Associations between family characteristics and parental empowerment in the family, family service situations and the family service system.

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Vuorenmaa, M; Perälä, M-L; Halme, N; Kaunonen, M; Åstedt-Kurki, P

2016-01-01

Parental empowerment signifies parents' sense of confidence in managing their children, interacting with services that their children use and improving child care services. High empowerment is associated with parents' resilience to demands and their confidence to make decisions and take actions that positively affect their families. Most families with children access various healthcare and education services. Professionals working in these services are therefore ideally placed to reinforce parental empowerment. However, little is known about the characteristics associated with parental empowerment within a generic sample of parents or in the context of basic child care services. The aim of this study was to assess how family characteristics are associated with maternal and paternal empowerment in the family, in service situations and in the service system. Parental empowerment was measured among 955 parents (mothers = 571; fathers = 384) of children aged 0-9 years using the Generic Family Empowerment Scale. Family characteristics were assessed through questions on children, parents and the life situation. Associations between empowerment and family characteristics were evaluated using one-way analysis of variance and t-test. Parental empowerment was predicted by multiple linear regression analysis. Parents' concerns related to their parenting, such as whether they possessed sufficient skills as a parent or losing their temper with children, as well as experiences of stress in everyday life, were negatively associated with all dimensions of maternal and paternal empowerment. Both determinants were more common and more significant in empowerment than child-related problems. Promoting parental self-confidence and providing appropriate emotional and concrete support for everyday functioning may reinforce parental empowerment, thereby enhancing families' well-being and coping, as well as improving their access to required services and timely support. Finally

Data Resources for Conducting Health Services and Policy Research.

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Blewett, Lynn A; Call, Kathleen Thiede; Turner, Joanna; Hest, Robert

2018-04-01

Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.

Utilization of clean and safe delivery service package of health services extension program and associated factors in rural kebeles of Kafa Zone, Southwest Ethiopia.

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Bayou, Negalign Berhanu; Gacho, Yohannes Haile Michael

2013-07-01

In Ethiopia, 94% of births take place at home unattended by trained persons. The government introduced an innovative strategy, Health Services Extension Program in 2003. Clean and safe delivery service is a component of maternal and child healthcare package of the program. However, little is known about the status of uptake of the service. This study thus aimed to assess utilization of clean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia. A community based cross sectional survey was conducted in rural kebeles of Kefa Zone from January 21(st) to February 25(th), 2009 using a sample of 229 mothers. Kafa Zone is located 465 kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structured questionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. Phistory of abortion, knowledge of danger signs and antenatal care attendance. Educating women and improving their knowledge about danger signs of pregnancy and labor is recommended. Health extension workers should consider antenatal care visits as opportunities for this purpose.

Factors associated with the utilization of dental health services by the pediatric population: an integrative review.

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Curi, Davi Silva Carvalho; Figueiredo, Andreia Cristina Leal; Jamelli, Silvia Regina

2018-05-01

This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

Association between full service and fast food restaurant density, dietary intake and overweight/obesity among adults in Delhi, India.

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Patel, Opal; Shahulhameed, Safraj; Shivashankar, Roopa; Tayyab, Mohammad; Rahman, Atiqur; Prabhakaran, Dorairaj; Tandon, Nikhil; Jaacks, Lindsay M

2017-07-19

The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs). The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India. Data are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs). Geographic information system data were available for 131 CEBs (n = 5264) from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m 2 . The most common full service and fast food restaurants were Indian savory restaurants (57.2%) and Indian sweet shops (25.8%). Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval), 1.44 (1.24, 1.67). After adjustment for age, household income, and education, the effect was attenuated: 1.08 (0.92, 1.26). Results were consistent with further adjustment for tobacco and alcohol use, moderate physical activity

Factors associated with adolescent mental health service need and utilization

NARCIS (Netherlands)

Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.

2003-01-01

Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of

Association between health service utilisation of internal migrant children and parents’ acculturation in Guangdong, China: a cross-sectional study

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Peng, Bo-li; Zou, Guan-yang; Chen, Wen; Lin, Yan-wei; Ling, Li

2018-01-01

Objectives To assess the health service utilisation of internal migrant children in Guangdong, China, and to explore the association between children’s health service utilisation and their parents’ acculturation. Design Cross-sectional survey between April and May 2016. Setting Six society-run schools of Tianhe and Baiyun districts in Guangzhou City of China. Participants We recruited all students at grade 7 or 8 and one of their parents who resided in Guangzhou over 6 months without permanent registered residence (hukou) in Guangzhou (1161 pairs completed this survey). 258 children were ill within the past 2 weeks or during the last year. Main outcome measures The main outcome was self-reported health service utilisation. Logistic regression analysis was conducted to explore the association between children’s unmet needs for outpatient or inpatient service and their parents’ acculturation (categorised into high, middle and low groups). Results In total, 216 children, or 18.6% of the total subjects, were ill within the past 2 weeks and were in need of outpatient service; 94 children, or 8.1% of the total subjects, were in need of inpatient service. Among them, 17.6% and 46.8% of the migrant children had unmet needs for outpatient and inpatient services, respectively. After controlling for enabling resources and predisposing characteristics, migrant children with parents in the middle-acculturation group (adjusted OR=3.17, 95% CIs 1.2 to 8.3, Pacculturation or low-acculturation groups, although only statistically significant when comparing with the high-acculturation group. Stratified analysis suggested that this association could be moderated by their family economic status. Conclusions Our study suggested that the association between migrant children’s health service utilisation and their parents’ acculturation was complex and could be moderated by family economic status. Increasing the service utilisation among migrant children requires

Farmers’ Awareness of Ecosystem Services and the Associated Policy Implications

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Fangfang Xun

2017-09-01

Full Text Available This study analyzes the primary factors influencing farmers’ awareness of ecosystem services. This study, through questionnaires, conducts research on farmers’ awareness of and demand for ecosystem service functions. The research encapsulates 156 households from 21 groups of villagers in the Guangxi Karst Ecological Immigration District in China. The results of the factors influencing farmers’ awareness of ecosystem services, analyzed using a regression model, show that: (1 Farmers are concerned with ecosystem service functions that directly benefit them; however, they do not sufficiently understand the ecosystem’s ecological security maintenance or cultural landscape functions; (2 Farmers’ awareness of ecosystem service functions is not consistent with their corresponding demand, including the ecosystem’s leisure and entertainment, social security, disaster prevention and water purification services; (3 Education level, land area cultivated by the household, proportion of the household’s income from agriculture and immigration status directly affect farmers’ awareness of ecosystem services; (4 Farmers’ personal characteristics, family characteristics and subjective attitudes have different effects on the level of ecological service cognition. Understanding farmers’ awareness of ecosystem services, and the influencing factors can help policymakers and development managers plan local development and policies, and enable harmonious development of the human-earth system in immigration regions of China.

Association between full service and fast food restaurant density, dietary intake and overweight/obesity among adults in Delhi, India

Directory of Open Access Journals (Sweden)

Opal Patel

2017-07-01

Full Text Available Abstract Background The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs. The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India. Methods Data are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs. Geographic information system data were available for 131 CEBs (n = 5264 from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m2. Results The most common full service and fast food restaurants were Indian savory restaurants (57.2% and Indian sweet shops (25.8%. Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p < 0.05. In unadjusted logistic regression models, participants in the highest versus lowest tertile of full service and fast food restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval, 1.44 (1.24, 1.67. After adjustment for age

Association between neighbourhood fast-food and full-service restaurant density and body mass index: a cross-sectional study of Canadian adults.

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Hollands, Simon; Campbell, M Karen; Gilliland, Jason; Sarma, Sisira

2014-05-07

Frequent fast-food consumption is a well-known risk factor for obesity. This study sought to determine whether the availability of fast-food restaurants has an influence on body mass index (BMI). BMI and individual-level confounding variables were obtained from the 2007-08 Canadian Community Health Survey. Neighbourhood socio-demographic variables were acquired from the 2006 Canadian Census. The geographic locations of all restaurants in Canada were assembled from a validated business registry database. The density of fast-food, full-service and non-chain restaurants per 10,000 individuals was calculated for respondents' forward sortation area. Multivariable regression analyses were conducted to analyze the association between restaurant density and BMI. Fast-food, full-service and non-chain restaurant density variables were statistically significantly associated with BMI. Fast-food density had a positive association whereas full-service and non-chain restaurant density had a negative association with BMI (additional 10 fast-food restaurants per capita corresponded to a weight increase of 1 kilogram; p<0.001). These associations were primarily found in Canada's major urban jurisdictions. This research was the first to investigate the influence of fast-food and full-service restaurant density on BMI using individual-level data from a nationally representative Canadian survey. The finding of a positive association between fast-food restaurant density and BMI suggests that interventions aiming to restrict the availability of fast-food restaurants in local neighbourhoods may be a useful obesity prevention strategy.

48 CFR 52.244-4 - Subcontractors and outside associates and consultants (Architect-engineer services).

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2010-10-01

... associates and consultants (Architect-engineer services). 52.244-4 Section 52.244-4 Federal Acquisition... consultants (Architect-engineer services). As prescribed in 44.204(b), insert the following clause: Subcontractors and Outside Associates and Consultants (Architect-Engineer Services) (AUG 1998) Any subcontractors...

Antenatal care service utilization and associated factors in Metekel ...

African Journals Online (AJOL)

socioeconomic and some obstetric factors have been stated by few studies in other areas, the factors associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, the objective of this study was to assess the status of Antenatal care service utilization and associated factors among ...

Organizational capacity for service integration in community-based addiction health services.

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Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A

2014-04-01

We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study.

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Evans-Lacko, S; Takizawa, R; Brimblecombe, N; King, D; Knapp, M; Maughan, B; Arseneault, L

2017-01-01

Research supports robust associations between childhood bullying victimization and mental health problems in childhood/adolescence and emerging evidence shows that the impact can persist into adulthood. We examined the impact of bullying victimization on mental health service use from childhood to midlife. We performed secondary analysis using the National Child Development Study, the 1958 British Birth Cohort Study. We conducted analyses on 9242 participants with complete data on childhood bullying victimization and service use at midlife. We used multivariable logistic regression models to examine associations between childhood bullying victimization and mental health service use at the ages of 16, 23, 33, 42 and 50 years. We estimated incidence and persistence of mental health service use over time to the age of 50 years. Compared with participants who were not bullied in childhood, those who were frequently bullied were more likely to use mental health services in childhood and adolescence [odds ratio (OR) 2.53, 95% confidence interval (CI) 1.88-3.40] and also in midlife (OR 1.30, 95% CI 1.10-1.55). Disparity in service use associated with childhood bullying victimization was accounted for by both incident service use through to age 33 years by a subgroup of participants, and by persistent use up to midlife. Childhood bullying victimization adds to the pressure on an already stretched health care system. Policy and practice efforts providing support for victims of bullying could help contain public sector costs. Given constrained budgets and the long-term mental health impact on victims of bullying, early prevention strategies could be effective at limiting both individual distress and later costs.

Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study.

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Gebremedhn, Endale Gebreegziabher; Lemma, Girmay Fitiwi

2017-01-01

Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients' expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors. Hospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively. The level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.

Factors associated with emergency medical services scope of practice for acute cardiovascular events.

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Williams, Ishmael; Valderrama, Amy L; Bolton, Patricia; Greek, April; Greer, Sophia; Patterson, Davis G; Zhang, Zefeng

2012-01-01

To examine prehospital emergency medical services (EMS) scope of practice for acute cardiovascular events and characteristics that may affect scope of practice; and to describe variations in EMS scope of practice for these events and the characteristics associated with that variability. In 2008, we conducted a telephone survey of 1,939 eligible EMS providers in nine states to measure EMS agency characteristics, medical director involvement, and 18 interventions authorized for prehospital care of acute cardiovascular events by three levels of emergency medical technician (EMT) personnel. A total of 1,292 providers responded to the survey, for a response rate of 67%. EMS scope of practice interventions varied by EMT personnel level, with the proportion of authorized interventions increasing as expected from EMT-Basic to EMT-Paramedic. Seven of eight statistically significant associations indicated that EMS agencies in urban settings were less likely to authorize interventions (odds ratios department-based EMS agencies were two to three times more likely to authorize interventions for EMT-Intermediate personnel. Volunteer EMS agencies were more than twice as likely as nonvolunteer agencies to authorize interventions for EMT-Basic and EMT-Intermediate personnel but were less likely to authorize any one of the 11 interventions for EMT-Paramedics. Greater medical director involvement was associated with greater likelihood of authorization of seven of the 18 interventions for EMT-Basic and EMT-Paramedic personnel but had no association with EMT-Intermediate personnel. We noted statistically significant variations in scope of practice by rural vs. urban setting, medical director involvement, and type of EMS service (fire department-based/non-fire department-based; volunteer/paid). These variations highlight local differences in the composition and capacity of EMS providers and offer important information for the transition towards the implementation of a national scope of

77 FR 37959 - Financial Management Service; Proposed Collection of Information: Pools and Associations-Annual...

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2012-06-25

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Pools and Associations--Annual Letter AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of...

Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study.

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Wolfenden, Luke; Finch, Meghan; Nathan, Nicole; Weaver, Natasha; Wiggers, John; Yoong, Sze Lin; Jones, Jannah; Dodds, Pennie; Wyse, Rebecca; Sutherland, Rachel; Gillham, Karen

2015-09-01

Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A cross-sectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder's Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18-1.61; p = <0.01), indicating that for every one point increase in implementation score, ECEC services were 38 % more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.

Gender Differences in the Association between Conduct Disorder and Risky Sexual Behavior

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Brooks Holliday, Stephanie; Ewing, Brett A.; Storholm, Erik D.; Parast, Layla; D’Amico, Elizabeth J.

2017-01-01

Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population. PMID:28182979

Asthma-Like Symptoms in Homeless Children in the Greater Paris Area in 2013: Prevalence, Associated Factors and Utilization of Healthcare Services in the ENFAMS Survey.

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Delphine Lefeuvre

Full Text Available Asthma remains poorly studied in homeless children. We sought to estimate the prevalence of asthma-like symptoms (ALS and to identify the factors associated with ALS and healthcare service utilisation.A cross-sectional survey of a random sample of sheltered homeless families was conducted by interviewing 801 parents of children (0-12 years in 17 languages. ALS were defined as wheezing or night cough without fever during the previous year. Poisson regression models with robust error variance were used to compute prevalence ratios (PR for factors associated with ALS and healthcare service utilisation for ALS.The prevalence of ALS among the children was 19.9%. Poor housing sanitation was significantly associated with ALS, as being born in the European Union. Most of the children with ALS had used healthcare services (85.4%. The main barriers to accessing such services were having lived in France for less than 49 months, having difficulties in French and living in poor housing conditions.ALS prevalence seemed lower than in the general child population, possibly because of the children's origins. Environmental factors associated with ALS point to the need to improve the indoor environment of family shelters. The relatively high rate of healthcare service utilisation should not overshadow existing barriers.

Factors associated with the utilization of institutional and home birth services among women in Ethiopia: A scoping review

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Bronwyn Lapp

2016-12-01

Full Text Available Objective: To examine the factors associated with the use of institutional delivery and home birth services among women in Ethiopia. Methods: Fifteen peer-reviewed, primary research articles published between 2011 and 2015 were selected for this scoping review. The articles included case-control, cross-sectional, and retrospective follow-up studies conducted in Ethiopia. Results: Findings were categorized with use of content and factorial analysis. The data in this scoping review revealed a significant inequality in skilled care use among Ethiopian women with differences in economic status, education, residence, autonomy in decision making, parity, and antenatal care attendance. Conclusion: Sociodemographic, accessibility, and obstetric factors are key determinants of skilled care utilization. Strategies and policy changes to address maternal health service use should aim to improve economic status, facilitate higher education, increase access to care, promote the empowerment of women, and enhance antenatal care initiatives. Additional research should be conducted to evaluate the influence of the media and culture on skilled care utilization, since few studies have examined these factors.

Level of male involvement and associated factors in family planning services utilization among married men in Debremarkos town, Northwest Ethiopia.

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Kassa, Mihretie; Abajobir, Amanuel Alemu; Gedefaw, Molla

2014-12-02

Men's participation is crucial to the success of family planning programs and women's empowerment and associated with better outcomes in reproductive health such as contraceptive acceptance and continuation, and safer sexual behaviors. Limited choice and access to methods, attitudes of men towards family planning, perceived fear of side-effects, poor quality of available services, cultural or religious oppositions and gender-based barriers are some of the reasons for low utilization of family planning. Hence, this study assessed the level of male involvement in family planning services utilization and its associated factors in Debremarkos town, Northwest Ethiopia. A community-based cross-sectional study was conducted from October to November, 2013. Multi-stage sampling technique was used to select 524 eligible samples. Data were collected by using semi-structured questionnaires. Epi Info and SPSS were used to enter and analyze the data; univariate, bivariate and logistic regression analyses were performed to display the outputs. Only 44 (8.4%) respondents were using or directly participating in the use of family planning services mainly male condoms. The reasons mentioned for the low participation were the desire to have more children, wife or partner refusal, fear of side effects, religious prohibition, lack of awareness about contraceptives and the thinking that it is the only issue for women. Opinion about family planning services, men approval and current use of family planning methods were associated with male involvement in the services utilization. In this study, the level of male involvement was low. Lack of information, inaccessibility to the services and the desire to have more children were found to be the reasons for low male involvement in family planning services utilization. Governmental and nongovernmental organizations, donors and relevant stakeholders should ensure availability, accessibility and sustained advocacy for use of family planning

Cost of placement and complications associated with osseointegrated bone-conducting hearing prostheses: a retrospective analysis of medicare billing data.

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Pross, Seth E; Layton, Andrew; Tong, Kuo; Lustig, Lawrence R

2014-03-01

To report the cost of placement and complications related to osseointegrated bone-conducting hearing prostheses (OBHPs) in a Medicare population. We performed a retrospective analysis of nationwide Medicare claims data for operative and nonoperative complications associated with the placement of percutaneous OBHPs between the first quarter of 2007 and the second quarter of 2009 for which there were 6 subsequent quarters of follow-up. We used Medicare Standard Analytical Files (SAF), which contain a 5% random sample of Medicare fee-for-service beneficiaries, excluding those that also were enrolled in a managed-care organization. We identified 118 patients who had OBHPs placed in the requisite period. Their complication billing data were analyzed for the six-quarters after initial placement. Seventy patients (59%) had no billing codes for complications or repeat procedures after receiving the implant, whereas 48 patients (41%) had such codes. The total adjusted mean cost with repeat/revision operations or complications was $7,812 per patient compared with $6,733 for those without these issues, an increase of $1,079 or 16%. We estimate that complications associated with the implantation of percutaneous OBHPs led to $417,616 in additional costs in the entire Medicare fee-for-service population during the study period and that the total cost of placement of these devices together with the cost of their complications totaled $6,789,248. In conclusion, the Medicare SAF database suggests that complications associated with OBHP increased the overall cost of placement by 16%. Like all surgical procedures, these complications and their associated costs should be taken into account when considering treatment options for patients who experience hearing loss.

Associated and mediating variables related to quality of life among service users with mental disorders.

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Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

2018-02-01

This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

Associations between the peer support relationship, service satisfaction and recovery-oriented outcomes: a correlational study.

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Thomas, Elizabeth C; Salzer, Mark S

2017-12-18

The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.

Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia.

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Negash, Wassie; Dessalegn, Muluken; Yitayew, Berhanu; Demsie, Mohammed; Wagnew, Maereg; Nyagero, Josephat

2016-01-01

Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia. A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%. Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.

Reducing barriers associated with delivering health care services to migratory agricultural workers.

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Schmalzried, Hans D; Fallon, L Fleming

2012-01-01

travel an average of 29.1 km (18.1 miles) (range 0-129 km [0-80 miles]) to obtain medical services. Female heads of households had significantly less access to transportation compared with male heads of households (t=2.35; df=74; presources; and (3) healthcare clinic practices. Work environment issues relate mostly to the employers. Resources are barriers for MAWs because they are poor and have limited funds for the cost of transportation to clinics and the fees associated with accessing health care. Most of the barriers identified related to healthcare clinic practices. Some strategies to address healthcare clinic practice barriers were developed by the group conducting the study. By listening to what MAWs described as barriers to health care, providers can help improve access which can reduce the use of high cost hospital emergency room care.

Healthcare workers' behaviors and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review.

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Jonas, Kim; Crutzen, Rik; van den Borne, Bart; Reddy, Priscilla

2017-03-13

Healthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services. A systematic review of literature was conducted to identify studies focusing on healthcare workers' behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria. Negative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines. Healthcare workers' negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA. A protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509 .

Organizational cultural competence in community health and social service organizations: how to conduct a self-assessment.

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Olavarria, Marcela; Beaulac, Julie; Bélanger, Alexandre; Young, Marta; Aubry, Tim

2009-01-01

In an effort to address the significant socio-cultural changes in the population demographics of the United States (US) and Canada, organizations are increasingly seeking ways of improving their level of cultural competence. Evaluating organizational cultural competence is essential to address the needs of ethnic and cultural minorities. Yet, research related to organizational cultural competence is relatively new. The purpose of this paper is to review the extant literature with a specific focus on: (1) identifying the key standards that define culturally competent community health and social service organizations; and (2) outlining the core elements for evaluating cultural competence in a health and social service organization. Furthermore, issues related to choosing self-assessment tools and conducting an evaluation will be explored.

Characteristics associated with organizational independence in consumer-operated service organizations.

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Tanenbaum, Sandra J

2011-01-01

This research compares two types of consumer organizations in one state in order to explore the significance of organizational independence for internal structure/operations and external relationships. The first type, consumeroperated service organizations (COSOs), are independent and fully self-governing; the second are peer-support service organizations (PSSOs), which are part of larger non-consumer entities. Mail surveys were completed by COSO and PSSO directors of a geographically representative sample of organizations; telephone interviews were conducted with a sub-sample. Owing to small sample size, matched COSO-PSSO pairs were analyzed using non-parametric statistics. COSOs and PSSOs are similar in some ways, e.g., types of services provided, but significantly different on internal variables, such as budget size, and external variables, such as number of relationships with community groups. Organizational independence appears to be a significant characteristic for consumer service organizations and should be encouraged by funders and among participants. Funders might establish administrative and/or programmatic measures to support consumer organizations that are independent or moving toward independence; their participants would also benefit from the provision, by authorities or advocates, of materials to guide organizations toward, for example, 501(c)3 status.

The Association Between Gender Inequalities and Women's Utilization of Maternal Health Services: A Cross-Sectional Survey in Eight South Central Coast Provinces, Vietnam.

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Bui, Ha Thi Thu; Le, Thi Minh; Van Pham, Tac; Doan, Duong Thi Thuy; Nguyen, Duy Anh; Nguyen, Canh Chuong; Duong, Duc Minh

Gender inequalities influence the utilization of maternal health services in Vietnam, but little research has been published. This study, therefore, aimed to explore the association between gender inequalities and women's utilization of maternal health services in Vietnam. The study was conducted in 8 provinces in the South Central Coast region of Vietnam during August 2013 to May 2014. A total of 907 women who delivered a year prior to the date of interview participated in the study. A multiple logistic regression model was used to examine the association between gender inequalities (including sociodemographic determinants of health) and utilization of 4 or more antenatal care (ANC4+) services, institutional delivery, and ever used contraceptive methods. The utilization rate of maternal health services was varied, from 53.9% for ANC4+ to 87.7% for ever used a contraceptive method and 97% for institutional delivery. Ethnicity was identified as the most influential variable out of all sociodemographic determinants of health. Regarding gender inequalities, couple communication was the only variable having significant association with women's utilization of maternal health services. Women's equal role within context of their daily life and relations with their husbands (discussing maternal care with husband and having equal income to husband) supported their use of maternal health services. Therefore, there should be concerted efforts from all relevant stakeholders including the health system to focus on disadvantaged women in planning and delivery of maternal health services, especially to ethnic minority women. Male involvement strategy should be implemented to promote maternal health care, especially during the prenatal and postpartum period. To provide more culturally sensitive and right-based approaches in delivery of maternal health services to disadvantaged women in Vietnam, interventions are recommended that promote male involvement, that is, to engage men in

Frequent users of emergency services: associated factors and reasons for seeking care

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Aline Marques Acosta

2015-04-01

Full Text Available Aim: to identify the profile of frequent users of emergency services, to verify the associated factors and to analyze the reasons for the frequent use of the services. METHOD: An explanatory sequential type mixed method was adopted. Quantitative data were collected from the electronic medical records, with a sample of 385 users attended four or more times in an emergency service, during the year 2011. Qualitative data were collected through semi-structured interviews with 18 users, intentionally selected from the results of the quantitative stage. Quantitative data were analyzed using descriptive and inferential statistics and qualitative data using thematic analysis. RESULTS: It was found that 42.9% were elderly, 84.9% had chronic diseases, 63.5% were classified as urgent, 42.1% stayed for more than 24 hours in the service and 46.5% were discharged. Scheduled follow-up appointment, risk classification, length of stay and outcome were factors associated with frequent use. The reasons for seeking the services were mainly related to the exacerbation of chronic diseases, to easier access and concentration of technology, to the bond, and to the scheduled appointments. CONCLUSIONS: The results contribute to comprehending the repeated use of emergency services and provide additional data to plan alternatives to reduce frequent use.

Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

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Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

2018-01-01

Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

Childhood Conduct Problems Are Associated with Increased Partnership and Parenting Difficulties in Adulthood

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Raudino, Alessandra; Woodward, Lianne J.; Fergusson, David M.; Horwood, L. John

2012-01-01

This paper uses data from a sample of 337 parents studied at age 30 to examine the linkages between childhood conduct problems assessed at ages 7-9 and later partnership and parenting outcomes. The key findings of this study were: 1) increasing levels of childhood conduct problems were associated with increased risk of partnership difficulties,…

26 CFR 31.3306(n)-1 - Services on American vessel whose business is conducted by general agent of Secretary of Commerce.

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2010-04-01

... conducted by general agent of Secretary of Commerce. 31.3306(n)-1 Section 31.3306(n)-1 Internal Revenue... conducted by general agent of Secretary of Commerce. (a) Section 3306(n) and this section of the regulations... by a general agent of the Secretary of Commerce. Whether services performed by such an officer or...

[Quality management is associated with high quality services in health care].

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Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

Context-Aware HCI Service Selection

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Yao Shen

2012-01-01

Full Text Available Context-awareness has become a key issue in Human-Computer Interaction(HCI to provide better user experience under multi-device and multi-modal environment. With this intuition, we have proposed a web service based framework, which associates interactions with services, and provided service selection mechanism using context knowledge to achieve smart interaction migration [1]. A fundamental problem of such a service-oriented framework for interaction migration is to design an effective while scalable algorithm for service selection. In this paper, we propose a service selection algorithm considering not only context information and user preferences but also inter-service relations such as relative location. Our algorithm detects interaction hot spots within user active scope and presents the best service combination based on evaluation of interaction effectiveness. We also conduct simulation and the results illustrate that our algorithm is effective and scalable for interaction service selection.

Utilization of cervical cancer screening services and its associated factors among primary school teachers in Ilala Municipality, Dar es Salaam, Tanzania.

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Kileo, Neema Minja; Michael, Denna; Neke, Nyasule Majura; Moshiro, Candida

2015-12-15

Worldwide cervical cancer is one of the more common forms of carcinoma among women, causing high morbidity and high mortality. Despite being a major health problem in Tanzania, screening services for cervical cancer are very limited, and uptake of those services is low. We therefore conducted a study to investigate utilization of cancer screening services, and its associated factors among female primary school teachers in Ilala Municipality, Dar es Salaam. We conducted a cross-sectional study between May - August 2011 which involved 110 primary schools in Ilala Municipality in Dar es Salaam. Five hundred and twelve female primary school teachers were sampled using a two-stage cluster sampling procedure. Data on utilization of cervical cancer and risk factors were collected using a self-administered questionnaire. Proportional utilization of cervical cancer screening services was identified through a self report. Risk factors for services utilization were assessed using logistic regression analyses. Out of 512 female primary school teachers, only 108 (21 %) reported to ever been screened for cervical cancer. Utilization of cervical cancer screening services was 28 % among those aged 20-29, 22 % among married and 24 % among those with higher level of education. Women were more likely to utilize the cancer-screening service if they were multiparous (age-adjusted OR = 3.05, 95 % CI 1.15-8.06, P value 0.025), or reported more than one lifetime sexual partner (age-adjusted OR 2.17, 95 % CI 1.04-4.54, P value 0.038), or did not involve their spouse in making health decisions (adjusted OR 3.56, 95 % CI 2.05-6.18, P value service among female primary school teachers in Ilala munipality. Female primary school teachers with more than one previous pregnancy and those with more than one life-time sex partners were more likely to report utilization of the service. Spouse or partners support was an important factor in the utilization of cervical cancer screening

Prison health service directors' views on research priorities and organizational issues in conducting research in prison: outcomes of a national deliberative roundtable.

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Simpson, Paul Leslie; Guthrie, Jill; Butler, Tony

2017-06-12

Purpose Given that prisoners have significant health needs across most areas, the paucity of prisoner health research, and the difficulties involved in the conduct of research in this setting, there is a need to develop research priorities that align with key stakeholder groups. One such group are those responsible for health service provision in prisons - prison health service directors. The paper aims to discuss these issues. Design/methodology/approach Prison health service directors in each Australian state and territory were invited to participate in a national (deliberative) roundtable where the consensus building nominal group technique was utilized. This involved the identification of research priorities and organizational issues in conducting research with prisoners, and ranking research priorities. A thematic analysis was conducted on organizational issues. Findings In total, 13 participants attended the roundtable. Participants identified 28 research priorities and 12 organizational issues. Top ranked research priorities were mental health, cognitive and intellectual disability, post-release health maintenance, ageing prisoners, chronic health conditions and Aboriginal and Torres Strait Islander health. Themes identified from the organizational issues included prisoner access to research participation, health and research literacy of custodial staff, and institutional protectionism in response to research that may discover negative information about the custodial setting. Research limitations/implications These findings should inform future efforts to improve research infrastructures to undertake research to improve the health of people in Australian prisons, and help to align researchers' efforts with those of a key organizational stakeholder. Originality/value This is the first paper to determine the research priorities and organizational issues in conducting research in prisons of prison health service directors.

Demand for long acting and permanent contraceptive methods and associated factors among family planning service users, Batu town, Central Ethiopia.

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Haile, Anley; Fantahun, Mesganaw

2012-01-01

Evidence suggests a high unsatisfied demand for long acting and permanent contraceptive methods in sub-Saharan Africa. However, there is limited knowledge on demand for long acting and permanent contraceptive methods and associated factors in Ethiopia. The objective of this study was to assess demand for long acting and permanent contraceptive methods and associated factors among women of age group 18-49 years in Batu town, East Shoa Zone, Ethiopia. A facility based cross-sectional survey was conducted in six service delivery points from March to April 2009 on 398 women of age 18-49 years old. Thirteen (3%) were using long acting and permanent contraceptive methods and 89 (22.4%) wanted no more child in the future making the total demand of long acting and permanent contraceptive methods 24.4%. Older age group, multiparty, that the provider asked about reproductive intention, and the provider explained side effects of method selected were significantly associated with using LA and MPs (P demand and several socio demographic and family planning service quality related factors were associated with demand for long acting and permanent contraceptive methods indicating that multi-dimensional measures are needed to improve the use of long acting and permanent contraceptive methods.

Apparel Merchandising Students Learn Customer Service Strategies while Conducting Research.

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Paulins, V, Ann

2000-01-01

Apparel merchandising students participated in a cooperative research project in which they observed customer service techniques by posing as customers in retail stores. The project taught research processes, collaboration, and principles of customer service. (SK)

Home care clients in the last year of life: is material deprivation associated with service characteristics?

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Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve

2011-09-01

To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

Factors associated with psychosocial services in ogun state, Nigeria

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Olorunfemi Emmanuel Amoran

2013-01-01

Full Text Available Background: Belonging to a social network group may influence a person′s decisions to engage in desired behavior. Aim: The objective of our study was to determine factors associated with utilization of psychosocial group services among people living with human immunodeficiency virus acquired immunodeficiency syndrome (PLWHAs in a Teaching Hospital in Sagamu, Southwestern Nigeria. Settings and Design: This was an analytical cross-sectional study. All consenting PLHAs who attended the anti-retroviral clinic (ART clinic during the study period were recruited into the study. Materials and Methods: A structured self-administered questionnaire was used to collect relevant information and a total of 205 PLWHAs were interviewed. Statistical Analysis Used: The data analysis focused on univariate frequency table and bivariate cross tabulations that identify important relationships between the variables. Odds ratio (OR at 95% confidence level (CI and Chi-squared and t-tests were also computed. Results: The overall point utilization of psychosocial services among the PLWHAs was 23.4%. Utilization of psychosocial services was statistically significantly associated with religion (χ2 = 11.74, P = 0.003, disclosure of human immunodeficiency virus status (χ2 = 9.18, P = 0.01 and satisfactory self-reported health-related quality-of-life (HRQOL (χ2 = 5.67, P = 0.017 while sex (χ2 = 0.02, P = 0.96, education (χ2 = 4.67, P = 0.32 tribe (χ2 = 1.46, P = 0.48 adherence to ART drugs (χ2 = 0.44, P = 0.51, mental health status (χ2 = 0.64, P = 0.42 and occupation (χ2 = 3.61, P = 0.61 were not. The only predictor of utilization of psychosocial group services was religion (OR = 0.44, CI = 0.23-0.84. Conclusion: This study shows the effectiveness of the psychosocial networks group in improving the overall HRQOL of the PLWHAs.

Predisposing, enabling, and need factors associated with utilization of institutional delivery services: A community-based cross-sectional study in far-western Nepal.

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Freidoony, Leila; Ranabhat, Chhabi Lal; Kim, Chun-Bae; Kim, Chang-Soo; Ahn, Dong-Won; Doh, Young Ah

2018-01-01

Use of institutional delivery services can be effective in reducing maternal and infant mortality. In Nepal, however, the majority of women deliver at home. Using Andersen's behavioral model of use of health care services, this cross-sectional study aimed to identify factors associated with use of institutional delivery services in four villages and one municipality in Kailali district, Nepal. Mothers (N = 500) who had given birth in the 5 years preceding the survey (conducted between January and February 2015) were randomly selected by cluster sampling and interviewed using a semi-structured questionnaire. Bivariate analyses and multivariate hierarchical logistic regression analyses were performed. Among the women surveyed, 65.6% had used institutional delivery services for their last delivery, a higher proportion than the national average. Primiparity, having a secondary or higher education level, living in the Durgauli village, having husbands with occupations other than agriculture or professional/technical jobs, and having attended four or more antenatal care (ANC) visits had significantly increased use of institutional deliveries. Also, belonging to the richest 20% of the community and having experienced pregnancy complications were marginally significantly associated. These findings demonstrate the need for improving mother's education, encouraging them to attend ANC visits and addressing disparities between different regions.

Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey.

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Xie, Zhenzhen; Or, Calvin

2017-01-01

The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.

Distributions of Conductance and Shot Noise and Associated Phase Transitions

International Nuclear Information System (INIS)

Vivo, Pierpaolo; Majumdar, Satya N.; Bohigas, Oriol

2008-01-01

For a chaotic cavity with two identical leads each supporting N channels, we compute analytically, for large N, the full distribution of the conductance and the shot noise power and show that in both cases there is a central Gaussian region flanked on both sides by non-Gaussian tails. The distribution is weakly singular at the junction of Gaussian and non-Gaussian regimes, a direct consequence of two phase transitions in an associated Coulomb gas problem

Factors associated with use of maternal health services in Haiti: a multilevel analysis

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Stella O. Babalola

2014-07-01

Full Text Available OBJECTIVE: To assess factors associated with utilization of maternal health services (MHS among women giving birth in Haiti from 2007 - 2012. METHODS: Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA. RESULTS: The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR = 0.47; 95% confidence interval (CI: 0.37-0.57 with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78 with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88 with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34 with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73 with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61 with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61. Significant clustering of use of MHS exists at the community level. CONCLUSIONS: Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

Factors associated with use of maternal health services in Haiti: a multilevel analysis.

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Babalola, Stella O

2014-07-01

To assess factors associated with utilization of maternal health services (MHS) among women giving birth in Haiti from 2007 - 2012. Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA). The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR) = 0.47; 95% confidence interval (CI): 0.37-0.57) with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78) with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88) with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34) with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73) with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61) with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61). Significant clustering of use of MHS exists at the community level. Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

Factors associated with non-reimbursable activity on an inpatient pediatric consultation-liaison service.

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Bierenbaum, Melanie L; Katsikas, Steven; Furr, Allen; Carter, Bryan D

2013-12-01

The aim of this study was to identify factors contributing to clinician time spent in non-reimbursable activity on an inpatient pediatric consultation-liaison (C-L) service. A retrospective study was conducted using inpatient C-L service data on 1,246 consecutive referrals. For this patient population, the strongest predictor of level of non-reimbursable clinical activity was illness chronicity and the number of contacts with C-L service clinicians during their hospital stay. Patients with acute life-threatening illnesses required the highest mean amount of non-reimbursable service activity. On average, 28 % of total clinician time in completing a hospital consultation was spent in non-reimbursable activity. Effective C-L services require a proportion of time spent in non-reimbursable clinical activity, such as liaison and coordinating care with other providers. Identifying referral and systemic factors contributing to non-reimbursable activity can provide insight into budgeting/negotiating for institutional support for essential clinical and non-clinical functions in providing competent quality patient care.

Risk estimation in association with diagnostic techniques in the nuclear medicine service of the Camaguey Ciego de Avila Territory

International Nuclear Information System (INIS)

Barrerras, C.A.; Brigido, F.O.; Naranjo, L.A.; Lasserra, S.O.; Hernandez Garcia, J.

1999-01-01

The nuclear medicine service at the Maria Curie Oncological Hospital, Camaguey, has experience of over three decades in using radiofarmaceutical imaging agents for diagnosis. Although the clinical risk associated with these techniques is negligible, it is necessary to evaluate the effective dose administered to the patient due to the introduction of radioactive substances into the body. The study of the dose administered to the patient provides useful data for evaluating the detriment associated with this medical practice, its subsequently optimization and consequently, for minimizing the stochastic effects on the patient. The aim of our paper is to study the collective effective dose administered by nuclear medicine service to Camaguey and Ciego de Avila population from 1995 to 1998 and the relative contribution to the total annual effective collective dose of the different diagnostic examinations. The studies were conducted on the basis of statistics from nuclear medicine examinations given to a population of 1102353 inhabitants since 1995. The results show that the nuclear medicine techniques of neck examinations with 1168.8 Sv man (1.11 Sv/expl), thyroid explorations with 119.6 Sv man (55.5 mSv/expl) and iodide uptake with 113.7 Sv man (14.0 mSv/expl) are the main techniques implicated in the relative contribution to the total annual effective collective dose of 1419.5 Sv man. The risk estimation in association with diagnostic techniques in the nuclear medicine service studied is globally low (total detriment: 103.6 as a result of 16232 explorations), similar to other published data

Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive School Nutrition Services

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Briggs, Marilyn; Mueller, Constance G.; Fleischhacker, Sheila

2010-01-01

It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health,…

Nocturnal Enuresis Is Associated with Attention Deficit Hyperactivity Disorder and Conduct Problems

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Park, Subin; Kim, Jae-Won; Hong, Soon-Beom; Shin, Min-Sup; Yoo, Hee Jeong; Cho, Soo-Churl

2013-01-01

Objective There are no published prevalence estimates of elimination disorders and their association with disruptive-behavior disorders among children in the Asian region using standardized diagnostic interviews. This study was conducted to determine the prevalence of elimination disorders and its association with disruptive-behavior disorders in a representative sample of children in Seoul, Korea. Methods The diagnosis of enuresis and encopresis was derived from parent-reported data for "enuresis and encopresis," collected using the Diagnostic Interview Schedule for Children, from a representative sample of 6- to 12-year-old children (n=1,645) who participated in the 2005 Seoul Child and Adolescent Mental Health Survey. Prevalence data for attention deficit and disruptive-behavior disorders were collected from the same sample. Results The overall 12-month prevalence of nocturnal enuresis and encopresis was 1.8% and 0.6%, respectively. Enuresis and encopresis prevalence in boys was significantly greater than that in girls. Enuresis and encopresis was most common at 7 to 9 years of age. Enuresis was significantly associated with ADHD (OR 2.6, 95% CI 1.0-6.9) and conduct disorder (CD; OR 4.7, 95% CI 1.0-22.4). Conclusion Enuresis is significantly associated with ADHD and CD, so these conditions must be assessed together during the evaluation of children with enuresis. PMID:24302948

Using trajectory analyses to refine phenotype for genetic association: conduct problems and the serotonin transporter (5HTTLPR).

Science.gov (United States)

Sakai, Joseph T; Boardman, Jason D; Gelhorn, Heather L; Smolen, Andrew; Corley, Robin P; Huizinga, David; Menard, Scott; Hewitt, John K; Stallings, Michael C

2010-10-01

Conduct disorder is a serious, relatively common disorder of childhood and adolescence. Findings from genetic association studies searching for genetic determinants of the liability toward such behaviors have been inconsistent. One possible explanation for differential results is that most studies define phenotype from a single assessment; for many adolescents conduct problems decrease in severity over time, whereas for others such behaviors persist. Therefore, longitudinal datasets offer the opportunity to refine phenotype. We used Caucasians that were first assessed during adolescence from the National Youth Survey Family Study. Nine waves of data were used to create latent growth trajectories and test for associations between trajectory class and 5HTTLPR genotype. For the full sample, 5HTTLPR was not associated with conduct problem phenotypes. However, the short (s) allele was associated with chronic conduct problems in females; a nominally significant sex by 5HTTLPR genotype interaction was noted. Longitudinal studies provide unique opportunities for phenotypic refinement and such techniques, with large samples, may be useful for phenotypic definition with other study designs, such as whole genome association studies.

Childhood adversity and conduct disorder: A developmental pathway to violence in schizophrenia.

Science.gov (United States)

Oakley, Clare; Harris, Stephanie; Fahy, Thomas; Murphy, Declan; Picchioni, Marco

2016-04-01

Both childhood adversity and conduct disorder are over-represented among adult patients with schizophrenia and have been proposed as significant factors that may increase the risk of violence. It is not known how childhood adversity and conduct disorder might interact to contribute towards an increased risk of violence in schizophrenia. This study aimed to explore the relationships between childhood adversity, conduct disorder and violence among men with schizophrenia. 54 male patients with schizophrenia from a range of inpatient and outpatient mental health services were assessed for exposure to a variety of childhood adversities, conduct disorder before the age of 15 and later violent behaviour in adulthood. Exposure to domestic violence during childhood was associated with an increased propensity to violence in adulthood. Symptoms of conduct disorder were associated both with cumulative exposure to childhood adversities and with later propensity to violence. The cumulative number of childhood adversities was associated with adult propensity to violence. This association was significantly attenuated by inclusion of conduct disorder in the model. This is the first study to demonstrate an association between childhood exposure to domestic violence and later violent behaviour in schizophrenia. Conduct disorder may mediate the association between cumulative childhood adversities and adult propensity to violence, indicating an indirect pathway. These results indicate a complex interplay between childhood adversity, conduct disorder and later violent behaviour in schizophrenia, and suggest that there may be shared aetiological risk factors on a common developmental pathway to violence. Copyright © 2016 Elsevier B.V. All rights reserved.

Cost associated with stroke: outpatient rehabilitative services and medication.

Science.gov (United States)

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

2011-10-01

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

The dilemma of service productivity and service innovation : An empirical exploration in financial services

NARCIS (Netherlands)

Aspara, Jaakko; Klein, Jan; Luo, Xueming; Tikkanen, Henrikki

2017-01-01

We conduct a systematic exploratory investigation of the effects of firms’ existing service productivity on the success of their new service innovations. Although previous research extensively addresses service productivity and service innovation, respectively, this is the first empirical study that

An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

Science.gov (United States)

Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

2015-02-01

Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

Science.gov (United States)

Petkari, Eleni; Pietschnig, Jakob

2015-01-01

Background Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients’ satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment. Aim This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction. Methods: In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined. Results Analyses revealed a highly significant medium-sized effect (r = .30, p service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs. Conclusion Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients’ perception of the service adequacy for achieving QoL enhancement into account. PMID:26275139

Mastery of mothering skills and satisfaction with associated health services: an ethnocultural comparison.

Science.gov (United States)

Whitley, Rob

2009-09-01

In this paper, I examine the mastery of mothering skills and satisfaction with associated health services in women who had recently given birth in Montreal (n = 33). I compare experience between women of two distinct ethnocultural groups: Anglophone Euro-Canadian and Anglophone Afro-Caribbean. The overall aim is to discern differentials in the mastery of mothering skills and associated satisfaction with maternal and child health services. The study is framed by neo-Weberian social theory suggesting that modernization and bureaucratization increasingly eviscerate everyday skills and knowledge. These processes also lead to changes regarding what is considered credible 'authoritative knowledge.' I found that older Anglophone Euro-Canadians expressed the greatest skill deficits. They attempted to redress these deficits through consultation of professionally authored books, medical Web sites and health professionals. Older Anglophone Euro-Canadians saw these resources as sources of 'authoritative knowledge.' They also expressed dissatisfaction with related health services. In contrast, Anglophone Afro-Caribbeans and younger lower-income Anglophone Euro-Canadians expressed satisfaction with their skills. This derived from widespread previous experience with children and more extensive and readily available kith and kin networks. These were considered sources of 'authoritative knowledge' in this group. This group expressed less dissatisfaction with health services, as they did not need, or expect, these services to redress skill deficits.

Measuring Service Quality in the Information Services Environment.

Science.gov (United States)

Maddox-Swan, Ruth

1998-01-01

The purpose of this research was to identify the service factors that influence judgments of customer satisfaction in the academic library/media center. The study, conducted at Florida State University examined the relative importance of these determinants of service quality and compared these results to earlier studies conducted with customers of…

Identification of heart rate-associated loci and their effects on cardiac conduction and rhythm disorders

DEFF Research Database (Denmark)

den Hoed, Marcel; Eijgelsheim, Mark; Esko, Tõnu

2013-01-01

of dilated cardiomyopathy, congenital heart failure and/or sudden cardiac death. In addition, genetic susceptibility to increased heart rate is associated with altered cardiac conduction and reduced risk of sick sinus syndrome, and both heart rate-increasing and heart rate-decreasing variants associate...

[Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].

Science.gov (United States)

Valdez-Santiago, Rosario; Juárez-Ramírez, Clara; Salgado-de Snyder, V Nelly; Agoff, Carolina; Avila-Burgos, Leticia; Híjar, Martha C

2006-01-01

To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public

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.

Test of Association Between 10 SNPs in the Oxytocin Receptor Gene and Conduct Disorder

OpenAIRE

Sakai, Joseph T.; Crowley, Thomas J.; Stallings, Michael C.; McQueen, Matthew; Hewitt, John K.; Hopfer, Christian; Hoft, Nicole R.; Ehringer, Marissa A.

2012-01-01

Animal and human studies have implicated oxytocin (OXT) in affiliative and prosocial behaviors. We tested whether genetic variation in the OXT receptor (OXTR) gene is associated with conduct disorder (CD).

Family planning utilization and factors associated among women receiving abortion services in health facilities of central zone towns of Tigray, Northern Ethiopia: a cross sectional Study.

Science.gov (United States)

Hagos, Goshu; Tura, Gurmesa; Kahsay, Gizienesh; Haile, Kebede; Grum, Teklit; Araya, Tsige

2018-06-05

Abortion remains among the leading causes of maternal death worldwide. Post-abortion contraception is significantly effective in preventing unintended pregnancy and abortion if provided before women leave the health facilty. However, the status of post-abortion family planning (PAFP) utilization and the contributing factors are not well studied in Tigray region. So, we conduct study aimed on family planning utilization and factors associated with it among women receiving abortion services. A facility based cross-sectional study design was conducted among women receiving abortion services in central zone of Tigray from December 2015to February 2016 using a total of 416 sample size. Women who came for abortion services were selected using systematic random sampling technique.. The data were collected using a pre-tested interviewer administered questionnair. Data were coded and entered in to Epi info 7 and then exported to SPSS for analysis. Descriptive statisticslike frequencies and mean were computed to display the results. Both Bivariable and multivariable logistic regression was used in the analysis. Variables statistically significant at p < 0.05 in the bivariable analysis were checked in multivariable logistic regration to identify independently associated factors. Then variables which were significantly associated with post abortion family planning utilization at p-value < 0.05 in the multivariable analysis were declared as significantly associated factors. A total of 409 abortion clients were interviewed in this study with 98.3% of response rate. Majority 290 (70.9%) of study participants utilized contracepives after abortion. Type of health facility, the decision maker on timing of having child, knowledge that pregnancy can happen soon after abortion and husband's opposition towards contraceptives were significantly associated with Post-abortion family planning ustilization. About one-third of abortion women failed to receive contraceptive before

Association between attendance at religious services and self-reported health in 22 European countries.

Science.gov (United States)

Nicholson, Amanda; Rose, Richard; Bobak, Martin

2009-08-01

There are consistent reports of protective associations between attendance at religious services and better self-rated health but existing data rarely consider the social or individual context of religious behaviour. This paper investigates whether attendance at religious services is associated with better self-rated health in diverse countries across Europe. It also explores whether the association varies with either individual-level (gender, educational, social contact) or country-level characteristics (overall level of religious practice, corruption, GDP). Cross-sectional data from round 2 of the European Social Survey were used and 18,328 men and 21,373 women from 22 European countries were included in multilevel analyses, with country as higher level. Compared to men who attended religious services at least once a week, men who never attended were almost twice as likely to describe their health as poor, with an age and education adjusted odds ratio of 1.83 [95% CI, 1.49-2.26]. A similar but weaker effect was seen in women, with an age and education adjusted odds ratio of 1.38 [1.19-1.61]. The associations were reduced only marginally in men by controlling for health status, social contact and country-level variables, but weakened in women. The relationships were stronger in people with longstanding illness, less than university education and in more affluent countries with lower levels of corruption and higher levels of religious belief. These analyses confirm that an association between less frequent attendance at religious services and poor health exists across Europe, but emphasise the importance of taking individual and contextual factors into account. It remains unclear to what extent the observed associations reflect reverse causality or are due to differing perceptions of health.

What factors are associated with state performance on provision of transition services to CSHCN?

Science.gov (United States)

Kane, Debra J; Kasehagen, Laurin; Punyko, Judy; Carle, Adam C; Penziner, Andy; Thorson, Sarah

2009-12-01

To examine whether individual, condition-related, and system-related characteristics are associated with state performance (high, medium, low) on the provision of transition services to children with special health care needs (CSHCN). We conducted descriptive, bivariate, and multivariable analyses of 16876 children aged 12 to 17 years by using data from the 2005-2006 National Survey of Children With Special Health Care Needs. Polytomous logistic regression was used to compare the characteristics of CSHCN residing within high-, medium-, and low-performance states, with low-performance states serving as the reference group. Compared with non-Hispanic white CSHCN, Hispanic (adjusted odds ratio [aOR]: 0.25 [95% confidence interval (CI): 0.17-0.37]) and non-Hispanic black (aOR: 0.44 [95% CI: 0.30-0.62]) CSHCN were less likely to reside in a high-performance than in a low-performance state. Compared with CSHCN who had a medical home or adequate insurance coverage, CSHCN who did not have a medical home or adequate insurance coverage were less likely to reside in a high-performance than in a low-performance state (aOR: 0.73 [95% CI: 0.57-0.95]; aOR: 0.73 [95% CI: 0.58-0.93], respectively). Key factors found to be important in a state's performance on provision of transition services to CSHCN were race/ethnicity and having a medical home and adequate insurance coverage. Efforts to support the Maternal and Child Health Bureau's integration of system-level factors in quality-improvement activities, particularly establishing a medical home and attaining and maintaining adequate insurance, are likely to help states improve their performance on provision of transition services.

Ectrodactyly, Ectodermal dysplasia, and Cleft Lip-Palate Syndrome; Its Association with Conductive Hearing Loss

Science.gov (United States)

Robinson, Geoffrey C.; And Others

1973-01-01

Conductive hearing loss associated with the ectrodactyly, ectodermal dysplasia, and cleft lip palate syndrome was reported in one sporadic case and in a pedigree with four cases in three generations. (GW)

Intimate partner violence among pregnant women in Rwanda, its associated risk factors and relationship to ANC services attendance: a population-based study.

Science.gov (United States)

Rurangirwa, Akashi Andrew; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

2017-02-22

To investigate the prevalence of four forms of intimate partner violence during pregnancy in Rwandan women, associated sociodemographic and psychosocial factors and relationship to antenatal care service usage. This was a cross-sectional population-based study conducted in the Northern province of Rwanda and in Kigali city. A total of 921 women who gave birth within the past 13 months were included. Villages in the study area were selected using a multistage random sampling technique and community health workers helped in identifying eligible participants. Clinical psychologists, nurses or midwives carried out face-to-face interviews using a structured questionnaire. Bivariable and multivariable logistic regression were used to assess associations. The prevalence rates of physical, sexual, psychological violence and controlling behaviour during pregnancy were 10.2% (95% CI 8.3 to 12.2), 9.7% (95% CI 7.8 to 11.6), 17.0% (95% CI 14.6 to 19.4) and 20.0% (95% CI 17.4 to 22.6), respectively. Usage of antenatal care services was less common among women who reported controlling behaviour (OR) 1.93 (95% CI 1.34 to 2.79). No statistically significant associations between physical, psychological and sexual violence and antenatal care usage were found. Low socioeconomic status was associated with physical violence exposure (OR) 2.27 (95% CI 1.29 to 3.98). Also, young age, living in urban areas and poor social support were statistically significant in their associations with violence exposure during pregnancy. Intimate partner violence inquiry should be included in the standard antenatal care services package and professionals should be trained in giving support, advice and care to those exposed. Gender-based violence is criminalised behaviour in Rwanda; existing policies and laws must be followed and awareness raised in society for preventive purposes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

78 FR 17652 - Tri-State Generation and Transmission Association, Inc. v. Public Service Company of New Mexico...

Science.gov (United States)

2013-03-22

... Generation and Transmission Association, Inc. v. Public Service Company of New Mexico; Notice of Complaint... CFR 385.206 and 18 CFR 385.212, Tri-State Generation and Transmission Association, Inc. (Complainant), filed a complaint against the Public Service Company of New Mexico (Respondent or PNM) alleging that...

Service Journalism in the Association Magazine: A Case Study of the "Angus Journal."

Science.gov (United States)

Jeffers, Dennis W.

Examining the role of service journalism in association magazines (magazines focusing on technical and educational information relating to specific practices of association members), a case study of the "Angus Journal" (a monthly magazine devoted to the beef breeding industry) investigated the problem of determining the amount of service…

Opportunities of Trade in Services between the EU and Ukraine: the Case of Telecommunications Services under the GATS and the Association Agreement

DEFF Research Database (Denmark)

Batura, Olga; Kretova, Olga A.

This working paper studies the legal and regulatory conditions for trade in ser- vices between the European Union (EU) and Ukraine on the example of tele- communications services that are important carrier services for various busi- ness activities in the cross-border trade. The paper outlines...... the general frame- work for trade in services under the GATS as expressed in the commitments undertaken by Ukraine and examines the detailed provisions of the EU- Ukraine Association Agreement on trade liberalisation and regulatory approx- imation that is a WTO-extra agreement. It also provides an overview...... – the internal mar- ket treatment – is difficult to reach due to unclear and complicated rules on regulatory approximation. Key words: EU, Ukraine, trade in services, telecommunications services, liber- alisation, regulatory approximation...

[Determinants of dental services utilization by adults: a population-based study in Florianópolis, Santa Catarina State, Brazil].

Science.gov (United States)

Miranda, Camila Dal-Bó Coradini; Peres, Marco Aurélio

2013-11-01

This study aimed to estimate the prevalence of dental services utilization by adults and to identify associated socioeconomic, demographic, behavioral, and self-awareness factors. A cross-sectional population-based study was conducted with adults living in the urban area of Florianópolis, Santa Catarina State, Brazil, in 2009. Associations were tested between use of dental services and predisposing, enabling, and needs-based variables. Multivariate analysis was conducted using Poisson regression with estimates of prevalence ratios and was stratified by place of last dental appointment. Prevalence of dental services utilization was 66% (95%CI: 62.9-70.7). Dental visits were 20% more frequent among women and 72% more frequent among individuals with more schooling (the latter in both public and private dental services). Individuals with private dental plans used dental services 13% more than those without. Schooling was the most important variable in predicting utilization. The study's results show the importance of monitoring associated factors in order to promote more equitable use of dental services.

The nature of science and technology for pre-service chemistry teacher: A case of techno-chemistry experiment "From Stannum Metalicum to conductive glass"

Science.gov (United States)

Mudzakir, A.; Widhiyanti, T.; Hernani, Arifin, M.; Lestari, A. N.; Jauhariansyah, S.

2017-08-01

The study was conducted to address the problems related to low Indonesian students' scientific literacy as revealed in the PISA (Program for International Student Assessment) since 2000-2015. Science teachers (e.g. chemistry teacher) must recognize the nature of science (NOS) to assist their students in preparing an explanation of a phenomenon scientifically correctly. Teachers also need to understand critically about nature of technology (NOT) and it relationship with science as well as society. To integrate those two kinds of knowledge (NOS and NOT), we can conduct a techno-science activity, which integrate the technology to science course in pre-service teacher education program, so that they can improve their knowledge about nature of science and technology (NOST) and pedagogical content knowledge related to NOST. The purpose of this study was to construct an inquiry based laboratory activity worksheet for making conductive glass so that the pre-service teacher could explain how the structure of the semiconductor Fluor doped Tin Oxide (SnO2.F) affect their performance. This study we conducted, described how to design a pre-service chemistry teacher education course that can improve recognizing view of NOST by using a framework called model of educational reconstruction (MER). The scientific activities in the course were guided inquiry based techno-chemistry experiments involving "From Stannum Metallicum to Conductive Glass". Conductive glasses are interesting subject research for several reason. The application of this technology could be found on solar cell, OLED, and display panel. The doped Tin dioxide has been deposited on glass substrate using the spray pyrolysis technique at 400-550°C substrate temperature, 4-5 times, 20 cm gap between glass and sprayer and 450 angle to form a thin film which will act as electrical contact. The resistivity is about 0.5 - 15Ω. The product resulted on this study was rated by several expert to find if the worksheet could

Factors associated with worker slipping in limited-service restaurants.

Science.gov (United States)

Courtney, Theodore K; Verma, Santosh K; Huang, Yueng-Hsiang; Chang, Wen-Ruey; Li, Kai Way; Filiaggi, Alfred J

2010-02-01

Slips, trips and falls (STF) are responsible for a substantial injury burden in the global workplace. Restaurant environments are challenged by STF. This study assessed individual and work environment factors related to slipping in US limited-service restaurant workers. Workers in 10 limited-service restaurants in Massachusetts were recruited to participate. Workers' occupational slip and/or fall history within the past 4 weeks was collected by multilingual written questionnaires. Age, gender, job tenure, work hours per week and work shift were also collected. Shoe type, condition and gross shoe contamination were visually assessed. Floor friction was measured and each restaurant's overall mean coefficient of friction (COF) was calculated. The logistic generalised estimating equations model was used to compute adjusted odds ratios (OR). Of 125 workers, 42 reported one or more slips in the past 4 weeks with two reporting a resultant fall. Results from multivariable regression showed that higher restaurant mean COF was significantly associated with a decreased risk of self-reported slipping (OR 0.59, 95% CI 0.42 to 0.82). From the highest to the lowest COF restaurant, the odds of a positive slip history increased by a factor of more than seven. Younger age, male gender, lower weekly work hours and the presence of gross contamination on worker's shoe sole were also associated with increased odds of slip history. Published findings of an association between friction and slipping and falling in actual work environments are rare. The findings suggest that effective intervention strategies to reduce the risk of slips and falls in restaurant workers could include increasing COF and improving housekeeping practices.

Skilled delivery service utilization and its association with the establishment of Women's Health Development Army in Yeky district, South West Ethiopia: a multilevel analysis.

Science.gov (United States)

Negero, Melese Girmaye; Mitike, Yifru Berhan; Worku, Abebaw Gebeyehu; Abota, Tafesse Lamaro

2018-01-30

Because of the unacceptably high maternal and perinatal morbidity and mortality, the government of Ethiopia has established health extension program with a community-based network involving health extension workers (HEWs) and a community level women organization which is known as "Women's Health Development Army" (WHDA). Currently, the HEWs and WHDA network is the approach preferred by the government to register pregnant women and encourage them to link in the healthcare system. However, its association with skilled delivery service utilization is not well known. A community-based cross-sectional study was conducted from January to February 2015. Within 380 clusters of WHDA, a total of 748 reproductive-age women who gave birth in 1 year preceding the study, were included using multistage sampling technique. The data were entered into EPI info version 7 statistical software and exported to STATA version 11 for analysis. Multilevel analysis technique was applied to check for an association of selected variables with a utilization of skilled delivery service. About 45% of women have received skilled delivery care. A significant heterogeneity was observed between "Women's Health Development Teams (clusters)" for skilled delivery care service utilization which explains about 62% of the total variation. Individual-level predictors including urban residence [AOR (95% CI) 35.10 (4.62, 266.52)], previous exposure of complications [AOR (95% CI) 3.81 (1.60, 9.08)], at least four ANC visits [AOR (95% CI) 7.44 (1.48, 37.42)] and preference of skilled personnel [AOR (95% CI) 8.11 (2.61, 25.15)] were significantly associated with skilled delivery service use. Among cluster level variables, the distance of clusters within 2 km radius from the nearest health facility was significantly associated [AOR (95% CI) 6.03 (1.92, 18.93)] with skilled delivery service utilization. In this study, significant variation among clusters of WHDA was observed. Both individual and cluster level

Changes in Service and Associated Ridership Impacts near a New Light Rail Transit Line

Directory of Open Access Journals (Sweden)

Jeongwoo Lee

2017-10-01

Full Text Available Los Angeles (LA, for many years a city with limited rail transit, is substantially expanding its public transit system. This paradigm change in transportation policy and investment creates new requirements for monitoring. One area needing evaluation is whether new, high quality transit options, such as light rail, near existing transit services increase sustainable transportation mode shares and reduce car travel. Few studies have explored light rail’s role as a catalyst to increase overall transit use and achieve sustainability goals within an auto-oriented city like LA. Metro’s data show that trips taken on its bus and rail system dropped overall by 10.5% between 2009 and 2016, but its rail ridership grew 21% during the same period due to the debut of the Gold Line and Expo Line extensions. We analyze changes to bus service and associated ridership impacts that resulted from the opening of these two LRT lines in LA. The immediate effect of the city’s bus service changes along the Gold Line light rail extension appear to be associated with a net “bus plus rail” ridership decline in that corridor. In contrast, the Expo Line corridor experienced an initial increase in ridership during the two years immediately after its opening, possibly because the bus service was not reduced by the same magnitude as along the Gold Line extension. Our findings indicate that changes in bus service made to coincide with the introduction of new light rail transit (LRT can negatively affect the overall transit ridership in the corridor. Planners and policy makers should closely monitor changes in bus service and ridership associated with new rail transit to ensure investments results in an overall net increase in more sustainable travel.

Ecosystem-service tradeoffs associated with switching from annual to perennial energy crops in riparian zones of the US Midwest.

Directory of Open Access Journals (Sweden)

Timothy D Meehan

Full Text Available Integration of energy crops into agricultural landscapes could promote sustainability if they are placed in ways that foster multiple ecosystem services and mitigate ecosystem disservices from existing crops. We conducted a modeling study to investigate how replacing annual energy crops with perennial energy crops along Wisconsin waterways could affect a variety of provisioning and regulating ecosystem services. We found that a switch from continuous corn production to perennial-grass production decreased annual income provisioning by 75%, although it increased annual energy provisioning by 33%, decreased annual phosphorous loading to surface water by 29%, increased below-ground carbon sequestration by 30%, decreased annual nitrous oxide emissions by 84%, increased an index of pollinator abundance by an average of 11%, and increased an index of biocontrol potential by an average of 6%. We expressed the tradeoffs between income provisioning and other ecosystem services as benefit-cost ratios. Benefit-cost ratios averaged 12.06 GJ of additional net energy, 0.84 kg of avoided phosphorus pollution, 18.97 Mg of sequestered carbon, and 1.99 kg of avoided nitrous oxide emissions for every $1,000 reduction in income. These ratios varied spatially, from 2- to 70-fold depending on the ecosystem service. Benefit-cost ratios for different ecosystem services were generally correlated within watersheds, suggesting the presence of hotspots--watersheds where increases in multiple ecosystem services would come at lower-than-average opportunity costs. When assessing the monetary value of ecosystem services relative to existing conservation programs and environmental markets, the overall value of enhanced services associated with adoption of perennial energy crops was far lower than the opportunity cost. However, when we monitized services using estimates for the social costs of pollution, the value of enhanced services far exceeded the opportunity cost. This

Ecosystem services provided by bats.

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

2011-03-01

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

Predisposing, enabling, and need factors associated with high service use in a public mental health system.

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Lindamer, Laurie A; Liu, Lin; Sommerfeld, David H; Folsom, David P; Hawthorne, William; Garcia, Piedad; Aarons, Gregory A; Jeste, Dilip V

2012-05-01

The purpose of this study was twofold: (1) To investigate the individual- and system-level characteristics associated with high utilization of acute mental health services according to a widely-used theory of service use-Andersen's Behavioral Model of Health Service Use -in individuals enrolled in a large, public-funded mental health system; and (2) To document service utilization by high use consumers prior to a transformation of the service delivery system. We analyzed data from 10,128 individuals receiving care in a large public mental health system from fiscal years 2000-2004. Subjects with information in the database for the index year (fiscal year 2000-2001) and all of the following 3 years were included in this study. Using logistic regression, we identified predisposing, enabling, and need characteristics associated with being categorized as a single-year high use consumer (HU: >3 acute care episodes in a single year) or multiple-year HU (>3 acute care episodes in more than 1 year). Thirteen percent of the sample met the criteria for being a single-year HU and an additional 8% met the definition for multiple-year HU. Although some predisposing factors were significantly associated with an increased likelihood of being classified as a HU (younger age and female gender) relative to non-HUs, the characteristics with the strongest associations with the HU definition, when controlling for all other factors, were enabling and need factors. Homelessness was associated with 115% increase in the odds of ever being classified as a HU compared to those living independently or with family and others. Having insurance was associated with increased odds of being classified as a HU by about 19% relative to non-HUs. Attending four or more outpatient visits was an enabling factor that decreased the chances of being defined as a HU. Need factors, such as having a diagnosis of schizophrenia, bipolar disorder or other psychotic disorder or having a substance use disorder

Association Between Helicopter vs Ground Emergency Medical Services and Survival for Adults With Major Trauma

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Galvagno, Samuel M.; Haut, Elliott R.; Zafar, S. Nabeel; Millin, Michael G.; Efron, David T.; Koenig, George J.; Baker, Susan P.; Bowman, Stephen M.; Pronovost, Peter J.; Haider, Adil H.

2012-01-01

Context Helicopter emergency medical services and their possible effect on outcomes for traumatically injured patients remain a subject of debate. Because helicopter services are a limited and expensive resource, a methodologically rigorous investigation of its effectiveness compared with ground emergency medical services is warranted. Objective To assess the association between the use of helicopter vs ground services and survival among adults with serious traumatic injuries. Design, Setting, and Participants Retrospective cohort study involving 223 475 patients older than 15 years, having an injury severity score higher than 15, and sustaining blunt or penetrating trauma that required transport to US level I or II trauma centers and whose data were recorded in the 2007–2009 versions of the American College of Surgeons National Trauma Data Bank. Interventions Transport by helicopter or ground emergency services to level I or level II trauma centers. Main Outcome Measures Survival to hospital discharge and discharge disposition. Results A total of 61 909 patients were transported by helicopter and 161 566 patients were transported by ground. Overall, 7813 patients (12.6%) transported by helicopter died compared with 17 775 patients (11%) transported by ground services. Before propensity score matching, patients transported by helicopter to level I and level II trauma centers had higher Injury Severity Scores. In the propensity score–matched multivariable regression model, for patients transported to level I trauma centers, helicopter transport was associated with an improved odds of survival compared with ground transport (odds ratio [OR], 1.16; 95% CI, 1.14–1.17; P<.001; absolute risk reduction [ARR], 1.5%). For patients transported to level II trauma centers, helicopter transport was associated with an improved odds of survival (OR, 1.15; 95% CI, 1.13–1.17; P < .001; ARR, 1.4%). A greater proportion (18.2%) of those transported to level I trauma centers

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

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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

NDE of Possible Service-Induced PWSCC in Control Rod Drive Mechanism Housings Removed from Service

International Nuclear Information System (INIS)

Cumblidge, Stephen E.; Doctor, Steven R.; Schuster, George J.; Harris, Robert V.; Crawford, Susan L.

2006-01-01

Studies being conducted at the Pacific Northwest National Laboratory (PNNL) in Richland, Washington are being performed to assess the effectiveness of nondestructive examination (NDE) techniques on removed-from-service control rod drive mechanism (CRDM) nozzles and the associated J-groove attachment welds. This work is being performed to provide information to the United States Nuclear Regulatory Commission (US NRC) on the effectiveness of NDE techniques such as ultrasonic testing (UT), eddy current testing (ET), and visual testing (VT) as related to the in-service inspection of CRDM nozzles and J-groove weldments, and to enhance the knowledge base of primary water stress corrosion cracking (PWSCC) through destructive characterization of the CRDM assemblies. The basic NDE measurements follow standard industry techniques for conducting in-service inspections of CRDM nozzles and the crown of the J-groove welds and buttering. In addition, laboratory-based NDE methods were employed to conduct inspections of the CRDM assemblies, with particular emphasis on the J-groove weld and buttering. This paper describes the NDE measurements that were employed on the two CRDMs to detect and characterize the indications and the analysis of these indications. The two CRDM assemblies were removed from service from the North Anna 2 vessel head, including the CRDM nozzle, the J-groove weld, buttering, and a portion of the ferritic head material. One nozzle contains suspected PWSCC, based on in-service inspection data; the second contains evidence suggesting through-wall leakage, although this was unconfirmed. A destructive test plan is being developed to directly characterize the indications found using nondestructive testing. The results of this destructive testing will be included when the destructive testing is completed.

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

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

2016-11-01

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

Association between perceived stress, multimorbidity and primary care health services: a Danish population-based cohort study.

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Prior, Anders; Vestergaard, Mogens; Larsen, Karen Kjær; Fenger-Grøn, Morten

2018-02-24

Mental stress is common in the general population. Mounting evidence suggests that mental stress is associated with multimorbidity, suboptimal care and increased mortality. Delivering healthcare in a biopsychosocial context is key for general practitioners (GPs), but it remains unclear how persons with high levels of perceived stress are managed in primary care. We aimed to describe the association between perceived stress and primary care services by focusing on mental health-related activities and markers of elective/acute care while accounting for mental-physical multimorbidity. Population-based cohort study. Primary healthcare in Denmark. 118 410 participants from the Danish National Health Survey 2010 followed for 1 year. Information on perceived stress and lifestyle was obtained from a survey questionnaire. Information on multimorbidity was obtained from health registers. General daytime consultations, out-of-hours services, mental health-related services and chronic care services in primary care obtained from health registers. Perceived stress levels were associated with primary care activity in a dose-response relation when adjusted for underlying conditions, lifestyle and socioeconomic factors. In the highest stress quintile, 6.8% attended GP talk therapy (highest vs lowest quintile, adjusted incidence rate ratios (IRR): 4.96, 95% CI 4.20 to 5.86), 3.3% consulted a psychologist (IRR: 6.49, 95% CI 4.90 to 8.58), 21.5% redeemed an antidepressant prescription (IRR: 4.62, 95% CI 4.03 to 5.31), 23.8% attended annual chronic care consultations (IRR: 1.22, 95% CI 1.16 to 1.29) and 26.1% used out-of-hours services (IRR: 1.47, 95% CI 1.51 to 1.68). For those with multimorbidity, stress was associated with more out-of-hours services, but not with more chronic care services. Persons with high stress levels generally had higher use of primary healthcare, 4-6 times higher use of mental health-related services (most often in the form of psychotropic drug

17 CFR 250.88 - Approval of mutual service companies; organization and conduct of business of subsidiary service...

Science.gov (United States)

2010-04-01

... and economical performance of services or construction or sale of goods by the company for or to its.... (a) Application for approval of a company as a mutual service company shall be filed by the company... finds that the company is so organized as to capitalization, ownership by, and representation of, member...

Evaluation of service quality of hospital outpatient department services.

Science.gov (United States)

Chakravarty, Abhijit

2011-07-01

It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.

Child sex moderates the association between negative parenting and childhood conduct problems.

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Tung, Irene; Li, James J; Lee, Steve S

2012-01-01

Although multiple dimensions of negative parenting behavior are associated with childhood conduct problems (CP), there is relatively little research on whether the association is equally robust in boys and girls. To improve the specificity of current models of negative parenting and offspring CP, we explored the potential moderating role of child sex in a sample of 179 5- to 10-year-old ethnically diverse boys and girls with and without attention-deficit/hyperactivity disorder (ADHD) who were assessed using multiple methods (i.e., rating scales, semistructured interviews) and informants (i.e., parents, teachers). Controlling for children's age, race-ethnicity, and ADHD diagnostic status (i.e., ADHD vs. non-ADHD), inconsistent discipline was positively associated with offspring aggression and rule-breaking behavior, whereas harsh punishment was positively associated with aggression, rule-breaking behavior, and oppositional defiant disorder symptoms. Furthermore, child sex significantly moderated the association of inconsistent discipline and aggression and rule-breaking behavior, such that inconsistent discipline was positively associated with CP for boys, but not for girls. Given the centrality of negative parenting to theories of and efficacious interventions for aggression and CP, we discuss these findings within a developmental psychopathology framework and consider their implications for intervention. © 2012 Wiley Periodicals, Inc.

The Modernization and Associated Restructuring of the National Weather Service: An Overview.

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Friday, Elbert W., Jr.

1994-01-01

The scientific understanding of the atmosphere and the ability to forecast large-and small-scale hydrometeorological phenomena have increased dramatically over the last two decades. As a result, the National Oceanic and Atmospheric Administration has set an ambitious goal: to modernize the National Weather Service (NWS)through the deployment of proven observational, information processing, and communications technologies, and to establish an associated cost-effective operational structure. The modernization and associated restructuring of the NWS will assure that the major advances that have been made in our ability to observe and understand the atmosphere are applied to the practical problems of providing atmospheric and hydrologic services to the nation. Implementation and practice of the new science will improve forecasts, provide more reliable detection of and warnings for severe weather and flooding, achieve more uniform hydrometeorological services across the nation, permit a more cost-effective NWS, and increase productivity among NWS employees. The changes proposed by the NWS will allow increased productivity and efficiency for any entity dependent on weather information, including local, state, and federal government agencies; researchers; private-sector meteorologists; private industry; and resource management organizations. This is the first in a series of articles intended to highlight these changes.

Management of poisoning with ethylene glycol and methanol in the UK: a prospective study conducted by the National Poisons Information Service (NPIS).

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Thanacoody, Ruben H K; Gilfillan, Claire; Bradberry, Sally M; Davies, Jeremy; Jackson, Gill; Vale, Allister J; Thompson, John P; Eddleston, Michael; Thomas, Simon H L

2016-01-01

Poisoning with methanol and ethylene glycol can cause serious morbidity and mortality. Specific treatment involves the use of antidotes (fomepizole or ethanol) with or without extracorporeal elimination techniques. A prospective audit of patients with methanol or ethylene glycol poisoning reported by telephone to the National Poisons Information Service (NPIS) in the UK was conducted during the 2010 calendar year and repeated during the 2012 calendar year. The study was conducted to determine the frequency of clinically significant systemic toxicity and requirement for antidote use and to compare outcomes and rates of adverse reaction and other problems in use between ethanol and fomepizole. The NPIS received 1315 enquiries involving methanol or ethylene glycol, relating to 1070 individual exposures over the 2-year period. Of the 548 enquiries originating from hospitals, 329 involved systemic exposures (enteral or parenteral as opposed to topical exposure), of which 216 (66%) received an antidote (204 for ethylene glycol and 12 for methanol), and 90 (27%) extracorporeal treatment (86 for ethylene glycol and 4 for methanol). Comparing ethanol with fomepizole, adverse reactions (16/131 vs. 2/125, p methanol results in hospitalisation at least 2-3 times per week on average in the UK. No difference in outcome was detected between ethanol and fomepizole-treated patients, but ethanol was associated with more frequent adverse reactions.

A service brokering and recommendation mechanism for better selecting cloud services.

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Gui, Zhipeng; Yang, Chaowei; Xia, Jizhe; Huang, Qunying; Liu, Kai; Li, Zhenlong; Yu, Manzhu; Sun, Min; Zhou, Nanyin; Jin, Baoxuan

2014-01-01

Cloud computing is becoming the new generation computing infrastructure, and many cloud vendors provide different types of cloud services. How to choose the best cloud services for specific applications is very challenging. Addressing this challenge requires balancing multiple factors, such as business demands, technologies, policies and preferences in addition to the computing requirements. This paper recommends a mechanism for selecting the best public cloud service at the levels of Infrastructure as a Service (IaaS) and Platform as a Service (PaaS). A systematic framework and associated workflow include cloud service filtration, solution generation, evaluation, and selection of public cloud services. Specifically, we propose the following: a hierarchical information model for integrating heterogeneous cloud information from different providers and a corresponding cloud information collecting mechanism; a cloud service classification model for categorizing and filtering cloud services and an application requirement schema for providing rules for creating application-specific configuration solutions; and a preference-aware solution evaluation mode for evaluating and recommending solutions according to the preferences of application providers. To test the proposed framework and methodologies, a cloud service advisory tool prototype was developed after which relevant experiments were conducted. The results show that the proposed system collects/updates/records the cloud information from multiple mainstream public cloud services in real-time, generates feasible cloud configuration solutions according to user specifications and acceptable cost predication, assesses solutions from multiple aspects (e.g., computing capability, potential cost and Service Level Agreement, SLA) and offers rational recommendations based on user preferences and practical cloud provisioning; and visually presents and compares solutions through an interactive web Graphical User Interface (GUI).

A Service Brokering and Recommendation Mechanism for Better Selecting Cloud Services

Science.gov (United States)

Gui, Zhipeng; Yang, Chaowei; Xia, Jizhe; Huang, Qunying; Liu, Kai; Li, Zhenlong; Yu, Manzhu; Sun, Min; Zhou, Nanyin; Jin, Baoxuan

2014-01-01

Cloud computing is becoming the new generation computing infrastructure, and many cloud vendors provide different types of cloud services. How to choose the best cloud services for specific applications is very challenging. Addressing this challenge requires balancing multiple factors, such as business demands, technologies, policies and preferences in addition to the computing requirements. This paper recommends a mechanism for selecting the best public cloud service at the levels of Infrastructure as a Service (IaaS) and Platform as a Service (PaaS). A systematic framework and associated workflow include cloud service filtration, solution generation, evaluation, and selection of public cloud services. Specifically, we propose the following: a hierarchical information model for integrating heterogeneous cloud information from different providers and a corresponding cloud information collecting mechanism; a cloud service classification model for categorizing and filtering cloud services and an application requirement schema for providing rules for creating application-specific configuration solutions; and a preference-aware solution evaluation mode for evaluating and recommending solutions according to the preferences of application providers. To test the proposed framework and methodologies, a cloud service advisory tool prototype was developed after which relevant experiments were conducted. The results show that the proposed system collects/updates/records the cloud information from multiple mainstream public cloud services in real-time, generates feasible cloud configuration solutions according to user specifications and acceptable cost predication, assesses solutions from multiple aspects (e.g., computing capability, potential cost and Service Level Agreement, SLA) and offers rational recommendations based on user preferences and practical cloud provisioning; and visually presents and compares solutions through an interactive web Graphical User Interface (GUI

A mixed-methods approach to conducting Internal Revenue Service-compliant community health needs assessments: a case example for nonprofit hospital leaders

Directory of Open Access Journals (Sweden)

Oglesby WH

2014-10-01

Full Text Available Willie H Oglesby, Ken Slenkovich Department of Health Policy and Management, College of Public Health, Kent State University, Kent, OH, USA Background: The Patient Protection and Affordable Care Act created new requirements for nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA at least once every 3 years, with a significant tax penalty for noncompliance. While some resources exist to help nonprofit hospital leaders conduct various aspects of a CHNA, few reflect the new Internal Revenue Service requirements. Methods: Many different models of CHNAs have emerged over the years. Although each has its unique features, the essential elements of a CHNA include engaging stakeholders, defining the community, gathering sufficient representative data, prioritizing information, and reporting results. In this paper, we expand upon this basic approach by offering a practical step-by-step guide to conducting CHNAs that meets new Internal Revenue Service regulations. Results: We developed and tested this methodology in partnership with several nonprofit hospital systems in Northeast Ohio, USA. In this paper, we discuss our use of the methodology and identify recommendations for other nonprofit hospital leaders. Conclusion: The methodology presented in this paper is a cost-effective approach to satisfying new CHNA requirements and nonprofit hospital leaders should consider using it or modifying it to fit their unique needs. Keywords: Affordable Care Act, CHNA, community benefit, community hospital

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

Directory of Open Access Journals (Sweden)

Hannah H Leslie

2017-12-01

Full Text Available It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs-the structural inputs to care-predicts the clinical quality of care provided to patients.Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC, sick-child care, and (in 2 countries labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania. Facilities with similar

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

Science.gov (United States)

Leslie, Hannah H; Sun, Zeye; Kruk, Margaret E

2017-12-01

It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients. Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores

Provision of financial services, violation of public law conduct of business rules, and private law norm settinga Dutch, German, and European perspective

NARCIS (Netherlands)

Wallinga, Marnix

2014-01-01

Legal uncertainty exists with regards to the relationship between a violation of public law conduct of business rules and private law norm setting. In the area of financial services this uncertainty has led to the question whether private law duties of care can deviate from the norms pursuant to

Barriers to accessing low vision services.

Science.gov (United States)

Pollard, Tamara L; Simpson, John A; Lamoureux, Ecosse L; Keeffe, Jill E

2003-07-01

To investigate barriers to accessing low vision services in Australia. Adults with a vision impairment (vision difficulties, duration of vision loss and satisfaction with vision and also examined issues of awareness of low vision services and referral to services. Focus groups were also conducted with vision impaired (Vision Australia Foundation. The discussions were recorded and transcribed. The questionnaire revealed that referral to low vision services was associated with a greater degree of vision loss (p = 0.002) and a greater self-perception of low vision (p = 0.005) but that referral was not associated with satisfaction (p = 0.144) or difficulties related to vision (p = 0.169). Participants with mild and moderate vision impairment each reported similar levels of difficulties with daily activities and satisfaction with their vision (p > 0.05). However, there was a significant difference in the level of difficulties experienced with daily activities between those with mild-moderate and severe vision impairment (p low vision services related to awareness of services among the general public and eye care professionals, understanding of low vision and the services available, acceptance of low vision, the referral process, and transport. In addition to the expected difficulties with lack of awareness of services by people with low vision, many people do not understand what the services provide and do not identify themselves as having low vision. Knowledge of these barriers, from the perspective of people with low vision, can now be used to guide the development and content of future health-promotion campaigns.

Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

DEFF Research Database (Denmark)

Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis

2012-01-01

at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender......, disease duration, psychiatric inpatient admissions, and treatment site as covariates. RESULTS: The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy...

Prevalence of mental disorders in a population requesting health services at a primary health care center and its association with suicidal ideation and perceived disability

Directory of Open Access Journals (Sweden)

Mérida R. Rodríguez

2012-10-01

Full Text Available Objective: this study’s goal was to determine the most prevalent mental disorders and the impact on the perception of disability and suicidal ideation among the population from a primary health care center in the city of Cali. Methodology: a cross sectional study was conducted on 254 patients who were screened with the prime-md instrument. Descriptive statistics was used in the analysis to determine the most frequent disorders. Similarly, a multiple analysis with logistic and Poisson regressions using robust variance was conducted to determine the influence of mental disorders on disability and suicidal ideation. Results: most patients were female, young, and mature adults. Depression was present in 66.8% of all cases, followed by somatization disorder and anxiety. Half of the patients had had suicidal ideations at some point in their lives, and three out of four patients claimed to suffer from some kind of disability. Upon adjusting for the covariables, depression and anxiety disorders had a strong association with suicidal ideation and perceived disability that was overestimated by the logistic regression. Conclusion: depression and anxiety were the most common disorders and showed a strong association with suicidal ideation and disability. This is why it is necessary to screen for those disorders among adults using primary health care services. Likewise, we suggest considering Poisson regression with robust variance in cross-sectional studies in health services.

13 CFR 107.900 - Management fees for services provided to a Small Business by Licensee or its Associate.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Management fees for services... Licensees Management Services and Fees § 107.900 Management fees for services provided to a Small Business... apply to management services that you or your Associate provide to a Small Business that you do not...

Patterns of smoking and its association with psychosocial work conditions among blue-collar and service employees of hospitality venues in Shenyang, PR China.

Science.gov (United States)

Li, Xun; Liang, Huiying; Li, Xuelian; Guan, Peng; Yin, Zhihua; Zhou, Baosen

2010-01-27

To characterize the smoking patterns of hospitality employees in blue-collar and service occupations, and to examine its relations with psychosocial work conditions. The Shenyang Hospitality Industry Employees Survey-a face-to-face cross-sectional study of representative hospitality industry employees-was conducted between March and July 2008. A total of 4,213 workers were selected using stratified random cluster sampling designs, and final analyses were performed on 2,508 blue-collar and service subjects. Multilevel-logistic regression models were used to estimate the contribution of psychosocial work conditions to smoking status. Blue-collar and service employees smoked at a rate 1.4 times that of the general population (49.4% vs. 35.8%), more particularly for females (12.9% vs. 3.08%). Strain jobs had significantly higher odds ratio of daily smoking (OR 2.09, 95%CI: 1.28-3.41) compared to the relaxed category. The passive jobs (OR 2.01, 95%CI 1.27 to 3.17), highest job demands (OR 1.72, 95%CI: 1.13-2.61), and lowest job control (OR 2.56, 95%CI: 1.57-4.16) were also associated with a significantly higher daily smoking ratio. The negative relationship between job stability and smoking behavior was slightly stronger among daily than occasional smokers. However, neither job strain nor any of its components was found to be significantly associated with occasional smoking. Smoking in hospitality blue-collar and service employees is certainly a major occupational health problem in Shenyang. This evidence also suggests an association between psychosocial-work conditions and smoking status, and implies that more intervention studies where changes in work environment are carried out in combination with health promotion interventions should be performed.

Conduct Disorders and Social Maladjustments: Policies, Politics, and Programming. Working with Behavioral Disorders: CEC Mini-Library.

Science.gov (United States)

Wood, Frank H.; And Others

This booklet reviews the literature and examines issues associated with providing services to students who exhibit externalizing or acting-out behaviors in the schools. Considered are the following issues: eligibility (whether socially maladjusted or conduct-disordered students are eligible for special education); legal intent (intent of the…

Multimedia applications in differential services

International Nuclear Information System (INIS)

Mahfooz, S.; Merabti, M.; Pereira, R.

2003-01-01

In this paper we present a mechanism to provide Quality of Service (QoS) guarantees to different multimedia applications that share link bandwidth in IP-based differential services domain. In this mechanism weights are associated with each and to individual users according to their priorities. In order to evaluate the performance of our scheme we conducted simulations. The test data used portray different multimedia applications i.e. MPEG-2, IP telephony. The simulation results obtained show the effectiveness of our scheme for multimedia applications by allocating link share to each multimedia application and minimising end-to-end transmission delay 9Y bringing them in line with the recommended standard acceptable transmission delay for multimedia applications. This paper also presents extension to our proposed Relative Bandwidth Sharing (RES) scheme for differential services. We have identified and highlighted the role of border routers and core routers in differential services domain. Exploring features of Internet Protocol IPv6 in our architecture. (author)

The Association between Early Conduct Problems and Early Marijuana Use in College Students

Science.gov (United States)

Falls, Benjamin J.; Wish, Eric D.; Garnier, Laura M.; Caldeira, Kimberly M.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

2011-01-01

Early conduct problems have been linked to early marijuana use in adolescence. The present study examines this association in a sample of 1,076 college students that was divided into three groups: (1) early marijuana users (began marijuana use prior to age 15; N = 126), (2) late marijuana users (began marijuana use at or after age 15; N = 607),…

Associations of alcohol use disorder, alcohol use, housing, and service use in a homeless sample of 255 individuals followed over two years.

Science.gov (United States)

Asana, Olubunmi O; Ayvaci, Emine R; Pollio, David E; Hong, Barry A; North, Carol S

2018-03-29

Homeless individuals with alcohol use disorders have multiple comorbidities and therefore various service needs. Despite need for services, homeless individuals face numerous barriers to treatment. Little is known about the associations of specific services in relation to homelessness in the context of alcohol problems. The current study analyzed 2-year prospective longitudinal data on a homeless sample, examining relationships between alcohol use disorder, alcohol use, housing status, and service use over time. 255 of 400 individuals recruited systematically from shelters and street locations completed 3 annual assessments (69% completion). Data on lifetime and current psychiatric disorders, housing status, and past year service use were obtained and merged with service use data gathered from local agencies. GEE models were created to predict dependent outcome variables of stable housing, alcohol use, and service use in both follow-up years. Lifetime alcohol use disorder was positively associated with substance and medical service use. Alcohol problems did not hinder attainment of stable housing, and placement in housing did not necessarily increase risk for alcohol use. Stable housing was negatively associated with psychiatric and substance service use. In the second year, when alcohol use was finally associated with receiving substance services, it appears that these services provided a gateway to psychiatric services. The psychiatric services in turn appeared to provide a gateway to medical services. Alcohol use acted differently compared to lifetime alcohol use disorder in relation to service use. Lack of association between alcohol use and housing supports Housing First policy. Obtaining housing may have ameliorative effects on mental health, diminishing perceived need for psychiatric services. Services may also be more accessible during homelessness. Obtaining substance treatment may provide a gateway for those who use alcohol after becoming homeless to

Job coding (PCS 2003): feedback from a study conducted in an Occupational Health Service

Science.gov (United States)

Henrotin, Jean-Bernard; Vaissière, Monique; Etaix, Maryline; Malard, Stéphane; Dziurla, Mathieu; Lafon, Dominique

2016-10-19

Aim: To examine the quality of manual job coding carried out by occupational health teams with access to a software application that provides assistance in job and business sector coding (CAPS). Methods: Data from a study conducted in an Occupational Health Service were used to examine the first-level coding of 1,495 jobs by occupational health teams according to the French job classification entitled “PSC- Professions and socio-professional categories” (INSEE, 2003 version). A second level of coding was also performed by an experienced coder and the first and second level codes were compared. Agreement between the two coding systems was studied using the kappa coefficient (κ) and frequencies were compared by Chi2 tests. Results: Missing data or incorrect codes were observed for 14.5% of social groups (1 digit) and 25.7% of job codes (4 digits). While agreement between the first two levels of PCS 2003 appeared to be satisfactory (κ=0.73 and κ=0.75), imbalances in reassignment flows were effectively noted. The divergent job code rate was 48.2%. Variation in the frequency of socio-occupational variables was as high as 8.6% after correcting for missing data and divergent codes. Conclusions: Compared with other studies, the use of the CAPS tool appeared to provide effective coding assistance. However, our results indicate that job coding based on PSC 2003 should be conducted using ancillary data by personnel trained in the use of this tool.

ClaimAssociationService

Data.gov (United States)

Department of Veterans Affairs — Retrieves and updates a veteranÆs claim status and claim-rating association (claim association for current rating) from the Corporate database for a claim selected...

Factors associated with the utilization of institutional delivery services in Bangladesh.

Science.gov (United States)

Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael

2017-01-01

Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; pdelivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; pservice utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; pdelivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2

38 CFR 21.362 - Satisfactory conduct and cooperation.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Satisfactory conduct and.... Chapter 31 Conduct and Cooperation § 21.362 Satisfactory conduct and cooperation. (a) General. The... satisfactory conduct and cooperation in developing and implementing a program of rehabilitation services under...

Racism and health service utilisation: A systematic review and meta-analysis

Science.gov (United States)

Cormack, Donna; Harris, Ricci; Paradies, Yin

2017-01-01

Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field. PMID:29253855

Racism and health service utilisation: A systematic review and meta-analysis.

Science.gov (United States)

Ben, Jehonathan; Cormack, Donna; Harris, Ricci; Paradies, Yin

2017-01-01

Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field.

Factors associated with utilization of dental services in a long-term care facility: a descriptive cross-sectional study.

Science.gov (United States)

Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine

2017-03-01

To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

Science.gov (United States)

Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

2013-08-23

Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management. A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed. Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management. VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are

[Ambulance services in Copenhagen, Odense and Ringkøbing County. Results of the spot test conducted by the Ministry of Health and the County Councils Association in 1990. 1. Epidemiological data].

Science.gov (United States)

Trier, H; Larsen, C F

1992-02-17

In 1990, The Danish Ministry of Health and the County Council Association undertook a spot test investigation of the activities in connection with 3,182 emergency ambulance services (AU) in the Municipality of Copenhagen (a city), the Odense district (a large provincial town) and the County of Ringkøbing (a mixed rural and urban region). The investigation included data collected by the ambulance staff before hospitalization and the diagnoses on discharge from casualty and hospital departments. The frequency of AU per 1,000 population was found to be 101 annually in Copenhagen, 44 in Odense and 19 in the County of Ringkøbing. More than 10% of the services in all three regions did not result in transport of the patient to hospital treatment. The average age of the patients was 52 years in Copenhagen compared with 44 years in the other two regions. The age-specific frequency of AU for patients aged 0-4 year-old was nine times as great in Copenhagen than in Odense and the County of Ringkøbing and, where patients aged more than 80 years were concerned, the frequency was 4-10 times as great. In all three regions, the activities of ambulance services were most numerous between 6-16 hours and lowest during the period 0-6 hours. Services to patients' homes constituted 44-46% and to traffic regions 32-40%. Services on account of illness constituted 41-45% and, on account of accidents, 27-35%. In cases of rapid emergency transport (using signals), 78% of the ambulances had reached the patient within five minutes in Copenhagen as compared with 44% in Odense and the County of Ringkøbing.(ABSTRACT TRUNCATED AT 250 WORDS)

Association Between Parental Barriers to Accessing a Usual Source of Care and Children's Receipt of Preventive Services.

Science.gov (United States)

Bellettiere, John; Chuang, Emmeline; Hughes, Suzanne C; Quintanilla, Isaac; Hofstetter, C Richard; Hovell, Melbourne F

Preventive health services are important for child development, and parents play a key role in facilitating access to services. This study examined how parents' reasons for not having a usual source of care were associated with their children's receipt of preventive services. We used pooled data from the 2011-2014 National Health Interview Survey (n = 34 843 participants). Parents' reasons for not having a usual source of care were framed within the Penchansky and Thomas model of access and measured through 3 dichotomous indicators: financial barriers (affordability), attitudes and beliefs about health care (acceptability), and all other nonfinancial barriers (accessibility, accommodation, and availability). We used multivariable logistic regression models to test associations between parental barriers and children's receipt of past-year well-child care visits and influenza vaccinations, controlling for other child, family, and contextual factors. In 2014, 14.3% (weighted percentage) of children had at least 1 parent without a usual source of care. Children of parents without a usual source of care because they "don't need a doctor and/or haven't had any problems" or they "don't like, trust, or believe in doctors" had 35% lower odds of receiving well-child care (adjusted odds ratio = 0.65; 95% CI, 0.56-0.74) and 23% lower odds of receiving influenza vaccination (adjusted odds ratio = 0.77; 95% CI, 0.69-0.86) than children of parents without those attitudes and beliefs about health care. Financial and other nonfinancial parental barriers were not associated with children's receipt of preventive services. Results were independent of several factors relevant to children's access to preventive health care, including whether the child had a usual source of care. Parents' attitudes and beliefs about having a usual source of care were strongly associated with their children's receipt of recommended preventive health services. Rates of receipt of child preventive

Modeling the Association Between Home Care Service Use and Entry Into Residential Aged Care: A Cohort Study Using Routinely Collected Data.

Science.gov (United States)

Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Warland, Andrew; Westbrook, Johanna

2018-02-01

To examine home care service-related and person-based factors associated with time to entry into permanent residential aged care. Longitudinal cohort study using routinely collected client management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. A total of 1116 people aged 60 years and older who commenced home care services for higher-level needs between July 1, 2015 and June 30, 2016. Survival analysis methods were used to examine service-related and person-based factors that were associated with time between first home care service and entry into permanent residential aged care. Predictors included service hours per week, combination of service types, demographics, needs, hospital leave, and change in care level. Cluster analysis was used to determine patterns of types of services used. By December 31, 2016, 21.1% of people using home care services had entered into permanent residential care (n = 235). After adjusting for significant factors such as age and care needs, each hour of service received per week was associated with a 6% lower risk of entry into residential care (hazard ratio = 0.94, 95% confidence interval 0.90-0.98). People who were predominant users of social support services, those with an identified carer, and those born in a non-main English-speaking country also remained in their own homes for longer. Greater volume of home care services was associated with significantly delayed entry into permanent residential care. This study provides much-needed evidence about service outcomes that could be used to inform older adults' care choices. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

A Content Analysis of College Reading Association/Association of Literacy Educators and Researchers Teacher Education Publications: Past, Present, and Future

Science.gov (United States)

Schumm, Jeanne Shay; Lewis-Spector, Jill; Price, Debra; Doorn, Kristen

2014-01-01

The purpose of this investigation was to conduct a content analysis of the publications of the Association of Literacy Educators and Researchers (ALER), previously known as College Reading Association (CRA), in the area of preservice teacher education in literacy. As a service to the organization, 71 articles published in ALER's flagship…

Introduction of electronic referral from community associated with more timely review by secondary services.

Science.gov (United States)

Warren, J; White, S; Day, K J; Gu, Y; Pollock, M

2011-01-01

Electronic referral (eReferral) from community into public secondary healthcare services was introduced to 30 referring general medical practices and 28 hospital based services in late 2007. To measure the extent of uptake of eReferral and its association with changes in referral processing. Analysis of transactional data from the eReferral message service and the patient information management system of the affected hospital; interview of clinical, operational and management stakeholders. eReferral use rose steadily to 1000 transactions per month in 2008, thereafter showing moderate growth to 1200 per month in 2010. Rate of eReferral from the community in 2010 is estimated at 56% of total referrals to the hospital from general practice, and as 71% of referrals from those having done at least one referral electronically. Referral latency from letter date to hospital triage improves significantly from 2007 to 2009 (psystem usability issues. With eReferrals, a referral's status can be checked, and its content read, by any authorized user at any time. The period of eReferral uptake was associated with significant speed-up in referral processing without changes in staffing levels. The eReferral system provides a foundation for further innovation in the community-secondary interface, such as electronic decision support and shared care planning systems. We observed substantial rapid voluntary uptake of eReferrals associated with faster, more reliable and more transparent referral processing.

Level of service at airport passenger terminals

Directory of Open Access Journals (Sweden)

Tasić Tamara D.

2016-01-01

Full Text Available Airport terminals are designed by level of service standards which are regulated by International Air Transport Association (IATA. Level of service offered to passengers, regarding to the primary processes, is not necessarily equivalent to the level of service perceived by them. The fact that passengers spending longer times in terminals makes the secondary processes more important in passenger experience. Aiming to improving airport attractiveness, and business success, passenger perception is approached by paying close attention. This paper discusses the two aspects of level of service. Concept of level of service used in air traffic industry with purpose of designing and planning of passenger terminal is derived from the Highway Capacity Manual. Subject of the paper regards last changes which have been introduced during 2014. Second part of the paper explains the needs of examining and analyzing passenger perception from the management point of view, and gives overview of methods which are conducted during researches. Similarities and differences are shown among measurements of level of service and perceived level of service, including the importance of these aspects mutual complementing.

The State of the Psychology Health Service Provider Workforce

Science.gov (United States)

Michalski, Daniel S.; Kohout, Jessica L.

2011-01-01

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

A conductance study of guanidinium chloride, thiocyanate, sulfate, and carbonate in dilute aqueous solutions: ion-association and carbonate hydrolysis effects.

Science.gov (United States)

Hunger, Johannes; Neueder, Roland; Buchner, Richard; Apelblat, Alexander

2013-01-17

We study the conductance of dilute aqueous solutions for a series of guandinium salts at 298.15 K. The experimental molar conductivities were analyzed within the framework of the Quint-Viallard theory in combination with Debye-Hückel activity coefficients. From this analysis, we find no evidence for significant ion association in aqueous solutions of guanidinium chloride (GdmCl) and guanidinium thiocyanate (GdmSCN), and the molar conductivity of these electrolytes can be modeled assuming a complete dissociation. The limiting ionic conductivity of the guanidinium ion (Gdm(+)) is accurately determined to λ(Gdm(+)) = 51.45 ± 0.10 S cm(2) mol(-1). For the bivalent salts guanidinium sulfate (Gdm(2)SO(4)) and guanidinium carbonate (Gdm(2)CO(3)), the molar conductivities show small deviations from ideal (fully dissociated electrolyte) behavior, which are related to weak ion association in solution. Furthermore, for solutions of Gdm(2)CO(3), the hydrolysis of the carbonate anion leads to distinctively increased molar conductivities at high dilutions. The observed ion association is rather weak for all studied electrolytes and cannot explain the different protein denaturing activities of the studied guanidinium salts, as has been proposed previously.

Sex differences in abnormal white matter development associated with conduct disorder in children.

Science.gov (United States)

Decety, Jean; Yoder, Keith J; Lahey, Benjamin B

2015-08-30

Associations between white matter pathway abnormalities and antisocial personality disorder in adults are well replicated, and there is some evidence for an association of white matter abnormalities with conduct disorder (CD) in adolescents. In this study, white matter maturation using diffusion tensor imaging (DTI) was examined in 110 children aged 10.0 ± 0.8 years selected to vary widely in their numbers of CD symptoms. The results replicated age-related increases in fractional anisotropy (FA) found in previous studies. There was not a significant association between the number of CD symptoms and FA, but CD symptoms were found to be significantly associated with greater axial and radial diffusivity in a broad range of white matter tracts, particularly in girls. In complementary analyses, there were similar significant differences in axial and radial diffusivity between children who met diagnostic criteria for CD and healthy children with no symptoms of CD, particularly in girls. Brain structural abnormalities may contribute to the emergence of CD in childhood, perhaps playing a greater role in girls. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Participation in Organized Activities and Conduct Problems in Elementary School: The Mediating Effect of Social Skills

Science.gov (United States)

Denault, Anne-Sophie; Déry, Michèle

2015-01-01

The goal of this study was to test a mediation model in which social skills mediate the relationship between participation in organized activities and conduct problems among elementary school children. Two moderators of these associations were also examined, namely, gender and reception of special education services. A total of 563 children (45%…

a te atal care service utilizatio ad associated factors i metekel zo e

African Journals Online (AJOL)

user

access to the service in Ethiopia in general and in Benishangul Gumuz Region in particular. ... associated with low utilization of Antenatal care in Metekel Zone are not well assed before. ... information, education and communication, promoting female education, improving .... the proposal by ethical review committee of.

Child advocacy center multidisciplinary team decision and its association to child protective services outcomes.

Science.gov (United States)

Brink, Farah W; Thackeray, Jonathan D; Bridge, Jeffrey A; Letson, Megan M; Scribano, Philip V

2015-08-01

Limited studies exist evaluating the multidisciplinary team (MDT) decision-making process and its outcomes. This study evaluates the MDT determination of the likelihood of child sexual abuse (CSA) and its association to the outcome of the child protective services (CPS) disposition. A retrospective cohort study of CSA patients was conducted. The MDT utilized an a priori Likert rating scale to determine the likelihood of abuse. Subjects were dichotomized into high versus low/intermediate likelihood of CSA as determined by the MDT. Clinical and demographic characteristics were compared based upon MDT and CPS decisions. Fourteen hundred twenty-two patients were identified. A high likelihood for abuse was determined in 997 cases (70%). CPS substantiated or indicated the allegation of CSA in 789 cases (79%, Kappa 0.54). Any CSA disclosure, particularly moderate risk disclosure (AOR 59.3, 95% CI 26.50-132.80) or increasing total number of CSA disclosures (AOR 1.3, 95% CI 1.11-1.57), was independently associated with a high likelihood for abuse determination. Specific clinical features associated with discordant cases in which MDT determined high likelihood for abuse and CPS did not substantiate or indicate CSA included being white or providing a low risk CSA disclosure or other non-CSA disclosure. MDT determination regarding likelihood of abuse demonstrated moderate agreement to CPS disposition outcome. CSA disclosure is predictive of the MDT determination for high likelihood of CSA. Agreement between MDT determination and CPS protection decisions appear to be driven by the type of disclosures, highlighting the importance of the forensic interview in ensuring appropriate child protection plans. Published by Elsevier Ltd.

Alterations of Brain Functional Architecture Associated with Psychopathic Traits in Male Adolescents with Conduct Disorder.

Science.gov (United States)

Pu, Weidan; Luo, Qiang; Jiang, Yali; Gao, Yidian; Ming, Qingsen; Yao, Shuqiao

2017-09-12

Psychopathic traits of conduct disorder (CD) have a core callous-unemotional (CU) component and an impulsive-antisocial component. Previous task-driven fMRI studies have suggested that psychopathic traits are associated with dysfunction of several brain areas involved in different cognitive functions (e.g., empathy, reward, and response inhibition etc.), but the relationship between psychopathic traits and intrinsic brain functional architecture has not yet been explored in CD. Using a holistic brain-wide functional connectivity analysis, this study delineated the alterations in brain functional networks in patients with conduct disorder. Compared with matched healthy controls, we found decreased anti-synchronization between the fronto-parietal network (FPN) and default mode network (DMN), and increased intra-network synchronization within the frontothalamic-basal ganglia, right frontoparietal, and temporal/limbic/visual networks in CD patients. Correlation analysis showed that the weakened FPN-DMN interaction was associated with CU traits, while the heightened intra-network functional connectivity was related to impulsivity traits in CD patients. Our findings suggest that decoupling of cognitive control (FPN) with social understanding of others (DMN) is associated with the CU traits, and hyper-functions of the reward and motor inhibition systems elevate impulsiveness in CD.

Significance, Nature, and Direction of the Association Between Child Sexual Abuse and Conduct Disorder: A Systematic Review.

Science.gov (United States)

Maniglio, Roberto

2015-07-01

To elucidate the significance, nature, and direction of the potential relationship between child sexual abuse and conduct disorder, all the pertinent studies were reviewed. Ten databases were searched. Blind assessments of study eligibility and quality were performed by two independent researchers. Thirty-six studies including 185,358 participants and meeting minimum quality criteria that were enough to ensure objectivity and to not invalidate results were analyzed. Across the majority of studies, conduct disorder was significantly and directly related to child sexual abuse, especially repeated sexual molestation and abuse involving penetration, even after controlling for various sociodemographic, family, and clinical variables. The association between child sexual abuse and conduct disorder was not confounded by other risk factors, such as gender, socioeconomic status, school achievement, substance problems, physical abuse, parental antisocial behavior or substance problems, parent-child relationships, and family disruption, conflict, or violence. Evidence for a significant interactive effect between child sexual abuse and monoamine oxidase A gene on conduct disorder was scant. Early sexual abuse might predispose to the subsequent onset of conduct disorder which, in turn, may lead to further sexual victimization through association with sexually abusive peers or involvement in dangerous situations or sexual survival strategies. © The Author(s) 2014.

Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

Science.gov (United States)

Ward, C L; Lombard, C J; Gwebushe, N

2006-01-01

Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

Is there an association between Fahr′s disease and cardiac conduction system disease?: A case report

Directory of Open Access Journals (Sweden)

Prashanth Panduranga

2012-01-01

Full Text Available Background: Fahr′s disease is a rare neurodegenerative disorder of unknown cause characterized by idiopathic basal ganglia calcification that is associated with neuropsychiatric and cognitive impairment. No case of Fahr′s disease with associated cardiac conduction disease has been described in the literature to date. The objective of this case report was to describe a young female with various cardiac conduction system abnormalities and bilateral basal ganglia calcifica-tion suggestive of Fahr′s disease. Case Report: A 19-year-old female was transferred to our hospital for a pacemaker insertion. Her past medical history included cognitive impairment and asymptomatic congenital complete heart block since birth. Her manifestations in-cluded cognitive impairment, tremors, rigidity, ataxia, bilateral basal ganglia calcification without clinical manifesta-tions of mitochondrial cytopathy. She also had right bundle branch block, left anterior fascicular block, intermittent complete heart block, atrial arrhythmias with advanced atrioventricular blocks and ventricular asystole manifested by Stokes-Adams seizures, which was diagnosed as epilepsy. Conclusions: According to our knowledge, this was the first case report of a su spected association between Fahr′s disease and isolated cardiac conduction system disease. In addition, this case illustrated that in patients with heart blocks and seizures, a diagnosis of epilepsy needs to be made with caution and such patients need further evaluations by a cardiologist or electrophysiologist to consider pacing and prevent future catastrophic events.

Service co-innovation

DEFF Research Database (Denmark)

Henten, Anders; Sundbo, Jon; Sundbo, Donna

of studies of the degree of satisfaction of the users with the services in the service encounters and studies that examine service innovation processes. The paper is based on research conducted in 21 service delivery situations in as many service companies. Drivers of and barriers to encounterbased service......This paper examines the factors affecting the innovativeness of service encounters. The assumption is that a considerable share of innovations in service industries is initiated in the service encounters. The theoretical foundation of this paper builds on a combination of research tradition...

Managing evolving services

NARCIS (Netherlands)

Papazoglou, M.; Andrikopoulos, V.; Benbernou, S.

2011-01-01

Services are subject to constant change and variation, leading to continuous redesign and improvement. However, service changes shouldn't be disruptive by requiring radical modifications or by altering the way that business is conducted. In this article, we discuss a causal model of service changes

Designing a New Car Rental Service Using Location-Based Services

OpenAIRE

Dessie, Solomon

2015-01-01

This thesis concentrates on improving the car rental services offered by the case company by introducing location-based services. For many years, the company has conducted a rental business in a similar manner with other car rental companies, and now it is introducing a new service system based on online interaction and location-based services. The outcome of the study is a blueprint for the case company regarding the design of a car rental service using location-based services. This stud...

Managing postgraduate research service quality: Developing and assessing a conceptual model

Directory of Open Access Journals (Sweden)

Shawn Ramroop

2013-05-01

Full Text Available This paper reports on the conceptual development and empirical evaluation of a postgraduate (PG research service quality management model, through conducting an electronic survey among a cohort of master’s and doctorate graduates at one of the top three research universities in South Africa, using specifically developed and validated research instruments.By fitting the data from a sample of 117 graduates to a conceptual model using structural equation modelling, it became evident that the PG research students’ perception of the Organisational Climate for Research (OCR is associated with their perception of the PG Research Service Quality (PGSQUAL, the PG Service Experience (SERVEXP and their perception of their Role (RC. However, no association was found between the students’ perception of the research climate (OCR and their satisfaction (SERVSAT with the research service; the service experience (SERVEXP and postgraduate research service quality (PGSQUAL; service satisfaction (SERVSAT and postgraduate service quality (PGSQUAL.  The aforementioned findings imply that higher education institutions need to create a research climate which is supportive of service quality, and better manage the research climate, so that the PG students are clear about their role, which will eventually translate to a better PG service experience and improved perception of PG service quality.

Adolescent Callous-Unemotional Traits Mediates the Longitudinal Association between Conduct Problems and Media Violence Exposure

Directory of Open Access Journals (Sweden)

Kostas. A. Fanti

2013-09-01

Full Text Available The current study investigates the bidirectional longitudinal association between conduct problems (CPs and media violence exposure (MVE, with callous-unemotional (CU traits as a potential mediator of this association. The sample consisted of 1,451 (49.9% boys Greek Cypriot adolescents. CPs and MVE were measured at Year 1 and Year 3 and CU traits were measured at Year 2, enabling the examination of longitudinal associations and indirect effects between these variables. A bidirectional association between CPs and MVE was identified. Further, both CPs and MVE at Year 1 were positively associated with Year 2 CU traits, and youth high on CU traits at Year 2 were more likely to exhibit CP behaviors and to be exposed to media violence at Year 3. Finally, two indirect pathways were identified, suggesting that the longitudinal bidirectional association between CPs and MVE was partially mediated by CU traits. These findings suggest that CU traits constitute an underlying mechanism explaining the longitudinal association between CPs and MVE.

Patients' willingness to pay for cognitive pharmacist services in community pharmacies.

Science.gov (United States)

Lakić, Dragana; Stević, Ivana; Odalović, Marina; Vezmar-Kovačević, Sandra; Tadić, Ivana

2017-10-31

To determine the general population willingness to pay for cognitive pharmacist service in community pharmacy, describe the behavior of participants regarding health care issues, and evaluate correlation between participants' sociodemographic characteristics or attitudes and their willingness to pay. A questionnaire-based survey was conducted among general population visiting community pharmacies. The participants were asked about receiving cognitive pharmacist services to identify and resolve potential medication therapy problems after the initiation of a new medicine to optimize health outcomes of the patients. A univariate and multivariate analysis were used to analyze associations between different variables and willingness to pay for pharmacy service. Of 444 respondents, 167 (38%) reported that they were willing to pay for a medication management service provided in the community pharmacy. Univariate analysis showed significant association between the willingness to pay for pharmacist-provided service and respondents' socio-demographic factors, health-related characteristics, and behavior, dilemmas, or need for certain pharmacist-provided service. The logistic regression model was statistically significant (χ2=4.599, Ppay for cognitive pharmacist services, which has not been fully recognized within the health care system. In future, pharmacists should focus on practical implementation of the service and models of funding.

Retrospective chart review for obesity and associated interventions among rural Mexican-American adolescents accessing healthcare services.

Science.gov (United States)

Champion, Jane Dimmitt; Collins, Jennifer L

2013-11-01

To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Pre-Service Teachers' Mathematics Content Knowledge: Implications for How Mathematics Is Taught in Higher Education

Science.gov (United States)

Lowrie, Tom; Jorgensen, Robyn

2016-01-01

This investigation explored pre-service teachers' mathematics content knowledge (MCK) and beliefs associated with mathematics education practices. An Exploratory Factor Analysis, conducted on a beliefs and attitudes questionnaire, produced three common attitude factors associated with (1) inquiry-based teaching; (2) how mathematics knowledge is…

Association between Parental Involvement in School and Child Conduct, Social, and Internalizing Problems: Teacher Report

Science.gov (United States)

Kirkhaug, Bente; Drugli, May Britt; Klockner, Christian A.; Morch, Willy-Tore

2013-01-01

The present study examined the factor structure of the Teacher Involvement Questionnaire (Involve-T) by means of exploratory factor analysis and examined the association between children's socio-emotional and behavioural problems and teacher-reported parental involvement in school, using structural equation modelling. The study was conducted with…

Customer retention: A theoretical perspective of service failure and service recovery in the hotel industry

Directory of Open Access Journals (Sweden)

D. J. Petzer

2006-12-01

Full Text Available Purpose: The purpose of this paper is to provide a theoretical perspective on customer retention activities associated with service failure management and service recovery as a means to retain customers in the hotel industry - and to improve the competitiveness of a hotel. The research is pursued with the following objectives in mind: To determine the customer retention activities involved in the service failure management needed by hotels to retain customers. To determine the customer retention activities associated with the service recovery that hotels might perform in order to retain customers. Design/methodology/approach: Secondary sources such as textbooks, scientific journals, and previous studies on the subject were used to obtain relevant background information. A literature search of secondary sources was conducted to elucidate questions and areas of enquiry that relate to the research. Findings: The theoretical perspectives on service failure management and service recovery provided in this paper suggest several customer retention activities that might be used by hotels in order to manage service failure and service recovery - and thus become more competitive. Implications: This paper suggests a number of approaches that hotel managers might take to improve service failure management and service recovery. Such activities could assist a hotel in determining where it is lacking and where to improve its performance in these areas. These activities could provide guidance to managers who are dealing with the day-to-day operations of a hotel. They might help to avoid service failures in the first place, and, secondly, to give ideas about service recovery if failures do occur. On a more strategic level, these activities could also assist managers to develop a general customer retention strategy that incorporates service failure management and service recovery. Originality/value: Service failure management and service recovery are viewed as

National Association of School Psychologists Model for Comprehensive and Integrated School Psychological Services

Science.gov (United States)

School Psychology Review, 2010

2010-01-01

The mission of the National Association of School Psychologists (NASP) is to represent school psychology and support school psychologists to enhance the learning and mental health of all children and youth. "School psychologists" provide effective services to help children and youth succeed academically, socially, behaviorally, and emotionally.…

Health care service utilization and associated factors among heroin users in northern Taiwan.

Science.gov (United States)

Chen, Yi-Chih; Chen, Chih-Ken; Lin, Shih-Ku; Chiang, Shu-Chuan; Su, Lien-Wen; Wang, Liang-Jen

2013-11-01

Due to the needs of medical care, the probability of using health care service from heroin users is high. This cross-sectional study investigated the frequency and correlates of health service utilization among heroin users. From June to September 2006, 124 heroin users (110 males and 14 females, mean age: 34.2 ± 8.3 years) who entered two psychiatric hospitals (N = 83) and a detention center (N = 41) in northern Taiwan received a face-to-face interview. Therefore, socio-demographic characteristics, patterns of drug use, psychiatric comorbidities, blood-borne infectious diseases and health service utilization were recorded. The behaviors of health service utilization were classified into the frequency of out-patient department visit and hospitalization, as well as the purchase of over-the-counter drugs. During 12 months prior to interview, 79.8% of the participants attended health care service at least once. The rate of having any event in out-patients service visit, hospitalization, and over-the-counter drugs were 66.1%, 29.8% and 25.8% respectively. The frequency of health service utilization was associated with numerous factors. Among these factors, patients who were recruited from hospital and having a mood disorder were conjoint predictors of out-patient department visit, hospitalization and purchase of over-the-counter drugs. According to the results of this study, social education and routine screening for mood disorders can help heroin users to obtain adequate health care service. The findings of this study are useful references for targeting the heroin users for whom a successful intervention represents the greatest cost benefit. © 2013 Elsevier Ltd. All rights reserved.

7 CFR 900.303 - Conduct of referendum.

Science.gov (United States)

2010-01-01

... Conduct of Referenda To Determine Producer Approval of Milk Marketing Orders To Be Made Effective Pursuant to Agricultural Marketing Agreement Act of 1937, as Amended § 900.303 Conduct of referendum. The... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

The association between in-service sexual harassment and post-traumatic stress disorder among Department of Veterans Affairs disability applicants.

Science.gov (United States)

Murdoch, Maureen; Polusny, Melissa A; Hodges, James; Cowper, Diane

2006-02-01

The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally representative sample of Department of Veterans Affairs PTSD disability applicants. The study was a cross-sectional survey. Of 4,918 eligible veterans, 3,337 (68%) returned surveys. Nonresponse bias appeared to be minimal. After adjustment for other reported traumas, women's reported in-service sexual harassment severity was significantly associated with PTSD symptom severity (p men and for in-service sexual assault among the women. Men showed no association between in-service sexual harassment and PTSD (p = 0.33), although power was low for this test. Sexual harassment significantly contributed to female veterans' PTSD symptoms; its contribution to men's symptoms was unclear. We discuss mechanisms through which sexual harassment might affect PTSD symptom severity, including the possibility that sexual harassment sometimes meets the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, definition of a criterion A stressor.

76 FR 37876 - Hours of Service (HOS) of Drivers; Renewal of American Pyrotechnics Association (APA) Exemption...

Science.gov (United States)

2011-06-28

...-28043] Hours of Service (HOS) of Drivers; Renewal of American Pyrotechnics Association (APA) Exemption... announces the renewal of the exemption of specified members of the American Pyrotechnics Association (APA... of this exemption in effect, designated APA-member motor carriers will maintain a level of safety...

76 FR 30232 - Hours of Service (HOS) of Drivers; Application of American Pyrotechnics Association (APA) for...

Science.gov (United States)

2011-05-24

...-28043] Hours of Service (HOS) of Drivers; Application of American Pyrotechnics Association (APA) for... American Pyrotechnics Association (APA) has applied for a limited exemption from FMCSA's regulation that... exemption would apply solely to the operation of CMVs by 9 designated APA-member motor carriers in...

Customers' perceptions of and satisfaction with medicine retail outlet services in Addis Ababa, Ethiopia

DEFF Research Database (Denmark)

Gebregeorgise, Dawit T; Mohammed, Tofik A; Redi, Zebiba S

2018-01-01

OBJECTIVES: The aim of this study was to assess customers' perceptions of and satisfaction with MRO services in Addis Ababa and to explore factors associated with their satisfaction and reasons for visits. METHODS: A cross-sectional survey was conducted among customers selected from 28 MROs...... for visiting, being married was positively associated with buying over-the-counter, higher educational status was linked with more satisfaction. Overall, 56.8% (225/396) of the respondents reported that they were satisfied with the service provided by MROs. CONCLUSION: Customers of MROs had mixed perceptions...... of and satisfaction with the current service. Marital status and age were associated with the reason for visiting, while the educational level was associated with the level of satisfaction. The overall positive perceptions and satisfaction about MROs should be taken as an opportunity to promote and improve...

Effective interventions on service quality improvement in a physiotherapy clinic.

Science.gov (United States)

Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

2014-01-01

Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (PService quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

Association of "ADAM10" and "CAMK2A" Polymorphisms with Conduct Disorder: Evidence from Family-Based Studies

Science.gov (United States)

Jian, Xue-Qiu; Wang, Ke-Sheng; Wu, Tie-Jian; Hillhouse, Joel J.; Mullersman, Jerald E.

2011-01-01

Twin and family studies have shown that genetic factors play a role in the development of conduct disorder (CD). The purpose of this study was to identify genetic variants associated with CD using a family-based association study. We used 4,720 single nucleotide polymorphisms (SNPs) from the Illumina Panel and 11,120 SNPs from the Affymetrix 10K…

IoT Service Clustering for Dynamic Service Matchmaking.

Science.gov (United States)

Zhao, Shuai; Yu, Le; Cheng, Bo; Chen, Junliang

2017-07-27

As the adoption of service-oriented paradigms in the IoT (Internet of Things) environment, real-world devices will open their capabilities through service interfaces, which enable other functional entities to interact with them. In an IoT application, it is indispensable to find suitable services for satisfying users' requirements or replacing the unavailable services. However, from the perspective of performance, it is inappropriate to find desired services from the service repository online directly. Instead, clustering services offline according to their similarity and matchmaking or discovering service online in limited clusters is necessary. This paper proposes a multidimensional model-based approach to measure the similarity between IoT services. Then, density-peaks-based clustering is employed to gather similar services together according to the result of similarity measurement. Based on the service clustering, the algorithms of dynamic service matchmaking, discovery, and replacement will be performed efficiently. Evaluating experiments are conducted to validate the performance of proposed approaches, and the results are promising.

Prenatal Alcohol Exposure Is Associated with Conduct Disorder in Adolescence: Findings from a Birth Cohort

Science.gov (United States)

Larkby, Cynthia A.; Goldschmidt, Lidush; Hanusa, Barbara H.; Day, Nancy L.

2011-01-01

Objective: To evaluate the association between prenatal alcohol exposure and the rate of conduct disorder in exposed compared with unexposed adolescents. Method: Data for these analyses are from a longitudinal study of prenatal substance exposures. Women were interviewed at their fourth and seventh prenatal months, and with their children, at…

Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations.

Science.gov (United States)

Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M

2010-07-01

Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.

13 CFR 108.900 - Fees for management services provided to a Small Business by a NMVC Company or its Associate.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Fees for management services... Small Businesses by NMVC Companies Management Services and Fees § 108.900 Fees for management services... management services that you or your Associate provide to a Small Business during the term of a Financing or...

77 FR 38378 - Hours of Service (HOS) of Drivers; Revision of Exemption; American Pyrotechnics Association (APA)

Science.gov (United States)

2012-06-27

...-28043] Hours of Service (HOS) of Drivers; Revision of Exemption; American Pyrotechnics Association (APA... Pyrotechnics Association (APA) that were granted an exemption from FMCSA's prohibition on driving commercial...-July 8, inclusive, in 2011 and 2012. The exemption covered renewal of 53 APA-member motor carriers and...

76 FR 37880 - Hours of Service (HOS) of Drivers; Granting of Exemption; American Pyrotechnics Association (APA)

Science.gov (United States)

2011-06-28

...-28043] Hours of Service (HOS) of Drivers; Granting of Exemption; American Pyrotechnics Association (APA... exemption from the American Pyrotechnics Association (APA) on behalf of 9 member motor carriers seeking... such exemption'' (49 U.S.C. 31315(b)(1)). The initial APA application for waiver or exemption relief...

Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

Science.gov (United States)

Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

2013-10-01

Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

7 CFR 4290.900 - Management fees for services provided to an Enterprise by RBIC or its Associate.

Science.gov (United States)

2010-01-01

... AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Financing of Enterprises by RBICs Limitations on Disposition of Assets § 4290.900 Management fees for services provided to an Enterprise by RBIC or... management services that you or your Associate provide to an Enterprise that you do not finance. (b) The...

Associations between Language Development and Skin Conductance Responses to Faces and Eye Gaze in Children with Autism Spectrum Disorder

Science.gov (United States)

Stagg, Steven D.; Davis, Robert; Heaton, Pamela

2013-01-01

Attention to social stimuli is associated with language development, and arousal is associated with the increased viewing of stimuli. We investigated whether skin conductance responses (SCRs) are associated with language development in autism spectrum disorder (ASD): a population that shows abnormalities in both attention to others and language…

Community Violence Exposure and Conduct Problems in Children and Adolescents with Conduct Disorder and Healthy Controls

OpenAIRE

Linda Kersten; Noortje Vriends; Martin Steppan; Nora M. Raschle; Martin Praetzlich; Helena Oldenhof; Robert Vermeiren; Lucres Jansen; Katharina Ackermann; Anka Bernhard; Anne Martinelli; Karen Gonzalez-Madruga; Ignazio Puzzo; Amy Wells; Jack C. Rogers

2017-01-01

Exposure to community violence through witnessing or being directly victimized has been associated with conduct problems in a range of studies. However, the relationship between community violence exposure (CVE) and conduct problems has never been studied separately in healthy individuals and individuals with conduct disorder (CD). Therefore, it is not clear whether the association between CVE and conduct problems is due to confounding factors, because those with high conduct problems also te...

Studies of molecular association in H2O and D2O vapors by measurement of thermal conductivity

International Nuclear Information System (INIS)

Curtiss, L.A.; Frurip, D.J.; Blander, M.

1979-01-01

The thermal conductivities of H 2 O and D 2 O vapors were measured in a modified thick hot wire cell between 358 and 386 K at pressures ranging from 100 to 1000 Torr. Analysis of the data indicates that molecular association to form a dimeric species is the main source of enhancement of the thermal conductivity of both vapors. The enthalpy and entropy of association of the H 2 O dimer are -3.59 kcal mol -1 and -18.59 cal deg -1 mol -1 , respectively. The enthalpy and entropy of association of the D 2 O dimer are -3.66 kcal mol -1 and -18.67 cal deg -1 mol -1 , respectively. The measured enthalpy of association of the H 2 O dimer is in agreement with recently reported ab initio molecular orbital calculations on the H 2 O dimer. The entropies of association of the H 2 O and D 2 O dimers are calculated theoretically and are found to be in agreement with the measured values

Benzene monitoring at CPPI service stations

International Nuclear Information System (INIS)

Davis, C.S.

1996-01-01

A study was conducted in which ambient airborne concentration levels of benzene were measured at a representative set of gasoline service stations in Toronto and Vancouver. Benzene is considered to be toxic under the Canadian Environmental Protection Act (CEPA). It is a component in gasoline (0.1 to 4.7 per cent by volume) and is present in vehicle evaporative and exhaust emissions. Measurements were made every 18 days at each station for one year. The objective of the study was to assess the ambient and employee exposure levels of benzene at service stations and to determine whether the levels were typical of those published in the literature. In a 1986 PACE (Petroleum Association for Conservation of the Canadian Environment) survey of exposure to gasoline hydrocarbon vapours at Canadian service stations, airborne benzene concentration data was inconsistent with similar ambient and personal exposure data in the international literature. It was concluded that both the mean ambient benzene concentration and the personal exposure level measurements in this study were generally lower than similar measurements made in other countries. The same observation was made with respect to ambient and personal exposure levels measured in this study vis-a-vis those measured during the PACE study conducted in 1985/86. . 31 refs., 24 tabs., 5 figs

Integrated services

International Nuclear Information System (INIS)

Chafcouloff, S.; Michel, G.; Trice, M.; Clark, G.; Cosad, C.; Forbes, K.

1995-01-01

Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs

Integrated services

Energy Technology Data Exchange (ETDEWEB)

Chafcouloff, S.; Michel, G.; Trice, M. [Schlumberger Integrated Project Management Group, Montrouge (France); Clark, G. [Schlumberger Testing Services, Aberdeen (United Kingdom); Cosad, C.; Forbes, K. [Schlumberger Integrated Project Management Group, Aberdeen (United Kingdom)

1995-12-31

Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs

28 CFR 549.80 - Authority to conduct autopsies.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Authority to conduct autopsies. 549.80... MEDICAL SERVICES Authority To Conduct Autopsies § 549.80 Authority to conduct autopsies. (a) The Warden may order an autopsy and related scientific or medical tests to be performed on the body of a deceased...

Community Violence Exposure and Conduct Problems in Children and Adolescents with Conduct Disorder and Healthy Controls.

Science.gov (United States)

Kersten, Linda; Vriends, Noortje; Steppan, Martin; Raschle, Nora M; Praetzlich, Martin; Oldenhof, Helena; Vermeiren, Robert; Jansen, Lucres; Ackermann, Katharina; Bernhard, Anka; Martinelli, Anne; Gonzalez-Madruga, Karen; Puzzo, Ignazio; Wells, Amy; Rogers, Jack C; Clanton, Roberta; Baker, Rosalind H; Grisley, Liam; Baumann, Sarah; Gundlach, Malou; Kohls, Gregor; Gonzalez-Torres, Miguel A; Sesma-Pardo, Eva; Dochnal, Roberta; Lazaratou, Helen; Kalogerakis, Zacharias; Bigorra Gualba, Aitana; Smaragdi, Areti; Siklósi, Réka; Dikeos, Dimitris; Hervás, Amaia; Fernández-Rivas, Aranzazu; De Brito, Stephane A; Konrad, Kerstin; Herpertz-Dahlmann, Beate; Fairchild, Graeme; Freitag, Christine M; Popma, Arne; Kieser, Meinhard; Stadler, Christina

2017-01-01

Exposure to community violence through witnessing or being directly victimized has been associated with conduct problems in a range of studies. However, the relationship between community violence exposure (CVE) and conduct problems has never been studied separately in healthy individuals and individuals with conduct disorder (CD). Therefore, it is not clear whether the association between CVE and conduct problems is due to confounding factors, because those with high conduct problems also tend to live in more violent neighborhoods, i.e., an ecological fallacy. Hence, the aim of the present study was: (1) to investigate whether the association between recent CVE and current conduct problems holds true for healthy controls as well as adolescents with a diagnosis of CD; (2) to examine whether the association is stable in both groups when including effects of aggression subtypes (proactive/reactive aggression), age, gender, site and socioeconomic status (SES); and (3) to test whether proactive or reactive aggression mediate the link between CVE and conduct problems. Data from 1178 children and adolescents (62% female; 44% CD) aged between 9 years and 18 years from seven European countries were analyzed. Conduct problems were assessed using the Kiddie-Schedule of Affective Disorders and Schizophrenia diagnostic interview. Information about CVE and aggression subtypes was obtained using self-report questionnaires (Social and Health Assessment and Reactive-Proactive aggression Questionnaire (RPQ), respectively). The association between witnessing community violence and conduct problems was significant in both groups (adolescents with CD and healthy controls). The association was also stable after examining the mediating effects of aggression subtypes while including moderating effects of age, gender and SES and controlling for effects of site in both groups. There were no clear differences between the groups in the strength of the association between witnessing violence

Community Violence Exposure and Conduct Problems in Children and Adolescents with Conduct Disorder and Healthy Controls

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Linda Kersten

2017-11-01

Full Text Available Exposure to community violence through witnessing or being directly victimized has been associated with conduct problems in a range of studies. However, the relationship between community violence exposure (CVE and conduct problems has never been studied separately in healthy individuals and individuals with conduct disorder (CD. Therefore, it is not clear whether the association between CVE and conduct problems is due to confounding factors, because those with high conduct problems also tend to live in more violent neighborhoods, i.e., an ecological fallacy. Hence, the aim of the present study was: (1 to investigate whether the association between recent CVE and current conduct problems holds true for healthy controls as well as adolescents with a diagnosis of CD; (2 to examine whether the association is stable in both groups when including effects of aggression subtypes (proactive/reactive aggression, age, gender, site and socioeconomic status (SES; and (3 to test whether proactive or reactive aggression mediate the link between CVE and conduct problems. Data from 1178 children and adolescents (62% female; 44% CD aged between 9 years and 18 years from seven European countries were analyzed. Conduct problems were assessed using the Kiddie-Schedule of Affective Disorders and Schizophrenia diagnostic interview. Information about CVE and aggression subtypes was obtained using self-report questionnaires (Social and Health Assessment and Reactive-Proactive aggression Questionnaire (RPQ, respectively. The association between witnessing community violence and conduct problems was significant in both groups (adolescents with CD and healthy controls. The association was also stable after examining the mediating effects of aggression subtypes while including moderating effects of age, gender and SES and controlling for effects of site in both groups. There were no clear differences between the groups in the strength of the association between witnessing

Facing the Challenge--Conduct Disorders and Aggression.

Science.gov (United States)

Arllen, Nancy L.; Gable, Robert A.

This paper examines the nature of student conduct disorders, including both the origin and treatment of such disorders. In Part I, distinguishing characteristics of the syndrome are discussed and issues related to philosophy, definition, and delivery of services are considered. Two major subcategories of conduct disorder, socialized and…

A state-space modeling approach to estimating canopy conductance and associated uncertainties from sap flux density data.

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Bell, David M; Ward, Eric J; Oishi, A Christopher; Oren, Ram; Flikkema, Paul G; Clark, James S

2015-07-01

Uncertainties in ecophysiological responses to environment, such as the impact of atmospheric and soil moisture conditions on plant water regulation, limit our ability to estimate key inputs for ecosystem models. Advanced statistical frameworks provide coherent methodologies for relating observed data, such as stem sap flux density, to unobserved processes, such as canopy conductance and transpiration. To address this need, we developed a hierarchical Bayesian State-Space Canopy Conductance (StaCC) model linking canopy conductance and transpiration to tree sap flux density from a 4-year experiment in the North Carolina Piedmont, USA. Our model builds on existing ecophysiological knowledge, but explicitly incorporates uncertainty in canopy conductance, internal tree hydraulics and observation error to improve estimation of canopy conductance responses to atmospheric drought (i.e., vapor pressure deficit), soil drought (i.e., soil moisture) and above canopy light. Our statistical framework not only predicted sap flux observations well, but it also allowed us to simultaneously gap-fill missing data as we made inference on canopy processes, marking a substantial advance over traditional methods. The predicted and observed sap flux data were highly correlated (mean sensor-level Pearson correlation coefficient = 0.88). Variations in canopy conductance and transpiration associated with environmental variation across days to years were many times greater than the variation associated with model uncertainties. Because some variables, such as vapor pressure deficit and soil moisture, were correlated at the scale of days to weeks, canopy conductance responses to individual environmental variables were difficult to interpret in isolation. Still, our results highlight the importance of accounting for uncertainty in models of ecophysiological and ecosystem function where the process of interest, canopy conductance in this case, is not observed directly. The StaCC modeling

Understanding the Collaborative Planning Process in Homeless Services: Networking, Advocacy, and Local Government Support May Reduce Service Gaps.

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Jarpe, Meghan; Mosley, Jennifer E; Smith, Bikki Tran

2018-06-07

The Continuum of Care (CoC) process-a nationwide system of regional collaborative planning networks addressing homelessness-is the chief administrative method utilized by the US Department of Housing and Urban Development to prevent and reduce homelessness in the United States. The objective of this study is to provide a benchmark comprehensive picture of the structure and practices of CoC networks, as well as information about which of those factors are associated with lower service gaps, a key goal of the initiative. A national survey of the complete population of CoCs in the United States was conducted in 2014 (n = 312, 75% response rate). This survey is the first to gather information on all available CoC networks. Ordinary least squares (OLS) regression was used to determine the relationship between internal networking, advocacy frequency, government investment, and degree of service gaps for CoCs of different sizes. United States. Lead contacts for CoCs (n = 312) that responded to the 2014 survey. Severity of regional service gaps for people who are homeless. Descriptive statistics show that CoCs vary considerably in regard to size, leadership, membership, and other organizational characteristics. Several independent variables were associated with reduced regional service gaps: networking for small CoCs (β = -.39, P < .05) and local government support for midsized CoCs (β = -.10, P < .05). For large CoCs, local government support was again significantly associated with lower service gaps, but there was also a significant interaction effect between advocacy and networking (β = .04, P < .05). To reduce service gaps and better serve the homeless, CoCs should consider taking steps to improve networking, particularly when advocacy is out of reach, and cultivate local government investment and support.

The Dilemma of Service Productivity and Service Innovation: An Empirical Exploration in Financial Services.

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Aspara, Jaakko; Klein, Jan F; Luo, Xueming; Tikkanen, Henrikki

2018-05-01

We conduct a systematic exploratory investigation of the effects of firms' existing service productivity on the success of their new service innovations. Although previous research extensively addresses service productivity and service innovation, this is the first empirical study that bridges the gap between these two research streams and examines the links between the two concepts. Based on a comprehensive data set of new service introductions in a financial services market over a 14-year period, we empirically explore the relationship between a firm's existing service productivity and the firm's success in introducing new services to the market. The results unveil a fundamental service productivity-service innovation dilemma: Being productive in existing services increases a firm's willingness to innovate new services proactively but decreases the firm's capabilities of bringing these services to the market successfully. We provide specific insights into the mechanism underlying the complex relationship between a firm's productivity in existing services, its innovation proactivity, and its service innovation success. For managers, we not only unpack and elucidate this dilemma but also demonstrate that a focused customer scope and growth market conditions may enable firms to mitigate the dilemma and successfully pursue service productivity and service innovation simultaneously.

Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa.

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Meehan, Sue-Ann; Sloot, Rosa; Draper, Heather R; Naidoo, Pren; Burger, Ronelle; Beyers, Nulda

2018-01-01

Diagnosing HIV and/or TB is not sufficient; linkage to care and treatment is conditional to reduce the burden of disease. This study aimed to determine factors associated with linkage to HIV care and TB treatment at community-based services in Cape Town, South Africa. This retrospective cohort study utilized routinely collected data from clients who utilized stand-alone (fixed site not attached to a health facility) and mobile HIV testing services in eight communities in the City of Cape Town Metropolitan district, between January 2008 and June 2012. Clients were included in the analysis if they were ≥12 years and had a known HIV status. Generalized estimating equations (GEE) logistic regression models were used to assess the association between determinants (sex, age, HIV testing service and co-infection status) and self-reported linkage to HIV care and/or TB treatment. Linkage to HIV care was 3 738/5 929 (63.1%). Linkage to HIV care was associated with the type of HIV testing service. Clients diagnosed with HIV at mobile services had a significantly reduced odds of linking to HIV care (aOR 0.7 (CI 95%: 0.6-0.8), p<0.001. Linkage to TB treatment was 210/275 (76.4%). Linkage to TB treatment was not associated with sex and service type, but was associated with age. Clients in older age groups were less likely to link to TB treatment compared to clients in the age group 12-24 years (all, p-value<0.05). A large proportion of clients diagnosed with HIV at mobile services did not link to care. Almost a quarter of clients diagnosed with TB did not link to treatment. Integrated community-based HIV and TB testing services are efficient in diagnosing HIV and TB, but strategies to improve linkage to care are required to control these epidemics.

Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007

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Titaley Christiana R

2010-08-01

Full Text Available Abstract Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most recent birth within five years preceding each survey was examined. Twenty-three potential risk factors were identified and categorized into four main groups, external environment, predisposing, enabling, and need factors. Logistic regression models were used to examine the association between all potential risk factors and underutilization of antenatal services. The Population Attributable Risk (PAR was calculated for selected significant factors associated with the outcome. Results Factors strongly associated with underutilization of antenatal care services were infants from rural areas and from outer Java-Bali region, infants from low household wealth index and with low maternal education level, and high birth rank infants with short birth interval of less than two years. Other associated factors identified included mothers reporting distance to health facilities as a major problem, mothers less exposed to mass media, and mothers reporting no obstetric complications during pregnancy. The PAR showed that 55% of the total risks for underutilization of antenatal care services were attributable to the combined low household wealth index and low maternal education level. Conclusions Strategies to increase the accessibility and availability of health care services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting

Buying business services : towards a structured service purchasing process

NARCIS (Netherlands)

Valk, van der W.; Rozemeijer, F.A.

2009-01-01

Abstract: Purpose – This paper aims to uncover the specific difficulties associated with buying services and proposes a structured purchasing process which can help organisational buyers to overcome the problems associated with services purchasing. Design/methodology/approach – The authors

Ante natal care services utilization, delivery practices and factors affecting them in tribal area of North Maharashtra

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Sachin S Mumbare

2011-01-01

Full Text Available Background: Utilization of Ante natal care (ANC services is poor in the tribal areas, causing increased maternal morbidity and mortality. Objective: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. Design: Cross-sectional study. Materials and Methods: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. Results: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. Conclusion: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.

Factors associated with regulatory action involving investigation of illnesses associated with Shiga toxin-producing Escherichia coli in products regulated by the Food Safety and Inspection Service.

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Green, Alice L; Seys, Scott; Douris, Aphrodite; Levine, Jeoff; Robertson, Kis

2014-07-01

We described characteristics of the Escherichia coli O157 and Escherichia coli non-O157 illness investigations conducted by the United States Department of Agriculture's Food Safety and Inspection Service (FSIS) during the 5-year period from 2006 through 2010. We created a multivariable logistic regression model to determine characteristics of these investigations that were associated with FSIS regulatory action, which was defined as having occurred if a product recall occurred or if FSIS personnel performed an environmental health assessment (Food Safety Assessment) at the implicated establishment. During this period, FSIS took regulatory action in 38 of 88 (43%) investigations. Illness investigations in which FoodNet states were involved were more likely to result in regulatory action. Illness investigations in which state and local traceback, or FSIS traceback occurred were more likely to result in regulatory action. Reasons for lack of action included evidence of cross-contamination after the product left a regulated establishment, delayed notification, lack of epidemiological information, and insufficient product information.

Cost-effectiveness analysis on the results of screening of lung cancer using helical CT conducted by the anti-lung cancer association (ALCA)

International Nuclear Information System (INIS)

Iinuma, Takeshi; Kaneko, Masahiro; Moriyama, Noriyuki; Misawa, Jun

1999-01-01

To compare Yen/person saved in lung cancer screening using helical CT with Yen/person in the screening using conventional direct chest X-rays conducted under the Anti-lung cancer association program of the Tokyo Health Service Association. A mathematical model for cancer screening was used to estimate net number of person relieved from lung cancer by the screening and net cost required for the screening. Finally cost-effectiveness ratios in terms of Yen/person saved were calculated and compared between the two programs. Several important variables employed in the model were as follows: 5 year survival rate in chest X-ray group was 50%, and the rate in helical CT group was 75%. Cost of screening in the chest X-ray group was 15,000 Yen, and that in the helical CT group was 25,000 Yen. Cost/person screened was 14,470 Yen for chest X-ray and 21,890 Yen for helical CT. Cost/person saved was 267 x 10 5 Yen in X-ray group and 112 x 10 5 Yen in CT group. Thus the cost was higher, but cost-effectiveness ratio was better in the CT screening group. Helical CT can be adopted for lung cancer screening in stead of chest X-ray if total cost is affordable. (author)

Influence of employees' service-oriented behavior on service quality

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Vučković Jelisaveta

2015-01-01

Full Text Available In order to constantly improve the quality of service program, organizations in tourism industry, have to pay special attention to managing employees' behavior, especially those in the first line of service provision and their direct superiors. Encouraging the employees towards service-oriented behavior is greatly determined by the adequate and consistent implementation of human resources management instruments. The subject of this research is an empirical examination of relations between employees' behavior in the service providing process and service quality. This research was conducted during 2012, in a five-star hotel 'Izvor', situated in Arandjelovac.

Mental Health Service Use Among Lesbian, Gay, and Bisexual Older Adults.

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Stanley, Ian H; Duong, Jeffrey

2015-07-01

Empirical efforts to measure use of mental health services among lesbian, gay, and bisexual (LGB) older adults have been notably lacking. Thus this study assessed associations between sexual orientation and mental health service use among older adults and determined the mediating role of nonspecific psychological distress, excessive alcohol use, and self-perceived poor general medical health. Data from the 2011 New York City Community Health Survey were analyzed. The analytic sample comprised 5,138 adults ages 50 and over. Logistic regression modeling was used to examine associations between sexual orientation (LGB versus heterosexual) and past-year mental health service use (counseling or medication), adjusting for sociodemographic and clinical characteristics. Mediation analyses using bootstrapping were conducted. Among LGB older adults, 23.9% reported receiving counseling, and 23.4% reported taking psychiatric medication in the past year. LGB respondents were significantly more likely than heterosexuals to have received counseling (adjusted odds ratio [AOR]=2.16, 95% confidence interval [CI]=1.49-3.13) and psychiatric medication (AOR=1.97, CI=1.36-2.86). Psychological distress, excessive alcohol use, and self-perceived poor general medical health did not mediate the association between sexual orientation and mental health service use. LGB older adults were more likely than heterosexuals to utilize mental health services, and this association was not explained by indicators of general medical, mental, or behavioral health.

A blueprint for community benefit. A CHA-AAHA (Catholic Health Association-American Association of Homes for the Aging) document helps long-term care providers plan for and implement needed services.

Science.gov (United States)

Forschner, B; Trocchio, J

1993-05-01

A collaborative effort of the Catholic Health Association (CHA) and the American Association of Homes for the Aging, The Social Accountability Program: Continuing the Community Benefit Tradition of Not-for-Profit Homes and Services for the Aging helps long-term care organizations plan and report community benefit activities. The program takes long-term care providers through five sequential tasks: reaffirming commitment to the elderly and others in the community; developing a community service plan; developing and providing community services; reporting community services; and evaluating the community service role. To help organizations reaffirm commitment, the Social Accountability Program presents a process facilities can use to review their historical roots and purposes and evaluate whether current policies and procedures are consistent with the organizational philosophy. Once this step is completed, providers can develop a community service plan by identifying target populations and the services they need. For facilities developing and implementing such services, the program suggests ways of measuring and monitoring them for budgetary purposes. Once they have implemented services, not-for-profit healthcare organizations must account for their impact on the community. The Social Accountability Program lists elements to be included in community service reports. It also provides guidelines for evaluating these services' effectiveness and the organization's overall community benefit role.

Factors associated with the utilization of institutional delivery services in Bangladesh.

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Sanni Yaya

Full Text Available Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A. However, the provision of universal access to reproductive healthcare (MDG-5B and the utilization of maternal healthcare services (MHS such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh.Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011; participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression.According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604, and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437. Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624, and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional

Postnatal Care Service Utilization and Associated Factors among Women Who Gave Birth in the Last 12 Months prior to the Study in Debre Markos Town, Northwestern Ethiopia: A Community-Based Cross-Sectional Study

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Miteku Andualem Limenih

2016-01-01

Full Text Available Improving maternal and newborn health through proper postnatal care services under the care of skilled health personnel is the key strategy to reduce maternal and neonatal mortality. However, there were limited evidences on utilization of postnatal care services in Ethiopia. A community based cross-sectional study was conducted in Debremarkos town, Northwest Ethiopia. Cluster sampling technique was used to select 588 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with postnatal care utilization. Odds ratio with 95% confidence interval was computed to determine the level of significance. Postnatal care service utilization was found to be 33.5%. Awareness about maternal complication (AOR: 2.72, 95% CI (1.71, 4.34, place of delivery of last child (AOR: 1.68, 95% CI: (1.01, 2.79, outcome of birth (AOR: 2.71, 95% CI (1.19, 6.19, delivery by cesarean section (AOR: 4.82, 95% CI (1.86, 12.54, and delivery complication that occurred during birth (AOR: 2.58, 95% CI (1.56, 4.28 were factors associated with postnatal care service utilization. Postnatal care service utilization was found to be low. Increasing awareness about postnatal care, preventing maternal and neonatal complication, and scheduling mothers based on the national postnatal care follow-up protocol would increase postnatal care service utilization.

Postnatal Care Service Utilization and Associated Factors among Women Who Gave Birth in the Last 12 Months prior to the Study in Debre Markos Town, Northwestern Ethiopia: A Community-Based Cross-Sectional Study.

Science.gov (United States)

Limenih, Miteku Andualem; Endale, Zerfu Mulaw; Dachew, Berihun Assefa

2016-01-01

Improving maternal and newborn health through proper postnatal care services under the care of skilled health personnel is the key strategy to reduce maternal and neonatal mortality. However, there were limited evidences on utilization of postnatal care services in Ethiopia. A community based cross-sectional study was conducted in Debremarkos town, Northwest Ethiopia. Cluster sampling technique was used to select 588 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with postnatal care utilization. Odds ratio with 95% confidence interval was computed to determine the level of significance. Postnatal care service utilization was found to be 33.5%. Awareness about maternal complication (AOR: 2.72, 95% CI (1.71, 4.34)), place of delivery of last child (AOR: 1.68, 95% CI: (1.01, 2.79)), outcome of birth (AOR: 2.71, 95% CI (1.19, 6.19)), delivery by cesarean section (AOR: 4.82, 95% CI (1.86, 12.54)), and delivery complication that occurred during birth (AOR: 2.58, 95% CI (1.56, 4.28)) were factors associated with postnatal care service utilization. Postnatal care service utilization was found to be low. Increasing awareness about postnatal care, preventing maternal and neonatal complication, and scheduling mothers based on the national postnatal care follow-up protocol would increase postnatal care service utilization.

Factors associated to the imposition of types of violence against women informed in sentry services

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Luiza Jane Eyre de Souza Vieira

2013-07-01

Full Text Available OBJECTIVE: to identify the prevalence and the factors associated to the imposition of the different types of violence against women informed in sentry services. METHOD: transversal study accomplished through 939 notification forms of cases of violence against women, referring to the three years from 2006 to 2008 in Fortaleza, Ceará. Univariate and multiple analyses by logistic regression were realized. RESULT: the results showed a positive association between the imposition of types of violence against women with a schooling varying from illiterate to basic education and the aggression which had occurred other times. CONCLUSION: this knowledge contributes to the delineation of specific actions that aim at facing this problem, as well as generates subsidies for adequate attendance proposals and guidance for the victims who call on health services.

Association of comorbidities with home care service utilization of patients with heart failure while receiving telehealth.

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Radhakrishnan, Kavita; Jacelon, Cynthia S; Bigelow, Carol; Roche, Joan P; Marquard, Jenna L; Bowles, Kathryn H

2013-01-01

Comorbidities adversely impact heart failure (HF) outcomes. Telehealth can assist healthcare providers, especially nurses, in guiding their patients to follow the HF regimen. However, factors, including comorbidity patterns, that act in combination with telehealth to reduce home care nursing utilization are still unclear. The purpose of this article was to examine the association of the comorbidity characteristics of HF patients with nursing utilization along with withdrawal from telehealth service during an episode of tele-home care. A descriptive, correlational study design using retrospective chart review was used. The sample comprised Medicare patients admitted to a New England home care agency who had HF as a diagnosis and had used telehealth from 2008 to 2010. The electronic documentation at the home care agency served as the data source, which included Outcome and Assessment Information Set data of patients with HF. Logistic and multiple regression analyses were used to analyze data. The sample consisted of 403 participants, of whom 70% were older than 75 years, 55% were female, and 94% were white. Comorbidities averaged 5.19 (SD, 1.92), ranging from 1 to 11, and nearly 40% of the participants had 5 or more comorbidities. The mean (SD) nursing contacts in the sample was 9.9 (4.7), ranging from 1 to 26, and 52 (12.7%) patients withdrew from telehealth service. For patients with HF on telehealth, comorbidity characteristics of anemia, anxiety, musculoskeletal, and depression were significantly associated with nursing utilization patterns, and renal failure, cancer, and depression comorbidities were significantly associated with withdrawal from telehealth service. Knowledge of the association of comorbidity characteristics with the home care service utilization patterns of patients with HF on telehealth can assist the home health nurse to develop a tailored care plan that attains optimal patient outcomes. Knowledge of such associations would also focus home

Association between fee-for-service expenditures and morbidity burden in primary care

DEFF Research Database (Denmark)

Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik

2014-01-01

BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....

Trade-Offs in Values Assigned to Ecological Goods and Services Associated with Different Coral Reef Management Strategies

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Christina C. Hicks

2009-06-01

Full Text Available Societies value ecosystems and the services they provide in a number of ways. These values can help inform the management of ecosystems such as coral reefs. However, the trade-offs in ecosystem goods and services associated with different social and management conditions are poorly understood. Consequently, we examined values assigned to the goods and services identified across three types of management on the Kenyan coast: (1 a government-imposed no-take area in the Mombasa Marine National Park; (2 co-management of gear between fishing communities and the government's fisheries department; and (3 community-initiated no-take area management, where a community independently initiated and controlled a small closed area. We compared the ecosystem goods and services and the broader total economic value to explore how the history of these sites, their social conditions, and different management choices were associated with these values. The highest total economic values were associated with government management interventions and were probably due to the government's priority to be involved in the high-value beach tourism destinations. This is, however, associated with losses in a range of local community-level values and the social capital of the resource-user community. For example, resource users near the government marine protected area had the lowest value for measures of biological knowledge. Sites displaying greater community-level values were characterized by high social capital, and users had the most confidence in their ability to manage the resource. This study suggests that trade-offs occur in values associated with the interests and responsibilities of the management. The ability to cope with disturbance and change will depend on these values and responsibilities, and local communities are less likely to respond when government management and interests are strong.

Dental Workforce Availability and Dental Services Utilization in Appalachia: A Geospatial Analysis

Science.gov (United States)

Feng, Xue; Sambamoorthi, Usha; Wiener, R. Constance

2016-01-01

Objectives There is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia. Methods We derived county-level (n = 364) data on demographic, socio-economic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resource File, and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate Local Indicators of Spatial Association (LISA) and geographically weighted regression (GWR). Results Bivariate LISA showed that counties in the central and southern Appalachian regions had significant (p dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics >1.96) and 13.45% (t-statistics >1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively. Conclusions Dental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest

Patterns of the utilization of prenatal diagnosis services among pregnant women, their satisfaction and its associated factors in Viet Nam.

Science.gov (United States)

Doan, Duong Thi Thuy; Nguyen, Huong Thi Thu; Bui, Ha Thi Thu

2017-02-01

This study aimed at understanding the patterns of the utilization of prenatal diagnostic (PND) services among pregnant women, their satisfaction and its associated factors at three regional prenatal diagnostic centres in Viet Nam. A cross-sectional design was used, with a consecutive sampling method to recruit pregnant women who used PND services at the three biggest regional PND services centres in Viet Nam between January and June, 2014. A total of 298 participants, about 100 participants per centre were interviewed and included in data analysis. Descriptive analyses and logistic regression methods were applied to identify association between satisfaction of women and their socio-economic characteristics. 80% of pregnant women received counselling on PND services, whilst 90% received ultrasonography services; 65.4% were satisfied with the PND services they used. Pregnant women, who were in a lower income group and received counselling but did not receive ultrasonography, were more likely to have higher satisfaction levels of PND services. A process to ensure that every pregnant woman receives sufficient PND counselling before and after receiving PND testing must be given careful and thorough consideration.

Neighborhood disadvantage moderates associations of parenting and older sibling problem attitudes and behavior with conduct disorders in African American children.

Science.gov (United States)

Brody, Gene H; Ge, Xiaojia; Kim, Su Yeong; Murry, Velma McBride; Simons, Ronald L; Gibbons, Frederick X; Gerrard, Meg; Conger, Rand D

2003-04-01

Data from 296 sibling pairs (mean ages 10 and 13 years), their primary caregivers, and census records were used to test the hypothesis that African American children's likelihood of developing conduct problems associated with harsh parenting, a lack of nurturant-involved parenting, and exposure to an older sibling's deviance-prone attitudes and behavior would be amplified among families residing in disadvantaged neighborhoods. A latent construct representing harsh-inconsistent parenting and low levels of nurturant-involved parenting was positively associated with younger siblings' conduct disorder symptoms, as were older siblings' problematic attitudes and behavior. These associations were strongest among families residing in the most disadvantaged neighborhoods. Future research and prevention programs should focus on the specific neighborhood processes associated with increased vulnerability for behavior problems.

User involvement and supporting tools in business-to-business service innovations: Insights from Facility Management services

DEFF Research Database (Denmark)

Nardelli, Giulia

is the generalizability of the findings to other business-to-business service sectors. More research conducted both in FM services and other service sectors would help to shed light on the generalizability of these findings. Originality/value – The study contributes with new and detailed insights into the complexity......Purpose – This article investigates and conceptualizes user involvement in business-to-business service innovations as well as the tools that are used to support interactions in such a service innovation process. Design/methodology/approach – The paper uses a qualitative research approach to answer...... the research question. By following Miles and Huberman (1984)’s this study started with a literature review of studies investigating service innovation, service innovations models, user roles and tools in service innovation in general, to conduct an empirical investigation in facility management (FM) services...

Volunteer Service and Service Learning: Opportunities, Partnerships, and United Nations Millennium Development Goals.

Science.gov (United States)

Dalmida, Safiya George; Amerson, Roxanne; Foster, Jennifer; McWhinney-Dehaney, Leila; Magowe, Mabel; Nicholas, Patrice K; Pehrson, Karen; Leffers, Jeanne

2016-09-01

This article explores approaches to service involvement and provides direction to nurse leaders and others who wish to begin or further develop global (local and international) service or service learning projects. We review types of service involvement, analyze service-related data from a recent survey of nearly 500 chapters of the Honor Society of Nursing, Sigma Theta Tau International (STTI), make recommendations to guide collaborative partnerships and to model engagement in global and local service and service learning. This article offers a literature review and describes results of a survey conducted by the STTI International Service Learning Task Force. Results describe the types of service currently conducted by STTI nursing members and chapters, including disaster response, service learning, and service-related responses relative to the Millennium Development Goals (MDGs). The needs of chapter members for information about international service are explored and recommendations for promoting global service and sustainability goals for STTI chapters are examined. Before engaging in service, volunteers should consider the types of service engagement, as well as the design of projects to include collaboration, bidirectionality, sustainability, equitable partnerships, and inclusion of the United Nations Sustainable Development Goals. STTI supports the learning, knowledge, and professional development of nurses worldwide. International service and collaboration are key to the advancement of the nursing profession. Culturally relevant approaches to international service and service learning are essential to our global organization, as it aims to impact the health status of people globally. © 2016 Sigma Theta Tau International.

Health Services Utilization Patterns Associated with Emergency Department Closure

DEFF Research Database (Denmark)

Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

2011-01-01

, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...

Are doctors and nurses associated with coverage of essential health services in developing countries? A cross-sectional study

Directory of Open Access Journals (Sweden)

de Pinho Helen

2009-03-01

Full Text Available Abstract Background There is broad policy consensus that a shortage of doctors and nurses is a key constraint to increasing utilization of essential health services important for achieving the health Millennium Development Goals. However there is limited research on the quantitative links between health workers and service coverage rates. We examined the relationship between doctor and nurse concentrations and utilization rates of five essential health services in developing countries. Methods We performed cross-national analyses of low- and middle-income countries by means of ordinary least squares regression with coverage rates of antenatal care, attended delivery, caesarean section, measles immunization, tuberculosis case diagnosis and care for acute respiratory infection as outcomes. Doctor, nurse and aggregate health worker (sum of doctors and nurses concentrations were the main explanatory variables. Results Nurses were associated with utilization of skilled birth attendants (P = 0.02 and doctors were associated with measles immunization rates (P = 0.01 in separate adjusted analyses. Aggregate health workers were associated with the utilization of skilled birth attendants (P Conclusion A range of health system and population-level factors aside from health workers influences coverage of health services in developing countries. However, it is also plausible that health workers who are neither doctors nor nurses, such as clinical officers and community health workers, may be providing a substantial proportion of health services. The human resources for health research agenda should be expanded beyond doctors and nurses.

Using the ecosystem services concept to analyse stakeholder involvement in wetland management

NARCIS (Netherlands)

Cohen-Shacham, E.; Dayan, T.; Groot, de R.S.; Beltrame, C.; Guillet, F.; Feitelson, E.

2015-01-01

Wetland management usually involves multiple stakeholders. This paper describes how the use of the ecosystem services (ES) concept can help to identify the main stakeholders associated with wetland conservation, using the Hula Wetland in the Sea of Galilee’s watershed as a case study. We conducted a

Medicaid Reimbursement for School Nursing Services: A Position Paper of the National Association of State School Nurse Consultants.

Science.gov (United States)

Journal of School Health, 1996

1996-01-01

This statement of the National Association of State School Nurse Consultants lists those school nursing services and procedures the organization believes should be reimbursable by Medicaid to school districts. Identified services are in the areas of case finding, nursing care procedures, care coordination, patient/student counseling, and emergency…

47 CFR 1.1603 - Conduct of random selection.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Conduct of random selection. 1.1603 Section 1.1603 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1603 Conduct of random selection. The...

The Dilemma of Service Productivity and Service Innovation

Science.gov (United States)

Aspara, Jaakko; Klein, Jan F.; Luo, Xueming; Tikkanen, Henrikki

2017-01-01

We conduct a systematic exploratory investigation of the effects of firms’ existing service productivity on the success of their new service innovations. Although previous research extensively addresses service productivity and service innovation, this is the first empirical study that bridges the gap between these two research streams and examines the links between the two concepts. Based on a comprehensive data set of new service introductions in a financial services market over a 14-year period, we empirically explore the relationship between a firm’s existing service productivity and the firm’s success in introducing new services to the market. The results unveil a fundamental service productivity-service innovation dilemma: Being productive in existing services increases a firm’s willingness to innovate new services proactively but decreases the firm’s capabilities of bringing these services to the market successfully. We provide specific insights into the mechanism underlying the complex relationship between a firm’s productivity in existing services, its innovation proactivity, and its service innovation success. For managers, we not only unpack and elucidate this dilemma but also demonstrate that a focused customer scope and growth market conditions may enable firms to mitigate the dilemma and successfully pursue service productivity and service innovation simultaneously. PMID:29706764

Community pharmacy-based asthma services--what do patients prefer?

Science.gov (United States)

Naik Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

2010-12-01

Patient preferences can influence the outcomes of treatment and so understanding and organizing health-care services around these preferences is vital. To explore patient preferences for types of community pharmacy-based asthma services, to investigate the influence of "experience" in molding preferences for such services, and to identify aspects of the services that patients prefer over others. Semistructured face-to-face interviews were conducted with a convenience sample of two types of asthma patients: (1) those naïve to a specialized asthma service and (2) those who had experienced a specialized asthma service. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Eighteen interviews were conducted (8 experienced patients, 10 naïve patients). The majority of the patients wanted the pharmacist to play a greater role in their asthma management. Patients experiencing increased levels of service had increased levels of expectations as well as more specific preferences for various aspects of the service. The key aspects of an asthma service that all patients wanted their pharmacists to provide were the provision of information about asthma and its medications, lung function testing and monitoring of their asthma, and checking/correcting their inhaler technique. Patients also expressed a desire for skilled communication and behavioral aspects from the pharmacist such as friendliness, empathy, attentiveness, and dedicated time. Patients highlighted the importance of privacy in the pharmacy. There was a high level of satisfaction toward the currently delivered asthma service among both naïve and experienced patients. The provision of the specialized service was associated with increased patient loyalty to the particular pharmacy. All patients indicated a willingness to participate in future pharmacy-delivered specialized asthma services. Elements of the specialized pharmacy-based asthma services important from a patient's perspective were

7 CFR 900.302 - Associations eligible to vote.

Science.gov (United States)

2010-01-01

... Conduct of Referenda To Determine Producer Approval of Milk Marketing Orders To Be Made Effective Pursuant to Agricultural Marketing Agreement Act of 1937, as Amended § 900.302 Associations eligible to vote... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

Assessing the service quality in Software-as-a-Service from the customers’ perspective: a methodological approach and case of use

Directory of Open Access Journals (Sweden)

André Luís Policani Freitas

2017-11-01

Full Text Available Abstract Despite the advances in the evaluation of the quality of Software-as-a-Service (SaaS, new studies seem to be necessary, since the existing criticisms concerning the SERVQUAL scale and the lack of studies concerning the use of SERVPERF for this purpose. This work aims to fulfil this gap by proposing a methodological approach to assess the SaaS service quality by measuring SaaS customers’ satisfaction. Factor analysis is used to summarize the information contained in the original items into a smaller set of new dimensions and Quartile analysis is suggested to determine the most critical items. By conducting a study, the factors that most influence customer’s satisfaction are customer service, customer assistance and the reliability of SaaS. Most of the critical items are associated with the transparency and accuracy in correcting errors, the company's interest in solving customer problems, SaaS application's ability to meet business requirements, implemented updates and regularity of service performance.

Food Service Management

Science.gov (United States)

Rappole, C. L.; Louvier, S. A.

1985-01-01

A study to design a food service system using current technology to serve a small scale Space Station was conducted. The psychological, sociological and nutritional factors affecting feeding in microgravity conditions was investigated. The logistics of the food service system was defined.

Service innovation methodologies I : what can we learn from service innovation and new service development research? : report no 1 from the TIPVIS-project

OpenAIRE

Nysveen, Herbjørn; Pedersen, Per E.

2007-01-01

This report presents a review of service innovation and service development literature. The main purpose of the review is to identify normative implications for service innovation methodologies. Three separate reviews are conducted and reported; an open search review based on specific search terms of relevance to service innovation methodologies, a review of articles in four of the most influential journals on service innovation/service development, and a review focusing contri...

Pre-Service Visual Art Teachers' Perceptions of Assessment in Online Learning

Science.gov (United States)

Allen, Jeanne Maree; Wright, Suzie; Innes, Maureen

2014-01-01

This paper reports on a study conducted into how one cohort of Master of Teaching pre-service visual art teachers perceived their learning in a fully online learning environment. Located in an Australian urban university, this qualitative study provided insights into a number of areas associated with higher education online learning, including…

Service Modularity

DEFF Research Database (Denmark)

Avlonitis, Viktor; Hsuan, Juliana

2015-01-01

The purpose of this research is to investigate the studies on service modularity with a goal of informing service science and advancing contemporary service systems research. Modularity, a general systems property, can add theoretical underpinnings to the conceptual development of service science...... in general and service systems in particular. Our research is guided by the following question: how can modularity theory inform service system design? We present a review of the modularity literature and associated concepts. We then introduce the contemporary service science and service system discourse...

Prevalence and Factors Associated with the Utilization of Dental Care Services among Factory Workers in Nava Nakorn Industrial Estate, Pathumthani Province, Thailand.

Science.gov (United States)

Jaidee, Jeeratip; Ratanasiri, Amornrat; Chatrchaiwiwatana, Supaporn; Soonthon, Surasak

2015-07-01

The present study aimed to find out the utilization prevalence of dental care services among factory workers over a period of one year and factors associated with utilization of dental care services. This was a cross-sectional analytic study. The study population was factory workers in Nava Nakorn Industrial Estate randomly sampled using Probability Proportion to Size Cluster Sampling Method. The tool was a questionnaire about utilization of dental care services. Among the sample group of 1,500 workers from 16 factories, almost 2/3 (63.9%) had never used any dental care services in the previous year while only 36.1% did. A multivariable logistic regression analysis showed that workplace, accommodation, tooth decay, toothache history, transportation, experience in using social security fund for dental care services, availability and accessibility of dental care services, brushing teeth regularly after meals, using dental care services regularly in a dental clinic, and agreement with the idea that a tooth extraction and medication by a dentist could reduce the risk of progression of disease, statistical significance (p-value < 0.05), were factors associated with the utilization of dental care services at R2 (The Nagelkerke R Square) 0.38. That the prevalence of the factory workers who did not use dental care services during the last one year was 63.9 percent. This study identified three groups of factors associated with the utilization of dental care services as: 1) Predisposing factors, 2) Enabling factors, and 3) Need factors.

Mental health services for homeless: patient profile and factors associated with suicide and homicide.

LENUS (Irish Health Repository)

Dunne, E

2012-03-01

This study aimed to establish a profile of users of the mental health service for homeless in Cork, comparing this group with those attending a General Adult Service. The homeless group were significantly more likely to be male (89% v. 46%o), unemployed (96% v. 68%), unmarried (98% v. 75%) and under 65 (94% v. 83%). Diagnostically, there was a significantly higher prevalence of schizophrenia (50% v. 34%); personality disorder (37% v. 11%) and substance dependence (74% v. 19%) in the homeless service users. They were more likely to have a history of deliberate self harm (54% v. 21%) and violence (48% v. 10%). Severe mental illness has a high prevalence in the homeless population, with particularly high levels of factors associated with suicide and homicide. Poor compliance and complexity of illness lead to a requirement for significant input from multidisciplinary mental health teams members.

18 CFR 284.286 - Standards of conduct for unbundled sales service.

Science.gov (United States)

2010-04-01

... ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY OTHER REGULATIONS UNDER THE NATURAL GAS POLICY ACT OF... POLICY ACT OF 1978 AND RELATED AUTHORITIES Blanket Certificates Authorizing Certain Natural Gas Sales by...) A pipeline that provides unbundled sales service under § 284.284 must have tariff provisions on file...

Association between time of pay-for-performance for patients and community health services use by chronic patients.

Directory of Open Access Journals (Sweden)

Xi Sun

Full Text Available BACKGROUND: Pay-for-performance for patients is a cost-effective means of improving health behaviours. This study examined the association between the pay time for performance for patients and CHS use by chronic patients. METHODS: A cross-sectional study was undertaken to estimate distribution characteristics of CHS use in 2011 and collect data of socio-demographic characteristics (sex, age, education level, occupation, disposable personal income in 2011, distance between home and community health agency, chronic disease number, and time of pay-for-performance for patients. Participants were 889 rural adults with hypertension or type II diabetes aged 35 and above. Standardized CHS use means chronic patients use CHS at least once per quarter. RESULTS: Patients who received incentives prior to services had 2.724 times greater odds of using standardized CHS than those who received incentives after services (95%CI, 1.986-3.736, P<0.001. For all subgroups (socio-demographic characteristics and chronic disease number, patients who received incentives prior to services were more likely to use standardized CHS than those receiving incentives after services. CONCLUSIONS: Pay time for performance for patients was associated with CHS use by chronic patients. Patients receiving incentive prior to services were more likely to use standardized CHS. And pay time should not be ignored when the policy on pay-for-performance for patients is designed.

Association of Cost Sharing With Use of Home Health Services Among Medicare Advantage Enrollees.

Science.gov (United States)

Li, Qijuan; Keohane, Laura M; Thomas, Kali; Lee, Yoojin; Trivedi, Amal N

2017-07-01

Several policy proposals advocate introducing copayments for home health care in the Medicare program. To our knowledge, no prior studies have assessed this cost-containment strategy. To determine the association of home health copayments with use of home health services. A difference-in-differences case-control study of 18 Medicare Advantage (MA) plans that introduced copayments for home health care between 2007 and 2011 and 18 concurrent control MA plans. The study included 135 302 enrollees in plans that introduced copayment and 155 892 enrollees in matched control plans. Introduction of copayments for home health care between 2007 and 2011. Proportion of enrollees receiving home health care, annual numbers of home health episodes, and days receiving home health care. Copayments for home health visits ranged from $5 to $20 per visit, which were estimated to be associated with $165 (interquartile range [IQR], $45-$180) to $660 (IQR, $180-$720) in out-of-pocket spending for the average user of home health care. The increased copayment for home health care was not associated with the proportion of enrollees receiving home health care (adjusted difference-in-differences, -0.15 percentage points; 95% CI, -0.38 to 0.09), the number of home health episodes per user (adjusted difference-in-differences, 0.01; 95% CI, -0.01 to 0.03), and home health days per user (adjusted difference-in-differences, -0.19; 95% CI, -3.02 to 2.64). In both intervention and control plans and across all levels of copayments, we observed higher disenrollment rates among enrollees with greater baseline use of home health care. We found no evidence that imposing copayments reduced the use of home health services among older adults. More intensive use of home health services was associated with increased rates of disenrollment in MA plans. The findings raise questions about the potential effectiveness of this cost-containment strategy.

7 CFR 97.157 - Professional conduct.

Science.gov (United States)

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... appearing before the Office shall conform to the standards of ethical and professional conduct, generally...

39 CFR 10.2 - Advisory service.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Advisory service. 10.2 Section 10.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE RULES OF CONDUCT FOR POSTAL SERVICE GOVERNORS (ARTICLE X) § 10.2 Advisory service. (a) The General Counsel is the Ethical...

Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study.

Science.gov (United States)

Habte, Feleke; Demissie, Meaza

2015-11-17

Ethiopia is one of the six countries that contributes' to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia. A community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression. A total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband's attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2(nd) youngest child were found to have statistically significant association with institutional delivery. Institutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service

Determinants of psychology service utilization in a palliative care outpatient population.

Science.gov (United States)

Azuero, Casey; Allen, Rebecca Sue; Kvale, Elizabeth; Azuero, Andres; Parmelee, Patricia

2014-06-01

Research has demonstrated that treating cancer patients' psychological and physical health leads to improved overall health. This may be especially true for palliative care patients facing serious illness. This study examines the proportion and determinants of psychology service utilization in an outpatient palliative care population. Data from an existing clinical database in an outpatient palliative clinic utilizing a collaborative care model to deliver psychology services were explored. This study was framed by Andersen's Behavioral Model of Health Service Use, which incorporates three main components: predisposing, enabling, and need factors to model health service utilization. The sample (N = 149) was majority middle aged, female, and White with a primary diagnosis of cancer. Cross-tabulations were conducted to determine how many patients who met screening criteria for depression or anxiety sought psychology services. Logistic regression analyses were conducted to assess for predisposing, enabling, and need factor determinants of psychology service utilization. Among patients who met criteria for moderate depression or anxiety, 50% did not access readily available psychology services. Enabling factors were the strongest determinant of psychology utilization. Factors associated with need for psychology services (i.e., emotional distress and psychological symptom burden) did not reach significance in determining psychology service use. This study extends current knowledge about psychology utilization to palliative care outpatients receiving care within a collaborative care model. Directions for future research include further investigation of care models that optimize enabling strategies to enhance access to these services, and examination of patient-reported barriers to receiving this care. Copyright © 2013 John Wiley & Sons, Ltd.

Impact of Service Quality of House Wedding Events on the Service Value and Satisfaction

Directory of Open Access Journals (Sweden)

Kim Soungyeon

2014-01-01

Full Text Available With the current popularity of the newly emerged house wedding events (HWE, this study aims to investigate the impact of service quality of house wedding events on service value and satisfaction of customers. Based on literature review, two main components of HWE service quality attributes were selected: physical service and human service. For service value, three components were chosen: social, aesthetic, and monetary value. The study conducted self-administered questionnaire survey from July 1st to August 31st 2013 targeting 300 male and female over age 20 with experiences of participating in HWE held in Seoul metropolitan areas. The final valid samples were 267 copies. Frequency analysis, exploratory factor analysis, reliability analysis and regression analysis were conducted on the collected data. The result of this study showed a significant positive impact of HWE’s service quality, which in turn influence satisfaction. In addition, the study found the direct impact of HWE’s service quality on customer satisfaction. Based on the results, this study also discussed practical implications.

Fostering creativity in product and service development: validation in the domain of information technology.

Science.gov (United States)

Zeng, Liang; Proctor, Robert W; Salvendy, Gavriel

2011-06-01

This research is intended to empirically validate a general model of creative product and service development proposed in the literature. A current research gap inspired construction of a conceptual model to capture fundamental phases and pertinent facilitating metacognitive strategies in the creative design process. The model also depicts the mechanism by which design creativity affects consumer behavior. The validity and assets of this model have not yet been investigated. Four laboratory studies were conducted to demonstrate the value of the proposed cognitive phases and associated metacognitive strategies in the conceptual model. Realistic product and service design problems were used in creativity assessment to ensure ecological validity. Design creativity was enhanced by explicit problem analysis, whereby one formulates problems from different perspectives and at different levels of abstraction. Remote association in conceptual combination spawned more design creativity than did near association. Abstraction led to greater creativity in conducting conceptual expansion than did specificity, which induced mental fixation. Domain-specific knowledge and experience enhanced design creativity, indicating that design can be of a domain-specific nature. Design creativity added integrated value to products and services and positively influenced customer behavior. The validity and value of the proposed conceptual model is supported by empirical findings. The conceptual model of creative design could underpin future theory development. Propositions advanced in this article should provide insights and approaches to facilitate organizations pursuing product and service creativity to gain competitive advantage.

Skin Conductance Level Reactivity Moderates the Association between Harsh Parenting and Growth in Child Externalizing Behavior

Science.gov (United States)

Erath, Stephen A.; El-Sheikh, Mona; Hinnant, J. Benjamin; Cummings, E. Mark

2011-01-01

Skin conductance level reactivity (SCLR) was examined as a moderator of the association between harsh parenting at age 8 years and growth in child externalizing behavior from age 8 to age 10 (N = 251). Mothers and fathers provided reports of harsh parenting and their children's externalizing behavior; children also provided reports of harsh…

Organizational Attributes Associated With Medicare ACO Quality Performance.

Science.gov (United States)

Zhu, Xi; Mueller, Keith; Huang, Huang; Ullrich, Fred; Vaughn, Thomas; MacKinney, A Clinton

2018-05-08

To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively. Results show that after adjusting for other organizational factors, rural ACOs' average quality score was comparable to that of ACOs serving other geographic categories. ACOs with hospital-system sponsorship, larger beneficiary panels, and higher posthospitalization follow-up rates achieved better quality performance. There is no significant difference in average quality performance between rural ACOs and other ACOs after adjusting for structural and service-provision factors. MSSP ACO quality performance is positively associated with hospital-system sponsorship, beneficiary panel size, and posthospitalization follow-up rate. © 2018 National Rural Health Association.

Women in service uniforms

Directory of Open Access Journals (Sweden)

Hanna Karaszewska

2012-12-01

Full Text Available The article discusses the problems of women who work in the uniformed services with the particular emphasis on the performing of the occupation of the prison service. It presents the legal issues relating to equal treatment of men and women in the workplace, formal factors influencing their employment, the status of women in prison, and the problems of their conducting in the professional role. The article also presents the results of research conducted in Poland and all over the world, on the functioning of women in prison and their relations with officers of the Prison Service, as well as with inmates.

Uncovering ecosystem service bundles through social preferences.

Directory of Open Access Journals (Sweden)

Berta Martín-López

Full Text Available Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem's capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem's capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis. We found a clear trade-off among provisioning services (and recreational hunting versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs.

Uncovering Ecosystem Service Bundles through Social Preferences

Science.gov (United States)

Martín-López, Berta; Iniesta-Arandia, Irene; García-Llorente, Marina; Palomo, Ignacio; Casado-Arzuaga, Izaskun; Amo, David García Del; Gómez-Baggethun, Erik; Oteros-Rozas, Elisa; Palacios-Agundez, Igone; Willaarts, Bárbara; González, José A.; Santos-Martín, Fernando; Onaindia, Miren; López-Santiago, Cesar; Montes, Carlos

2012-01-01

Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem’s capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem’s capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs. PMID:22720006

Capability of Poultry Farmers Association for Extension Services ...

African Journals Online (AJOL)

dr funmi owolade

information on poultry management techniques and marketing during in-house ... optimum human and material resources for extension services delivery to its .... vii. investigate the constraints to extension services programme in Oyo state. ..... developing countries in Agricultural Extension in Nigeria S.F. Afolayan (ed) Ilorin.

Alterations of Brain Functional Architecture Associated with Psychopathic Traits in Male Adolescents with Conduct Disorder

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Pu, Weidan; Luo, Qiang; Jiang, Yali; Gao, Yidian; Ming, Qingsen; Yao, Shuqiao

2017-01-01

Psychopathic traits of conduct disorder (CD) have a core callous-unemotional (CU) component and an impulsive-antisocial component. Previous task-driven fMRI studies have suggested that psychopathic traits are associated with dysfunction of several brain areas involved in different cognitive functions (e.g., empathy, reward, and response inhibition etc.), but the relationship between psychopathic traits and intrinsic brain functional architecture has not yet been explored in CD. Using a holist...

[Accessibility and quality to health social services in Italy for the patients with rare diseases: the opinion of associations].

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Agazio, E; Salerno, P; Mirabella, F; Gnessi, F; Mastroiacovo, P; Morosini, P; Tarsitani, G; Taruscio, D

2005-01-01

This paper concerns the first phase of a study about the perception of social and health needs of people with rare diseases. The study was performed by the National Center for Rare Diseases at the Italian National Institute of Health (Istituto Superiore di Sanità - ISS). The project wants to be an example of collaboration between the research and the association worlds. Responsible of Associations of Patients and their relatives were asked their opinion about the accessibility and quality of important features of health and social services (accessibility and quality of diagnostic, pharmacological, psychological and rehabilitative interventions, social support, school and vocational training, information that was given to relatives). An ad hoc questionnaire was developed through focus groups. The questionnaire was completed by 108 associations (26,5% of the associations thar are recorded in the ISS database). Average scores showed satisfaction only for some variables and a negative gradient north-south was observed. The most frequent complaints were about information, quality of school and job training services and availability of psychological support. The study showed an high level of dissatisfaction with availability, quality and integration health and social services.

From admission to discharge in mental health services: a qualitative analysis of service user involvement.

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Wright, Nicola; Rowley, Emma; Chopra, Arun; Gregoriou, Kyriakos; Waring, Justin

2016-04-01

User involvement and recovery are now widely used terms within the mental health policy, research and practice discourse. However, there is a question mark about the impact these ideas have in everyday practice. Of interest is the degree of involvement in key transitions of care. In particular, admission to and discharge from acute inpatient mental health wards. To explore the nature of service user involvement in the admission and discharge process into and out of acute inpatient mental health care. A qualitative study using focus groups. One acute, inpatient mental health ward was the focus of the study. Seven uniprofessional focus group interviews were conducted with ward staff, community staff and service users (total number of participants = 52). Conventional, thematic qualitative techniques were used to analyse the data. The data analysed and presented in this article relate to the loss of the service user voice at the key transition points into and out of acute inpatient care. Due to the lack of resources (inpatient beds and community care follow-up), the role service users could play was diminished. In their narratives, clinical staff associated the person with the process and used language which dehumanized the individual. Service users experience numerous care transitions into and out of hospital. As there is the potential for these encounters to have a lasting negative effect, the importance of ensuring service users have a voice in what is happening to them is crucial. © 2015 John Wiley & Sons Ltd.

Conducting research in clinical psychology practice: Barriers, facilitators, and recommendations.

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Smith, Kirsten V; Thew, Graham R

2017-09-01

The combination of clinical psychologists' therapeutic expertise and research training means that they are in an ideal position to be conducting high-quality research projects. However, despite these skills and the documented benefits of research to services and service users, research activity in practice remains low. This article aims to give an overview of the advantages of, and difficulties in conducting research in clinical practice. We reviewed the relevant literature on barriers to research and reflected on our clinical and research experiences in a range of contexts to offer practical recommendations. We considered factors involved in the planning, sourcing support, implementation, and dissemination phases of research, and outline suggestions to improve the feasibility of research projects in post-qualification roles. We suggest that research leadership is particularly important within clinical psychology to ensure the profession's continued visibility and influence within health settings. Clinical implications Emerging evidence suggests that clinical settings that foster research are associated with better patient outcomes. Suggestions to increase the feasibility of research projects in clinical settings are detailed. Limitations The present recommendations are drawn from the authors' practical experience and may need adaptation to individual practitioners' settings. This study does not attempt to assess the efficacy of the strategies suggested. © 2017 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan

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Abdullah Alkhawaldeh

2014-01-01

Full Text Available Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR=13.32, (OR=19.63, and (OR=17.91, respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.

Associations between perceptions of drinking water service delivery and measured drinking water quality in rural Alabama.

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Wedgworth, Jessica C; Brown, Joe; Johnson, Pauline; Olson, Julie B; Elliott, Mark; Forehand, Rick; Stauber, Christine E

2014-07-18

Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure-a risk factor for contamination-may be relatively reliable and therefore useful in future monitoring efforts.

Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

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Jessica C. Wedgworth

2014-07-01

Full Text Available Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure and general aesthetic characteristics (taste, odor and color, providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets and as-delivered from the distribution network (from outside flame-sterilized taps, if available, where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color. Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts.

Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

Science.gov (United States)

Wedgworth, Jessica C.; Brown, Joe; Johnson, Pauline; Olson, Julie B.; Elliott, Mark; Forehand, Rick; Stauber, Christine E.

2014-01-01

Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts. PMID:25046635

The barriers associated with emergency medical service use for acute coronary syndrome: the awareness and influence of an Australian public mass media campaign.

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Cartledge, Susie; Finn, Judith; Straney, Lahn; Ngu, Phillip; Stub, Dion; Patsamanis, Harry; Shaw, James; Bray, Janet

2017-07-01

Emergency medical services (EMS) transport to hospital is recommended in acute coronary syndrome (ACS) guidelines, but only half of patients with ACS currently use EMS. The recent Australian Warning Signs campaign conducted by the Heart Foundation addressed some of the known barriers against using EMS. Our aim was to examine the influence of awareness of the campaign on these barriers in patients with ACS. Interviews were conducted with patients admitted to an Australian tertiary hospital between July 2013 and April 2014 with a diagnosis of ACS. Patient selection criteria included: aged 35-75 years, competent to provide consent, English speaking, not in residential care and medically stable. Multivariable logistic regression was used to examine factors associated with EMS use. Only 54% of the 199 patients with ACS interviewed used EMS for transport to hospital. Overall 64% of patients recalled seeing the campaign advertising, but this was not associated with increased EMS use (52.0%vs56.9%, p=0.49) or in the barriers against using EMS. A large proportion of patients (43%) using other transport thought it would be faster. Factors associated with EMS use for ACS were: age >65 years, ST-elevation myocardial infarction, a sudden onset of pain and experiencing vomiting. In medically stable patients with ACS, awareness of the Australian Warning Signs campaign was not associated with increased use of EMS or a change in the barriers for EMS use. Future education strategies could emphasise the clinical role that EMS provide in ACS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The association between income source and met need among community mental health service users in Ontario, Canada.

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Durbin, Anna; Bondy, Susan J; Durbin, Janet

2012-10-01

We examined income source and match between recommended and received care among users of community mental health services. We conducted a secondary analysis of needs-based planning data on adults in Ontario community mental health programs from 2000 to 2002. The outcome was whether clients were severely underserved (yes/no) based on the match between level of care recommended and received. A logistic regression model investigated if income source predicted this outcome. 13% of clients were severely underserved. Over 40% were on public assistance and they had a higher risk of being severely undeserved than the others. Men were at greater risk. One aim of mental health reform is to increase access to care for vulnerable individuals. The finding that among users of community mental health services, individuals with public assistance income support are most vulnerable to being severely underserved should be considered by service planners and providers.

Factors associated with the utilization and costs of health and social services in frail elderly patients

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Kehusmaa Sari

2012-07-01

Full Text Available Abstract Background Universal access is one of the major aims in public health and social care. Services should be provided on the basis of individual needs. However, municipal autonomy and the fragmentation of services may jeopardize universal access and lead to variation between municipalities in the delivery of services. This paper aims to identify patient-level characteristics and municipality-level service patterns that may have an influence on the use and costs of health and social services of frail elderly patients. Methods Hierarchical analysis was applied to estimate the effects of patient and municipality-level variables on services utilization. Results The variation in the use of health care services was entirely due to patient-related variables, whereas in the social services, 9% of the variation was explained by the municipality-level and 91% by the patient-level characteristics. Health-related quality of life explained a major part of variation in the costs of health care services. Those who had reported improvement in their health status during the preceding year were more frequent users of social care services. Low informal support, poor functional status and poor instrumental activities of daily living, living at a residential home, and living alone were associated with higher social services expenditure. Conclusions The results of this study showed municipality-level variation in the utilization of social services, whereas health care services provided for frail elderly people seem to be highly equitable across municipalities. Another important finding was that the utilization of social and health services were connected. Those who reported improvement in their health status during the preceding year were more frequently also using social services. This result suggests that if municipalities continue to limit the provision of support services only for those who are in the highest need, this saving in the social sector may, in

Patterns of dental services and factors that influence dental services among 64-65-year-old regular users of dental care in Denmark.

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Christensen, Lisa B; Rosing, Kasper; Lempert, Susanne M; Hede, Børge

2016-03-01

To describe the pattern of dental services provided to 64-65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related to dental status and caries experience. Finally, to discuss the future planning of dental services aimed at the increasing population of elderly citizens. [Correction made on 21 March 2014, after first online publication: The sentence 'Data on elderly's dental service are scarce, although increased use is seen and more teeth are present in this age group.' was removed.] A cross-sectional study of all aged 64-65 (n = 37 234) who received a dental examination in 2009 was conducted. Clinical data comprised dental services received under the National Health Insurance reimbursement scheme, dental status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public registers. Almost all received restorations, while periodontal treatment was received by dental services was dominated by periodontal services. Periodontal services were most prevalent in the capital and the most affluent areas. Relatively more extractions were related to low income and persons in least affluent areas. Total number of services was highest among women, persons with ≥20 teeth, persons living in the capital, and where the ratio user per dentist was low. For future planning of dental care for elderly, dental status, geographical and social area-based factors and to some degree gender, income, and education must be taken into consideration as all these factors seem to influence the future demand for dental services. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

A Pre-Diffusion Comparison of Urban and Rural Attitudes toward Advanced Television Services.

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Braun, Mark J.; Scully, Timothy L.

This study was grounded in the geography school of diffusion theory, specifically focusing on Ormrod's concept of "spatial receptiveness." A survey was conducted to test how location of residence (urban vs. rural) is associated with consumer attitudes toward high-definition television (HDTV) and other expanded television services.…

Combined Bicarbonate Conductance-Impairing Variants in CFTR and SPINK1 Are Associated with Chronic Pancreatitis in Patients without Cystic Fibrosis

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Schneider, Alexander; LaRusch, Jessica; Sun, Xiumei; Aloe, Amy; Lamb, Janette; Hawes, Robert; Cotton, Peter; Brand, Randall E.; Anderson, Michelle A.; Money, Mary E.; Banks, Peter A.; Lewis, Michele D.; Baillie, John; Sherman, Stuart; DiSario, James; Burton, Frank R.; Gardner, Timothy B.; Amann, Stephen T.; Gelrud, Andres; George, Ryan; Kassabian, Sirvart; Martinson, Jeremy; Slivka, Adam; Yadav, Dhiraj; Oruc, Nevin; Barmada, M. Michael; Frizzell, Raymond; Whitcomb, David C.

2010-01-01

Background & Aims Idiopathic chronic pancreatitis (ICP) is a complex inflammatory disorder associated with multiple genetic and environmental factors. In individuals without cystic fibrosis (CF), variants of CFTR that inhibit bicarbonate conductance but maintain chloride conductance might selectively impair secretion of pancreatic juice, leading to trypsin activation and pancreatitis. We investigated whether sequence variants in the gene encoding the pancreatic secretory trypsin inhibitor, SPINK1, further increase the risk of pancreatitis in these patients. Methods We screened patients with ICP (sporadic or familial) and controls for variants in SPINK1 associated with chronic pancreatitis (CP) risk (in exon 3) and in all 27 exons of CFTR. The final study group included 53 patients with sporadic ICP, 27 probands with familial ICP, and 150 unrelated controls, plus 503 controls for limited genotyping. CFTR wild-type (wt) and p.R75Q were cloned and expressed in HEK293 cells and relative conductances of HCO3− and Cl− were measured. Results SPINK1 variants were identified in 36% of subjects and 3% controls (odds ratio [OR]=16.5). One variant of CFTR that has not been associated with CF, p.R75Q, was found in 16% of subjects and 5.4% controls (OR=3.4). Co-inheritance of CFTR p.R75Q and SPINK1 variants occurred in 8.75% of patients and 0.15% controls (OR=62.5). Patch-clamp recordings of cells that expressed CFTR p.R75Q demonstrated normal chloride currents but significantly reduced bicarbonate currents (P=0.0001). Conclusions The CFTR variant p.R75Q causes a selective defect in bicarbonate conductance and increases risk for pancreatitis. Co-inheritance of CF-associated, and some not associated, CFTR variants with SPINK1 variants significantly increase risk of ICP. PMID:20977904

Cervical Cancer Screening Service Uptake and Associated Factors among Age Eligible Women in Mekelle Zone, Northern Ethiopia, 2015: A Community Based Study Using Health Belief Model.

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Hinsermu Bayu

Full Text Available Cervical cancer is the third most common cancer among women worldwide, with about 500,000 new patients diagnosed and over 250,000 deaths every year. Cervical cancer screening offers protective benefits and is associated with a reduction in the incidence of invasive cervical cancer and cervical cancer mortality. But there is very low participation rate in screening for cervical cancer among low and middle-income countries.This study aimed to determine cervical cancer screening service uptake and its associated factor among age eligible women in Mekelle zone, northern Ethiopia, 2015.A community based cross-sectional study was conducted in Mekelle zone among age eligible women from February to June 2015. Systematic sampling technique was used to select 1286 women in to the study. A pre-tested structured questionnaire was used to collect relevant data. Data was entered and cleaned using EPINFO and analyzed using SPSS version 20 software package. Bivariate and Multivariate logistic regression was performed to assess association between dependent and independent variables with 95% CI and p-value less than 0.05 was set for association.The study revealed that among 1186 age eligible women, only 235(19.8% have been screened for cervical cancer. Age (AOR = 1.799, 95%CI = 1.182-2.739, history of multiple sexual partners (AOR = 1.635, 95%CI = 1.094-2.443, history of sexually transmitted disease (AOR = 1.635,95%CI = 1.094-2.443, HIV sero status (AOR = 5.614, 95%CI = 2.595-12.144, perceived susceptibility to cervical cancer (AOR = 2.225, 95%CI = 1.308-3.783, perceived barriers to premalignant cervical lesions screening (AOR = 2.256, 95%CI = 1.447-3.517 and knowledge on cervical cancer and screening (AOR = 2.355, 95%CI = 1.155-4.802 were significant predictors of cervical cancer screening service uptake.Magnitude of cervical cancer screening service uptake among age eligible women is still unacceptably low. Age of the women, history of multiple sexual partners

Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China.

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Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng

2015-06-26

This study assessed the association between accessibility of catering service venues and adolescents' alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

Awareness of occupational skin disease in the service sector.

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Holness, D L; Kudla, I; Brown, J; Miller, S

2017-06-01

Occupational skin disease (OSD) is a common occupational disease. Although primary prevention strategies are known, OSDs remain prevalent in a variety of work environments including the service sector (restaurant/food services, retail/wholesale, tourism/hospitality and vehicle sales and service). To obtain information about awareness and prevention of OSD in the service sector. Focus groups and a survey were conducted with two groups. The first consisted of staff of the provincial health and safety association for the service sector and the second group comprised representatives from sector employers. Focus groups highlighted key issues to inform the survey that obtained information about perceptions of awareness and prevention of OSD and barriers to awareness and prevention. Both provincial health and safety association staff and sector employer representatives highlighted low awareness and a low level of knowledge of OSD in the sector. Barriers to awareness and prevention included a low reported incidence of OSD, low priority, lack of training materials, lack of time and cost of training, lack of management support and workplace culture. A starting point for improving prevention of OSD in the service sector is increased awareness. Identification of the barriers to awareness and prevention will help to shape an awareness campaign and prevention strategies. Building on existing experience in Europe will be important. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Women in service uniforms

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Hanna Karaszewska; Maciej Muskała

2012-01-01

The article discusses the problems of women who work in the uniformed services with the particular emphasis on the performing of the occupation of the prison service. It presents the legal issues relating to equal treatment of men and women in the workplace, formal factors influencing their employment, the status of women in prison, and the problems of their conducting in the professional role. The article also presents the results of research conducted in Poland and all over the world, on th...

Barriers to Seeking Mental Health Services among Adolescents in Military Families

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Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony

2014-01-01

Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070

Risk and Protective Factors Associated with Gambling Products and Services: Indigenous Gamblers in North Queensland

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Breen, Helen

2012-01-01

As part of a larger study, this paper reports on findings into risk and protective factors associated with gambling products and services by Indigenous Australians. Both Indigenous card gambling (traditional or unregulated) and commercial gambling (regulated) were investigated. Permission was granted by Indigenous Elders and by a university ethics…

Compound heterozygosity for mutations (W156X and R225W) in SCN5A associated with severe cardiac conduction disturbances and degenerative changes in the conduction system

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Bezzina, Connie R.; Rook, Martin B.; Groenewegen, W. Antoinette; Herfst, Lucas J.; van der Wal, Allard C.; Lam, Jan; Jongsma, Habo J.; Wilde, Arthur A. M.; Mannens, Marcel M. A. M.

2003-01-01

Cardiac conduction defects associate with mutations in SCN5A, the gene encoding the cardiac Na+ channel. In the present study, we characterized a family in which the proband was born in severe distress with irregular wide complex tachycardia. His older sister died at 1 year of age from severe

Working relationships of infection prevention and control programs and environmental services and associations with antibiotic-resistant organisms in Canadian acute care hospitals.

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Zoutman, Dick E; Ford, B Douglas; Sopha, Keith

2014-04-01

Environmental contamination in hospitals with antibiotic-resistant organisms (AROs) is associated with patient contraction of AROs. This study examined the working relationship of Infection Prevention and Control (IPAC) and Environmental Services and the impact of that relationship on ARO rates. Lead infection control professionals completed an online survey that assessed the IPAC and Environmental Services working relationship in their acute care hospital in 2011. The survey assessed cleaning collaborations, staff training, hospital cleanliness, and nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection, vancomycin-resistant Enterococcus (VRE) infection, and Clostridium difficile infection (CDI). The survey was completed by 58.3% of hospitals (119 of 204). Two-thirds (65.8%; 77 of 117) of the respondents reported that their cleaners were adequately trained, and 62.4% (73 of 117) reported that their hospital was sufficiently clean. Greater cooperation between IPAC and Environmental Services was associated with lower rates of MRSA infection (r = -0.22; P = .02), and frequent collaboration regarding cleaning protocols was associated with lower rates of VRE infection (r = -0.20; P = .03) and CDI (r = -0.31; P Environmental Services, and this was associated with lower rates of ARO. Deficits in the adequacy of cleaning staff training and hospital cleanliness were identified. The promotion of collaborative working relationships and additional training for Environmental Services workers would be expected to lower ARO rates. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

[Relationship of the effectiveness of care management services and burdens of primary family caregivers].

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Lee, Chia-Ling; Liu, Li-Fan; Chen, Shuh-Sin; Lin, Hsiu-Chun

2014-02-01

In Taiwan, long-term care management centers hold primary responsibility for administering long-term care services, assisting with long-term care placements, and sharing the care burden with family caregivers in need. Research into the effectiveness of current care management services and the effectiveness of these services in reducing care burdens remains limited. This study investigates the relationship among care management center service effectiveness, care management personnel, and burdens in relation to the provision of care services from the prospective of caregivers. A purposive sampling method and structured questionnaire survey were used to conduct telephone interviews with 154 home caregivers who had been transferred from care management centers to homecare service centers. Participants expressed overall satisfaction with care management centers and with the services provided by these centers. Satisfaction toward the care managers' professional competence was associated with lower physical burden for caregivers. Participants' psychological and social burdens were associated with overall satisfaction with the care management centers and their satisfaction with the services provided by care managers. The implementation of care management services has improved satisfaction. However, center services remain inadequate to reduce the psychological and social burdens of caregivers. Greater focus on these two aspects will be critical to the successful implementation of the proposed intensive care management model and multiple services intervention in order to meet the complex care needs of home service recipients and their primary caregivers.

HIV Case Management Support Service Is Associated with Improved CD4 Counts of Patients Receiving Care at the Antiretroviral Clinic of Pantang Hospital, Ghana

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Bismark Sarfo

2017-01-01

Full Text Available Background. Factors associated with individual patient-level management of HIV have received minimal attention in sub-Saharan Africa. This study determined the association between support services and cluster of differentiation 4 (CD4 counts among HIV patients attending ART clinic in Ghana. Methodology. This was a cross-sectional study involving adults with HIV recruited between 1 August 2014 and 31 January 2015. Data on support services were obtained through a closed-ended personal interview while the CD4 counts data were collected from their medical records. Data were entered into EpiData and analyzed using Stata software. Results. Of the 201 patients who participated in the study, 67% (129/191 received case management support service. Counseling about how to prevent the spread of HIV (crude odds ratio (cOR (95% confidence interval (CI (2.79 (1.17–6.68, mental health services (0.2 (0.04–1.00, and case management support service (2.80 (1.34–5.82 was associated with improved CD4 counts of 350 cells/mm3 or more. After adjusting for counseling about how to prevent the spread of HIV and mental health services, case management support service was significantly associated with CD4 counts of 350 cells/mm3 or more (aOR = 2.36 (CI = 1.01–5.49. Conclusion. Case management support service for HIV patients receiving ART improves their CD4 counts above 350 cells/mm3. Incorporating HIV case management services in ART regimen should be a priority in sub-Saharan Africa.

[Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

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Kim, Jiyeon; Kim, Hongsoo

2016-12-01

The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

Within-unit relationship quality mediates the association between military sexual trauma and posttraumatic stress symptoms in veterans separating from military service.

Science.gov (United States)

Laws, Holly; Mazure, Carolyn M; McKee, Sherry A; Park, Crystal L; Hoff, Rani

2016-09-01

Few studies have examined the impact of military sexual trauma (MST) on social functioning during deployment. Yet consideration of unit relationships during deployment may be important, given that military unit cohesion and support can provide protective effects against the stress of combat, and reduce the likelihood of developing posttraumatic stress disorder. Although prior research has posited that depleted social resources are one pathway through which MST is associated with posttraumatic stress symptoms (PTSS), no studies have statistically tested this theory. This study examined the association of MST and PTSS and evaluated the potential mediating role of decreased unit relationship quality. Mediational analyses were conducted on a sample of veterans following discharge from military service (N = 818; 328 women, 490 men). Women were significantly more likely to experience MST than men. As hypothesized, experiences of MST during deployment were associated with higher PTSS. MST experiences were associated with less trust in and support from one's military unit, which partially mediated the association between MST and PTSS. The indirect effect of MST on PTSS through lower unit relationship quality accounted for 20.4% of the total effect of MST on PTSS. While the retrospective study design precludes tests of causality, mediational findings provided statistical evidence that lower unit relationship quality partially explains the association between MST and PTSS. This finding is consistent with interpersonal theories of trauma response suggesting that the deleterious effects of MST may be in part due to its erosion of social resources during deployment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Oppositional Defiant Disorder, Conduct, and ADHD

OpenAIRE

J Gordon Millichap

1996-01-01

The link between oppositional defiant disorder (ODD) and conduct disorder (CD) was evaluated in 140 children with attention-deficit hyperactivity disorder (ADHD) and 120 normal controls examined at baseline and 4 years later, in midadolescence, at the Pediatric Psychopharmacology Unit, Psychiatric Service, Massachusetts General Hospital, Boston, MA.

Calibration-free electrical conductivity measurements for highly conductive slags

International Nuclear Information System (INIS)

Macdonald, Christopher J.; Gao, Huang; Pal, Uday B.; Van den Avyle, James A.; Melgaard, David K.

2000-01-01

This research involves the measurement of the electrical conductivity (K) for the ESR (electroslag remelting) slag (60 wt.% CaF 2 - 20 wt.% CaO - 20 wt.% Al 2 O 3 ) used in the decontamination of radioactive stainless steel. The electrical conductivity is measured with an improved high-accuracy-height-differential technique that requires no calibration. This method consists of making continuous AC impedance measurements over several successive depth increments of the coaxial cylindrical electrodes in the ESR slag. The electrical conductivity is then calculated from the slope of the plot of inverse impedance versus the depth of the electrodes in the slag. The improvements on the existing technique include an increased electrochemical cell geometry and the capability of measuring high precision depth increments and the associated impedances. These improvements allow this technique to be used for measuring the electrical conductivity of highly conductive slags such as the ESR slag. The volatilization rate and the volatile species of the ESR slag measured through thermogravimetric (TG) and mass spectroscopy analysis, respectively, reveal that the ESR slag composition essentially remains the same throughout the electrical conductivity experiments

Comparison of asbestos-associated respiratory disease by medical examination between shipyard retiree and workers of active service with asbestos exposure

International Nuclear Information System (INIS)

Ikeda, Tooru; Yoshida, Toshiaki; Fujisawa, Hiroyuki; Tanaka, Ayako; Ikeda, Hideki; Kawano, Hiroaki

2009-01-01

We examined 407 shipyard workers with asbestos exposure (406 men and one woman; mean age, 60.4 years) for asbestos-associated respiratory disease using the multi-slice chest CT in addition to the regular examinations. After the examination, workers with suspicion of malignancy by the multi-slice CT, other examinations including biopsy were performed to make the final diagnosis. We divided these people into two groups as follows; retiree (133 cases, 132 men and one woman; mean age, 65.9 years) and workers of shipyard active service (274 cases, all men, mean age, 57.6 years). We compared the incidence of asbestos-associated respiratory disease, age, incubation time and work period at asbestos exposure in these two groups. 97 of 133 (72.9%) retired workers and 94 of 274 (34.4%) active service had asbestos-associated respiratory disease as follows: pleural plaque without calcification, 25 cases (18.8%) (retired) and 35 (12.8%) (active service); pleural plaque with calcification, 65 (48.7%) and 51 (18.6%); diffuse pleural thickening, 0 (0%) and 0 (0%); asbestosis, 5 (3.8%) and 6 (2.2%); lung cancer, 1 case (0.8%) and 2 cases (0.7%) and malignant pleural mesothelioma 1 case (0.8%) and none (0%). The rate of workers with total asbestos-associated respiratory disease in the retired group was significantly higher than that in active service (P<0.01). Especially pleural plaque with calcification were detected more in shipyard retired workers than active service workers. The incidence of pleural plaque is related to age and incubation time but not to work period at asbestos exposure. (author)

Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use.

Science.gov (United States)

Brinkman, William B; Epstein, Jeffery N; Auinger, Peggy; Tamm, Leanne; Froehlich, Tanya E

2015-02-01

The association of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) with tobacco and alcohol use has not been assessed in a young adolescent sample representative of the U.S. population. Data are from the 2000-2004 National Health and Nutrition Examination Survey, a cross-sectional sample representative of the U.S. population. Participants were age 12-15 years (N=2517). Exposure variables included diagnosis of ADHD and CD, and counts of ADHD and CD symptoms based on caregiver responses to the Diagnostic Interview Schedule for Children. Primary outcomes were adolescent-report of any use of tobacco or alcohol and age of initiating use. Multivariate logistic regression and Cox proportional hazard models were conducted. Adolescents with ADHD+CD diagnoses had a 3- to 5-fold increased likelihood of using tobacco and alcohol and initiated use at a younger age compared to those with neither disorder. Having ADHD alone was associated with an increased likelihood of tobacco use but not alcohol use. Hyperactive-impulsive symptom counts were not independently associated with any outcome, while every one symptom increase in inattention increased the likelihood of tobacco and alcohol use by 8-10%. Although participants with a diagnosis of CD alone (compared to those without ADHD or CD) did not have a higher likelihood of tobacco or alcohol use, for every one symptom increase in CD symptoms the odds of tobacco use increased by 31%. ADHD and CD diagnoses and symptomatology are linked to higher risk for a range of tobacco and alcohol use outcomes among young adolescents in the U.S. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Pattern of optometry practice and range of services in India.

Science.gov (United States)

Thite, Nilesh; Jaggernath, Jyoti; Chinanayi, Farai; Bharadwaj, Shrikant; Kunjeer, Gauri

2015-05-01

This study was conducted to evaluate the range of services provided by optometrists in various modes of optometric practice in India. An online questionnaire was administered to 1674 optometrists to collect information on the range of optometric services offered. Data were analyzed based on variables including sex, educational qualification, and modes of practice. Two-sample Wilcoxon rank sum tests, χ tests, and Fisher exact text were used to conduct inferential statistics. A total of 563 valid and completed survey questionnaires were received from graduates of 41 optometry institutes working across 23 states of India. Of these, 225 (40.0%) were female, 288 (51.2%) had completed postgraduate education, and 340 (60.5%) were involved in more than one mode of practice. The top three modes of practice were hospital-based practice (44.8%), academia (42.8%), and optical retail (33.0%). Of the 441, out of 563 (78.3%) respondents involved in patient care, the majority (98.4%) performed refraction and routine eye examination, 70.3% dispensed contact lenses, and 66.9% practiced optical dispensing. Lower involvement was seen in providing binocular-vision (45.1%) and low-vision services (30.2%). Higher education was associated with advanced level of practice (p < 0.05) except clinical investigative procedures. There was a significant association between postgraduate studies and involvement in academics and research (p < 0.01). Most optometrists are engaged in multiple modes of practice, with optical practice, hospital-based practice, and academia being the leading modes. Optometrists need to be more involved in providing the core optometric services of binocular vision and low vision. Higher education has an impact on the level of optometric practice.

Preterm birth-associated cost of early intervention services: an analysis by gestational age.

Science.gov (United States)

Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

2007-04-01

Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 3. Podiatry services and related foot care issues.

Science.gov (United States)

Winocour, P H; Morgan, J; Ainsworth, A; Williams, D R R

2002-07-01

To examine the provision of, and variations in, podiatry and other services for diabetic foot care in the UK. A postal survey of secondary care providers of diabetes services in the UK in 2000. Following two reminders a 77% response rate was achieved. The responses indicated that 97% had a state-registered podiatrist attached to the service, providing three (median) sessions each week for diabetes care, although only 44% had availability at all diabetic clinics, and only 3% had availability at paediatric diabetic services. Podiatry access at all diabetic clinics increased the likelihood of associated preventative as opposed to reactive ('trouble shooting') care (P podiatry input to patient education was common (84%), only 6% had received formal training in education. Guidelines and strategies for management of active foot problems were available in 50-74% of cases. Orthotic input was highly variable, and absent in 15% of responses. Podiatrist fitting and application of foot protective apparatus was only recorded in 22-61% of responses. Access to isotopic and/or MR foot imaging and peripheral angiography and angioplasty was recorded in 75-83% of responses. Separate specialist foot clinics were available in 49%, and where this was the case the use of newer foot ulcer healing applications was higher (P podiatry support to diabetes care over the last 10 years, the level of access and the nature of the services provided is much less than recommended in many advisory documents. The strategy of a co-ordinated 'team' approach to foot care still takes place in less than 50% of centres. There are clear regional differences in diabetes foot care services. Both providers and purchasers of diabetes services may not have given sufficient attention to this area, given the relatively small number of documented bids for service improvements in this area, and the very low success rate of such bids.

Protein kinase C activation induces conductance changes in Hermissenda photoreceptors like those seen in associative learning.

Science.gov (United States)

Farley, J; Auerbach, S

Phosphorylation of ion channels has been suggested as one molecular mechanism responsible for learning-produced long-term changes in neuronal excitability. Persistent training-produced changes in two distinct K+ currents (IA (ref. 2), IK-Ca (refs 3,4)) and a voltage-dependent calcium current (ICa; refs 3,4) have previously been shown to occur in type B photoreceptors of Hermissenda, as a result of associative learning. But the identity of the phosphorylation pathway(s) responsible for these changes has not as yet been determined. Injections of cyclic AMP-dependent protein kinase reduce a K+ current (IK) in B cells which is different from those changed by training, but fails to reduce IA and IK-Ca. Phosphorylase b kinase (an exogenous calcium/calmodulin-dependent kinase) reduces IA, but whether IK-Ca and ICa are changed in the manner of associative training is not yet known. Another protein kinase present in high concentrations in both mammalian brain and molluscan nervous systems is protein kinase C, which is both calcium- and phospholipid-sensitive. We now present evidence that activation of protein kinase C by the tumour promoter phorbol ester (PDB) and intracellular injection of the enzyme induce conductance changes similar to those caused by associative training in Hermissenda B cells (that is a reduction of IA and IK-Ca, and enhancement of ICa). These results represent the first direct demonstration that protein kinase C affects membrane K+ ion conductance mechanisms.

Service Operations Optimization: Recent Development in Supply Chain Management

Directory of Open Access Journals (Sweden)

Bin Shen

2015-01-01

Full Text Available Services are the key of success in operation management. Designing the effective strategies by optimization techniques is the fundamental and important condition for performance increase in service operations (SOs management. In this paper, we mainly focus on investigating SOs optimization in the areas of supply chain management, which create the greatest business values. Specifically, we study the recent development of SOs optimization associated with supply chain by categorizing them into four different industries (i.e., e-commerce industry, consumer service industry, public sector, and fashion industry and four various SOs features (i.e., advertising, channel coordination, pricing, and inventory. Moreover, we conduct the technical review on the stylish industries/topics and typical optimization models. The classical optimization approaches for SOs management in supply chain are presented. The managerial implications of SOs in supply chain are discussed.

RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

Science.gov (United States)

Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

2017-08-01

To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

Science.gov (United States)

Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

2017-03-10

This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

Outdoor fungi and child asthma health service attendances.

Science.gov (United States)

Tham, Rachel; Dharmage, Shyamali C; Taylor, Philip E; Katelaris, Constance H; Vicendese, Don; Abramson, Michael J; Erbas, Bircan

2014-08-01

Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outdoor fungi play a significant role in child asthma exacerbations. Systematic search of seven electronic databases and hand searching for peer-reviewed studies published in English, up to 31 August 2013. Inclusion criteria were study population aged asthma, attended a health service; outdoor fungi exposure was reported. Quality and risk of bias assessments were conducted. Due to significant heterogeneity, meta-analysis was not conducted. Of the 1896 articles found, 15 were eligible. Findings were not consistent, possibly due to methodological variations in exposure classifications, statistical methods and inclusion of confounders. Cross-sectional studies found no or weak associations. All but one time series studies indicated an association that varied between fungal species. Increasing evidence indicates that asthmatic children are susceptible to asthma exacerbations when exposed to outdoor fungal spores. There is limited understanding of the contributions of different fungal species. Research is needed to investigate interactions of outdoor fungi with pollen, air pollutants and respiratory viruses. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

NOAA NOS SOS, EXPERIMENTAL, 1902-present, Conductivity

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA NOS SOS server is part of the IOOS DIF SOS Project. The stations in this dataset have conductivity data. *These services are for testing and evaluation use...

Facilitating Fresh: State Laws Supporting School Gardens Are Associated With Use of Garden-Grown Produce in School Nutrition Services Programs.

Science.gov (United States)

Turner, Lindsey; Leider, Julien; Piekarz, Elizabeth; Schermbeck, Rebecca M; Merlo, Caitlin; Brener, Nancy; Chriqui, Jamie F

2017-06-01

To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs. Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens. Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program. Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals. State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law. State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

Evaluation of outpatient service quality in Eastern Saudi Arabia

Science.gov (United States)

Fraihi, Khalid J. Al; FAMCO, Dip; FAMCO, Fellow; Latif, Shahid A.

2016-01-01

Objectives: To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. Methods: In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients’ demographic characteristics, and 22 items scales of patients’ expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test. Results: The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients’ expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, pservices showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. Conclusion: The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management. PMID:27052285

Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being.

Science.gov (United States)

Martinussen, Monica; Kaiser, Sabine; Adolfsen, Frode; Patras, Joshua; Richardsen, Astrid M

2017-07-01

This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T 1 ) and after (T 2 , T 3 ) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T 1 to T 2 . No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T 3 ) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

Franchising reproductive health services.

Science.gov (United States)

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-12-01

Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context.

Comparing the characteristics of users of an online service for STI self-sampling with clinic service users: a cross-sectional analysis.

Science.gov (United States)

Barnard, Sharmani; Free, Caroline; Bakolis, Ioannis; Turner, Katy M E; Looker, Katharine J; Baraitser, Paula

2018-02-07

Online services for self-sampling at home could improve access to STI testing; however, little is known about those using this new modality of care. This study describes the characteristics of users of online services and compares them with users of clinic services. We conducted a cross-sectional analysis of routinely collected data on STI testing activity from online and clinic sexual health services in Lambeth and Southwark between 1January 2016 and 31March 2016. Activity was included for chlamydia, gonorrhoea, HIV and syphilis testing for residents of the boroughs aged 16 years and older. Logistic regression models were used to explore potential associations between type of service use with age group, gender, ethnic group, sexual orientation, positivity and Index of Multiple Deprivation (IMD) quintiles. We used the same methods to explore potential associations between return of complete samples for testing with age group, gender, ethnic group, sexual orientation and IMD quintiles among online users. 6456 STI tests were carried out by residents in the boroughs. Of these, 3582 (55.5%) were performed using clinic services and 2874 (44.5%) using the online service. In multivariate analysis, online users were more likely than clinic users to be aged between 20 and 30 years, female, white British, homosexual or bisexual, test negative for chlamydia or gonorrhoea and live in less deprived areas. Of the individuals that ordered a kit from the online service, 72.5% returned sufficient samples. In multivariate analysis, returners were more likely than non-returners to be aged >20 years and white British. Nearly half (44.5%) of all basic STI testing was done online, although the characteristics of users of clinic and online services differed and positivity rates for those using the online service for testing were lower. Clinics remain an important point of access for some groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

[Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

Science.gov (United States)

González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

2016-12-01

Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

Science.gov (United States)

Kranz, Ashley M; Preisser, John S; Rozier, R Gary

2015-07-01

Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS. We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding. Kindergarten students with ≥4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ≥4 POHS visits compared with those with 0 visits. POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings. Copyright © 2015 by the American Academy of Pediatrics.

Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China

Directory of Open Access Journals (Sweden)

Shijun Lu

2015-06-01

Full Text Available This study assessed the association between accessibility of catering service venues and adolescents’ alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR and 95% confidence intervals (CI of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57 and 1.47 (1.06, 2.02, respectively (p < 0.001 for trend test. This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

Association of ionic liquids in solution: a combined dielectric and conductivity study of [bmim][Cl] in water and in acetonitrile.

Science.gov (United States)

Bešter-Rogač, Marija; Stoppa, Alexander; Hunger, Johannes; Hefter, Glenn; Buchner, Richard

2011-10-21

Ion association of the ionic liquid [bmim][Cl] in acetonitrile and in water was studied by dielectric spectroscopy for salt concentrations c ≤ 1.3 M at 298.15 K and by measurement of molar electrical conductivities, Λ, of dilute solutions (c ≤ 0.006 M) in the temperature range 273.15 ≲ T/K ≤ 313.15. Whilst acetonitrile solutions of [bmim][Cl] exhibit moderate ion pairing, with an association constant of K°(A) ≈ 60 M(-1) and increasing with temperature, [bmim][Cl] is only weakly associated in water (K°(A) ≈ 6 M(-1)) and ion pairing decreases with rising temperature. Only contact ion pairs were detected in both solvents. Standard-state enthalpy, entropy and heat capacity changes of ion association were derived, as well as the activation enthalpy of charge transport and the limiting conductivity of the cation, λ(∞) ([bmim](+)). These data, in conjunction with effective solvation numbers obtained from the dielectric spectra, suggest that the solvation of [bmim](+) is much weaker in water than in acetonitrile. This journal is © the Owner Societies 2011

Childhood adverse life events, disordered eating, and body mass index in US Military service members.

Science.gov (United States)

Bakalar, Jennifer L; Barmine, Marissa; Druskin, Lindsay; Olsen, Cara H; Quinlan, Jeffrey; Sbrocco, Tracy; Tanofsky-Kraff, Marian

2018-03-02

US service members appear to be at high-risk for disordered eating. Further, the military is experiencing unprecedented prevalence of overweight and obesity. US service members also report a high prevalence of childhood adverse life event (ALE) exposure. Despite consistent links between early adversity with eating disorders and obesity, there is a dearth of research examining the association between ALE exposure and disordered eating and weight in military personnel. An online survey study was conducted in active duty personnel to examine childhood ALE history using the Life Stressor Checklist - Revised, disordered eating using the Eating Disorder Examination - Questionnaire total score, and self-reported body mass index (BMI, kg/m 2 ). Among 179 respondents, multiple indices of childhood ALE were positively associated with disordered eating. Traumatic childhood ALE and subjective impact of childhood ALE were associated with higher BMI and these associations were mediated by disordered eating. Findings support evaluating childhood ALE exposure among service members with disordered eating and weight concerns. Moreover, findings support the need for prospective research to elucidate these relationships. © 2018 Wiley Periodicals, Inc.

An application of data mining techniques in designing catalogue for a laundry service

Directory of Open Access Journals (Sweden)

Khasanah Annisa Uswatun

2018-01-01

Full Text Available Catalogues are the media that companies use to promote their products or services. Since catalogue is one of marketing media, the first essential step before designing product catalogue is determining the market target. Besides, it is also important to put some information that appeal to the target market, such as discount or promos by analysing customer pattern preferences in using services or buying product. This study conduct two data mining technique. The first is clustering analysis to segment customer and the second one is association rule mining to discover an interesting pattern about the services that commonly used by the customer at the same service time. Thus, the results will be used as a recommendation to make an attractive marketing strategy to be put in the service catalogue promo for a laundry in Sleman Yogyakarta. The clustering result showed that the biggest customer segment is university student who come 3 until 5 times in a month on weekends, while the association rule result showed that clothes, shoes, and bed sheet have strong relationship. The catalogue design is presented in the end of the paper.

Interaction matters: quantifying conduct problem × depressive symptoms interaction and its association with adolescent alcohol, cigarette, and marijuana use in a national sample.

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Maslowsky, Julie; Schulenberg, John E

2013-11-01

Substance use is a major contributor to morbidity and mortality among American adolescents. Conduct problems and depressive symptoms have each been found to be associated with adolescent substance use. Although they are highly comorbid, the role of the interaction of conduct problems and depressive symptoms in substance use is not clear. In national samples of 8th-, 10th-, and 12th-grade students from the Monitoring the Future study, latent moderated structural equation modeling was used to estimate the association of conduct problems, depressive symptoms, and their interaction to the use of alcohol (including binge drinking), cigarettes, and marijuana. Moderation by age and sex was tested. The interaction of conduct problems with depressive symptoms was a strong predictor of substance use, particularly among younger adolescents. With few exceptions, adolescents with high levels of both conduct problems and depressive symptoms used substances most frequently. Conduct problems were a strong positive predictor of substance use, and depressive symptoms were a weak positive predictor. Whereas conduct problems are often thought to be a primary predictor of substance use, this study revealed that depressive symptoms potentiate the relation of conduct problems to substance use. Therefore, substance use prevention efforts should target both depressive symptoms and conduct problems.

Preferences for Early Intervention Mental Health Services: A Discrete-Choice Conjoint Experiment.

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Becker, Mackenzie P E; Christensen, Bruce K; Cunningham, Charles E; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Bieling, Peter J; Madsen, Victoria; Chen, Yvonne Y S; Mielko, Stephanie; Zipursky, Robert B

2016-02-01

Early intervention services (EISs) for mental illness may improve outcomes, although treatment engagement is often a problem. Incorporating patients' preferences in the design of interventions improves engagement. A discrete-choice conjoint experiment was conducted in Canada to identify EIS attributes that encourage treatment initiation. Sixteen four-level attributes were formalized into a conjoint survey, completed by patients, family members, and mental health professionals (N=562). Participants were asked which EIS option people with mental illness would contact. Latent-class analysis identified respondent classes characterized by shared preferences. Randomized first-choice simulations predicted which hypothetical options, based on attributes, would result in maximum utilization. Participants in the conventional-service class (N=241, 43%) predicted that individuals would contact traditional services (for example, hospital location and staffed by psychologists or psychiatrists). Membership was associated with being a patient or family member and being male. Participants in the convenient-service class (N=321, 57%) predicted that people would contact services promoting easy access (for example, self-referral and access from home). Membership was associated with being a professional. Both classes predicted that people would contact services that included short wait times, direct contact with professionals, patient autonomy, and psychological treatment information. The convenient-service class predicted that people would use an e-health model, whereas the conventional-service class predicted that people would use a primary care or clinic-hospital model. Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

Family-centred care delivery: comparing models of primary care service delivery in Ontario.

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Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-11-01

To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

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

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Lusi Kristiana

2015-01-01

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

NOS CO-OPS Meteorological Data, Conductivity, 6-Minute

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National Oceanic and Atmospheric Administration, Department of Commerce — This dataset has Conductivity data from NOAA NOS Center for Operational Oceanographic Products and Services (CO-OPS). WARNING: These preliminary data have not been...

Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, north west of Ethiopia: a community-based cross sectional study.

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Teferra, Alemayehu Shimeka; Alemu, Fekadu Mazengia; Woldeyohannes, Solomon Meseret

2012-07-31

Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio and improving maternal health is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Amhara Regional State, Ethiopia. Therefore, this study aimed to assess factors affecting institutional delivery service utilization among mothers who gave birth in the last 12 months in Sekela District, Amhara Region, Ethiopia. Community-based cross-sectional study was conducted among mothers with birth in the last 12 months during August, 2010. Multistage sampling technique was used to select 371 participants. A pre tested and structured questionnaire was used to collect data. Bivariate and multivariate data analysis was performed using SPSS version 16.0 software. The study indicated that 12.1% of the mothers delivered in health facilities. Of 87.9% mothers who gave birth at home, 80.0% of them were assisted by family members and relatives. The common reasons for home delivery were closer attention from family members and relatives (60.9%), home delivery is usual practice (57.7%), unexpected labour (33.4%), not being sick or no problem at the time of delivery (21.6%) and family influence (14.4%). Being urban resident (AOR [95% CI] = 4.6 [1.91, 10.9]), ANC visit during last pregnancy (AOR [95% CI] = 4.26 [1.1, 16.4]), maternal education level (AOR [95%CI] =11.98 [3.36, 41.4]) and knowledge of mothers on pregnancy and delivery services (AOR [95% CI] = 2.97[1.1, 8.6]) had significant associations with institutional delivery service utilization. Very low institutional delivery service utilization was observed in the study area. Majority of the births at home were assisted by family members and relatives. ANC visit and lack of knowledge on pregnancy and delivery services were found to

Sweating under pressure: skin conductance level reactivity moderates the association between peer victimization and externalizing behavior.

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Gregson, Kim D; Tu, Kelly M; Erath, Stephen A

2014-01-01

This study examined whether the association between peer victimization and externalizing behavior may be illuminated by individual differences in skin conductance level reactivity (SCLR) in the context of peer stress. Participants included 123 fifth and sixth graders (Mean age = 12.03 years, 50% females; 42% ethnic minorities). SCLR was assessed in the context of an ecologically relevant, lab-based peer-evaluative stress experience in preadolescence. As hypothesized, self-reported peer victimization was linked with parent- and teacher-reported externalizing behavior, and SCLR consistently moderated these associations. Peer victimization was associated with parent- and teacher-reported externalizing behavior among preadolescents who exhibited lower SCLR, but not among preadolescents who exhibited higher SCLR. Results suggest that promoting engagement with peer stress experiences and enhancing inhibitory control are potential intervention targets that may reduce externalizing behavior in the context of peer victimization (or reduce peer victimization among preadolescents who exhibit externalizing behavior). © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

A Process Mining Based Service Composition Approach for Mobile Information Systems

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Chengxi Huang

2017-01-01

Full Text Available Due to the growing trend in applying big data and cloud computing technologies in information systems, it is becoming an important issue to handle the connection between large scale of data and the associated business processes in the Internet of Everything (IoE environment. Service composition as a widely used phase in system development has some limits when the complexity of relationship among data increases. Considering the expanding scale and the variety of devices in mobile information systems, a process mining based service composition approach is proposed in this paper in order to improve the adaptiveness and efficiency of compositions. Firstly, a preprocessing is conducted to extract existing service execution information from server-side logs. Then process mining algorithms are applied to discover the overall event sequence with preprocessed data. After that, a scene-based service composition is applied to aggregate scene information and relocate services of the system. Finally, a case study that applied the work in mobile medical application proves that the approach is practical and valuable in improving service composition adaptiveness and efficiency.

Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

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Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

2013-01-01

Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

Integrated Regulatory Review Service (IRRS) Guidelines for the Preparation and Conduct of IRRS Missions

International Nuclear Information System (INIS)

2013-01-01

: International Basic Safety Standards (IAEA Safety Standards Series No. GSR Part 3 - Interim Edition), may be used in conjunction with GSR Part 1 in order to conduct a thorough review of a national legal and governmental infrastructure. The IRRS recognizes that organizational structure and regulatory processes vary from country to country depending on national legal and administrative systems, the size and structure of the nuclear and radiation protection programme, financial resources available to the regulatory body, social customs and cultural traditions. The IRRS process allows for such variations within a single integrated review service. The IRRS process includes performance and prescriptive approaches to varying degrees. It is performance oriented in that it accepts various approaches to the organization and practices of a regulatory framework and body that contribute to a strong national nuclear and radiation safety regime. At the same time the review process is prescriptive in its objective comparison against IAEA standards and guidance. These IRRS guidelines have been published to encourage consistency and comprehensiveness in the preparation for, conduct and follow-up of an IRRS mission. During an IRRS mission, recommendations and suggestions may be offered to the host country. Recommendations made are related to items of direct relevance to safety as referenced in IAEA Safety Requirements, while suggestions made are related to items which are not be essential to compatibility with IAEA standards but may enhance the effectiveness of the national nuclear and radiation safety regime and/or improve the organization or performance of the regulatory body. Good practices identified may be documented for consideration by other States.

Reducing child conduct disordered behaviour and improving parent mental health in disadvantaged families: a 12-month follow-up and cost analysis of a parenting intervention.

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McGilloway, Sinead; NiMhaille, Grainne; Bywater, Tracey; Leckey, Yvonne; Kelly, Paul; Furlong, Mairead; Comiskey, Catherine; O'Neill, Donal; Donnelly, Michael

2014-09-01

The effectiveness of the Incredible Years Basic parent programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health was examined in a 12-month follow-up. Pre- to post-intervention service use and related costs were also analysed. A total of 103 families and their children (aged 32-88 months), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. An intention-to-treat analysis was carried out using a one-way repeated measures ANOVA. Pairwise comparisons were subsequently conducted to determine whether treatment outcomes were sustained 1 year post-baseline assessment. Results indicate that post-intervention improvements in child conduct problems, parenting behaviour and parental mental health were maintained. Service use and associated costs continued to decline. The results indicate that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later. A reduced reliance on formal services is also indicated.

Franchising Reproductive Health Services

Science.gov (United States)

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-01-01

Objectives Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Methods Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Results Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Conclusions Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context. PMID:15544644

Trends in Medicare Service Volume for Cataract Surgery and the Impact of the Medicare Physician Fee Schedule.

Science.gov (United States)

Gong, Dan; Jun, Lin; Tsai, James C

2017-08-01

To calculate the associations between Medicare payment and service volume for complex and noncomplex cataract surgeries. The 2005-2009 CMS Part B National Summary Data Files, CMS Part B Carrier Summary Data Files, and the Medicare Physician Fee Schedule. Conducting a retrospective, longitudinal analysis using a fixed-effects model of Medicare Part B carriers representing all 50 states and the District of Columbia from 2005 to 2009, we calculated the Medicare payment-service volume elasticities for noncomplex (CPT 66984) and complex (CPT 66982) cataract surgeries. Service volume data were extracted from the CMS Part B National Summary and Carrier Summary Data Files. Payment data were extracted from the Medicare Physician Fee Schedule. From 2005 to 2009, the proportion of total cataract services billed as complex increased from 3.2 to 6.7 percent. Every 1 percent decrease in Medicare payment was associated with a nonsignificant change in noncomplex cataract service volume (elasticity = 0.15, 95 percent CI [-0.09, 0.38]) but a statistically significant increase in complex cataract service volume (elasticity = -1.12, 95 percent CI [-1.60, -0.63]). Reduced Medicare payment was associated with a significant increase in complex cataract service volume but not in noncomplex cataract service volume, resulting in a shift toward performing a greater proportion of complex cataract surgeries from 2005 to 2009. © Health Research and Educational Trust.

Designing and Conducting Health Systems Research Projects ...

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

Home · Resources · Publications. Designing and Conducting Health Systems Research Projects Volume 1: Proposal Development and Fieldwork ... IDRC and the United Kingdom's Global AMR Innovation Fund—managed by the ... New website will help record vital life events to improve access to services for all.

Differential Association of Stigma with Perceived Need and Mental Health Service Use.

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Wong, Eunice C; Collins, Rebecca L; Breslau, Joshua; Burnam, M Audrey; Cefalu, Matthew; Roth, Elizabeth A

2018-06-01

This study examined the role of stigma at two stages of the treatment-seeking process by assessing associations between various types of stigma and perceived need for mental health treatment as well as actual treatment use. We analyzed cross-sectional data from the 2014 and 2016 California Well-Being Survey, a telephone survey with a representative sample of 1954 California residents with probable mental illness. Multivariable logistic regression indicated that perceived need was associated with less negative beliefs about mental illness (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.95) and greater intentions to conceal a mental illness (OR = 1.47; 95% CI = 1.12-1.92). Among respondents with perceived need, treatment use was associated with greater mental health knowledge/advocacy (OR = 1.63; 95% CI = 1.03-2.56) and less negative treatment attitudes (OR = 0.66; 95% CI = 0.43-1.00). Understanding which aspects of stigma are related to different stages of the help-seeking process is essential to guiding policy and program initiatives aimed at ensuring individuals with mental illness obtain needed mental health services.

National Collegiate Athletic Association Division I Certified Athletic Trainers' Perceptions of the Benefits of Sport Psychology Services

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Zakrajsek, Rebecca A.; Martin, Scott B.; Wrisberg, Craig A.

2016-01-01

Context:  Certified athletic trainers (ATs) are responsible for integrating relevant professionals into the rehabilitation team to assist with the holistic care of injured athletes. Objective:  To explore National Collegiate Athletic Association Division I (DI) ATs' experience with sport psychology consultants (SPCs), willingness to encourage athletes to use SPCs for injury rehabilitation, and perceptions of the benefits of sport psychology services. Design:  Quantitative study. Setting:  A Web-based survey was administered to a national sample of DI ATs. Patients or Other Participants:  A total of 659 (341 men, 318 women) ATs completed the survey. Main Outcome Measure(s):  Athletic trainers' experience with SPCs, willingness to encourage athletes to seek sport psychology services, and perceptions of the benefits of those services in injury-rehabilitation settings were self-reported using a rating scale that ranged from 1 (never or not at all) to 5 (definitely or extremely). Results:  Logistic regression revealed that the availability of SPCs, previous encouragement to athletes to seek sport psychology services, and previous positive interactions with SPCs predicted the ATs' willingness to encourage athletes to use these services (P psychology services might call on SPCs to complement their work with injured athletes. PMID:27159188

The Association between Parent-Child Conflict and Adolescent Conduct Problems over Time: Results from a Longitudinal Adoption Study

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Klahr, Ashlea M.; McGue, Matt; Iacono, William G.; Burt, S. Alexandra

2010-01-01

A handful of prior adoption studies have confirmed that the cross-sectional relationship between child conduct problems and parent/child conflict is at least partially shared environmental in origin. However, as the direction of causation between parenting and delinquency remains unclear, this relationship could be better explained by the adolescent's propensity to elicit conflictive parenting, a phenomenon referred to as an evocative gene-environment correlation. The current study thus examined the prospective relationship between conduct problems and parent-child conflict in a sample of adoptive families. Participants included 672 adolescents in 405 adoptive families assessed at two time points roughly 4 years apart. Results indicated that parent-child conflict predicts the development of conduct problems, whereas conduct problems do not predict increases in parent-child conflict. Such findings suggest that evocative gene-environment correlations are highly unlikely as an explanation of prior shared environmental effects during adolescence. Moreover, because the adolescents in this study do not share genes with their adoptive parents, the association between conduct problems and parent-child conflict is indicative of shared environmental mediation in particular. Implications of our findings are discussed. PMID:21038930

Cost-benefit study of school nursing services.

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Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

2014-07-01

In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in

Quality standards for bone conduction implants.

Science.gov (United States)

Gavilan, Javier; Adunka, Oliver; Agrawal, Sumit; Atlas, Marcus; Baumgartner, Wolf-Dieter; Brill, Stefan; Bruce, Iain; Buchman, Craig; Caversaccio, Marco; De Bodt, Marc T; Dillon, Meg; Godey, Benoit; Green, Kevin; Gstoettner, Wolfgang; Hagen, Rudolf; Hagr, Abdulrahman; Han, Demin; Kameswaran, Mohan; Karltorp, Eva; Kompis, Martin; Kuzovkov, Vlad; Lassaletta, Luis; Li, Yongxin; Lorens, Artur; Martin, Jane; Manoj, Manikoth; Mertens, Griet; Mlynski, Robert; Mueller, Joachim; O'Driscoll, Martin; Parnes, Lorne; Pulibalathingal, Sasidharan; Radeloff, Andreas; Raine, Christopher H; Rajan, Gunesh; Rajeswaran, Ranjith; Schmutzhard, Joachim; Skarzynski, Henryk; Skarzynski, Piotr; Sprinzl, Georg; Staecker, Hinrich; Stephan, Kurt; Sugarova, Serafima; Tavora, Dayse; Usami, Shin-Ichi; Yanov, Yuri; Zernotti, Mario; Zorowka, Patrick; de Heyning, Paul Van

2015-01-01

Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.

Direct-to-consumer sales of genetic services on the Internet.

Science.gov (United States)

Gollust, Sarah E; Wilfond, Benjamin S; Hull, Sara Chandros

2003-01-01

PURPOSE The increasing use of the Internet to obtain genetics information and to order medical services without a prescription, combined with a rise in direct-to-consumer marketing for genetic testing, suggests the potential for the Internet to be used to sell genetic services. METHODS A systematic World Wide Web search was conducted in May 2002 to assess the availability of genetic services sold directly to consumers on the Internet. RESULTS Out of 105 sites that offered genetic services directly, most offered non-health-related services, including parentage confirmation testing (83%), identity testing (56%), and DNA banking (24%); however, health-related genetic tests were offered through 14 sites (13%). The health-related genetic tests available ranged from standard tests, such as hemochromatosis and cystic fibrosis, to more unconventional tests related to nutrition, behavior, and aging. Of these 14 sites, 5 described risks associated with the genetic services and 6 described the availability of counseling. CONCLUSIONS The availability of direct sales of health-related genetic tests creates the potential for inadequate pretest decision making, misunderstanding test results, and access to tests of questionable clinical value.

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.

Service Quality of Online Shopping Platforms: A Case-Based Empirical and Analytical Study

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Tsan-Ming Choi

2013-01-01

Full Text Available Customer service is crucially important for online shopping platforms (OSPs such as eBay and Taobao. Based on the well-established service quality instruments and the scenario of the specific case on Taobao, this paper focuses on exploring the service quality of an OSP with an aim of revealing customer perceptions of the service quality associated with the provided functions and investigating their impacts on customer loyalty. By an empirical study, this paper finds that the “fulfillment and responsiveness” function is significantly related to the customer loyalty. Further analytical study is conducted to reveal that the optimal service level on the “fulfillment and responsiveness” function for the risk averse OSP uniquely exists. Moreover, the analytical results prove that (i if the customer loyalty is more positively correlated to the service level, it will lead to a larger optimal service level, and (ii the optimal service level is independent of the profit target, the source of uncertainty, and the risk preference of the OSP.

Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

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Gudu, William; Addo, Bright

2017-05-31

Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great

Skin Conductance Level Reactivity Moderates the Association Between Harsh Parenting and Growth in Child Externalizing Behavior

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Erath, Stephen A.; El-Sheikh, Mona; Hinnant, J. Benjamin; Cummings, E. Mark

2011-01-01

Skin conductance level reactivity (SCLR) was examined as a moderator of the association between harsh parenting at age 8 years and growth in child externalizing behavior from age 8 to age 10 (N = 251). Mothers and fathers provided reports of harsh parenting and their children’s externalizing behavior; children also provided reports of harsh parenting. SCLR was assessed in response to a socioemotional stress task and a problem-solving challenge task. Latent growth modeling revealed that boys w...

An examination of the prospective association between religious service attendance and suicide: Explanatory factors and period effects.

Science.gov (United States)

Kleiman, Evan M; Liu, Richard T

2018-01-01

We addressed two unanswered questions from prior research, demonstrating a prospective association between frequent religious service attendance and decreased risk for suicide. First, we assessed whether religious service attendance conferred protection from suicide even after accounting for strength of religious affiliation. Second, we evaluated whether the relationship between religious service attendance and suicide was subject to period effects. Data were drawn from the 1978-2010 General Social Survey, a nationally representative study of 30,650 non-institutionalized, English-speaking American residents age 18 or older. Data were linked with the National Death Index through the end of 2014. We analyzed these data using moderated Cox proportional hazard analyses. Religious affiliation had no relationship with suicide. Religious service attendance only had a protective effect against suicide death among those in later (2000-2010) rather than earlier (1998 and earlier) data collection periods. Secondary analysis of data limited the types of variables that were available. The protective nature of religion is due more to participating in religious activities, such as attending religious services, than to having a strong religious affiliation, and this effect exists primarily in more recent data collection periods. Copyright © 2017 Elsevier B.V. All rights reserved.

Immigrants' use of primary health care services for mental health problems.

Science.gov (United States)

Straiton, Melanie; Reneflot, Anne; Diaz, Esperanza

2014-08-13

Equity in health care across all social groups is a major goal in health care policy. Immigrants may experience more mental health problems than natives, but we do not know the extent to which they seek help from primary health care services. This study aimed to determine a) the rate immigrants use primary health care services for mental health problems compared with Norwegians and b) the association between length of stay, reason for immigration and service use among immigrants. National register data covering all residents in Norway and all consultations with primary health care services were used. We conducted logistic regression analyses to compare Norwegians' with Polish, Swedish, German, Pakistani and Iraqi immigrants' odds of having had a consultation for a mental health problem (P-consultation). After accounting for background variables, all immigrants groups, except Iraqi men had lower odds of a P-consultation than their Norwegian counterparts. A shorter length of stay was associated with lower odds of a P-consultation. Service use varies by country of origin and patterns are different for men and women. There was some evidence of a possible 'healthy migrant worker' effect among the European groups. Together with previous research, our findings however, suggest that Iraqi women and Pakistanis in particular, may experience barriers in accessing care for mental health problems.

KBWS: an EMBOSS associated package for accessing bioinformatics web services.

Science.gov (United States)

Oshita, Kazuki; Arakawa, Kazuharu; Tomita, Masaru

2011-04-29

The availability of bioinformatics web-based services is rapidly proliferating, for their interoperability and ease of use. The next challenge is in the integration of these services in the form of workflows, and several projects are already underway, standardizing the syntax, semantics, and user interfaces. In order to deploy the advantages of web services with locally installed tools, here we describe a collection of proxy client tools for 42 major bioinformatics web services in the form of European Molecular Biology Open Software Suite (EMBOSS) UNIX command-line tools. EMBOSS provides sophisticated means for discoverability and interoperability for hundreds of tools, and our package, named the Keio Bioinformatics Web Service (KBWS), adds functionalities of local and multiple alignment of sequences, phylogenetic analyses, and prediction of cellular localization of proteins and RNA secondary structures. This software implemented in C is available under GPL from http://www.g-language.org/kbws/ and GitHub repository http://github.com/cory-ko/KBWS. Users can utilize the SOAP services implemented in Perl directly via WSDL file at http://soap.g-language.org/kbws.wsdl (RPC Encoded) and http://soap.g-language.org/kbws_dl.wsdl (Document/literal).

KBWS: an EMBOSS associated package for accessing bioinformatics web services

Directory of Open Access Journals (Sweden)

Tomita Masaru

2011-04-01

Full Text Available Abstract The availability of bioinformatics web-based services is rapidly proliferating, for their interoperability and ease of use. The next challenge is in the integration of these services in the form of workflows, and several projects are already underway, standardizing the syntax, semantics, and user interfaces. In order to deploy the advantages of web services with locally installed tools, here we describe a collection of proxy client tools for 42 major bioinformatics web services in the form of European Molecular Biology Open Software Suite (EMBOSS UNIX command-line tools. EMBOSS provides sophisticated means for discoverability and interoperability for hundreds of tools, and our package, named the Keio Bioinformatics Web Service (KBWS, adds functionalities of local and multiple alignment of sequences, phylogenetic analyses, and prediction of cellular localization of proteins and RNA secondary structures. This software implemented in C is available under GPL from http://www.g-language.org/kbws/ and GitHub repository http://github.com/cory-ko/KBWS. Users can utilize the SOAP services implemented in Perl directly via WSDL file at http://soap.g-language.org/kbws.wsdl (RPC Encoded and http://soap.g-language.org/kbws_dl.wsdl (Document/literal.

Distribution and utilization of curative primary healthcare services in Lahej, Yemen.

Science.gov (United States)

Bawazir, A A; Bin Hawail, T S; Al-Sakkaf, K A Z; Basaleem, H O; Muhraz, A F; Al-Shehri, A M

2013-09-01

No evidence-based data exist on the availability, accessibility and utilization of healthcare services in Lahej Governorate, Yemen. The aim of this study was to assess the distribution and utilization of curative services in primary healthcare units and centres in Lahej. Cross-sectional study (clustering sample). This study was conducted in three of the 15 districts in Lahej between December 2009 and August 2010. Household members were interviewed using a questionnaire to determine sociodemographic characteristics and types of healthcare services available in the area. The distribution of health centres, health units and hospitals did not match the size of the populations or areas of the districts included in this study. Geographical accessibility was the main obstacle to utilization. Factors associated with the utilization of curative services were significantly related to the time required to reach the nearest facility, seeking curative services during illness and awareness of the availability of health facilities (P < 0.01). There is an urgent need to look critically and scientifically at the distribution of healthcare services in the region in order to ensure accessibility and quality of services. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Diversite et importance socio-economique des services ...

African Journals Online (AJOL)

Ecosystems and protected areas provide important ecosystem services to local communities. These services are incentives for natural resources conservation. The current project, conducted in Pendjari Biosphere Reserve, northern Benin aimed at assessing ecosystem services and their contribution to local people ...

Health Trajectories of Family Caregivers: Associations With Care Transitions and Adult Day Service Use

Science.gov (United States)

Liu, Yin; Kim, Kyungmin; Zarit, Steven H.

2017-01-01

Objective The study examines family caregivers’ health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. Method The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Results Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers’ trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives’ placement. Discussion Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. PMID:25348275

Childhood ADHD Symptoms: Association with Parental Social Networks and Mental Health Service Use during Adolescence

OpenAIRE

Bussing, Regina; Meyer, Johanna; Zima, Bonnie T.; Mason, Dana M.; Gary, Faye A.; Garvan, Cynthia Wilson

2015-01-01

Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD) risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207) and low risk (n = 167) for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescent...

Impact of Support Services on Associate Level Nursing Programs

Science.gov (United States)

Busby-Parker, Michelle N.

2014-01-01

The goal of the research was to show the impact of the implementation of support services on admissions and graduation from nursing programs. The use of support services has been linked to higher levels of success in nursing students in the classroom and the work place. As nursing schools experience pressure to increase the student capacity to…

Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice

Science.gov (United States)

Aarons, Gregory A.

2006-01-01

Objective Leadership in organizations is important in shaping workers’ perceptions, responses to organizational change, and acceptance of innovations, such as evidence-based practices. Transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. Studies have shown that in youth and family service organizations, mental health providers’ attitudes toward adopting an evidence-based practice are associated with organizational context and individual provider differences. The purpose of this study was to expand these findings by examining the association between leadership and mental health providers’ attitudes toward adopting evidence-based practice. Methods Participants were 303 public-sector mental health service clinicians and case managers from 49 programs who were providing mental health services to children, adolescents, and their families. Data were gathered on providers’ characteristics, attitudes toward evidence-based practices, and perceptions of their supervisors’ leadership behaviors. Zero-order correlations and multilevel regression analyses were conducted that controlled for effects of service providers’ characteristics. Results Both transformational and transactional leadership were positively associated with providers’ having more positive attitudes toward adoption of evidence-based practice, and transformational leadership was negatively associated with providers’ perception of difference between the providers’ current practice and evidence-based practice. Conclusions Mental health service organizations may benefit from improving transformational and transactional supervisory leadership skills in preparation for implementing evidence-based practices. PMID:16870968

The Pluralism of Women?s Associations in Spanish Cities: A Proposed Typology [ENG

Directory of Open Access Journals (Sweden)

Jonas Radl

2013-01-01

Full Text Available The main objective of this article is to analyse pluralism within the context of women?s associations in Spanish cities. Specifically, a methodological proposal is made in order to develop a typology of women?s associations. It is applied to data from a survey conducted in five cities in Spain. The main results confirm the pluralism within this type of associations. However, besides the two main types of women?s associations identified by the literature (the feminist movement and women?s associations, other hybrid types are identified here according to their role in the coproduction of public services. Thus, co-production, as well as their own agendas, their political activism and the delivery of their own public services, appears as an important dimension in classifying women?s associations and enhancing the knowledge about them in Spain.

Evaluation of stroke services in Anglia stroke clinical network to examine the variation in acute services and stroke outcomes

Directory of Open Access Journals (Sweden)

George Abraham

2011-02-01

Full Text Available Abstract Background Stroke is the third leading cause of death in developed countries and the leading cause of long-term disability worldwide. A series of national stroke audits in the UK highlighted the differences in stroke care between hospitals. The study aims to describe variation in outcomes following stroke and to identify the characteristics of services that are associated with better outcomes, after accounting for case mix differences and individual prognostic factors. Methods/Design We will conduct a cohort study in eight acute NHS trusts within East of England, with at least one year of follow-up after stroke. The study population will be a systematically selected representative sample of patients admitted with stroke during the study period, recruited within each hospital. We will collect individual patient data on prognostic characteristics, health care received, outcomes and costs of care and we will also record relevant characteristics of each provider organisation. The determinants of one year outcome including patient reported outcome will be assessed statistically with proportional hazards regression models. Self (or proxy completed EuroQol (EQ-5D questionnaires will measure quality of life at baseline and follow-up for cost utility analyses. Discussion This study will provide observational data about health service factors associated with variations in patient outcomes and health care costs following hospital admission for acute stroke. This will form the basis for future RCTs by identifying promising health service interventions, assessing the feasibility of recruiting and following up trial patients, and provide evidence about frequency and variances in outcomes, and intra-cluster correlation of outcomes, for sample size calculations. The results will inform clinicians, public, service providers, commissioners and policy makers to drive further improvement in health services which will bring direct benefit to the patients.

Consumer preferences for telemedicine devices and services in South Korea.

Science.gov (United States)

Ahn, Joongha; Shin, Jungwoo; Lee, Jongsu; Shin, Kwangsoo; Park, Hayoung

2014-02-01

The scope of healthcare has been expanding from caring for sick people to keeping people from becoming sick, and telemedicine will play a significant role in this new healthcare paradigm. This study investigated consumer preferences and willingness to pay for attributes of telemedicine services in South Korea. A market simulation was conducted to examine the market shares of alternative services and their relationships to the perceived usefulness of service types and preferred device types. Using a conjoint survey, we collected data on consumer preferences for six telemedicine service attributes. Data analysis used the Bayesian mixed logit model. The market simulation estimated the probabilities of a specific service alternative being chosen using estimated model coefficients. Wearable devices were the most preferred, followed by smart-home and smartphone devices. Consumers perceived managing blood glucose to be the most useful telemedicine service, followed by monitoring oxygen saturation and blood pressure. The market simulation indicated that consumer preferences for device types were associated with the types of chronic diseases for which management through telemedicine services is perceived to be useful. As the focus of healthcare moves from treating patients to keeping individuals healthy, a key factor for the successful deployment of telemedicine services is understanding consumer perceptions and attitudes. The results of this study revealed the dynamics of consumer preferences with regard to service attributes.

30 CFR 250.131 - Will MMS notify me before conducting an inspection?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Will MMS notify me before conducting an inspection? 250.131 Section 250.131 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR... § 250.131 Will MMS notify me before conducting an inspection? MMS conducts both scheduled and...

An epidemiological study of ADHD and conduct disorder: does family conflict moderate the association?

Science.gov (United States)

Sigfusdottir, Inga Dora; Asgeirsdottir, Bryndis Bjork; Hall, Hildigunnur Anna; Sigurdsson, Jon Fridrik; Young, Susan; Gudjonsson, Gisli H

2017-04-01

To examine the role of family conflict in the relationship between attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD). A cross-sectional national population survey was carried out among 10,838 14-16 year old students in all secondary schools in Iceland. Three latent measures, financial status, ADHD and CD, and one observed measure, family structure, were included in the study. A structural equation model was used to evaluate direct effects between ADHD and CD for four different groups; females and males, experiencing family conflict and those not experiencing family conflict. ADHD was significantly and positively associated with CD for all groups. When controlling for financial status and family structure it was found that ADHD was positively and significantly associated with CD for adolescent females and males not experiencing family conflict as well as for those experiencing family conflict. The link between ADHD and CD was significantly stronger for those adolescents who had experienced family conflict compared to those who had not experienced family conflict. These results suggest that family conflict moderates the association between ADHD and CD for both girls and boys. The results of this study indicate that family environment and ADHD symptoms are important when predicting CD among adolescent youth. Most notably, family conflict exacerbates the effects of ADHD symptoms on CD among both females and males.

Forestry-service entrepreneurs as producers of services

International Nuclear Information System (INIS)

Koistinen, A.

1999-01-01

The concept of forestry-service enterprise used in the joint study (1997-7999) by the TTS-Institute and the Finnish Forest Research Institute (Metla) refers to enterprises and co-operatives (including forest workers operating as entrepreneurs) offering services in the fields of silviculture, basic forest improvement, planning and wood-harvesting sector. Companies practicing large-scale wood-conversion and traditional forestry-machine and road haulage contractors are not included in this approach. It can be estimated that there is a total of 450 such entrepreneurs in the country Those engaged in only a minor degree in providing forestry services are not included in the figure. The nation-wide research material was collected in the form of a mail questionnaire addressed to forestry-service entrepreneurs (n=320) in the spring of 1998. Almost all forestry-service entrepreneurs provide timber felling as a service. More than half of them do planting, cleaning of young stands, tending of young stands, and forest haulage of timber. Forestry planning is done by nearly a quarter. With the focus of operations as calculated from the enterprises turnover serving as the basis, it became apparent that the majority of entrepreneurship takes place in the form of logging. The means of transport is mostly an agricultural tractor. Most of entrepreneurs have switched to entrepreneurship only recently. Nearly a third have college level education in forestry, 39 % have switched over from their previous occupation of forest worker. Most entrepreneurs are full-time, private practitioners. Their median turnover in 1997 was FIM 180 000. Non-industrial private forest owners form the clientele for 82 % of the entrepreneurs, while local forest management associations are sources of employment for 68 % of the entrepreneurs. As to the average breakdown of the sources of their turnover 31 % is earned from jobs done for local forest management associations, 31 % comes from local forest management

Tactical Web Services: Using XML and Java Web Services to Conduct Real-Time Net-Centric Sonar Visualization

National Research Council Canada - National Science Library

Rosetti, Scott

2004-01-01

With the unveiling of ForceNet, the Navy's architectural framework for how naval warfare is to be conducted in the information age, much of the technological focus has been placed on Web technology...

Using Satellite Technology to Increase Professional Communications Among Teachers: a Report of Experiments Conducted by the National Education Association.

Science.gov (United States)

National Education Association, Washington, DC. Div. of Instruction and Professional Development.

The National Education Association (NEA) in conjunction with the National Aeronautics and Space Administration, the National Library of Medicine, The Alaska Broadcasting Commission, and the Pacific PEACESAT Network, conducted four satellite experiments designed to improve professional communication among teachers. These programs were the Satellite…

PERSEPSI NASABAH TENTANG LAYANAN PERBANKAN: PENGARUH SERVICE FAILURE DAN STRATEGI SERVICE RECOVERY TERHADAP BEHAVIORAL INTENTIONS

Directory of Open Access Journals (Sweden)

Yuli Liestyana

2017-03-01

Full Text Available The research was conducted to verify the ability of service quality and service recoverystrategy to predict behavioral intentions in the banking industry. A survey questionnaire wasdeveloped, then it was distributed to 150 customers of banks in Yogyakarta. Data was analyzedusing multiple regression analysis. The results provided support for hypothesis of the negativeeffect of service failure and positive effect of recovery strategy on behavioral intentions.

IPERS guidelines for the international peer review service. Second edition. Procedures for conducting independent peer reviews of probabilistic safety assessments

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-10-01

This publication describes the purposes and the objectives of an International Peer Review Service (IPERS) review. The main objective is first to assess whether important technological and methodological issues in the PSA are treated in an adequate manner and, second, whether specific conclusions and applications of the PSA are supported by the underlying technical analysis in an appropriate way. An important aspect for an IPERS review is the communication and exchange of views between the international experts carrying out the review and the members of the PSA team. This TECDOC is intended to give guidance on how an IPERS review is organized and conducted, it describes the steps needed to prepare the review and it highlights the PSA aspects which should be covered in detail. 30 refs, 1 fig., 2 tabs.

IPERS guidelines for the international peer review service. Second edition. Procedures for conducting independent peer reviews of probabilistic safety assessments

International Nuclear Information System (INIS)

1995-10-01

This publication describes the purposes and the objectives of an International Peer Review Service (IPERS) review. The main objective is first to assess whether important technological and methodological issues in the PSA are treated in an adequate manner and, second, whether specific conclusions and applications of the PSA are supported by the underlying technical analysis in an appropriate way. An important aspect for an IPERS review is the communication and exchange of views between the international experts carrying out the review and the members of the PSA team. This TECDOC is intended to give guidance on how an IPERS review is organized and conducted, it describes the steps needed to prepare the review and it highlights the PSA aspects which should be covered in detail. 30 refs, 1 fig., 2 tabs

Does empowering resident families or nursing home employees in decision making improve service quality?

Science.gov (United States)

Hamann, Darla J

2014-08-01

This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

Mammography screening services: market segments and messages.

Science.gov (United States)

Scammon, D L; Smith, J A; Beard, T

1991-01-01

Mammography has become a vital tool for the early detection of breast cancer. Although many organizations and health care facilities are working to educate and motivate women to take advantage of the life saving opportunity that is offered through screening mammography, only twenty percent of women who should be screened actually have the procedure performed. In order to reach women who have not been screened, it is important to learn which factors most strongly motivate those women who do choose to have a mammogram. Depth interviews with 18 women attending a mobile mammography unit were conducted to explore the decision making process of women obtaining mammography screening services and to develop a profile of prevalent emotions, attitudes, and feelings associated with receiving breast cancer screening services. Analysis of the interview transcripts revealed several important themes to which health care professionals can direct marketing and health promotion strategies.

Diabetes knowledge and utilization of healthcare services among patients with type 2 diabetes mellitus in Dhaka, Bangladesh.

Science.gov (United States)

Siddique, Md Kaoser Bin; Islam, Sheikh Mohammed Shariful; Banik, Palash Chandra; Rawal, Lal B

2017-08-22

Diabetes is a significant global public health concern. Poor knowledge of disease and healthcare utilization is associated with worse health outcomes, leading to increasing burden of diabetes in many developing countries. This study aimed to determine diabetes related knowledge and factors affecting utilization of healthcare services among patients with type 2 diabetes mellitus in Bangladesh. This analytical study was conducted among 318 patients with type 2 diabetes (T2DM) attending two large tertiary hospitals in Dhaka, Bangladesh between August 2014 and January 2015. Interviewer assisted semi-structured survey questionnaire was used to collect data on diabetes knowledge (measured by a validated Likert scale) and self-reported utilization of service for diabetes. Univariate and bivariate analyses were conducted to determine the factors associated with diabetes knowledge and healthcare utilization. The mean (±SD) age of participants was 52 (±10) years. Majority of the participants were females (58%) and urban residents (74%). Almost two-third (66%) of the participants had an average level of knowledge of T2DM. One-fifth (21%) of the participants had poor knowledge which was significantly associated with gender (P knowledge of diabetes which might affect the utilization of healthcare services for diabetes management. Innovations in increasing diabetes knowledge and health behavior change are recommended specially for females, those with lower education and less income.

Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada.

Science.gov (United States)

Baiden, Philip; Fallon, Barbara

2018-05-01

Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice

Challenges associated with nerve conduction block using kilohertz electrical stimulation

Science.gov (United States)

Patel, Yogi A.; Butera, Robert J.

2018-06-01

Neuromodulation therapies, which electrically stimulate parts of the nervous system, have traditionally attempted to activate neurons or axons to restore function or alleviate disease symptoms. In stark contrast to this approach is inhibiting neural activity to relieve disease symptoms and/or restore homeostasis. One potential approach is kilohertz electrical stimulation (KES) of peripheral nerves—which enables a rapid, reversible, and localized block of conduction. This review highlights the existing scientific and clinical utility of KES and discusses the technical and physiological challenges that must be addressed for successful translation of KES nerve conduction block therapies.

Human Rights and Health Services

DEFF Research Database (Denmark)

Skitsou, Alexandra; Bekos, Christos; Charalambous, George

2016-01-01

Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions of the Ombuds......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...

Collaborative Business Services Provision

NARCIS (Netherlands)

Camarinha-Matos, L.M.; Afsarmanesh, H.; Oliveira, A.I.; Ferrada, F.; Hammoudi, S.; Maciaszek, L.A.; Cordeiro, J.; Dietz, J.L.G.

2013-01-01

The association of services to manufactured products, leading to service-enhanced products, is an important mechanism for value creation and differentiation. This is particularly relevant in the case of complex, highly customized and long-life products. Suitable servicing in this context typically

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

Directory of Open Access Journals (Sweden)

Soon-hoo So

2006-12-01

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

CUSTOMER SERVICES AND PRODUCT QUALITY

Directory of Open Access Journals (Sweden)

NEAMŢU Liviu

2013-04-01

Full Text Available Objective level of product is a combination of material elements. They are supplemented by satisfying highly heterogeneous and complex motivations, representing highly diverse subjective functions associated to product until individualization for each type of consumption. Thus it observes highly surprising developments of subjective function associated with a product and which determines in the consumer's opinion the quality level of the product. The present study examines the role of associated services covering the subjective function of the product in view of the fact that the utility or subjective function is dependent on elements such as style, fashion and fads. Consumers will no longer accept products with average quality of related services. For a company that wants to stay in the market and achieve profitability, the only solution is moving towards a complete product package type goods-services. Associated services are thus an indicator of quality and the best customer loyalty insurance policy, there is a close relationship between the quality of services provided by a firm, customer satisfaction and company profitability.

National Collegiate Athletic Association Division I Certified Athletic Trainers' Perceptions of the Benefits of Sport Psychology Services.

Science.gov (United States)

Zakrajsek, Rebecca A; Martin, Scott B; Wrisberg, Craig A

2016-05-01

Certified athletic trainers (ATs) are responsible for integrating relevant professionals into the rehabilitation team to assist with the holistic care of injured athletes. To explore National Collegiate Athletic Association Division I (DI) ATs' experience with sport psychology consultants (SPCs), willingness to encourage athletes to use SPCs for injury rehabilitation, and perceptions of the benefits of sport psychology services. Quantitative study. A Web-based survey was administered to a national sample of DI ATs. A total of 659 (341 men, 318 women) ATs completed the survey. Athletic trainers' experience with SPCs, willingness to encourage athletes to seek sport psychology services, and perceptions of the benefits of those services in injury-rehabilitation settings were self-reported using a rating scale that ranged from 1 (never or not at all) to 5 (definitely or extremely). Logistic regression revealed that the availability of SPCs, previous encouragement to athletes to seek sport psychology services, and previous positive interactions with SPCs predicted the ATs' willingness to encourage athletes to use these services (P sport and building confidence). Chi-square analyses indicated that female ATs' ratings of perceived benefits were higher (P ≤ .001) than those of male ATs, and the ratings of ATs who were likely to encourage the use of SPCs were higher (P ≤ .001) than those who were unlikely to encourage SPC service use. Athletic trainers in our study who had previous positive SPC experiences were most likely to use SPCs and their services during the injury-rehabilitation process. Possible implications are offered for how ATs interested in sport psychology services might call on SPCs to complement their work with injured athletes.

Quantitative marketing research on behavior of the small and medium companies on financial advisory services

Directory of Open Access Journals (Sweden)

Duguleana, L.

2013-12-01

Full Text Available This paper presents the results of quantitative marketing research conducted among small and medium enterprises in Braşov County. The research identified organizational elements of the consumer behavior in the use of the financial advisory services. The objective is to determine whether there is association between firm size and the number of financial advice services outsourced. Results of the study will be based construction of the price policy for financial advisory firms, tailored to the financial constraints faced by small and medium enterprises in Romania.

Distribution of conductive minerals as associated with uranium minerals at Dendang Arai sector by induced polarization method

International Nuclear Information System (INIS)

Nurdin, M.; Nikijuluw, N.; Subardjo; Sudarto, S.

2000-01-01

Based on previous investigation results, a favourable zone of 20-80 meters in wide, 80-240 meters in length and in the direction of East-West to Northwest-Southeast was found. The favourable zone is conductor, associated with sulfide. Induced polarization method has been applied to find vertical and horizontal sulfide distribution. The measurement was conducted in perpendicular to lateral direction of the conductive zone in an interval of 20 meters. Properties measured are apparent resistivity and charge ability. Measurement results indicated the presence of sulfide zone with the position and dip are sub-vertical. Sulfide zones were found on the fault cross-point with the directions being East-West to East South East-West North West by fault is North-South. This anomalies were then represented in 3 (three) dimension tomographic model. (author)

Reductions in access to HIV prevention and care services are associated with arrest and convictions in a global survey of men who have sex with men.

Science.gov (United States)

Santos, Glenn-Milo; Makofane, Keletso; Arreola, Sonya; Do, Tri; Ayala, George

2017-02-01

Men who have sex with men (MSM) are disproportionately impacted by HIV. Criminalisation of homosexuality may impede access to HIV services. We evaluated the effect of the enforcement of laws criminalising homosexuality on access to services. Using data from a 2012 global online survey that was published in a prior paper, we conducted a secondary analysis evaluating differences in perceived accessibility to health services (ie, 'how accessible are ____' services) between MSM who responded 'yes'/'no' to: 'have you ever been arrested or convicted for being gay/MSM?' Of the 4020 participants who completed the study and were included in the analysis, 8% reported ever being arrested or convicted under laws relevant to being MSM. Arrests and convictions were most common in sub-Saharan Africa (23.6% (58/246)), Eastern Europe/Central Asia (18.1% (123/680)), the Caribbean (15% (15/100)), Middle East/North Africa (13.2% (10/76)) and Latin America (9.7% (58/599)). Those arrested or convicted had significantly lower access to sexually transmitted infection treatment (adjusted OR (aOR)=0.81; 95% CI 0.67 to 0.97), condoms (aOR=0.77; 95% CI 0.61 to 0.99) and medical care (aOR=0.70; 95% CI 0.54 to 0.90), compared with other MSM, while accounting for clustering by country and adjusting for age, HIV status, education and country-level income. Arrests and convictions under laws relevant to being MSM have a strong negative association with access to HIV prevention and care services. Creating an enabling legal and policy environment, and increasing efforts to mitigate antihomosexuality stigma to ensure equitable access to HIV services are needed, along with decriminalisation of homosexuality, to effectively address the public health needs of this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Supervisor vs. employee safety perceptions and association with future injury in US limited-service restaurant workers.

Science.gov (United States)

Huang, Yueng-Hsiang; Verma, Santosh K; Chang, Wen-Ruey; Courtney, Theodore K; Lombardi, David A; Brennan, Melanye J; Perry, Melissa J

2012-07-01

Many studies have found management commitment to safety to be an important construct of safety climate. This study examined the association between supervisor and employee (shared and individual) perceptions of management commitment to safety and the rate of future injuries in limited-service restaurant workers. A total of 453 participants (34 supervisors/managers and 419 employees) from 34 limited-service restaurants participated in a prospective cohort study. Employees' and managers' perceptions of management commitment to safety and demographic variables were collected at the baseline. The survey questions were made available in three languages: English, Spanish, and Portuguese. For the following 12 weeks, participants reported their injury experience and weekly work hours. A multivariate negative binomial generalized estimating equation model with compound symmetry covariance structure was used to assess the association between the rate of self-reported injuries and measures of safety perceptions. There were no significant relationships between supervisor and either individual or shared employee perceptions of management commitment to safety. Only individual employee perceptions were significantly associated with future employee injury experience but not supervisor safety perceptions or shared employee perceptions. Individual employee perception of management commitment to safety is a significant predictor for future injuries in restaurant environments. A study focusing on employee perceptions would be more predictive of injury outcomes than supervisor/manager perceptions. Copyright © 2012 Elsevier Ltd. All rights reserved.

12 CFR 561.45 - Service corporation.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Service corporation. 561.45 Section 561.45... AFFECTING ALL SAVINGS ASSOCIATIONS § 561.45 Service corporation. The term service corporation means any corporation, the majority of the capital stock of which is owned by one or more savings associations and which...

76 FR 22293 - Supplemental Standards of Ethical Conduct for Employees of the Court Services and Offender...

Science.gov (United States)

2011-04-21

... employment involves solicitation or advertising services. (f) Appeal. If the Designated Agency Ethics... the prospective employment involves solicitation or advertising services. The request must be... 8001.102(f) describes the appeal process if the request is denied by the DAEO. The employee may appeal...

Conducted Electromagnetic Interference (EMI) in Smart Grids

CERN Document Server

Smolenski, Robert

2012-01-01

As power systems develop to incorporate renewable energy sources, the delivery systems may be disrupted by the changes involved. The grid’s technology and management must be developed to form Smart Grids between consumers, suppliers and producers. Conducted Electromagnetic Interference (EMI) in Smart Grids considers the specific side effects related to electromagnetic interference (EMI) generated by the application of these Smart Grids. Conducted Electromagnetic Interference (EMI) in Smart Grids presents specific EMI conducted phenomena as well as effective methods to filter and handle them once identified. After introduction to Smart Grids, the following sections cover dedicated methods for EMI reduction and potential avenues for future development including chapters dedicated to: •potential system services, •descriptions of the EMI spectra shaping methods, •methods of interference voltage compensation, and theoretical analysis of experimental results.  By focusing on these key aspects, Conducted El...

Ubiquitous Computing Services Discovery and Execution Using a Novel Intelligent Web Services Algorithm

Science.gov (United States)

Choi, Okkyung; Han, SangYong

2007-01-01

Ubiquitous Computing makes it possible to determine in real time the location and situations of service requesters in a web service environment as it enables access to computers at any time and in any place. Though research on various aspects of ubiquitous commerce is progressing at enterprises and research centers, both domestically and overseas, analysis of a customer's personal preferences based on semantic web and rule based services using semantics is not currently being conducted. This paper proposes a Ubiquitous Computing Services System that enables a rule based search as well as semantics based search to support the fact that the electronic space and the physical space can be combined into one and the real time search for web services and the construction of efficient web services thus become possible.

Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: A community - based cross sectional study

Directory of Open Access Journals (Sweden)

Teferra Alemayehu

2012-07-01

Full Text Available Abstract Background Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio and improving maternal health is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Amhara Regional State, Ethiopia. Therefore, this study aimed to assess factors affecting institutional delivery service utilization among mothers who gave birth in the last 12 months in Sekela District, Amhara Region, Ethiopia. Methods Community-based cross-sectional study was conducted among mothers with birth in the last 12 months during August, 2010. Multistage sampling technique was used to select 371 participants. A pre tested and structured questionnaire was used to collect data. Bivariate and multivariate data analysis was performed using SPSS version 16.0 software. Results The study indicated that 12.1% of the mothers delivered in health facilities. Of 87.9% mothers who gave birth at home, 80.0% of them were assisted by family members and relatives. The common reasons for home delivery were closer attention from family members and relatives (60.9%, home delivery is usual practice (57.7%, unexpected labour (33.4%, not being sick or no problem at the time of delivery (21.6% and family influence (14.4%. Being urban resident (AOR [95% CI] = 4.6 [1.91, 10.9], ANC visit during last pregnancy (AOR [95% CI] = 4.26 [1.1, 16.4], maternal education level (AOR [95%CI] =11.98 [3.36, 41.4] and knowledge of mothers on pregnancy and delivery services (AOR [95% CI] = 2.97[1.1, 8.6] had significant associations with institutional delivery service utilization. Conclusions Very low institutional delivery service utilization was observed in the study area. Majority of the births at home were assisted by family members and relatives. ANC visit and lack of

Organizational characteristics associated with cultural and linguistic service provision within Alabama hospitals.

Science.gov (United States)

Davis, Jullet A; Whitman, Marilyn V

2008-01-01

Like several states in the Southeast, Alabama is in the nascent stages of an increase in the population of foreign-born individuals for whom English is a second language. These individuals are also culturally different from the traditional southern population. Given the impact of culture and language on a person's service utilization, the introduction of new cultures may pose significant challenges for Alabama's health care providers if they are not prepared. The purpose of this project is to examine the organizational characteristics associated with the provision of culturally and linguistically appropriate services by Alabama hospitals. The data for the project come from a survey of all medical/surgical hospitals (N = 101). Fifty-nine surveys were returned, giving us a 58% response rate. The data were analyzed using correlations, analysis of variance, and logistic regression. Approximately 47% of the sample hospitals reported having a staff interpreter. Furthermore, hospitals that had staff interpreters did seem to be more aware of their community, which was reflected in their mission statements. In addition, directors who viewed their role as fulfilling the strategic plan accepted the task of providing staff interpreters. Thus, several hospitals in Alabama seemed to be ready to meet the cultural and language needs of their markets.

Skilled antenatal care service utilization and its association with the ...

African Journals Online (AJOL)

Data were entered into EPI info version 7 statistical software and exported to STATA ... Conclusions: Skilled ANC service utilization is the joint effect of individual and ... analysis, skilled antenatal care service, women's health development team ...

A Developmental Perspective in Mental Health Services Use Among Adults with Mental Disorders.

Science.gov (United States)

Huỳnh, Christophe; Caron, Jean; Pelletier, Marilou; Liu, Aihua; Fleury, Marie-Josée

2018-07-01

This study examined factors associated with mental health services (MHS) use by individuals with mental disorders within a developmental perspective of adulthood. Bivariate and multivariate analyses were conducted separately for each developmental stage on independent variables using the Andersen's behavioral health service model. For 18-29-year-old emerging adults (n = 141), autonomy, daily life/relations, Internet searching, alcohol dependence, cognitive impulsiveness, number of stressful events, and self-harm were associated with MHS use. For 30-49-year olds (n = 292), being female, country of origin, being on welfare, social integration, Internet searching, and number of stressful events were associated with MHS use. For 50-64-year-old middle-aged adults (n = 126), current occupation was associated with MHS use. Developing online resources for emerging adults may increase MHS use. For 30-49-year olds, outreach should target male, immigrants, and individuals less socially integrated and on welfare. For middle-aged adults, workplace programs that reduce stigma and offer psychological help could increase MHS use.

The role of transformational leadership and organizational culture in service delivery within a public service organization

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Ophillia Ledimo

2014-08-01

Full Text Available Continuous changes in the external environment deriving from legislative, economic and technological factors, puts pressure not only to corporate organizations, but also to public service organizations. These changes have increased pressure on service delivery and calls for accountability in public service organizations. With this increased pressure comes the need for public service organizations to discover how to most effectively enhance their organizational performance. Two of the most effective ways to improve performance are through the organizational leadership and culture. Although many studies were conducted on transformational leadership and organizational culture, there is still a need to investigate the link between these constructs in public service organizations. Hence the objective of this study was to explore the relationship between transformational leadership and organizational culture for service delivery practices. The Leadership Practice Inventory (LPI and Organizational Culture Inventory (OCI were administered to a random sample size of N=238, from a population of 4350 employees working within the public service organization. Descriptive statistics and Pearson’s correlation were conducted to analyse the data. The results of this study indicated a significant positive relationship between transformational leadership and the constructive dimension of organizational culture within a public service organization. In terms of contributions and practical implications, insight gained from the findings may be used in proposing leadership and organizational development interventions and future research

Development of a service organization. CHA (Catholic Hospital Association) from post-World War II through Vatican II.

Science.gov (United States)

Kauffman, C J

1990-06-01

Having weathered the Depression and war years, CHA in the late 1940s looked forward to a new era in Catholic healthcare. The third and fourth articles of Health Progress's six-part history of CHA described how Rev. Alphonse M. Schwitalla, SJ, led the association through one of the most difficult periods in U.S. history. This article follows CHA's development into a modern service organization under the leadership of Rev. John J. Flanagan, SJ. The series' final installment, which will appear in the July-August issue, describes how CHA has modernized its services and structure in the past two decades to help its members adjust to a turbulent environment.

Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey

Science.gov (United States)

2013-01-01

Background The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. Methods A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. Results The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose–response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. Conclusions An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for

Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey.

Science.gov (United States)

Perkins, David; Fuller, Jeffrey; Kelly, Brian J; Lewin, Terry J; Fitzgerald, Michael; Coleman, Clare; Inder, Kerry J; Allan, John; Arya, Dinesh; Roberts, Russell; Buss, Richard

2013-04-30

The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose-response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from

Patient satisfaction and perceived quality of care: evidence from a cross-sectional national exit survey of HIV and non-HIV service users in Zambia.

Science.gov (United States)

Dansereau, Emily; Masiye, Felix; Gakidou, Emmanuela; Masters, Samuel H; Burstein, Roy; Kumar, Santosh

2015-12-30

To examine the associations between perceived quality of care and patient satisfaction among HIV and non-HIV patients in Zambia. Patient exit survey conducted at 104 primary, secondary and tertiary health clinics across 16 Zambian districts. 2789 exiting patients. Five dimensions of perceived quality of care (health personnel practice and conduct, adequacy of resources and services, healthcare delivery, accessibility of care, and cost of care). Respondent, visit-related, and facility characteristics. Patient satisfaction measured on a 1-10 scale. Indices of perceived quality of care were modelled using principal component analysis. Statistical associations between perceived quality of care and patient satisfaction were examined using random-effect ordered logistic regression models, adjusting for demographic, socioeconomic, visit and facility characteristics. Average satisfaction was 6.9 on a 10-point scale for non-HIV services and 7.3 for HIV services. Favourable perceptions of health personnel conduct were associated with higher odds of overall satisfaction for non-HIV (OR=3.53, 95% CI 2.34 to 5.33) and HIV (OR=11.00, 95% CI 3.97 to 30.51) visits. Better perceptions of resources and services were also associated with higher odds of satisfaction for both non-HIV (OR=1.66, 95% CI 1.08 to 2.55) and HIV (OR=4.68, 95% CI 1.81 to 12.10) visits. Two additional dimensions of perceived quality of care--healthcare delivery and accessibility of care--were positively associated with higher satisfaction for non-HIV patients. The odds of overall satisfaction were lower in rural facilities for non-HIV patients (OR 0.69; 95% CI 0.48 to 0.99) and HIV patients (OR=0.26, 95% CI 0.16 to 0.41). For non-HIV patients, the odds of satisfaction were greater in hospitals compared with health centres/posts (OR 1.78; 95% CI 1.27 to 2.48) and lower at publicly-managed facilities (OR=0.41, 95% CI=0.27 to 0.64). Perceived quality of care is an important driver of patient satisfaction with

Context-Specific Associations Between Harsh Parenting and Peer Rejection on Child Conduct Problems at Home and School.

Science.gov (United States)

Tung, Irene; Lee, Steve S

2016-02-06

Although harsh parenting and peer rejection are independently associated with childhood conduct problems (CP), these patterns are often informant specific, suggesting that their associations across contexts (i.e., home and school) should be considered. In a sample of 142 children with and without attention-deficit/hyperactivity disorder (ADHD; ages 5-10; 66% male), we used structural equation modeling to evaluate the structure of multi-informant (parent, teacher) and multimethod (semi-structured interview, questionnaire) rated aggressive, rule-breaking, and oppositional behavior. Next, we explored context-specific associations by modeling harsh parenting and peer rejection as simultaneous and independent predictors of home and school CP. We observed several key findings: (a) the structure of parent- and teacher-reported CP was best accounted by context-specific CP (i.e., home vs. school) and a second-order general CP factor; (b) harsh punishment and peer rejection each independently predicted the second-order general CP factor; and (c) peer rejection was uniquely associated with school CP, whereas harsh punishment was associated only with the second-order general CP factor and did not exhibit specificity with home CP. Whereas harsh parenting and peer rejection were each independently associated with generalized CP, peer rejection showed an additional, unique context-specific association with CP exclusively expressed at school. We discuss potential explanatory mechanisms underlying context-specific associations of CP, as well as address etiological and clinical implications for understanding informant-discrepancies in CP.

Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans.

Science.gov (United States)

Gibson, Carolyn J; Gray, Kristen E; Katon, Jodie G; Simpson, Tracy L; Lehavot, Keren

2016-01-01

Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts. Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined. The sample included 781 women veterans. Compared with the oldest age group (≥ 65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77-6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25-7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32-9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64. Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care. Published by Elsevier Inc.

Boys with conduct problems and callous-unemotional traits: Neural response to reward and punishment and associations with treatment response

Directory of Open Access Journals (Sweden)

Amy L. Byrd

2018-04-01

Full Text Available Abnormalities in reward and punishment processing are implicated in the development of conduct problems (CP, particularly among youth with callous-unemotional (CU traits. However, no studies have examined whether CP children with high versus low CU traits exhibit differences in the neural response to reward and punishment. A clinic-referred sample of CP boys with high versus low CU traits (ages 8–11; n = 37 and healthy controls (HC; n = 27 completed a fMRI task assessing reward and punishment processing. CP boys also completed a randomized control trial examining the effectiveness of an empirically-supported intervention (i.e., Stop-Now-And-Plan; SNAP. Primary analyses examined pre-treatment differences in neural activation to reward and punishment, and exploratory analyses assessed whether these differences predicted treatment outcome. Results demonstrated associations between CP and reduced amygdala activation to punishment independent of age, race, IQ and co-occurring ADHD and internalizing symptoms. CU traits were not associated with reward or punishment processing after accounting for covariates and no differences were found between CP boys with high versus low CU traits. While boys assigned to SNAP showed a greater reduction in CP, differences in neural activation were not associated with treatment response. Findings suggest that reduced sensitivity to punishment is associated with early-onset CP in boys regardless of the level of CU traits. Keywords: Conduct problems, Callous-unemotional (CU traits, Reward, Punishment, fMRI

Reduction in thermal conductivity of ceramics due to radiation damage

International Nuclear Information System (INIS)

Klemens, P.G.; Hurley, G.F.; Clinard, F.W. Jr.

1976-01-01

Ceramics are required for a number of applications in fusion reactors. In several of these applications, the thermal conductivity is an important design parameter as it affects the level of temperature and thermal stress in service. Ceramic insulators are known to suffer substantial reduction in thermal conductivity due to neutron irradiation damage. The present study estimates the reduction in thermal conductivity at high temperature due to radiation induced defects. Point, extended, and extended partly transparent defects are considered

An IMP interaction approach to modelling business-to-business professional service quality: the case of Hong Kong consulting engineering service

OpenAIRE

Woo, Ka-shing

2001-01-01

In the domain of services marketing, the most researched area is in service quality. Since the pioneering stage of service quality research in the early 1980s, most of the studies have been conducted in the context of consumer services and consumer professional services. The purpose of this study is to bridge the gap in the existing literature to measure service quality of a particular business-to-business professional service industry (i.e., Hong Kong consulting engineering industry). I...

The service of public services performance management

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

perspectives on the potential impact of public service performance measurement offer a range of contradictory propositions. Its alleged benefits include public assurance, better functioning of supply markets for public services, and direct improvements of public services. But the literature also demonstrates...... the existence of significant concern about the actual impact, the costs and unintended consequences associated with performance measurement.  Performance measurement and management have been part of the political agenda within the public sphere since their adoption in the post-Second World War period...... of political masters and their mistresses rather than public service. Another area of concern is the cost of performance measurement. Hood & Peters (2004:278) note that performance measurement is likely to “distract middle- and upper-level officials, create massive paperwork, and produce major unintended...

The service of public services performance measurement

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

2014-01-01

that performance measurement serves as “rituals of verification” which promotes the interests of political masters and their mistresses rather than public service. Another area of concern is the cost of performance measurement. Hood & Peters (2004:278) note that performance measurement is likely to “distract...... measurement suggests a range of contested and contradictory propositions. Its alleged benefits include public assurance, better functioning of supply markets for public services, and direct improvements of public services. But the literature also demonstrates the existence of significant concern about...... the actual impact, the costs and unintended consequences associated with performance measurement. This paper identifies the main rationales and rationalities in the scholarly discourse on public services performance measurement. It concludes with some suggestions on how to deal with the many rationales...

Definition of technology development missions for early Space Station satellite servicing. Volume 2: Technical

Science.gov (United States)

Cable, D. A.; Diewald, C. A.; Hills, T. C.; Parmentier, T. J.; Spencer, R. A.; Stone, G. E.

1984-01-01

Volume 2 contains the Technical Report of the approach and results of the Phase 2 study. The phase 2 servicing study was initiated in June 1983, and is being reported in this document. The scope of the contract was to: (1) define in detail five selected technology development missions (TDM); (2) conduct a design requirement analysis to refine definitions of satellite servicing requirements at the space station; and (3) develop a technology plan that would identify and schedule prerequisite precursor technology development, associated. STS flight experiments and space station experiments needed to provide onorbit validation of the evolving technology.

Shared services - Implementation and continuous evolution (Article 2 of 3

Directory of Open Access Journals (Sweden)

T. N. Van der Linde

2006-12-01

Full Text Available Purpose: Now that an organisation understands the concept of shared services (Article 1, it needs to implement shared services as a business model. The purpose of this second article in the trilogy is to describe the phases during the implementation process, as well as the various models through which a shared services business unit will evolve to continuously add value to the organisation. Methodology: A comprehensive literature study was conducted in order to: - Determine the steps in implementing a shared services business model, - Determine the various models associated with a shared services business unit, - Determine how the continuous evolution of shared services results in moving from one shared services model to the next shared services model. Findings: In this article, a framework is generated to help organisations understand the various phases and steps it needs to go through to successfully implement a shared services business unit. This work has further potential: when applied correctly, organisations will provide a business environment where effectiveness and efficiency is a given. Implications: This article presents the context for organisations to implement a shared services business model and to continuously evolve from one shared services business model to the other to create value for the organisation. The findings are important for organisations that are in the process of implementing or have implemented shared services, as they can easily stagnate and fall into the trap of centralisation. Value: This article provides an understanding of what is required for the successful implementation of shared services. This value is further enhanced through continuous evolution from a basic shared services business model to the virtual shared services business model and beyond.

Managing customer service.

Science.gov (United States)

Paget, Zoe

2015-02-28

Zoe Paget is the customer services manager at YourVets. Her role includes managing the company's call centre, social media marketing, working with the marketing department to develop customer care initiatives and reporting service levels to the company's directors. British Veterinary Association.

The Integration of Synchronous Communication Technology into Service Learning for Pre-Service Teachers' Online Tutoring of Middle School Students

Science.gov (United States)

Chen, Chao-Hsiu; Liao, Chen-Hung; Chen, Yi-Chieh; Lee, Chen-Feng

2011-01-01

To well prepare pre-service teachers for their future teaching, researchers and teacher-educators have been employing information and communication technology to improve pre-service teachers' learning of subject-matter knowledge, pedagogies, classroom-management skills, and so on. This study illustrates a service-learning project we conducted to…

Exploring the relationship between service quality and customer satisfaction in postal financial service

Directory of Open Access Journals (Sweden)

Steven K Msosa

2015-09-01

Full Text Available Service quality and customer satisfaction are related and are important factors for the success of service providers be it in the public or the private sector. This study aims to examine the relationship between service quality and customer satisfaction in the Malawian public postal service, specifically its banking division. A cross-sectional, quantitative and descriptive study was undertaken and data was collected from 400 customers using the SERVPERF model. A non-probability sampling approach was adopted and respondents were selected using convenience sampling. Reliability of the study was tested using Cronbach alpha. Correlation tests were conducted using Spearman’s rho. The results show that all the five service quality dimensions, viz. tangibles, reliability, empathy, assurance and responsiveness, are significantly and positively correlated. There was also a significant correlation between the service quality dimensions and overall service quality, customer satisfaction and customer loyalty

Beliefs Associated with Support for Child-Centred Learning Environment among Hong Kong Pre-Service Early Childhood Teachers

Science.gov (United States)

Cheung, Sum Kwing; Ling, Elsa Ka-wei; Leung, Suzannie Kit Ying

2017-01-01

The physical, social and temporal dimensions of the classroom environment have an important role in children's learning. This study examines the level of support for child-centred learning, and its associated beliefs, that is provided by Hong Kong's pre-service early childhood teachers. Two hundred and seventy-five students from a pre-service…

Perancangan Tata Kelola Layanan Teknologi Informasi Menggunakan ITIL versi 3 Domain Service Transition Dan Service Operation Di Pemerintah Kota Bandung

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Luki Aisha Kusuma Wardani

2016-10-01

Full Text Available Nowadays, Information Technology plays an important role in an organization, and not only as a support equipment. Bandung City Government, as a government agency, make IT into one of the visions that need to be achieved. To achieve good governance based on Minister Regulation Number 41 in 2007, IT Governance is needed to ensure that the investment of IT can add value and align with institution’s objective. Bandung City Government currently doesn’t have policies and procedure that regulate about IT Service Management. Therefore, this study was conducted with the aim to create a guidance for Office of Communications and Information Technology of Bandung (Diskominfo to optimize the service provided. This study also aims to make Service Management governance so that the management of IT service have certain quality and meet the needs of business customers, and improve the quality as the agreement with the customers. This study was conducted using ITIL v3 with Service Operation and Service Transition domain. ITIL is IT Service Management best practice to improve the efficiency of IT operational. ISO 15504 was conducted to asses Capability Level of ITIL Process. Capability Level of Service Transition is 24.5% and Capability Level of Service Operation is 23%. Because of the inadequacy of the primary data, the assessment was also carried out by mapping the objective of institution with the risks related to the lack of ITIL processes. The results of the design are the governance policies and procedures related to the ITIL processes needed by the institution.

Outsourcing in State Service Activity Outsourcing in State Service Activity

OpenAIRE

Ivan Kotliarov

2012-01-01

The article gives an analysis of the problem of outsourcing in public management of the RF. It clarifies the definition of the term of public services; proposes concepts of public service and public service product; discusses the hypothesis that outsourcing really can help improve the performance of the state structures by attracting external resources.Results: the resource and contact activities are most promising for outsourcing. However, outsourcing of government activities is associated w...

The association between psychological well-being and problematic use of Internet communicative services among young people.

Science.gov (United States)

Casale, Silvia; Lecchi, Stefano; Fioravanti, Giulia

2015-01-01

Previous studies on problematic Internet use have focused almost exclusively on the fact that presence of negative functioning, such as social anxiety, depressive symptoms, or loneliness, represents a risk factor for unhealthy use of the web. For this reason the aim of the present study was to investigate the association between psychological well-being dimensions and problematic use of Internet communicative services. In the current study 495 undergraduate students were recruited. The Italian adaptations of the Psychological Well-being Scales and the Generalized Problematic Internet Use Scale 2 (GPIUS2) were used to assess psychological well-being dimensions and generalized problematic Internet use, respectively. Psychological well-being dimensions explained a significant portion of variance for the GPIUS2 total score levels, after controlling for sex, age, and occupational status. The levels of Autonomy, Environmental Mastery, and Positive Relations with Others acted as significant negative predictors of the tendency to use the web for regulating negative feelings, compulsive use of the web, and the negative outcomes that can arise as a result. The overall findings of the present study provide preliminary evidence that low psychological well-being is associated with problematic use of Internet communicative services.

Association between obesity, quality of life, physical activity and health service utilization in primary care patients with osteoarthritis.

NARCIS (Netherlands)

Rosemann, T.J.; Grol, R.P.T.M.; Herman, K.; Wensing, M.J.P.; Szecsenyi, J.

2008-01-01

ABSTRACT: OBJECTIVE: To assess the association of obesity with quality of life, health service utilization and physical activity in a large sample of primary care patients with osteoarthritis (OA). METHODS: Data were retrieved from the PraxArt project, representing a cohort of 1021 primary care

Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey.

Science.gov (United States)

Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

2015-04-29

To investigate the experience of users of out of hours general practitioner services in England, UK. Population based cross sectional postal questionnaire survey. General Practice Patient Survey 2012-13. Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users' experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users' experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. The overall response rate was 35%; 971,232/2,750,000 patients returned surveys. Data from 902,170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of -3.13 (95% confidence interval -4.96 to -1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care -3.62, -4.36 to -2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care -4.73, -5.29 to -4.17). Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and

Risks for Conduct Disorder Symptoms Associated with Parental Alcoholism in Stepfather Families versus Intact Families from a Community Sample

Science.gov (United States)

Foley, Debra L.; Pickles, Andrew; Rutter, Michael; Gardner, Charles O.; Maes, Hermine H.; Silberg, Judy L.; Eaves, Lindon J.

2004-01-01

Background: It is not known if the prevalence of parental psychiatric disorders is higher in stepfather than intact families, or if parental alcoholism is differentially associated with risk for conduct disorder (CD) symptoms in stepfather families versus intact families. Method: The sample comprised 839 girls and 741 boys from 792 intact families…

Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.

Science.gov (United States)

Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E

2017-04-01

Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.

Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

Directory of Open Access Journals (Sweden)

Anne Kumurenzi

2015-12-01

Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study. Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills. Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

77 FR 76052 - Health Resources and Services Administration

Science.gov (United States)

2012-12-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency..., Public Law 104-13), the Health Resources and Services Administration (HRSA) publishes periodic summaries... Administration (HRSA) plans to conduct a survey of the National Practitioner Data Bank and the Healthcare...

12 CFR 7.5007 - Correspondent services.

Science.gov (United States)

2010-01-01

... Electronic Activities § 7.5007 Correspondent services. It is part of the business of banking for a national... of software that performs data processing functions; (d) The development, operation, management, and marketing of products and processing services for transactions conducted at electronic terminal devices; (e...

Factors associated with no dental treatment in preschoolers with toothache: a cross-sectional study in outpatient public emergency services.

Science.gov (United States)

Machado, Geovanna C M; Daher, Anelise; Costa, Luciane R

2014-08-08

Many parents rely on emergency services to deal with their children's dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children's age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children's mean age was 4.1 (SD 1.0) years (range 1-5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of "sex", the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5-0.8), radiography request (OR 3.8; 95% CI 1.7-8.2), medication prescribed (OR 7.5; 95% CI 4.9-11.5) and patient referred to another service (OR 5.7; 3.0-10.9). Many children with toothache received no oral procedure for pain relief.

Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.

Science.gov (United States)

Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk

2017-03-28

Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and

The Relationship between Paramedic Competency, Teamwork and Career Development with Quality of Service at Mengwi I Community Health Centre

Directory of Open Access Journals (Sweden)

Alit Naya

2015-04-01

Full Text Available Background and objective: Recent survey indicated that patient opinion of services at Mengwi I Community Health Centre was low and there was noticeable decline in patient visits. This study aimed to investigate the issues related to the quality of health services given by the paramedics. Methods: A crosssectional study was conducted with 38 paramedics on duty at the outpatient unit. They were interviewed to obtain the data on their opinions about the quality of their service, competence, teamwork and career development opportunities. Chi square test was used for bivariate analysis and logistic regression for multivariate analysis. Results: The results of bivariate analysis indicated there was significant association between the paramedics’quality of service with the competence, teamwork and career development (p<0,001. Multivariate analysis indicated that the paramedics’competence (OR=43,1; 95%CI: 1,3-1422,5 and development of career (OR=31,7; 95%CI: 1,1-829,7 were related to the paramedics’ quality of service. Conclusion: The quality of service of paramedics at Mengwi I Community Health Centre were significantly associated with the paramedics’competence and development of career. Keywords: competency, teamwork, career development, quality of service

Fiber/matrix interfacial thermal conductance effect on the thermal conductivity of SiC/SiC composites

International Nuclear Information System (INIS)

Nguyen, Ba Nghiep; Henager, Charles H.

2013-01-01

SiC/SiC composites used in fusion reactor applications are subjected to high heat fluxes and require knowledge and tailoring of their in-service thermal conductivity. Accurately predicting the thermal conductivity of SiC/SiC composites as a function of temperature will guide the design of these materials for their intended use, which will eventually include the effects of 14-MeV neutron irradiations. This paper applies an Eshelby–Mori–Tanaka approach (EMTA) to compute the thermal conductivity of unirradiated SiC/SiC composites. The homogenization procedure includes three steps. In the first step EMTA computes the homogenized thermal conductivity of the unidirectional (UD) SiC fiber embraced by its coating layer. The second step computes the thermal conductivity of the UD composite formed by the equivalent SiC fibers embedded in a SiC matrix, and finally the thermal conductivity of the as-formed SiC/SiC composite is obtained by averaging the solution for the UD composite over all possible fiber orientations using the second-order fiber orientation tensor. The EMTA predictions for the transverse thermal conductivity of several types of SiC/SiC composites with different fiber types and interfaces are compared to the predicted and experimental results by Youngblood et al. [J. Nucl. Mater. 307–311 (2002) 1120–1125, Fusion Sci. Technol. 45 (2004) 583–591, Compos. Sci. Technol. 62 (2002) 1127–1139.

Performance Evaluation of Cloud Service Considering Fault Recovery

Science.gov (United States)

Yang, Bo; Tan, Feng; Dai, Yuan-Shun; Guo, Suchang

In cloud computing, cloud service performance is an important issue. To improve cloud service reliability, fault recovery may be used. However, the use of fault recovery could have impact on the performance of cloud service. In this paper, we conduct a preliminary study on this issue. Cloud service performance is quantified by service response time, whose probability density function as well as the mean is derived.

Skin Conductance Level Reactivity Moderates the Association Between Parental Psychological Control and Relational Aggression in Emerging Adulthood.

Science.gov (United States)

Wagner, Caitlin R; Abaied, Jamie L

2016-04-01

When studying factors that may heighten risk for relational aggression in youth, it is important to consider characteristics of both the individual and their environment. This research examined the associations between parental psychological control and reactive and proactive relational aggression in emerging adults in college. Given that sympathetic nervous system (SNS) activation may underlie differences between reactive and proactive aggression and has been shown to moderate the effects of parenting on youth development, the moderating role of SNS reactivity [indexed by skin conductance level reactivity (SCLR)] was also examined. Emerging adults (N = 180; 77.2 % female) self-reported on perceptions of parental psychological control and reactive and proactive relational aggression. SCLR was assessed in response to an interpersonal laboratory challenge task. Parental psychological control was positively associated with reactive relational aggression only for emerging adults who exhibited high SCLR. Parental psychological control was positively associated with proactive relational aggression only among emerging adults who showed low SCLR. This study extends previous research on parenting and aggression and suggests that parental psychological control is differentially associated with reactive versus proactive relational aggression, depending on emerging adults' SCLR to interpersonal stress.

BrdsNBz: A mixed methods study exploring adolescents' use of a sexual health text message service

Science.gov (United States)

Willoughby, Jessica Fitts

Sexual health text message services are becoming increasingly popular, but little is known about who uses such services and why. This project details the implementation of a campaign promoting a state-wide sexual health text message service that allows teens to text directly with a health educator and uses a mixed method design to assess who uses the service, what motivates use, and potential barriers to using the service. A theory of information seeking through text messaging is posited based on previous information seeking and communication theory and tested with adolescents. A social marketing campaign was created promoting a North Carolina sexual health text message service and conducted in six middle and high schools in the North Carolina Piedmont region in Fall 2012. More than 2000 students in four schools completed online questionnaires that assessed awareness of the service, perceptions, and use. Focus groups and in depth interviews were then conducted with middle and high school students. Results indicate teens who are sexually active and in relationships are more likely to use the service. A teens' level of uncertainty about sexual health influences affect, which in turn leads adolescents to assess various information options. Positive attitudes toward the service and credibility perceptions are direct predictors of intentions to use. Efficacy was found to be an indirect predictor, working through credibility perceptions to influence intentions to use. Although teens may have an interest in using the service, there are barriers associated with use. Survey findings and qualitative results indicate that teens are interested in using a sexual health text message service, but perceived costs, fear of parents finding out about service use, and a lack of understanding of how to use the service were barriers for some teens. This study has implications for sexual health text message services, especially those that allow teens to connect directly with a health

Analyzing Music Services Positioning Through Qualitative Research

Directory of Open Access Journals (Sweden)

Manuel Cuadrado

2015-12-01

Full Text Available Information technologies have produced new ways of distributing and consuming music, mainly by youth, in relation to both goods and services. In the case of goods, there has been a dramatic shift from traditional ways of buying and listening to music to new digital platforms. There has also been an evolution in relation to music services. In this sense, live music concerts have been losing their audiences over the past few years, as have music radio stations, in favor of streaming platforms. Curious about this phenomenon, we conducted an exploratory research in order to analyze how all these services, both traditional and new ones were perceived. Specifically, we aimed to study youth´s assessment of the three most relevant music service categories: music radio stations, digital streaming platforms, and pop-rock music festivals. To do so, we used the projective technique of image association to gather information. The population of the study consisted of individuals between 18 and 25 years of age. Our results, after using content analysis, were poor due to spontaneous recall. Therefore, we duplicated the study, but in a more focus-oriented way. Information gathered this time allowed us not only to better know how all these organizations are positioned but also to obtain a list of descriptors to be used in a subsequent descriptive research study.

The association of generalized anxiety disorder and Somatic Symptoms with frequent attendance to health care services: A cross-sectional study from the Northern Finland Birth Cohort 1966.

Science.gov (United States)

Kujanpää, Tero S; Jokelainen, Jari; Auvinen, Juha P; Timonen, Markku J

2017-03-01

Objective Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms. Method This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n = 4) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors. Results Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58-3.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99-1.64), 1.94 (95% CI 1.46-2.58), 2.33 (95% CI 1.65-3.28), and 3.64 (95% CI 2.15-6.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder. Conclusions Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.

Fourth-year dental students' perceived barriers to providing tobacco intervention services.

Science.gov (United States)

Pendharkar, Bhagyashree; Levy, Steven M; McQuistan, Michelle R; Qian, Fang; Squier, Christopher A; Slach, Nancy A; Aquilino, Mary L

2010-10-01

In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth-year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by incoming fourth-year dental students (a convenience sample of seventy students) at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate, and linear regression analyses were conducted. The response rate was 97 percent. The most frequently reported barriers were patients' resistance to tobacco intervention services (96 percent), inadequate time available for tobacco intervention services (96 percent), and forgetting to give tobacco intervention advice (91 percent). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower "adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years" and greater "perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention." Students probably could benefit from additional didactic training, but most important may be enhanced clinical experiences and faculty reinforcement to facilitate effective practical student learning and adaptation for future delivery of intervention services in private practice settings.

Bidirectional Associations between Parenting Practices and Conduct Problems in Boys from Childhood to Adolescence: The Moderating Effect of Age and African-American Ethnicity

Science.gov (United States)

Pardini, Dustin A.; Fite, Paula J.; Burke, Jeffrey D.

2008-01-01

This study examined the bidirectional relationship between parent and teacher reported conduct problems in youth and parenting practices using a longitudinal sample of boys assessed from 6 to 16 years of age. Analyses tested whether these bidirectional associations changed across development and whether the nature of these associations varied…

Gunite and associated tanks dry well conductivity monitoring report, Oak Ridge National Laboratory, Oak Ridge, Tennessee, February 1998 - December 1998

International Nuclear Information System (INIS)

1999-04-01

A waste removal program is being implemented for the Gunite and Associated Tanks Operable Unit at Oak Ridge National Laboratory, Oak Ridge, Tennessee. The waste is being removed by means of remotely operated, in-tank, confined sluicing equipment. During sluicing operations the dry wells adjacent to each of the tanks are instrumented so that potential releases can be detected by means external to the tank. The method of detection is by monitoring the electrical conductivity of the water in the dry well associated with each tank. This report documents the dry well conductivity monitoring data for the period from February 1998 through December 1998. The dry wells monitored during this period include DW-5, DW-6, DW-7, DW-8, DW-9 and DW-10. The conductivity of the water passing through Pump Station 1 (PS1) was also monitored. During this period the sluicing activities at Tank W-6 were initiated and successfully completed. In addition, flight mixers were used to remove wastes from Tank W-5, and sluicing operations were initiated on Tank W-7. Presented in this report are the dry well conductivity, rainfall, tank level, and other appropriate information relevant to the analysis and interpretation of the monitoring data for the reporting period. A thorough analysis of the monitoring results from the six dry wells in the STF and PS1 for the period between February 1998 and December 1998 indicates that no releases have occurred from the gunite tanks being monitored. Overall, the dry well conductivity monitoring continues to provide a robust and sensitive method for detecting potential releases from the gunite tanks and for monitoring seasonal and construction-related changes in the dry well and drain system

Illiteracy, Financial Services and Social Exclusion.

Science.gov (United States)

Hajaj, Khaldoun

Despite calls by consumer advocates for Australia's governments and financial services institutions to provide consumers with resources to help them understand how the financial services sector operates, financial education remains something that most Australians gain by default. Research conducted in the United Kingdom and United States, has…

Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan.

Science.gov (United States)

Lin, Huei-Ru; Otsubo, Tetsuya; Imanaka, Yuichi

2017-08-15

Japan is known for its long life expectancy and rapidly aging society that there are various demands of older adults need to be fulfilled with, and one of them is long-term care needs. Therefore, Japan implemented the Long-Term Care Insurance in year 2000 for citizens who are above 65-year old and citizens who are above 40-year old in needs of long-term care services. This study was undertaken to longitudinally examine the influence of dementia and living alone on care needs increases among older long-term care insurance service users in Japan. Long-term care insurance claims data were used to identify enrollees who applied for long-term care services between October 2010 and September 2011, and subjects were tracked until March 2015. A Kaplan-Meier survival analysis was conducted to examine increases in care needs over time in months. Cox regression models were used to examine the effects of dementia and living alone on care needs increases. The cumulative survival rates before care needs increased over the 4.5-year observation period were 17.6% in the dementia group and 31.9% in the non-dementia group. After adjusting for age, sex, care needs level, and status of living alone, the risk of care needs increases was found to be 1.5 times higher in the dementia group. Living alone was not a significant risk factor of care needs increases, but people with dementia who lived alone had a higher risk of care needs increases than those without dementia. Dementia, older age, the female sex, and lower care needs levels were associated with a higher risk of care needs increases over the study period. Among these variables, dementia had the strongest impact on care needs increases, especially in persons who lived alone.

Research and Practice of the News Map Compilation Service

Science.gov (United States)

Zhao, T.; Liu, W.; Ma, W.

2018-04-01

Based on the needs of the news media on the map, this paper researches on the news map compilation service, conducts demand research on the service of compiling news maps, designs and compiles the public authority base map suitable for media publication, and constructs the news base map material library. It studies the compilation of domestic and international news maps with timeliness and strong pertinence and cross-regional characteristics, constructs the hot news thematic gallery and news map customization services, conducts research on types of news maps, establish closer liaison and cooperation methods with news media, and guides news media to use correct maps. Through the practice of the news map compilation service, this paper lists two cases of news map preparation services used by different media, compares and analyses cases, summarizes the research situation of news map compilation service, and at the same time puts forward outstanding problems and development suggestions in the service of news map compilation service.