerable to breathing influence accessed by HF% (independently from body position) than for PPGs from fingers. We reveal the increase of index S under the tilt test indicating the activation of interaction between the heart and distal vessels. The PPGV spectra for finger PPGs from different hands are highly coherent, but differ substantially from the PPGV spectrum for the ear PPG. We conclude that joint analysis of frequency components of PPGV (for the earlobe and finger PPGs of both hands) and HRV and assessment of their synchronization provide additional information about cardiovascular autonomic control. (paper)

  7. Differences in chewing behaviors between healthy fully dentate young and older adults assessed by electromyographic recordings.

    Science.gov (United States)

    Zhu, Yong; Hollis, James H

    2015-01-01

    To characterize changes in chewing behaviors associated with healthy aging, 10 young and 10 older fully dentate healthy participants were enrolled in this study. They chewed carrot samples that differed in hardness until their normal swallowing threshold. Their chewing behaviors were assessed using an electromyographic recording device. Adjusting for gender and body mass index, older adults had a higher number of chewing cycles (p = 0.020), a longer chewing duration (p chewing rate (p = 0.002), a greater maximal electromyographic voltage (p = 0.003) and a greater muscle activity (p = 0.002) before they could comfortably swallow the food bolus. A statistically significant main effect of food hardness on the number of chewing cycles, chewing duration, chewing rate and muscle activity was also observed (p < 0.001 for all). These results suggest that reduced mastication efficiency is associated with healthy aging in fully dentate adults. This ingestive behavior may contribute to aging-related reduction in appetite in older adults.

  8. Coronary artery disease risk assessment from unstructured electronic health records using text mining.

    Science.gov (United States)

    Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

    2015-12-01

    Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

    Science.gov (United States)

    Kneale, Laura; Choi, Yong; Demiris, George

    2016-01-01

    Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

  10. Use of the Electronic Medical Record to Assess Pancreas Size in Type 1 Diabetes

    Science.gov (United States)

    Virostko, John; Hilmes, Melissa; Eitel, Kelsey; Moore, Daniel J.; Powers, Alvin C.

    2016-01-01

    Aims This study harnessed the electronic medical record to assess pancreas volume in patients with type 1 diabetes (T1D) and matched controls to determine whether pancreas volume is altered in T1D and identify covariates that influence pancreas volume. Methods This study included 25 patients with T1D and 25 age-, sex-, and weight-matched controls from the Vanderbilt University Medical Center enterprise data warehouse. Measurements of pancreas volume were made from medical imaging studies using magnetic resonance imaging (MRI) or computed tomography (CT). Results Patients with T1D had a pancreas volume 47% smaller than matched controls (41.16 ml vs. 77.77 ml, P pancreas volume normalized by subject body weight, body mass index, or body surface area (all P pancreas volume over time (~ 6% of volume/year), whereas five controls scanned a year apart did not exhibit a decline in pancreas size (P = 0.03). The pancreas was uniformly smaller on the right and left side of the abdomen. Conclusions Pancreas volume declines with disease duration in patients with T1D, suggesting a protracted pathological process that may include the exocrine pancreas. PMID:27391588

  11. Assessing the ecosystem service potential of Tucson AZ's urban forest

    Science.gov (United States)

    Pavao-Zuckerman, M.

    2011-12-01

    Urbanization is arguably one of the most dramatic forms of landscape change, and an important anthropogenic influence on the structure and function of ecosystems. Cities have obvious impacts on local ecologies and environments, such as shifts in species diversity and alteration of local microclimates. While scientists are now familiar with many of these localized impacts of urbanization, cities and suburban areas contribute to 10-15 % of surface land cover in the conterminous U.S., pointing to the potential, yet poorly understood, contribution of cities to regional, national, and global carbon (C) and energy budgets. As cities continue to expand urban ecologists place more emphasis on understanding the functions of urban ecosystems and the ecosystem services (e.g. habitat, air, and water quality) that cities provide. While studies demonstrate that the urban environment alters the structure and function of remnant patches of native ecosystems relative to their non-urban counterparts, the ability of restoration, planning, and design to improve the provision of ecosystem services is a new approach within ecology. One strategy involves green urban design, or using ecological principles for planning or reinvigorating certain ecological processes, in cities. Increasing the amount of vegetative cover can reduce this effect by reinforcing ecosystem services in cities, including shading of surfaces, promotion of cooling through evapotranspiration, and the sequestration of atmospheric CO2 in plant tissues and soils. However, the on-the-ground reality of such strategies is relatively unknown. A pilot study is being conducted in Tucson, AZ to investigate the impact of increasing the cover of trees in the urban landscape on local microclimates and the urban heat island. Trees (Velvet Mesquite, Chilean Mesquite, and Desert Willow) were planted in two neighborhoods in Tucson in 1990. We are collecting data during the summer 2011 monsoon (DBH, crown volume, and hemispherical

  12. Assessing the Idaho Transportation Department's customer service performance.

    Science.gov (United States)

    2011-10-23

    This report assesses customer satisfaction with the Idaho Transportation Department. It also compares and contrasts the results of customer satisfaction surveys conducted for the Idaho Transportation Department with the results from other state trans...

  13. Needs Assessment of Guidance Services in Schools as A Method

    African Journals Online (AJOL)

    Emeka Egbochuku

    Key Words: Academic programme evaluation; counselling; educational standards ... good success in a needs assessment study of any educational programme. ..... technology colleges in Ontario: Jones and Geis, 1995; and for physical.

  14. assessment of clients' satisfaction with health service deliveries at ...

    African Journals Online (AJOL)

    Abrham

    Hence, the objective of this study was to assess the perceived levels of clients' ... doctor. Furthermore, satisfaction with the health care was found to have a significant association with the age ... those client values and expectations, which are.

  15. Berlengas Biosphere Reserve - Plan for the assessment of ecosystem services and functions

    Directory of Open Access Journals (Sweden)

    Sergio Miguel Leandro

    2014-05-01

    Full Text Available The project Berlengas Biosphere Reserve - Plan for the Assessment of Ecosystem Services and Functions arises from the need to identify and assess ecosystem services, promoting sustainable uses of the services in the Reserve. The high degradation rate currently observed in the natural systems, thus reducing the level and quality of ecosystem services, is reflected in a negative effect on environmental quality, human well-being and in some economic activities. Thus, it becomes inevitable to promote the need to convey the importance of these services to society. It is also essential to contribute to the development of innovative and environmentally sustainable practices which will maintain the functioning of the local ecosystem and the sustainability of the services. Thus, the main goals of this project are i to identify and analyse the impacts and dependencies on ecosystem services in the Reserve; ii to analyse the trends of the priority services, iii to identify the risks and opportunities associated with these services; iv to evaluate their value and ultimately iv to disseminate the results improving conservation and management. Based on the results to be obtained through the evaluation and maintenance of these services it is expected an improvement on the environment in the region and the development of efficient mechanisms for the management of resources. Started in February 2014, over the past 3 months much research has already been conducted, with emphasis for the identification of services and opportunities in the Reserve. Ecosystem services in Berlengas can range from simply providing essential goods or support (e.g. fish to cultural services (e.g. field trips, diving. Work is also being done to develop, define and optimize the methods to assess ecosystems services trends and values.

  16. Assessing ELT Pre-Service Teachers via Web 2.0 Tools: Perceptions toward Traditional, Online and Alternative Assessment

    Science.gov (United States)

    Cirit, Nazli Ceren

    2015-01-01

    The purpose of this study is to investigate the perceptions of the ELT pre-service teachers toward the traditional, alternative, and online assessment methods and examine whether the participants' attitudes change toward the types of assessment after the tasks via Web 2.0 tools are implemented. In the light of these aims, the study was conducted…

  17. Assessing Learner Satisfaction by Simultaneously Measuring Learner Attitude, Motivation, Loyalty and Service Quality in English Academies

    Science.gov (United States)

    Huong, Vu Thi; Casadesus, Marti; Marimon, Frederic

    2017-01-01

    The aims of this study are threefold in their approach to English academy teaching: (i) to assess learner satisfaction, (ii) to assess the impact of satisfaction on loyalty and (iii) to assess the three constructs that we considered to be the antecedents of learner satisfaction: learner motivation, learner attitude and service quality. To collect…

  18. North Carolina Family Assessment Scale: Measurement Properties for Youth Mental Health Services

    Science.gov (United States)

    Lee, Bethany R.; Lindsey, Michael A.

    2010-01-01

    Objective: The purpose of this study is to assess the reliability and validity of the North Carolina Family Assessment Scale (NCFAS) among families involved with youth mental health services. Methods: Using NCFAS data collected by child mental health intake workers with 158 families, factor analysis was conducted to assess factor structure, and…

  19. Assessing Land Use Change and Its Impact on Ecosystem Services in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Sunsanee Arunyawat

    2016-08-01

    Full Text Available Ecosystem services are highly vulnerable to a number of impacts due to the complex effects of human use of natural resources and subsequent land use change. Assessment of the impact of change in land use with respect to ecosystem services is necessary in order to implement appropriate land uses that enhance ecosystem services. This study analysed the impact of change in land use on ecosystem services using the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST model to map and quantify a set of ecosystem services, namely sediment retention, water yield, carbon stock, and habitat quality, in northern Thailand, which has experienced substantial policy induced land use change. The study also assessed the changes in land use from 1989 to 2013 and their impact on overall ecosystem services using GIS. Increased rubber plantation cultivation and built-up areas resulting in reduced forest cover were the major changes found in land use in the area. The results of the study show a general decrease in ecosystem services for the study period in the watershed, in particular, a negative impact on ecosystem services was observed in agricultural areas. The study findings on spatial and temporal distribution of ecosystem services can help guide the development of appropriate land use options to enhance ecosystem services.

  20. Social Values for Ecosystem Services (SolVES): using GIS to include social values information in ecosystem services assessments

    Science.gov (United States)

    Sherrouse, B.C.; Semmens, D.J.

    2010-01-01

    Ecosystem services can be defined in various ways; simply put, they are the benefits provided by nature, which contribute to human well-being. These benefits can range from tangible products such as food and fresh water to cultural services such as recreation and esthetics. As the use of these benefits continues to increase, additional pressures are placed on the natural ecosystems providing them. This makes it all the more important when assessing possible tradeoffs among ecosystem services to consider the human attitudes and preferences that express underlying social values associated with their benefits. While some of these values can be accounted for through economic markets, other values can be more difficult to quantify, and attaching dollar amounts to them may not be very useful in all cases. Regardless of the processes or units used for quantifying such values, the ability to map them across the landscape and relate them to the ecosystem services to which they are attributed is necessary for effective assessments. To address some of the needs associated with quantifying and mapping social values for inclusion in ecosystem services assessments, scientists at the Rocky Mountain Geographic Science Center (RMGSC), in collaboration with Colorado State University, have developed a public domain tool, Social Values for Ecosystem Services (SolVES). SolVES is a geographic information system (GIS) application designed to use data from public attitude and preference surveys to assess, map, and quantify social values for ecosystem services. SolVES calculates and maps a 10-point Value Index representing the relative perceived social values of ecosystem services such as recreation and biodiversity for various groups of ecosystem stakeholders. SolVES output can also be used to identify and model relationships between social values and physical characteristics of the underlying landscape. These relationships can then be used to generate predicted Value Index maps for areas

  1. Use of lecture recordings in dental education: assessment of status quo and recommendations.

    Science.gov (United States)

    Horvath, Zsuzsa; O'Donnell, Jean A; Johnson, Lynn A; Karimbux, Nadeem Y; Shuler, Charles F; Spallek, Heiko

    2013-11-01

    This research project was part of a planned initiative at the University of Pittsburgh School of Dental Medicine to incorporate lecture recordings as standard educational support technologies. The goal of an institutional survey was 1) to gather current data about how dental educators across the United States and Canada use lecture recordings; 2) determine dental educators' perceived value and outcomes of using lecture recordings; and 3) develop recommendations based on #1 and #2 for the dental education community. Of the sixty-six North American dental schools at the time of the study, forty-five schools responded to the survey, for a 68 percent response rate. Of the respondents, twenty-eight schools were found to currently conduct lecture recording; these comprised the study sample. This study focused on the dental schools' past experiences with lecture recording; thus, those not currently engaged in lecture recording were excluded from further analysis. The survey questions covered a wide range of topics, such as the scope of the lecture recording, logistics, instructional design considerations, outcomes related to student learning, evaluation and reception, barriers to lecture recording, and issues related to copyright and intellectual property. The literature review and results from the survey showed that no common guidelines for best practice were available regarding lecture recordings in dental education. The article concludes with some preliminary recommendations based on this study.

  2. Assessment of annoyance, loudness and unpleasantness with different recording and playback techniques

    DEFF Research Database (Denmark)

    Celik, Emine; Persson Waye, Kerstin; Møller, Henrik

    2005-01-01

    if there is a difference in perception related to annoyance, loudness and unpleasantness between monophonic recordings played back through a loudspeaker and binaural recordings played back via headphones and to evaluate whether a possible difference depends on temporal and frequency characteristics as well as spatial...... through a loudspeaker and the binaural recordings were presented through both closed (circum-aural) and completely open (free of the ear) headphones. The results show that for all judgments (annoyance, loudness and unpleasantness), there was no significant main effect of recording and playback techniques...

  3. The importance of recording and playback technique for assessment of annoyance

    DEFF Research Database (Denmark)

    Celik, Emine; Persson Waye, Kerstin; Møller, Henrik

    2005-01-01

    in perception related to annoyance, loudness and unpleasantness between monophonic recordings played back through a loudspeaker and binaural recordings played back via headphones and to evaluate whether a possible difference depends on temporal and frequency characteristics as well as spatial characteristics...... a loudspeaker and the binaural recordings were presented through both closed (circum-aural) and completely open (free of the ear) headphones. The results show that for all judgments (annoyance, loudness and unpleasantness), there was no significant main effect of recording and playback techniques; however...

  4. DEVELOPMENT OF REMOTE TOOLS TO ASSESS THE EFFECTIVENESS AND QUALITY OF CAR SERVICE ENTERPRISES WORK

    Directory of Open Access Journals (Sweden)

    Vladimir Kozlovskiy

    2017-09-01

    Full Text Available The paper is updated development problem of remote tools to assess the effectiveness and work quality of the corporate car service enterprises. This paper presents the author’s methodology of activity estimation car service enterprises based on corporate information reflecting the report on the production activities of the service company. Specialized information system has been developed and implemented based on the proposed methodology. Specialized information system is the analytical tool for assessing the activities of enterprises the brand network of car service, for one of the largest national carmakers. The aim of research is development and realization of a monitoring system for certain areas of the car service work that significantly affect the quality process of the maintenance service. In addition, the paper is devoted to solving urgent issues of collection and processing of real data on warranty defects of cars.

  5. Service oriented architecture assessment based on software components

    Directory of Open Access Journals (Sweden)

    Mahnaz Amirpour

    2016-01-01

    Full Text Available Enterprise architecture, with detailed descriptions of the functions of information technology in the organization, tries to reduce the complexity of technology applications resulting in tools with greater efficiency in achieving the objectives of the organization. Enterprise architecture consists of a set of models describing this technology in different components performance as well as various aspects of the applications in any organization. Therefore, information technology development and maintenance management can perform well within organizations. This study aims to suggest a method to identify different types of services in service-oriented architecture analysis step that applies some previous approaches in an integrated form and, based on the principles of software engineering, to provide a simpler and more transparent approach through the expression of analysis details. Advantages and disadvantages of proposals should be evaluated before the implementation and costs allocation. Evaluation methods can better identify strengths and weaknesses of the current situation apart from selecting appropriate model out of several suggestions, and clarify this technology development solution for organizations in the future. We will be able to simulate data and processes flow within the organization by converting the output of the model to colored Petri nets and evaluate and test it by examining various inputs to enterprise architecture before implemented in terms of reliability and response time. A model of application has been studied for the proposed model and the results can describe and design architecture for data.

  6. 37 CFR 270.2 - Reports of use of sound recordings under statutory license for preexisting subscription services.

    Science.gov (United States)

    2010-07-01

    ... “Intended Playlists” for each channel and each day of the reported month. The “Intended Playlists” shall...; (2) The channel; (3) The sound recording title; (4) The featured recording artist, group, or... sound recording); (6) The marketing label of the commercially available album or other product on which...

  7. 37 CFR 370.3 - Reports of use of sound recordings under statutory license for preexisting subscription services.

    Science.gov (United States)

    2010-07-01

    ... “Intended Playlists” for each channel and each day of the reported month. The “Intended Playlists” shall...; (2) The channel; (3) The sound recording title; (4) The featured recording artist, group, or... sound recording); (6) The marketing label of the commercially available album or other product on which...

  8. Ecosystem services - from assessements of estimations to quantitative, validated, high-resolution, continental-scale mapping via airborne LIDAR

    Science.gov (United States)

    Zlinszky, András; Pfeifer, Norbert

    2016-04-01

    service potential" which is the ability of the local ecosystem to deliver various functions (water retention, carbon storage etc.), but can't quantify how much of these are actually used by humans or what the estimated monetary value is. Due to its ability to measure both terrain relief and vegetation structure in high resolution, airborne LIDAR supports direct quantification of the properties of an ecosystem that lead to it delivering a given service (such as biomass, water retention, micro-climate regulation or habitat diversity). In addition, its high resolution allows direct calibration with field measurements: routine harvesting-based ecological measurements, local biodiversity indicator surveys or microclimate recordings all take place at the human scale and can be directly linked to the local value of LIDAR-based indicators at meter resolution. Therefore, if some field measurements with standard ecological methods are performed on site, the accuracy of LIDAR-based ecosystem service indicators can be rigorously validated. With this conceptual and technical approach high resolution ecosystem service assessments can be made with well established credibility. These would consolidate the concept of ecosystem services and support both scientific research and evidence-based environmental policy at local and - as data coverage is continually increasing - continental scale.

  9. A service dedicated to Cultural Heritage Risk Assessment and Monitoring on the Web

    Science.gov (United States)

    Dore, Nicole; Monteleone, Antonio; Benenati, Luca; Bernardi, Lorenzo; Giovagnoli, Annamaria; Cacace, Carlo

    2017-04-01

    , for which also UNESCO reports indicate the earthquake as a potential risk for the Villa. Seismic waves of the most severe events recorded in central Italy were well distinguished also in Rome and surroundings, damaging some monuments and private buildings of the city. After the stronger seismic events of October 2016 and January 2017 (magnitude superior to 5.5), VIDEOR service activated for performing interferometric analyses over Villa Adriana for the assessment of monuments' stress associated to the static-structural modified conditions. The system, in fact, recorded movements (of few millimeters) of some of the Villa Adriana's monuments. These monuments, furthermore previously surveyed and recorded by ISCR in summer 2016 during the project's phase of cataloguing, are located on different geological conformation that justified differences in monuments behaviors. Soon after earthquake events, additional inspections in loco were done by ISCR, while multispectral acquisitions by drones allowed to deepening analyses performed by satellite and the general monuments status.

  10. e-GovQual: A Multiple-Item Scale for Assessing e-Government Service Quality

    Science.gov (United States)

    Papadomichelaki, Xenia; Mentzas, Gregoris

    2012-01-01

    A critical element in the evolution of governmental services through the internet is the development of sites that better serve the citizens' needs. To deliver superior service quality, we must first understand how citizens perceive and evaluate online. Citizen assessment is built on defining quality, identifying underlying dimensions, and…

  11. Design and initial validation of the Raster method for telecom service availability risk assessment

    NARCIS (Netherlands)

    Vriezekolk, E.; Wieringa, R.J.; Etalle, S.; Rothkrantz, L.; Ristvej, J.; Franco, Z.

    2012-01-01

    Crisis organisations depend on telecommunication services; unavailability of these services reduces the effectiveness of crisis response. Crisis organisations should therefore be aware of availability risks, and need a suitable risk assessment method. Such a method needs to be aware of the

  12. Truancy Assessment and Service Centers (TASC): Engaging Elementary School Children and Their Families

    Science.gov (United States)

    Rhodes, Judith L. F.; Thomas, Johanna M.; Lemieux, Catherine M.; Cain, Daphne S.; Guin, Cecile C.

    2010-01-01

    This article reviews literature describing truancy and its correlates, and it analyzes the current research on truancy prevention programs. Few truancy prevention programs exist in elementary school settings. This article describes Truancy Assessment and Service Centers, a theory-driven program providing case management services to children in 85…

  13. Form follows function? Proposing a blueprint for ecosystem service assessments based on reviews and case studies

    NARCIS (Netherlands)

    Seppelt, R.; Fath, B.; Burkhard, B.; Fisher, J.L.; Grêt-Regamey, A.; Lautenbach, S.; Pert, P.; Hotes, S.; Spangenberg, J.; Verburg, P.H.; Oudenhoven, van A.P.E.

    2012-01-01

    Ecosystem service assessments (ESA) hold the promise of supporting the quantification and valuation of human appropriation of nature and its goods and services. The concept has taken flight with the number of studies published on the topic increasing rapidly. This development, and the variation of

  14. An Assessment of Experiential Learning of Global Poverty Issues through International Service Projects

    Science.gov (United States)

    Le, Quan V.; Raven, Peter V.

    2015-01-01

    Service learning has been used to supplement a standard business curriculum, but not typically in an international business context. We report the results of two short-term study abroad programs in which we incorporated service learning projects, one in Cambodia and the other in Vietnam. Our objective is to assess how we organized and delivered…

  15. Children with Epilepsy in School: Special Service Usage and Assessment Practices

    Science.gov (United States)

    Wodrich, David L.; Kaplan, Allen M.; Deering, William M.

    2006-01-01

    Special services usage and related assessment procedures were investigated for 50 students with epilepsy. Fifty-six percent of students with epilepsy received special education services, with mental retardation designation and self-contained placement common, especially among individuals with epilepsy plus a coexisting neurological diagnosis.…

  16. Assessment of health care services on crop farmers' activities in Oke ...

    African Journals Online (AJOL)

    Assessment of health care services on crop farmers' activities in Oke-Ero Local Government Area of Kwara State, Nigeria. ... It is concluded that, malaria was the most common sickness experienced by the farmers and they usually received healthcare services mainly on malaria and child delivery. It is therefore ...

  17. Design and initial validation of the Raster method for telecom service availability risk assessment

    NARCIS (Netherlands)

    Vriezekolk, E.; Wieringa, Roelf J.; Etalle, Sandro; Rothkrantz, L.J.M.; Ristvej, J.; Franco, Z.

    Crisis organisations depend on telecommunication services; unavailability of these services reduces the effectiveness of crisis response. Crisis organisations should therefore be aware of availability risks, and need a suitable risk assessment method. Such a method needs to be aware of the

  18. The EMR-scan: assessing the quality of Electronic Medical Records in general practice.

    NARCIS (Netherlands)

    Verheij, R.; Jabaaij, L.; Njoo, K.; Hoogen, H. van den; Bakker, D. de

    2008-01-01

    Background: The use of electronic medical records (EMR) in general practice has spread rapidly in the last decade (more than 90% today). Traditionally, these records are primarily used for direct patient care and for administrative purposes by the practice involved. In recent years, further

  19. Privacy Impact Assessment for the Lead-based Paint System of Records

    Science.gov (United States)

    The Lead-based Paint System of Records collects personally identifiable information, test scores, and submitted fees. Learn how this data is collected, how it will be used, access to the data, the purpose of data collection, and record retention policies.

  20. Assessing the impact of student counselling service centres at ...

    African Journals Online (AJOL)

    strategic purpose and in satisfying key strategic stakeholders. What is needed is a forward-looking role definition linked to a set of strategic impact and performance indicators as a basis for assessment. Such an approach opens up a way to view benefits not only in traditional accounting terms such as cost savings, but also ...

  1. Clean Energy and Water : an Assessment of Services for Adaptation ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project aims to assess the potential of - and barriers to - the use of decentralized renewable energy technologies, as opposed to fossil-fuel based large-scale-systems. Independent researchers will prepare 12 case studies that will provide the basis for four reports to be presented and discussed in an expert meeting ...

  2. National recording systems and the measurement of international migration in Canada: an assessment.

    Science.gov (United States)

    Samuel, T J; White, P M; Perreault, J

    1987-01-01

    This article provides a critical assessment of the adequacy of Canada's statistical sources on immigration and emigration for both scientific study and policy needs. These data collection systems are discussed: 1) registration systems, 2) the census, and 3) administrative records and surveys. The authors conclude that Canadian migration data systems have both strengths and weaknesses. The following are some of these strengths. 1) The census is a unique source of consistent, up-to-date information on the immigrant stock. 2) Surveys provide insights on attitudes towards immigrants. 3) Citizenship data tell how many immigrants have acquired Canadian citizenship. 4) When data gaps were noticed, special efforts were made to fill them. The following are some of the data systems' weaknesses. 1) The most significant weakness is the absence of data on the characteristics of emigrants and their destination. 2) Information on returning residents is limited. 3) Undocumented immigrants defy documentation and very little is known on this group. 4) There are only skimpy data on refugee claimants. 5) There are few analyses of the differential fertility, mortality, and nuptiality patterns of the immigrants and the Canadian born. 6) The rate of return of immigrants is unknown. 7) The number of Canadian students abroad and their field of study is unknown. 8) Information on change of status and enforcement is limited. 9) The de facto population of Canada is unknown since Statistics Canada enumerates and estimates only the de jure population. 10) Lack of coordination among the multiple agencies that collect data is a major weakness; data are often unavailable in the form in which, or time when, it is required.

  3. Assessment of BSRN radiation records for the computation of monthly means

    Science.gov (United States)

    Roesch, A.; Wild, M.; Ohmura, A.; Dutton, E. G.; Long, C. N.; Zhang, T.

    2011-02-01

    The integrity of the Baseline Surface Radiation Network (BSRN) radiation monthly averages are assessed by investigating the impact on monthly means due to the frequency of data gaps caused by missing or discarded high time resolution data. The monthly statistics, especially means, are considered to be important and useful values for climate research, model performance evaluations and for assessing the quality of satellite (time- and space-averaged) data products. The study investigates the spread in different algorithms that have been applied for the computation of monthly means from 1-min values. The paper reveals that the computation of monthly means from 1-min observations distinctly depends on the method utilized to account for the missing data. The intra-method difference generally increases with an increasing fraction of missing data. We found that a substantial fraction of the radiation fluxes observed at BSRN sites is either missing or flagged as questionable. The percentage of missing data is 4.4%, 13.0%, and 6.5% for global radiation, direct shortwave radiation, and downwelling longwave radiation, respectively. Most flagged data in the shortwave are due to nighttime instrumental noise and can reasonably be set to zero after correcting for thermal offsets in the daytime data. The study demonstrates that the handling of flagged data clearly impacts on monthly mean estimates obtained with different methods. We showed that the spread of monthly shortwave fluxes is generally clearly higher than for downwelling longwave radiation. Overall, BSRN observations provide sufficient accuracy and completeness for reliable estimates of monthly mean values. However, the value of future data could be further increased by reducing the frequency of data gaps and the number of outliers. It is shown that two independent methods for accounting for the diurnal and seasonal variations in the missing data permit consistent monthly means to within less than 1 W m-2 in most cases

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

    Science.gov (United States)

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

    2012-05-15

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

  5. The need for the implementation of an Ecosystem Services assessment in Greece: drafting the national agenda

    OpenAIRE

    Dimopoulos,Panayotis; Drakou,Evangelia; Kokkoris,Ioannis; Katsanevakis,Stelios; Kallimanis,Athanasios; Tsiafouli,Maria; Bormpoudakis,Dimitrios; Kormas,Konstantinos; Arends,Jeroen

    2017-01-01

    This paper presents the establishment and the first outcomes of the Hellenic Ecosystem Services Partnership (HESP), a scientific-technical committee aiming at the guidance and coordination of the Ecosystem Services (ES) assessment in Greece. HESP consists of experts from different disciplines (ecology, marine biology, socio-ecological system science) and aims to: i) coordinate ES assessment efforts under a shared framework; ii) promote the ES approach in Greece; iii) support the European impl...

  6. Linking Land Cover Data and Crop Yields for Mapping and Assessment of Pollination Services in Europe

    OpenAIRE

    Grazia Zulian; Joachim Maes; Maria Luisa Paracchini

    2013-01-01

    Pollination is a key ecosystem service as many crops but in particular, fruits and vegetables are partially dependent on pollinating insects to produce food for human consumption. Here we assessed how pollination services are delivered at the European scale. We used this assessment to estimate the relative contribution of wild pollinators to crop production. We developed an index of relative pollination potential, which is defined as the relative potential or relative capacity of ecosystems t...

  7. Assessment of Service Desk Quality at an Academic Health Sciences Library.

    Science.gov (United States)

    Blevins, Amy E; DeBerg, Jennifer; Kiscaden, Elizabeth

    2016-01-01

    Due to an identified need for formal assessment, a small team of librarians designed and administered a survey to gauge the quality of customer service at their academic health sciences library. Though results did not drive major changes to services, several important improvements were implemented and a process was established to serve as a foundation for future use. This article details the assessment process used and lessons learned during the project.

  8. Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

    Science.gov (United States)

    Wright, Heathcote R; Diamond, Jeremy P

    2015-03-01

    To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. 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.

  9. Assessment of Customer Service in Academic Health Care Libraries (ACSAHL): an instrument for measuring customer service*†

    Science.gov (United States)

    Crossno, Jon E.; Berkins, Brenda; Gotcher, Nancy; Hill, Judith L.; McConoughey, Michelle; Walters, Mitchel

    2001-01-01

    Objectives: In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries. Methods: Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys. Results: Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results. Conclusions: ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas. PMID:11337948

  10. Far-Field Tsunami Hazard Assessment Along the Pacific Coast of Mexico by Historical Records and Numerical Simulation

    Science.gov (United States)

    Ortiz-Huerta, Laura G.; Ortiz, Modesto; García-Gastélum, Alejandro

    2018-03-01

    Historical records of the Chile (22 May 1960), Alaska (27 March 1964), and Tohoku (11 March 2011) tsunamis recorded along the Pacific Coast of Mexico are used to investigate the goodness of far-field tsunami modeling using a focal mechanism consisting in a uniform slip distribution on large thrust faults around the Pacific Ocean. The Tohoku 2011 tsunami records recorded by Deep ocean Assessment and Reporting of Tsunami (DART) stations, and at coastal tide stations, were used to validate transoceanic tsunami models applicable to the harbors of Ensenada, Manzanillo, and Acapulco on the coast of Mexico. The amplitude resulting from synthetic tsunamis originated by M w 9.3 earthquakes around the Pacific varies from 1 to 2.5 m, depending on the tsunami origin region and on the directivity due to fault orientation and waveform modification by prominent features of sea bottom relief.

  11. Far-Field Tsunami Hazard Assessment Along the Pacific Coast of Mexico by Historical Records and Numerical Simulation

    Science.gov (United States)

    Ortiz-Huerta, Laura G.; Ortiz, Modesto; García-Gastélum, Alejandro

    2018-04-01

    Historical records of the Chile (22 May 1960), Alaska (27 March 1964), and Tohoku (11 March 2011) tsunamis recorded along the Pacific Coast of Mexico are used to investigate the goodness of far-field tsunami modeling using a focal mechanism consisting in a uniform slip distribution on large thrust faults around the Pacific Ocean. The Tohoku 2011 tsunami records recorded by Deep ocean Assessment and Reporting of Tsunami (DART) stations, and at coastal tide stations, were used to validate transoceanic tsunami models applicable to the harbors of Ensenada, Manzanillo, and Acapulco on the coast of Mexico. The amplitude resulting from synthetic tsunamis originated by M w 9.3 earthquakes around the Pacific varies from 1 to 2.5 m, depending on the tsunami origin region and on the directivity due to fault orientation and waveform modification by prominent features of sea bottom relief.

  12. Spatial Assessment of Forest Ecosystem Functions and Services using Human Relating Factors for SDG

    Science.gov (United States)

    Song, C.; Lee, W. K.; Jeon, S. W.; Kim, T.; Lim, C. H.

    2015-12-01

    Application of ecosystem service concept in environmental related decision making could be numerical and objective standard for policy maker between preserving and developing perspective of environment. However, pursuing maximum benefit from natural capital through ecosystem services caused failure by losing ecosystem functions through its trade-offs. Therefore, difference between ecosystem functions and services were demonstrated and would apply human relating perspectives. Assessment results of ecosystem functions and services can be divided 3 parts. Tree growth per year set as the ecosystem function factor and indicated through so called pure function map. After that, relating functions can be driven such as water conservation, air pollutant purification, climate change regulation, and timber production. Overall process and amount are numerically quantified. These functional results can be transferred to ecosystem services by multiplying economic unit value, so function reflecting service maps can be generated. On the other hand, above services, to implement more reliable human demand, human reflecting service maps are also be developed. As the validation, quantified ecosystem functions are compared with former results through pixel based analysis. Three maps are compared, and through comparing difference between ecosystem function and services and inversed trends in function based and human based service are analysed. In this study, we could find differences in PF, FRS, and HRS in relation to based ecosystem conditions. This study suggests that the differences in PF, FRS, and HRS should be understood in the decision making process for sustainable management of ecosystem services. Although the analysis is based on in sort existing process separation, it is important to consider the possibility of different usage of ecosystem function assessment results and ecosystem service assessment results in SDG policy making. Furthermore, process based functional approach

  13. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  14. Assessing Pre-Service Physics Teachers’ Energy Literacy: An Application of Rasch measurement

    Science.gov (United States)

    Yusup, M.; Setiawan, A.; Rustaman, N. Y.; Kaniawati, I.

    2017-09-01

    This paper aims to present a summary of pre-service physics teachers’ responses on energy literacy assessment. A total of 123 pre-service physics teacher in first through third year of education participated. Data were analyzed using Rasch modeling. Research findings indicate that pre-service physics teachers show their low self-system toward energy conservation. They were also still lack of metacognitive and cognitive competencies. These finding provide information for the future development of curriculum, teaching and learning that can improve pre-service physics teachers’ energy literacy.

  15. An Investigation of the Development of Pre-Service Teacher Assessment Literacy through Individualized Tutoring and Peer Debriefing

    Science.gov (United States)

    Odo, Dennis Murphy

    2016-01-01

    Many pre-service teachers lack deep understanding of assessment concepts and have low selfefficacy for using assessments but pre-service on-campus programs have been shown to support their assessment literacy development. Likewise, individualized tutoring has helped pre-service candidates improve instructional practice and peer debriefing has been…

  16. Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance.

    Science.gov (United States)

    Miloslavsky, Eli M; Chang, Yuchiao

    2017-12-01

    Subspecialty consultation in inpatient medicine is increasing, and enhancing performance of consultation services may have a broad-reaching impact. Multisource feedback is an important tool in assessing competence and improving performance. A mechanism for primary team resident feedback on performance of consult services has not been described. We developed and evaluated an instrument designed to assess internal medicine (IM) subspecialty inpatient consult service performance. We hypothesized that the instrument would be feasible to administer and provide important information to fellowship directors. The instrument was administered in 2015 and 2016 at a single academic center. All IM residents were invited to evaluate 10 IM subspecialty consult services on 4 items and an overall satisfaction rating. The instrument allowed for free-text feedback to fellows. Program directors completed another survey assessing the impact of the consult service evaluation. A total of 113 residents responded (47 in 2015 and 66 in 2016, for a combined response rate of 35%). Each of the 4 items measured (communication, professionalism, teaching, and pushback) correlated significantly with the overall satisfaction rating in univariate and multivariate analyses. There were no differences in ratings across postgraduate year or year of administration. There was considerable variation in ratings among the services evaluated. The 7 program directors who provided feedback found the survey useful and made programmatic changes following evaluation implementation. A primary team resident evaluation of inpatient medicine subspecialty consult services is feasible, provides valuable information, and is associated with changes in consult service structure and curricula.

  17. 20 CFR 402.180 - Procedure on assessing and collecting fees for providing records.

    Science.gov (United States)

    2010-04-01

    ... fashion, or if our initial review of your request indicates that we will charge you fees exceeding $250... the furnishing of the records. For example, we may do this if you have a history of prompt payment. We...

  18. Privacy Impact Assessment for the Medical and Research Study Records of Human Volunteers

    Science.gov (United States)

    The Medical & Research Study Records of Human Volunteers System collects demographic and medical information on subjects who participate in research. Learn how this data is collected, used, access to the data, and the purpose of data collection.

  19. Do service innovations influence the adoption of electronic health records in long-term care organizations? Results from the U.S. National Survey of Residential Care Facilities.

    Science.gov (United States)

    Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P

    2014-12-01

    Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs. We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs. In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption. Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in

  20. The provision of aids and adaptations, risk assessments, and incident reporting and recording procedures in relation to injury prevention for adults with intellectual disabilities: cohort study.

    Science.gov (United States)

    Finlayson, J; Jackson, A; Mantry, D; Morrison, J; Cooper, S-A

    2015-06-01

    Adults with intellectual disabilities (IDs) experience a higher incidence of injury, compared with the general population. The aim of this study was to investigate the provision of aids and adaptations, residential service providers' individual risk assessments and training in these, and injury incident recording and reporting procedures, in relation to injury prevention. Interviews were conducted with a community-based cohort of adults with IDs (n = 511) who live in Greater Glasgow, Scotland, UK and their key carer (n = 446). They were asked about their aids and adaptations at home, and paid carers (n = 228) were asked about individual risk assessments, their training, and incident recording and reporting procedures. Four hundred and twelve (80.6%) of the adults with IDs had at least one aid or adaptation at home to help prevent injury. However, a proportion who might benefit, were not in receipt of them, and surprisingly few had temperature controlled hot water or a bath thermometer in place to help prevent burns/scalds, or kitchen safety equipment to prevent burns/scalds from electric kettles or irons. Fifty-four (23.7%) of the paid carers were not aware of the adult they supported having had any risk assessments, and only 142 (57.9%) had received any training on risk assessments. Considerable variation in incident recording and reporting procedures was evident. More work is needed to better understand, and more fully incorporate, best practice injury prevention measures into routine support planning for adults with IDs within a positive risk-taking and risk reduction framework. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  1. Assessment of patient satisfaction with acute pain management service: Monitoring quality of care in clinical setting

    Directory of Open Access Journals (Sweden)

    Fizzah Farooq

    2016-01-01

    Full Text Available Background and Aims: Assessment of patient satisfaction is an important tool for monitoring the quality of care in hospitals. The aim of this survey was to develop a reliable tool to assess patient satisfaction with acute pain management service (APMS and identify variables affecting this so that care can be improved. Methods: A questionnaire was developed and administered to  patients after being discharged from APMS care by an unbiased person. Data collected from record included patient demographics, surgical procedure, analgesic modality, co-analgesics and dynamic and static pain scores. Questions included pain expected and pain experienced, APMS response time, quality of pain relief with treatment, professionalism of APMS team, overall experience of pain relief and choosing/suggesting same modality for themselves/family/friends again. Five-point Likert scale was used for most of the options. Statistical analysis was done using SPSS 19. Results: Frequency and percentages were computed for qualitative observation and presented on pie chart and histogram. Seventy-one per cent patients expected severe pain while 43% actually experienced it. About 79.4% would choose same analgesia modality in future for self/family/friends. Ninety-nine per cent found APMS staff courteous and professional. About 89% rated their experience of pain management as excellent to very good. Conclusion: The survey of patients′ satisfaction to monitor the quality of care provided by APMS provided positive inputs on its role. This also helps to identify areas requiring improvement in care and as a tool to gauge the quality of care.

  2. Students’ Perceptions about Role of Faculty and Administrative Staff in Business Education Service Quality Assessment

    Directory of Open Access Journals (Sweden)

    Maja Arslanagić-Kalajdžić

    2014-06-01

    Full Text Available This paper focuses on dimensions of the perceived service quality measurement for business schools. We propose an adapted SERVQUAL measure of expected and perceived quality, where employees at business schools are split into two groups: faculty and administrative staff, and assessed separately. This measure represents a tool for comparable service quality assessment at business schools. Empirical data were collected among undergraduate students in a developing economy. A total of 282 respondents were used to assess the overall fit of the proposed model and to test the differences between the expectations and the perceptions of service quality in a business school. The results support usability of the proposed adapted SERVQUAL measure. Therefore, the study contributes to the existing literature reporting the findings on service quality in an educational context.

  3. Evaluation of a Clinical Service Model for Dysphagia Assessment via Telerehabilitation

    Directory of Open Access Journals (Sweden)

    Elizabeth C. Ward

    2013-01-01

    employed to examine the outcomes of a weekly dysphagia assessment clinic conducted via telerehabilitation and examine issues relating to service delivery and user perceptions. Data was collected across a total of 100 patient assessments. Information relating to primary patient outcomes, session statistics, patient perceptions, and clinician perceptions was examined. Results revealed that session durations averaged 45 minutes, there was minimal technical difficulty experienced, and clinical decisions made regarding primary patient outcomes were comparable between the online and face to face clinicians. Patient satisfaction was high and clinicians felt that they developed good rapport, found the system easy to use, and were satisfied with the service in over 90% of the assessments conducted. Key factors relating to screening patient suitability, having good general organization, and skilled staff were identified as facilitators for the service. This trial has highlighted important issues for consideration when planning or implementing a telerehabilitation service for dysphagia management.

  4. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    Science.gov (United States)

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

  5. [Risk assessment for food preparation, cooking and service].

    Science.gov (United States)

    Cottica, Danilo; Grignani, Elena

    2014-01-01

    The restaurant and food preparation, cooking and distribution sector includes hotels, restaurants, catering, fast food, ecc. The restaurant and food preparation, cooking and distribution sector form a significant part of the Italian economy; they provide employment for a large number of people, both direct employees as well as part-time and contract staff. In this sector there are many hazards that can lead to a broad range of injuries and/or diseases to the workers. For the safety these hazards principally are slick floors, open flames, high temperature cooking surfaces, steam, knives and other cutting instruments and machineries. For the health: cleaning and disinfecting chemicals substances, cooking fumes and vapors, biological agents, heavy loads handling, thermal comfort, ecc. The paper presents an overview of the hazards in the sector and then make a focus on chemical risks identification and assessment to evaluate the workers' exposure (by skin adsorption and inhalation).

  6. The development and implementation of stroke risk prediction model in National Health Insurance Service's personal health record.

    Science.gov (United States)

    Lee, Jae-Woo; Lim, Hyun-Sun; Kim, Dong-Wook; Shin, Soon-Ae; Kim, Jinkwon; Yoo, Bora; Cho, Kyung-Hee

    2018-01-01

    The purpose of this study was to build a 10-year stroke prediction model and categorize a probability of stroke using the Korean national health examination data. Then it intended to develop the algorithm to provide a personalized warning on the basis of each user's level of stroke risk and a lifestyle correction message about the stroke risk factors. Subject to national health examinees in 2002-2003, the stroke prediction model identified when stroke was first diagnosed by following-up the cohort until 2013 and estimated a 10-year probability of stroke. It sorted the user's individual probability of stroke into five categories - normal, slightly high, high, risky, very risky, according to the five ranges of average probability of stroke in comparison to total population - less than 50 percentile, 50-70, 70-90, 90-99.9, more than 99.9 percentile, and constructed the personalized warning and lifestyle correction messages by each category. Risk factors in stroke risk model include the age, BMI, cholesterol, hypertension, diabetes, smoking status and intensity, physical activity, alcohol drinking, past history (hypertension, coronary heart disease) and family history (stroke, coronary heart disease). The AUC values of stroke risk prediction model from the external validation data set were 0.83 in men and 0.82 in women, which showed a high predictive power. The probability of stroke within 10 years for men in normal group (less than 50 percentile) was less than 3.92% and those in very risky group (top 0.01 percentile) was 66.2% and over. The women's probability of stroke within 10 years was less than 3.77% in normal group (less than 50 percentile) and 55.24% and over in very risky group. This study developed the stroke risk prediction model and the personalized warning and the lifestyle correction message based on the national health examination data and uploaded them to the personal health record service called My Health Bank in the health information website - Health

  7. From Assessment to Implementation: Using Qualitative Interviews to Inform Distance Learning Library Services

    Science.gov (United States)

    Wharton, Lindsey N.

    2017-01-01

    While broad assessment projects are often used to steer library strategic planning initiatives, this article will present the benefits of qualitative interviews with distance learning constituents as a framework for developing a focused vision and targeted services. This article will describe the planning and execution of an assessment project…

  8. How Is My Child Doing?: Preparing Pre-Service Teachers to Engage Parents through Assessment

    Science.gov (United States)

    Mehlig, Lisa M.; Shumow, Lee

    2013-01-01

    The aim of this study was to help pre-service teachers develop basic knowledge and skill for partnering with families on assessment-related issues. An assessment class for teacher educators (experimental group) participated in role-playing activities designed to expand their understanding and skill in a way that would help them learn how to…

  9. Unsupervised deep learning for real-time assessment of video streaming services

    NARCIS (Netherlands)

    Torres Vega, M.; Mocanu, D.C.; Liotta, A.

    2017-01-01

    Evaluating quality of experience in video streaming services requires a quality metric that works in real time and for a broad range of video types and network conditions. This means that, subjective video quality assessment studies, or complex objective video quality assessment metrics, which would

  10. Evaluation Services from Needs Assessment to Follow-up: A Case Study.

    Science.gov (United States)

    Broadbooks, Wendy J.

    This paper describes the nature and scope of evaluation services provided within the training division of Arthur Andersen & Company, and highlights some of the evaluation results. The cycle of assessment began with a needs assessment study at the curriculum level. Curriculum planning was undertaken for first-year trainees in the Tax Division.…

  11. CMS Records Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Records Schedule provides disposition authorizations approved by the National Archives and Records Administration (NARA) for CMS program-related records...

  12. The use of the BDA Case Mix Model to assess the need for referral of patients to specialist dental services.

    Science.gov (United States)

    AlKindi, N A; Nunn, J

    2016-04-22

    Access to health services is a right for every individual. However, there is evidence that people with disabilities face barriers in accessing dental health. One of the reasons associated with this is the unclear referral pathway existing in the Irish dental health service. The appropriate assignment of patients to relevant services is an important issue to ensure better access to healthcare. This is all the more pertinent because there are only a few trained dental practitioners to provide dental treatment for people with disabilities, as well as even fewer qualified specialists in special care dentistry. The aim of this part of the study was to assess the use of the BDA Case Mix Model to determine the need for referral of patients to specialist dental services, and to determine any association between patient complexity and the need for adjunct measures, such as sedation and general anaesthesia for the management of people with disabilities and complex needs. A retrospective analysis of dental records using the BDA Case Mix Model.Results The results showed that patients with different levels of complexities were being referred to the special care dentistry clinic at the Dublin Dental University Hospital. The results also showed that the need for supportive adjunct measures such as sedation and general anaesthesia was not necessarily the main reason for referring patients to specialist services. The assessment with the BDA Case Mix Model was comprehensive as it looked at many factors contributing to the cases' complexity. Not all categories in the Case Mix Model had significant association with the need for an adjunct.Conclusion The BDA Case Mix Model can be used to measure the need for supportive adjunct measures, such as sedation and general anaesthesia.

  13. Effect of a Neonatal Resuscitation Course on Healthcare Providers' Performances Assessed by Video Recording in a Low-Resource Setting.

    Science.gov (United States)

    Trevisanuto, Daniele; Bertuola, Federica; Lanzoni, Paolo; Cavallin, Francesco; Matediana, Eduardo; Manzungu, Olivier Wingi; Gomez, Ermelinda; Da Dalt, Liviana; Putoto, Giovanni

    2015-01-01

    We assessed the effect of an adapted neonatal resuscitation program (NRP) course on healthcare providers' performances in a low-resource setting through the use of video recording. A video recorder, mounted to the radiant warmers in the delivery rooms at Beira Central Hospital, Mozambique, was used to record all resuscitations. One-hundred resuscitations (50 before and 50 after participation in an adapted NRP course) were collected and assessed based on a previously published score. All 100 neonates received initial steps; from these, 77 and 32 needed bag-mask ventilation (BMV) and chest compressions (CC), respectively. There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for "initial steps", the score increased from 33% (IQR 28-39) to 44% (IQR 39-56), pproviders improved after participation in an adapted NRP course. Video recording was well-accepted by the staff, useful for objective assessment of performance during resuscitation, and can be used as an educational tool in a low-resource setting.

  14. Feasibility of utilizing a commercial eye tracker to assess electronic health record use during patient simulation.

    Science.gov (United States)

    Gold, Jeffrey Allen; Stephenson, Laurel E; Gorsuch, Adriel; Parthasarathy, Keshav; Mohan, Vishnu

    2016-09-01

    Numerous reports describe unintended consequences of electronic health record implementation. Having previously described physicians' failures to recognize patient safety issues within our electronic health record simulation environment, we now report on our use of eye and screen-tracking technology to understand factors associated with poor error recognition during an intensive care unit-based electronic health record simulation. We linked performance on the simulation to standard eye and screen-tracking readouts including number of fixations, saccades, mouse clicks and screens visited. In addition, we developed an overall Composite Eye Tracking score which measured when, where and how often each safety item was viewed. For 39 participants, the Composite Eye Tracking score correlated with performance on the simulation (p = 0.004). Overall, the improved performance was associated with a pattern of rapid scanning of data manifested by increased number of screens visited (p = 0.001), mouse clicks (p = 0.03) and saccades (p = 0.004). Eye tracking can be successfully integrated into electronic health record-based simulation and provides a surrogate measure of cognitive decision making and electronic health record usability. © The Author(s) 2015.

  15. Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

    Science.gov (United States)

    Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

    2018-05-01

    Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with

  16. [Performance assessment of health services in Catalonia (Spain): evaluation of initial results of the Catalan healthcare service project].

    Science.gov (United States)

    García-Altés, Anna; Dalmau-Bueno, Albert; Colls, Cristina; Mendivil, Joan; Benet, Josep; Mompart, Anna; Torné, Elvira; Zara, Corinne; Borrell, Carme; Brugulat, Pilar; Guarga, Alex

    2009-01-01

    Performance assessment of healthcare services is receiving greater attention due to increasing health care expenditures, greater expectations among the population, and the need to obtain results from the invested resources. Taking advantage of the existing experience of the Agència de Salut Pública de Barcelona and the Consorci Sanitari de Barcelona, which compared the healthcare services of Barcelona and Montreal, a grant from the Agència d'Avaluació de Tecnologia i Recerca Mèdiques, and the health planning interest of the Departament de Salut, the performance assessment of the Catalan healthcare service project was started in Catalonia in 2005. This article aims to present the development of the project, to provide some examples that illustrate the kind of numerical and graphical information that could be obtained and the kind of analysis that could be performed, to provide possible explanations for the results shown, and to discuss some limitations and implications. Currently, the added value of this project is that it identifies the extent to which the healthcare system is achieving its objectives, establishes a set of homogeneous indicators that could be used in the future, and is a key tool in the development of the Central de Resultats del Departament de Salut de la Generalitat de Catalunya.

  17. Ecosytem Services: A Rapid Assessment Method Tested at 35 Sites of the LTER-Europe Network

    Directory of Open Access Journals (Sweden)

    Dick Jan

    2014-08-01

    Full Text Available The identification of parameters to monitor the ecosystem services delivered at a site is fundamental to the concept’s adoption as a useful policy instrument at local, national and international scales. In this paper we (i describe the process of developing a rapid comprehensive ecosystem service assessment methodology and (ii test the applicability of the protocol at 35 long-term research (LTER sites across 14 countries in the LTER-Europe network (www.lter-europe.net including marine, urban, agricultural, forest, desert and conservation sites. An assessment of probability of occurrence with estimated confidence score using 83 ecosystem service parameters was tested. The parameters were either specific services like food production or proxies such as human activities which were considered surrogates for cultural diversity and economic activity. This initial test of the ecosystem service parameter list revealed that the parameters tested were relatively easy to score by site managers with a high level of certainty (92% scored as either occurring or not occurring at the site with certainty of over 90%. Based on this assessment, we concluded that (i this approach to operationalise the concept of ecosystem services is practical and applicable by many sectors of civil society as a first screen of the ecosystem services present at a site, (ii this study has direct relevance to land management and policy decision makers as a transparent vehicle to focus testing scenarios and target data gathering, but (iii further work beyond the scale investigated here is required to ensure global applicability.

  18. A comparative assessment of tools for ecosystem services quantification and valuation

    Science.gov (United States)

    Bagstad, Kenneth J.; Semmens, Darius; Waage, Sissel; Winthrop, Robert

    2013-01-01

    To enter widespread use, ecosystem service assessments need to be quantifiable, replicable, credible, flexible, and affordable. With recent growth in the field of ecosystem services, a variety of decision-support tools has emerged to support more systematic ecosystem services assessment. Despite the growing complexity of the tool landscape, thorough reviews of tools for identifying, assessing, modeling and in some cases monetarily valuing ecosystem services have generally been lacking. In this study, we describe 17 ecosystem services tools and rate their performance against eight evaluative criteria that gauge their readiness for widespread application in public- and private-sector decision making. We describe each of the tools′ intended uses, services modeled, analytical approaches, data requirements, and outputs, as well time requirements to run seven tools in a first comparative concurrent application of multiple tools to a common location – the San Pedro River watershed in southeast Arizona, USA, and northern Sonora, Mexico. Based on this work, we offer conclusions about these tools′ current ‘readiness’ for widespread application within both public- and private-sector decision making processes. Finally, we describe potential pathways forward to reduce the resource requirements for running ecosystem services models, which are essential to facilitate their more widespread use in environmental decision making.

  19. Are binaural recordings needed for subjective and objective annoyance assessment of traffic noise?

    DEFF Research Database (Denmark)

    Rodríguez, Estefanía Cortés; Song, Wookeun; Brunskog, Jonas

    2011-01-01

    Humans are annoyed when they are exposed to environmental noise. Traditional measures such as sound pressure levels may not correlate well with how humans perceive annoyance, therefore it is important to investigate psychoacoustic metrics that may correlate better with the perceived annoyance...... of environmental noise than the A-weighted equivalent sound pressure level. This study examined whether the use of binaural recordings of sound events improves the correlation between the objective metrics and the perceived annoyance, particularly for road traffic noise. Metrics based on measurement with a single...... microphone and on binaural sound field recordings have been examined and compared. In order to acquire data for the subjective perception of annoyance, a series of listening tests has been carried out. It is concluded that binaural loudness metrics from binaural recordings are better correlated...

  20. An assessment of an environmental gradient using coral geochemical records, Whitsunday Islands, Great Barrier Reef, Australia

    International Nuclear Information System (INIS)

    Lewis, S.E.; Brodie, J.E.; McCulloch, M.T.; Mallela, J.; Jupiter, S.D.; Stuart Williams, H.; Lough, J.M.; Matson, E.G.

    2012-01-01

    Coral cores were collected along an environmental and water quality gradient through the Whitsunday Island group, Great Barrier Reef (Australia), for trace element and stable isotope analysis. The primary aim of the study was to examine if this gradient could be detected in coral records and, if so, whether the gradient has changed over time with changing land use in the adjacent river catchments. Y/Ca was the trace element ratio which varied spatially across the gradient, with concentrations progressively decreasing away from the river mouths. The Ba/Ca and Y/Ca ratios were the only indicators of change in the gradient through time, increasing shortly after European settlement. The Mn/Ca ratio responded to local disturbance related to the construction of tourism infrastructure. Nitrogen isotope ratios showed no apparent trend over time. This study highlights the importance of site selection when using coral records to record regional environmental signals.

  1. Assessment of diffusive isotopic fractionation in polar firn, and application to ice core trace gas records

    DEFF Research Database (Denmark)

    Buizert, C.; Sowers, T.; Blunier, T.

    2013-01-01

    During rapid variations of the atmospheric mixing ratio of a trace gas, diffusive transport in the porous firn layer atop ice sheets and glaciers alters the isotopic composition of that gas relative to the overlying atmosphere. Records of past atmospheric trace gas isotopic composition from ice...... cores and firn need to be corrected for this diffusive fractionation artifact. We present a novel, semi-empirical method to accurately estimate the magnitude of the diffusive fractionation in the ice core record. Our method (1) consists of a relatively simple analytical calculation; (2) requires only...... commonly available ice core data; (3) is not subject to the uncertainties inherent to estimating the accumulation rate, temperature, close-off depth and depth-diffusivity relationship back in time; (4) does not require knowledge of the true atmospheric variations, but uses the smoothed records obtained...

  2. Assessing rural small community water supply in Limpopo, South Africa: water service benchmarks and reliability.

    Science.gov (United States)

    Majuru, Batsirai; Jagals, Paul; Hunter, Paul R

    2012-10-01

    Although a number of studies have reported on water supply improvements, few have simultaneously taken into account the reliability of the water services. The study aimed to assess whether upgrading water supply systems in small rural communities improved access, availability and potability of water by assessing the water services against selected benchmarks from the World Health Organisation and South African Department of Water Affairs, and to determine the impact of unreliability on the services. These benchmarks were applied in three rural communities in Limpopo, South Africa where rudimentary water supply services were being upgraded to basic services. Data were collected through structured interviews, observations and measurement, and multi-level linear regression models were used to assess the impact of water service upgrades on key outcome measures of distance to source, daily per capita water quantity and Escherichia coli count. When the basic system was operational, 72% of households met the minimum benchmarks for distance and water quantity, but only 8% met both enhanced benchmarks. During non-operational periods of the basic service, daily per capita water consumption decreased by 5.19l (pwater sources were 639 m further (p ≤ 0.001, 95% CI 560-718). Although both rudimentary and basic systems delivered water that met potability criteria at the sources, the quality of stored water sampled in the home was still unacceptable throughout the various service levels. These results show that basic water services can make substantial improvements to water access, availability, potability, but only if such services are reliable. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. A proposed model for assessing service quality in small machining and industrial maintenance companies

    Directory of Open Access Journals (Sweden)

    Morvam dos Santos Netto

    2014-11-01

    Full Text Available Machining and industrial maintenance services include repair (corrective maintenance of equipments, activities involving the assembly-disassembly of equipments, fault diagnosis, machining operations, forming operations, welding processes, assembly and test of equipments. This article proposes a model for assessing the quality of services provided by small machining and industrial maintenance companies, since there is a gap in the literature regarding this issue and because the importance of small service companies in socio-economic development of the country. The model is an adaptation of the SERVQUAL instrument and the criteria determining the quality of services are designed according to the service cycle of a typical small machining and industrial maintenance company. In this sense, the Moments of Truth have been considered in the preparation of two separate questionnaires. The first questionnaire contains 24 statements that reflect the expectations of customers, and the second one contains 24 statements that measure perceptions of service performance. An additional item was included in each questionnaire to assess, respectively, the overall expectation about the services and the overall company performance. Therefore, it is a model that considers the interfaces of the client/supplier relationship, the peculiarities of the machining and industrial maintenance service sector and the company size.

  4. Assessing Medical Tourism Services Quality Using SERVQUAL Model: A Patient’s Perspective

    Science.gov (United States)

    QOLIPOUR, Mohammad; TORABIPOUR, Amin; FARAJI KHIAVI, Farzad; SAKI MALEHI, Amal

    2018-01-01

    Background: Continuous quality improvement of the hospital services is a basic requirement of medical tourism industry. The different dimensions of hospital services quality are assessed constantly to improve the service of medical tourism. The aim of this study was to determine the services quality of medical tourism in private and public hospitals. Methods: In this cross-sectional study, the quality of hospital services were assessed in view of 250 Iraqi tourists referred to Ahvaz private and public hospitals in 2015. Data were collected using a valid medical tourism SERVQUAL questionnaire (MTSQ). This questionnaire includes 8 main dimensions with 31 items. Finally, Mann-Whitney, Kruskal-Wallis and Wilcoxon tests were used to analyze the data. Results: The mean of age of patients was 39±2.2 yr. The mean of hospital length of stay was 3.87±1.36 days. The most patients were admitted to Orthopedics, Otorhinolaryngology, Obstetrics, and Gynecology departments, respectively. There was a negative gap in all of the dimensions of service quality in the studied hospitals (P>0.001). The highest and lowest quality gap was seen in the “exchange and travel facilities” (−2.63) and the “tangibles” (−0.68) dimension, respectively. Conclusion: There was a negative gap in all of the dimensions of service quality in the studied hospitals. Therefore, the hospital services quality is improved to attract the foreign patients. PMID:29318124

  5. Assessing Medical Tourism Services Quality Using SERVQUAL Model: A Patient's Perspective.

    Science.gov (United States)

    Qolipour, Mohammad; Torabipour, Amin; Faraji Khiavi, Farzad; Saki Malehi, Amal

    2018-01-01

    Continuous quality improvement of the hospital services is a basic requirement of medical tourism industry. The different dimensions of hospital services quality are assessed constantly to improve the service of medical tourism. The aim of this study was to determine the services quality of medical tourism in private and public hospitals. In this cross-sectional study, the quality of hospital services were assessed in view of 250 Iraqi tourists referred to Ahvaz private and public hospitals in 2015. Data were collected using a valid medical tourism SERVQUAL questionnaire (MTSQ). This questionnaire includes 8 main dimensions with 31 items. Finally, Mann-Whitney, Kruskal-Wallis and Wilcoxon tests were used to analyze the data. The mean of age of patients was 39±2.2 yr. The mean of hospital length of stay was 3.87±1.36 days. The most patients were admitted to Orthopedics, Otorhinolaryngology, Obstetrics, and Gynecology departments, respectively. There was a negative gap in all of the dimensions of service quality in the studied hospitals ( P >0.001). The highest and lowest quality gap was seen in the "exchange and travel facilities" (-2.63) and the "tangibles" (-0.68) dimension, respectively. There was a negative gap in all of the dimensions of service quality in the studied hospitals. Therefore, the hospital services quality is improved to attract the foreign patients.

  6. Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study.

    Science.gov (United States)

    Maas, Marjo J M; Nijhuis-van der Sanden, Maria W G; Driehuis, Femke; Heerkens, Yvonne F; van der Vleuten, Cees P M; van der Wees, Philip J

    2017-02-10

    To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. Mixed methods study. 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. This study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform

  7. Patient satisfaction with a chronic kidney disease risk assessment service in community pharmacies.

    Science.gov (United States)

    Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L

    2018-04-01

    Patient satisfaction is an important determinant of the feasibility and sustainability of community pharmacy screening services. However, few studies have evaluated this, with no such study performed for a chronic kidney disease risk assessment service. The aim was to determine patient satisfaction with a chronic kidney disease risk assessment service performed in community pharmacies. Community pharmacies in the state of Tasmania, Australia. An anonymous nine-item satisfaction survey, with Likert-type scales, was developed following a literature review of existing surveys. Reliability of the nine-item scale was determined using Cronbach's alpha. Patients were asked an additional question on willingness to pay, with choices of amount from $5 to $25. The satisfaction survey was mailed to 389 patients who participated in the chronic kidney disease risk assessment study. Patient level of satisfaction with and willingness to pay for the chronic kidney disease service. Responses from 143 participants were included in the final analysis. Cronbach's alpha for the nine-item satisfaction scale was 0.87. The majority of participants agreed that the time required to undergo the risk assessment process was justified (90.2%); overall, they were satisfied with the chronic kidney disease risk assessment service (90.0%) and they felt comfortable with the pharmacist referring their results to their doctor (88.9%). Of 136 participants who answered the question on willingness to pay, 62.9% indicated that they would pay for the chronic kidney disease service. Of these, 29.2, 25.8 and 19.1% were willing to pay $20, $10 and $5, respectively. Patient satisfaction with the community pharmacy-based chronic kidney disease risk assessment was high. These findings provide support for the implementation of the service within community pharmacy practice.

  8. Determinants of first-time utilization of long-term care services in the Netherlands : An observational record linkage study

    NARCIS (Netherlands)

    Slobbe, L.C.J.; Wong, A.; Verheij, R.A.; Van Oers, J.A.M.; Polder, J.J.

    Background Since in an ageing society more long-term care (LTC) facilities are needed, it is important to understand the main determinants of first-time utilization of (LTC) services. Methods The Andersen service model, which distinguishes predisposing, enabling and need factors, was used to develop

  9. Determinants of first-time utilization of long-term care services in the Netherlands: an observational record linkage study.

    NARCIS (Netherlands)

    Slobbe, L.C.J.; Wong, A.; Verheij, R.A.; Oers, H.J.A.M. van; Polder, J.J.

    2017-01-01

    Background: Since in an ageing society more long-term care (LTC) facilities are needed, it is important to understand the main determinants of first-time utilization of (LTC) services. Methods: The Andersen service model, which distinguishes predisposing, enabling and need factors, was used to

  10. Decision Support System for Medical Care Quality Assessment Based on Health Records Analysis in Russia.

    Science.gov (United States)

    Taranik, Maksim; Kopanitsa, Georgy

    2017-01-01

    The paper presents developed decision system, oriented for healthcare providers. The system allows healthcare providers to detect and decrease nonconformities in health records and forecast the sum of insurance payments taking into account nonconformities. The components are ISO13606, fuzzy logic and case-based reasoning concept. The result of system implementation allowed to 10% increase insurance payments for healthcare provider.

  11. Anthropogenic effects on sediment quality offshore southwestern Taiwan: Assessing the sediment core geochemical record

    Digital Repository Service at National Institute of Oceanography (India)

    Selvaraj, K.; Parthiban, G.; Chen, C.T.A.; Lou, J.Y.

    -Fernández, A.C., Páez-Osuna, F., Urrutia-Fucugauchi, J., Preda, M., Rehault, I., 2004. Historical trace metal fluxes in the Mexico City Metropolitan Zone as evidenced by a sedimentary record from the Espejo de los Lirios lake. Journal of Environmental...

  12. Validation of a dietary questionnaire assessed with multiple weighed dietary records or 24-hour recalls

    Science.gov (United States)

    The authors evaluated the validity of a 152-item semiquantitative food frequency questionnaire (SFFQ) by comparing it with two 7-day dietary records (7DDRs) or up to 4 automated self-administered 24-hour recalls (ASA24s) over a 1-year period in the women's Lifestyle Validation Study (2010-2012), con...

  13. Assessment of Coastal Ecosystem Services for Conservation Strategies in South Korea.

    Science.gov (United States)

    Chung, Min Gon; Kang, Hojeong; Choi, Sung-Uk

    2015-01-01

    Despite the fact that scientific and political consideration for ecosystem services has dramatically increased over the past decade, few studies have focused on marine and coastal ecosystem services for conservation strategies. We used an ecosystem services approach to assess spatial distributions of habitat risks and four ecosystem services (coastal protection, carbon storage, recreation, and aesthetic quality), and explored the tradeoffs among them in coastal areas of South Korea. Additionally, we analyzed how the social and ecological characteristics in coastal areas interact with conservation and development policies by using this approach. We found strong negative associations between the habitat risks and ecosystem services (aquaculture, carbon storage, recreation, and aesthetic quality) across the coastal counties. Our results showed that the intensity of the habitat risks and the provision of ecosystem services were significantly different between reclamation-dominated and conservation-dominated counties, except for coastal vulnerability. A generalized linear model suggested that reclamation projects were dependent on economic efficiency, whereas demographic pressures and habitat conditions influenced the designation of protected areas at a county level. The ecosystem services approach provided guidelines to achieve both sustainable development and environment conservation. By using the approach, we can select the priority areas for developments while we can minimize the degradation of biodiversity and ecosystem services. As cultural ecosystem services are evenly distributed throughout coastal areas of South Korea, decision makers may employ them to improve the conditions of coastal wetlands outside of protected areas.

  14. Assessment of Coastal Ecosystem Services for Conservation Strategies in South Korea

    Science.gov (United States)

    Chung, Min Gon; Kang, Hojeong; Choi, Sung-Uk

    2015-01-01

    Despite the fact that scientific and political consideration for ecosystem services has dramatically increased over the past decade, few studies have focused on marine and coastal ecosystem services for conservation strategies. We used an ecosystem services approach to assess spatial distributions of habitat risks and four ecosystem services (coastal protection, carbon storage, recreation, and aesthetic quality), and explored the tradeoffs among them in coastal areas of South Korea. Additionally, we analyzed how the social and ecological characteristics in coastal areas interact with conservation and development policies by using this approach. We found strong negative associations between the habitat risks and ecosystem services (aquaculture, carbon storage, recreation, and aesthetic quality) across the coastal counties. Our results showed that the intensity of the habitat risks and the provision of ecosystem services were significantly different between reclamation-dominated and conservation-dominated counties, except for coastal vulnerability. A generalized linear model suggested that reclamation projects were dependent on economic efficiency, whereas demographic pressures and habitat conditions influenced the designation of protected areas at a county level. The ecosystem services approach provided guidelines to achieve both sustainable development and environment conservation. By using the approach, we can select the priority areas for developments while we can minimize the degradation of biodiversity and ecosystem services. As cultural ecosystem services are evenly distributed throughout coastal areas of South Korea, decision makers may employ them to improve the conditions of coastal wetlands outside of protected areas. PMID:26221950

  15. The use of taxation records in assessing historical floods in South Moravia, Czech Republic

    Science.gov (United States)

    Brázdil, R.; Chromá, K.; Řezníčková, L.; Valášek, H.; Dolák, L.; Stachoň, Z.; Soukalová, E.; Dobrovolný, P.

    2014-10-01

    Since the second half of the 17th century, tax relief has been available to farmers and landowners to offset flood damage to property (buildings) and land (fields, meadows, pastures, gardens) in South Moravia, Czech Republic. Historically, the written applications for this were supported by a relatively efficient bureaucratic process that left a clear data trail of documentation, preserved at several levels: in the communities affected, in regional offices, and in the Moravian Land Office, all of which are to be found in estate and family collections in the Moravian Land Archives in the city of Brno, the provincial capital. As well as detailed information about damage done and administrative responses to it, data are often preserved as to the flood event itself, the time of its occurrence and its impacts, sometimes together with causes and stages. The final flood database based on taxation records is used here to describe the temporal and spatial density of both flood events and the records themselves. The information derived is used to help create long-term flood chronologies for the rivers Dyje, Jihlava, Svratka and Morava, combining floods interpreted from taxation records with other documentary data and floods derived from later systematic hydrological measurements (water levels, discharges). Common periods of higher flood frequency appear largely in the periods 1821-1850 and 1921-1950, although this shifts to several other decades for individual rivers. A number of uncertainties are inseparable from flood data taxation records: their spatial and temporal incompleteness; the inevitable limitation to larger-scale damage and restriction to the summer half-year; and the different characters of rivers, including land-use changes and channel modifications. Taxation data have considerable potential for extending our knowledge of past floods for the rest of the Czech Republic, not to mention other European countries in which records have survived.

  16. Quality and the academic library reviewing, assessing and enhancing service provision

    CERN Document Server

    2016-01-01

    Quality and the Academic Library: Reviewing, Assessing and Enhancing Service Provision provides an in-depth review and analysis of quality management and service quality in academic libraries. All aspects of quality are considered in the book, including quality assessment, quality review, and quality enhancement. An overview of quality management and service quality concepts, principles, and methods leads to a detailed consideration of how they have been applied in universities and their libraries. A case study approach is used with different perspectives provided from the different stakeholders involved in the quality processes. All contributors adopt a critical reflection approach, reflecting on the implications, impact, and significance of the activities undertaken and the conclusions that can be drawn for future developments. The book concludes with an overall reflection on quality management and service quality in academic libraries with a final analysis of priorities for the future.

  17. The role of damage analysis in the assessment of service-exposed components

    International Nuclear Information System (INIS)

    Bendick, W.; Muesch, H.; Weber, H.

    1987-01-01

    Components in power stations are subjected to service conditions under which creep processes take place limiting the component's lifetime by material exhaustion. To ensure a safe and economic plant operation it is necessary to get information about the exhaustion grade of single components as well as of the whole plant. A comprehensive lifetime assessment requests the complete knowledge of the service parameters, the component's deformtion behavior, and the change in material properties caused by longtime exposure to high service temperatures. A basis of evaluation is given by: 1) determination of material exhaustion by calculation, 2) investigation of the material properties, and 3) damage analysis. The purpose of this report is to show the role which damage analysis can play in the assessment of service-exposed components. As an example the test results of a damaged pipe bend will be discussed. (orig./MM)

  18. Assessing the spatial representability of charcoal and PAH-based paleofire records with integrated GIS, modelling, and empirical approaches

    Science.gov (United States)

    Vachula, R. S.; Huang, Y.; Russell, J. M.

    2017-12-01

    Lake sediment-based fire reconstructions offer paleoenvironmental context in which to assess modern fires and predict future burning. However, despite the ubiquity, many uncertainties remain regarding the taphonomy of paleofire proxies and the spatial scales for which they record variations in fire history. Here we present down-core proxy analyses of polycyclic aromatic hydrocarbons (PAHs) and three size-fractions of charcoal (63-150, >150 and >250 μm) from Swamp Lake, California, an annually laminated lacustrine archive. Using a statewide historical GIS dataset of area burned, we assess the spatial scales for which these proxies are reliable recorders of fire history. We find that the coherence of observed and proxy-recorded fire history inherently depends upon spatial scale. Contrary to conventional thinking that charcoal mainly records local fires, our results indicate that macroscopic charcoal (>150 μm) may record spatially broader (250 μm) may be a more conservative proxy for local burning. We find that sub-macroscopic charcoal particles (63-150 μm) reliably record regional (up to 150 km) changes in fire history. These results indicate that charcoal-based fire reconstructions may represent spatially broader fire history than previously thought, which has major implications for our understanding of spatiotemporal paleofire variations. Our analyses of PAHs show that dispersal mobility is heterogeneous between compounds, but that PAH fluxes are reliable proxies of fire history within 25-50 km, which suggests PAHs may be a better spatially constrained paleofire proxy than sedimentary charcoal. Further, using a linear discriminant analysis model informed by modern emissions analyses, we show that PAH assemblages preserved in lake sediments can differentiate vegetation type burned, and are thus promising paleoecological biomarkers warranting further research and implementation. In sum, our analyses offer new insight into the spatial dimensions of paleofire

  19. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

  20. A TOOL FOR EMOTIONAL USER EXPERIENCE ASSESSMENT OF WEB-BASED MEDICAL SERVICES

    OpenAIRE

    Alexander Nikov; Tramaine Alaina Gumaia

    2016-01-01

    Emotional User Experience Design (eUXD) has become increasingly important for web-based services. The primary objective of this study is to enable users to use websites that are easy to understand and operate and pleasing to use. A checklist tool for an emotional user experience (eUX) assessment that supports web-based medical services is proposed. This tool measures user moods while using medical services’ websites. The tool allocates emotive design-oriented problems and thus defines relevan...

  1. Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self-Assessment Evaluations - Redacted

    Science.gov (United States)

    2016-12-20

    from mandatory disclosure under the Freedom of Information Act. Defense Logistics Agency Disposition Services Needs to Improve Demilitarization...Project No. D2016-D000RD-0057.000) │ i Results in Brief Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self...Assessment Evaluations Visit us at www.dodig.mil December 20, 2016 Objective Our audit objective was to determine whether the Defense Logistics Agency

  2. [Audit as a tool to assess and promote the quality of medical records and hospital appropriateness: metodology and preliminary results].

    Science.gov (United States)

    Poscia, Andrea; Cambieri, Andrea; Tucceri, Chiara; Ricciardi, Walter; Volpe, Massimo

    2015-01-01

    In the actual economic context, with increasing health needs, efficiency and efficacy represents fundamental keyword to ensure a successful use of the resources and the best health outcomes. Together, the medical record, completely and correctly compiled, is an essential tool in the patient diagnostic and therapeutic path, but it's becoming more and more essential for the administrative reporting and legal claims. Nevertheless, even if the improvement of medical records quality and of hospital stay appropriateness represent priorities for every health organization, they could be difficult to realize. This study aims to present the methodology and the preliminary results of a training and improvement process: it was carried out from the Hospital Management of a third level Italian teaching hospital through audit cycles to actively involve their health professionals. A self assessment process of medical records quality and hospital stay appropriateness (inpatients admission and Day Hospital) was conducted through a retrospective evaluation of medical records. It started in 2012 and a random sample of 2295 medical records was examined: the quality assessment was performed using a 48-item evaluation grid modified from the Lombardy Region manual of the medical record, while the appropriateness of each days was assessed using the Italian version of Appropriateness Evaluation Protocol (AEP) - 2002ed. The overall assessment was presented through departmental audit: the audit were designed according to the indication given by the Italian and English Ministry of Health to share the methodology and the results with all the involved professionals (doctors and nurses) and to implement improvement strategies that are synthesized in this paper. Results from quality and appropriateness assessment show several deficiencies, due to 40% of minimum level of acceptability not completely satisfied and to 30% of inappropriateness between days of hospitalization. Furthermore, there are

  3. Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

    Science.gov (United States)

    Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

    2018-03-12

    For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

  4. Comparing instrumental and deliberative paradigms underpinning the assessment of social values for cultural ecosystem services

    DEFF Research Database (Denmark)

    Raymond, Christopher M.; Kenter, Jasper O.; Plieninger, Tobias

    2014-01-01

    Despite rapid advancements in the development of non-monetary techniques for the assessment of social values for ecosystem services, little research attention has been devoted to the evaluation of their underpinning paradigms. This study evaluates two contrasting paradigms for the assessment...... of social values in non-monetary terms: an instrumental paradigm involving an objective assessment of the distribution, type and/or intensity of values that individuals assign to the current state of ecosystems and a deliberative paradigm involving the exploration of desired end states through group...... discussion. We present and then justify through case examples two approaches for assessing social values for ecosystem services using the instrumental paradigm and two approaches using the deliberative paradigm. Each approach makes different assumptions about: the underlying rationale for values assessment...

  5. MAPPING AND ASSESSING MULTIPLE ECOSYSTEM SERVICES IN AN ALPINE REGION: A STUDY IN TRENTINO, ITALY

    Directory of Open Access Journals (Sweden)

    M. Ferrari

    2014-04-01

    Full Text Available This research aims to identify ecosystem services relevant for Trentino (a region in the Italian Alps, and to assess them through spatial indicators. 51 experts were involved in the identification of relevant ecosystem services and appropriate indicators to represent them. Indicators were computed using the database available at administrative level. Indicators represent the actual or the potential supply of ecosystem services, expressed in terms of either stock or flow. Moreover, indicators may refer to biophysical, economic or socio-cultural values. In total, the experts selected 25 ecosystem services and 57 assessment indicators. Accordingly, the selected indicators were mapped over different spatial units of ecosystem services representation, including land use and forest types. This research was the first attempt to assess a multiple set of ecosystem services for Trentino. The results provide new information that can be used to achieve the objectives of the EU Biodiversity Strategy by 2014. The proposed approach can be reasonably extended to other Alpine areas with similar morphology, land cover and land use.

  6. Combining ecosystem services assessment with structured decision making to support ecological restoration planning.

    Science.gov (United States)

    Martin, David M; Mazzotta, Marisa; Bousquin, Justin

    2018-04-10

    Accounting for ecosystem services in environmental decision making is an emerging research topic. Modern frameworks for ecosystem services assessment emphasize evaluating the social benefits of ecosystems, in terms of who benefits and by how much, to aid in comparing multiple courses of action. Structured methods that use decision analytic-approaches are emerging for the practice of ecological restoration. In this article, we combine ecosystem services assessment with structured decision making to estimate and evaluate measures of the potential benefits of ecological restoration with a case study in the Woonasquatucket River watershed, Rhode Island, USA. We partnered with a local watershed management organization to analyze dozens of candidate wetland restoration sites for their abilities to supply five ecosystem services-flood water retention, scenic landscapes, learning opportunities, recreational opportunities, and birds. We developed 22 benefit indicators related to the ecosystem services as well as indicators for social equity and reliability that benefits will sustain in the future. We applied conceptual modeling and spatial analysis to estimate indicator values for each candidate restoration site. Lastly, we developed a decision support tool to score and aggregate the values for the organization to screen the restoration sites. Results show that restoration sites in urban areas can provide greater social benefits than sites in less urban areas. Our research approach is general and can be used to investigate other restoration planning studies that perform ecosystem services assessment and fit into a decision-making process.

  7. Assessing Capacity for Providing Culturally Competent Services to LGBT Older Adults

    Science.gov (United States)

    Portz, Jennifer Dickman; Retrum, Jessica H.; Wright, Leslie A.; Boggs, Jennifer M.; Wilkins, Shari; Grimm, Cathy; Gilchrist, Kay; Gozansky, Wendolyn S.

    2014-01-01

    This qualitative, interview-based study assessed the cultural competence of health and social service providers to meet the needs of LGBT older adults in an urban neighborhood in Denver, Colorado, known to have a large LGBT community. Only 4 of the agencies were categorized as “high competency” while 12 were felt to be “seeking improvement” and 8 were considered “not aware.” These results indicate significant gaps in cultural competency for the majority of service providers. Social workers are well-suited to lead efforts directed at improving service provision and care competencies for the older LGBT community. PMID:24798180

  8. Assessing the efficiency of hospital pharmacy services in Thai public district hospitals.

    Science.gov (United States)

    Rattanachotphanit, Thananan; Limwattananon, Chulaporn; Limwattananon, Supon; Johns, Jeff R; Schommer, Jon C; Brown, Lawrence M

    2008-07-01

    The purpose of this study was to assess the efficiency of hospital pharmacy services and to determine the environmental factors affecting pharmacy service efficiency. The technical efficiency of a hospital pharmacy was assessed to evaluate the hospital's ability to use pharmacy manpower in order to produce the maximum output of the pharmacy service. Data Envelopment Analysis (DEA) was used as an efficiency measurement. The two labor inputs were pharmacists and support personnel and the ten outputs were from four pharmacy activities: drug dispensing, drug purchasing and inventory control, patient-oriented activities, and health consumer protection services. This was used to estimate technical efficiency. A Tobit regression model was used to determine the effect of the hospital size, location, input mix of pharmacy staff, working experience of pharmacists at the study hospitals, and use of technology on the pharmacy service efficiency. Data for pharmacy service input and output quantities were obtained from 155 respondents. Nineteen percent were found to have full efficiency with a technical efficiency score of 1.00. Thirty-six percent had a technical efficiency score of 0.80 or above and 27% had a low technical efficiency score (location were significantly associated with pharmacy service efficiency.

  9. Military Emergency Medical Service System Assessment: Application of the National Park Service Needs Assessment and Program Audit to Objectively Evaluate the Military EMS System of Okinawa, Japan.

    Science.gov (United States)

    Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U

    2017-03-01

    As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  10. Electronic System for Data Record and Automatic Diagnosis Assessment in the Temporomandibular Joint Disorders

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Nagy, Miroslav; Dostálová, T.; Zvárová, Jana; Seydlová, M.

    2011-01-01

    Roč. 7, č. 1 (2011), s. 11-16 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : temporomandibular joint * temporomandibular joint disorders * DentCross * electronic health record * AAOP classification Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Hippmann_en.pdf

  11. Utilizing Health Records to Characterize Obesity, Comorbidities, and Health-Care Services in One Human Service Agency in the United States

    Science.gov (United States)

    Fisher, Kathleen; Hardie, Thomas L.; Ranjan, Sobhana; Peterson, Justin

    2017-01-01

    US surveys report higher prevalence of obesity in adults with intellectual disability. Health records of 40 adults with intellectual disability were retrospectively reviewed for data on health status, problem lists with International Classification of Diseases, Ninth Revision codes, medication lists, and health encounters over 18 months. Mean age…

  12. Language Assessment of Latino English Learning Children: A Records Abstraction Study

    Science.gov (United States)

    Kraemer, Robert; Fabiano-Smith, Leah

    2017-01-01

    The researchers examined how speech-language pathologists (SLPs) in a small northern California school district assessed Spanish speaking English learning (EL) Latino children suspected of language impairments. Specifically we sought to (1) determine whether SLPs adhered to federal, state, and professional guidelines during initial assessments and…

  13. Considerations in the Use of Interactive Voice Recording for the Temporal Assessment of Suicidal Ideation and Alcohol Use.

    Science.gov (United States)

    Bishop, Todd M; Maisto, Stephen A; Britton, Peter C; Pigeon, Wilfred R

    2016-09-01

    A greater understanding of the temporal variation of suicidal ideation and suicidal behavior is needed to inform more effective prevention efforts. Interactive voice recording (IVR) allows for the study of temporal relationships that cannot be captured with most traditional methodologies. To examine the feasibility of implementing IVR for the assessment of suicidal ideation. Participants (n = 4) receiving a brief intervention based on dialectical behavior therapy were asked to respond to three phone-based surveys each day over 6 weeks that assessed suicidal ideation and alcohol consumption. Participants completed 77.7% of daily assessments, reported that calls were not burdensome, and indicated that calls were sometimes helpful in interrupting suicidal ideation. The preliminary data reported here provide optimism for the use of IVR and other forms of ecological momentary assessment in the exploration of the antecedents of suicidal behavior.

  14. Assessing care-givers' satisfaction with child immunisation services in Zambia: Evidence from a national survey.

    Science.gov (United States)

    Chama-Chiliba, Chitalu Miriam; Masiye, Felix; Mphuka, Chrispin

    2017-10-09

    The main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants. This study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5. We used an ordered logistic regression model to analyse the significance of perceived quality of vaccination services, immunisation delivery mode and a range of individual characteristics in predicting care-giver satisfaction. Findings show that one in five care givers were unsatisfied with the vaccination services that they had received, with rural populations showing a significantly higher level of satisfaction. Poor quality of care, defined by long waiting times, poor quality of communication between health staff and care givers, long distance to vaccination sites, mode of delivery, and personal characteristics were among major factors driving care-giver satisfaction ratings. We also find that receiving a vaccination at outreach mode of delivery was associated with higher odds of greater satisfaction compared to on-facility vaccination services. The odds of satisfaction were lower for respondents living further away from a health facility, which emphasizes the importance of access in seeking vaccination services. These findings suggest that major improvements in quality of vaccination and service organisation will be needed to increase client satisfaction and service utilisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Going beyond the Millennium Ecosystem Assessment: an index system of human dependence on ecosystem services.

    Science.gov (United States)

    Yang, Wu; Dietz, Thomas; Liu, Wei; Luo, Junyan; Liu, Jianguo

    2013-01-01

    The Millennium Ecosystem Assessment (MA) estimated that two thirds of ecosystem services on the earth have degraded or are in decline due to the unprecedented scale of human activities during recent decades. These changes will have tremendous consequences for human well-being, and offer both risks and opportunities for a wide range of stakeholders. Yet these risks and opportunities have not been well managed due in part to the lack of quantitative understanding of human dependence on ecosystem services. Here, we propose an index of dependence on ecosystem services (IDES) system to quantify human dependence on ecosystem services. We demonstrate the construction of the IDES system using household survey data. We show that the overall index and sub-indices can reflect the general pattern of households' dependences on ecosystem services, and their variations across time, space, and different forms of capital (i.e., natural, human, financial, manufactured, and social capitals). We support the proposition that the poor are more dependent on ecosystem services and further generalize this proposition by arguing that those disadvantaged groups who possess low levels of any form of capital except for natural capital are more dependent on ecosystem services than those with greater control of capital. The higher value of the overall IDES or sub-index represents the higher dependence on the corresponding ecosystem services, and thus the higher vulnerability to the degradation or decline of corresponding ecosystem services. The IDES system improves our understanding of human dependence on ecosystem services. It also provides insights into strategies for alleviating poverty, for targeting priority groups of conservation programs, and for managing risks and opportunities due to changes of ecosystem services at multiple scales.

  16. KEY FUNDAMENTAL ASPECTS FOR MAPPING AND ASSESSING ECOSYSTEM SERVICES: PREDICTABILITY OF ECOSYSTEM SERVICE PROVIDERS AT SCALES FROM LOCAL TO GLOBAL.

    Directory of Open Access Journals (Sweden)

    G. Zurlini

    2014-04-01

    Full Text Available How an apparent static and ordered landscape condition in social ecological landscapes (SELs, can be made sustainable in terms of maintenance and improvement of the provision of ecosystem services (ESs in face of unpredictable disturbance and change? Our contribution to the Mapping and Assessment of Ecosystem Services (MAES working group is to advance some recommendations on how to approach the dynamic analysis of complex adaptive systems to improve ecosystem resilience, habitat connectivity and the delivery of ESs. We show exemplary cases where we utilize the NDVI provided by remote sensing to evaluate land cover transformations and processes and ES provisioning. We focus on NDVI because it allows the supply of information on net primary production, i.e., the energetic foundation of nearly all ecosystems and that provides the basis of most of ESs. The use of spectral entropy, and nonlinear analysis of spatial temporal dynamics to investigate trajectory predictability of SELs provide very useful insight into the dynamics of SELs and can assist in the characterization of the links between land cover patterns with ecological processes to support more reliable assessments and accountings of ESs.

  17. Measuring the food service environment: development and implementation of assessment tools.

    Science.gov (United States)

    Minaker, Leia M; Raine, Kim D; Cash, Sean B

    2009-01-01

    The food environment is increasingly being implicated in the obesity epidemic, though few reported measures of it exist. In order to assess the impact of the food environment on food intake, valid measures must be developed and tested. The current study describes the development of a food service environment assessment tool and its implementation in a community setting. A descriptive study with mixed qualitative and quantitative methods at a large, North American university campus was undertaken. Measures were developed on the basis of a conceptual model of nutrition environments. Measures of community nutrition environment were the number, type and hours of operation of each food service outlet on campus. Measures of consumer nutrition environment were food availability, food affordability, food promotion and nutrition information availability. Seventy-five food service outlets within the geographic boundaries were assessed. Assessment tools could be implemented in a reasonable amount of time and showed good face and content validity. The food environments were described and measures were grouped so that food service outlet types could be compared in terms of purchasing convenience, cost/value, healthy food promotion and health. Food service outlet types that scored higher in purchasing convenience and cost/value tended to score lower in healthy food promotion and health. This study adds evidence that food service outlet types that are convenient to consumers and supply high value (in terms of calories per dollar) tend to be less health-promoting. Results from this study also suggest the possibility of characterizing the food environment according to the type of food service outlet observed.

  18. Geographic information systems (GIS): an emerging method to assess demand and provision for rehabilitation services.

    Science.gov (United States)

    Passalent, Laura; Borsy, Emily; Landry, Michel D; Cott, Cheryl

    2013-09-01

    To illustrate the application of geographic information systems (GIS) as a tool to assess rehabilitation service delivery by presenting results from research recently conducted to assess demand and provision for community rehabilitation service delivery in Ontario, Canada. Secondary analysis of data obtained from existing sources was used to establish demand and provision profiles for community rehabilitation services. These data were integrated using GIS software. A number of descriptive maps were produced that show the geographical distribution of service provision variables (location of individual rehabilitation health care providers and location of private and publicly funded community rehabilitation clinics) in relation to the distribution of demand variables (location of the general population; location of specific populations (i.e., residents age 65 and older) and distribution of household income). GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.

  19. National assessment of validity of coding of acute mastoiditis: a standardised reassessment of 1966 records.

    Science.gov (United States)

    Stalfors, J; Enoksson, F; Hermansson, A; Hultcrantz, M; Robinson, Å; Stenfeldt, K; Groth, A

    2013-04-01

    To investigate the internal validity of the diagnosis code used at discharge after treatment of acute mastoiditis. Retrospective national re-evaluation study of patient records 1993-2007 and make comparison with the original ICD codes. All ENT departments at university hospitals and one large county hospital department in Sweden. A total of 1966 records were reviewed for patients with ICD codes for in-patient treatment of acute (529), chronic (44) and unspecified mastoiditis (21) and acute otitis media (1372). ICD codes were reviewed by the authors with a defined protocol for the clinical diagnosis of acute mastoiditis. Those not satisfying the diagnosis were given an alternative diagnosis. Of 529 records with ICD coding for acute mastoiditis, 397 (75%) were found to meet the definition of acute mastoiditis used in this study, while 18% were not diagnosed as having any type of mastoiditis after review. Review of the in-patients treated for acute media otitis identified an additional 60 cases fulfilling the definition of acute mastoiditis. Overdiagnosis was common, and many patients with a diagnostic code indicating acute mastoiditis had been treated for external otitis or otorrhoea with transmyringeal drainage. The internal validity of the diagnosis acute mastoiditis is dependent on the use of standardised, well-defined criteria. Reliability of diagnosis is fundamental for the comparison of results from different studies. Inadequate reliability in the diagnosis of acute mastoiditis also affects calculations of incidence rates and statistical power and may also affect the conclusions drawn from the results. © 2013 Blackwell Publishing Ltd.

  20. The utility of the historical record for assessing the transient climate response to cumulative emissions

    Science.gov (United States)

    Friedlingstein, Pierre

    2018-01-01

    The historical observational record offers a way to constrain the relationship between cumulative carbon dioxide emissions and global mean warming. We use a standard detection and attribution technique, along with observational uncertainties to estimate the all-forcing or ‘effective’ transient climate response to cumulative emissions (TCRE) from the observational record. Accounting for observational uncertainty and uncertainty in historical non-CO2 radiative forcing gives a best-estimate from the historical record of 1.84°C/TtC (1.43–2.37°C/TtC 5–95% uncertainty) for the effective TCRE and 1.31°C/TtC (0.88–2.60°C/TtC 5–95% uncertainty) for the CO2-only TCRE. While the best-estimate TCRE lies in the lower half of the IPCC likely range, the high upper bound is associated with the not-ruled-out possibility of a strongly negative aerosol forcing. Earth System Models have a higher effective TCRE range when compared like-for-like with the observations over the historical period, associated in part with a slight underestimate of diagnosed cumulative emissions relative to the observational best-estimate, a larger ensemble mean-simulated CO2-induced warming, and rapid post-2000 non-CO2 warming in some ensemble members. This article is part of the theme issue ‘The Paris Agreement: understanding the physical and social challenges for a warming world of 1.5°C above pre-industrial levels'. PMID:29610381

  1. The utility of the historical record for assessing the transient climate response to cumulative emissions

    Science.gov (United States)

    Millar, Richard J.; Friedlingstein, Pierre

    2018-05-01

    The historical observational record offers a way to constrain the relationship between cumulative carbon dioxide emissions and global mean warming. We use a standard detection and attribution technique, along with observational uncertainties to estimate the all-forcing or `effective' transient climate response to cumulative emissions (TCRE) from the observational record. Accounting for observational uncertainty and uncertainty in historical non-CO2 radiative forcing gives a best-estimate from the historical record of 1.84°C/TtC (1.43-2.37°C/TtC 5-95% uncertainty) for the effective TCRE and 1.31°C/TtC (0.88-2.60°C/TtC 5-95% uncertainty) for the CO2-only TCRE. While the best-estimate TCRE lies in the lower half of the IPCC likely range, the high upper bound is associated with the not-ruled-out possibility of a strongly negative aerosol forcing. Earth System Models have a higher effective TCRE range when compared like-for-like with the observations over the historical period, associated in part with a slight underestimate of diagnosed cumulative emissions relative to the observational best-estimate, a larger ensemble mean-simulated CO2-induced warming, and rapid post-2000 non-CO2 warming in some ensemble members. This article is part of the theme issue `The Paris Agreement: understanding the physical and social challenges for a warming world of 1.5°C above pre-industrial levels'.

  2. Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

    Science.gov (United States)

    Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

    2016-02-06

    Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

  3. Assessing the cost of electronic health records: a review of cost indicators.

    Science.gov (United States)

    Gallego, Ana Isabel; Gagnon, Marie-Pierre; Desmartis, Marie

    2010-11-01

    We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

  4. Accounting for ecosystem services in life cycle assessment, Part I: a critical review.

    Science.gov (United States)

    Zhang, Yi; Singh, Shweta; Bakshi, Bhavik R

    2010-04-01

    If life cycle oriented methods are to encourage sustainable development, they must account for the role of ecosystem goods and services, since these form the basis of planetary activities and human well-being. This article reviews methods that are relevant to accounting for the role of nature and that could be integrated into life cycle oriented approaches. These include methods developed by ecologists for quantifying ecosystem services, by ecological economists for monetary valuation, and life cycle methods such as conventional life cycle assessment, thermodynamic methods for resource accounting such as exergy and emergy analysis, variations of the ecological footprint approach, and human appropriation of net primary productivity. Each approach has its strengths: economic methods are able to quantify the value of cultural services; LCA considers emissions and assesses their impact; emergy accounts for supporting services in terms of cumulative exergy; and ecological footprint is intuitively appealing and considers biocapacity. However, no method is able to consider all the ecosystem services, often due to the desire to aggregate all resources in terms of a single unit. This review shows that comprehensive accounting for ecosystem services in LCA requires greater integration among existing methods, hierarchical schemes for interpreting results via multiple levels of aggregation, and greater understanding of the role of ecosystems in supporting human activities. These present many research opportunities that must be addressed to meet the challenges of sustainability.

  5. Biodiversity, ecosystem functions and services in environmental risk assessment: introduction to the special issue.

    Science.gov (United States)

    Schäfer, Ralf B

    2012-01-15

    This Special Issue focuses on the questions if and how biodiversity, ecosystem functions and resulting services could be incorporated into the Ecological Risk Assessment (ERA). Therefore, three articles provide a framework for the integration of ecosystem services into ERA of soils, sediments and pesticides. Further articles demonstrate ways how stakeholders can be integrated into an ecosystem service-based ERA for soils and describe how the current monitoring could be adapted to new assessment endpoints that are directly linked to ecosystem services. Case studies show that the current ERA may not be protective for biodiversity, ecosystem functions and resulting services and that both pesticides and salinity currently adversely affect ecosystem functions in the field. Moreover, ecological models can be used for prediction of new protection goals and could finally support their implementation into the ERA. Overall, the Special Issue stresses the urgent need to enhance current procedures of ERA if biodiversity, ecosystem functions and resulting services are to be protected. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. An assessment of key health indicators among emergency medical services professionals.

    Science.gov (United States)

    Studnek, Jonathan R; Bentley, Melissa; Crawford, J Mac; Fernandez, Antonio R

    2010-01-01

    Ensuring the health and productivity of emergency medical services (EMS) professionals is important. However, there has been no known national baseline assessment of the health and wellness of EMS professionals in the United States. According to Healthy People 2010, top indicators of personal health include physical activity, body mass index (BMI), and smoking prevalence. The objectives of this study included quantifying existing health conditions and describing key health indicators among EMS professionals. It was hypothesized that work-life characteristics were associated with existing health conditions and key health indicators. Data utilized for this analysis were obtained from a 2007 questionnaire included in biennial national recertification packets. This questionnaire utilized validated items from the Behavioral Risk Factor Surveillance System (BRFSS) and the Longitudinal EMT Attributes and Demographics Study (LEADS). Along with common demographic characteristics, items inquired about existing health conditions (diabetes, asthma, hypertension, myocardial infarction, angina, stroke, and/or high blood cholesterol level), general health, physical activity, and smoking status. Descriptive analyses were performed utilizing chi-square tests, and logistic regression was utilized to describe associations between existing health conditions and the key health indicators. There were 58,435 individuals who became recertified in 2007, with 30,560 (52%) returning questionnaires. Individuals with missing data were removed, leaving 19,960 individual records. There were 4,681 (23.5%) individuals who reported at least one existing health condition. The mean BMI for the study participants was 27.69 kg/m(2). There were 5,742 (28.8%) individuals classified as having normal weight and 5,146 (25.8%) who were obese. The overwhelming majority of individuals did not meet the Centers for Disease Control and Prevention (CDC) recommendations for physical activity (15,022, 75.3%). There

  7. The 2017 México Tsunami Record, Numerical Modeling and Threat Assessment in Costa Rica

    Science.gov (United States)

    Chacón-Barrantes, Silvia

    2018-03-01

    An M w 8.2 earthquake and tsunami occurred offshore the Pacific coast of México on 2017-09-08, at 04:49 UTC. Costa Rican tide gauges have registered a total of 21 local, regional and far-field tsunamis. The Quepos gauge registered 12 tsunamis between 1960 and 2014 before it was relocated inside a harbor by late 2014, where it registered two more tsunamis. This paper analyzes the 2017 México tsunami as recorded by the Quepos gauge. It took 2 h for the tsunami to arrive to Quepos, with a first peak height of 9.35 cm and a maximum amplitude of 18.8 cm occurring about 6 h later. As a decision support tool, this tsunami was modeled for Quepos in real time using ComMIT (Community Model Interface for Tsunami) with the finer grid having a resolution of 1 arcsec ( 30 m). However, the model did not replicate the tsunami record well, probably due to the lack of a finer and more accurate bathymetry. In 2014, the National Tsunami Monitoring System of Costa Rica (SINAMOT) was created, acting as a national tsunami warning center. The occurrence of the 2017 México tsunami raised concerns about warning dissemination mechanisms for most coastal communities in Costa Rica, due to its short travel time.

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

    Science.gov (United States)

    Beverley, Charles St. Clare, Jr.

    2013-01-01

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

  9. Assessment of Passenger Satisfaction with Public Bus Transport Services: A Case Study of Lucknow City (India

    Directory of Open Access Journals (Sweden)

    Singh Sanjay

    2016-12-01

    Full Text Available The main aim of this study is threefold. First, it tries to assess the passenger satisfaction with public bus transport services in the city of Lucknow in India. Second, it tries to examine the service quality attributes that influence the passenger satisfaction. Third, it tries to evaluate the relative importance of service quality attributes to find out the priority for service quality improvements to enhance passenger satisfaction. The study is based on a survey of objective as well as subjective questions conducted between May and July 2014. Five major bus stops of Lucknow were selected for the survey. Total 148 respondents were randomly selected to elicit their overall satisfaction and factors that influence their satisfaction in the use of public bus transport services in Lucknow using a self-rated questionnaire. The collected sample of responses is subjected to principal component analysis, a statistical technique for dimensionality reduction of the dataset, and descriptive analysis. The result of theses analyses shows that passengers are mostly dissatisfied with public bus transport services in Lucknow. Using principal component analysis, five underlying factors were extracted that influenced passenger satisfaction with public bus transport services in the city. Out of these five factors, comfort and safety has the greatest impact on overall satisfaction, followed by the adequacy of capacity of public bus transport services, orderly and clean environment inside buses, elegant design of buses and bus stops, and accessibility to public bus transport services in the city. The study thus provides a direction for public bus transport administration in the city to understand the gaps that exist and try to fill them to improve its services so that passenger satisfaction can be enhanced and consequently more people can be attracted towards public bus transport.

  10. Consistent data recording across a health system and web-enablement allow service quality comparisons: online data for commissioning dermatology services.

    Science.gov (United States)

    Dmitrieva, Olga; Michalakidis, Georgios; Mason, Aaron; Jones, Simon; Chan, Tom; de Lusignan, Simon

    2012-01-01

    A new distributed model of health care management is being introduced in England. Family practitioners have new responsibilities for the management of health care budgets and commissioning of services. There are national datasets available about health care providers and the geographical areas they serve. These data could be better used to assist the family practitioner turned health service commissioners. Unfortunately these data are not in a form that is readily usable by these fledgling family commissioning groups. We therefore Web enabled all the national hospital dermatology treatment data in England combining it with locality data to provide a smart commissioning tool for local communities. We used open-source software including the Ruby on Rails Web framework and MySQL. The system has a Web front-end, which uses hypertext markup language cascading style sheets (HTML/CSS) and JavaScript to deliver and present data provided by the database. A combination of advanced caching and schema structures allows for faster data retrieval on every execution. The system provides an intuitive environment for data analysis and processing across a large health system dataset. Web-enablement has enabled data about in patients, day cases and outpatients to be readily grouped, viewed, and linked to other data. The combination of web-enablement, consistent data collection from all providers; readily available locality data; and a registration based primary system enables the creation of data, which can be used to commission dermatology services in small areas. Standardized datasets collected across large health enterprises when web enabled can readily benchmark local services and inform commissioning decisions.

  11. Mapping regional livelihood benefits from local ecosystem services assessments in rural Sahel.

    Directory of Open Access Journals (Sweden)

    Katja Malmborg

    Full Text Available Most current approaches to landscape scale ecosystem service assessments rely on detailed secondary data. This type of data is seldom available in regions with high levels of poverty and strong local dependence on provisioning ecosystem services for livelihoods. We develop a method to extrapolate results from a previously published village scale ecosystem services assessment to a higher administrative level, relevant for land use decision making. The method combines remote sensing (using a hybrid classification method and interviews with community members. The resulting landscape scale maps show the spatial distribution of five different livelihood benefits (nutritional diversity, income, insurance/saving, material assets and energy, and crops for consumption that illustrate the strong multifunctionality of the Sahelian landscapes. The maps highlight the importance of a diverse set of sub-units of the landscape in supporting Sahelian livelihoods. We see a large potential in using the resulting type of livelihood benefit maps for guiding future land use decisions in the Sahel.

  12. Mapping regional livelihood benefits from local ecosystem services assessments in rural Sahel.

    Science.gov (United States)

    Malmborg, Katja; Sinare, Hanna; Enfors Kautsky, Elin; Ouedraogo, Issa; Gordon, Line J

    2018-01-01

    Most current approaches to landscape scale ecosystem service assessments rely on detailed secondary data. This type of data is seldom available in regions with high levels of poverty and strong local dependence on provisioning ecosystem services for livelihoods. We develop a method to extrapolate results from a previously published village scale ecosystem services assessment to a higher administrative level, relevant for land use decision making. The method combines remote sensing (using a hybrid classification method) and interviews with community members. The resulting landscape scale maps show the spatial distribution of five different livelihood benefits (nutritional diversity, income, insurance/saving, material assets and energy, and crops for consumption) that illustrate the strong multifunctionality of the Sahelian landscapes. The maps highlight the importance of a diverse set of sub-units of the landscape in supporting Sahelian livelihoods. We see a large potential in using the resulting type of livelihood benefit maps for guiding future land use decisions in the Sahel.

  13. Mapping regional livelihood benefits from local ecosystem services assessments in rural Sahel

    Science.gov (United States)

    Sinare, Hanna; Enfors Kautsky, Elin; Ouedraogo, Issa; Gordon, Line J.

    2018-01-01

    Most current approaches to landscape scale ecosystem service assessments rely on detailed secondary data. This type of data is seldom available in regions with high levels of poverty and strong local dependence on provisioning ecosystem services for livelihoods. We develop a method to extrapolate results from a previously published village scale ecosystem services assessment to a higher administrative level, relevant for land use decision making. The method combines remote sensing (using a hybrid classification method) and interviews with community members. The resulting landscape scale maps show the spatial distribution of five different livelihood benefits (nutritional diversity, income, insurance/saving, material assets and energy, and crops for consumption) that illustrate the strong multifunctionality of the Sahelian landscapes. The maps highlight the importance of a diverse set of sub-units of the landscape in supporting Sahelian livelihoods. We see a large potential in using the resulting type of livelihood benefit maps for guiding future land use decisions in the Sahel. PMID:29389965

  14. Landscapes‘ Capacities to Provide Ecosystem Services – a Concept for Land-Cover Based Assessments

    Directory of Open Access Journals (Sweden)

    Benjamin Burkhard

    2009-12-01

    Full Text Available Landscapes differ in their capacities to provide ecosystem goods and services, which are the benefits humans obtain from nature. Structures and functions of ecosystems needed to sustain the provision of ecosystem services are altered by various human activities. In this paper, a concept for the assessment of multiple ecosystem services is proposed as a basis for discussion and further development of a respective evaluation instrument. Using quantitative and qualitative assessment data in combination with land cover and land use information originated from remote sensing and GIS, impacts of human activities can be evaluated. The results reveal typical patterns of different ecosystems‘ capacities to provide ecosystem services. The proposed approach thus delivers useful integrative information for environmental management and landscape planning, aiming at a sustainable use of services provided by nature. The research concept and methodological framework presented here for discussion have initially been applied in different case studies and shall be developed further to provide a useful tool for the quantification and spatial modelling of multiple ecosystem services in different landscapes. An exemplary application of the approach dealing with food provision in the Halle-Leipzig region in Germany is presented. It shows typical patterns of ecosystem service distribution around urban areas. As the approach is new and still rather general, there is great potential for improvement, especially with regard to a data-based quantification of the numerous hypotheses, which were formulated as base for the assessment. Moreover, the integration of more detailed landscape information on different scales will be needed in future in order to take the heterogeneous distribution of landscape properties and values into account. Therefore, the purpose of this paper is to foster critical discussions on the methodological development presented here.

  15. A GIS application for assessing, mapping, and quantifying the social values of ecosystem services

    Science.gov (United States)

    Sherrouse, Benson C.; Clement, Jessica M.; Semmens, Darius J.

    2011-01-01

    As human pressures on ecosystems continue to increase, research involving the effective incorporation of social values information into the context of comprehensive ecosystem services assessments is becoming more important. Including quantified, spatially explicit social value metrics in such assessments will improve the analysis of relative tradeoffs among ecosystem services. This paper describes a GIS application, Social Values for Ecosystem Services (SolVES), developed to assess, map, and quantify the perceived social values of ecosystem services by deriving a non-monetary Value Index from responses to a public attitude and preference survey. SolVES calculates and maps the Value Index for social values held by various survey subgroups, as distinguished by their attitudes regarding ecosystem use. Index values can be compared within and among survey subgroups to explore the effect of social contexts on the valuation of ecosystem services. Index values can also be correlated and regressed against landscape metrics SolVES calculates from various environmental data layers. Coefficients derived through these analyses were applied to their corresponding data layers to generate a predicted social value map. This map compared favorably with other SolVES output and led to the addition of a predictive mapping function to SolVES for value transfer to areas where survey data are unavailable. A more robust application is being developed as a public domain tool for decision makers and researchers to map social values of ecosystem services and to facilitate discussions among diverse stakeholders involving relative tradeoffs among different ecosystem services in a variety of physical and social contexts.

  16. User Satisfaction Assessment To Edu-Eco Tourism Services Of Cibodas Botanical Garden

    Science.gov (United States)

    Hidayat, I. W.; Winarni

    2017-10-01

    Cibodas Botanical Garden (CBG) is a government institution which has principal duties and functions as area of conservation ex situ of wet highland plants, research, education and tourism, it very closely related to aspect of the services to user. Good services will support the sustainability and existence of CBG as a world class edu-eco tourism destination. The purpose of this study was to measure the quality of services which delivered and improvement which necessary at the future. Assessments were made based on 14 criteria of services aspect for user which need research-education services and regular tourism services activities. The study was conducted by distributing questionnaires to users of these services. Questionnaires distribution was conducted in early August 2015 and August 2016, the respondents were 124 and 207. The results were showed the user satisfaction at good level, there were 77.685 in 2015 and 72.08 in 2016. Although still at a good level, there were a decline in satisfaction levels based on the value. In the future, the managerial needs to continuously to improve it, in order to get a good or very good valuation.

  17. Families at risk of poor parenting: a model for service delivery, assessment, and intervention.

    Science.gov (United States)

    Ayoub, C; Jacewitz, M M

    1982-01-01

    The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.

  18. Outdoor recreation trends and futures: a technical document supporting the Forest Service 2010 RPA Assessment

    Science.gov (United States)

    H. Ken Cordell

    2012-01-01

    This publication presents a national study of outdoor recreation trends as part of the Renewable Resources Planning Act Assessment by the Forest Service, U.S. Department of Agriculture. The objectives are to review past trends in outdoor recreation participation by Americans, to describe in detail current outdoor recreation participation patterns, and to compare...

  19. Assessing impacts of intensified biomass production and biodiversity protection on ecosystem services provided by European forests

    NARCIS (Netherlands)

    Verkerk, P.J.; Mavsar, R.; Giergiczny, M.; Lindner, M.; Edwards, D.; Schelhaas, M.J.

    2014-01-01

    To develop viable strategies for intensifying the use of forest biomass and for increasing forest protection, impacts on ecosystem services need to be assessed. We investigated the biophysical and economic impacts of increased forest biomass production and biodiversity protection on forest ecosystem

  20. Comparative Assessment of Goods and Services Provided by Grazing Regulation and Reforestation in Degraded Mediterranean Rangelands

    NARCIS (Netherlands)

    Papanastasis, Vasilios P.; Bautista, Susana; Chouvardas, Dimitrios; Mantzanas, Konstantinos; Papadimitriou, Maria; Garcia Mayor, Angeles; Koukioumi, Polina; Papaioannou, Athanasios; Vallejo, Ramon V.

    2017-01-01

    Several management actions are applied to restore ecosystem services in degraded Mediterranean rangelands, which range from adjusting the grazing pressure to the removal of grazers and pine plantations. Four such actions were assessed in Quercus coccifera L. shrublands in northern Greece: (i)

  1. Employee Health Service for Teaching and Nonteaching Staff: A Needs Assessment.

    Science.gov (United States)

    Long, Bonita C.; And Others

    1986-01-01

    A needs assessment was conducted to identify the health needs of school district employees in planning a comprehensive employee health service. Survey questionnaires were analyzed to determine characteristics of those individuals who may be at greatest health risk. Results indicate that degree of stress can differentiate health risk predictors.…

  2. Service life assessment of timber highway bridges in USA climate zones

    Science.gov (United States)

    James P. Wacker; Brian K. Brashaw; Thomas G. Williamson; P. David Jones; Matthew S. Smith; Travis K. Hosteng; David L. Strahl; Lola E. Coombe; V.J. Gopu

    2014-01-01

    As engineers begin to estimate life-cycle costs and sustainable design approaches for timber bridges, there is a need for more reliable data about their durability and expected service life. This paper summarizes a comprehensive effort to assess the current condition of more than one hundred timber highway bridge superstructures throughout the United States. This...

  3. A spatially explicit and quantitative vulnerability assessment of ecosystem service change in Europe

    NARCIS (Netherlands)

    Metzger, M.J.; Schröter, D.; Leemans, R.; Cramer, W.

    2008-01-01

    Environmental change alters ecosystem functioning and may put the provision of services to human at risk. This paper presents a spatially explicit and quantitative assessment of the corresponding vulnerability for Europe, using a new framework designed to answer multidisciplinary policy relevant

  4. Assessing the Merits of International Service-Learning in Developing Professionalism in Mass Communication

    Science.gov (United States)

    Motley, Phillip; Sturgill, Amanda

    2013-01-01

    This project assessed how an international service-learning course affected mass communication students' knowledge of professionalism. Using written reflections and focus group transcripts from four courses that took place in Central America, we observed that placing students in immersive environments, where they are able to work on authentic…

  5. Elder Abuse and Neglect: Assessment Tools, Interventions, and Recommendations for Effective Service Provision

    Science.gov (United States)

    Imbody, Bethany; Vandsburger, Etty

    2011-01-01

    With our communities rapidly aging, there is always a clear need for greater knowledge on how to serve elders. Professionals must be able to recognize cases of abuse and neglect and provide appropriate follow up services. Through reviewing recent literature, this paper surveys existing assessment tools and interventions, describes characteristics…

  6. Psychometric properties of the consumer quality index to assess shelter and community care services

    NARCIS (Netherlands)

    Beijersbergen, M.D.; Asmoredjo, J.K.; Christians, M.G.M.; Wolf, J.R.L.M.

    2015-01-01

    BACKGROUND: Our aim was to design a valid and reliable consumer quality index (CQI) specifically suited to assess the experiences that homeless people, homeless youth, and abused women have with shelter and community care services. METHODS: A pilot CQI questionnaire was constructed on the basis of

  7. Distance Education Programs in Texas Community & Technical Colleges: Assessing Student Support Services in a Virtual Environment.

    Science.gov (United States)

    Luedtke, Cherry Beth

    This project evaluates the status of distance learning at 54 public, two-year community, and technical colleges in Texas. Data was collected from the Web sites of each of the institutions. The Web site data indicted that 44 of the colleges refer specifically to distance education courses offered. To assess what student support services are…

  8. Improving the Leadership Skills of Pre-Service School Librarians through Leadership Pre-Assessment

    Science.gov (United States)

    Smith, Daniella

    2014-01-01

    School librarian guidelines encourage active leadership in schools. Two ways school librarian educators can encourage school librarians to be leaders are to embed the standards into the certification curriculum and to assess the leadership potential of pre-service school librarians in order to adapt the curriculum to their needs. This mixed-method…

  9. Dilemmas Faced Establishing Portfolio Assessment of Pre-Service Teachers in the Southeastern United States

    Science.gov (United States)

    Van Sickle, Meta; Bogan, Margaret B.; Kamen, Michael; Baird, William; Butcher, Carolyn

    2005-01-01

    There is increasing pressure to evaluate and document the capabilities of students exiting teacher education programs. A professional portfolio can serve as an effective tool for documenting this process. Faculty wishing to institute portfolios in pre-service teacher assessment should be aware of the difficulties that arise during discourse and…

  10. How Do Colleges and Universities Assess the Education and Training of Military Service Personnel?

    Science.gov (United States)

    Palmer, James C.; Ludwig, Meredith J.

    1991-01-01

    In a study of the ways colleges and universities regard prior learning of military service members who apply for admission to undergraduate degree programs, 66 colleges evaluated prototype transcripts and assessed problems in awarding degree credit. A number of problems are seen as needing to be addressed by both schools and the military.…

  11. Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit.

    Science.gov (United States)

    Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana

    2014-01-01

    In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting

  12. Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.

    Science.gov (United States)

    Worku, Mesfin; Loha, Eskindir

    2017-06-27

    Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap. Cross-sectional study was conducted from March 13 to May 15/2014. Systematic sampling method was used to enroll study participants. The data was collected by trained data collectors using pre-structured questionnaire. A total 407 clients were enrolled under this study with respondent rate of 96.9%. Nearly two third of study participants were male, 270 (66.3%). 86.7% of study participants were satisfied by services provided in Emergency Out Patient Department (OPD). The percentage of study satisfaction with physical examination by Doctor, nursing, laboratory and pharmacy services were 95.6%, 89.9%, 84.7% and 67.6%, respectively. Only 31.9% were satisfied with availability of drugs in the pharmacy. Regarding to staff courtesy, 91.7% of study participants were satisfied by the manner shown by the staffs working in Emergency OPD. The vast majority of the participants (97%) were satisfied with the courtesy of Medical laboratory personnel and the least satisfaction (79.4%) was recorded for security guards. This study showed low level of patient satisfaction in pharmacy services specifically due to unavailability of drugs due to lack of sustained supply of drugs.

  13. Assessing artificial neural networks and statistical methods for infilling missing soil moisture records

    Science.gov (United States)

    Dumedah, Gift; Walker, Jeffrey P.; Chik, Li

    2014-07-01

    Soil moisture information is critically important for water management operations including flood forecasting, drought monitoring, and groundwater recharge estimation. While an accurate and continuous record of soil moisture is required for these applications, the available soil moisture data, in practice, is typically fraught with missing values. There are a wide range of methods available to infilling hydrologic variables, but a thorough inter-comparison between statistical methods and artificial neural networks has not been made. This study examines 5 statistical methods including monthly averages, weighted Pearson correlation coefficient, a method based on temporal stability of soil moisture, and a weighted merging of the three methods, together with a method based on the concept of rough sets. Additionally, 9 artificial neural networks are examined, broadly categorized into feedforward, dynamic, and radial basis networks. These 14 infilling methods were used to estimate missing soil moisture records and subsequently validated against known values for 13 soil moisture monitoring stations for three different soil layer depths in the Yanco region in southeast Australia. The evaluation results show that the top three highest performing methods are the nonlinear autoregressive neural network, rough sets method, and monthly replacement. A high estimation accuracy (root mean square error (RMSE) of about 0.03 m/m) was found in the nonlinear autoregressive network, due to its regression based dynamic network which allows feedback connections through discrete-time estimation. An equally high accuracy (0.05 m/m RMSE) in the rough sets procedure illustrates the important role of temporal persistence of soil moisture, with the capability to account for different soil moisture conditions.

  14. 12 CFR 228.24 - Service test.

    Science.gov (United States)

    2010-01-01

    ... 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...

  15. [Assessing food acceptance in scholar children; qualitative visual record versus food waste analysis].

    Science.gov (United States)

    Rodriguez Tadeo, Alejandra; Patiño Villena, Begoña; Periago Castón, María Jesús; Ros Berruezo, Gaspar; González Martínez-Lacuesta, Eduardo

    2014-05-01

    School canteens have rules of management and supervision of menus, however has not been assessed if they are totally consumed. To assess the acceptance of food by weigh food leftovers and validation of a methodology for visual estimation in school canteens of Murcia. Participated pupils in the second and third cycle of primary education, between 8 and 12 years. The estimate of leftovers was performed by 765 food trays. Visual estimation of 300 trays was based on a categorical scale as follow: 1 (0-25%), 2 (26-50%), 3 (51- 75%), 4 (76-100%) by two dietitians and reliability was assessed with respect to the weighed food. The reliability between both methods was assessed in two samples stratified by presence or absence of school kitchen. The first dishes with leftovers were pasta, rice and vegetable purees and was higher in those schools without kitchen (p foods according to the type of menu offered. The visual scale is a reliable to measure acceptance indirectly, but training to catering staff is needed. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Quality assessment of information about medications in primary care electronic patient record (EPR systems

    Directory of Open Access Journals (Sweden)

    Maria Pous

    2010-06-01

    Conclusions This project highlighted the poor quality of drug information provided by these EPR programmes. The ten-item tool seems suitable for assessing their quality. Based on this analysis, we have proposed a set of ten quality standards for prescribing software.

  17. The Need for a Uniform Method of Recording and Reporting Functional Vision Assessments

    Science.gov (United States)

    Shaw, Rona; Russotti, Joanne; Strauss-Schwartz, Judy; Vail, Helen; Kahn, Ronda

    2009-01-01

    The use of functional vision by school-age students who have visual impairments, including those with additional disabilities, is typically reported by teachers of students with visual impairments. Functional vision assessments determine how well a student uses his or her vision to perform tasks throughout the school day. The information that is…

  18. N-Nitroso compounds: Assessing agreement between food frequency questionnaires and 7-day food records

    Science.gov (United States)

    N-nitroso compounds are recognized as important dietary carcinogens. Accurate assessment of N-nitroso intake is fundamental to advancing research regarding its role with cancer. Previous studies have not used a quantitative database to estimate the intake of these compounds in a US population. To ad...

  19. 78 FR 110 - Supplemental Record of Decision; Final Supplementary Risk Assessment for the Boston University...

    Science.gov (United States)

    2013-01-02

    ..., questions were raised specifically about the potential risks of the biosafety level 4 (BSL-4) laboratory. To... epidemiology, risk assessment, environmental justice, risk communications, biosafety, and infectious disease... functional personal protective equipment, and standard operating procedures were not taken into account in...

  20. Self-Assessment of Video-Recorded Presentations: Does It Improve Skills?

    Science.gov (United States)

    Ritchie, Sian M.

    2016-01-01

    The opportunity to give oral presentations is important because it helps develop skills that are necessary for many aspects of professional careers. Competencies for oral presentations include appropriate content, design and organization of the presentation, and delivery skills. Self-assessment has been shown to help students develop…

  1. An integrable, web-based solution for easy assessment of video-recorded performances

    DEFF Research Database (Denmark)

    Subhi, Yousif; Todsen, Tobias; Konge, Lars

    2014-01-01

    , and access to this information should be restricted to select personnel. A local software solution may also ease the need for customization to local needs and integration into existing user databases or project management software. We developed an integrable web-based solution for easy assessment of video...

  2. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    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

  3. Experiences of Healthcare Professionals to the Introduction in Sweden of a Public eHealth Service: Patients' Online Access to their Electronic Health Records.

    Science.gov (United States)

    Ålander, Ture; Scandurra, Isabella

    2015-01-01

    Patients' increasing demands for medical information, the digitization of health records and the fast spread of Internet access form a basis of introducing new eHealth services. An international trend is to provide access for patients to health information of various kind. In Sweden, access by patients to their proper electronic health record (EHR) has been provided in a pilot county since November 2012. This eHealth service is controversial and criticism has arised from the clinical professions, mainly physicians. Two web surveys were conducted to discover whether the opinions of healthcare professionals differ; between staff that have had experience with patients accessing their own EHR and those who have no such expericence. Experienced nurses found the EHR more important for the patients and a better reform, compared to unexperienced nurses in the rest of the country. Similarly, physicians with their own experience had a more positive attitude compared to non-experienced physicians. The conclusion of this study is that healthcare professionals must be involved in the implementation of public eHealth services such as EHRs and that real experiences of the professionals should be better disseminated to their inexperienced peers.

  4. Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting.

    Science.gov (United States)

    Agu, Kenneth Anene; Oqua, Dorothy; Agada, Peter; Ohiaeri, Samuel I; Adesina, Afusat; Abdulkareem, Mohammed Habeeb; King, Rosalyn C; Wutoh, Anthony K

    2014-06-01

    The patient's perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Seventeen HIV treatment centres in Nigeria. This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Patient satisfaction with pharmaceutical services. Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26-40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3-26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists' efforts to solve patients' medication related problems was negative. The participants' rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with

  5. Supply sensitive services in Swiss ambulatory care: An analysis of basic health insurance records for 2003-2007

    Directory of Open Access Journals (Sweden)

    Künzi Beat

    2010-11-01

    Full Text Available Abstract Background Swiss ambulatory care is characterized by independent, and primarily practice-based, physicians, receiving fee for service reimbursement. This study analyses supply sensitive services using ambulatory care claims data from mandatory health insurance. A first research question was aimed at the hypothesis that physicians with large patient lists decrease their intensity of services and bill less per patient to health insurance, and vice versa: physicians with smaller patient lists compensate for the lack of patients with additional visits and services. A second research question relates to the fact that several cantons are allowing physicians to directly dispense drugs to patients ('self-dispensation' whereas other cantons restrict such direct sales to emergencies only. This second question was based on the assumption that patterns of rescheduling patients for consultations may differ across channels of dispensing prescription drugs and therefore the hypothesis of different consultation costs in this context was investigated. Methods Complete claims data paid for by mandatory health insurance of all Swiss physicians in own practices were analyzed for the years 2003-2007. Medical specialties were pooled into six main provider types in ambulatory care: primary care, pediatrics, gynecology & obstetrics, psychiatrists, invasive and non-invasive specialists. For each provider type, regression models at the physician level were used to analyze the relationship between the number of patients treated and the total sum of treatment cost reimbursed by mandatory health insurance. Results The results show non-proportional relationships between patient numbers and total sum of treatment cost for all provider types involved implying that treatment costs per patient increase with higher practice size. The related additional costs to the health system are substantial. Regions with self-dispensation had lowest treatment cost for primary care

  6. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study.

    Science.gov (United States)

    van Gelder, Marleen M H J; Schouten, Naomi P E; Merkus, Peter J F M; Verhaak, Chris M; Roeleveld, Nel; Roukema, Jolt

    2015-06-16

    Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman's general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0.61, P=.04), inhalation allergies (0

  7. ANALYSING PERFORMANCE ASSESSMENT IN PUBLIC SERVICES: HOW USEFUL IS THE CONCEPT OF A PERFORMANCE REGIME?

    Science.gov (United States)

    Martin, Steve; Nutley, Sandra; Downe, James; Grace, Clive

    2016-03-01

    Approaches to performance assessment have been described as 'performance regimes', but there has been little analysis of what is meant by this concept and whether it has any real value. We draw on four perspectives on regimes - 'institutions and instruments', 'risk regulation regimes', 'internal logics and effects' and 'analytics of government' - to explore how the concept of a multi-dimensional regime can be applied to performance assessment in public services. We conclude that the concept is valuable. It helps to frame comparative and longitudinal analyses of approaches to performance assessment and draws attention to the ways in which public service performance regimes operate at different levels, how they change over time and what drives their development. Areas for future research include analysis of the impacts of performance regimes and interactions between their visible features (such as inspections, performance indicators and star ratings) and the veiled rationalities which underpin them.

  8. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    Science.gov (United States)

    Ludwick, D. A.; Doucette, John

    2009-01-01

    Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787

  9. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    Directory of Open Access Journals (Sweden)

    D. A. Ludwick

    2009-01-01

    Full Text Available Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT. Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation.

  10. Needs assessment under the Maternal and Child Health Services Block Grant: Massachusetts.

    Science.gov (United States)

    Guyer, B; Schor, L; Messenger, K P; Prenney, B; Evans, F

    1984-09-01

    The Massachusetts maternal and child health (MCH) agency has developed a needs assessment process which includes four components: a statistical measure of need based on indirect, proxy health and social indicators; clinical standards for services to be provided; an advisory process which guides decision making and involves constituency groups; and a management system for implementing funds distribution, namely open competitive bidding in response to a Request for Proposals. In Fiscal Years 1982 and 1983, the process was applied statewide in the distribution of primary prenatal (MIC) and pediatric (C&Y) care services and lead poisoning prevention projects. Both processes resulted in clearer definitions of services to be provided under contract to the state as well as redistribution of funds to serve localities that had previously received no resources. Although the needs assessment process does not provide a direct measure of unmet need in a complex system of private and public services, it can be used to advocate for increased MCH funding and guide the distribution of new MCH service dollars.

  11. Consumer-Based Brand Equity of Products and Services: Assessing a Measurement Model with Competing Brands

    Directory of Open Access Journals (Sweden)

    Rafael Barreiros Porto

    2018-04-01

    Full Text Available  Objective: Identifying which brand in a category conveys more or less value to the consumer raises questions about the composition of brand equity measures and the brands that make up the category. Measures to identify Consumer-Based Brand Equity (CBBE may include functional assessments of consumer’s brand choice and firms’ brand performance, as long as they embrace competing brands. In view of this, this study comes up with a validation of a measurement model of Consumer-Based Brand Equity for competing brands of products and services, testing for possible moderation (product / service and experienced / non-experienced consumers. Method: Appraising 39 brands, the model was composed of 6 metrics: awareness, perceived quality, loyalty, association, exclusiveness and willingness to pay a price premium. Confirmatory factorial analysis revealed the CBBE structure and multigroup moderation tests showed the comparisons between products and services and between experienced and non-experienced consumers. Main Result: The metrics have convergent validity with very good model fit. The metrics are similar for products / services, but different for consumers with / without experience (evidence of moderation. Contributions: Based on this measure, researchers and marketers can identify whether their brand's performance has been perceived better or worse than that of their competitors. Relevance/Originality: This article is the first to offer a more complete scale to assess the consumer-based brand equity of products and services, allowing the researcher to compare the competitiveness between brands. 

  12. The natural language of the surgeon's clinical note in outcomes assessment: a qualitative analysis of the medical record.

    Science.gov (United States)

    Miller, J Michael; Velanovich, Vic

    2010-06-01

    Physician-generated clinical notes are the central document in recording the clinical decision-making and outcome of care. This is particularly true in an environment where outcomes assessment is becoming increasingly important. The hypothesis of this study is that these notes are inadequate to assess patient-centered outcomes and determine surgeons' core competencies. We preformed a retrospective review of postoperative clinical notes of general surgery patients for a 1-month period. Information from these notes underwent qualitative analysis using the reductionist thematic approach for patient-centered and physician-centered outcomes. Outcomes included 2 physician-centered items (physical examination and objective tests) and 3 patient-centered items (postoperative complications, functional status, and satisfaction). The presence or absence of each item in the clinical note was recorded. Six hundred eighty-one patients of 18 general surgeons were included. Among the surgeons, 28% failed to document symptomatic change in even 1 patient; similarly, 67% failed to document functional change, and 50% failed to document satisfaction. Among all 681 clinical notes only 7% of records mentioned symptomatic change, 1% functional change, 87% physical examination, 26% objective tests, and 3% patient satisfaction. These results were not affected by procedure type or number of patients seen. In general surgery practice, the surgeon's clinical note is a poor measure of physician-centered or patient-centered outcomes, implying that an audit of clinical notes would be an inaccurate method to assess patient outcomes. This has implications for issues surrounding maintenance of certification. Copyright 2010 Elsevier Inc. All rights reserved.

  13. Assessing biodiversity on the farm scale as basis for ecosystem service payments.

    Science.gov (United States)

    von Haaren, Christina; Kempa, Daniela; Vogel, Katrin; Rüter, Stefan

    2012-12-30

    Ecosystem services payments must be based on a standardised transparent assessment of the goods and services provided. This is especially relevant in the context of EU agri-environmental programs, but also for organic-food companies that foster environmental services on their contractor farms. Addressing the farm scale is important because land users/owners are major recipients of payments and they could be more involved in data generation and conservation management. A standardised system for measuring on-farm biodiversity does not yet exist that concentrates on performance indicators and includes farmers in generating information. A method is required that produces ordinal or metric scaled assessment results as well as management measures. Another requirement is the ease of application, which includes the ease of gathering input data and understandability. In order to respond to this need, we developed a method which is designed for automated application in an open source farm assessment system named MANUELA. The method produces an ordinal scale assessment of biodiversity that includes biotopes, species, biotope connectivity and the influence of land use. In addition, specific measures for biotope types are proposed. The open source geographical information system OpenJump is used for the implementation of MANUELA. The results of the trial applications and robustness tests show that the assessment can be implemented, for the most part, using existing information as well as data available from farmers or advisors. The results are more sensitive for showing on-farm achievements and changes than existing biotope-type classifications. Such a differentiated classification is needed as a basis for ecosystem service payments and for designing effective measures. The robustness of the results with respect to biotope connectivity is comparable to that of complex models, but it should be further improved. Interviews with the test farmers substantiate that the assessment

  14. Forging Consensus for Atrocity Prevention: Assessing the Record of the OSCE

    Directory of Open Access Journals (Sweden)

    Matthew Levinger

    2018-03-01

    Full Text Available This essay examines the record of the Organization for Security and Cooperation in Europe (OSCE in fostering norms and collaborative practices for preventing mass atrocities in Eurasia. Comprising fifty-seven participating states “from Vancouver to Vladivostok,” the OSCE is the sole regional security organization spanning all of the members of NATO and the former Warsaw Pact. Its consensus-based approach to advancing “common and comprehensive security” has proved successful in preventing escalation or containing levels of violence in various conflicts in the Baltic states, Ukraine, Southeastern Europe, and the Caucasus. Since the late 1990s, however, rising geopolitical tensions between NATO and the Russian Federation have undermined the effectiveness of the OSCE’s conflict prevention initiatives. In order for the OSCE to play a more robust role in enhancing human security in Eurasia, it will need to find a path toward rebuilding the normative consensus between Russia and its Western participating states.

  15. Paired assessment of volatile anesthetic concentrations with synaptic actions recorded in vitro.

    Directory of Open Access Journals (Sweden)

    Stuart J McDougall

    Full Text Available The volatile anesthetic isoflurane poses a number of experimental challenges in the laboratory. Due to its rapid evaporation, the open conditions of most in vitro electrophysiological recording systems make the determination of actual isoflurane concentrations a challenge. Since the absolute anesthetic concentration in solution is directly related to efficacy, concentration measurements are important to allow comparisons between laboratory and clinical studies. In this study we quantify the sources of isoflurane loss during experimentation and describe a method for the measurement of isoflurane concentrations using gas chromatography and mass spectrometry simultaneous to in vitro electrophysiological measurements. Serial samples of perfused bath solution allowed correlation of isoflurane concentrations with ongoing biological effects. Saturated physiological solutions contained 13.4 +/- 0.2 mM isoflurane and were diluted to desired "nominal" concentrations for experiments. The perfusion system established stable isoflurane concentrations within the bath by 2 minutes. However, bath isoflurane concentrations varied substantially and unpredictably between experiments. The magnitudes of such discrepancies in isoflurane concentrations spanned clinically important levels. Our studies suggest that, despite countermeasures, solution handling significantly impacted the isoflurane content in the tissue bath. The magnitude of these discrepancies appears to necessitate systematic direct measurement of bath isoflurane concentrations during most in vitro conditions.

  16. Data-driven approach for assessing utility of medical tests using electronic medical records.

    Science.gov (United States)

    Skrøvseth, Stein Olav; Augestad, Knut Magne; Ebadollahi, Shahram

    2015-02-01

    To precisely define the utility of tests in a clinical pathway through data-driven analysis of the electronic medical record (EMR). The information content was defined in terms of the entropy of the expected value of the test related to a given outcome. A kernel density classifier was used to estimate the necessary distributions. To validate the method, we used data from the EMR of the gastrointestinal department at a university hospital. Blood tests from patients undergoing surgery for gastrointestinal surgery were analyzed with respect to second surgery within 30 days of the index surgery. The information content is clearly reflected in the patient pathway for certain combinations of tests and outcomes. C-reactive protein tests coupled to anastomosis leakage, a severe complication show a clear pattern of information gain through the patient trajectory, where the greatest gain from the test is 3-4 days post index surgery. We have defined the information content in a data-driven and information theoretic way such that the utility of a test can be precisely defined. The results reflect clinical knowledge. In the case we used the tests carry little negative impact. The general approach can be expanded to cases that carry a substantial negative impact, such as in certain radiological techniques. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  17. The Melbourne East Monash General Practice Database (MAGNET: Using data from computerised medical records to create a platform for primary care and health services research

    Directory of Open Access Journals (Sweden)

    Danielle Mazza

    2016-07-01

    Full Text Available The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia

  18. The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research.

    Science.gov (United States)

    Mazza, Danielle; Pearce, Christopher; Turner, Lyle Robert; De Leon-Santiago, Maria; McLeod, Adam; Ferriggi, Jason; Shearer, Marianne

    2016-07-04

    The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia.

  19. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service.

    Science.gov (United States)

    Bath, Brenna; Janzen, Bonnie

    2012-01-01

    To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons. People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding. A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were "very satisfied" with the service and 55% were "very satisfied" with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were "very satisfied" with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction), negative (ie, lack of detail, time to follow-up, cost) and neutral related to the triage service, and an "other" category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.) The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given the low response rate, these results should be interpreted with caution. Qualitative analysis of participant and provider comments revealed a diverse range of themes. These other issues may be important contextual factors that have the potential to impact patient relevant outcomes.

  20. Ecosystem Services Mapping Uncertainty Assessment: A Case Study in the Fitzroy Basin Mining Region

    Directory of Open Access Journals (Sweden)

    Zhenyu Wang

    2018-01-01

    Full Text Available Ecosystem services mapping is becoming increasingly popular through the use of various readily available mapping tools, however, uncertainties in assessment outputs are commonly ignored. Uncertainties from different sources have the potential to lower the accuracy of mapping outputs and reduce their reliability for decision-making. Using a case study in an Australian mining region, this paper assessed the impact of uncertainties on the modelling of the hydrological ecosystem service, water provision. Three types of uncertainty were modelled using multiple uncertainty scenarios: (1 spatial data sources; (2 modelling scales (temporal and spatial and (3 parameterization and model selection. We found that the mapping scales can induce significant changes to the spatial pattern of outputs and annual totals of water provision. In addition, differences in parameterization using differing sources from the literature also led to obvious differences in base flow. However, the impact of each uncertainty associated with differences in spatial data sources were not so great. The results of this study demonstrate the importance of uncertainty assessment and highlight that any conclusions drawn from ecosystem services mapping, such as the impacts of mining, are likely to also be a property of the uncertainty in ecosystem services mapping methods.

  1. The use of virtual reality in the military's assessment of service members with traumatic brain injury: recent developments and emerging opportunities.

    Science.gov (United States)

    Edwards, Joe; Vess, James; Reger, Greg; Cernich, Alison

    2014-01-01

    Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.

  2. The Ethics of Rationing of Critical Care Services: Should Technology Assessment Play a Role?

    Directory of Open Access Journals (Sweden)

    Eric L. Bloomfield

    2009-01-01

    Full Text Available The costs of health care continue to increase rapidly and steeply in the United States. One area of great expense is that of intensive care units (ICUs. The causes of inflation have not been addressed effectively. ICU resources could become stretched such that they may no longer be available. This paper discusses some of the ethics and concerns behind decision making when providing ICU services in the United States. In particular, the use of electronic records with decision making tools, risk-analysis methods, and documentation of patient wishes for extraordinary care may help with better utilization of resources in the future.

  3. Linking employee perceptions of collective efficacy in self-managing service teams with customer-perceived service quality : a psychometric assessment

    NARCIS (Netherlands)

    Jong, de A.; Wetzels, M.G.M.; Ruyter, de J.C.

    2008-01-01

    Purpose – The purpose of this paper is to investigate the linkage between self-managing team (SMT) member perceptions of collective efficacy and customer-perceived service quality, and the most cost-efficient way to reliably assess collective efficacy and customer-perceived service quality, using

  4. Assessment of Data Management Services at New England Region Resource Libraries

    Directory of Open Access Journals (Sweden)

    Julie Goldman

    2015-07-01

    Full Text Available Objective: To understand how New England medical libraries are addressing scientific research data management and providing services to their communities. Setting: The National Network of Libraries of Medicine, New England Region (NN/LM NER contains 17 Resource Libraries. The University of Massachusetts Medical School serves as the New England Regional Medical Library (RML. Sixteen of the NER Resource Libraries completed this survey. Methods: A 40-question online survey assessed libraries’ services and programs for providing research data management education and support. Libraries shared their current plans and institutional challenges associated with developing data services. Results: This study shows few NER Resource Libraries currently integrate scientific research data management into their services and programs, and highlights the region’s use of resources provided by the NN/LM NER RML at the University of Massachusetts Medical School. Conclusions: Understanding the types of data services being delivered at NER libraries helps to inform the NN/LM NER about the eScience learning needs of New England medical librarians and helps in the planning of professional development programs that foster effective biomedical research data services.

  5. A New Collaborative Methodology for Assessment and Management of Ecosystem Services

    Directory of Open Access Journals (Sweden)

    Marina Segura

    2015-05-01

    Full Text Available Collaborative management is a new framework to help implement programmes in protected areas. Within this context, the aim of this work is twofold. First, to propose a robust methodology to implement collaborative management focused on ecosystem services. Second, to develop indicators for the main functions of ecosystem services. Decision makers, technical staff and other stakeholders are included in the process from the beginning, by identifying ecosystem services and eliciting preferences using the AHP method. Qualitative and quantitative data are then integrated into a PROMETHEE based method in order to obtain indicators for provisioning, maintenance and direct to citizens services. This methodology, which has been applied in a forest area, provides a tool for exploiting available technical and social data in a continuous process, as well as providing easy to understand graphical results. This approach also overcomes the difficulties found in prioritizing management objectives in a multiple criteria context with limited resources and facilitates consensus between all of the people involved. The new indicators define an innovative approach to assessing the ecosystem services from the supply perspective and provide basic information to help establish payment systems for environmental services and compensation for natural disasters.

  6. Ecosystem services sustainability in the Mediterranean Sea: assessment of status and trends using multiple modelling approaches

    Science.gov (United States)

    Liquete, Camino; Piroddi, Chiara; Macías, Diego; Druon, Jean-Noël; Zulian, Grazia

    2016-09-01

    Mediterranean ecosystems support important processes and functions that bring direct benefits to human society. Yet, marine ecosystem services are usually overlooked due to the challenges in identifying and quantifying them. This paper proposes the application of several biophysical and ecosystem modelling approaches to assess spatially and temporally the sustainable use and supply of selected marine ecosystem services. Such services include food provision, water purification, coastal protection, lifecycle maintenance and recreation, focusing on the Mediterranean region. Overall, our study found a higher number of decreasing than increasing trends in the natural capacity of the ecosystems to provide marine and coastal services, while in contrast the opposite was observed to be true for the realised flow of services to humans. Such a study paves the way towards an effective support for Blue Growth and the European maritime policies, although little attention is paid to the quantification of marine ecosystem services in this context. We identify a key challenge of integrating biophysical and socio-economic models as a necessary step to further this research.

  7. Design and impact assessment of watershed investments: An approach based on ecosystem services and boundary work

    International Nuclear Information System (INIS)

    Adem Esmail, Blal; Geneletti, Davide

    2017-01-01

    Watershed investments, whose main aim is to secure water for cities, represent a promising opportunity for large-scale sustainability transitions in the near future. If properly designed, they promote activities in the watershed that enhance ecosystem services while protecting nature and biodiversity, as well as achieving other societal goals. In this paper, we build on the concepts of ecosystem services and boundary work, to develop and test an operative approach for designing and assessing the impact of watershed investments. The approach is structured to facilitate negotiations among stakeholders. Its strategic component includes setting the agenda; defining investment scenarios; and assessing the performance of watershed investments as well as planning for a follow-up. Its technical component concerns data processing; tailoring spatially explicit ecosystem service models; hence their application to design a set of “investment portfolios”, generate future land use scenarios, and model impacts on selected ecosystem services. A case study illustrates how the technical component can be developed in a data scarce context in sub-Saharan Africa in a way that is functional to support the steps of the strategic component. The case study addresses soil erosion and water scarcity-related challenges affecting Asmara, a medium-sized city in Eritrea, and considers urban water security and rural poverty alleviation as two illustrative objectives, within a ten-year planning horizon. The case study results consist in spatially explicit data (investment portfolio, land use scenario, impact on ecosystem services), which were aggregated to quantitatively assess the performance of different watershed investments scenarios, in terms of changes in soil erosion control. By addressing stakeholders' concerns of credibility, saliency, and legitimacy, the approach is expected to facilitate negotiation of objectives, definition of scenarios, and assessment of alternative watershed

  8. Design and impact assessment of watershed investments: An approach based on ecosystem services and boundary work

    Energy Technology Data Exchange (ETDEWEB)

    Adem Esmail, Blal, E-mail: blal.ademesmail@unitn.it; Geneletti, Davide

    2017-01-15

    Watershed investments, whose main aim is to secure water for cities, represent a promising opportunity for large-scale sustainability transitions in the near future. If properly designed, they promote activities in the watershed that enhance ecosystem services while protecting nature and biodiversity, as well as achieving other societal goals. In this paper, we build on the concepts of ecosystem services and boundary work, to develop and test an operative approach for designing and assessing the impact of watershed investments. The approach is structured to facilitate negotiations among stakeholders. Its strategic component includes setting the agenda; defining investment scenarios; and assessing the performance of watershed investments as well as planning for a follow-up. Its technical component concerns data processing; tailoring spatially explicit ecosystem service models; hence their application to design a set of “investment portfolios”, generate future land use scenarios, and model impacts on selected ecosystem services. A case study illustrates how the technical component can be developed in a data scarce context in sub-Saharan Africa in a way that is functional to support the steps of the strategic component. The case study addresses soil erosion and water scarcity-related challenges affecting Asmara, a medium-sized city in Eritrea, and considers urban water security and rural poverty alleviation as two illustrative objectives, within a ten-year planning horizon. The case study results consist in spatially explicit data (investment portfolio, land use scenario, impact on ecosystem services), which were aggregated to quantitatively assess the performance of different watershed investments scenarios, in terms of changes in soil erosion control. By addressing stakeholders' concerns of credibility, saliency, and legitimacy, the approach is expected to facilitate negotiation of objectives, definition of scenarios, and assessment of alternative watershed

  9. Use of a mini-computer for the processing of medical records in a radioisotope cardiac functional investigation service

    International Nuclear Information System (INIS)

    Belleguic, J.-C.

    1978-01-01

    The aim of this work is to familiarize medical users with informatics and to show what advantages can offer this technique in the handling of medical records. The field is limited here to isotopic functional explorations in cardiology, but obviously this data processing method can be applied to any isolated problem. Considering the invaluable contribution of nuclear medicine to coronary deficiency, on which 2/3 of the scintigraphic or gamma camera explorations are carried out, the study of results is centred on this branch of pathology [fr

  10. Linking a research register to clinical records in older adults' mental health services:a mixed-methods study

    OpenAIRE

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    INTRODUCTION: Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities.METHODS: This was a two-stage cross-s...

  11. On-farm welfare assessment systems: what are the recording costs?

    DEFF Research Database (Denmark)

    Sørensen, Jan Tind; Nielsen, Tine Rousing; Møller, Steen Henrik

    2007-01-01

    To illustrate that different approaches lead to different costs a cost calculation on four different welfare assessment systems for four different animal species has been carried out; an integrated pig herd (450 sows), a dairy cattle herd with automatic milking (90 cows), an organic egg production...... system (3000 layers) and a mink farm (1000 mink). We calculated the cost to be: E 375 per annum for the mink farm and E 2205, E 2430 and E 2435 for the egg production system, the AMS dairy herd and the integrated pig farm, respectively. The costs can be reduced by: reducing the number of indicators and...

  12. African Dust Fertilizing the Amazon Rainforest: An Assessment with Seven-year Record of CALIOP Measurements

    Science.gov (United States)

    Yu, H.; Chin, M.; Yuan, T.; Bian, H.; Prospero, J. M.; Omar, A. H.; Remer, L. A.; Winker, D. M.; Yang, Y.; Zhang, Y.; Zhang, Z.

    2014-12-01

    The productivity of Amazon rainforest is constrained by the availability of nutrients, in particular phosphorus (P). Deposition of transported African dust in boreal winter and spring is considered an important nutrient input for the Amazon Basin, though its magnitude is not well qunatified. This study provides a remote sensing observation-based estimate of dust deposition in the Amazon Basin using a 7-year (2007-2013) record of three dimensional (3D) distributions of aerosol in both cloud-free and above-cloud conditions from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP). It is estimated that the 7-year average of dust deposition into the Amazon Basin amounts to 15.1 ~ 32.1 Tg a-1 (Tg = 1012 g). This imported dust could provide 0.012 ~ 0.025 Tg P a-1 or equivalent to 12 ~ 26 g P ha-1 a-1 to fertilize the Amazon rainforest, which largely compensates the hydrological loss of P. The CLAIOP-based estimate agrees better with estimates from in-situ measurements and model simulations than what has been reported in literature. The closer agreement benefits from a more realistic geographic definition of the Amazon Basin and inclusion of meridional dust transport calculation in addition to the 3D nature of CALIOP aerosol measurements. The trans-Atlantic transport and deposition of dust shows strong interannual variations that are found to correlate with the North Atlantic Oscillation index in the winter season and anticorrelate with the prior-year Sahel Precipitation Index on an annual basis. Uncertainties associated with the estimate will also be discussed.

  13. [Effects of Mental Disorders on the Academic Outcomes of University Students--A Retrospective Study Using Medical Records from a Health Services Center].

    Science.gov (United States)

    Ishii, Terumi; Tachikawa, Hirokazu; Hori, Takafumi; Ishikawa, Masanori; Hatanaka, Kimitaka; Aiba, Miyuki; Asada, Takashi

    2015-01-01

    Falling behind in class is a serious problem for university students as it can lead to social problems and increase the risk of suicide. Although it is common for students suffering from mental disorders to fall behind academically, there have been few studies investigating the difficulties these students face in order to graduate from university. Therefore, we investigated factors associated with dropping out of school with the purpose of creating a strategy to improve the academic outcomes of students who regularly seek psychiatric consultation. We investigated undergraduate students who received consultation at Tsukuba University's Health Services Center Psychiatry Department and whose academic outcomes between the 2004 and 2013 academic years were known. Academic outcomes were obtained from Tsukuba University's grade management system by permission of the authority. The students were divided into either a graduate or dropout group depending on their academic outcomes. The medical records for both groups were retrospectively investigated, and factors that were predicted to affect academic outcomes were assessed using statistical methods. The dropout group was younger in grade and had a greater severity of illness at initial consultation. Moreover, this group had a greater number of consultation visits, showed less cooperation with the instructor in charge, had a significantly longer duration of social with drawal and temporary leave of absence from school, and had a significantly greater number of students with grade retention. When a time factor was incorporated in the analysis, the presence of grade retention/temporary leave of absence from school and social withdrawal was significantly correlated with dropping out of school. It was revealed that not only the mental disorder itself, but also psychosocial severity and the maladjusted state that occur secondary to such mental disorder influence academic outcomes. These results indicated that in order to improve

  14. Linking Land Cover Data and Crop Yields for Mapping and Assessment of Pollination Services in Europe

    Directory of Open Access Journals (Sweden)

    Maria Luisa Paracchini

    2013-09-01

    Full Text Available Pollination is a key ecosystem service as many crops but in particular, fruits and vegetables are partially dependent on pollinating insects to produce food for human consumption. Here we assessed how pollination services are delivered at the European scale. We used this assessment to estimate the relative contribution of wild pollinators to crop production. We developed an index of relative pollination potential, which is defined as the relative potential or relative capacity of ecosystems to support crop pollination. The model for relative pollination potential is based on the assumption that different habitats, but in particular forest edges, grasslands rich in flowers and riparian areas, offer suitable sites for wild pollinator insects. Using data of the foraging range of wild bees with short flight distances, we linked relative pollination potential to regional statistics of crop production. At aggregated EU level, the absence of insect pollination would result in a reduction of between 25% and 32% of the total production of crops which are partially dependent on insect pollination, depending on the data source used for the assessment. This production deficit decreases to 2.5% if only the relative pollination potential of a single guild of pollinators is considered. A strength of our approach is the spatially-explicit link between land cover based relative pollination potential and crop yield which enables a general assessment of the benefits that are derived from pollination services in Europe while providing insight where pollination gaps in the landscape occur.

  15. Assessing the impacts of dams and levees on the hydrologic record of the Middle and Lower Mississippi River, USA

    Science.gov (United States)

    Remo, Jonathan W.F.; Ickes, Brian; Ryherd, Julia K.; Guida, Ross J.; Therrell, Matthew D.

    2018-01-01

    The impacts of dams and levees on the long-term (>130 years) discharge record was assessed along a ~1200 km segment of the Mississippi River between St. Louis, Missouri, and Vicksburg, Mississippi. To aid in our evaluation of dam impacts, we used data from the U.S. National Inventory of Dams to calculate the rate of reservoir expansion at five long-term hydrologic monitoring stations along the study segment. We divided the hydrologic record at each station into three periods: (1) a pre-rapid reservoir expansion period; (2) a rapid reservoir expansion period; and (3) a post-rapid reservoir expansion period. We then used three approaches to assess changes in the hydrologic record at each station. Indicators of hydrologic alteration (IHA) and flow duration hydrographs were used to quantify changes in flow conditions between the pre- and post-rapid reservoir expansion periods. Auto-regressive interrupted time series analysis (ARITS) was used to assess trends in maximum annual discharge, mean annual discharge, minimum annual discharge, and standard deviation of daily discharges within a given water year. A one-dimensional HEC-RAS hydraulic model was used to assess the impact of levees on flood flows. Our results revealed that minimum annual discharges and low-flow IHA parameters showed the most significant changes. Additionally, increasing trends in minimum annual discharge during the rapid reservoir expansion period were found at three out of the five hydrologic monitoring stations. These IHA and ARITS results support previous findings consistent with the observation that reservoirs generally have the greatest impacts on low-flow conditions. River segment scale hydraulic modeling revealed levees can modestly increase peak flood discharges, while basin-scale hydrologic modeling assessments by the U.S. Army Corps of Engineers showed that tributary reservoirs reduced peak discharges by a similar magnitude (2 to 30%). This finding suggests that the effects of dams and

  16. Assessment of service delays and impact on bed utilisation in a major teaching hospital.

    LENUS (Irish Health Repository)

    Conway, R

    2010-12-14

    BACKGROUND: Increasing economic pressures coupled with an expanding and ageing population and a hostile economic climate have led to growing interest in the optimisation of bed usage within hospitals. There are many causes for delay in a patient\\'s discharge. METHODS: This prospective observational study assessed consecutive patients admitted and discharged from hospital within a 52-day period for waiting times in the provision of requested diagnostic tests and services. RESULTS: Seventy patients were included in the study. There were median delays of 2 and 3 days for an MRI and colonoscopy, a delay of 3 days for a Holter monitor report, and 9 days for an occupational therapy referral. The median wait for consults was 1 day across all three services. CONCLUSIONS: Significant remediable delays exist during the course of many acute medical admissions. Addressing these factors will enable the provision of a faster and more cost-efficient service.

  17. The Nuclear Regulator's Role in Assessing Licensee. Oversight of Vendor and Other Contracted Services

    International Nuclear Information System (INIS)

    2011-01-01

    Contracted services are an integral part of the design, construction and operation of a nuclear facility. Changes in the nuclear industry sector, including varied availability of nuclear expertise, the expansion of the international supply market and the introduction of new technologies, have tended to increase licensees' use of contracted services. These changes have created challenges for licensees and regulators related to the retention of nuclear expertise, the effective management of the interfaces between the licensees and contractors, and the oversight of contractor manufacturing quality in the context of greater multinational diversity. The regulatory body must address these challenges to provide assurance that the licensees maintain their responsibility for the safety of the facilities, regardless of who provides goods and services or where the activities involved in the supply chain take place. This report is intended to assist regulatory bodies in assessing their current practices for the regulatory oversight of licensees' use of contractors, and adapting them where necessary to meet the evolving situation

  18. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    Science.gov (United States)

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

  19. Exploring pre-service science teachers' pedagogical capacity for formative assessment through analyses of student answers

    Science.gov (United States)

    Aydeniz, Mehmet; Dogan, Alev

    2016-05-01

    Background: There has been an increasing emphasis on empowering pre-service and in-service science teachers to attend student reasoning and use formative assessments to guide student learning in recent years. Purpose: The purpose of this study was to explore pre-service science teachers' pedagogical capacity for formative assessment. Sample: This study took place in Turkey. The participants include 53 pre-service science teachers in their final year of schooling. All but two of the participants are female. Design and methods: We used a mixed-methods methodology in pursing this inquiry. Participants analyzed 28 responses to seven two-tiered questions given by four students of different ability levels. We explored their ability to identify the strengths and weaknesses in students' answers. We paid particular attention to the things that the pre-service science teachers noticed in students' explanations, the types of inferences they made about students' conceptual understanding, and the affordances of pedagogical decisions they made. Results: The results show that the majority of participants made an evaluative judgment (i.e. the answer is correct or incorrect) in their analyses of students' answers. Similarly, the majority of the participants recognized the type of mistake that the students made. However, they failed to successfully elaborate on fallacies, limitations, or strengths in student reasoning. We also asked the participants to make pedagogical decisions related to what needs to be done next in order to help the students to achieve academic objectives. Results show that 8% of the recommended instructional strategies were of no affordance, 64% of low-affordance, and 28% were of high affordance in terms of helping students achieve the academic objectives. Conclusion: If our goal is to improve pre-service science teachers' noticing skills, and the affordance of feedback that they provide, engaging them in activities that asks them to attend to students' ideas

  20. State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services

    Science.gov (United States)

    Hoss, Aila; Menon, Akshara; Corso, Liza

    2016-01-01

    Context Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention’s Public Health Law Program conducted a fundamental activities legal assessment on state public health laws. Objective The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems. Design In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016. Results Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions. Conclusions Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework. PMID

  1. An assessment of the impact of climate adaptation measures to reduce flood risk on ecosystem services.

    Science.gov (United States)

    Verburg, Peter H; Koomen, Eric; Hilferink, Maarten; Pérez-Soba, Marta; Lesschen, Jan Peter

    Measures of climate change adaptation often involve modification of land use and land use planning practices. Such changes in land use affect the provision of various ecosystem goods and services. Therefore, it is likely that adaptation measures may result in synergies and trade-offs between a range of ecosystems goods and services. An integrative land use modelling approach is presented to assess such impacts for the European Union. A reference scenario accounts for current trends in global drivers and includes a number of important policy developments that correspond to on-going changes in European policies. The reference scenario is compared to a policy scenario in which a range of measures is implemented to regulate flood risk and protect soils under conditions of climate change. The impacts of the simulated land use dynamics are assessed for four key indicators of ecosystem service provision: flood risk, carbon sequestration, habitat connectivity and biodiversity. The results indicate a large spatial variation in the consequences of the adaptation measures on the provisioning of ecosystem services. Synergies are frequently observed at the location of the measures itself, whereas trade-offs are found at other locations. Reducing land use intensity in specific parts of the catchment may lead to increased pressure in other regions, resulting in trade-offs. Consequently, when aggregating the results to larger spatial scales the positive and negative impacts may be off-set, indicating the need for detailed spatial assessments. The modelled results indicate that for a careful planning and evaluation of adaptation measures it is needed to consider the trade-offs accounting for the negative effects of a measure at locations distant from the actual measure. Integrated land use modelling can help land use planning in such complex trade-off evaluation by providing evidence on synergies and trade-offs between ecosystem services, different policy fields and societal

  2. State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services.

    Science.gov (United States)

    Hoss, Aila; Menon, Akshara; Corso, Liza

    2016-01-01

    Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention's Public Health Law Program conducted a fundamental activities legal assessment on state public health laws. The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems. In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016. Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions. Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework.

  3. Insights and Opportunities Offered by a Rapid Ecosystem Service Assessment in Promoting a Conservation Agenda in an Urban Biodiversity Hotspot

    Directory of Open Access Journals (Sweden)

    Patrick J. O'Farrell

    2012-09-01

    Full Text Available Regional and global scale ecosystem service assessments have demonstrated the socioeconomic value of protecting biodiversity and have been integrated into associated policy. Local government decision makers are still unsure of the applicability, return on investment, and usefulness of these assessments in aiding their decision making. Cape Town, a developing city in a globally recognized biodiversity hotspot, has numerous competing land uses. City managers, with a tightly constrained budget, requested an exploratory study on the links between ecosystem services and biodiversity conservation within this municipal area. We set out to develop and test a simple and rapid ecosystem service assessment method aimed at determining the contribution natural vegetation remnants make to ecosystem service provision. We took selected services, identified in conjunction with city managers, and assessed these in two ways. First we used an area weighted approach to attribute services to vegetation types and assessed how these had changed through time and into the future given development needs. Second, we did a regulatory and cultural service remnant distance analysis to better understand proximity effects and linkages. Provisioning services were found to have been most severely affected through vegetation transformation. Regulatory services have been similarly affected, and these losses are more significant because regulatory services can only function in situ and cannot be outsourced in the way provisioning services can. The most significant losses were in coastal zone protection and flood mitigation services, both of which will be placed under even greater pressure given the predicted changes in climatic regimes. The role of remnant vegetation in regulating and cultural services was shown to be a significant additional consideration in making the case for conservation in the city. Our rapid assessment approach does not allow for nuanced and individual

  4. Network analysis of mesoscale optical recordings to assess regional, functional connectivity.

    Science.gov (United States)

    Lim, Diana H; LeDue, Jeffrey M; Murphy, Timothy H

    2015-10-01

    With modern optical imaging methods, it is possible to map structural and functional connectivity. Optical imaging studies that aim to describe large-scale neural connectivity often need to handle large and complex datasets. In order to interpret these datasets, new methods for analyzing structural and functional connectivity are being developed. Recently, network analysis, based on graph theory, has been used to describe and quantify brain connectivity in both experimental and clinical studies. We outline how to apply regional, functional network analysis to mesoscale optical imaging using voltage-sensitive-dye imaging and channelrhodopsin-2 stimulation in a mouse model. We include links to sample datasets and an analysis script. The analyses we employ can be applied to other types of fluorescence wide-field imaging, including genetically encoded calcium indicators, to assess network properties. We discuss the benefits and limitations of using network analysis for interpreting optical imaging data and define network properties that may be used to compare across preparations or other manipulations such as animal models of disease.

  5. Reliability assessment of serviceability performance of braced retaining walls using a neural network approach

    Science.gov (United States)

    Goh, A. T. C.; Kulhawy, F. H.

    2005-05-01

    In urban environments, one major concern with deep excavations in soft clay is the potentially large ground deformations in and around the excavation. Excessive movements can damage adjacent buildings and utilities. There are many uncertainties associated with the calculation of the ultimate or serviceability performance of a braced excavation system. These include the variabilities of the loadings, geotechnical soil properties, and engineering and geometrical properties of the wall. A risk-based approach to serviceability performance failure is necessary to incorporate systematically the uncertainties associated with the various design parameters. This paper demonstrates the use of an integrated neural network-reliability method to assess the risk of serviceability failure through the calculation of the reliability index. By first performing a series of parametric studies using the finite element method and then approximating the non-linear limit state surface (the boundary separating the safe and failure domains) through a neural network model, the reliability index can be determined with the aid of a spreadsheet. Two illustrative examples are presented to show how the serviceability performance for braced excavation problems can be assessed using the reliability index.

  6. Assessing the quality of reproductive health services in Egypt via exit interviews.

    Science.gov (United States)

    Zaky, Hassan H M; Khattab, Hind A S; Galal, Dina

    2007-05-01

    This study assesses the quality of reproductive health services using client satisfaction exit interviews among three groups of primary health care units run by the Ministry of Health and Population of Egypt. Each group applied a different model of intervention. The Ministry will use the results in assessing its reproductive health component in the health sector reform program, and benefits from the strengths of other models of intervention. The sample was selected in two stages. First, a stratified random sampling procedure was used to select the health units. Then the sample of female clients in each health unit was selected using the systematic random approach, whereby one in every two women visiting the unit was approached. All women in the sample coming for reproductive health services were included in the analysis. The results showed that reproductive health beneficiaries at the units implementing the new health sector reform program were more satisfied with the quality of services. Still there were various areas where clients showed significant dissatisfaction, such as waiting time, interior furnishings, cleanliness of the units and consultation time. The study showed that the staff of these units did not provide a conductive social environment as other interventions did. A significant proportion of women expressed their intention to go to private physicians owing to their flexible working hours and variety specializations. Beneficiaries were generally more satisfied with the quality of health services after attending the reformed units than the other types of units, but the generalization did not fully apply. Areas of weakness are identified.

  7. Personality assessment of homeless adults as a tool for service planning.

    Science.gov (United States)

    Tolomiczenko, G S; Sota, T; Goering, P N

    2000-01-01

    The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibility and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups characterized by distinct profiles. Two of these were characterized by extreme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and differed primarily on the dimension of suicidality. The third reflected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The validity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assessment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interpersonal dimensions that will likely affect service provision.

  8. A Novel Dietary Assessment Method to Measure a Healthy and Sustainable Diet Using the Mobile Food Record: Protocol and Methodology.

    Science.gov (United States)

    Harray, Amelia J; Boushey, Carol J; Pollard, Christina M; Delp, Edward J; Ahmad, Ziad; Dhaliwal, Satvinder S; Mukhtar, Syed Aqif; Kerr, Deborah A

    2015-07-03

    The world-wide rise in obesity parallels growing concerns of global warming and depleting natural resources. These issues are often considered separately but there may be considerable benefit to raising awareness of the impact of dietary behaviours and practices on the food supply. Australians have diets inconsistent with recommendations, typically low in fruit and vegetables and high in energy-dense nutrient-poor foods and beverages (EDNP). These EDNP foods are often highly processed and packaged, negatively influencing both health and the environment. This paper describes a proposed dietary assessment method to measure healthy and sustainable dietary behaviours using 4-days of food and beverage images from the mobile food record (mFR) application. The mFR images will be assessed for serves of fruit and vegetables (including seasonality), dairy, eggs and red meat, poultry and fish, ultra-processed EDNP foods, individually packaged foods, and plate waste. A prediction model for a Healthy and Sustainable Diet Index will be developed and tested for validity and reliability. The use of the mFR to assess adherence to a healthy and sustainable diet is a novel and innovative approach to dietary assessment and will have application in population monitoring, guiding intervention development, educating consumers, health professionals and policy makers, and influencing dietary recommendations.

  9. A Novel Dietary Assessment Method to Measure a Healthy and Sustainable Diet Using the Mobile Food Record: Protocol and Methodology

    Directory of Open Access Journals (Sweden)

    Amelia J. Harray

    2015-07-01

    Full Text Available The world-wide rise in obesity parallels growing concerns of global warming and depleting natural resources. These issues are often considered separately but there may be considerable benefit to raising awareness of the impact of dietary behaviours and practices on the food supply. Australians have diets inconsistent with recommendations, typically low in fruit and vegetables and high in energy-dense nutrient-poor foods and beverages (EDNP. These EDNP foods are often highly processed and packaged, negatively influencing both health and the environment. This paper describes a proposed dietary assessment method to measure healthy and sustainable dietary behaviours using 4-days of food and beverage images from the mobile food record (mFR application. The mFR images will be assessed for serves of fruit and vegetables (including seasonality, dairy, eggs and red meat, poultry and fish, ultra-processed EDNP foods, individually packaged foods, and plate waste. A prediction model for a Healthy and Sustainable Diet Index will be developed and tested for validity and reliability. The use of the mFR to assess adherence to a healthy and sustainable diet is a novel and innovative approach to dietary assessment and will have application in population monitoring, guiding intervention development, educating consumers, health professionals and policy makers, and influencing dietary recommendations.

  10. Assessing supply-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study and document and record review in two regions of Uganda.

    Science.gov (United States)

    Rassi, Christian; Graham, Kirstie; Mufubenga, Patrobas; King, Rebecca; Meier, Joslyn; Gudoi, Sam Siduda

    2016-07-04

    Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), provided as part of routine antenatal care (ANC), is one of three malaria-in-pregnancy prevention and control mechanisms recommended by the World Health Organization (WHO). However, despite high ANC attendance and increased efforts to address known obstacles, IPTp uptake figures have remained low. This study aimed to identify and assess barriers that continue to impede IPTp uptake in Uganda, in particular for women who attend ANC. The paper focuses on supply-side barriers, i.e., challenges relating to the health service provider. In-depth interviews were conducted in two regions of Uganda in November 2013 and April/May 2014 with four different target audiences: seven district health officials, 15 health workers, 19 women who had attended ANC, and five opinion leaders. In addition, a document and record review was carried out at four health facilities. Guidelines with regard to IPTp provision in Uganda have been shown to be inconsistent and, at the time of the research, did not reflect the most recent WHO policy recommendation. There is a lack of training and supervision opportunities for health workers, resulting in poor knowledge of IPTp guidelines and uncertainty about the safety and efficacy of SP. ANC is not consistently offered in health facilities, leading to some women being denied services. While strengthening of the supply chain appears to have reduced the occurrence of stock-outs of SP in public facilities, stock-outs reportedly continue to occur in the private sector. There are also sources of data inaccuracy along the data recording and reporting chain, limiting policy makers' ability to react adequately to trends and challenges. Given the high ANC attendance rates in Uganda, supply-side barriers are likely to account for many missed opportunities for the provision of IPTp in Uganda. Improvements will require consistent provision of ANC, implementation of current

  11. Investigating the role of Fuzzy as confirmatory tool for service quality assessment (Case study: Comparison of Fuzzy SERVQUAL and SERVQUAL in hotel service evaluation)

    Science.gov (United States)

    Wahyudi, R. D.

    2017-11-01

    The problem was because of some indicators qualitatively assessed had been discussed in engineering field. Whereas, qualitative assessment was presently used in certain occasion including in engineering field, for instance, the assessment of service satisfaction. Probably, understanding of satisfaction definition caused bias if customers had their own definition of satisfactory level of service. Therefore, the use of fuzzy logic in SERVQUAL as service satisfaction measurement tool would probably be useful. This paper aimed to investigate the role of fuzzy in SERVQUAL by comparing result measurement of SERVQUAL and fuzzy SERVQUAL for study case of hotel service evaluation. Based on data processing, initial result showed that there was no significant different between them. Thus, either implementation of fuzzy SERVQUAL in different case or study about the role of fuzzy logic in SERVQUAL would be interesting further discussed topic.

  12. ICT services for active ageing and independent living: identification and assessment.

    Science.gov (United States)

    Christophorou, Christophoros; Kleanthous, Styliani; Georgiadis, Dimosthenis; Cereghetti, Donato M; Andreou, Panayiotis; Wings, Cindy; Christodoulou, Eleni; Samaras, George

    2016-09-01

    Based on the demographic changes and the rapid increase of older population in Europe, major challenges are expected to rise, both in the economy as well as the society, whether the dominant care model for supporting elderly in living independently at home continues to rely on informal and formal caregivers' assistance. To respond to the above challenges, assistive technologies are called to develop Information and Communication Technology (ICT) services for supporting seniors to remain active and independent, for as long as possible, in their chosen home environment. The work described in this Letter is based on the Miraculous-Life project and it emphasises the identification and assessment of a set of services that an ICT system for Ageing Well should support, in an actual end-users setting. The outcome of this work may inform fellow researchers and other projects in the area of Ageing Well in: (i) understanding which ICT services can be the most valuable for end-users' Quality of Life, (ii) prioritising the development of related ICT services and (iii) facilitating better recourse allocation in order to reduce any risks associated to implementation failures of these services within their respective projects. A final trial phase is planned, aiming to validate the Miraculous Life prototype longitudinally in a naturalistic environment with a larger sample size. During this trial, it will be investigated if perceived usefulness, satisfaction and motivation could be predicted by sociodemographic variables and personality.

  13. Critical Zone services as environmental assessment criteria in intensively managed landscapes

    Science.gov (United States)

    Richardson, Meredith; Kumar, Praveen

    2017-06-01

    The Critical Zone (CZ) includes the biophysical processes occurring from the top of the vegetation canopy to the weathering zone below the groundwater table. CZ services provide a measure for the goods and benefits derived from CZ processes. In intensively managed landscapes, cropland is altered through anthropogenic energy inputs to derive more productivity, as agricultural products, than would be possible under natural conditions. However, the actual costs of alterations to CZ functions within landscape profiles are unknown. Through comparisons of corn feed and corn-based ethanol, we show that valuation of these CZ services in monetary terms provides a more concrete tool for characterizing seemingly abstract environmental damages from agricultural production systems. Multiple models are combined to simulate the movement of nutrients throughout the soil system, enabling the measurement of agricultural anthropogenic impacts to the CZ's regulating services. Results indicate water quality and atmospheric stabilizing services, measured by soil carbon storage, carbon respiration, and nitrate leaching, among others, can cost more than double that of emissions estimated in previous studies. Energy efficiency in addition to environmental impact is assessed to demonstrate how the inclusion of CZ services is necessary in accounting for the entire life cycle of agricultural production systems. These results conclude that feed production systems are more energy efficient and less environmentally costly than corn-based ethanol.

  14. Principles of Assessment of Rehabilitation Services in Health Systems: Learning from experiences.

    Science.gov (United States)

    Gutenbrunner, Christoph; Nugraha, Boya

    2018-04-18

    Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization's 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance). The development of recommendations based on situation analysis and best-available data is crucial. In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT)) were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders). The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.

  15. Principles of Assessment of Rehabilitation Services in Health Systems: Learning from experiences

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2017-06-01

    Full Text Available Objective: Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization’s 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance. The development of recommendations based on situation analysis and best-available data is crucial. Methods: In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. Results: The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders. Conclusion: The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.

  16. Risk assessment for implementing e-services in some ministries in the State of Kuwait

    International Nuclear Information System (INIS)

    Zaied, A.N.H.; Al-Khairalla, F.

    2007-01-01

    The movement to e-government is basically about changing the way people and business interact with government. Kuwait, like any developing country, is currently launching major e-service projects aiming at improving government processes, connect government to citizens, and build interaction within the civil society. The e-services category of e-government applications enables interactions and relationships between the government and citizens, through which the latter gain access to a range of public services. However, the implementation process of e-services involves many factors of risk that could threaten the success of process. Therefore, an effective risk management process is an important component of a successful information security program. This paper investigates and discusses the possibilities of e-services risk areas and assesses the security and privacy protection issues in some ministries in Kuwait. The results show that the total average percentage of applying security and privacy issues in the studied ministries is moderate. The Ministry of Communication (MoC) has the highest percentage of applications, whereas the Ministry of Trading and Industry (MoTI) has the lowest. Physical security is the highest applied variable, while prevention of unauthorized access is the lowest one. (author)

  17. Assessment of Family Planning Services at Community Pharmacies in San Diego, California

    Directory of Open Access Journals (Sweden)

    Sally Rafie

    2013-10-01

    Full Text Available Levonorgestrel emergency contraception and other contraceptive methods are available over-the-counter (OTC; however youth continue to face a number of barriers in accessing healthcare services, including lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. A descriptive, nonexperimental, cross-sectional study of a sample of 112 community pharmacies in San Diego, California was conducted between December 2009 and January 2010 to assess community pharmacy practices related to the availability and accessibility of family planning health pharmacy services and products, particularly to youth. A majority (n = 79/112, 70.5% of the pharmacies carried a wide selection of male condoms; however, the other OTC nonhormonal contraceptive products were either not available or available with limited selection. A majority of the pharmacies sold emergency contraception (n = 88/111, 78.6%. Most patient counseling areas consisted of either a public or a semi-private area. A majority of the pharmacy sites did not provide materials or services targeting youth. Significant gaps exist in providing family planning products and services in the majority of community pharmacies in San Diego, California. Education and outreach efforts are needed to promote provision of products and services, particularly to the adolescent population.

  18. Assessing the Sustainability Performance of Urban Plans based on Ecosystem Services

    Science.gov (United States)

    Menteşe, E. Y.; Tezer, A.

    2017-12-01

    Aiming at efficient and mindful use of natural resources while enabling social cohesion and economic development; sustainable development is one of the most emerging phenomenon in last decade. In this regard, role of urban development is critical by means of achieving sustainability since more than half of the world's population lives in cities. However, there is no solid and widely accepted approach for sustainability assessment in land use planning because there is not enough evidence on the relation between land use plans and environmental sustainability. With the basic aim of setting up relation between environmental sustainability and urban plans, this study utilizes ecosystem services phenomenon to define sustainability performance of a land use plan. Since ecosystem services can easily be related with land cover and land use they can be used as an efficient tool to act as indicators of sustainability. Meanwhile, while urban plans can provide ecosystem services and their level of service provision can be quantified, this is not solely enough for understanding its sustainability. Because it is also known that a land use plan mostly has negative impact on sustainability. Hence, this study embraces land use plans as a source of ecosystem services and environmental impacts. The difference between these entities are assumed to be the sustainability performance of a plan. The analysis relies on four parameters: ecosystem service capacity (environmental impact capacity), areal quantity of a land cover / use function, fragmantation level of the land use / cover and weight of ecosystem services / environmental impacts. Lastly, this approach is adopted for Istanbul's environmental master plan of 2009 and actual land cover of the same period. By calculating both data's environmental performance, the change of sustainability level sourced from environmental plan is analyzed.

  19. Assessing support for supervised injection services among community stakeholders in London, Canada.

    Science.gov (United States)

    Bardwell, Geoff; Scheim, Ayden; Mitra, Sanjana; Kerr, Thomas

    2017-10-01

    Few qualitative studies have examined support for supervised injection services (SIS), and these have been restricted to large cities. This study aimed to assess support for SIS among a diverse representation of community stakeholders in London, a mid-sized city in southwestern Ontario, Canada. This qualitative study was undertaken as part of the Ontario Integrated Supervised Injection Services Feasibility Study. We used purposive sampling methods to recruit a diversity of key informants (n=20) from five sectors: healthcare; social services; government and municipal services; police and emergency services; and the business and community sector. Interview data, collected via one-to-one semi structured interviews, were coded and analyzed using thematic analyses through NVivo 10 software. Interview participants unanimously supported the implementation of SIS in London. However, participant support for SIS was met with some implementation-related preferences and/or conditions. These included centralization or decentralization of SIS; accessibility of SIS for people who inject drugs; proximity of SIS to interview participants; and other services and strategies offered alongside SIS. The results of this study challenge the assumptions that smaller cities like London may be unlikely to support SIS. Community stakeholders were supportive of the implementation of SIS with some preferences or conditions. Interview participants had differing perspectives, but ultimately supported similar end goals of accessibility and reducing community harms associated with injection drug use. Future research and SIS programming should consider these factors when determining optimal service delivery in ways that increase support from a diversity of community stakeholders. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. ASSESSMENT OF E-COMMERCE USAGE FOR EFFECTIVE SERVICE DELIVERY IN NIGERIA BANKING SECTOR

    OpenAIRE

    Soneye Gbolade Michael

    2017-01-01

    This study assessed the extent of e-commerce usage for effective service delivery in Nigeria banking sector. Four research questions and four null hypotheses guided the study. Descriptive survey research design was adopted for the study. The study covered 64 microfinance banks in Oyo State, South-West, Nigeria. The population was made up of 1275 staffs from the 64 microfinance banks. The sample size consisted of 28 microfinance banks of which 280 staffs were purposively selected. A 28-item st...